HomeMy WebLinkAboutResolutions - 1999.12.16 - 25678December 16, 1999
MISCELLANEOUS RESOLUTION #99332
BY: GENERAL GOVERNMENT COMMITTEE, SHELLEY TAUB, CHAIRPERSON
IN RE: DEPARTMENT OF HUMAN SERVICES/HEALTH DIVISION - IMPLEMENTATION OF FEES
FOR HEPATITIS A AND B VACCINES
TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS
Chairperson, Ladies, and Gentlemen:
WHEREAS the number of reported Hepatitis A cases has increased sharply
in the last few years in the southeast Michigan area; and
WHEREAS in 1998 the number of Hepatitis A cases reported in Oakland
County was approximately ten times higher than the number reported in a
typical year; and
WHEREAS the Oakland County Health Division has recently responded to
Hepatitis A outbreaks in restaurants and day care facilities; and
WHEREAS Hepatitis B continues to be a serious disease resulting in
chronic infection in 5-101; of the cases, and, of that group, 15-25% will die
prematurely of cirrhosis or liver cancer; and
WHEREAS to stem the tide of hepatitis infection, affordable hepatitis
vaccine should be made available to the public at risk; and
WHEREAS a vaccine program is a crucial component of a successful viral
hepatitis prevention and control program; and
WHEREAS the Oakland County Health Division requests $50,000 to implement
a self-sustaining fee for service hepatitis vaccine program for the purchase
of vaccine, supplies, and printed materials to be fully offset by fee
reimbursement; and
WHEREAS no additional staff are being requested as existing clinical
staff would be utilized to administer the vaccine.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of
Commissioners authorizes the Oakland County Health Division to establish a
self-sustaining fee for service hepatitis vaccine program in accordance with
the attached fee schedule.
Chairperson, on behalf of the General Government Committee, I move the
adoption of the foregoing resolution.
GENERAL GOVERNMENT COMMITTEE
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General Government Committee Vote:
Motion carried on unanimous roll call vote with Law absent
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DEPARTMENT OF HUMAN SERVICES/HEALTH DIVISION
IMPLEMENTATION OF FEES FOR HEPATITIS A AND B VACCINE
FEE SCHEDULE
Fee Per Dose
Hepatitis A (two doses required)
Children (ages 2-18)
Adults (19 and older)
Hepatitis B (three doses required)
Adults (18 and older) $25
DEPARTMENT OF HUMAN SERVICES,
HEALTH DIVISION
Implementation of Fees for Hepatitis A and B Vaccines
• Several distinct viral agents cause similar disease of the liver. They differ in how they
present, how they are transmitted and the ultimate course of the disease. Hepatitis A (HAV)
is generally an abrupt short-lived infection which may be without symptoms or with only
mild symptoms. Complete recovery without residual problems is universal and the death
rate is extremely low (-‹ 1/100), occurring in persons with serious medical problems or other
previous insults to the liver. HAV is transmitted via the fecal-oral route, mainly through
person-to-person contact.
Hepatitis B (HBV) has a much slower onset and also may be without symptoms. Case
fatality rates are around 10/1000 cases. Chronic hepatitis B infection occurs in 5-10% of
acute cases. Fifteen to twenty-five percent (15-25%) of persons with chronic hepatitis B
infection will die prematurely of cirrhosis or hepatocellular carcinoma (liver cancer).
Health Division requests hepatitis A vaccine because hepatitis A is a common disease (333
cases in 1998, two food borne outbreaks and two day-care related outbreaks in two years in
Oakland County) which has serious implications for the ill, elderly and those with chronic
liver disease from other causes. Hepatitis A vaccine is not widely available from private
medical providers and when it is available, the cost is prohibitive for many of our residents.
• Health Division requests hepatitis B vaccine because it is a serious disease which can lead
to cancer, disability and death. Many of our citizens who need to protect themselves are
unable to access this vaccine at a reasonable price. This includes many with chronic hepatitis
from HCV infection due to transfusion, organ transplantation or hemodialysis. Many others
need vaccine for predictable future exposures such as matriculation into medical programs
or living with a hepatitis B carrier.
A voucher system will be implemented to administer the required multiple doses of hepatitis
vaccine; two doses are required for hepatitis A vaccine and three doses are required for
hepatitis B vaccine. Upon initiation of the hepatitis vaccine regimen for a client, the fees will
be collected for the entire dose sequence. At that point, a voucher will be issued to the client
which entitles that person to receive the future remaining doses. The voucher system will
help to ensure that this program is self-sultaining and will also help to project the vaccine
inventory level that is required.
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Resolution #99332 December 16, 1999
The Chairperson referred the resolution to the Finance Committee. There
were no objections.
