BOX 1–1 Funding of State Activities Under Section 317 Grant Program
CDC provides annual immunization project grants to 64 separate grantees, including 50 states, the District of Columbia, New York City, Chicago, Houston, San Antonio, Puerto Rico, the Virgin Islands, American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the Federated States of Micronesia, the Republic of Belau, and the Republic of the Marshall Islands. Immunization grant funds are intended to supplement but not supplant ongoing state and local immunization efforts. Each grantee’s funding level is contingent on a number of factors, including historical funding levels, the population size, the size of the state and local public health infrastructure, the size of the grantee’s immunization program, the geographical area of the grantee, the proportion of the childhood population served by the public sector, the level of state and local support for the immunization program, the occurrence of vaccine-preventable disease outbreaks, and the grantee’s ability to develop programs and expend funds.
Vaccine is available as Direct Assistance (in lieu of cash), as requested by the applicant, in the form of a “credit line.” Grantees may order childhood or adult vaccines until the credit line is exhausted. CDC also considers requests for CDC personnel (and their travel) and other forms of direct assistance to purchase goods and services through General Services Administration contracts in order to develop and implement immunization registries.
Grant funds in the form of Financial Assistance may be used for costs associated with planning, organizing, and conducting immunization programs. Grantees use financial assistance to pay for project personnel, travel, supplies, contracts, other miscellaneous costs, and indirect charges. Grantee personnel carry out programmatic functions such as conducting audits and surveys; investigating vaccine-preventable disease outbreaks; assisting with outbreak control measures; coordinating program efforts with other federal, state, and local governments and private and community-based organizations; and carrying out a variety of professional and community educational efforts.
CDC has always specified that immunization grants are intended to supplement and may not supplant state and local resources. The immunization grants are “discretionary,” and no formula exists for the allocation of CDC funding to grantees. Each grantee’s funding level is contingent primarily on the grantee’s need as expressed in the amount requested annually. Matching funds from the states or territories are not required for the federal grants, and grantees need not allocate any of their own funds to purchase or distribute vaccines or pay for other operational costs. CDC does rely on some grantees to assume a larger share of the responsibility so that a greater proportion of the available funds can be allocated to other grantees.
CDC adjusts the grant awards to meet each grantee’s operational needs and unique circumstances in each project area. In general, CDC is unable to provide grantees with as much funding as they request. In the past, the funds have been distributed among geographic regions and earmarked for specific program activities, such as perinatal hepatitis B prevention.
Since 1998, CDC has determined the size of grant awards for each state by applying a uniform percentage reduction to all grantees’ operational funding needs.