New York City health officials regularly overpaid a contractor to administer COVID-19 tests and vaccines, paying as much as $14,050 for a single COVID-19 vaccination, an audit shows.
Officials let Executive Medical Services, a contractor awarded a contract early in the COVID-19 pandemic, to set its own staffing levels, leading to uncontrolled costs, New York City Comptroller Brad Lander found.
That led to exorbitant costs and low efficiency, with an analysis of invoices showing that only one vaccination was administered for every two billed hours.
“Emergency contracting allows the City to stand up vital services in times of crisis, but demands heightened vigilance to safeguard the fiscal interests of the City. Our audit reveals significant weaknesses in the control mechanisms that impact past, present, and potentially future emergencies. By addressing these challenges head-on, agencies can better spend New York City’s taxpayer dollars wisely and efficiently, even in crises,” Lander, a Democrat, said in a statement.
The New York City Department of Health and Mental Health Services, which paid Executive Medical Services, did not respond to a request for comment.
Executive Medical Services, also known as Affiliated Physicians, did not return an inquiry.
Contract
The agency originally agreed to pay Executive Medical Services up to $500,000. After six amendments to the contract, stretching it through the end of 2022, the agency paid the contractor some $390 million.
The contract paid Executive Medical Services to create long-term and temporary, or popup, sites for COVID-19 testing or vaccination. Out of 302 sites, 267 were temporary.
Lander’s office investigated to see whether the Department of Health made sure payments to the contractor were legal, that staffing levels were reasonably aligned with demand, and whether sites were established equitably under the contract provisions.
While auditors found sites were set up in communities heavily impacted by COVID-19, as required, and that invoices were usually supported by documentation, they uncovered concerning data on staffing levels and costs.
The department “did not adequately control or monitor staffing levels,” Lander’s office said.
Under the contract, Executive Medical Services would be paid $150 per hour all sites, plus $100 per test administered and $25 per vaccine administered. The department was the party responsible for monitoring contractor performance, but the plan lacked standards for whether sites were appropriately staffed based on demand, auditors said. That left the department with “limited means of effectively controlling expenditures or minimizing waste.”
Auditors analyzed a sample of 49 invoices and documentation for the invoices and found that one test was administered per 1.6 staff hours, and that one vaccination was administered every two staff hours.
Auditors also found ballooning costs, including payments of up to $14,050 for each vaccination administered and payments of up to $2,040 for each test carried out.
Costs ranged significantly across different sites. The lowest payment per vaccine administered was $70, and the lowest payment per test carried out was $128.
The agency told auditors that it helped set staffing levels according to U.S. Centers for Disease Control and Prevention guidance and that a number of workers did not directly administer tests or vaccinations, including managers and observers. Officials said staffing numbers were “pre- determined based on the layout of a particular venue, number of vaccine products offered and anticipated demand.”
“The lives of New Yorkers were saved because of the City’s efforts to provide testing and vaccination services. It is not possible to place a monetary value on a life,” officials added.
Other Failings
The audit also found that officials began requiring the contractor to submit daily summary reports in December 2020.
The reports included the number of staffers at each site as well as the work performed.
The reports were supposed to be signed by an Executive Medical Services worker as well as a Department of Health employee.
A sample review, though, found that a quarter of the reports were not signed by the latter.
The lack of approval by the department means the agency “did not have independent confirmation” of data from some sites before paying the contractor, auditors said.
In another failing, the department did not complete a vendor performance evaluation for the contract within a timeframe required by the city’s Procurement Policy Board.
Recommendations
Auditors recommended that the department develop a standardized process for how staffing levels are set for contracts, conduct regular analyses of contracts to make sure they’re being met in an efficient manner, and to make sure the evaluations are filled out as required.
The department agreed with those recommendations.
The department diverged from the comptroller on two other recommendations.
Officials said processes are already in place for making sure certain documents, such as the summary reports, are signed by agency staff, and for documenting why sites are opened or closed.
Lander’s office told agencies in a letter after the audit was published that they should take steps to make sure emergency contractors are handled well.
Article cross-posted from our premium news partners at The Epoch Times.
Two Storms, One Harvest
Every food crisis in living memory has been a one-shock event. The 2008 price spike was a commodity bubble. The 2020 shortages were a logistics failure. The 2022 grain scare was a war on one exporter’s ports. Each time, the system bent, adjusted, and recovered, and each time the experts assured us afterward that global markets are simply too big and too diversified to fail.
What nobody in Washington seems eager to discuss is that 2026 is shaping up to be something the modern food system has never actually faced. Two independent shocks, one climatic and one geopolitical, are converging on the same harvest cycle at the same time. Not sequentially. Simultaneously.
Start with the weather. The Pacific Ocean is currently building toward what forecasters now openly call a record event. NOAA’s Climate Prediction Center puts the odds of at least a strong El Niño near 88 percent, with roughly two in three odds it reaches “very strong” status, the tier reserved for perhaps three or four events in the entire satellite era. Every major global model now projects a median peak in Super El Niño territory, and most of them project it exceeding the 2015-16 event, which until now held the modern record. Sea surface anomalies were already brushing the super threshold in mid-July, months before these events normally peak. The atmosphere has already shifted into El Niño mode, and the event is forecast to crest in late fall and early winter.
