SACRAMENTO, Calif. — California Gov. Gavin Newsom has embraced Silicon Valley tech companies and health care industry titans in response to the covid-19 pandemic like no other governor in America — routinely outsourcing life-or-death public health duties to his allies in the private sector.
At least 30 tech and health care companies have received lucrative, no-bid government contracts, or helped fund and carry out critical public health activities during the state’s battle against the coronavirus, a KHN analysis has found. The vast majority are Newsom supporters and donors who have contributed more than $113 million to his political campaigns and charitable causes, or to fund his policy initiatives, since his first run for statewide office in 2010.
For instance, the San Francisco-based software company Salesforce — whose CEO, Marc Benioff, is a repeat donor and is so tight with the governor that Newsom named him the godfather of his first child — helped create My Turn, California’s centralized vaccine clearinghouse, which has been unpopular among Californians seeking shots and has so far cost the state $93 million.
Verily Life Sciences, a sister company of Google, another deep-pocketed Newsom donor, received a no-bid contract in March 2020 to expand covid testing — a $72 million venture that the state later retreated on. And after Newsom handed another no-bid testing contract — now valued at $600 million — to OptumServe, its parent company, national insurance giant UnitedHealth Group dropped $100,000 into a campaign account he can tap to fight the recall effort against him.
Newsom’s unprecedented reliance on private companies — including health and technology start-ups — has come at the expense of California’s overtaxed and underfunded public health system. Current and former public health officials say Newsom has entrusted the essential work of government to private-sector health and tech allies, hurting the ability of the state and local health departments to respond to the coronavirus pandemic and prepare for future threats.
“This outsourcing is weakening us. The lack of investment in our public health system is weakening us,” said Flojaune Cofer, a former state Department of Public Health epidemiologist and senior director of policy for Public Health Advocates, which has lobbied unsuccessfully for years for more state public health dollars.
“These are companies that are profit-driven, with shareholders. They’re not accountable to the public,” Cofer said. “We can’t rely on them helicoptering in. What if next time it’s not in the interest of the business or it’s not profitable?”
Kathleen Kelly Janus, Newsom’s senior adviser on social innovation, said the governor is “very proud of our innovative public-private partnerships,” which have provided “critical support for Californians in need during this pandemic.”
State Health and Human Services Secretary Dr. Mark Ghaly echoed the praise, saying private-sector companies have filled “important” roles during an unprecedented public health crisis.
The state’s contract with OptumServe has helped dramatically lower covid test turnaround times after a troubled start. Another subsidiary of UnitedHealth Group, OptumInsight, received $41 million to help California rescue its outdated infectious disease reporting and monitoring system last year after it crashed.
“Not only are we much better equipped on all of these things than we were at the beginning, but we are also seeing some success,” Ghaly said, “whether it’s on the vaccination front, which has really picked up and put us in a place of success, or just being able to do testing at a broad scale. So, I feel like we’re in a reasonable position to continue to deal with covid.”
The federal government finances most public health activities in California and significantly boosted funding during the pandemic, but local health departments also rely on state and local money to keep their communities safe.
In his first year as governor, the year before the pandemic, Newsom denied a budget request from California’s 61 local public health departments to provide $50 million in state money per year to help rebuild core public health infrastructure — which had been decimated by decades of budget cuts — despite warnings from his own public health agency that the state wasn’t prepared for what was coming.
After the pandemic struck, Newsom and state lawmakers turned away another budget request to support the local health departments driving California’s pandemic response, this time for $150 million in additional annual infrastructure funding. Facing deficits at the time, the state couldn’t afford it, Newsom said, and federal help was on the way.
Yet covid cases continued to mount, and resources dwindled. Bare-bones staffing meant that some local health departments had to abandon fundamental public health functions, such as contact tracing, communicable disease testing and enforcement of public health orders.
“As the pandemic rages on and without additional resources, some pandemic activities previously funded with federal CARES Act resources simply cannot be sustained,” a coalition of public health officials warned in a late December letter to Newsom and legislative leaders.
Newsom has long promoted tech and private companies as a way to improve government, and has leaned on the private sector throughout his political career, dating to his time as San Francisco mayor from 2004 to 2011, when he called on corporations to contribute to his homelessness initiatives.
