A Mobile Vaccine Unit approved by County Commissioners

By Paul Hall on Thursday, September 16th, 2021 in Northeastern Oregon News Northeastern Oregon Top Stories

UNION COUNTY – (Information provided by Union County Commissioners and CHD) Union County has received funding from the State of Oregon through the Department of Administrative Services to be used for culturally-responsive, low-barrier vaccination opportunities, with a focus on populations experiencing racial or ethnic vaccine inequities. These funds will be passed on to the Center for Human Development (CHD) as it is completing the work of vaccination on behalf of the County.

I consulted with the Department of Administrative Services and reviewed the relevant Treasury guidance and this is an allowable expense if the purchase is necessary because without it we would be unable to meet the need arising from the public health emergency in a cost effective manner by leasing such items. Leasing this item is not an option; the Union County Commissioners approved the purchase to begin the request.

Mobile Vaccine Unit Purchase and Retrofit Background and Proposal

Union County has received funding from the State of Oregon through the Department of Administrative Services to be used for culturally-responsive, low-barrier vaccination opportunities, with a focus on populations experiencing racial or ethnic vaccine inequities. These funds will be passed on to the Center for Human Development (CHD) as it is completing the work of vaccination on behalf of the County. Funds can be used for the following activities:

• Providing culturally responsive, low-barrier access to COVID-19 vaccination, with a special emphasis on populations experiencing vaccine inequality or reduced vaccination rates;

• Marketing and promotional costs encouraging COVID-19 vaccination; and • Transporting persons to and from COVID-19 vaccination sites.

In considering options for providing low-barrier vaccination opportunities, one option being considered is the acquisition of a cargo van that is retrofitted to provide mobile vaccination throughout Union County in outlying communities where geographic or transportation barriers may limit access. Union County covers a large geographic area, and some of our smaller communities do not have health care providers.

Transportation barriers are most significant for those living in the more rural areas of our county. The bulk of our health care providers and services are located in La Grande, and while there is transportation available through our local transit provider this takes some effort and does not always provide the greatest ease of access for people that live outside of La Grande.

The vaccines we currently have for COVID-19 have very specific storage requirements, which make it difficult to provide vaccine outside of a health care facility. This is particularly challenging on 90 to 100-degree summer days when it would be best to provide vaccine in an outdoor setting or where access to an appropriate facility would not be available.

Adding a mobile unit to our resources would allow us to have increased flexibility for offering vaccine and helping close vaccine equity gaps among specific racial/ethnic groups by supporting ease of access and being able to meet and serve people in the community.

Recently we had an experience that demonstrates how this mobile vaccine unit would improve our ability to provide low-barrier vaccine and address vaccine inequities. Last month we were contacted by Northeast Oregon Network (NEON) who has been working specifically on conducting outreach and education among our agricultural workers. Through this work they identified a group of that was interested in getting vaccine but due to their work hours and limited transportation they had a difficult time making it to our vaccine clinics. NEON asked if we could help with transportation or go to them in the evening after they were done working and we gladly agreed to go to them to provide the vaccine. The location was in an outlying community, the turnaround time needed to be quick because the workers would be leaving the area soon, and we were experiencing extreme heat and there was no indoor location where the vaccines could be provided. Our team made it work and were able to provide vaccine to these workers, but this is not the ideal situation for regular ongoing service provision. The mobile unit would be ready to go, have everything we need set up so we could leave at a moment’s notice and not risk forgetting anything, and alleviate concerns about vaccine temperature or transport.

CHD reached out to the Department of Administrative Services to confirm that this is an allowable use of these funds. In response we were encouraged to review the Treasury guidance available online (CRF-Guidance-Federal-Register_2021-00827.pdf (treasury.gov)). This guidance indicates that the funds may be used for equipment if the acquisition is necessary and that a government must (i) determine that it is not able to meet the need arising from the public health emergency in a cost-effective manner by leasing property or equipment or by improving property already owned and (ii) maintain documentation to support this determination. CHD has attempted to local a mobile vaccine unit that we could lease but given the specialized nature of this item were not able to locate any so we do not see leasing this item as a viable option. We also do not have current property that could be improved to meet this need. As a result, approval of this purchase by the Board of Commissioners is being requested. CHD has been in communication with OHA who has purchased a cargo van and retrofitted it to conduct mobile vaccination events. They shared with us that they purchased a 2021 Dodge High-Roof Cargo Van as the base for their mobile units. A search for this vehicle shows options through our local dealer ranging in price from $43,905 to $45,570. They then worked with RC Display Vans to outfit the van with the flooring, shelving, generator, etc. The schematics of the shelving they used, which was pre-fabricated by a third party and then installed, are attached for reference and cost about $57K. They also shared another contact that OHSU used for retrofitting, Van Haus Conversations in Vancouver.