Why Massachusetts has only gotten a fraction of the emergency stockpile supplies it requested

FEMA says the system isn't based on requests. But the state's delegation wants more details.

BOSTON, MA. - MARCH 24: Governor Charlie Baker speaks as Lt. Governor Karyn Polito, a sign language interpreter and Sec. of Health and Human Services Marylou Sudders stand at least six feet apart during a news briefing in the Gardner Auditorium at the State House as the Coronavirus continues to spread on March 24, 2020 in Boston, Massachusetts.  (Matt Stone/Pool)
Gov. Charlie Baker speaks as Lt. Gov. Karyn Polito, a sign language interpreter and Health and Human Services Secretary Marylou Sudders stand at least six feet apart during a news briefing last week at the State House. –Matt Stone / Pool

Massachusetts has gotten only a fraction of the medical equipment it has requested from the federal government to treat its increasing number of COVID-19 patients. And the state’s congressional delegation is demanding to know the reason.

“Massachusetts has still received significantly less than even the Commonwealth’s initial request from the Strategic National Stockpile,” the state’s nine House members and two U.S. senators — led by Sen. Ed Markey and Rep. Ayanna Pressley — wrote in a letter Monday to the Federal Emergency Management Agency Administrator Pete Gaynor and Vice President Mike Pence, who is leading President Donald Trump’s coronavirus task force.

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Gov. Charlie Baker has said acquiring personal protective equipment (PPE) from the overwhelmed federal stockpile has been a “difficult” issue for governors across the country, amid a national shortage of crucial gear like masks and gowns. The scramble to obtain more gear has been a source of particular frustration in Massachusetts; state health officials said last week that they had received 17 percent of their initial request, though Baker said Monday that they did receive a new shipment over the weekend.

But as the state prepares for a surge in COVID-19 patients, the Republican governor added that “obviously we will need more.”

To that point, lawmakers are calling for more reliability in the shipments.

“The lack of transparency and information from the federal government about the allocation and availability of PPE is highly problematic,” the all-Democratic delegation wrote in their letter, adding that the the shortage was “exacerbating existing inequities within our health care system.”

However, according to FEMA, the allocation of supplies isn’t based on state requests, but rather an allocation formula based on state population and determined need. While states and major cities can request to receive their allocation immediately, the Department of Health and Human Services, which oversees the stockpile of equipment, uses those factors to prioritize shipments from the stockpile.

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“High transmission areas are prioritized, and quantities are based on population,” a FEMA spokesperson told Boston.com. “Because of the finite supply of PPE in the commercial supply chain, SNS-held product is prioritized for the highest-risk healthcare personnel.”

The spokesperson said that every jurisdiction — which includes all 50 states; New York City, Chicago, Los Angeles County and Washington, D.C.; and eight islands — will receive 100 percent of its allocations, and that 90 percent was in the process of being shipped, with the first 50 percent “nearly complete.”

In a press release Monday, the agency said that the strategy is aimed on “ensuring the right quantities of supplies get to the right place, at the right time” with a focus on areas that are currently seen as the least-equipped to deal with the outbreak.

“FEMA is focusing allocation of critical resources to areas experiencing the greatest increase in COVID-19 cases with the largest forecast capacity shortfalls,” the release said. “This approach also considers the at-risk population distribution across the nation.”

Still, Massachusetts lawmakers want more information on the approach, given the state-to-state differences in shipments.

In their letter Monday, the delegation asked for details of the formula and a projected timeline of the shipments. They also reported hearing from state officials that “the contents of PPE shipments received have often varied from what FEMA had previously confirmed they would contain” and asked if the administration was doing anything to ensure the accuracy of condition of equipment being sent out.

“In this unprecedented public health emergency, transparency and predictably is crucial,” the letter said. “Our state and local officials need communication and clarity as they work to provide our health care and other frontline workers the supplies they need to survive this fight.”

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Massachusetts is hardly alone; as ProPublica recently reported, most states have only gotten a fraction of what they requested. HHS officials told the outlet that the population-based allocations are “likely less than what states are currently requesting,” though Florida did get 100 percent of its initial request.

In a separate letter Monday to Gaynor, Sen. Elizabeth Warren wrote that the Trump administration had created “a logistical black hole in the federal COVID-19 response that has left states struggling to find key medical supplies on their own.” Democrats have called on Trump to fully utilize the Defense Production Act to direct private companies to produce needed medical gear and equipment. So far, the president has used the wartime act to direct General Motors to produce ventilators, but has otherwise told states to independently procure supplies on the private market rather than rely on the stockpile.

However, the delegation says that approach has resulted in “bidding wars between states, cities, and towns desperate for equipment,” as well as with the Trump administration itself. The Baker administration has said the federal government has repeatedly either outbid or used its legal authority to poach “millions” of pieces of gear ordered by the state. Connecticut Sen. Chris Murphy said Tuesday that the shortage — and subsequent “bidding war” between local governments and hospitals — has incentivized price gouging and hoarding and turned the supply chain into “Lord of the Flies.”

The Baker administration also announced an online process Sunday for local organizations and businesses to donate or sell PPE. The governor added Monday that Massachusetts will “continue to chase PPE through a whole variety of alternative supply chains.”


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