And since becoming governor in January 2019, he has regularly held private meetings with health and tech executives, his calendars show, including Facebook CEO Mark Zuckerberg, Google CEO Sundar Pichai and Apple CEO Tim Cook.
“We’re right next door to Silicon Valley, of course, so technology is our friend,” Newsom wrote in his 2013 book, “Citizenville,” arguing that “government needs to adapt to this new technological age.”
With California’s core public health infrastructure already gutted, Newsom funneled taxpayer money to tech and health companies during the pandemic or allowed them to help design and fund certain public health activities.
Other industries have jumped into covid response, including telecommunications and entertainment, but not to the degree of the health and technology sectors.
“It’s not the ideal situation,” said Daniel Zingale, who has steered consequential health policy decisions under three California governors, including Newsom. “What is best for Google is not necessarily best for the people of California.”
Among the corporate titans that have received government contracts to conduct core public health functions is Google’s sister company Verily.
Google and its executives have given more than $10 million to Newsom’s gubernatorial campaigns and special causes since 2010, according to state records. It has infiltrated the state’s pandemic response: The company, along with Apple, helped build a smartphone alert system called CA Notify to assist state and local health officials with contact tracing, a venture Newsom hailed as an innovative, “data-driven” approach to reducing community spread. Google, Apple and Facebook are sharing tracking data with the state to help chart the spread of covid. Google — as well as Facebook, Snapchat, TikTok, Twitter and other platforms — also contributed millions of dollars in free advertising to California, in Newsom’s name, for public health messaging.
Other companies that have received lucrative contracts to help carry out the state’s covid plans include health insurance company Blue Shield of California, which received a $15 million no-bid contract to oversee vaccine allocation and distribution, and the private consulting firm McKinsey & Co., which has received $48 million in government contracts to boost vaccinations and testing and work on genomic sequencing to help track and monitor covid variants. Together, they have given Newsom more than $20 million in campaign and charitable donations since 2010.
Private companies have also helped finance government programs and core public health functions during the pandemic — at times bypassing local public health departments — under the guise of making charitable or governmental contributions, known as “behested payments,“ in Newsom’s name. They have helped fund vaccination clinics, hosted public service announcements on their platforms, and paid for hotel rooms to safely shelter and quarantine homeless people.
Facebook and the Chan Zuckerberg Initiative, the philanthropic organization started by Facebook founder Mark Zuckerberg and his wife, Priscilla Chan, have been among the most generous, and have given $36.5 million to Newsom, either directly or to causes and policy initiatives on his behalf. Much of that money was spent on pandemic response efforts championed by Newsom, such as hotel rooms and child care for front-line health care workers; computers and internet access for kids learning at home; and social services for incarcerated people leaving prison because of covid outbreaks.
Facebook said it is also partnering with the state to deploy pop-up vaccination clinics in hard-hit areas like the Central Valley, Inland Empire and South Los Angeles.
In prepared statements, Google and Facebook said they threw themselves into the pandemic response because they wanted to help struggling workers and businesses in their home state, and to respond to the needs of vulnerable communities.
“We’re doing really well. We got almost 20 million people vaccinated and our test positivity rate is at an all-time low,” Kocher said. “Our public health system was set up to handle small-scale outbreaks like E. coli or hepatitis. Things work better when you build coalitions that go beyond government.”
Public health leaders acknowledge that private-sector participation during an emergency can help the state respond quickly and on a large scale. But by outsourcing so much work to the private sector, they say, California has also undercut its already struggling public health system — and missed an opportunity to invest in it.
Take Verily. Newsom tapped the company to help expand testing to underserved populations, but the state chose to end its relationship with the company in January after county health departments rejected the partnership, in part because testing was not adequately reaching Black and Latino neighborhoods. In addition to requiring that residents have a car and Gmail account, Verily was seen by many local health officials as an outsider that didn’t understand the communities.
It takes years of shoe leather public health work to build trusted relationships within communities, said Dr. Noha Aboelata, founder and CEO of the Roots Community Health Center in the predominantly Black and Latino neighborhood of East Oakland.
