A letter from the doctor.
A reader of the Times
' Facebook page complained that her 11-year-old son, who was covered by ARKids B — for the underinsured, or, as she described it, the "working poor" — was not able to get his tetanus shot because of what was described to her as "muddled insurance." She learned is that while there is vaccine for children covered under ARKids A, there is a shortage for kids covered under ARKids B. "I don't know what's going on here, but something is amiss and I'm one pissed off mama that vaccines are sitting there but he can't have them because of his "class," she wrote.
But ARKids A recipients aren't getting vaccine at a cost to ARKids B. Here's how Dr. Gary Wheeler,
branch chief for infectious diseases
chief medical officer at the State Health Department, explains what has happened:
The federal government wanted Arkansas's Medicaid system — created in 1998 by a kinder [my description, not Wheeler's] Gov. Mike Huckabee and Amy Rossi, then director of Arkansas Advocates for Children and Family — to get in line with other states and move its underinsured clients into the federal SCHIP (State Children's Health Insurance) program. That program provides federal dollars to states to subsidize private insurance.
Vaccines supplied by Medicaid can only be used for ARKids A. The Health Department had to purchase vaccines for SCHIP kids with SCHIP dollars. [See clarification below.]
Using an estimator provided by the Centers for Disease Control because the exact number of children on SCHIP was unknown, the Health Department, using $1.2 million in SCHIP funding, ordered 18,000 doses of childhood vaccines. The estimator was way off. The department has now ordered 44,000 more doses of vaccines (with $2 million in SCHIP funds). The vaccines should be in Arkansas in a month or so. An appointment to get needed vaccines is now all that's needed for kids to be able to attend school.
The tetanus shot is actually a combination of tetanus, diphtheria and pertussis (whooping cough).
The bright picture, Wheeler said, is that Arkansas is catching up to the rest of the country in the percentage of vaccinated children, especially those getting the meningococcal vaccine, which is now required for school attendance.
Private doctors who have vaccine on hand that they
have paid for may use that vaccine for their SCHIP patients and be resupplied by the Health Department.
Children covered by ARKids A (Medicaid) receive vaccine through the federal Vaccine for Children (VFC) program. VFC vaccine can only be used for ARKids A. Children on ARKids B must now receive vaccine through SCHIP. The Health Department had to purchase vaccines for SCHIP kids with SCHIP dollars provided by Medicaid.