How 1 scheduling software company with a high-powered lobbyist left competitors in the dust in race for a Utah vaccine contract
Firm got millions in public contracts but fewer than half of local health districts opted in
Utah Investigative Journalism Project
Editor’s note: The following story was reported by The Utah Investigative Journalism Project in partnership with The Park Record, The Daily Herald, The Standard Examiner, The Park Record and The Spectrum News.
Companies of all stripes hoping to get in on the massive infusion of public dollars in the fight against the COVID-19 pandemic were aggressive and fast in ramping up amid the fierce competition.
Among these were the makers of business scheduling software that could be adapted to streamline the task of getting shots into hundreds of millions of arms. By mid-December there were dozens of them jockeying for position but one emerged as the clear winner in the Utah market: a company named Salesforce.
Not only did the global company with headquarters in San Francisco land a $1.8 million contract with the Utah Department of Technology Services for a vaccination scheduling platform made available to all county health departments, but it scooped up the entire $4.5 million in federal CARES Act money spent by the state for such software services. These included projects with Utah’s departments of transportation, technology services, environmental quality and the division of risk management.
Salesforce didn’t have to go through a new competitive bidding process for these contracts. It was prequalified through an existing state cooperative contract for these other non-vaccine scheduling services, according to the state’s Department of Technology Services.
Some state and local health officials have raised concerns about the selection, a conflict of interest with the powerful lobbyist involved and suggested politics played an outsized role. And while several counties using the Salesforce scheduler praise its effectiveness, fewer than half the local health districts in the state, serving a bit more than 40% of the population, have adopted it. The Summit County Health Department, for one, already had its own system in place over a month before Salesforce contracts were even offered.
Pressure, politics and lobbying
“I’m not sure what is going on with this Salesforce issue,” Utah Department of Health Executive Director Richard Saunders emailed Phil Dean, then interim director for the Governor’s Office of Management and Budget early last November.
Saunders told Dean and others copied on that email that he and Rich Lakin, the health department’s immunization manager, did not intend to use Salesforce for vaccine distribution.
“I’ve since received at least three phone calls asking if we are going to use Salesforce, and now this email. I would be very grateful if someone would share the other reasons, if any, we need to be using Salesforce,” Saunders said in that Nov. 3 email.
“I feel like I’m being rushed to make a decision which is not a good way to proceed,” Lakin said in his email response to Dean.
Despite those objections, the state contract with Salesforce was signed the next month.
Lincoln Shurtz, then the government affairs director for the Utah Association of Counties, provided the heavy lift for Salesforce in the state, emails obtained through open-records requests show. In addition to his duties with the county group, funded by public monies, Shurtz signed on as the Utah lobbyist for Salesforce last July.
Shurtz said there was nothing nefarious with his work for this client — one of 29 for which he is currently registered as a lobbyist — adding that the county association actually tasked him with the project and state decision-makers knew of his conflict of interest.
The deal just made sense, he said.
“We had numerous counties trying to architect their own software solutions from the ground up,” Shurtz said. “So the cost of doing that was going to be more expensive than a collective solution.”
He noted that the Salesforce software has served the counties well and is also used by the federal Centers for Disease Control and Prevention (CDC).
In truth, only five of the state’s 13 local health districts signed on to use the program — and one of those five abandoned the software after giving it a trial run.
Still, the four local health districts currently using Salesforce — Salt Lake, San Juan, Tooele and Weber-Morgan — cover 42 percent of the state’s population, according to state technology services spokesperson Stephanie Weteling.
Vaccines began arriving in Utah in mid-December, initially earmarked for frontline health care workers. By year’s end, people 75 and older could begin signing up.
But the five local health districts who opted into Salesforce’s platform didn’t sign on until February, or in one case early March.
Utah’s latest statistics show nearly 2.5 million vaccines have been administered. But more than a fifth of those shots — 559,921 — had already been put into residents’ arms before the Salesforce project started scheduling appointments.
Because of that slow start, how much of an assist the $1.8 million Salesforce program actually provided is difficult to measure. But local health districts were tasked with quickly pulling together all available resources to beat back the virus. The state’s second and third most populous counties — Utah County and Davis County — chose not to sign on to Salesforce because they had already designed their own COVID-specific vaccine scheduling systems in advance. The same was true for Summit County.
Health departments decide
Derek Siddoway, spokesperson for the Summit County Health Department, says the agency was working hard on outreach and prepping residents for use of their VAMS system.
“We were driving signups prior to our vaccine clinic opening through an email list,” Siddoway says. “We tried to capture as many individuals as we could ahead of time and that continued through January and February.”
When e-mail failed, a contracted call center reached residents who lacked internet access.
The outreach was so successful and residents so engaged that “we were giving all our vaccines out every weekend for a month and a half, kind of like Black Friday,” he says.
The efforts were successful as Centers for Disease Control shows the county to be the leader in the state, with over 40% of the population fully vaccinated.
The Weber-Morgan Health Department, which receives 8% of Utah’s weekly vaccine allotment based on population, began scheduling vaccinations in early January. Weber is Utah’s fourth most populous county.
Weber-Morgan began using Salesforce in early March, but the more rural Morgan area stuck with the simpler JotForm system instead. Weber-Morgan Executive Director Brian Cowan described Salesforce as a “one-size-fits-all” service.
“In some ways we haven’t been able to tailor it specific to what we would like, but in other ways it improved our process,” Cowan said, noting it streamlined reporting to the state and also cut down on data entry errors.
“We’ve definitely seen more benefits with the transition than detriments,” Cowan said.
The Bear River Health Department, which serves Box Elder, Cache and Rich Counties, test-drove the system in-house and decided against transitioning from the JotForm program it already had in place.
“In the end, we wanted to keep it very simple for the public and create less barriers to get their vaccines,” Director Jordan Mathis said, noting that Jotform was “super easy for the public on the front end”
He also had misgivings as to how Salesforce became the state’s product of choice.
“I think there was some concern with how the product came to be made available to us,” Mathis said. “There was a lot of politics involved and we weren’t sure it would be the best product for public health.”
Troy Davis, a nurse supervisor with Salt Lake County Health Department, said the state’s most populous county began using Salesforce at the end of February to schedule appointments. Prior to that time, the county used the ezEMRx system.
Davis credited Salesforce with providing the streamlined capability to schedule multiple days under one event — rather than having to create separate events for each of several vaccination locations every day.
Like other agencies, though, he says they had to field roughly 1,000 calls a day, from those lacking e-mails or internet.
Leena Chapman, Tooele’s family, school and health secretary, said when her county switched to Salesforce in April it added more work on the front end during the scheduling process, but “once they’re in clinic and on the back end, it’s a lot more accurate.”
Mike Moulton, San Juan’s interim public health director, said his department switched to Salesforce in early March.
“There were a lot of issues that came up that we needed to iron out,” Moulton says, “but they were patient and persistent to address all our concerns and customize the program to be as useful as possible.”
Timing the shot
SalesForce lobbyist Shurtz said that vaccine rollouts were delayed in part while the state awaited key guidance from the CDC.
“To get those guidelines, get into a proven concept and then roll it out,” took until mid-February, he said.
And yet other departments were ready to hit the ground running in January, like the Summit County Health Department, which leads the state in vaccinations.
Summit’s health department looked into Salesforce but decided against switching systems midway into the rollout.
”It took us about a month to get things up and running smoothly,” Siddoway said. “At that point, we decided that if it wasn’t broke, we weren’t going to fix it.”
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