ANDERSON — The Madison County Health Department is in a quandary over providing immunizations to local residents.
The department has been hit by three problems that have led to an increase in patient and vaccinations despite a tightening budget.
For the first nine months of the year there have been significant increases in the number of patients being seen by the department and in the number of vaccinations being provided, officials said.
Through September the department saw 678 patients compared to 554 last year. The number of immunizations has also climbed from 1,543 to 2,024.
“We have been inundated with kids,” Dixie Cummings, nursing supervisor, reported to the Madison County Board of Health.
The increases are due in part to action in 2013 by the Indiana State Board of Health (ISDH) that terminated the Vaccine for Children program with the Madison County Community Health Center.
In a letter dated in October 2013, ISDH notified the Health Center that it was terminated immediately from the program, which provides free vaccine.
A grant in the amount of $226,625 was withdrawn by the state.
The agreement was terminated because of the health center’s failure to comply with eligibility screening requirements, the letter stated.
“Based on information gathered from multiple sources, the Madison County Community Health Center is not in compliance with the Indiana State Department of Health’s requirements for proper eligibility screening and vaccine administration,” the ISDH letter said.
Although the Madison County Health Center could have submitted a new application in 2014, ISDH is not providing any grant funds to the local clinic because seven conditions have not been met.
Those conditions included: removal of Anthony Malone as president and CEO; that a replacement CEO or interim CEO needed to be approved by the ISDH; no pain medications were to be offered; and submission of a remediation plan submitted for participation in the Vaccines for Children Program.
“MCCHC has not addressed the concerns raised by the Indiana State Department of Health and is not currently eligible to be a provider in the VCF program,” Jennifer O’Malley, director of the ISDH Office of Public Affairs, said this past week.
MCCHC officials failed to respond to requests for comment to The Herald Bulletin by email and telephone on Friday.
Patients of the health center are being directed to the county health department to get required childhood immunizations.
“We don’t know if they have purchased vaccine on their own,” Steve Ford, administrator of the Health Department, said. “The patients we’re seeing are behind on their immunizations.”
Also at issue is a local physician's storage of vaccines at improper temperatures. The physician is not associated with the health center.
Cummings said the vaccines provided by the physician for the 11-month period from September, 2014 to August, 2015 were not viable. The county health department has been asked to treat children affected.
“The state wants the health department to vaccinate all those children,” she said. “Those patients have been told to go to the health department.”
Thirdly, the local health department frequently runs out of vaccine and is short staffed, officials said.
“We’re swamped,” Cummings said.
Currently the department has two full-time nurses and one part-time nurse who works four days a week.
“There are two part-time nursing positions, funded by grants, that are vacant,” Cummings said. “Filling those positions would help considerably.”
Ford said the problem is that nurses usually seek a higher pay rate than the county is offering. There was no additional funding to increase the nurses’ salary in the county’s 2016 budget.
Ford said the county can only get vaccine from the state based on what was used in the previous month.
He said that becomes a problem at the start of the school year when students are required to have the proper immunizations to attend classes.
“At the top of the school’s list to get immunizations is the health department,” Cummings said.
“We have requested additional doses of vaccine, but we don’t know if we will get it,” she said.
In addition to administering the vaccine, nurses are required to perform data entry and billing as well as provide the state with the date and lot number of the vaccine, Cummings said.
Ford said some local physicians have stopped providing vaccinations because of the paperwork involved.