Top Orange County officials are publicly pushing back on major parts of Sacramento’s response to the coronavirus pandemic.
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Their criticism and questions came earlier this week at Tuesday’s Board of Supervisors’ meeting. County supervisors and public health executives echoed the state’s caution that relaxing stay-at-home orders too quickly, before testing is more widely available, risks causing a spike in infections that could overwhelm hospitals.
They took issue with other elements of the state’s approach: creating overflow hospital capacity, shelter homeless people in motels, and questioned who will pay for the county’s state-mandated costs.
Michelle Steel, who chairs the Orange County Board of Supervisors, questioned why the state was pursuing an overflow hospital at the Fairview Developmental Center when hospitalizations have been flattening in recent days.
“I don’t understand…why we have to waste money on that site,” Steel said.
“I saw in other states that they prepared all these hospitals and beds, and you know what? Actually they had to close down because they’re not using it. So it’s interesting to see that, you know, we are going [in the] wrong directions there, wasting money.”
County CEO Frank Kim responded that it’s to prepare for a potential worst-case scenario.
“Generally what’s happening is that the state is setting their planning effort for the worst case scenario, in case the social distancing efforts become less effective and we see this tremendous spike that we hope never comes,” Kim said.
Gov. Gavin Newsom’s office didn’t respond to a request for comment.
OC officials also have been at odds with the state’s request for the county to lease 2,300 motel beds to shelter healthy homeless people to prevent the spread of COVID-19.
Three weeks ago, the state asked Orange County to lease the beds to allow homeless people to socially distance from one another instead of being clustered at shelters and encampments. About 4,000 homeless people were unsheltered in Orange County as of the latest county last year.
As of Tuesday, the county was making rooms to available to nine homeless people out of the roughly 500 rooms they’ve leased, because the county was limiting rooms to people who had tested positive for COVID-19 or had symptoms.
“I may personally feel, as perhaps not a homeless expert, that we have enough motel beds. But the state keeps pressing us and saying ‘you should get more and more,’ ” county CEO Frank Kim said at a county supervisors’ meeting Tuesday.
“As a political subdivision of the state, we do take our direction from the state, in terms of master planning efforts and the type of facilities that we should have,” he added.
If homeless people with symptoms end up testing negative for coronavirus, they are moved out of isolation motels and into other unspecified programs, county officials said.
As of Tuesday, nine people were sheltered in the one motel the county had up and running at that point, said Jason Austin, who leads the county’s homelessness efforts as director of care coordination.
“This program is very temporary. Once they test negative and they have recovered, then we work to transition them out to another program or service,” Austin said at Tuesday’s meeting.
That seemed to be at odds with what state officials have wanted, which is for the motel rooms to be available for healthy homeless people in order to prevent COVID’s spread.
“Their preference would be for us to house otherwise healthy homeless in the motel program as well,” Kim said at a news briefing Monday.
County officials said this week that at the state’s request, they planned make 342 motel rooms available by the end of next week to homeless people over age 65 and those who are medical vulnerable to COVID.
Under the state’s motel shelter program – called “Project Roomkey” – the Federal Emergency Management Agency is covering 75 percent of the costs, with the County of Orange also on track to receive over $500 million from the federal stimulus law to cover its coronavirus response costs.
County Supervisor Don Wagner criticized the state for reportedly backing out of its original plans to lease motels directly, and praised county staff for reducing the county’s financial exposure.
“You’ve taken some very deliberate and appropriate actions to reduce the exposure of the county,” Wagner told Kim.
As for the funding for motel rooms, Kim said it’s still unclear what the federal stimulus money can be used for.
The stimulus law itself, known as the CARES Act, says the money can be used for “necessary expenditures incurred due to the public health emergency with respect to the Coronavirus Disease 2019 (COVID-19)” between March 1 and the end of the year.
“Very clearly the message that we’re receiving is, these are [for] costs that you didn’t anticipate, these are the direct costs related to your local government’s direct response to addressing COVID,” Kim said at Tuesday’s meeting.
“What is a direct COVID-related response? It is not defined at this time.”
For decades, Orange County supervisors have had a strained relationship with Sacramento, with OC getting among lowest return on property tax dollars in state. The lower funding level continues to rankle OC supervisors and executives.
Some supervisors agreed that any lifting of stay at home orders should be done cautiously to prevent another surge in COVID cases.
“The worst thing we can do is basically lift restrictions and next thing we know, we have huge surge in cases and our health care system gets overwhelmed,” said Supervisor Lisa Bartlett.
“I know we really want to ramp up the testing,” she added. “Also I think the antibody tests are really critical as well, because that will tell us those who have been infected in the past” and who has immunity.
Supervisor Doug Chaffee also highlighted the role of wider-spread testing in eventually easing social distancing measures. Less than 1 percent of Orange Count residents had been tested for COVID-19 as of Tuesday, as officials tell people with mild symptoms to stay home and not get tested due to the testing shortage.
“I agree with the importance of testing. That may be key when we eventually get out of the pandemic,” Chaffee said.
Wagner questioned why state health officials were still expecting a surge in May when hospitalization rates have been flattening.
“You’re now saying…what we’re doing is working and we can expect a surge. Why a surge if what we’re doing is working? Is that just a matter of the lag time, or is it something else?” Wagner asked.
“The goal of our stay at home orders and social distancing, as we’ve talked about before, is to flatten the curve. So it’s to spread the cases out over time, and ideally to reduce the height of the surge,” responded David Souleles, the county’s director of public health services.
“So we still expect to see additional hospitalizations beyond our current hospitalization levels, but what we’re hoping is that that surge does not exceed beyond what our hospital capacities will have available to them.”
Looking forward, Wagner wondered if the county should be preparing for a potential second surge in the fall.
“I had a conference call with some folks at UCI Medical Center, and they warn us that the flattening of the curve that we have successfully accomplished to date sows the seeds of a rebirth of coronavirus in the fall. We don’t have the herd immunities we might otherwise have…And as the weather chills again, this comes back,” Wagner said.
“What’s your response? Is that a fair concern? And what are we doing to prepare for that?” he asked.
“As we lift restrictions and allow people to get back to work, allow kids to get back to school, allow some of the parts of our lives to get back to some version of the way they were – the risk that everyone is concerned about is exactly what you’re saying, is the potential for a surge [of coronavirus cases] to occur,” Souleles replied, adding that it remains to be seen if coronavirus is seasonal or not.
“Which is why I think our planning really needs to focus on the things we need to have in place to assure we can manage that as best as possible,” he added, pointing to the importance of increasing access to testing statewide and other measures.
Supervisor Andrew Do took note that Orange County is behind other large counties in testing per capita, following a Voice of OC report last week that similar-sized San Diego County has done about 80 percent more COVID tests than Orange County.
“When we look at other jurisdictions, like say LA [County]. Yesterday they reported doing 6,000 tests in one day. We have done, what? A total of 12,870 in the last month and a half. I don’t understand,” Supervisor Andrew Do said at Tuesday’s meeting.
County staff said they plan to provide a report to supervisors next week on what they would need to expand testing in Orange County.
Nick Gerda covers county government for Voice of OC. You can contact him at ngerda@voiceofoc.org.