“I think what’s not fine is when these corporations are claiming to be the center of equity, when in fact it can manifest as the opposite,” she said. “We’re in a neighborhood where people walk to our clinic, which is why when Verily testing first started and they were drive-up and you needed a Gmail account, most of our community wasn’t able to take advantage of it.”
To fill the gap, the clinic worked with Alameda County to offer old-fashioned walk-up appointments. “We’re very focused on disparities, and we’re definitely seeing the folks who are most at risk,” Aboelata said.
The state took a similar approach to vaccination. Instead of giving local health departments the funding and power to manage their own vaccination programs with community partners, it looked to the private sector again. Among the companies that received a vaccination contract is Color Health Inc., awarded $10 million to run 10 vaccine clinics across the state, among other covid-related work. Since partnering with California, Color has seen its valuation soar to $1.5 billion — helping it achieve “unicorn” start-up status.
As the state’s Silicon Valley partners rake in money, staffing at local health departments has suffered, in part because they don’t have enough funding to hire or replace workers. “It is our biggest commodity and it’s our No. 1 need,” said Kat DeBurgh, executive director of the Health Officers Association of California.
With inadequate staffing to address the pandemic, the state is falling further behind on other basic public health duties, such as updating data systems and technology — many county health departments still rely on fax machines to report lab results — and combating record-setting levels of sexually transmitted diseases such as syphilis.
“We’ve put so many resources into law enforcement and private tech companies instead of public health,” said Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Network. “This is having a devastating impact.”
Dr. Karen Smith, former director of the state Department of Public Health, left the state in July 2019 and now is a consultant with Google Health, one of Big Tech’s forays into the business of health care.
She believes Silicon Valley can improve the state’s crumbling public health infrastructure, especially when it comes to collecting and sharing data, but it can’t be done without substantial investment from the state. “Who the heck still uses fax? Public health doesn’t have the kind of money that tech companies have,” said Smith, who said she wasn’t speaking on behalf of Google.
Without adequate funding to rebuild its infrastructure and hire permanent workers, Smith and others fear California isn’t prepared to ride out the remainder of this pandemic — let alone manage the next public health crisis.
Statewide public health advocacy groups have formed a coalition called “California Can’t Wait” to pressure state lawmakers and Newsom to put more money into the state budget for local public health departments. They’re asking for $200 million annually. Newsom will unveil his latest state budget proposal by mid-May.
“We’re in one of those change-or-die moments,” Capitol health care veteran Zingale said. “Newsom has been at the vanguard of the nation in marshaling the help of our robust technological private sector, and we’re thankful for their contributions, but change is better than charity. I don’t want to show ingratitude, but we should keep our eyes on building a better system.”
KHN data editor Elizabeth Lucas and California politics correspondent Samantha Young contributed to this report.
Methodology: How KHN compiled data about political spending and the role of technology and health care companies in California’s covid response.
Private-sector companies from Silicon Valley and the health care industry have participated in California’s public health response to covid-19 in a variety of ways, big and small. Some have received multimillion-dollar contracts from the state of California to perform testing, vaccination and other activities. Others have donated money and resources to the effort, such as free public health advertising time.
KHN identified the companies that received pandemic-related contracts or work from the state by filing Public Records Act requests with state agencies; searching other sources, including California’s “Released COVID-19 Response Contracts” page; and contacting state agencies and companies directly.
We then searched the California Fair Political Practices Commission website for tech and health care companies that didn’t receive contracts but played a role in the state’s pandemic response by donating money and resources. Through what are known as “behested payments,” these companies donated to charitable causes or Gov. Gavin Newsom’s policy initiatives on his behalf. These contributions included money to help fund and design state public health initiatives such as quarantine hotel rooms.
