Post on 14-Jan-2016
description
Vaccination Financing: Program Vaccination Financing: Program Funding and PressuresFunding and Pressures
Vaccination Financing: Program Vaccination Financing: Program Funding and PressuresFunding and Pressures
AIM Program Managers MeetingAIM Program Managers MeetingNovember 19, 2008November 19, 2008
New Orleans, LANew Orleans, LA
Lance E. Rodewald, MDLance E. Rodewald, MD
Director, Immunization Services DivisionDirector, Immunization Services Division
National Center for Immunization and Respiratory Diseases, CDCNational Center for Immunization and Respiratory Diseases, CDC
GoalsGoals
Account for FY06 through FY08 actual Account for FY06 through FY08 actual operations fundingoperations funding
Project maximum and minimum Project maximum and minimum funding for FY09 operationsfunding for FY09 operations
Project possible vaccine funding for Project possible vaccine funding for FY09FY09
Section 317 Operations Funding: Section 317 Operations Funding: FY06 – FY08FY06 – FY08
FY06 FY07 FY08
New Money 169,424,191 175,587,975 176,775,795
DA Other 2,338,817 2,231,103 2,029,275
Carryover Awarded 23,125,166 17,698,692 4,999,821
Total 194,888,174 195,517,770 183,804,891
VFC Non-Vaccine Funding: VFC Non-Vaccine Funding: FY06 – FY08FY06 – FY08
FY06 FY07 FY08
OPS 46,620,538 48,816,452 41,682,574
AFIX 34,900,000 36,295,927 36,822,071
DA Other 1,803,018 132,498 Carryover
TOTAL 83,323,556 85,112,379 78,637,143
Total Operations Funding: Total Operations Funding: FY06 – FY08FY06 – FY08
FY06 FY07 FY08
New Money 255,086,564 262,931,457 257,442,213
Carryover Awarded 23,125,166 17,698,692 4,999,821
Pan Flu 15,422,284Total to
Grantees 278,211,730 280,630,149 277,864,318
Section 317 Operations Funding: Section 317 Operations Funding: FY08 – FY09 (projected)FY08 – FY09 (projected)
FY08 FY09 Max FY09 Min
New Money 176,775,795 175,111,886 169,858,529
DA Other 2,029,275
Carryover Awarded 4,999,821 17,364,000 17,364,000
Total 183,804,891 192,475,886 187,222,529
VFC Non-Vaccine Funding: VFC Non-Vaccine Funding: FY08 – FY09 (projected)FY08 – FY09 (projected)
FY08 FY09 Max FY09 Min
OPS 41,682,574 34,400,000 33,368,000
AFIX 36,822,071 37,705,454 37,705,454
DA Other 132,498 169,939 169,939
Carryover 391,735 391,735
TOTAL 78,637,143 72,667,128 71,635,128
Total Operations Funding: Total Operations Funding: FY08 – FY09 (projected)FY08 – FY09 (projected)
FY08 FY09 Max FY09 Min
New Money 257,442,213 247,217,340 241,101,922
Carryover Awarded 4,999,821 17,755,735 17,755,735
Pan Flu 15,422,284 15,830,061 8,006,000Total to
Grantees 277,864,318 280,973,075 266,863,657
Operations Funding Time LineOperations Funding Time Line
Continuing resolution until March 6, 2009 for Section Continuing resolution until March 6, 2009 for Section 317 and Pandemic Influenza funding; VFC not 317 and Pandemic Influenza funding; VFC not subject to CRsubject to CR
First roundFirst round– All carryoverAll carryover
– Almost all VFC fundingAlmost all VFC funding
– 43% of Section 317 and Pan Flu funding43% of Section 317 and Pan Flu funding
Because of CR, we are unlikely to be able to Because of CR, we are unlikely to be able to accomplish all funding in 2 roundsaccomplish all funding in 2 rounds
Operations Funding AwardsOperations Funding Awards
We will provide grantees with separate accounting for We will provide grantees with separate accounting for categoriescategories– Section 317Section 317
– VFC-AFIXVFC-AFIX
– VFC operationsVFC operations
– Pandemic influenzaPandemic influenza
Accounting will includeAccounting will include– First round amountFirst round amount
– Projected full-year minimumProjected full-year minimum
– Projected full-year maximumProjected full-year maximum
Goal is to allow as much information as early as possible in the Goal is to allow as much information as early as possible in the fiscal yearfiscal year
VFC Vaccine: FY08VFC Vaccine: FY08
