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COVID Vaccinations Lag For People On Medi-Cal

 August 4, 2021 at 12:13 PM PDT

Speaker 1: 00:00 All the way through the COVID pandemic. We've seen people in poor communities suffer the worst of the disease. People who couldn't work from home, who lived in crowded environments and who had to risk getting sick to bring in a paycheck, had higher rates of disease and death. And the general population. Now that economic divide is showing up in vaccination rates across California numbers revealed by the state show vaccination rates among low-income people on Medi-Cal are significantly lower than the general population, and they are urging healthcare providers to make sure Medi-Cal patients have more access to vaccines. Joining me is Cal matters health reporter on Ybarra and on a welcome to the program. Thanks for having me Marine, how big is the discrepancy between Medi-Cal patients vaccination rates and the general public? Yes. Speaker 2: 00:54 So at the state level about 70% of eligible Californians had received at least one dose as of July 18th. But when you look at the Medi-Cal population that rate fell to about 45%, um, this of course looks a little different in each county, although all 58 counties have gaps, um, in San Diego, while 86% of the overall eligible population have received at least one dose only 48% of the county's Medi-Cal enrollees had done. So, um, right next door and Imperial it's 81% and 50% so significant gaps. And, you know, just, of course, when we talk about eligible population, we're looking at everyone fall than older. And Speaker 1: 01:37 What do officials say is causing such low rates among Medi-Cal recipients? Speaker 2: 01:42 Yeah, so, you know, I've heard a variety of reasons, uh, but almost everyone I spoke to, uh, from providers, um, to, uh, you know, the, the state and other experts, they talked about practical challenges, um, for low-income people, you know, many have limited time they're juggling multiple jobs. If they don't have a car or rely on public transportation, um, or live in more rural areas, it's probably going to be harder for you to get to an appointment. Um, also people may be concerned about, you know, having to take time off work. I think that's still a very real problem. Um, and taking time off work, not just for the appointment, but if, you know, feeling any symptoms after they're shot. Um, and I think that's a, maybe a, a special concern, um, for heads of households, you know, and if your family relies on your income Speaker 1: 02:33 And take us through some of the obstacles that may face a low-income worker in accessing, or even deciding to get Speaker 3: 02:40 A vaccine. Yeah. Speaker 2: 02:42 So, you know, I think again, the taking time off work, um, we, I talked to some folks out in Humboldt county who made a really good point. You know, they talked about their farm workers and people who work in tourism, you know, they are at the peak of their season now. So, you know, they're less likely to want to take time off work or ask, um, for, for, uh, time off, uh, because you know, not going to work means, uh, you know, no, uh, means less income. So, you know, and those of us who've signed a vaccine, know that you can knock you out for a couple of days. And so that's obviously that just translates to less money for some families. And how Speaker 1: 03:24 Does the Delta variant increase the urgency to find a solution to this problem? Yes. So, Speaker 2: 03:31 You know, we're learning that the Delta variant is smart, contagious, and you know, we're already seeing cases and hospitalizations go up. Um, we seen how in past surges or how some past surges, you know, rip through some of these low income communities like you mentioned. So I think the concern is if this group is falling behind on vaccinations, they will continue to be vulnerable and at high risk. And we might see some of the same consequences that we saw, you know, in the winter and last summer, the disparity Speaker 1: 04:00 In vaccination rates between the general public and Medicaid recipients is showing up all over the country. Speaker 3: 04:06 Isn't it? Yeah. Speaker 2: 04:08 So this isn't, you know, special or unique to California. So while I was working on this story, I read that Ohio's governor had noticed a similar disparity in his state last month. And what he did was challenge health plans to focus on the Medicaid population. And they, you know, uh, to enroll an additional 900,000 people by mid-September. And so one way that health plans there are you're encouraging people to get vaccinated is by offering $100 gift cards to, to those on Medicaid. And, uh, once they get their first shot. Speaker 1: 04:43 Okay. So that's something that other states are doing, what are we doing about it here? What are some things employers and healthcare providers can do to reach more Medi-Cal patients? Yeah. Speaker 2: 04:55 So the one thing that I, I, you know, I keep hearing is we have to make vaccines as easy as possible to get, you have to sort of take vaccines where, uh, some of these folks live and work, right? So, you know, one thing that we hear about and some national polls have shown this too, is that what employers encourage vaccination or provide time off people are more likely to get their shot. So when vaccines first started rolling out to farm workers, for example, many growers or growers, employers were actually partnering up with counties and bringing vaccines to the workplace. Um, I actually went to one in Santa Clara county, uh, back in March. And, you know, in speaking to folks there, the number one thing workers mentioned was, uh, convenience. If they could get a shot during their lunch break or after their shift and not have to go anywhere, that was really what convinced some people Speaker 1: 05:47 Also one doctor says phone calls to Medi-Cal recipients might be very effective. Why Speaker 3: 05:52 Is that? Yeah, so, Speaker 2: 05:55 You know, one thing that is interesting focusing on Medi-Cal enrollees is that we know, or the state knows who these people are, right? So you can have health plans and providers reach out or do more targeted outreach to them. So, you know, phone calls, they say just direct calling. Um, uh, some of these enrollees is, um, of help because it gives the opportunity for people to ask questions. And so the way they're doing this is really doing these sort of check-in calls. So, you know, not necessarily trying to alarm people, but just asking how they're doing and whether they have any questions about the vaccine. And so when people, you know, are, are able to ask questions without necessarily feeling pressured, um, you know, that can help alleviate or answer some, some confusion and, and concerns for them. I've Speaker 1: 06:45 Been speaking with Cal matters, health reporter, Ana Ybarra on a thank you so much. Thank you so much, Maureen. [inaudible].

In all California counties, Medi-Cal enrollees have been vaccinated at substantially lower rates than the overall population. Experts point to several factors for this economic divide, like the inability of low-income people to take time off work.
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