People With Insurance May No Longer Get Health Department Vaccines

An estimated quarter of all patients who visit the Greenfield Health Department for vaccinations after Oct. 1 could be turned away, according to the city’s chief health official.

Health Officer/Director Darren Rausch said changes in federal funding will impact whom the city’s serves in just a few short weeks.

The Health Department will no longer be able to vaccinate persons who have insurance that covers the cost of vaccines due to the elimination of federal 317 funding effective at the start of the next federal fiscal year, or Oct. 1. This change coincides with a recent change required by the Affordable Care Act that provides coverage of preventive services – including vaccination without impacting the insurance deductible, according to Rausch.

Though the vaccine cost is not applicable to the insurance deductible, the office visit fee and administration fee may apply.

Historically, local health department vaccines were purchased using a combination of federal funds, Rausch said. The Vaccines for Children (VFC) funds were utilized to fund childhood vaccines for uninsured, whereas 317 funds were used to fund vaccines for underinsured children.

Rausch said after Oct. 1,  the Health Department will continue to provide vaccinations for:

• those without health insurance;
• those on BadgerCare or other state health insurance;
• and those who have health insurance that does not cover the cost of vaccines.

The only other exception includes influenza vaccine for school-age children and all pertussis-containing vaccines due to the current .

It is estimated the loss of 317 funds would have impacted more than 26 percent of all clients, or approximately 150, served by the department over the past year had the federal funding change been in place. And the ability to provide vaccines to adult patients is mostly gone with the change though Rausch said for now the department will continue to serve adults with Tdap (tetanus, diphtheria and pertussis vaccine) and a few others based on insurance status. 

The state-mandated immunization program is one of the city’s more visible health programs. The city offers three two-hour clinics each month, by appointment and serves approximately 600 clients each year with approximately 200 over the age of 18, according to Rausch. But with more than 400 births each year, the Health Department is not the primary immunizer of the city’s children, Rausch added.

“Our services were often chosen based on location, convenience, and or cost, with or without factoring insurance status,” he said.

Bad timing with school starting

Rausch said the announcement of the change came at a bad time and without much advanced warning. Local public health officials first heard about the potential change in May, but didn’t receive additional details until early July.

“There was hope of a waiver moving the enforcement date until Jan. 1, but that was rejected at the federal level in late August,” Rausch said. “As school starts this week for all public schools, parents may be faced with the difficulty of finding other providers for children that may not be fully compliant with the school immunization law. Historically, this was a role that the Health Department filled, but we won’t be able to after Oct. 1.”

Communicating this change to the public will likely be difficult, Rausch said. The department has prepared letters for parents who visit the clinic, and has distributed the letters to local schools.

“Additionally, letters were sent to clinicians and office managers at all primary care and pediatrics offices in the city; the loss of clients at public health clinics will increase demands at their facilities,” Rausch said. “Most residents have primary care physicians for themselves and their children, so they will need to seek immunization services at their “medical home” or where their primary care physician practices.”

The most recent 2-year-old immunization report indicates that nearly 68 percent are fully vaccinated for age-appropriate vaccines, according to Rausch. That total bumps up to 97 percent of school-aged children.