Poor oversight by New York City’s Health Department allowed an outside vendor to dramatically overstaff vaccination and testing sites during the COVID crisis, leading to a multi-million dollar cash grab, a new audit by the City Comptroller reveals.
The investigation revealed that the company, Executive Medical Services PC, was allowed to set its own staffing levels for its sites and then billed DOH based on a formula that included staffing levels, removing key oversight and cost controls.
That meant that the all-in costs for each test administered by EMS fluctuated wildly from an average of $202 to $937 per site, based entirely upon how busy the staff was.
There was an even bigger spread in costs for vaccination, where the average cost per shot ranged from $169 to $2,423 depending on the site and how busy it was.
“While the audit recognizes that DOHMH was responding to an unprecedented pandemic situation, effective cost-management was not incompatible with DOHMH’s overarching mission, and indeed, is an essential part of emergency preparedness,” wrote the comptroller, Brad Lander, in a letter.
The Health Department inked the contract with EMS during some of the darkest days of the COVID outbreak in May 2020, ultimately paying the company $390 million for the three years of services the company had provided as of March 2023.
The Comptroller said its review analyzed roughly $200 million worth of billings by the company.
The deal paid EMS a flat rate based on each person assigned to work a testing or vaccination site, plus an additional amount for each test or shot administered.
Every worker cost $150 per hour, while the city paid $100 for each test administered and $25 for each shot dispensed.
Even though the contract’s compensation was heavily weighted towards staffing, the audit found that “DOHMH did not establish or communicate optimal staffing level benchmarks or standard service levels for administering tests or vaccinations, or design any formal mechanisms for assessing EMS PC’s staffing levels on an ongoing basis.”
That meant “DOHMH was unable to effectively determine the number of tests and vaccines administered per hour by each EMS PC staff member assigned,” auditors added.
A spokesman for the Health Department retorted that several of the sites were placed in poorer neighborhoods hard hit by the coronavirus to ensure easy access to the vaccine, but that they were battling slower community uptake which meant more hours of labor were required.
“The COVID-19 response was the largest and most successful vaccination campaign in the city’s history, and it resulted in 99 percent of adult New Yorkers receiving at least one dose,” said Health Department spokesman Patrick Gallahue.
“The coordination between agencies, staff and administrations reflected an unprecedented whole-of-government approach that employed resources across jurisdictions to get services and supports to people who needed them most.”
He added: “The bottom line is that lives were saved.”
