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HomeMy WebLinkAboutAgenda - 10-20-2009 - 4eORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: October 20, 2009 Action Agenda Item No. ~~- ~ SUBJECT: Receipt of Funds for H1 N1 Influenza Response Phase I and II and Approval of Fees for Providin H1 N1 Vaccinations DEPARTMENT: Health PUBLIC HEARING: (Y/N) No ATTACHMENT(S): None INFORMATION CONTACT: Rosemary Summers, 245-2411 PURPOSE: To accept funds for H1 N1 Influenza Response Phase I and II and approval fees for providing H1N1 vaccinations. BACKGROUND: The Centers for Disease Control (CDC) allocated funds for pandemic flu preparation, specifically H1N1 influenza response. The CDC made funds available to states, and in turn the NC Division of Public Health is distributing these funds to each local health department on a population-based formula. This funding of Phase I has a required focus on planning and Phase II has a required focus on enhanced surveillance. The Health Department will use the funding for the purpose of supporting expedited revisions and expansion of the pandemic influenza (pan flu) plans and for activities that will enable the Health Department to rapidly detect and respond to the next outbreak of H1 N1 flu virus. • Phase I Scope of work includes: hiring temporary staff to develop, update & revise pandemic flu plans to comply with required benchmarks. These include: updated vaccination plans, updated policy and procedure to ensure cold chain security for vaccine transport and storage, updated plans for data entry into North Carolina Immunization Registry (NCIR), updated plans for training surge staff on data entry, and other H1N1 activities /documentation as directed by Public Health Emergency Response program guidance. The federal guidance has strict guidelines for non-supplantation. The Department is currently exploring the feasibility of re-directing current staff toward updating these plans and hiring temporary staff to back-fill current staff duties. • Phase II Scope of work includes: hiring temporary epidemiology staff to develop, update and revise plans to comply with required benchmarks. Benchmarks include: pan flu response plans that include epidemiologic response plans and provide surge capacity to investigate cases in the community. These plans should also include enhancement of Epi Teams, cross training of current staff and identification and recruitment of non-Health 2 Department staff. Staff anticipates having a standard analysis for- school absence reports that are currently received by both systems to enable rapid identification of an outbreak locus and an epidemiological curve that will enable prediction of when an outbreak has reached the peak and whether mitigation strategies are effective. Fees for H1N1 Vaccination In addition to Phase I and II, staff is expecting to receive additional funds for Phase III, implementation of vaccinations for H1N1 influenza. It is expected that this funding will be available sometime in October and will be a substantial amount of funds. The H 1 N 1 influenza vaccine itself is being provided to all medical providers and government agencies free by the federal government. The federal government has authorized all providers to charge a fee for administration and counseling for the H1 N1 vaccine. The authorized federal administration and counseling fee is $18.00. The Department is requesting that the following codes be added to the fee schedule which will enable the County to recover costs for the administration and counseling associated with these vaccinations. These fees will enable the Department to recover direct costs such as supplies (alcohol swabs, band-aids), and data entry and billing support functions. • 90470 H1 N1 immunization administration and counseling (Medicaid) $18.00 • G9141 H1N1 immunization administration and counseling (Medicare) $18.00 • Private insurers will be billed at the same rate Cost of immunization administration and counseling for uninsured will be covered by Phase III implementation funds. Vaccine is expected to be released in weekly distributions beginning slowly in mid-October. Most medical providers in Orange County have chosen to receive H1 N1 vaccine directly for their priority populations. If a provider indicated that it would be providing less than 100 doses, its vaccine total will be added to the Health Department's total. The Health Department will be working with those providers to determine how best to serve the provider's priority populations. The majority of the vaccine requested for priority populations was from UNC Health Care and UNC Campus Health Services and will be shipped directly to them by the NC Immunization Branch. The Health Department is considering alternative plans for providing the vaccine to the public. Distribution plans will depend on quantities available at any given time. This project is for H1 N1 influenza only and should not be confused with the previously approved funding for seasonal flu vaccinations in the schools project, which has already started. FINANCIAL IMPACT: A total of $80,000 is available for both Phases of this project. These funds must be expended by May 31, 2010 and are adequate to cover costs associated with this project. A final line item budget will be determined once the Department determines whether trained nurses are available to back-fill for communicable disease nurses. Further research is also needed to determine the appropriate cold-chain equipment for vaccine transport and storage. The administration and counseling fees will enable the Department to recover direct costs of providing the H1 N1 vaccine. RECOMMENDATION(S): The Manager recommends the Board: • Accept funding in the amount of $80,000 for the purpose of planning and enhanced surveillance of H1 N1 flu; • Approve the corresponding budget amendment; and • Approve the immunization administration and counseling fees for third party payers.