Case studies were conducted in Los Angeles and San Diego Counties to examine more closely the ways in which a local site had used Federal 317 funds, in combination with State and local dollars, to improve immunization coverage in the respective counties. Both Counties face special challenges because of language and cultural diversity and high immigrant populations. Strategies included supporting community-based street-level outreach assessment and referral through neighborhood "Promoturas;" assessment and referral at WIC centers; monitoring and oversight of immunization levels through provider assessments and feedback, primarily at the safety-net sites; and direct funding of immunization services at selected sites. Both Counties have reduced the scope of direct services and mass education activities as a consequence of reductions in 317 funding. WIC assessment and referral activities have also been scaled back. The two counties have taken different approaches to implementing managed care for Medicaid and SCHIP beneficiaries, and their different strategies have implications for the provision of immunization services and interventions to improve coverage rates. Because 75%-80% of the vaccinations are delivered in the private sector, both Counties would like to continue assessment and referral at all available sites, such as WIC centers, because they are persuaded that these activities are effective in bringing children to their medical homes for immunization.
Learning Objectives: 1. The case study will present the variability of local responses to immunization finance and delivery. 2. The impact of Federal funding levels and instability on local public health systems will be reviewed. 3. The increasing importance of the private sector in immunization delivery will be considered
Keywords: Immunizations, Funding
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Institute of Medicine, Centers for Disease Control and Prevention (National Immunization Program), State of California Health Department, Los Angeles and San Diego Counties
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.