Providence Health & Services gave early access to coveted COVID-19 vaccines to some members of its Oregon governing and foundation boards in December and January.
Lisa Vance, CEO of Providence Oregon, said the practice amounted to “preferential treatment” for insiders, some of whom are also donors.
The Oregon Health Authority said Providence’s actions didn’t meet the state’s guidelines for initial vaccine distribution.
“Vaccinating hospital administrators, managers, executives, board members and other staff who don’t have the greatest potential for direct or indirect exposure to patients or infectious materials is not in alignment with Phase 1a guidance,” said Jonathan Modie, spokesman for the Oregon Health Authority.
Providence’s questionable vaccine allocations were small in number and took place largely at facilities outside Portland. Some cases involved doses that were nearing expiration and needed to be injected that day, according to Providence. Still, they have prompted the organization to launch a review of its policies and procedures.
Providence operates eight hospitals in Oregon, making it the largest health system in the state. It was founded by Catholic nuns and Providence often refers to its individual hospitals and other businesses as “ministries.”
“While our ministries were acting in good faith and with the best intentions, we believe we need to ensure our decisions are fully aligned with our values, especially our value of justice,” said Vance. “We hold ourselves accountable to ensuring equity for all we serve. We are taking actions to do that going forward, including working with our partners in all of our community clinics.”
Providence’s senior executives in Oregon and all 17 members of the nonprofit’s governing body – the Oregon Community Ministry board – were vaccinated weeks ago. Providence insists that those vaccines for executives and its governing members were consistent with state rules because they qualify as administrative or volunteer personnel under Oregon’s broad definition of healthcare workers.
The rollout of the much-anticipated vaccines has been difficult in Oregon and most of the rest of the country. The ongoing vaccine shortage has fueled an intense debate about how to prioritize access to the life-saving shots.
State regulators have put together a detailed vaccine sequencing plan with health care workers at real risk of contracting the virus at the front of the line classified as 1a.
Oregon put health care workers at the front of the line under the state’s vaccine sequencing plan.
Providence in December offered the vaccine to all 27,000 of its Oregon employees and medical staff members. Just 70% accepted the offer. The others declined the vaccine outright or said they preferred to wait until more was known about its safety, Providence spokesman Gary Walker said.
Among those who accepted the vaccine were Vance, Chief Operating Officer William Olson and most of the rest of Providence Oregon’s senior executives.
All 17 members of the governing board also got the vaccine in December or early January.
Providence argues that it did nothing wrong in offering early vaccinations to its executives and to members of the board. It points to the state’s broad definition of qualifying health care worker, which includes “administrative” and “volunteers” personnel in addition to the nurses and doctors actually working the COVID wards.
Providence is interpreting “administrative” to include all of its executives, regardless of how much time, if any, they spend actually caring for patients.
The Oregon Health Authority said Providence’s interpretation is incorrect.
“With both the Pfizer and Moderna vaccines remaining in short supply, they must make sure these scarce resources are only administered to individuals who are eligible to receive them—and that means only staff who have the greatest potential for direct or indirect exposure to patients or infectious materials,” said Modie, the health authority spokesman.
However, Modie said the state does not anticipate sanctioning Providence. He said the health authority expects providers to take responsibility and allocate vaccines appropriately.
“We’re asking people who work or volunteer in health care, or serve on health care boards, to do the right thing: If your work doesn’t put you at risk of direct or indirect exposure to patients or infectious materials, you probably aren’t part of Phase 1a, you aren’t eligible, and you should wait your turn to get vaccinated,” Modie said.
Similar episodes to Providence’s have sparked controversy around the country. The Seattle Times has reported that three medical systems in that region, including Providence’s medical center in Everett, gave special vaccine access to big donors or foundation members.
Earlier this week, Washington warned that it may cut vaccine allocations to organizations that provide VIP access.
In Southern Oregon, Providence Medford Medical Center is distributing the vaccine. Members of the local Providence foundation board were quietly offered the opportunity to be put on a vaccine waiting list. They would be called in to receive the vaccine should the hospital finish the day with an excess of doses.
Both the Pfizer and the Moderna vaccines must be kept at extremely cold temperatures and can’t be refrozen after being thawed.
The hospital thaws a certain number of doses each day based on the number of appointments they have. If the patient doesn’t show up, it needs to find a replacement right away or discard the dose when it expires at the end of the day.
Providence officials said they’re not sure how many insiders in Medford accepted the offer and got the shot.
Out on the coast, Providence Seaside Hospital offered vaccines to both its community board and foundation board. Six of those board members accepted the offer and got early shots.
Providence’s Vance did not know about the arrangements in Medford or Seaside and would have objected if she did, according to Providence spokesman Gary Walker.
Providence has 10 foundations in Oregon, including the organizations in Medford and Seaside. Between them, they raised nearly $54 million in 2019.
Almost by definition, board members of foundations are also major donors.
“Certainly there is a longstanding tradition of asking board members to donate a lot of money,” said Jeri Alcock, partner and senior consultant at Rose City Philanthropy in Portland.
All philanthropic boards should also have conflict-of-interest rules on its books, Alcock added.
“The whole point of being on the board is that you’re a disinterested third party,” the consultant said. “You don’t profit from being part of it.”
Providence officials initially maintained that it had complied with all of Oregon’s rules for vaccine administration.
“Providence Oregon did not give any preferential treatment to donors in the COVID vaccination process,” the health system said in email Feb. 1 . “We act in good faith, aligning our actions with the guidance of the Oregon Health Authority.”
Two days later, Providence backed off that stance and admitted that indeed some insiders did get preferential access.
Statewide, 369,693 people have received at least one dose of the vaccine, about 8.6% of Oregon’s population.