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COUNTY OF SAN MATEO
Inter-Departmental Correspondence
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Health Services Agency
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DATE:
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October 21, 2004
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BOARD MEETING DATE:
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November 9, 2004
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TO:
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Honorable Board of Supervisors
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FROM:
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Charlene Silva, Director of Health Services
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Brian Zamora, Director of Public Health and Environmental Protection
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SUBJECT:
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Agreements with the State Department of Health Services for Implementation of an Immunization Registry
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Recommendation
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1. Adopt a resolution authorizing the President of the Board to execute an agreement with the State Department of Health Services for the Immunization Registry
2. Adopt a resolution authorizing the President of the Board to execute an agreement with the State Department of Health Services to provide immunization assistance.
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Background
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The Health Services Agency strives to reduce and ultimately prevent the incidence of disease among its youngest children by ensuring all infants and toddlers are up-to-date on immunizations. Its goal is to achieve the Healthy People 2010 objective that 90 percent of the County’s children will be up-to-date on immunizations by the age of two. To date, the County has fallen short of this goal, with approximately 70 percent of its youngest children meeting the target. Furthermore, disparities exist as African-American, Asian, and Hispanic children fall far below the countywide rate.
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Over the past several years, Health Services has embarked on an ambitious plan to meet the Healthy People 2010 objective by implementing an immunization registry. It is widely recognized that an immunization registry is paramount in maintaining high immunization rates, reducing the incidence of disease, and improving child health outcomes and school readiness.
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An immunization registry is a confidential, computerized information system designed to effectively increase vaccine coverage, meet the needs of a mobile population, and assist providers, parents and public health departments in solving immunization-related issues. Research has indicated that immunization registries are cost-effective and can produce savings once implemented. Some of the major features of a registry include:
q Keeping childhood immunization histories current and centralized, to ensure that different providers that come into contact with a child have the same information;
q Creating reminder notices to inform the provider and family when a vaccine is due;
q Reducing paperwork by consolidating vaccination from multiple providers into one immunization record;
q Ensuring providers follow the most current recommended vaccination schedule;
q Serving as a tool for information regarding community wide coverage rates to identify populations that are under vaccinated and may be at high risk for disease.
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San Mateo County is one of ten jurisdictions that participate in the Bay Area Regional Immunization Registry (BARR) collaborative. The State Department of Health Services supports the County’s implementation of the BARR through its Immunization Assistance Program (IAP) grant and the Immunization Registry grant.
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Discussion
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In November 2004, Health Services will embark on the first phase of the eventual Countywide implementation of the Bay Area Regional Immunization Registry. Health Services will work in collaboration with the San Mateo Medical Center (SMMC) to pilot the registry at SMMC outpatient clinics. Plans for FY 2004-05 include:
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q Uploading demographic data on children from the SMMC Core system into the BARR;
q Manually entering immunization data from SMMC charts into BARR;
q Training SMMC providers to use the registry;
q Implementing BARR for ongoing use at SMMC outpatient clinics; and
q Conducting outreach and recruitment activities to non-county providers.
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The State Department of Health grants for IAP and Immunization Registry will facilitate the rapid implementation of BARR. Registry activities funded by the grants include:
q Data entry assistance;
q Costs for four quarterly Immunization Registry Advisory Board meetings;
q Work with the SMMC to improve immunization delivery;
q Providing vaccine and patient information materials to SMMC and clinics; and
q A $44,000 subcontract with Ravenswood Family Health Center to support and enhance immunization services in the South County area.
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Performance Measure
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FY 2003-04
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FY 2004-05
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Number of County Clinics that have implemented BARR by the end of the fiscal year
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0
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3
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Percent of low-income children up-to-date on immunizations at age two
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70%
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72%
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Vision Alignment
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The agreements with the State Department of Health Services keep the commitment of ensuring basic health and safety for all and goal number 23: Leaders throughout the County provide the impetus for broader regional solutions in land use, housing, childcare, education, health and transportation. The agreements with the State Department of Health Services contribute to this commitment and goal by providing for a regional immunization registry, which will help ensure that children throughout the Bay Area receive complete immunizations and increase the likelihood of children growing up healthy.
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Fiscal Impact
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The term of both agreements with the State Department of Health Services is July 1, 2004 through June 30, 2005. The total amount of the Immunization Registry grant is $31,686 and has been included in the adopted FY 2004-05 Budget. There is no net County cost with this agreement. The IAP agreement is for $200,024 and has also been included in the adopted FY 2004-05 Budget. Net County cost for the IAP program is $44,236.
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