Department of Health
A Review of Management Controls at the
Department of Health's Immunization Program
December 1999
Report Number 00-007
Overall Conclusion
Incomplete immunization data, gaps in provider monitoring, and the inconsistent reporting of information makes it difficult to determine if resources provided by the State of Texas and the federal government have been efficiently and appropriately used by the Department of Health's Immunization Program (Program). The Department of Health (Department) has received more than $300 million in cash and vaccines for the Program over the past four years.
Immunization rates for school age children are high, and incidence of childhood disease is stable, which may indicate that the Program has been successful in getting children immunized. Our main areas of concern are the underutilization of the statewide immunization registry, the lack of information regarding performance of providers, and the inconsistent reporting of vaccine supplies.
Key Facts and Findings
- Fewer than half of Texas' 5.5 million children are being tracked by the statewide immunization registry. The objectives of a centralized statewide registry are to keep track of whether a child has received immunizations, to help remind parents when immunizations are due, and to provide a centralized immunization history for healthcare providers to use. Because the data is so incomplete, these benefits have not been realized to the extent intended. Texas has invested more than $10 million in this registry to date, with annual expenditures to maintain the system exceeding $1 million.
- The Department has not adequately documented provider monitoring activities necessary to ensure that vaccines and cash given to healthcare providers have been used as intended. Policies, procedures, and criteria that would provide for consistent programmatic monitoring have not been documented. Additionally, the Program has not implemented a consistently applied risk assessment methodology to determine high-risk providers.
- Reporting of vaccine inventory information is inconsistent, increasing the risk that decision makers do not have accurate information. The Department has not developed written policies and procedures to direct consistent statewide reporting of immunization and vaccine inventory information.
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