COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

September 8, 2006

BOARD MEETING DATE:

September 19, 2006

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department

Brian Zamora, Director, Public Health & Environmental Protection

SUBJECT:

Agreements with the State Department of Health Services for the Immunization Assistance Program and the Immunization Registry

RECOMMENDATION:

Adopt resolutions:

1)

Authorizing the execution of an agreement with the State Department of Health Services (DHS) for the Immunization Assistance Program (IAP) for the term of July 1, 2006 through June 30, 2007 in the amount of $346,824, $29,018 Net County Cost; and

2)

Authorizing the execution of an agreement with the DHS for the Immunization Registry (IR) for the term of July 1, 2006 through June 30, 2007 in the amount of $42,750.

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all

Goal(s) 6: Children grow up healthy in safe and supportive homes and neighborhoods

These agreements contribute to the goal by providing funding to support immunization activities to increase immunization rates in San Mateo County and continue development of the Bay Area Regional Immunization Registry (BARR).

Performance Measure(s):

Measure

FY 2005-06
Actual

FY 2006-07
Projected

Percentage of low-income children with up-to-date immunizations at age 2

73% *

75%

Number of new clinics/providers that have implemented BARR by the end of the fiscal year

5

5

*Data from one clinic still outstanding.

BACKGROUND:

The Health Department strives to reduce and ultimately prevent the incidence of disease among the County’s youngest children by ensuring that infants and toddlers are up-to-date on immunizations. The Health Department shares the federal Healthy People 2010 objective that 80% of children will be up-to-date on immunizations by age two. Though the current performance measure indicates that approximately 73% of the County’s two year olds are immunized, this measure is derived from a relatively small sample of the entire County. In addition, based on other data sources, it is believed that the actual rate is more likely above 80% and that the 73% rate is not a true reflection of the community at large. With the full implementation of BARR, accuracy of data on immunization rates should be greatly improved. In addition, BARR provides the ability to track children across providers, schedule appointment reminders and maintain records more efficiently. These functions of BARR will work to increase the number of children immunized as new providers are included.

San Mateo County is one of ten jurisdictions that participate in the BARR Collaborative. DHS supports the County’s implementation of BARR through its Immunization Assistance Program and Immunization Registry grant agreements.

DISCUSSION:

In November 2004, Public Health embarked on the first phase of the Countywide implementation of BARR. Public Health staff collaborated with the San Mateo Medical Center (SMMC) to implement the Registry at five SMMC outpatient clinics. Four private pediatric offices and Ravenswood Family Health Center also actively participate in BARR. Plans for FY 2006-07 include: conducting outreach and recruitment activities to additional private providers, assisting with the entry into BARR of demographic data on children seen by private providers, manually entering immunization data from private provider records into BARR, training private providers to use the Registry, and continuing to support SMMC activities.

Funding provided by the State in both agreements will facilitate the rapid development of BARR. Registry activities funded by the agreements include: Registry data entry assistance, costs for quarterly Immunization Registry Advisory Board meetings, working with SMMC to improve immunization delivery, providing vaccine and patient information materials to SMMC and clinics, a $40,000 contract for Ravenswood Family Health Center to support and enhance immunization services in the South County area, and a $35,000 contract with the Health Plan of San Mateo (HPSM) to recruit providers for BARR participation and to inform HPSM members of the regional registry. County Counsel has approved both agreements.

FISCAL IMPACT:

The term of both agreements is July 1, 2006 through June 30, 2007. Total amount of IAP is $346,824 with a Net County Cost of $29,018 and IR is $42,750 with no Net County Cost. Both have been included in the tentatively Adopted FY 2006-07 Budget.