Issue: #6

April 2013

This Issue
Statehouse Event Scheduled Vaccines in the State Budget Legislation Would Address Vaccine Payments More Pending Legislation to Affect Immunization Looking Ahead . . . Immunizations for Daycare and Preschool

Welcome to Ohio Upshot

Ohio Upshot is a newsletter to help educate policy makers, community leaders and the public on the valuable role vaccines play in keeping our schools, workplaces and communities healthy. It is sent to you by the Immunization Advocacy Network of Ohio, a network of public health advocates, medical associations, education groups, community organizations and others committed to a healthy Ohio.

Statehouse Event Scheduled

The Immunization Advocacy Network of Ohio (IANO) will host its first Immunization Advocacy Day at the Ohio Statehouse on Tuesday, April 9th, 2013 in Columbus. IANO members and immunization advocates from across Ohio will share their experiences and educate legislators about immunizations. With a considerable number of new members in the Ohio General Assembly, it is critical that we educate lawmakers on the public health value of vaccines, the need to improve access, and the important work being done in the field to ensure the health and well being of all Ohioans. IANO Statehouse Day activities include an advocacy training breakfast, private meetings with legislators and a luncheon with legislators. Luncheon speakers will include Dr. Ted Wymyslo, Director of the Ohio Department of Health, State Representative Anne Gonzales, Chairwoman of the House Finance and Appropriations Subcommittee on Health and Human Services, and Dr. Michael Brady, Physician-In-Chief at Nationwide Children's Hospital. Please join us for this important opportunity to educate lawmakers on immunization! If you have questions, please contact Angela Snyder at (614) 220-8659 or by email, asnyder@lesiccamper.com. You must register in advance to attend this event. To register, please visit http:// www.lesiccamper.com/IANO/register.html. To grow and maintain our strong system of vaccine delivery, IANO is a statewide network of immunization providers and supporters, to serve as a collective voice to advocate for vaccines in Ohio.

IANO Partners
to date
Action for Children Adult Immunization Coalition of Central Ohio CareSource Children's Defense Fund - Ohio Cincinnati Cervical Cancer Prevention Coalition City of Cincinnati Health Department Cuyahoga County Board of Health Greater Cincinnati Immunization Coalition Hospital Council of Northwest Ohio Immunizeohio.org Consortium for Healthy and Immunized Communities (CHIC) National Association of Social Workers - Ohio Chapter Ohio Association for the Education of Young Children Ohio Academy of Family Physicians Ohio Association of Community Health Centers Ohio Association of School Nurses Ohio Chapter of the American Academy of Pediatrics Ohio Children's Hospital Association Ohio Family Care Association Ohio Hispanic Coalition Ohio Hospital Association Ohio Osteopathic Association Ohio Pharmacists Association Ohio Public Health Association Ohio School Based Health Care Association Ohio State Medical Association Project L.O.V.E. Toledo / Lucas County CareNet Voices for Ohio's Children

Vaccines in the State Budget

It's budget time at the Statehouse again. Every two years, the Governor sends his proposed budget to the legislature, where changes are made before the final budget is adopted. In his proposal for the upcoming biennium, Governor Kasich held funding steady for the immunization program at the Ohio Department of Health (ODH). The executive budget allocates $8.8 million for the immunization program in each of the next two fiscal years. 13) for children not covered by the federal Vaccines for Children program. Before routine use of PCV-13, children younger than five were at significant risk of acute bacterial infection, with an estimated 17,000 cases in U.S. each year. Roughly 200 children died every year as a result of this disease.

ODH proposes shifting $1 million of its funding for PCV-13 in the next biennium to buy HPV vaccines instead. The HPV There is one significant change, however, vaccine is recommended for adolescents as described in budget testimony preand young adults to help prevent not only sented by ODH. The department will shift HPV, but also possible cervical cancer in $1 million currently used to buy pneumo- females and anal cancer in males. The coccal conjugate vaccine to purchase funding shift is simply a matter of invenHPV (human papillomavirus) vaccine intory: ODH doesn't need to buy as much stead. PCV-13 vaccine for the upcoming bienThis year, ODH has $2.5 million to buy nium and can use the extra funding to pneumococcal conjugate vaccine (PVCboost its HPV vaccine inventory.

