PHOENIX — Reversing course, the state's top health official agreed Friday to let Pima County work with the federal government to set up its own vaccination sites that could inoculate about 210,000 residents.
But Dr. Cara Christ made it clear she's not pleased about it, saying the county is guilty of "unauthorized testing'' and running up "unapproved costs.'' And Dr. Christ she said she may rescind that authority if she believes the county can't live up to its end of the bargain.
County Administrator Chuck Huckelberry, however, said it is the health director who is off base, pointing out the county already is running three vaccination sites.
"The state POD at the U of A has probably put in 80,000 vaccines,'' he said, referring to the "point of dispensing'' site on the mall of the University of Arizona.
"The county PODs have put in about 380,000 vaccines,'' Mr. Huckelberry told Capitol Media Services. "So I think we probably know how to do it.''
He said that the county could have the two new sites set up within 10 days. Both are being planned for areas of the county where Hispanics make up more than 90% of the population.
That, he said, is based on data that show, to date, Hispanics make up about 18% of the people who have been inoculated, far short of their 38% share of the county population.
Dr. Christ said her earlier objections to a bid by the county to work directly with the Federal Emergency Management Agency revolved largely around whether any doses given directly to the county would cut into how much was available to her agency and the rest of the state. She also said there were concerns about the ability of the county to run the two sites without state resources.
"We know that they were very interested in having those sites down in Pima,'' Dr. Christ said.
"So if they can do that and it's not going to impact the state's resources or vaccine supply, we're happy to let them do that.''
That expression of joy, however, may be an overstatement: Dr. Christ made it clear she doesn't think the county's plan is unnecessary, even if it doesn't cut into the state's allocation.
"We have a ton of unfilled capacity,'' she said.
"We have a lot of existing sites that already have the infrastructure,'' Dr. Christ continued. And she said that the requirements to establish a new site are "significant.''
"It's things like pharmacy support, it's security, it's a vaccine registration system, there's a number of things to be provided outside of FEMA supplying it,'' the health director said. More to the point, Dr. Christ said her experience suggests that the county isn't up to it.
"Given the issues that we've had where there were unapproved testing activities that they are now requesting that the state pay them back for, which were not agreed upon,'' she said.
Dr. Christ did more than complain about the county at a Friday briefing with reporters.
Also Friday, Dr. Christ wrote to Tammy Littrell, the acting regional administrator of FEMA, giving the formal go-ahead for the agency to work directly with Pima County.
But Dr. Christ also took a few swats at the county.
"We are skeptical of their ability to provide the necessary resources and personnel and would need to confirm in writing their plan for providing resources for these activities without impacting the state resources currently in place at our existing Pima County site,'' the health director wrote. And there was a word of warning.
"If these requirements are not able to be met or these concerns continue to persist, we will not be able to continue to delegate authority to Pima County for this activity,'' she said.
Relations between Dr. Christ's agency and the county have been chilly for months. That starts with the fact that county has been doing its own COVID-19 testing for months.
But Dr. Christ refused to reimburse the county for $10.7 million Mr. Huckelberry said the county spent on testing. Instead, she provided $14.4 million — but only for expenses the county incurred after Jan. 15.
What occurred before that was the "unauthorized testing'' referred to by Dr. Christ.
Mr. Huckelberry sniffed at that description.
"Our public health agency requires no authorization to test for COVID-19 during the height of a pandemic,'' he said.
"It was not unauthorized,'' Mr. Huckelberry continued. "All we're trying to do is get reimbursed from a portion of the $416 million they received from the federal government for testing.''
He also brushed aside claims by Dr. Christ that somehow the state is going to get stuck with the bills.
"Obviously, we'll pay for it if necessary,'' Mr. Huckelberry said. "FEMA typically pays for its own.''
He also said the county is managing to operate its existing three sites at $10,000 a day, even as the county waits for $7.1 million he said the state owes for those operations.
"So, if it costs more money, it costs more money,'' Mr. Huckelberry said. "We'll pay for it.''
As to the specific plans, he said the discussions with FEMA to this point have been to provide 6,000 doses a day for six weeks of the Pfizer vaccine. At seven days a week, Mr. Huckelberry said, that comes to 42,000 doses a week.
But the Pfizer vaccine requires two doses, so cut the number of people inoculated in half.
"And then they were talking an additional two weeks,'' he said, this time with the single-dose Johnson & Johnson vaccine. All totaled, Huckelberry said, that bring it up to about 210,000 people who can get inoculated.