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When asked if it’s appropriate to meet with senators during the trial, Schoen said, “Oh yeah, I think that’s the practice of impeachment.”dfsdsfdf

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A trio of Republican senators allied with former President Donald Trump met with his defense team Thursday evening, in the middle of an impeachment trial in which they will vote on whether to convict Trump and potentially bar him from holding public office again.

Sens. Lindsey Graham of South Carolina, Ted Cruz of Texas and Mike Lee of Utah were spotted going into a room in the US Capitol that Trump’s lawyers were using to prepare for their arguments.
Trump lawyer David Schoen said that the senators were “very friendly guys” who just wanted to make sure they were “familiar with procedure” on the eve of their rebuttal to the House impeachment managers’ presentation.
When asked if it’s appropriate to meet with senators during the trial, Schoen said, “Oh yeah, I think that’s the practice of impeachment.”
“There’s nothing about this thing that has any semblance of due process whatsoever,” he added.
Some senators view themselves as impartial jurors during impeachment trials, while others lend a hand to their party’s side.
Republican senators have already signaled that they will vote to acquit the former President of the charge of “incitement of insurrection,” preventing a subsequent vote on Trump’s political future. In a 50-50 Senate, the House impeachment managers — all of whom are Democrats — need to persuade 17 Republican senators to join every member of their party to convict Trump.
The managers on Thursday showed clips of Trump’s speech before the Capitol rampage on January 6, in which he urged his supporters to “fight like hell,” “never give up” and “never concede.” Many Republican senators point out that Trump also said “to peacefully and patriotically make your voices heard.” They’ve also blamed the rioters rather than the former President for the deadly violence that day.
Among the harrowing images presented during the impeachment trial of former President Donald J. Trump, one video stood out: a police officer sprinting toward a United States senator to warn of the angry mob nearby.

The senator, Mitt Romney, is shown turning on his heels and fleeing for safety.

“I don’t think my family or my wife understood that I was as close as I might have been to real danger,” Mr. Romney told reporters on Thursday, one day after the video showed Eugene Goodman, a Capitol Police officer already known for his bravery, aiding him. “They were surprised and very, very appreciative of Officer Goodman, in his being there and directing me back to safety.”

For Officer Goodman, it was the second time a video went viral displaying actions widely credited with saving members of Congress. The first, which showed him single-handedly luring a mob away from the entrance of the Senate toward an area with reinforcements, turned him into a hero. The second has added to his lore.

Both have catapulted Officer Goodman — a former Army infantryman who served in one of the most dangerous parts of Iraq during one of the most lethal times of the war — to fame he never sought.

On Wednesday, after watching the videos that showed Officer Goodman directing Mr. Romney to safety, Mr. Romney could be seen talking with Officer Goodman. Senator Rob Portman, Republican of Ohio, later walked over and fist-bumped Officer Goodman.

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On Thursday, Speaker Nancy Pelosi singled out Officer Goodman for his courage when she introduced legislation to award the Capitol Police and other law enforcement personnel who responded on Jan. 6 with the Congressional Gold Medal, the highest honor of Congress. On Jan. 20, Officer Goodman was given the task of escorting Vice President Kamala Harris at the inauguration of President Joseph R. Biden Jr.

The Trump Impeachment ›
What You Need to Know
A trial is being held to decide whether former President Donald J. Trump is guilty of inciting a deadly mob of his supporters when they stormed the Capitol on Jan. 6, violently breaching security measures and sending lawmakers into hiding as they met to certify President Biden’s victory.
The House voted 232 to 197 to approve a single article of impeachment, accusing Mr. Trump of “inciting violence against the government of the United States” in his quest to overturn the election results. Ten Republicans joined the Democrats in voting to impeach him.
To convict Mr. Trump, the Senate would need a two-thirds majority to be in agreement. This means at least 17 Republican senators would have to vote with Senate Democrats to convict.
A conviction seems unlikely. Last month, only five Republicans in the Senate sided with Democrats in beating back a Republican attempt to dismiss the charges because Mr. Trump is no longer in office. Only 27 senators say they are undecided about whether to convict Mr. Trump.
If the Senate convicts Mr. Trump, finding him guilty of “inciting violence against the government of the United States,” senators could then vote on whether to bar him from holding future office. That vote would only require a simple majority, and if it came down to party lines, Democrats would prevail with Vice President Kamala Harris casting the tiebreaking vote.
If the Senate does not convict Mr. Trump, the former president could be eligible to run for public office once again. Public opinion surveys show that he remains by far the most popular national figure in the Republican Party.

Veterans who served alongside Officer Goodman in the 101st Airborne Division some 15 years ago in Iraq say that the officer, known then as “Goody,” never craved accolades.

“I saw him come out in front of the vice president and he immediately ducked to the right,” said Mark Belda, who served with Officer Goodman in Iraq. “I thought that’s definitely Goody.”

When he closely watched the first video, Mr. Belda said, he saw attributes he recognized in Officer Goodman from Iraq. “He wasn’t prone to anger. As an infantryman, your job is to be violent but it was never his first reaction to use the stick before you use the carrot.”

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In Iraq, Officer Goodman was a sergeant and a leader of a 10-man rifle squad who assumed new responsibilities soon after his unit arrived in 2005.

His “Hardrock Company” operated in the Sunni triangle area near Baghdad in central Iraq, where American troops engaged in some of the fiercest combat of the war.

ImageOfficer Goodman, far left in the back row, with his platoon in Iraq.
Officer Goodman, far left in the back row, with his platoon in Iraq.Credit…via John Greis
The platoons were required to conduct multiple combat patrols each day to identify explosives before they were detonated, work that often resulted in various injuries, according to Lt. Col. Jeff Farmer, who served alongside Officer Goodman in the company.

“The front squad leader was critical, someone willing to take on this risk and lead his squad day in and day out,” Colonel Farmer said.

That leader was Officer Goodman.

“I cannot recall exactly how many dismounted patrols Goody led as a point man in the company, but I can say that it was likely in the hundreds, making him the go-to guy quite frankly when others needed that reassurance that things were going to be OK,” Colonel Farmer said.

