BILL ANALYSIS

C.S.H.B. 448

By: Hopson

Public Health

Committee Report (Substituted)

BACKGROUND AND PURPOSE

S.B. 811, enacted by the 80th Legislature, Regular Session, 2007, provided two methods for purchasing vaccines, one for flu vaccines and another for equivalent vaccines under the vaccines for children program. Since the legislation's enactment, additional changes in vaccine purchasing have been implemented by the Centers for Disease Control and Prevention (CDC), which have significantly diminished the role of the Department of State Health Services (DSHS) in the distribution of vaccines.  In light of those changes, DSHS has agreed to move the state toward a single method for vaccine purchasing and distribution.

C.S.H.B. 448 requires DSHS to establish a provider choice method for providers participating in the vaccines for children program and the adult safety-net vaccine program to order the provider's preference of vaccine, submit the order through the proper channels, and fill orders through CDC's distribution system.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

ANALYSIS

C.S.H.B. 448 amends the Health and Safety Code to require the Department of State Health Services (DSHS) to implement a provider choice system for the vaccines for children program operated by the department under federal authority and the adult safety-net program.

C.S.H.B. 448 requires DSHS to ensure that eligible health care providers participating in the vaccines for children program or adult safety-net program may select any licensed vaccine, including combination vaccines and any dosage forms, that is recommended by the Advisory Committee on Immunizations Practices, made available to the department by the Centers for Disease Control and Prevention (CDC), and, for an adult vaccine, is on the approved list of vaccines offered by the adult safety-net program.

C.S.H.B. 448 requires DSHS, if equivalent vaccines are available that meet the above requirements and the cost of one or more of those equivalent vaccines exceeds 115 percent of the lowest-price equivalent vaccine, to distribute the lowest-price equivalent vaccine or vaccines.  The bill specifies that equivalent vaccines means two or more vaccines, excluding the influenza vaccine, that protect a vaccine recipient against the same infection or infections, require the same number of doses, have similar safety and efficacy profiles, and are recommended for comparable populations.  The bill specifies that the provider choice system does not apply in the event of a disaster or public health emergency, terrorist attack, hostile military or paramilitary action, or extraordinary law enforcement emergency.

C.S.H.B. 448 requires DSHS to convene the immunization work group established to assist the department in developing continuing education programs for providers relating to immunizations and vaccines to develop a plan for the implementation of the provider choice system. The bill requires the plan to include education of participating health care providers about CDC procedures and distribution systems, vaccine options, the enrollment process, ordering, accountability, and reporting procedures. The bill requires DSHS to implement all or part of the provider choice system as soon as it is determined to be feasible, to be completed no later than August 31, 2010.

C.S.H.B. 448 repeals Section 161.0103, Health and Safety Code, relating to procurement by the department of equivalent vaccines for the vaccines for children program, effective September 1, 2010.

EFFECTIVE DATE

September 1, 2009.

COMPARISON OF ORIGINAL AND SUBSTITUTE

C.S.H.B. 448 differs from the original by adding the requirement that DSHS, if equivalent vaccines are available that meet the minimum requirements under provisions of the bill and the cost of one or more of those equivalent vaccines exceeds 115 percent of the lowest-price equivalent vaccine, distribute the lowest-price equivalent vaccine or vaccines. The substitute specifies that equivalent vaccines means two or more vaccines, excluding the influenza vaccine, that protect a vaccine recipient against the same infection or infections, require the same number of doses, have similar safety and efficacy profiles, and are recommended for comparable populations. The substitute specifies that the provider choice system does not apply in the event of a disaster or public health emergency, terrorist attack, hostile military or paramilitary action, or extraordinary law enforcement emergency.