Arizona changes course, offers short-term lifeline for Pima COVID testing
Continued coronavirus testing projected to cost $40 million in county; State officials shift stance a day after announcing no funding
Arizona state officials are offering at least a two-week reprieve for COVID-19 testing here a day after telling Pima County they weren't prepared to cover the expenses out of federal coronavirus funding.
With its projected cost for COVID-19 testing topping $40 million this year, Pima County was prepared to have to cut off the testing program after state officials said there would be no immediate funding Thursday.
Halting testing would create a potential "public health threat... (but) we have no options," Supervisor Sharon Bronson, the chair of the Board of Supervisors, told TucsonSentinel.com on Thursday.
Friday morning, state officials changed course, informing Pima that about $14 million would be provided "immediately" — enough to cover the costs for about two weeks, the county said.
The announcement by the Arizona Department of Health Services — which includes $60 million in immediate funding for Maricopa County testing and smaller amounts for other counties — prompted the county to call off a vote by the Board of Supervisors that would have ended the large-scale testing here for lack of funds.
Related: Pima County moves to end COVID testing as state won't pay for program
Pima County Administrator Chuck Huckelberry had advised the supervisors in a memo Thursday that the county should end its testing effort as of Monday, after state health officials said they could not provide any funding. TucsonSentinel.com broke the story that testing might be ended because of the lack of funding.
"We cannot continue to deficit spend and this less than responsible response from the state requires immediate action," Huckelberry said Thursday night, asking the supervisors to consider a vote to curtail testing at a joint meeting with the Tucson City Council on coronavirus issues set for Friday morning.
During that meeting, as officials got word that the state had announced the funding via a press release, Huckelberry said the county would take the information "at face value," and that the funds would cover testing here until March 2.
ADHS said that it "is coordinating with local health departments to immediately allocate an initial $100 million in federal funding intended for staffing, laboratory testing, informatics, disease surveillance, and other activities critical to combating COVID-19."
Although the state has been allocated nearly $420 million million by the federal government, under a CDC coronavirus program, Arizona officials said that although the funding will support work undertaken after January 15, that they have not yet submitted a complete budget to the feds, and that they have asked county health departments to draft proposals that may be incorporated into the state plan to be completed by mid-March.
"The immediate $100 million allocation is intended to provide critical funding to local health departments to continue to support testing efforts statewide as ADHS develops the overall budget," state officials said.
But Thursday morning, state officials had told the county that there was no money to support the testing program, outside of $1 million being spent with Paradigm Labs, which has conducted tests for both the county and state.
"Being at the state's mercy has never worked out for Pima County," commented City Councilman Paul Cunningham during Friday morning's joint meeting of the Council and Board of Supervisors.
"We welcome and appreciate the financial assistance but a pro-rata disbursement is not reimbursement," said county spokesman Mark Evans following the state's release.
"Pima County has run the best system of COVID-19 testing in the state, which has greatly aided the state's and county's surveillance of the virus," Evans said. "It fit hand-to-glove to our contact tracing effort and helped us stop hundreds of outbreaks. Pima County's effort to protect the public health during a pandemic should be fully reimbursed."
"The ongoing response to the pandemic will continue to require robust support of testing even as we scale up vaccination efforts," Huckelberry said Friday afternoon. "Especially as we try to understand the potential impact of COVID variants, this is not the time for the state to retreat on testing efforts."
"The delays and attempts to withhold this support at the state level are incredibly frustrating," said U.S. Rep. Raul Grijalva in a press release. "Congress passed this funding with a very clear intent, and frankly we need the state to be a better partner in getting these resources out in a timely and fair manner."
Earlier: 'We're going to have to suspend'
"It appears the funding we believed was set aside in the (federal) 2021 Consolidated Appropriations Act for COVID-19 testing of $416 million is being used by the state for other purposes," Huckelberry wrote Thursday.
"We're going to have to suspend testing unless the monies come to Pima County," Bronson told TucsonSentinel.com on Thursday. "We're out of money."
"If we can't test, we don't know what's going to happen next," she said.
The head of the Arizona state health department told reporters Thursday afternoon that "we know how important testing is," but did not explain why officials had told the county that there wouldn't be any funding for it even as new, more virulent and potentially more deadly variants of the disease are spreading across the country. "We're looking into it," she said, describing the county's effort as "phenomenal."
The county has already spent nearly $11 million in the first six weeks of the year on testing, and has forecast a total of more than $40 million in testing costs through August.