Legislation Would Address Vaccine Payments

State Representative Anne Gonzales has introduced House Bill 94 to address the issue of how local health departments are compensated for providing services covered by a private health insurance plan. One effect of the legislation would be to allow local health departments to bill insurers for vaccinations provided to children who have coverage under the plan. Representative Gonzales chairs the Health and Human Services subcommittee of the House finance committee. The bill is based on a similar law passed in Illinois. Low income children can receive free vaccines at local health departments and other public health providers through the federal Vaccines for Children program. However, some doctors refer other patients to the local public health clinic for vaccines as well. A physician may not have adequate refrigeration to store vaccines, or may not want to order vaccines that might go unused until they expire. As an alternative to keeping vaccines available in their offices, these providers may suggest that their privately insured patients visit the local public health clinic. According to Beth Bickford, Executive Director of the Ohio Association of Health Commissioners, local health departments are currently absorbing the cost of vaccinating these children because they don't have the ability to contract with insurance companies for payment. The issue is urgent because the VFC program restricts the availability of free vaccines for children covered by private insurance that pays for vaccines. With regard to H.B. 94 Bickford said, "We're supportive of that. As we lose access to public State Representative funding, being able to bill private Anne Gonzales insurance is even more critical." Although there is not currently any statewide evaluation of how much it costs local health departments to provide vaccines for insured children, Bickford said doing so can be a particular burden for smaller health departments that might be the only vaccine provider in their county. "It would be terrible if they had to get out of the business because they can't absorb the cost," she noted. H.B. 94 will be heard in the House Insurance Committee.

More Pending Legislation to Affect Immunization

Immunization is a hot topic at the legislature this session. In addition to H.B. 94 that would allow local health departments to bill private insurers for vaccinating the kids those plans cover, there are four additional bills that address immunization issues. Sponsored by State Senator Edna Brown, Senate Bill 39 would require insurance companies to cover screening for HPV (human papillomavirus) and vaccination for the disease. Three other bills deal with which vaccines pharmacists and/or pharmacy interns can administer: Senate Bill 79 allows pharmacists to administer certain vaccines to children seven years old and older. Pharmacy interns may also administer these vaccines under supervision of the pharmacist. The vaccines included in the bill are influenza, pneumonia, tetanus, Hepatitis A and B, meningitis, diphtheria, and pertussis (whooping cough). Senate Bill 80 would allow a pharmacy intern under the direct supervision of a pharmacist to administer all the same vaccines that the pharmacist is permitted to administer. Senate Bill 81 would allow pharmacy interns to give a flu shot to those 14 years old and older, under the supervision of a pharmacist. Senate Bills 79, 80 and 81 are all sponsored by State Senator Eric Kearney. Senate Bill 79 is the most expansive of the three, lowering the age limit so that both pharmacists and their interns could administer common childhood vaccines. The other two bills would provide a more limited expansion of the ability of pharmacy interns to give vaccines.

Looking Ahead . . . Immunizations for Daycare and Preschool

When they start kindergarten, Ohio children must be vaccinated against polio, chickenpox, measles, mumps, rubella, diphtheria, tetanus, whooping cough, and Hepatitis B. But in Ohio, there is currently no requirement tied to the CDC's Advisory Committee for Immunization Practices (ACIP) that says younger children who attend daycare or preschool must be protected at these standards. While most licensed child care centers, preschools or providers in Ohio require vaccinations for admission, there is no state law that ties any requirement to the full ACIP recommendations. At this point, some Ohio children's advocates are coming together to explore legislative changes to address the daycare and preschool requirements.

For information about the Immunization Advocacy Network of Ohio, to suggest content for future issues, or if you know of an organization that wishes to join IANO, please contact: Jenny Camper at jcamper@lesiccamper.com or Angela Snyder at asnyder@lesiccamper.com