Officer Goodman was a quiet professional, his superiors said, serious and focused on his missions but also quick with a joke to ease tension in the ranks, they said. His fellow soldiers could count on him to do “what needed to be done,” said John Greis, who served as his platoon sergeant in Iraq. “That’s coolness under pressure.”

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Continue reading the main story
Colonel Farmer said he was not surprised when he saw the video of Officer Goodman facing the angry mob in the Capitol.

“Calm, cool, and collected under fire, that’s just Goody,” Colonel Farmer said. “I trusted my life with him, and still would to this day.”

Officer Goodman is now in uncomfortable territory, according to his fellow veterans. He has not made public comments and did not return multiple requests for interviews, including a handwritten note at his apartment near District Heights, Md.

A neighbor said Officer Goodman had not returned to his apartment in the days after the attack at the Capitol, and had advised those in his apartment building not to speak to the news media.

“He doesn’t want to be in the center of the attention. He just wants to duck to the side and you all can do what you want to do,” said Mr. Belda, Mr. Goodman’s former first sergeant. “Let me do my job and you guys do what you want to do, just leave me alone.”

Charles H. Ramsey, who led police departments in Was
Cruz said the meeting with the Trump defense team was an opportunity for “sharing our thoughts” about their legal strategy. A wide array of Senate Republicans harshly criticized the defense team on Tuesday, the opening day of the trial, arguing that Trump attorney Bruce Castor had delivered a rambling and unfocused argument in making the case that the proceedings are unconstitutional.
When asked if he’s now comfortable with the Trump team’s legal strategy, Cruz said, “I think the end result of this impeachment trial is crystal clear to everybody.”
“Donald Trump will be acquitted,” he added. “It takes 67 votes to convict him and every person in the Senate chamber understands that there are not the votes to convict, nor should there be.”
Clare Foran, Ted Barrett and Ali Zaslav contributed to this report.

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Shortages abound: The order comes as automakers around the U.S. reel from a global shortage in semiconductors — the computer chips in everything from cell phones to SUVs — forcing manufacturers to halt auto production for weeks.

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President Joe Biden will sign an executive order on Wednesday to review the global supply chains used by four key industries in an effort to avoid the shortages in medical equipment, semiconductors and other goods seen as critical during the pandemic.

China reliance targeted: Biden’s order will institute 100-day reviews of the global producers and shippers for: computer chips used in consumer products; large-capacity batteries for electric vehicles; pharmaceuticals and their active ingredients; and critical minerals used in electronics.
A national health care provider has administered COVID-19 vaccinations to people deemed ineligible for the scarce vaccine by local health departments, including people with connections to company leaders and customers of its concierge medical service, according to internal communications leaked to NPR.
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San Francisco-based One Medical has been allocated thousands of vaccine doses by local health departments in some of the areas they provide medical services. Ineligible individuals with connections to company leadership were set up with vaccine appointments, and patients who were disqualified from receiving the vaccine were nonetheless permitted to skip the line ahead of other high-risk patients.

The problems have occurred in numerous company locations across several states. The Washington State Department of Health, citing a complaint it received this month, told NPR it had halted COVID-19 vaccine distribution to the company. Other regulators have also received complaints or stopped providing the vaccine.

One Medical has branded itself a high-end health care provider serving a relatively affluent clientele that pays a $199 fee annually to receive easy online access to appointments, telemedicine and access to a streamlined, tech-focused medical experience. The company went public with an IPO in January 2020, with a valuation in the billions.

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One Medical’s shortcomings take place amid broader anecdotal evidence that suggests patients throughout the country are skipping the line due in part to loose enforcement. The situation highlights a serious ethical issue: Determining who is entitled to a vaccine at a time of scarce availability and who is responsible for enforcing eligibility rules.

Experts say an appropriate system for vaccine distribution focuses on first targeting those most at risk for serious consequences from COVID-19. “We’re trying to focus on those individuals who are most likely to develop severe illness or death, and to most likely be exposed to the virus,” said Gabriel Lázaro-Muñoz, who teaches medical ethics and health policy at the Baylor College of Medicine. “The overall goal is to save as many lives as possible, and with that we are not valuing any life over another.”

One Medical claims it does not allow for ineligible patients to be vaccinated knowingly, and that it was confident that it was “doing everything reasonably in our power to ensure… our adherence to state and local department of health vaccine eligibility guidelines.” But NPR obtained internal communications that tell a different story.

‘We are not policing’

Messages between doctors, medical practitioners, administrative staff and leadership show that multiple staffers across One Medical locations in several states — Washington, Oregon and California — privately raised the alarm about what they believed were lax oversight and inappropriate practices within the organization. They also show what appear to be favors done for those close to the organization’s senior staff.

“It seems if you don’t screen out those jumping the [queue], then many will jump in the line and push those that need the vaccine further behind, delaying a potentially life saving injection. This could impact MANY members,” one doctor in California wrote to his colleagues in January, according to the internal documents.

“I have had two [patients] today, both in their 20-30s without risk factors and are tech workers who have gotten their covid vaccines. One was thru us,” wrote another One Medical doctor in Washington state. “I’m curious how these [people] are able to sign up for vaccines when we have a long list of higher priority [patients]? … I just want to understand how they can be prioritized for a vaccine when those at higher tiers have to wait.”

These internal communications indicate that ineligible friends and family of One Medical leadership were vaccinated, as were work-from-home administrative, support and IT staff at its headquarters in San Francisco. While healthcare workers waited in line in January, One Medical made the decision to offer the vaccine to any of its San Francisco County staff, regardless of whether they were patient-facing staff.

Lázaro-Muñoz, the ethics professor, said that offering the vaccine to all staff regardless of whether they see patients was unethical.

“There might not be regulations stopping this company from giving [the COVID vaccine] to their employees. But from an ethical standpoint, when you look at what is right and wrong, this is wrong,” Lázaro-Muñoz told NPR. “Your life and the life of your co-workers and those who work in this company is not any more valuable than the life of the elderly people that are not getting access to that vaccine, thanks to your criteria and system of distributing that vaccine.”

