COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

September 14, 2007

BOARD MEETING DATE:

September 25, 2007

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department

Mary J. Hansell, Director, Family Health Services Division

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, 2007 through June 30, 2008 in the amount of $405,887; and

2)

Authorizing the execution of an Agreement with the State Department of Health Services for the Immunization Registry (IR) for the term of July 1, 2007 through June 30, 2008 in the amount of $42,750.

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all.

Goal 6: Children grow up healthy in safe and supportive homes and neighborhoods.

These Agreements contribute to the commitment and 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 Measures:

Measure

FY 2006-07
Actual

FY 2007-08
Projected

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

84%

85%

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

3

3

BACKGROUND:

The Health Department strives to reduce and ultimately prevent the incidence of vaccine preventable disease among the County’s residents. The Immunization Program is responsible for the following activities: program management, service delivery, population assessment, surveillance and outbreak control, provider quality assurance, consumer information, immunization data tracking and vaccine management.

The Healthy People 2010 national goal is to have 95% of children five years and younger in population-based immunization registries. BARR is a critical tool for this success. All San Mateo Medical Center pediatric, teen and adult clinics are actively participating in BARR. Additionally, Ravenswood Family Health Center, the County’s community-based clinic, and three private pediatric providers are enrolled. With the continued and expanded implementation of BARR, accuracy of data on immunizations has improved, reducing missed opportunities and improving time-sensitive vaccine coverage. In addition, BARR provides the ability to track children and adults across providers, generate appointment reminders, and maintain records more efficiently. The current performance measure indicates that approximately 84% of two-year-olds are immunized, a significant increase from the previous year in which only 70% of two-year-olds were immunized appropriately.

DISCUSSION:

Funding provided by the DHS for both Agreements will facilitate the expansion of the Immunization Registry, continue vaccine preventable disease activities, and support the initiation of a perinatal hepatitis B project in the Public Health Division (PH). Included in this funding is a $40,000 subcontract with Ravenswood Family Health Center to support and enhance immunization services in the South County area and a $35,000 subcontract with the Health Plan of San Mateo (HPSM) to recruit providers for BARR participation.

BARR-related activities for the upcoming year include conducting outreach and recruitment activities to additional private providers, manually entering immunization data for providers, training newly enrolled provider staff, and continuing to support current immunization registry users.

This year additional funds have been awarded to implement a perinatal hepatitis B case management program that will encourage medical providers to screen pregnant women for hepatitis B, refer those who are positive to case management services, and promote the first dose of hepatitis B to newborns in the hospital. A Communicable Disease Investigator was added in the PH tentatively Adopted FY 2007-08 Budget for this program. County Counsel has reviewed and approved both Agreements.

FISCAL IMPACT:

The term of both Agreements is July 1, 2007 through June 30, 2008. The total amount of IAP funding is $405,887 with a Net County Cost of $89,269 and IR is $42,750 with a Net County Cost of $10,151. Revenues and expenditures for both Agreements have been included in the Family Health Services and Public Health tentatively Adopted FY 2007-08 Budgets.