Based on those searches, we found at least 30 health or technology companies that have participated in the state’s pandemic response: Google and its sister company Verily Life Sciences; Salesforce; Facebook; Apple; McKinsey & Co.; OptumServe and OptumInsight — subsidiaries of national health care company UnitedHealth Group; Netflix; Pandora; Spotify; Zoom Video Communications Inc.; electric car manufacturer BYD; Bloom Energy; Color Health Inc.; DoorDash; Twitter; Amazon; Accenture; Skedulo; Primary.Health; Pfizer; HP Inc.; Microsoft; Snapchat; Blue Shield of California; Kaiser Permanente; Lenovo Inc.; YouTube; and TikTok. The Chan Zuckerberg Initiative, the philanthropic organization started by Facebook founder Mark Zuckerberg and his wife, Priscilla Chan, also participated.
We then searched the California secretary of state’s website to determine which of those companies, and their executives, gave direct political contributions to Newsom’s personal campaign accounts and a ballot measure account run by the governor called “Newsom’s Ballot Measure Committee” during his five campaigns for statewide office since 2010, plus the ongoing recall effort against him.
We found that at least 24 of the tech or health companies that participated in the state’s pandemic response, or their executives, gave direct political contributions to Newsom, made behested payments in his name or both.
Introducing Facebook Graph API v18.0 and Marketing API v18.0
Today, we are releasing Facebook Graph API v18.0 and Marketing API v18.0. As part of this release, we are highlighting changes below that we believe are relevant to parts of our developer community. These changes include announcements, product updates, and notifications on deprecations that we believe are relevant to your application(s)’ integration with our platform.
For a complete list of all changes and their details, please visit our changelog.
Consolidation of Audience Location Status Options for Location Targeting
As previously announced in May 2023, we have consolidated Audience Location Status to our current default option of “People living in or recently in this location” when choosing the type of audience to reach within their Location Targeting selections. This update reflects a consolidation of other previously available options and removal of our “People traveling in this location” option.
We are making this change as part of our ongoing efforts to deliver more value to businesses, simplify our ads system, and streamline our targeting options in order to increase performance efficiency and remove options that have low usage.
This update will apply to new or duplicated campaigns. Existing campaigns created prior to launch will not be entered in this new experience unless they are in draft mode or duplicated.
Add “add_security_recommendation” and “code_expiration_minutes” to WA Message Templates API
Earlier this year, we released WhatsApp’s authentication solution which enabled creating and sending authentication templates with native buttons and preset authentication messages. With the release of Graph API v18, we’re making improvements to the retrieval of authentication templates, making the end-to-end authentication template process easier for BSPs and businesses.
With Graph API v18, BSPs and businesses can have better visibility into preset authentication message template content after creation. Specifically, payloads will return preset content configuration options, in addition to the text used by WhatsApp. This improvement can enable BSPs and businesses to build “edit” UIs for authentication templates that can be constructed on top of the API.
Note that errors may occur when upgrading to Graph API v18 if BSPs or businesses are taking the entire response from the GET request and providing it back to the POST request to update templates. To resolve, the body/header/footer text fields should be dropped before passing back into the API.
Re-launching dev docs and changelogs for creating Call Ads
- Facebook Reels Placement for Call Ads
Meta is releasing the ability to deliver Call Ads through the Facebook Reels platform. Call ads allow users to call businesses in the moment of consideration when they view an ad, and help businesses drive more complex discussions with interested users. This is an opportunity for businesses to advertise with call ads based on peoples’ real-time behavior on Facebook. Under the Ad set Level within Ads Manager, businesses can choose to add “Facebook Reels” Under the Placements section.
- Re-Launching Call Ads via API
On September 12, 2023, we’re providing updated guidance on how to create Call Ads via the API. We are introducing documentation solely for Call Ads, so that 3P developers can more easily create Call Ads’ campaigns and know how to view insights about their ongoing call ad campaigns, including call-related metrics. In the future, we also plan to support Call Add-ons via our API platform. Developers should have access to the general permissions necessary to create general ads in order to create Call Ads via the API platform.
Please refer to developer documentation for additional information.
Deprecations & Breaking Changes
Graph API changes for user granular permission feature
We are updating two graph API endpoints for WhatsAppBusinessAccount. These endpoints are as follows:
- Retrieve message templates associated with WhatsAppBusiness Account
- Retrieve phone numbers associated with WhatsAppBusiness Account
With v18, we are rolling out a new feature “user granular permission”. All existing users who are already added to WhatsAppBusinessAccount will be backfilled and will continue to have access (no impact).