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One Medical said that it had asked some of its staff to volunteer time in their clinics. However, all of its staff in San Francisco County were provided an opportunity to receive the vaccine, regardless of the nature of their job.

Further, patients of One Medical who were ineligible to be vaccinated based on local guidelines were also permitted to book vaccination appointments through an online portal. So was at least one executive of a partner organization with One Medical. Internal communications show providers trying to get eligible health care workers vaccinated, but instead told to put them on a wait list.

“Why are young patients without health problems, on a trial membership… allowed to book and receive a covid vaccine while healthcare workers are being waitlisted?” one medical professional asked in January. “I just saw two appointments for such.”

There were also shortcomings with the company’s system. A question asking patients whether they were in an eligible category was not added to the online portal until Jan. 14, though One Medical started vaccinating patients on Jan. 1. During this two-week period, COVID-19 cases in the United States reached its highest peak.

Following this, the internal documents show that in January, even if a patient noted that they were not in an eligible category for vaccination, some could continue to book an appointment for a COVID-19 vaccine. Suggestions on how the tech-heavy company could use algorithms to scan for ineligible patients were turned down.

The tech-heavy company said that blocking ineligible patients from booking vaccination appointments would have called for a complete overhaul of their system and was too technologically difficult to rebuild in the required timeframe.

The documents also show that in January One Medical was not verifying the eligibility of patients it vaccinated by requiring ID or other evidence at the point of vaccine administration.

“I have questions about our approach of not requiring [patients] to bring proof of vaccine eligibility,” said a One Medical staffer. “A quick Google search indicates that this is not consistent with many states’ requirements… I am concerned about advertising an overly permissive approach.”

“It seems crucial to at least attempt to ensure that the vaccines are going into the ‘right’ people’s arms.”

– a One Medical staff member

As ineligible patients began to get vaccines, staff began raising concerns that word was spreading about One Medical’s lax enforcement of eligibility requirements.

“I’ve had a few patients straight up tell me that once they realized there was no screening that they would be telling their friends…” another medical provider in California wrote. “My partner and I were shocked when we got ours through One Med… that at no point were we asked if we met criteria — let alone asked to prove it.”

Employees were told not to try to enforce the rules barring ineligible patients. “Scanning schedules and cancelling appointments [for ineligible patients] is not recommended,” Spencer Blackman, the director of clinical education at the company said in a communication to a range of staff. He added in another note to a doctor, “If this person sees themself in a tier that is being vaccinated they can attest to that and make an appointment. You don’t get to make the decision if someone ‘gets’ [a] vaccine or not.”

“We are not policing,” Blackman wrote in January, setting off objections in internal company communications.

When asked why One Medical did not verify eligibility, chief medical officer Andrew Diamond said, “There was never guidance that said ‘do not verify’… that would be counter to our principles.” When told NPR was in possession of communications that indicated otherwise, he responded, “that’s clearly not the guidance, nor is that the intent of the guidance. We’ve been far clearer since then.”

“If we don’t ‘police’ we contribute to inequity that rewards those who choose to lie/deceive … As a medical company with tech skills we CAN do more.”

– a One Medical staff member

In fact, many localities require medical providers to check for eligibility documentation. In Los Angeles County, where One Medical has been provided thousands of doses, vaccination is limited currently to healthcare workers, long-term care facility residents, and persons over the age of 65. Proper documentation of eligibility is required for vaccination. “Providers are then responsible for confirming eligibility responses and requesting accepted documentation of eligibility, once [the patient] arrives for onsite appointment,” an L.A. County Department of Public Health spokesperson said.

And in Alameda County, where the company was given close to 1,000 doses, the public health department said that personal ID and proof of a health care role is “required” for the vaccine doses that One Medical received.

As Forbes was preparing a story about One Medical’s practices, One Medical leadership sent out a note to staff warning of consequences, threatening them with “disciplinary action, up to and including termination” if they leaked internal communications. One Medical disputed this characterization. “One Medical is not, and has never been an organization that threatens its staff,” a spokesperson said, characterizing the note as merely “reminders about our business code of conduct.”

Regulators take action

It is not clear how many ineligible vaccine doses were distributed, and One Medical declined to provide a figure on how many total doses it had administered. But the company has likely provided tens of thousands of doses: Of just two jurisdictions that produced information on the doses it allocated to One Medical, San Francisco County said it had provided the company with 12,000 doses, while L.A. County has provided them with nearly 6,000 doses.

One Medical’s practices have not gone unnoticed by state and local regulators. The Washington State Department of Health told NPR that they had halted allocation of vaccine doses to One Medical due to a complaint received on February 10. “We are currently in communication with One Medical regarding the complaint we received,” a state spokesperson said. “We are removing them from the state’s Vaccine Locations webpage and One Medical will not be receiving vaccine from us until this issue is resolved.” One Medical disputed the reason for the halt, and said that it was a misunderstanding.

Bob Ferguson, the attorney general of Washington state, is also concerned about the wider issue of ineligible patients receiving COVID-19 vaccinations. While not commenting on whether or not there were any ongoing investigations into the topic, or on any individual company, a spokesperson for the attorney general said that Ferguson was “extremely concerned. And he has had conversations with his team about this issue.”

Los Angeles County’s Department of Public Health has also received a complaint about One Medical — and has reached out to express a warning by phone and email. “Public Health told One Medical if there are breaches and they are not holding tight to our priority groups, and checking and validating groups, we could not allocate vaccine to them any longer,” a spokesperson said. “We reinforced the fact that we could not provide vaccine to any entity not following our partner guidance for checking and ensuring people getting vaccinated are part of our priority groups.” One Medical claimed that complaints and warnings are both common for medical providers.

In Alameda County, California, which includes Oakland, the Public Health Department said that One Medical had received 975 doses of the COVID-19 vaccine, but received no more after the health care company indicated its desire to vaccinate ineligible patients. “Alameda County did not fulfill One Medical’s next request in early February for additional doses when they indicated that they planned to vaccinate more than their health care workers (who were the only approved group prioritized for vaccinations at the time),” said a county spokesperson. One Medical said that this explanation was “categorically untrue,” but did not contest that their vaccine allocation has not continued beyond the original 975 doses.

