County commission ends mask/sign order, adds $500k to budget for extended primary care hours at health department

BY JENNIFER CABRERA

At their September 28 Regular Meeting, the Alachua County Commission discussed whether to extend their COVID-19 emergency action and continue their COVID-19 employee policies; the emergency order that mandated masks and signs reached its 42nd day on September 30 and could not be renewed. 

Chair Ken Cornell led off the discussion by saying he wanted unvaccinated employees to continue to be tested every week: “I think we’re catching positive cases and we’re preventing the spread.” He said he was “kind of ready to stop” providing gift cards as an incentive to get vaccinated. He added, “I said last week that my number to discontinue the emergency action was 5%. We’re at 6.5%. I think we’re very close. In talking to the hospitals, they would be okay with us discontinuing that, so I’m okay with discontinuing that.” The emergency action was first signed on August 5, 2021, and mainly “allows streamlined operations during the pendency of a local declared state of emergency, which allows the County Administration and the Board of County Commissioners flexibility in the utilization of Federal, State and local Funds,” so it’s not clear why the hospitals were consulted on whether to continue the emergency action. The mask and sign mandates were part of the emergency order, not the emergency action.

Cornell also said he thought the policy on masking in County buildings should be referred to the County Manager to bring a recommendation back next week. 

Commissioner Mary Alford said she would like to extend the gift card incentives another month, and Cornell said he didn’t have a problem with that. She asked for clarification on the difference between the emergency action and the emergency order, and Cornell said, “So if you remember, two weeks before we put the order in place, one of the things we wanted to do was raise awareness that the Delta variant had hit our community, and we wanted to raise awareness to try to encourage folks to get a vaccine. We believe that’s our way out… That local emergency action doesn’t have any statutory limit… If there is someone that wants to get a vaccine, they are well aware that they can… I think that awareness campaign is kind of over… and based on the drop in cases, I’m comfortable letting the community know that we’re kind of out of this emergency, still recommending that folks get vaccinated, still recommending that if they can’t socially distance and if they’re inside, they put on a mask, but that we’re out of the emergency.”

Alford asked whether they could “maintain signage encouraging masking,” and Cornell said they can’t require that; they can only recommend it. Alford said, “Right, right, and that’s what I would like to do. I think that helps people feel comfortable wearing a mask inside. I go to other counties, and you feel much less comfortable wearing a mask inside. Sometimes even vilified for doing so. And I would like to maintain an environment where people feel comfortable protecting themselves, and I think signage and those kinds of things help provide that. You know, we can’t require masks, but we can require signs, as I understand it.” 

Cornell said they can’t. Alford responded, “We can’t? Not even—we can’t require signs saying we encourage? Okay. Well, darn it.”

County Attorney Sylvia Torres added that the 42-day limitation was on any restriction on the liberties of businesses or individuals, “and requiring basically store frontage is a restriction on the liberties of businesses.”

Alford said, “I feel like there ought to be a way around, but I can’t think of what it is.” Cornell said, “Yeah, it’s ‘talk to the legislature.’”

Commissioner Marihelen Wheeler made a motion to discontinue the local emergency action but continue with the gift card incentives for another month and recommend that businesses encourage mask use inside the business. She added direction to ask the County Manager to bring back recommendations for masking inside County buildings, continuing to test unvaccinated employees, and providing signs that businesses can post. 

Communications Director Mark Sexton said, “The kind of on-the-ground reality… we’ve seen signs that we did over a year ago still in windows. You know, some businesses have chosen to use those signs, to continue using them, regardless of whether or not the emergency order is still in effect. So I don’t know that we’re required to go around and take those down.”

Cornell said, “No, the businesses can,” but he said that the County could make signs available on their web site that say the County recommends wearing masks indoors. Sexton replied, “So we will change the wording, Mr. Chair, to go to voluntary, and do a push to make sure people know they can download those signs.”

