Kansas Immunization Program

Immunization Program Guidelines for Vaccine Use by LHD’s

October 2010

Objectives

• Understand VFC, 317, and State Vx. Funding

• Discuss the pros and cons of discretionary funding.

• Articulate the reasons why discretionary funds need to be targeted underserved children.

3 POTS OF MONEY

• VFC Entitlement Funds

• 317 Discretionary Funds

• State Funding(Discretionary)

Vaccines for Children (VFC)• Federal Entitlement Program

• Funds based on documented need.

• Strict Eligibility Criteria

• VFC Budget Nationally: $4 Billion

VFC Ops Guide Module 2 - Eligibility

• Medicaid eligible: A child who is eligible for the Medicaid program.(For the purposes of the VFC program the terms Medicaid-eligible and Medicaid-enrolled are equivalent and refer to children who have health insurance covered by a state Medicaid program)

• Uninsured: A child who has no health insurance coverage

• Indian (American Indian or Alaska Native): As defined by the Indian Health Care Improvement Act (25 U.S.C. 1603)

• Underinsured: Children who have commercial (private) health insurance but the coverage does not include vaccines, children whose insurance covers only selected vaccines(VFC - eligible for non-covered vaccines only), or children whose insurance caps vaccine coverage at a certain amount--once that coverage amount is reached, these children are categorized as underinsured.

Web Site

• VFC Operations Guide:http://www.cdc.gov/vaccines/programs/vfc/operations-guide.htm

or

GOOGLE “VFC Operations Guide”

317 Vaccine Funding

• 317 funds are “discretionary.”

• Considered a “safety net”

• Subject to yearly appropriation

How many children can be fully vaccinated with 317 funds?

• 1999: ~750,000 children

• 2008 ~215,000 children

Kansas SGF Appropriations:

• FY 2008: $869,932• FY 2009: $836,080• FY 2010: $807,058• FY 2011: $807,058

Vaccine Cost vs. 317 & State Funding

Vx. Costs 317 & State Funds

8%

Kansas Law Requires• To the extent that funds are

available, vaccines required for school entry must be provided.

• A sliding fee scale may be applied.

317 & State funds restricted to:• Underserved children/adolescents enrolled in

the federal free or reduced price lunch program• Have insurance that covers immunizations• Insurance co-pay or deductable poses a barrier to

vaccinations required for school attendance.• These children are not VFC eligible.• Vaccine provided to local health departments

• Cocoon Project

• Universal Hep. B Birth Dose Program

Will the HCRA change things?

• All pediatric well-child visits—including immunizations must be covered by certain insurance plans with no co-pays or deductibles for families.

• Health plans are prohibited from denying coverage or benefits for children <19 years due to pre-existing conditions.