San Diego County is cutting the requirement for reservations at a state-funded COVID-19 testing site in Southeast San Diego after a high percentage of people were missing their appointments.
The state sites have helped San Diego County expand its testing needs, especially in vulnerable and low-income communities, but a high no-show rate can put those resources at risk. A local physician and advocate said the low turnout is linked to hardships caused by a history of inequity.
County data shows 20 to 30% of people didn’t follow through on their appointments to receive a COVID-19 test at the Tubman-Chavez Community Center in Southeast San Diego.
San Diego County Health and Human Services Agency Director Nick Macchione said the state looks for 80% utilization. The Tubman-Chavez site, however, has been below that threshold most days this month, dipping at one point to as low as 67%.
"If you drop below 80% — and it's fair to state, it's a state asset; they're looking at this every day, every week — and if that continues, we jeopardize losing that testing site. We don't want that," Macchione told KPBS earlier this month.
In an email to KPBS on Monday, the California Department of Health said it doesn't rely on no-show rates to determine how testing resources are distributed but it "does monitor usage of each site with a target usage rate of greater than 80-85%." It pointed to a document that showed the state's testing task force may recommend reallocating resources based on three criteria that include a "consistent utilization below 50% for at least two consecutive weeks."
The health department's email also said the average no-show rate varies between 5 and 15% but the state recently permitted overbooking an additional 12 tests per day at testing sites to account for people who may not show up to their appointment. County data show there was not a drastic improvement in no-show rates at the Tubman Chavez Community Center even with the overbooking.
Other state sites in the cities of Chula Vista, El Cajon, Escondido and San Diego's San Ysidro neighborhood had daily utilization rates that ranged from 80 to 98%, according to data provided by the county.
Local physician Dr. Rodney Hood said food and transportation insecurity in the low-income Southeast San Diego neighborhood can be barriers to keeping appointments — a challenge he had to overcome when he started his practice there decades ago.
"It wasn’t that they didn’t want to keep the appointment, it was that they had other issues that other folks who are more economically well-off didn’t have to deal with," said Hood, head of the Multicultural Health Foundation.
Hood said he focused on building trust with his patients, including participating in community events and conducting regular appointment reminders, and the no-show rate significantly dropped. He also pointed to a grant-funded program by the foundation he leads that showed addressing social needs can improve health outcomes.
"If you build the infrastructure and support them with transportation, deal with their social needs, their appointment rate increases," Hood said.
He and colleagues recently established the COVID Equity Task Force that is working with the county to better engage with underserved communities.
A county spokesman said the Tubman Chavez Community Center will transition from a state site to a county walk-in location beginning June 29.
