The city Health Department plans to appeal an alleged violation of the Vaccines for Children program which could cost the city $1,536 to replace two vaccines permitted to expire without being used.
"We missed a reporting deadline," city Health Commissioner Richard Setty told health board members Wednesday.
Setty explained that the department received a letter from the Ohio Department of Health concerning the problem. He said there's a policy in place that requires the department, as a provider for the Vaccines For Children program, to notify the VFC when an unused vaccine is three months from its expiration date.
That did not happen for two vaccines last fall.
According to the letter, the ODH Immunization Program reviewed a vaccine order and vaccine accountability report from the city health department on Sept. 26 that showed 19 doses of DTaP/IPV and 13 doses of Rotavirus vaccines had expired. The letter said ODH did not receive notification that the doses were due to expire.
"The ODH Vaccine Handling and Wastage Policy (which took effect April 2, 2012) indicates that significant losses of non-viable vaccine must be replaced by the VFC provider in cases of non-compliance, including failure to notify ODH of excess stock at least three months prior to expiration," the letter said.
The department was given two options: either a dose-for-dose replacement at the open-market cost, which would total $1,889; or a dollar-for-dollar replacement at the federal contract price, which would total $1,536.
Setty said he was provided with several options for handling this, with a suggestion to submit the cost under the professional liability insurance for the department's nurse, which was attempted and denied, or appeal the non-compliance order. He said he was told Salem isn't the only local health department in this situation.
He showed the board members a letter he's submitting to outline a corrective action plan combined with an appeal. Vaccines for the Vaccines For Children program come from the Centers for Disease Control through ODH, which enrolls the local boards of health to administer the vaccines to children in need. He said there wasn't much usage of the vaccines in question, but they're expected to have some on hand in case a need arises.
Board member Newt McKnight questioned if it was a matter of not checking the expiration dates or not knowing the policy regarding the notification three months prior to a vaccine expiring. Mayor John Berlin, who serves as board president by virtue of his position, said it was the second part, about not knowing the policy.
"Now we're aware of it," he said.
When asked how everything was going to be tracked, Setty said the department nurse has already been tracking the vaccines.
"These two particular vaccines fell through the cracks," he said.
The number of vaccines in the program varies from 15 to 20 at any given time.
The letter regarding the situation was dated Nov. 25, but wasn't received by the city health district until Dec. 5. Setty said the state originally wanted an answer or written plan to replace the vaccine by Dec. 20, but he told the state that wasn't enough time. The city health district received an extension until Jan. 31 to respond. He was told the state's response could come in 45 days, which gives the department enough time to have something in place if the cost of the vaccine has to be reimbursed.
According to the ODH letter, "providers who do not pay ODH for the invoiced vaccine will be certified (for collections) to the Ohio Attorney General's office 45 days from the original invoice date and terminated from the VFC program."
In other business, the board tabled a request from an attorney Setty said he knew regarding support of efforts to challenge a situation with the National Association of Local Boards of Health. The board previously had membership in the NALBOH until this year when no membership renewal was received allegedly due to some unrest in the organization.
The letter from the attorney said the board laid off the staff, failed to fill empty board seats, has a sizeable debt and closed the offices with plans to possibly move the offices out of the state of Ohio. He's representing members who want to keep the NALBOH intact in Ohio and restored.
Salem board members questioned whether their support would require financial support and whether a resolution would obligate the city beyond the yearly dues, which they did not appear willing to do.