FY08 approved target budgetFY08 approved target budget– Based on PES/VOFABased on PES/VOFA
– $3.004 B$3.004 B
Emergency request for additional $113 M was Emergency request for additional $113 M was approved by OMB and included into FY08approved by OMB and included into FY08
FY08 spent VFC vaccine budgetFY08 spent VFC vaccine budget– Based on vaccine ordersBased on vaccine orders
– $2.681 B (89% of approved target amount)$2.681 B (89% of approved target amount)
VFC and Section 317 Vaccine VFC and Section 317 Vaccine Budget Spending: FY08Budget Spending: FY08
VFC Section 317
Target $ 3,004 M $ 273 M*
Routine Spending
$ 2,681 M $ 247 M
Hepatitis B Initiative
--------- $ 16 M
Total Budget Remaining
$ 323 M (11%)
$ 11 M(4%)
* Includes Base plus carryover funding
VFC Vaccine: FY09VFC Vaccine: FY09
Approved for FY09Approved for FY09– $2.442 B$2.442 B
Projected spending in FY09Projected spending in FY09– $3.019 B$3.019 B
– Based upon two projection methodsBased upon two projection methods PES/VOFAPES/VOFA Forward projection modelForward projection model Results nearly identicalResults nearly identical
– Additional projected spending from increased vaccine Additional projected spending from increased vaccine use and new ACIP recsuse and new ACIP recs
Shortfall will be requested in DecemberShortfall will be requested in December
VFC and Section 317 Vaccine VFC and Section 317 Vaccine Funding to Immunization Funding to Immunization Programs: 1990 - 2008Programs: 1990 - 2008
$0
$500,000,000
$1,000,000,000
$1,500,000,000
$2,000,000,000
$2,500,000,000
$3,000,000,000
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
Section 317 VFC
FUNDING TRENDSFUNDING TRENDSSection 317 ops and vaccineSection 317 ops and vaccine
Operations FundingOperations Funding
End of VFC adolescent vaccination fundingEnd of VFC adolescent vaccination funding
End of distribution funding in operations (with few End of distribution funding in operations (with few exceptions: PIs and AK)exceptions: PIs and AK)
Increasing categorizationIncreasing categorization– VFC-AFIXVFC-AFIX
– VFC operations/orderingVFC operations/ordering
– Pandemic influenzaPandemic influenza
Separate accounting for categoriesSeparate accounting for categories
New Section 317 Report to New Section 317 Report to CongressCongress
Third year this annual report was requested Third year this annual report was requested by both Appropriations Committeesby both Appropriations Committees
New request asked for same methodology for New request asked for same methodology for new reportnew report
NVAC recommended thatNVAC recommended that– Congress should continue to ask for this report Congress should continue to ask for this report
every yearevery year
– Congress should use the report in their Congress should use the report in their appropriations considerationsappropriations considerations
OMB Requested Section 317 OMB Requested Section 317 BenchmarksBenchmarks
Funding proposals for transition documentFunding proposals for transition document
CDC proposals based on Section 317 Report to CDC proposals based on Section 317 Report to CongressCongress– Adolescent vaccinationAdolescent vaccination
– Adult vaccinationAdult vaccination
– School-age influenzaSchool-age influenza
– Maintaining acceptanceMaintaining acceptance
Prospects unknown, but shows the helpfulness of Prospects unknown, but shows the helpfulness of the 317 Report for articulating projects with great the 317 Report for articulating projects with great value to society that are consistent with our programvalue to society that are consistent with our program
QUESTIONS AND QUESTIONS AND DISCUSSIONDISCUSSION
Topics for QuestionsTopics for Questions
2-tiered systems2-tiered systems
AccountabilityAccountability– Fraud and abuse algorithmFraud and abuse algorithm
– PESPES
– AIM Accountability WorkgroupAIM Accountability Workgroup
Tracking vaccine spendingTracking vaccine spending
VMBIP savingsVMBIP savings
Extra Slides