COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

April 4, 2003

BOARD MEETING DATE:

April 22, 2003

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Director of Health Services

Brian Zamora, Director of Public Health and Environmental Protection

SUBJECT:

Agreement with the State Department of Health Services for Immunization Assistance

Recommendation

Adopt a resolution authorizing the President of the Board to execute an agreement with the State Department of Health Services to provide immunization assistance for FY 2002-03.

Background

San Mateo County has received funding from the State Department of Health Services for immunization assistance each year since the mid-1970s. For FY 2002-03, it is estimated that the County will receive $141,112. This funding allows the Immunization Assistance Program (IAP) staff to plan and coordinate immunization outreach, education, and service delivery countywide. IAP staff distribute State-supplied vaccines to public clinics; conduct annual reviews of student immunization records; coordinate and conduct educational programs and distribute periodic immunization updates to community health providers; support development of the Bay Area Regional Immunization Registry; arrange for and conduct immunization clinics in response to identified need; and offer immunization information and referral services to the general public. The staff also monitor immunization providers and offer quality assurance and technical assistance.

Discussion

The IAP staff will be involved in the following activities to improve immunization coverage in San Mateo County:

·

Sponsoring a County-wide training for nurses on vaccine administration, storage and handling

·

Working with the Department of Hospitals and Clinics and Health Services divisions to improve immunization delivery by removing as many barriers to service as possible

·

Providing vaccine and patient information materials to Department of Hospitals and Clinics and Health Services divisions

·

Offering additional immunization clinics in under-served areas

·

Providing trainings to family day-care providers on immunization requirements and documentation

·

Hosting at least one immunization teleconference for public and private sector medical providers

·

Working with WIC staff to educate parents about the immunization schedule and assessing their children's immunization records for up-to-date status

·

Supporting the development of San Mateo County's part of the Bay Area Regional Immunization Registry

A review of the available data indicates that the percent of immunization may still be low. A significant portion of this is due to a lack of adequate technology to accurately measure the actual immunization rate in real time. The database is from a source that is collected manually with the indicator counted retrospectively at age 5, when a child enters Kindergarten. Because of this method, reporting of actual numbers is delayed by three years.

It may be noted that the actual measures presented in this memo are different and lower than those presented previously. This is primarily related to a stricter definition of "up-to-date" which has been adopted by the County in order to use the same standards used by the state and federal governments. For example, a child who received his measles vaccination one week before his first birthday would, for the purposes of the analysis, not be considered `up-to-date' under the revised definition. However, it is not believed these lower numbers reflect a decline in childhood immunization rates. The best use of these numbers is to compare them year to year to look for trends.

Program Indicators

Actual

Actual

Actual

Estimated

Children's Kindergarten Year

1999

2000

2001

2002*

Year children were age two

1996

1997

1998

1999

Percent of Children countywide with up-to-date immunizations by age two

71%

67.5%

70.4%

72%

* Data for kindergarten retrospective for 2002 are currently being entered and analyzed.

Through staff's participation in a regional registry, they will be able to determine the immunization status of every child in an efficient and accurate manner. Additional expected capabilities of the registry will include status updates and assessments of the overall immunization rates for population groups serviced by different health care providers across the County. The Immunization Program staff will be involved in several activities to improve immunization coverage in San Mateo County.

Vision Alignment

The agreement with the State Department of Health Services keeps the commitment of ensuring basic health and safety for all and goal number 6: Children grow up healthy in safe and supportive homes and neighborhoods. The agreement with the State Department of Health Services contributes to this commitment and goal by providing funds to support immunization activities in San Mateo County, thereby increasing the likelihood of children growing up healthy.

Fiscal Impact

The term of the agreement with the State Department of Health Services is July 1, 2002 through June 30, 2003. The recommended FY 2002-03 budget for Public Health includes $141,112 in revenue estimates for this program and the same level of expenditures. The net county cost for this program is $26,325.