Vaccination Financing: Program Funding and Pressures

1. Vaccination Financing: Program Funding and Pressures AIM Program Managers Meeting November 19, 2008 New Orleans, LA Lance E. Rodewald, MD Director, Immunization Services Division National Center for Immunization and Respiratory Diseases, CDC

2. Goals • Account for FY06 through FY08 actual operations funding • Project maximum and minimum funding for FY09 operations • Project possible vaccine funding for FY09

3. Section 317 Operations Funding: FY06 – FY08

4. VFC Non-Vaccine Funding: FY06 – FY08

5. Total Operations Funding: FY06 – FY08

6. Section 317 Operations Funding: FY08 – FY09 (projected)

7. VFC Non-Vaccine Funding: FY08 – FY09 (projected)

8. Total Operations Funding: FY08 – FY09 (projected)

9. Operations Funding Time Line • Continuing resolution until March 6, 2009 for Section 317 and Pandemic Influenza funding; VFC not subject to CR • First round • All carryover • Almost all VFC funding • 43% of Section 317 and Pan Flu funding • Because of CR, we are unlikely to be able to accomplish all funding in 2 rounds

10. Operations Funding Awards • We will provide grantees with separate accounting for categories • Section 317 • VFC-AFIX • VFC operations • Pandemic influenza • Accounting will include • First round amount • Projected full-year minimum • Projected full-year maximum • Goal is to allow as much information as early as possible in the fiscal year

11. VFC Vaccine: FY08 • FY08 approved target budget • Based on PES/VOFA • $3.004 B • Emergency request for additional $113 M was approved by OMB and included into FY08 • FY08 spent VFC vaccine budget • Based on vaccine orders • $2.681 B (89% of approved target amount)

12. VFC and Section 317 Vaccine Budget Spending: FY08 * Includes Base plus carryover funding

13. VFC Vaccine: FY09 • Approved for FY09 • $2.442 B • Projected spending in FY09 • $3.019 B • Based upon two projection methods • PES/VOFA • Forward projection model • Results nearly identical • Additional projected spending from increased vaccine use and new ACIP recs • Shortfall will be requested in December

14. VFC and Section 317 Vaccine Funding to Immunization Programs: 1990 - 2008

15. Section 317 ops and vaccine Funding trends

16. Operations Funding • End of VFC adolescent vaccination funding • End of distribution funding in operations (with few exceptions: PIs and AK) • Increasing categorization • VFC-AFIX • VFC operations/ordering • Pandemic influenza • Separate accounting for categories

17. New Section 317 Report to Congress • Third year this annual report was requested by both Appropriations Committees • New request asked for same methodology for new report • NVAC recommended that • Congress should continue to ask for this report every year • Congress should use the report in their appropriations considerations

18. OMB Requested Section 317 Benchmarks • Funding proposals for transition document • CDC proposals based on Section 317 Report to Congress • Adolescent vaccination • Adult vaccination • School-age influenza • Maintaining acceptance • Prospects unknown, but shows the helpfulness of the 317 Report for articulating projects with great value to society that are consistent with our program

19. Questions and discussion

20. Topics for Questions • 2-tiered systems • Accountability • Fraud and abuse algorithm • PES • AIM Accountability Workgroup • Tracking vaccine spending • VMBIP savings

21. Extra Slides