The county has fronted many of the costs thus far, with Pima financially responsible for 65 percent of the "large scale testing in the region," according to a county document sent to state officials.
The county has paid more than $47 million for RT-PCR testing for coronavirus, bearing more than $10.6 million out of its funds to date.
"If the county doesn't receive its fair share of the federal testing dollars being withheld by the state in the coming days, we will have to suspend our current viral surveillance program as early as February 22, putting the entire community at risk," said Supervisor Matt Heinz, a medical doctor who works at a local hospital treating COVID patients.
In a memo sent Thursday morning to county health officials, the chief of the state's Bureau of Epidemiology and Disease Control, Dr. Eugene Livar, said that the state would not be providing funding to the county at this point, but would "reassess the funding available to support Pima County's testing needs" after mid-March.
"It may be likely that we can not support the entirety of the $40,274,448 need but will likely be able to provide some level of support" then, Livar wrote to Dr. Theresa Cullen, head of the Pima County Health Department.
He said that the state would be providing $1 million to Paradigm Labs "for immediate needs... at this time."
Huckelberry wrote to the supervisors that "Paradigm Labs is also our contractor. It appears the uses for which the state will be using these funds is everything but COVID-19 testing."
State officials did not have an immediate response to questions about funding for coronavirus testing in Pima County on Thursday morning. Dr. Cara Christ, the head of the state Department of Health Services, held an afternoon press conference about the state takeover of the University of Arizona vaccination site.
"So, we're working very closely with our county partners to get funding for additional testing, and so hopefully, they got some updated messaging tonight," Christ told reporters. "We do have federal funding that's has come to the state, and we're looking into it. We know how important testing is."
Christ didn't explain why the county had been told that there would be no funding for COVID testing in the near future.
"They should have notice, because we are just being able to amend contracts, so it depends on what their plan is, and what they want to submit as their testing plan," Christ said. "Pima County has a phenomenal testing strategy, so we know we want to know that we want to keep that going. So hopefully, we'll be able to get those contracts amended pretty quickly."
County officials said Thursday night that there have been a few unofficial discussions about more federal funding being released by the state, but there have been no hard numbers provided — just possibilities.
"The discussed possibilities are still well short of what the county has spent on testing to date," county spokesman Evans said.
Although the number of people seeking testing has declined in recent weeks, public health experts have pointed to ongoing testing efforts as necessary to understand the continued progression of the virus.
"If we don't test, we can't in any way, shape or form respond to the newest strains," Bronson said, calling the situation "a public health threat."
"If we continue (to fund testing without state and federal support), we won't have any balance in our general fund," she told the Sentinel. "I don't know how you do early childhood education, I don't know how you do roads, or economic recovery" if the county spends millions on testing without reimbursement.
An end to county testing would make free tests inaccessible, Cullen told reporters Friday.
"If the whole county quit testing, it would look like COVID went away," she said. "We use the positivity rate to give us a sense of what is happening in the community with regard to COVID."
"If we test you (and you're positive), we work with you to isolate, to identify your contacts for quarantine," which reduces transmission, she said.
Bronson said Thursday that the county has had "no conversations with the governor" about the pandemic recently. Gov. Doug Ducey has reportedly not spoken to Tucson Mayor Regina Romero since the outbreak began a year ago.
The city may have to curtail its own contributions to coronavirus testing by the end of the month without state support, officials said.
"Counties and cities that are on the frontlines of providing testing and protecting public health deserve our fair share from the state," said Romero. "This is a positive step, however additional support will be needed to sustain current testing efforts."
"We need help now; we need it immediately," Bronson said Thursday. "Hopefully the federal government and the state will rethink their position. Monies need to flow directly to the local jurisdictions, not through the state. We need transparency and accountability, and I'm not sure we have that now."
Grijalva said Friday that he "applauds" the release of some testing funding to the counties.
"I appreciate the technical assistance available from the CDC to help ensure these funds are used efficiently, and I call on the state to continue releasing these funds to ensure our communities have access to testing and the needed resources available to help keep the people of Southern Arizona safe," he said.
The county administrator had told the supervisors Thursday that "there is no mention of an reimbursement of our costs incurred since January 1" in the state's letter to Cullen and Dr. Francisco Garcia, the county's medical director.
The prospect of suspending the testing effort is "unfortunate as it was abundantly clear to Pima County that the state allocation was for COVID-19 testing. At least that was the impression we were left with in reviewing (the federal budget act)," Huckelberry said.