In San Francisco, where One Medical’s headquarters are based, the county’s Department of Public Health stressed: “One Medical was engaged primarily to provide vaccine to in-home support services (IHSS), other in-home care providers and healthcare workers… SF DPH expects all its vaccine provider partners to follow State and SF DPH vaccination eligibility guidelines.”

One Medical contested several elements of this story, claiming that it “does not allow for ineligible persons to be vaccinated knowingly.” It also said that it had fired several members of its clinical staff due to disregard for eligibility requirements.

“We are doing absolutely everything in our power to vaccinate as many eligible people as possible,” said Diamond, the chief medical officer of One Medical, attributing difficulties to the “fog of war” that occurs during a period of “myriad uncertainties, conflicting jurisdictional guidance and profound public anxieties.”

The reviews will seek to determine whether U.S. firms in these sectors are relying too much on foreign suppliers, particularly those in China, a senior administration official told reporters. They will also consider other vulnerabilities, like extreme weather and environmental factors.

“Clearly we are looking at the risks posed by dependence on competitor nations, but that is only one of a range of risks we are looking at,” the administration official said.

The order will also direct yearlong reviews for six sectors: defense, public health, information technology, transportation, energy and food production.

Those reviews will be “modeled after the process the Defense Department uses to regularly evaluate and strengthen the defense industrial base,” the official said.

Remedies unclear: If risks are identified in the supply chains for critical sectors, the administration will aim to push those companies to move their suppliers out of countries like China and back to the U.S. mainland or allied nations.

“Resilient supply chains are not the same thing as all products being made in America,” said a second senior official. “That’s not our intention here.”

Any strict directive from the White House for firms to relocate to the U.S. would risk angering allies like Canada and the European Union, which Biden already irked by strengthening “Buy American” provisions on his first day in office by making it more difficult for foreign companies to supply the U.S. government.

But how the White House will prod companies remains to be seen. If the risks are dire, the Biden administration could use the Defense Production Act, a Cold War-era emergency law, to force companies to produce certain goods domestically. Or the president could work with Congress to fashion incentives and worker-training programs to get suppliers to relocate to the U.S. or allies.

For now, the White House is not ”taking anything off the table,” the first official said, and strategies to fix the supply chains will depend on the weak spots identified.

Shortages abound: The order comes as automakers around the U.S. reel from a global shortage in semiconductors — the computer chips in everything from cell phones to SUVs — forcing manufacturers to halt auto production for weeks.

Risks to the battery supply chain are also apparent. Ford and Volkswagen recently told U.S. trade authorities that they would have to delay production of their new electric vehicle lines if their battery supplier — Korean firm SK Innovation — was blacklisted for intellectual property theft. The International Trade Commission subsequently blocked those batteries from entering the U.S., but gave the automakers a grace period to find new suppliers.

Those situations both came on the heels of widespread shortages of masks and other medical protective gear early in the pandemic, which affected hospitals and average consumers alike. The White House says it aims to get out in front of those issues next time around.

“We’re going to get out of the business of reacting to supply chain crises as they arise, and get into the business of getting ahead of future supply chain problems,” one of the senior administration officials said.

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they arise, and get into the business of getting ahead of future supply chain problems,” one of the senior administration officials said.

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President Joe Biden will sign an executive order on Wednesday to review the global supply chains used by four key industries in an effort to avoid the shortages in medical equipment, semiconductors and other goods seen as critical during the pandemic.

China reliance targeted: Biden’s order will institute 100-day reviews of the global producers and shippers for: computer chips used in consumer products; large-capacity batteries for electric vehicles; pharmaceuticals and their active ingredients; and critical minerals used in electronics.
A national health care provider has administered COVID-19 vaccinations to people deemed ineligible for the scarce vaccine by local health departments, including people with connections to company leaders and customers of its concierge medical service, according to internal communications leaked to NPR.
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San Francisco-based One Medical has been allocated thousands of vaccine doses by local health departments in some of the areas they provide medical services. Ineligible individuals with connections to company leadership were set up with vaccine appointments, and patients who were disqualified from receiving the vaccine were nonetheless permitted to skip the line ahead of other high-risk patients.

The problems have occurred in numerous company locations across several states. The Washington State Department of Health, citing a complaint it received this month, told NPR it had halted COVID-19 vaccine distribution to the company. Other regulators have also received complaints or stopped providing the vaccine.

One Medical has branded itself a high-end health care provider serving a relatively affluent clientele that pays a $199 fee annually to receive easy online access to appointments, telemedicine and access to a streamlined, tech-focused medical experience. The company went public with an IPO in January 2020, with a valuation in the billions.

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One Medical’s shortcomings take place amid broader anecdotal evidence that suggests patients throughout the country are skipping the line due in part to loose enforcement. The situation highlights a serious ethical issue: Determining who is entitled to a vaccine at a time of scarce availability and who is responsible for enforcing eligibility rules.

Experts say an appropriate system for vaccine distribution focuses on first targeting those most at risk for serious consequences from COVID-19. “We’re trying to focus on those individuals who are most likely to develop severe illness or death, and to most likely be exposed to the virus,” said Gabriel Lázaro-Muñoz, who teaches medical ethics and health policy at the Baylor College of Medicine. “The overall goal is to save as many lives as possible, and with that we are not valuing any life over another.”

One Medical claims it does not allow for ineligible patients to be vaccinated knowingly, and that it was confident that it was “doing everything reasonably in our power to ensure… our adherence to state and local department of health vaccine eligibility guidelines.” But NPR obtained internal communications that tell a different story.

‘We are not policing’

Messages between doctors, medical practitioners, administrative staff and leadership show that multiple staffers across One Medical locations in several states — Washington, Oregon and California — privately raised the alarm about what they believed were lax oversight and inappropriate practices within the organization. They also show what appear to be favors done for those close to the organization’s senior staff.