Sexton added that if people want a gift card when getting vaccinated, they should check in before getting the shot and make sure they’re at a provider that is participating in the gift card program. For example, Publix does not provide gift cards, and not all CVS locations have them.  A list of locations with gift cards is here. 

During public comment on the motion, a caller asked whether the County plans to test vaccinated employees, given that vaccinated people can transmit the virus to others. Cornell said that was a “very good question” and that they would get to it after public comment, but after public comment ended, Cornell immediately called for a vote on the motion, which was unanimous. 

After the vote, County Manager Michele Lieberman asked if Cornell wanted her to answer the question. She said that vaccinated employees can voluntarily be tested while they’re testing the unvaccinated employees and that logistically it’s difficult to test 1100 employees a week. She added, “I think the likelihood of the issues are less with vaccinated employees.” Cornell said, “We know the data, most folks that are hospitalized are unvaccinated.” He asked whether Torres had any legal concerns with the policy, and she said they’re “comfortable with the policy as you have it today.”

Expanded health department hours

Paul Myers, Alachua County Administrator for the Florida Department of Health, told commissioners that three zip codes on the east side of the county have the highest per capita deaths per 100,000 population and that, of the top ten causes of death, eight of them can be addressed with primary care. He said that about 10 years ago, the Alachua County Health Department had expanded its primary care hours to seven days a week, but they stopped doing that because of lack of funding. “But now I think it’s time to have that conversation again.” He said that the primary care hours are currently 7:30 a.m. to 5:00 p.m., and he proposed staying open until 7:00 p.m. on weekdays and opening five hours on Saturday and five hours on Sunday, maybe 9:00 a.m. to 2:00 p.m. He said that would allow an extra 80 appointments a week and would cost about $500,000 per year. 

Alford said, “I recognize the need. I know many people in east Gainesville who would make use of those weekend hours, and I would be happy to make a motion to move forward with this.”

Lieberman said she thought they could use American Rescue Plan money as the funding source for the expansion, but Commissioner Anna Prizzia pointed out that it would be an ongoing cost “and I don’t want us to get to a point where in two years, people get used to having these hours, and then suddenly we can’t do them any more.”

Commissioner Chuck Chestnut said it was “outrageous to me” that the highest death rate is in those three zip codes: “That’s very, very disturbing to me.” He said he would prefer to see the proposed new UF facility stay open until 10 p.m. or 11 p.m. “because I think that’s where the need is. Because most things close at 5:00, and then 10 or 11 is when people have an emergency.”

Alford said that she thought that adding more preventative services would pay for itself “within the amount of time that we would see the results by having that extra emphasis on these very, very needed services. If I’m a working mom, I can’t get in there between 7:30 and 5 to get my birth control pills, you know? So just two or three of those cases, it can almost pay for itself right there.” She said she wanted to stick with her original motion “with maybe the added emphasis on tracking money saved because I think within that time, we’ll be able to easily justify those extra dollars in terms of what we can achieve.” She later added that she meant they could start with American Rescue Plan dollars “with the idea that we save that amount of money within the next couple of years. Do you see what I’m saying? I think there will be a return on investment that will show that we are saving that amount of money.”

Prizzia said that after the motion was voted on, she wanted them to “begin to explore… to bring back a conversation about, you know, health equity in these zip codes and how we achieve health equity in working with those other nonprofit organizations that have been working on these issues for many, many years and explore the idea of how we engage those partners in a multidisciplinary approach to addressing health through prevention and outreach, as well as through primary care.” She asked whether there was a health equity advisory board, and Myers said that could be rolled into the existing Health Care Advisory Board. They ended up adding that to the existing motion.

Cornell asked Lieberman, “We’re about to add $500,000 to the budget, how are we going to pay for it?” Lieberman said, “We’re not actually adding it to the budget because we’re adopting a budget tonight that’s already set. So we will deal with how we’re going to fund it after the budget is set… We’ll bring it back to you.”

The motion passed unanimously.