As of Oct. 1, Gila County’s health department can no longer provide free required childhood vaccines to children covered by private insurance.
The county will continue to provide the vaccines for children that are uninsured, are on AHCCCS rolls, Native American or Alaskan Native and KidsCare children. Underinsured children can get vaccines until told to stop by the Arizona Vaccines For Children Program. The Arizona Department of Health Services expects vaccines for underinsured children to continue until the spring 2013.
While underinsured children can still get the vaccine through the county for several months yet, staff will have to monitor how the federal and state government defines “underinsured.” This is a person who has health insurance that doesn’t cover the full range of vaccines. Children with deductibles and co-pays are considered insured. Children underinsured for selected vaccines can get the free county coverage for only those uncovered vaccines.
Michael O’Driscoll and JenDean Sartain of the Gila County Division of Health and Emergency Services, advised the board of supervisors about the change at its Sept. 25 work session.
The federally funded Vaccines For Children (VFC) program provides vaccines at no cost to children who might not get vaccinated because of the cost. CDC buys vaccines at a discount and distributes them to state health departments and certain local and territorial public health agencies —which in turn distribute them at no charge to those private physicians’ offices and public health clinics registered VFC providers like the Gila County health department.
Only four physicians in the Payson area and three in the Globe area have provided the childhood vaccines in the past, according to Sartain. She said after having met with the doctors, it appears those in Payson will continue with the vaccines, but probably not those in Globe.
The Gila County health officials are looking into possibly charging to provide the vaccines to non-qualified children and working with a third party billing system to bill insurance for the cost of services and vaccine.
“This is essentially turning the health department into a doctor’s office,” O’Driscoll said.
County manager Don McDaniel said this represents another unfunded mandate inflicted on every county in the country. He told the supervisors he would need additional investigation to determine the costs and benefits of the service. His report provoked an extended discussion about the problems families face in getting the vaccinations required before children can attend school.
Sartain said the lack of immunizations can create economic problems. She said several years ago a community in Yavapai County suffered a measles outbreak because residents didn’t believe in immunizations.
“Only a single case of measles is an outbreak. If one child gets the measles there is a 21-day incubation period, and you hope and pray you don’t have another case, because with that second case the 21-day period starts over,” she said.
In the Yavapai County outbreak, the children in that community were out of school for nine months due to the measles quarantine necessary when unvaccinated children are exposed to the disease. Keeping children at home imposed a major hardship on both the families and the school district, which gets paid by the state based on attendance.
The children eligible for vaccines through the VFC program can get flu shots for free at in-school flu shot clinics concluding this week. The shots are also available on a walk-in basis at the county health offices in Payson and Globe.
The clinics will try to bill insurance plans $20 for the shots, but people will have to pay cash if the insurance company rejects the claim and they’re not in the group that qualifies for free shots.