“It seems if you don’t screen out those jumping the [queue], then many will jump in the line and push those that need the vaccine further behind, delaying a potentially life saving injection. This could impact MANY members,” one doctor in California wrote to his colleagues in January, according to the internal documents.

“I have had two [patients] today, both in their 20-30s without risk factors and are tech workers who have gotten their covid vaccines. One was thru us,” wrote another One Medical doctor in Washington state. “I’m curious how these [people] are able to sign up for vaccines when we have a long list of higher priority [patients]? … I just want to understand how they can be prioritized for a vaccine when those at higher tiers have to wait.”

These internal communications indicate that ineligible friends and family of One Medical leadership were vaccinated, as were work-from-home administrative, support and IT staff at its headquarters in San Francisco. While healthcare workers waited in line in January, One Medical made the decision to offer the vaccine to any of its San Francisco County staff, regardless of whether they were patient-facing staff.

Lázaro-Muñoz, the ethics professor, said that offering the vaccine to all staff regardless of whether they see patients was unethical.

“There might not be regulations stopping this company from giving [the COVID vaccine] to their employees. But from an ethical standpoint, when you look at what is right and wrong, this is wrong,” Lázaro-Muñoz told NPR. “Your life and the life of your co-workers and those who work in this company is not any more valuable than the life of the elderly people that are not getting access to that vaccine, thanks to your criteria and system of distributing that vaccine.”

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One Medical said that it had asked some of its staff to volunteer time in their clinics. However, all of its staff in San Francisco County were provided an opportunity to receive the vaccine, regardless of the nature of their job.

Further, patients of One Medical who were ineligible to be vaccinated based on local guidelines were also permitted to book vaccination appointments through an online portal. So was at least one executive of a partner organization with One Medical. Internal communications show providers trying to get eligible health care workers vaccinated, but instead told to put them on a wait list.

“Why are young patients without health problems, on a trial membership… allowed to book and receive a covid vaccine while healthcare workers are being waitlisted?” one medical professional asked in January. “I just saw two appointments for such.”

There were also shortcomings with the company’s system. A question asking patients whether they were in an eligible category was not added to the online portal until Jan. 14, though One Medical started vaccinating patients on Jan. 1. During this two-week period, COVID-19 cases in the United States reached its highest peak.

Following this, the internal documents show that in January, even if a patient noted that they were not in an eligible category for vaccination, some could continue to book an appointment for a COVID-19 vaccine. Suggestions on how the tech-heavy company could use algorithms to scan for ineligible patients were turned down.

The tech-heavy company said that blocking ineligible patients from booking vaccination appointments would have called for a complete overhaul of their system and was too technologically difficult to rebuild in the required timeframe.

The documents also show that in January One Medical was not verifying the eligibility of patients it vaccinated by requiring ID or other evidence at the point of vaccine administration.

“I have questions about our approach of not requiring [patients] to bring proof of vaccine eligibility,” said a One Medical staffer. “A quick Google search indicates that this is not consistent with many states’ requirements… I am concerned about advertising an overly permissive approach.”

“It seems crucial to at least attempt to ensure that the vaccines are going into the ‘right’ people’s arms.”

– a One Medical staff member

As ineligible patients began to get vaccines, staff began raising concerns that word was spreading about One Medical’s lax enforcement of eligibility requirements.

“I’ve had a few patients straight up tell me that once they realized there was no screening that they would be telling their friends…” another medical provider in California wrote. “My partner and I were shocked when we got ours through One Med… that at no point were we asked if we met criteria — let alone asked to prove it.”

Employees were told not to try to enforce the rules barring ineligible patients. “Scanning schedules and cancelling appointments [for ineligible patients] is not recommended,” Spencer Blackman, the director of clinical education at the company said in a communication to a range of staff. He added in another note to a doctor, “If this person sees themself in a tier that is being vaccinated they can attest to that and make an appointment. You don’t get to make the decision if someone ‘gets’ [a] vaccine or not.”

“We are not policing,” Blackman wrote in January, setting off objections in internal company communications.

When asked why One Medical did not verify eligibility, chief medical officer Andrew Diamond said, “There was never guidance that said ‘do not verify’… that would be counter to our principles.” When told NPR was in possession of communications that indicated otherwise, he responded, “that’s clearly not the guidance, nor is that the intent of the guidance. We’ve been far clearer since then.”

“If we don’t ‘police’ we contribute to inequity that rewards those who choose to lie/deceive … As a medical company with tech skills we CAN do more.”

– a One Medical staff member

In fact, many localities require medical providers to check for eligibility documentation. In Los Angeles County, where One Medical has been provided thousands of doses, vaccination is limited currently to healthcare workers, long-term care facility residents, and persons over the age of 65. Proper documentation of eligibility is required for vaccination. “Providers are then responsible for confirming eligibility responses and requesting accepted documentation of eligibility, once [the patient] arrives for onsite appointment,” an L.A. County Department of Public Health spokesperson said.

And in Alameda County, where the company was given close to 1,000 doses, the public health department said that personal ID and proof of a health care role is “required” for the vaccine doses that One Medical received.

As Forbes was preparing a story about One Medical’s practices, One Medical leadership sent out a note to staff warning of consequences, threatening them with “disciplinary action, up to and including termination” if they leaked internal communications. One Medical disputed this characterization. “One Medical is not, and has never been an organization that threatens its staff,” a spokesperson said, characterizing the note as merely “reminders about our business code of conduct.”

Regulators take action

It is not clear how many ineligible vaccine doses were distributed, and One Medical declined to provide a figure on how many total doses it had administered. But the company has likely provided tens of thousands of doses: Of just two jurisdictions that produced information on the doses it allocated to One Medical, San Francisco County said it had provided the company with 12,000 doses, while L.A. County has provided them with nearly 6,000 doses.

