Introduction

Immunization offers a highly effective means of preventing serious illness and deaths in children and adults. However, instabilities in the nation’s immunization system, and in the public health infrastructure that supports it, are contributing to gaps in immunization services and increased risk for outbreaks of infectious disease. In 2000 the Institute of Medicine (IOM) published a report, Calling the Shots: Immunization Finance Policies and Practices, that points to several disturbing signs: growing financial burdens and operational complexities in immunization, short-comings in public- and private-sector investments in vaccine purchases and immunization programs, and fluctuations in coverage plans within the public and private health care sectors that create uncertainties regarding vaccine purchase and coverage arrangements.

The IOM report was initially developed at the request of the U.S. Senate Committee on Appropriations to guide national decision making about health care investments. But the national immunization partnership consists of multiple and diverse relationships involving health officials in state and local governments, health care providers, employers, insurers and health plans, vaccine manufacturers, and others in the private sector. The Centers for Disease Control and Prevention (CDC) requested that IOM undertake a special effort to reach these various groups as part of the dissemination activities for Calling the Shots. This dissemination effort includes three regional workshops and a national meeting to review the findings and recommendations of the IOM report and to examine their implications for health care policy within local and state govern-



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Setting the Course: A Strategic Vision for Immunization Finance - Part 1 Summary of the Chicago Workshop Introduction Immunization offers a highly effective means of preventing serious illness and deaths in children and adults. However, instabilities in the nation’s immunization system, and in the public health infrastructure that supports it, are contributing to gaps in immunization services and increased risk for outbreaks of infectious disease. In 2000 the Institute of Medicine (IOM) published a report, Calling the Shots: Immunization Finance Policies and Practices, that points to several disturbing signs: growing financial burdens and operational complexities in immunization, short-comings in public- and private-sector investments in vaccine purchases and immunization programs, and fluctuations in coverage plans within the public and private health care sectors that create uncertainties regarding vaccine purchase and coverage arrangements. The IOM report was initially developed at the request of the U.S. Senate Committee on Appropriations to guide national decision making about health care investments. But the national immunization partnership consists of multiple and diverse relationships involving health officials in state and local governments, health care providers, employers, insurers and health plans, vaccine manufacturers, and others in the private sector. The Centers for Disease Control and Prevention (CDC) requested that IOM undertake a special effort to reach these various groups as part of the dissemination activities for Calling the Shots. This dissemination effort includes three regional workshops and a national meeting to review the findings and recommendations of the IOM report and to examine their implications for health care policy within local and state govern-

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Setting the Course: A Strategic Vision for Immunization Finance - Part 1 Summary of the Chicago Workshop ments, the coverage of immunization benefits within private health plans, and the delivery and quality of health care services, especially within disadvantaged communities. The IOM workshop discussions are designed to achieve the following goals: foster awareness of the conclusions and recommendations of Calling the Shots; strengthen interactions among public and private sector health officials to build consensus about immunization infrastructure initiatives, measurement approaches, and financing plans; and identify unresolved public health and health finance issues and concerns at the regional, state, and local levels that require further attention from public and private policymakers. This report summarizes the discussions of the first dissemination workshop held in Chicago, Illinois, in June 2001. The workshop, held on the campus of the School of Public Health of the University of Illinois at Chicago, focused particular attention on concerns in the states of Illinois and Michigan and the cities of Chicago and Detroit. Participants included members and staff of the IOM planning committee, consultants and other contributors to Calling the Shots, state and local health officials from Illinois and Michigan, representatives of health plans and health care providers serving the Illinois and Michigan areas, faculty from the School of Public Health at the University of Illinois at Chicago, community leaders, and staff from CDC and other federal agencies. (See Appendixes for the workshop agenda, list of participants, and websites that pertain to the IOM report and the workshop discussions.)