S AMDT 1003

S 1003 IS

To increase immunization rates.

May 7, 2009

Mr. REED introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

To increase immunization rates.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title- This Act may be cited as the ‘Immunization Improvement Act of 2009’.

(b) Table of Contents- The table of contents for this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. Findings.

Sec. 3. State authority to purchase recommended vaccines for adults.

Sec. 4. Demonstration program to improve immunization coverage.

Sec. 5. Reauthorization of immunization program.

Sec. 6. Inclusion of recommended immunizations under part B of the Medicare program with no beneficiary cost-sharing.

Sec. 7. Medicaid coverage of recommended adult immunizations.

Sec. 8. Vaccine administration fees.

Sec. 9. Health insurance coverage for recommended immunizations.

Sec. 10. Immunization information systems.

Sec. 11. Reports.

SEC. 2. FINDINGS.

Congress makes the following findings:

(1) Immunizations recommended for routine use have been proven to be clinically effective in improving health and preventing the spread of disease. Routine childhood immunizations prevent over 14,000,000 cases of disease and over 33,500 deaths over the lifetime of children born in any given year. In addition to protecting individuals from disease, immunization provides population-based (herd) immunity.

(2) An economic evaluation of the impact of seven vaccines routinely given as part of the childhood immunization schedule found that the vaccines are cost-effective. Over the lifetime of children born in any given year, these immunizations result in an annual cost savings of $10,000,000,000 in direct medical costs and over $40,000,000,000 in indirect societal costs.

(3) There are significant and persistent gaps in public and private health insurance coverage of immunizations. About 11 percent of young children and 21 percent of adolescents are underinsured for immunizations. Among adults, 59 percent are underinsured and 17 percent are completely uninsured for immunizations. According to the Institute of Medicine, even those with insurance increasingly have to pay higher deductibles and copayments for immunizations.

(4) Each year, vaccine-preventable diseases cause the deaths of more than 42,000 people and hundreds of thousands cases of illness.

(5) In 2003, the Institute of Medicine’s Committee on the Evaluation of Vaccine Purchase Financing made the following conclusions:

(A) Current public and private financing strategies for immunization have had substantial success, especially in improving immunization rates for young children. However, significant disparities remain in assuring access to recommended vaccines across geographic and demographic populations.

(B) Many young children, adolescents, and high-risk adults have no or limited insurance for recommended vaccines. Gaps and fragmentation in insurance benefits create barriers for both vulnerable populations and clinicians that can contribute to lower immunization rates.

SEC. 3. STATE AUTHORITY TO PURCHASE RECOMMENDED VACCINES FOR ADULTS.

Section 317 of the Public Health Service Act (42 U.S.C. 247b) is amended by adding at the end the following:

‘(l) Authority To Purchase Recommended Vaccines for Adults-

‘(1) IN GENERAL- The Secretary may negotiate and enter into contracts with manufacturers of vaccines for the purchase and delivery of vaccines for adults otherwise provided vaccines under grants under this section.

‘(2) STATE PURCHASE- A State may obtain adult vaccines (subject to amounts specified to the Secretary by the State in advance of negotiations) through the purchase of vaccines from manufacturers at the applicable price negotiated by the Secretary under this subsection.’.

SEC. 4. DEMONSTRATION PROGRAM TO IMPROVE IMMUNIZATION COVERAGE.

Section 317 of the Public Health Service Act (42 U.S.C. 247b), as amended by section 3, is further amended by adding at the end the following:

‘(m) Demonstration Program To Improve Immunization Coverage-

‘(1) IN GENERAL- The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall establish a demonstration program to award grants to States to improve the provision of recommended immunizations for children, adolescents, and adults through the use of evidence-based, population-based interventions for high-risk populations.

‘(2) STATE PLAN- To be eligible for a grant under paragraph (1), a State shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require, including a State plan that describes the interventions to be implemented under the grant and how such interventions match with local needs and capabilities, as determined through consultation with local authorities.

‘(3) USE OF FUNDS- Funds received under a grant under this subsection shall be used to implement interventions that are recommended by the Task Force on Community Preventive Services (as established by the Secretary, acting through the Director of the Centers for Disease Control and Prevention) or other evidence-based interventions, including--

‘(A) providing immunization reminders or recalls for target populations of clients, patients, and consumers;

‘(B) educating targeted populations and health care providers concerning immunizations in combination with one or more other interventions;

‘(C) reducing out-of-pocket costs for families for vaccines and their administration;

‘(D) carrying out immunization-promoting strategies for participants or clients of public programs, including assessments of immunization status, referrals to health care providers, education, provision of on-site immunizations, or incentives for immunization;

‘(E) providing for home visits that promote immunization through education, assessments of need, referrals, provision of immunizations, or other services;

‘(F) providing reminders or recalls for immunization providers;

‘(G) conducting assessments of, and providing feedback to, immunization providers; or

‘(H) any combination of one or more interventions described in this paragraph.

‘(4) CONSIDERATION- In awarding grants under this subsection, the Secretary shall consider any reviews or recommendations of the Task Force on Community Preventive Services.

‘(5) EVALUATION- Not later than 3 years after the date on which a State receives a grant under this subsection, the State shall submit to the Secretary an evaluation of progress made toward improving immunization coverage rates among high-risk populations within the State.

‘(6) REPORT TO CONGRESS- Not later than 4 years after the date of enactment of the Immunization Improvement Act of 2009, the Secretary shall submit to Congress a report concerning the effectiveness of the demonstration program established under this subsection together with recommendations on whether to continue and expand such program.

‘(7) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be appropriated to carry out this subsection, such sums as may be necessary for each of fiscal years 2010 through 2014.’.

SEC. 5. REAUTHORIZATION OF IMMUNIZATION PROGRAM.