1. Kansas Immunization Program Immunization Program Guidelines for Vaccine Use by LHD’s October 2010

2. 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. 3 POTS OF MONEY • VFC Entitlement Funds • 317 Discretionary Funds • State Funding(Discretionary)

4. Vaccines for Children (VFC) • Federal Entitlement Program • Funds based on documented need. • Strict Eligibility Criteria • VFC Budget Nationally: $4 Billion

5. 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.

6. Web Site • VFC Operations Guide: http://www.cdc.gov/vaccines/programs/vfc/operations-guide.htm or GOOGLE “VFC Operations Guide”

7. 317 Vaccine Funding • 317 funds are “discretionary.” • Considered a “safety net” • Subject to yearly appropriation

8. How many children can be fully vaccinated with 317 funds? • 1999: ~750,000 children • 2008 ~215,000 children

9. Kansas SGF Appropriations: • FY 2008: $869,932 • FY 2009: $836,080 • FY 2010: $807,058 • FY 2011: $807,058

10. Vaccine Cost vs. 317 & State Funding Vx. Costs 317 & State Funds

11. KS 2010 Vx. Budget 8% ~$29.8 million

12. 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.

13. 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

14. 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 fro denying coverage or benefits for children <19 years due to pre-existing conditions.