One Medical’s practices have not gone unnoticed by state and local regulators. The Washington State Department of Health told NPR that they had halted allocation of vaccine doses to One Medical due to a complaint received on February 10. “We are currently in communication with One Medical regarding the complaint we received,” a state spokesperson said. “We are removing them from the state’s Vaccine Locations webpage and One Medical will not be receiving vaccine from us until this issue is resolved.” One Medical disputed the reason for the halt, and said that it was a misunderstanding.

Bob Ferguson, the attorney general of Washington state, is also concerned about the wider issue of ineligible patients receiving COVID-19 vaccinations. While not commenting on whether or not there were any ongoing investigations into the topic, or on any individual company, a spokesperson for the attorney general said that Ferguson was “extremely concerned. And he has had conversations with his team about this issue.”

Los Angeles County’s Department of Public Health has also received a complaint about One Medical — and has reached out to express a warning by phone and email. “Public Health told One Medical if there are breaches and they are not holding tight to our priority groups, and checking and validating groups, we could not allocate vaccine to them any longer,” a spokesperson said. “We reinforced the fact that we could not provide vaccine to any entity not following our partner guidance for checking and ensuring people getting vaccinated are part of our priority groups.” One Medical claimed that complaints and warnings are both common for medical providers.

In Alameda County, California, which includes Oakland, the Public Health Department said that One Medical had received 975 doses of the COVID-19 vaccine, but received no more after the health care company indicated its desire to vaccinate ineligible patients. “Alameda County did not fulfill One Medical’s next request in early February for additional doses when they indicated that they planned to vaccinate more than their health care workers (who were the only approved group prioritized for vaccinations at the time),” said a county spokesperson. One Medical said that this explanation was “categorically untrue,” but did not contest that their vaccine allocation has not continued beyond the original 975 doses.

In San Francisco, where One Medical’s headquarters are based, the county’s Department of Public Health stressed: “One Medical was engaged primarily to provide vaccine to in-home support services (IHSS), other in-home care providers and healthcare workers… SF DPH expects all its vaccine provider partners to follow State and SF DPH vaccination eligibility guidelines.”

One Medical contested several elements of this story, claiming that it “does not allow for ineligible persons to be vaccinated knowingly.” It also said that it had fired several members of its clinical staff due to disregard for eligibility requirements.

“We are doing absolutely everything in our power to vaccinate as many eligible people as possible,” said Diamond, the chief medical officer of One Medical, attributing difficulties to the “fog of war” that occurs during a period of “myriad uncertainties, conflicting jurisdictional guidance and profound public anxieties.”

The reviews will seek to determine whether U.S. firms in these sectors are relying too much on foreign suppliers, particularly those in China, a senior administration official told reporters. They will also consider other vulnerabilities, like extreme weather and environmental factors.

“Clearly we are looking at the risks posed by dependence on competitor nations, but that is only one of a range of risks we are looking at,” the administration official said.

The order will also direct yearlong reviews for six sectors: defense, public health, information technology, transportation, energy and food production.

Those reviews will be “modeled after the process the Defense Department uses to regularly evaluate and strengthen the defense industrial base,” the official said.

Remedies unclear: If risks are identified in the supply chains for critical sectors, the administration will aim to push those companies to move their suppliers out of countries like China and back to the U.S. mainland or allied nations.

“Resilient supply chains are not the same thing as all products being made in America,” said a second senior official. “That’s not our intention here.”

Any strict directive from the White House for firms to relocate to the U.S. would risk angering allies like Canada and the European Union, which Biden already irked by strengthening “Buy American” provisions on his first day in office by making it more difficult for foreign companies to supply the U.S. government.

But how the White House will prod companies remains to be seen. If the risks are dire, the Biden administration could use the Defense Production Act, a Cold War-era emergency law, to force companies to produce certain goods domestically. Or the president could work with Congress to fashion incentives and worker-training programs to get suppliers to relocate to the U.S. or allies.

For now, the White House is not ”taking anything off the table,” the first official said, and strategies to fix the supply chains will depend on the weak spots identified.

Shortages abound: The order comes as automakers around the U.S. reel from a global shortage in semiconductors — the computer chips in everything from cell phones to SUVs — forcing manufacturers to halt auto production for weeks.

Risks to the battery supply chain are also apparent. Ford and Volkswagen recently told U.S. trade authorities that they would have to delay production of their new electric vehicle lines if their battery supplier — Korean firm SK Innovation — was blacklisted for intellectual property theft. The International Trade Commission subsequently blocked those batteries from entering the U.S., but gave the automakers a grace period to find new suppliers.

Those situations both came on the heels of widespread shortages of masks and other medical protective gear early in the pandemic, which affected hospitals and average consumers alike. The White House says it aims to get out in front of those issues next time around.

“We’re going to get out of the business of reacting to supply chain crises as they arise, and get into the business of getting ahead of future supply chain problems,” one of the senior administration officials said.

Continue Reading

General

blocked those batteries from entering the U.S., but gave the automakers a grace period to find new suppliers.

Published

on

President Joe Biden will sign an executive order on Wednesday to review the global supply chains used by four key industries in an effort to avoid the shortages in medical equipment, semiconductors and other goods seen as critical during the pandemic.

China reliance targeted: Biden’s order will institute 100-day reviews of the global producers and shippers for: computer chips used in consumer products; large-capacity batteries for electric vehicles; pharmaceuticals and their active ingredients; and critical minerals used in electronics.
A national health care provider has administered COVID-19 vaccinations to people deemed ineligible for the scarce vaccine by local health departments, including people with connections to company leaders and customers of its concierge medical service, according to internal communications leaked to NPR.
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San Francisco-based One Medical has been allocated thousands of vaccine doses by local health departments in some of the areas they provide medical services. Ineligible individuals with connections to company leadership were set up with vaccine appointments, and patients who were disqualified from receiving the vaccine were nonetheless permitted to skip the line ahead of other high-risk patients.

The problems have occurred in numerous company locations across several states. The Washington State Department of Health, citing a complaint it received this month, told NPR it had halted COVID-19 vaccine distribution to the company. Other regulators have also received complaints or stopped providing the vaccine.

