The Vaccines for Children Program makes sure kids whose parents can’t afford vaccines can still get them. Funding for VFC comes via CMS to the CDC, who buys vaccines at a discount and distributes them to states. States then distribute them to physicians’ offices & clinics that take part in the VFC program. The Arizona Department of Health Services manages the VFC program in our state.
The VFC program covers vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) for these 16 diseases
Doctor’s offices and clinics are required to be enrolled as a VFC provider by ADHS in order to take part in the Medicaid program… so, the number of providers enrolled in VFC has a direct impact on the adequacy of a state’s care network for kids enrolled in Medicaid (AHCCCS).
Arizona’s VFC Provider Network Decreased Dramatically During the Ducey Administration
Arizona has a big problem that that you may not have heard much about: Providers have been dropping out of the VFC program in droves large part because of ADHS’ over-regulation of the VFC program (although industry consolidation has also played a role).
Arizona lost 50% of its VFC providers during the Ducey administration, going from 1,200 providers in 2015 to only 600 today
Why the decline? If you talk to providers who left VFC over the last few years, many will tell you they quit because of the administrative hassles that have been imposed on them by the state (ADHS not AHCCCS). At the top of the list of grievances is ADHS’ punitive practice of financially punishing providers with wastage rates over 5%.
Even though pediatric providers lose money by participating in the VFC program, the ADHS has been fining them for replacement doses if they had a 5% or higher wastage rate (see this letter to AZAAP members regarding the ADHS policy)
See Arizona’s Vaccines for Children (VFC) Program Requirements
How Does Arizona’s VFC Enrollment Compare to the Rest of the US?
Not good. Arizona has 6 VFC providers per 10,000 Medicaid eligible kids, while the national average is 24 providers per 10,000 Medicaid kids… meaning Arizona only has a quarter of the number of VFC providers per Medicaid kid compared with the national average. Many people believe that the declining immunization rates among AZ kids are in part due to a thinning network of VFC providers in Arizona.
Childhood Vaccination Rates Continue to Drop In the 2021-2022 School Year
Hopefully there will be new leadership coming to the ADHS in a few months – and perhaps that person will reverse the erosion in VFC participation that occurred during the Ducey administration. Maybe she or he will even alter their policies to encourage (rather than discourage) participation in VFC (and by extension, improve the pediatric Medicaid network).
The next ADHS director should start by engaging stakeholders like the Arizona Academy of Pediatrics, Arizona Academy of Family Physicians, the Arizona Partnership for Immunizations & AHCCCS and do a root-cause analysis of the decline in participation and then create and implement a plan to reengage providers in taking part in VFC.
The group should also decide whether the ADHS is actually the best place to manage the VFC program or whether it belongs over at AHCCCS.
