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Calling the Shots: Immunization Finance Policies and Practices Appendix D Overview of State Survey In May 1999, the Institute of Medicine Committee on Immunization Finance Policies and Practices commissioned a 50-state survey from Gary L.Freed, Sarah J.Clark, and Anne Cowan at the Division of General Pediatrics, University of Michigan. The University of Michigan team conducted the survey via phone and mail during the period May-October 1999 with the immunization program managers and project directors in each of the 50 states and the District of Columbia. The names of the program managers and project directors were provided by CDC. Each state project director was asked to designate a respondent who could provide information regarding immunization policies and practices within the state. The respondents were asked to identify other individuals within the state who could provide insights, experience, and data describing how federal, state, and local funds are used to support immunization efforts. These individuals included the state Medicaid director, the chief fiscal officer for state health efforts, and the state director for maternal and child health, among others. CDC also provided state-level data, including copies of the state immunization grant awards and core functions site visit data. In separate, individual interviews, respondents were asked to address a number of topics, including the major outreach campaigns in the 1990s; the state’s response to CDC’s pockets-of-need approach; the structure of the state health department and the relationship of the immunization program within the department; the scope of child health services deliv-
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Calling the Shots: Immunization Finance Policies and Practices ered in health departments through the 1990s; immunization-related “hot issues” with the state legislature; the experience with seeking funding for immunization within the state; the current status of the state’s immunization registry; the state’s role in assessing day care and school immunization coverage levels; enforcement of immunization requirements; exemptions, penalties, and sanctions in the school requirements; and state mandates for insurance coverage of immunizations. Responses were received from all 50 states. A summary of the survey findings is scheduled for publication (forthcoming, American Journal of Preventive Medicine, supplement, 19[3S], October 2000).
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