This is not about “climate change.” It’s about the standard cycles of weather, and the cycle we’re currently in is one that has likely devastated societies in the past. We’re better prepared as a society today, but not all Americans are equally prepared.
Serious households have started doing the quiet math on their own. Grocery bills tell part of the story, and the forecast maps tell the rest, which is why long-term food storage has moved from fringe hobby to mainstream line item in the family budget, with established suppliers like Heaven’s Harvest seeing demand from people who five years ago would have rolled their eyes at the idea. That instinct is not paranoia. It is pattern recognition, and the pattern is worth walking through carefully.
Editor’s Note: Heaven’s Harvest IS a sponsor, but the warnings of this article are real and would be written even if we didn’t have a survival food sponsor. With that said, those who take advantage of what they offer can use promo code “Patriot” for 15% off.
The Fertilizer Clock Is Already Running
While the Pacific warms, the second shock has been unfolding in the Strait of Hormuz. The conflict with Iran turned the world’s most important energy chokepoint into a contested waterway, and the consequences reach far beyond the gas pump. Roughly a third of global fertilizer trade moves through Hormuz, and the disruption sent urea prices up 86 percent year over year by March, with a 53 percent jump in a single month.
The World Bank projects energy prices rising about 24 percent in 2026 and fertilizer about 31 percent. By its own accounting, fertilizer prices ran 35 percent higher in the first five months of this year than the same period last year.
Here is the mechanism the nightly news will not explain. Fertilizer is not a grocery item. It is a time-delayed input. The nitrogen a farmer in Iowa or Punjab could not afford to apply this spring does not show up as a problem this spring. It shows up as a thinner harvest six to twelve months later.
The World Bank’s own food security brief concedes that the effects of reduced applications earlier this season “are likely to become visible only later in harvest outcomes.” Translate that from institutional language into plain English and it means this. The damage is already done, it is already in the ground, and we are simply waiting for it to arrive on the shelf.
Now check the calendar. Six to twelve months from the spring planting season lands us squarely in late 2026 and early 2027. Which is precisely when the strongest El Niño in the instrumental record is forecast to peak, bringing its signature droughts to Southeast Asia, Australia, southern Africa, northern Brazil, and South Asia, the very regions that grow the world’s rice, sugar, and oilseeds.
The World Bank warns openly that a strong El Niño “could disrupt multiple crop belts simultaneously” on top of the conflict-driven input costs. Their baseline projection assumes the Middle East disruptions ease by autumn. What in the last two years of Middle East history suggests that assumption is safe?
The System Has No Slack Left
The comfortable answer is that global markets always adjust. But adjustment requires slack, and the slack is gone. Global cereal production is expected to decline from last year’s records even before El Niño does its work. The UN World Food Programme, hardly a den of right-wing preppers, is calling this the most significant disruption to its supply chains since Covid and the invasion of Ukraine, and its supply chain director put the stakes bluntly.
Today’s supply chain challenges are tomorrow’s hunger crisis.
There is also a political dimension that markets cannot price. When food gets scarce, governments do not behave like economists. They behave like politicians. Export bans, hoarding mandates, and panic buying at the national level turned the modest rice shortfall of 2008 into a global crisis, and analysts are already warning that import-dependent nations are the first dominoes.
The 2015-16 Super El Niño, a far weaker event than what is now forecast, threw tens of millions into food stress across Africa and Asia. This one is projected to be stronger, and it arrives with fertilizer already rationed by price and shipping lanes already contested by missiles.
What Joseph Knew
Scripture does not treat preparation for lean years as faithlessness. It treats it as wisdom delivered in advance to those willing to act on it.
Behold, there come seven years of great plenty throughout all the land of Egypt: And there shall arise after them seven years of famine; and all the plenty shall be forgotten in the land of Egypt.
Joseph did not respond to that warning with a hashtag or a committee. He stored grain during the years of abundance, and when the famine came, Egypt stood while its neighbors begged. The lesson is not that famine is certain. It is that the time to prepare is precisely when preparation still looks optional.
Nobody who filled a pantry in a year of plenty has ever regretted it, and nobody standing in an empty aisle has ever been glad he waited for certainty.
None of this calls for panic, and panic is the enemy of sound judgment anyway. It calls for the same unglamorous prudence our grandparents considered ordinary. Keep some cash margin, know your local growers, and put real food in deep storage while it is cheap and available, because the entire arc of this story is that cheap and available is a closing window.
Families looking for a straightforward place to start can visit Heaven’s Harvest and use promo code Patriot for 15 percent off long-term storable food. The forecasts may yet soften, the strait may yet reopen, and we should pray they do. But hope is a fine thing to hold and a foolish thing to eat.