One Medical has branded itself a high-end health care provider serving a relatively affluent clientele that pays a $199 fee annually to receive easy online access to appointments, telemedicine and access to a streamlined, tech-focused medical experience. The company went public with an IPO in January 2020, with a valuation in the billions.

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One Medical’s shortcomings take place amid broader anecdotal evidence that suggests patients throughout the country are skipping the line due in part to loose enforcement. The situation highlights a serious ethical issue: Determining who is entitled to a vaccine at a time of scarce availability and who is responsible for enforcing eligibility rules.

Experts say an appropriate system for vaccine distribution focuses on first targeting those most at risk for serious consequences from COVID-19. “We’re trying to focus on those individuals who are most likely to develop severe illness or death, and to most likely be exposed to the virus,” said Gabriel Lázaro-Muñoz, who teaches medical ethics and health policy at the Baylor College of Medicine. “The overall goal is to save as many lives as possible, and with that we are not valuing any life over another.”

One Medical claims it does not allow for ineligible patients to be vaccinated knowingly, and that it was confident that it was “doing everything reasonably in our power to ensure… our adherence to state and local department of health vaccine eligibility guidelines.” But NPR obtained internal communications that tell a different story.

‘We are not policing’

Messages between doctors, medical practitioners, administrative staff and leadership show that multiple staffers across One Medical locations in several states — Washington, Oregon and California — privately raised the alarm about what they believed were lax oversight and inappropriate practices within the organization. They also show what appear to be favors done for those close to the organization’s senior staff.

“It seems if you don’t screen out those jumping the [queue], then many will jump in the line and push those that need the vaccine further behind, delaying a potentially life saving injection. This could impact MANY members,” one doctor in California wrote to his colleagues in January, according to the internal documents.

“I have had two [patients] today, both in their 20-30s without risk factors and are tech workers who have gotten their covid vaccines. One was thru us,” wrote another One Medical doctor in Washington state. “I’m curious how these [people] are able to sign up for vaccines when we have a long list of higher priority [patients]? … I just want to understand how they can be prioritized for a vaccine when those at higher tiers have to wait.”

These internal communications indicate that ineligible friends and family of One Medical leadership were vaccinated, as were work-from-home administrative, support and IT staff at its headquarters in San Francisco. While healthcare workers waited in line in January, One Medical made the decision to offer the vaccine to any of its San Francisco County staff, regardless of whether they were patient-facing staff.

Lázaro-Muñoz, the ethics professor, said that offering the vaccine to all staff regardless of whether they see patients was unethical.

“There might not be regulations stopping this company from giving [the COVID vaccine] to their employees. But from an ethical standpoint, when you look at what is right and wrong, this is wrong,” Lázaro-Muñoz told NPR. “Your life and the life of your co-workers and those who work in this company is not any more valuable than the life of the elderly people that are not getting access to that vaccine, thanks to your criteria and system of distributing that vaccine.”

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One Medical said that it had asked some of its staff to volunteer time in their clinics. However, all of its staff in San Francisco County were provided an opportunity to receive the vaccine, regardless of the nature of their job.

Further, patients of One Medical who were ineligible to be vaccinated based on local guidelines were also permitted to book vaccination appointments through an online portal. So was at least one executive of a partner organization with One Medical. Internal communications show providers trying to get eligible health care workers vaccinated, but instead told to put them on a wait list.

“Why are young patients without health problems, on a trial membership… allowed to book and receive a covid vaccine while healthcare workers are being waitlisted?” one medical professional asked in January. “I just saw two appointments for such.”

There were also shortcomings with the company’s system. A question asking patients whether they were in an eligible category was not added to the online portal until Jan. 14, though One Medical started vaccinating patients on Jan. 1. During this two-week period, COVID-19 cases in the United States reached its highest peak.

Following this, the internal documents show that in January, even if a patient noted that they were not in an eligible category for vaccination, some could continue to book an appointment for a COVID-19 vaccine. Suggestions on how the tech-heavy company could use algorithms to scan for ineligible patients were turned down.

The tech-heavy company said that blocking ineligible patients from booking vaccination appointments would have called for a complete overhaul of their system and was too technologically difficult to rebuild in the required timeframe.

The documents also show that in January One Medical was not verifying the eligibility of patients it vaccinated by requiring ID or other evidence at the point of vaccine administration.

“I have questions about our approach of not requiring [patients] to bring proof of vaccine eligibility,” said a One Medical staffer. “A quick Google search indicates that this is not consistent with many states’ requirements… I am concerned about advertising an overly permissive approach.”

“It seems crucial to at least attempt to ensure that the vaccines are going into the ‘right’ people’s arms.”

– a One Medical staff member

As ineligible patients began to get vaccines, staff began raising concerns that word was spreading about One Medical’s lax enforcement of eligibility requirements.

“I’ve had a few patients straight up tell me that once they realized there was no screening that they would be telling their friends…” another medical provider in California wrote. “My partner and I were shocked when we got ours through One Med… that at no point were we asked if we met criteria — let alone asked to prove it.”

Employees were told not to try to enforce the rules barring ineligible patients. “Scanning schedules and cancelling appointments [for ineligible patients] is not recommended,” Spencer Blackman, the director of clinical education at the company said in a communication to a range of staff. He added in another note to a doctor, “If this person sees themself in a tier that is being vaccinated they can attest to that and make an appointment. You don’t get to make the decision if someone ‘gets’ [a] vaccine or not.”

“We are not policing,” Blackman wrote in January, setting off objections in internal company communications.

When asked why One Medical did not verify eligibility, chief medical officer Andrew Diamond said, “There was never guidance that said ‘do not verify’… that would be counter to our principles.” When told NPR was in possession of communications that indicated otherwise, he responded, “that’s clearly not the guidance, nor is that the intent of the guidance. We’ve been far clearer since then.”

“If we don’t ‘police’ we contribute to inequity that rewards those who choose to lie/deceive … As a medical company with tech skills we CAN do more.”

