Oregon Sen. Ron Wyden visited Multnomah County’s free drive-through COVID-19 testing site in Gresham on Monday — asking local health administrators how best to expand low-barrier testing and what health departments need most to rein in a virus that disproportionately impacts low-income and essential workers, and Black, Indigenous and People of Color communities.
The visit comes as Wyden helps craft the next phase of federal COVID-19 relief.
“If you were writing this bill, what would be your priorities?” he asked Public Health Direct Rachael Banks, Integrated Clinical Services Interim Director Tasha Wheatt-Delancy, and Communicable Disease Services Director Kim Toevs.
They said health departments need more direct funding to county governments through the Centers for Disease Control and Prevention and more flexible funding that would allow them to expand partnerships with community organizations to provide culturally and linguistically appropriate services. They also raised concerns about an increasing lag in test results and demands from employers requiring employees provide proof of negative COVID-19 testing before beginning work.
Wyden is pushing to extend unemployment benefits and also expand low-barrier testing and services for communities most impacted by COVID-19. In Multnomah County, as is the case nationally, that means supporting communities of color, who have experienced an inequitable burden of disease.
Wyden has called on Congress to address racist policies in healthcare and ensure COVID-19 testing and care is covered for those most vulnerable to the virus. Last month he asked the Senate Committee on Finance to hold hearings on systemic racism in healthcare and identify policies to improve health outcomes for Black, Indigenous and People of Color communities.
And in a July 7 joint letter from House and Senate Democratic committee leaders to the secretaries of Health and Human Services, Labor and Treasury, Wyden and his colleagues raised concerns about federal guidance that allows insurance plans and group health plans to deny claims for COVID-19 tests and other related services, in apparent violation of Congress’ legislative intent in passing the Families First Coronavirus Response Act (the Families First Act) and the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act).
“With COVID-19 cases skyrocketing and our testing capacity nowhere near where it needs to be, it is unacceptable that this Administration’s priority seems to be giving insurance companies loopholes instead of getting people the free testing they need,” they wrote. “We believe this guidance is contrary to statute, and urge you to take immediate action to clarify the obligations of group health plans and insurers to provide robust and comprehensive coverage of COVID-19 testing.”
During the Monday briefing with Health Department leadership and Commissioners Lori Stegmann and Sharon Meieran, Wyden expressed frustration over the delay in residents accessing federal unemployment benefits and asked local officials to make sure residents know that those benefits are retroactive.
That’s important information, said Wheatt-Delancy, interim director of Integrated Clinical Services.
She also said flexible funding for community organizations, beyond funding for health departments that’s limited to testing or contract tracing, can also make a difference for those residents. Many families face an immediate need today for necessities like diapers and dish soap. They might trust community groups for that assistance more than local health officials.
“A lot of funds focus only on testing or contact tracing, and that boxes us in,” she told Wyden.
And with the disparities in cases among communities of color and immigrant and refugee commutes, those community partnerships are vital.
Public Health Director Banks said Wyden’s priority for communities of color in the next package of COVID-19 relief may help address longstanding disparities that have grown more stark during the pandemic. She asked the Senator to work on access to more direct funding for the local health departments that are leading contact tracing, outreach and education in their communities.
“How are we doing on outreach?” Wyden asked.
Communicable Disease Director Toevs said the County has sought to emphasize direct community education through social service providers, community health workers, businesses and government partners, as well as social media, culturally specific media and audio platforms in multiple languages to share the best information on the disease.
Even before the County reported its first case, Public Health staff held workshops for more than 100 community health workers who serve culturally specific communities to brief them on the virus. But Public Health is learning new information all the time about COVID-19, she explained, and it's a challenge to keep the expansive network of partners informed.
Toevs also said educating the business community is a pressing need that could benefit from increased federal support. Employers are requiring workers to provide negative COVID-19 test results before being hired or returning to a job.
That has put intense pressure on Multnomah County to provide testing for healthy residents who have no known exposure to the virus — contrary to federal recommendations around testing priorities — at a time when labs are so far beyond capacity that some results have been delayed as long as 11 days.
“Test results are useful so we can help you stay home and follow up with contacts,” Toevs said. “But if a result takes seven, eight or 11 days, that means we can’t take action on that case.”
Sick people, people with a known exposure, and residents of color who work in essential jobs and come from communities that are disproportionately impacted shouldn’t have to compete for priority with healthy residents, Toevs said.
Rather than provide testing for healthy employees, at a time when capacity remains limited, federal lawmakers might better support employers through support for paid sick leave policies and clarity on liability.
Wyden vowed to work on a relief package that could help the County, as the designated Local Public Health Authority, directly and swiftly respond to the shifting needs.
Before leaving he greeted the team of COVID-19 testers gathered beneath a pop-up tent.
“They were just filling me in on your wonderful work,” he shouted so they could hear him from behind their ventilator helmets. “I have a heavy load to get you the resources you need.”