The admin has the flexibility to change these permissions. If the admin changes the permission and removes access to view message templates or phone numbers for one of their users, that specific user will start getting an error message saying you do not have permission to view message templates or phone numbers on all versions v18 and older.
Deprecate legacy metrics naming for IG Media and User Insights
Starting on September 12, Instagram will remove duplicative and legacy, insights metrics from the Instagram Graph API in order to share a single source of metrics to our developers.
This new upgrade reduces any confusion as well as increases the reliability and quality of our reporting.
After 90 days of this launch (i.e. December 11, 2023), we will remove all these duplicative and legacy insights metrics from the Instagram Graph API on all versions in order to be more consistent with the Instagram app.
We appreciate all the feedback that we’ve received from our developer community, and look forward to continuing to work together.
Deprecate all Facebook Wi-Fi v1 and Facebook Wi-Fi v2 endpoints
Facebook Wi-Fi was designed to improve the experience of connecting to Wi-Fi hotspots at businesses. It allowed a merchant’s customers to get free Wi-Fi simply by checking in on Facebook. It also allowed merchants to control who could use their Wi-Fi and for how long, and integrated with ads to enable targeting to customers who had used the merchant’s Wi-Fi. This product was deprecated on June 12, 2023. As the partner notice period has ended, all endpoints used by Facebook Wi-Fi v1 and Facebook Wi-Fi v2 have been deprecated and removed.
API Version Deprecations:
- September 14, 2023: Graph API v11.0 will be deprecated and removed from the platform
- February 8, 2024: Graph API v12.0 will be deprecated and removed from the platform
- May 28, 2024: Graph API v13.0 will be deprecated and removed from the platform
- September 20, 2023: Marketing API v14.0 will be deprecated and removed from the platform
- September 20, 2023: Marketing API v15.0 will be deprecated and removed from the platform
- February 06, 2024: Marketing API v16.0 will be deprecated and removed from the platform
To avoid disruption to your business, we recommend migrating all calls to the latest API version that launched today.
Facebook Platform SDK
As part of our 2-year deprecation schedule for Platform SDKs, please note the upcoming deprecations and sunsets:
- October 2023: Facebook Platform SDK v11.0 or below will be sunset
- February 2024: Facebook Platform SDK v12.0 or below will be sunset
First seen at developers.facebook.com
Allowing Users to Promote Stories as Ads (via Marketing API)
Before today (August 28, 2023), advertisers could not promote images and/or videos used in Instagram Stories as ads via the Instagram Marketing API. This process created unwanted friction for our partners and their customers.
After consistently hearing about this pain point from our developer community, we have removed this unwanted friction for advertisers and now allow users to seamlessly promote their image and/or video media used in Instagram Stories as ads via the Instagram Marketing API as of August 28, 2023.
We appreciate all the feedback received from our developer community, and hope to continue improving your experience.
Please review the developer documentation to learn more.
First seen at developers.facebook.com
Launching second release of Facebook Reels API: An enterprise solution for desktop and web publishers
We’re excited to announce that the second release of FB Reels API is now publicly available for third-party developers. FB Reels API enables users of third-party platforms to share Reels directly to public Facebook Pages and the New Pages Experience.
FB Reels API has grown significantly since the first release in September 2022. The new version of the APIs now support custom thumbnails, automatic music tagging, tagging collaborators, longer format of reels and better error handling.
FB Reels API will also support scheduling and draft capability to allow creators to take advantage of tools provided either by Meta or by our partners. Based on the feedback we received from our partners, we’ll now provide additional audio insights via the Audio Recommendations API and reels performance metrics via the Insights API.
Our goal in the next couple of releases is to continue to make it easier for creators to develop quality content by adding features like early copyright detection and A/B testing. We’re also excited to start working on enhanced creation features like Video clipping- so stay tuned to hear more about those features in the future.
If you are a developer interested in integrating with the Facebook Reels API, please refer to the Developer Documents for more info.
Not sure if this product is for you? Check out our entire suite of sharing offerings.
Tune in to Product @scale event to learn more about FB Video APIs and hear from some of our customers.
First seen at developers.facebook.com
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