– a One Medical staff member

In fact, many localities require medical providers to check for eligibility documentation. In Los Angeles County, where One Medical has been provided thousands of doses, vaccination is limited currently to healthcare workers, long-term care facility residents, and persons over the age of 65. Proper documentation of eligibility is required for vaccination. “Providers are then responsible for confirming eligibility responses and requesting accepted documentation of eligibility, once [the patient] arrives for onsite appointment,” an L.A. County Department of Public Health spokesperson said.

And in Alameda County, where the company was given close to 1,000 doses, the public health department said that personal ID and proof of a health care role is “required” for the vaccine doses that One Medical received.

As Forbes was preparing a story about One Medical’s practices, One Medical leadership sent out a note to staff warning of consequences, threatening them with “disciplinary action, up to and including termination” if they leaked internal communications. One Medical disputed this characterization. “One Medical is not, and has never been an organization that threatens its staff,” a spokesperson said, characterizing the note as merely “reminders about our business code of conduct.”

Regulators take action

It is not clear how many ineligible vaccine doses were distributed, and One Medical declined to provide a figure on how many total doses it had administered. But the company has likely provided tens of thousands of doses: Of just two jurisdictions that produced information on the doses it allocated to One Medical, San Francisco County said it had provided the company with 12,000 doses, while L.A. County has provided them with nearly 6,000 doses.

One Medical’s practices have not gone unnoticed by state and local regulators. The Washington State Department of Health told NPR that they had halted allocation of vaccine doses to One Medical due to a complaint received on February 10. “We are currently in communication with One Medical regarding the complaint we received,” a state spokesperson said. “We are removing them from the state’s Vaccine Locations webpage and One Medical will not be receiving vaccine from us until this issue is resolved.” One Medical disputed the reason for the halt, and said that it was a misunderstanding.

Bob Ferguson, the attorney general of Washington state, is also concerned about the wider issue of ineligible patients receiving COVID-19 vaccinations. While not commenting on whether or not there were any ongoing investigations into the topic, or on any individual company, a spokesperson for the attorney general said that Ferguson was “extremely concerned. And he has had conversations with his team about this issue.”

Los Angeles County’s Department of Public Health has also received a complaint about One Medical — and has reached out to express a warning by phone and email. “Public Health told One Medical if there are breaches and they are not holding tight to our priority groups, and checking and validating groups, we could not allocate vaccine to them any longer,” a spokesperson said. “We reinforced the fact that we could not provide vaccine to any entity not following our partner guidance for checking and ensuring people getting vaccinated are part of our priority groups.” One Medical claimed that complaints and warnings are both common for medical providers.

In Alameda County, California, which includes Oakland, the Public Health Department said that One Medical had received 975 doses of the COVID-19 vaccine, but received no more after the health care company indicated its desire to vaccinate ineligible patients. “Alameda County did not fulfill One Medical’s next request in early February for additional doses when they indicated that they planned to vaccinate more than their health care workers (who were the only approved group prioritized for vaccinations at the time),” said a county spokesperson. One Medical said that this explanation was “categorically untrue,” but did not contest that their vaccine allocation has not continued beyond the original 975 doses.

In San Francisco, where One Medical’s headquarters are based, the county’s Department of Public Health stressed: “One Medical was engaged primarily to provide vaccine to in-home support services (IHSS), other in-home care providers and healthcare workers… SF DPH expects all its vaccine provider partners to follow State and SF DPH vaccination eligibility guidelines.”

One Medical contested several elements of this story, claiming that it “does not allow for ineligible persons to be vaccinated knowingly.” It also said that it had fired several members of its clinical staff due to disregard for eligibility requirements.

“We are doing absolutely everything in our power to vaccinate as many eligible people as possible,” said Diamond, the chief medical officer of One Medical, attributing difficulties to the “fog of war” that occurs during a period of “myriad uncertainties, conflicting jurisdictional guidance and profound public anxieties.”

The reviews will seek to determine whether U.S. firms in these sectors are relying too much on foreign suppliers, particularly those in China, a senior administration official told reporters. They will also consider other vulnerabilities, like extreme weather and environmental factors.

“Clearly we are looking at the risks posed by dependence on competitor nations, but that is only one of a range of risks we are looking at,” the administration official said.

The order will also direct yearlong reviews for six sectors: defense, public health, information technology, transportation, energy and food production.

Those reviews will be “modeled after the process the Defense Department uses to regularly evaluate and strengthen the defense industrial base,” the official said.

Remedies unclear: If risks are identified in the supply chains for critical sectors, the administration will aim to push those companies to move their suppliers out of countries like China and back to the U.S. mainland or allied nations.

“Resilient supply chains are not the same thing as all products being made in America,” said a second senior official. “That’s not our intention here.”

Any strict directive from the White House for firms to relocate to the U.S. would risk angering allies like Canada and the European Union, which Biden already irked by strengthening “Buy American” provisions on his first day in office by making it more difficult for foreign companies to supply the U.S. government.

But how the White House will prod companies remains to be seen. If the risks are dire, the Biden administration could use the Defense Production Act, a Cold War-era emergency law, to force companies to produce certain goods domestically. Or the president could work with Congress to fashion incentives and worker-training programs to get suppliers to relocate to the U.S. or allies.

For now, the White House is not ”taking anything off the table,” the first official said, and strategies to fix the supply chains will depend on the weak spots identified.

Shortages abound: The order comes as automakers around the U.S. reel from a global shortage in semiconductors — the computer chips in everything from cell phones to SUVs — forcing manufacturers to halt auto production for weeks.

Risks to the battery supply chain are also apparent. Ford and Volkswagen recently told U.S. trade authorities that they would have to delay production of their new electric vehicle lines if their battery supplier — Korean firm SK Innovation — was blacklisted for intellectual property theft. The International Trade Commission subsequently blocked those batteries from entering the U.S., but gave the automakers a grace period to find new suppliers.

Those situations both came on the heels of widespread shortages of masks and other medical protective gear early in the pandemic, which affected hospitals and average consumers alike. The White House says it aims to get out in front of those issues next time around.

“We’re going to get out of the business of reacting to supply chain crises as they arise, and get into the business of getting ahead of future supply chain problems,” one of the senior administration officials said.

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