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Department seeks increases for immunizations program and advanced-directive registry
Summary
The Health Department told appropriators it will seek $1.8 million additional special-fund authority for the statewide vaccine purchasing program and a $435,000 increase for the advanced-directive registry contract administered through the Vermont Ethics Network.
Mark Levine, commissioner of the Vermont Department of Health, told the appropriations committee the department's immunization program is a universal vaccine program that purchases vaccines through CDC contracts and distributes them to providers statewide. He said the department is proposing a $1.8 million increase in special-fund spending authority tied to the insurer assessment-based vaccine purchasing fund; the increase includes about $770,000 in global-commitment funding for adult vaccines such as shingles and influenza that have driven cost increases.
Levine explained the state's vaccine purchasing program assesses health insurers and deposits the receipts in a separate special fund that pays vaccine costs and associated program expenses; children on Medicaid continue to be covered through the federal Vaccines for Children program, and adult Medicaid vaccines are paid via existing Medicaid mechanisms. He told members the program's high K–12 vaccination rate — about 94 percent in the 2023–24 school year for required vaccines — reflects the state purchasing model.
The department also presented an increase in the grant to the Vermont Ethics Network that supports the state advanced-directive registry. Levine said the department's cost increase for that contract is $435,000, driven by higher fees charged by the registry vendor (the American Living Will Registry) and additional staff time required by the Vermont Ethics Network to administer the contract.
Representative committee members asked clarifying questions about drivers of vaccine cost increases, and Levine said the biggest cost increases have been on newer adult vaccines, such as shingles, rather than traditional childhood vaccines. He added the state benefits from CDC bulk purchasing but cannot negotiate federal contracts directly for national procurement.
The committee did not take final action on either line item during the hearing; staff requested more detailed historical comparison data and expected to review program-specific metrics as part of budget deliberations.
