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Home My WebLink AboutResolutions - 2000.01.27 - 26014December 16, 1999 MISCELLANEOUS RESOLUTION 199332 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 5-10% 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 General Government Committee Vote: Motion carried on unanimous roll call vote with Law absent $14 $18 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-staining and will also help to project the vaccine inventory level that is required. FISCAL NOTE (M.R. #99332) January 27, 2000 BY: FINANCE COMMITTEE, SUE ANN DOUGLAS, 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: Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced resolution and finds: 1. 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. 2. The Oakland County Health Division has recently responded to Hepatitis A outbreaks in restaurants and day care facilities. 3. The Oakland County Health Division is requesting authorization to implement a self-sustaining fee for service Hepatitis vaccine program. 4. The cost for the vaccine, supplies and printed materials will be fully offset by fee reimbursement. 5. A voucher system will be implemented to administer the required multiple doses of the hepatitis vaccine, whereby the fees for the vaccine will be collected for the entire dose sequence. At that point a voucher will be given to the client, which will entitle that person to receive the future remaining doses and help to ensure the program is self-sustaining and the inventory of vaccine required is maintained. 6. No additional staff is requested, as existing clinical staff will be utilized to administer the vaccine. 7. A budget amendment is recommended as follows for the program: Revenue 16-234100-xxxxx-0561 Expenditures 16-234200-xxxxx-4360 Hepatitis Vaccines Vaccines $ 50,000 50,000 $ - 0 - FINANCE COMMITTEE VOTE: Motion carried unanimously on a roll call vote with Obrecht absent. Resolution #99332 December 16, 1999 The Chairperson referred the resolution to the Finance Committee. There were no objections. THE FOREGOING RESOLUTIr eraon. County Executive 44w 'AO ""--6 Date Resolution #99332 January 27, 2000 Moved by Taub supported by Law the resolution be adopted. AYES: Galloway, Garfield, Gregory, Jensen, Law, McCulloch, McPherson, Melton, Millard, Moffitt, Obrecht, Palmer, Patterson, Schmid, Sever, Taub, Amos, Appel, Causey-Mitchell, Colasanti, Coleman, Buckley, Dingeldey, Douglas. (24) NAYS: None. (0) A sufficient majority having voted therefor, the resolution was adopted. STATE OF MICHIGAN) COUNTY OF OAKLAND) I, G. William Caddell, Clerk of the County of Oakland, do hereby certify that the foregoing resolution is a true and accurate copy of a resolution adopted by the Oakland County Board of Commissioners on January 27, 2000 with the original record thereof now remaining in my office. In Testimony Whereof, I have hereunto set my hand and affixed the seal of the County of Oakland at Pontiac, Michigan this 2,Agh da,of January, 2000. G. William Caddell, County Clerk