Monday, August 20th, 2012
August 15, 2012
TO: Health Care Providers, Hospitals, and Local Health Departments
FROM: New York State Department of Health, Bureau of Immunization
New York State Public Health Law (PHL) §2112 prohibits the administration of vaccines containing more than trace amounts of thimerosal, a mercury-containing preservative, to children less than 3 years of age and women who know they are pregnant, with certain exceptions. This law requires that the Commissioner of Health make a yearly determination of the adequacy of the supply of influenza vaccine that contains not more than 1.25 micrograms of mercury per 0.50 milliliter dose for women who know they are pregnant and not more than 0.625 micrograms of mercury per 0.25 milliliter dose for children less than 3 years of age.
The Commissioner of Health has determined that, as of August 15, 2012, it appears that there will be an adequate supply of thimerosal-free seasonal influenza vaccine for vaccination of pregnant women and children under the age of three years. Therefore, health care providers (physicians, nurse practitioners, physicians assistants, nurse midwives) providing influenza vaccinations to pregnant women and children under 3 years of age should purchase sufficient supplies of seasonal influenza vaccine to ensure vaccination compliance with PHL § 2112. In the event of late failure of vaccine production, the Commissioner may modify this determination.
Health care providers vaccinating pregnant women and children less than 3 years of age are expected to seek out vaccine that complies with PHL §2112. The NYSDOH, however, recognizes that in prior years, although the supply of thimerosal-free vaccine appeared adequate, certain New York State health care providers were unable to order such vaccine. In those instances when health care providers have in good faith sought out influenza vaccine that complies with PHL §2112, but such vaccine cannot be obtained, vaccination of children less than 3 years of age and pregnant women is still recommended because the substantial risk of complications or death from influenza disease in these groups outweighs the unproven risk of vaccination with thimerosal-containing vaccine. Health care providers should document the attempts that were made to locate and obtain the vaccine. They should also be aware that a pregnant woman or parent/guardian of a child less than 3 three years of age must provide informed consent for the administration of vaccine that contains more than trace amounts of thimerosal as noted above.
For additional information, please go to the NYSDOH webpage as noted below: http://www.nyhealth.gov/regulations/public_health_law/section/2112/information_for_physicians/
Additional information regarding vaccine safety, including the use of thimerosal in vaccines, can be obtained at the Centers for Disease Control and Prevention’s National Immunization Program website at http://www.cdc.gov/od/science/iso/, and at the website of the U.S. Food and Drug Administration at http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/default.htm
For further information, please contact your local health department or your regional New York State Department of Health Bureau of Immunization representative at the following:
Western Regional Office Central New York Regional Office
Buffalo / Rochester: 716 – 847 – 4501 Syracuse: 315 – 477 – 8164
Capital District Regional Office Metropolitan Area Regional Office
Troy: 518 – 408 – 5278 New Rochelle: 914 – 654 – 7149
Central Islip: 631 – 851 – 3096
Monticello: 845 – 794 – 2045
For questions about ordering vaccine in New York State (outside of New York City), Vaccines for Children (VFC) providers can call 518 – 474 – 4578 or toll free at 800 – KID – SHOT during business hours.
Providers and facilities in New York City should contact the New York City Department of Health and Mental Hygiene at 347 – 396 – 2400. For questions about ordering vaccine in New York City, VFC providers can call 347 – 396 – 2405 during business hours.
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Tuesday, August 7th, 2012
Federal Waiver Will Allow New York to Fully Implement the MRT Action Plan
Albany, NY (August 6, 2012)
Governor Andrew M. Cuomo today announced that New York has submitted an application for a waiver from the federal government that will allow the state to invest up to $10 billion in savings generated by the Medicaid Redesign Team (MRT) reforms to implement an action plan to transform the state’s health care system.
The Medicaid 1115 waiver amendment will enable New York to fully implement the MRT action plan, facilitate innovation, and lower health care costs over the long term. The waiver application submitted today by New York State requests that the federal government allow the state to reinvest over a five-year period up to $10 billion of the $17.1 billion in federal savings generated by MRT reforms.
“The reforms put in place by the Medicaid Redesign Team have already resulted in major savings for taxpayers and better quality of care for New Yorkers,” Governor Cuomo said. “This waiver amendment will allow New York State to fully implement the groundbreaking MRT action plan to permanently restructure our health care system and continue to make New York a national model.”
The initiatives proposed by the MRT – and adopted by the Legislature last year – have led to major savings for state and federal taxpayers. MRT initiatives are projected to save $34.3 billion over the next five years – divided between the State and federal government. If not for these MRT initiatives, state spending would have grown by $2.3 billion in the 2011-12 fiscal year alone.
The waiver amendment’s broad objectives are consistent with the Centers for Medicare and Medicaid Services’ (CMS ) Triple Aim: better health, better care, and lower costs. New York will use federal dollars generated through MRT savings to reinvest in the state’s health care system.
Key strategies outlined in the waiver amendment document include:
As part of the waiver amendment application process and in accordance with requirements outlined by the CMS, New York initiated an extensive public engagement effort. Citizens and stakeholders participated in public forums, topic-specific webinars, and Medicaid member focus groups. The process also included a survey tool, which enabled the public and stakeholders to submit ideas and comments which informed the waiver amendment application.
More information and a copy of the Medicaid waiver amendment application and is available at:http://www.health.ny.gov/health_care/medicaid/redesign/ .
U.S. Representative Brian Higgins said, “Health Care infrastructure investment in Western New York benefits both patient care and the region’s economy. This waiver will allow for continued progress to improve our health care delivery system, creating a better health care network for our region and beyond.”
U.S. Representative Peter King said, “The waiver amendment provides a critical opportunity for New York to modernize and strengthen its health system. I am proud to work with Governor Cuomo and to take the lead on the federal level to ensure that the application is approved quickly.”
U.S. Representative Eliot Engel, said, “Reinvesting our state’s savings to improve the Medicaid program can only help New Yorkers. Instead of Medicaid costing another $2.3 billion, in the 2011-12 fiscal year, savings initiatives are projected to save approximately $34 billion over the next five years, to be divided between the state and federal governments. Putting these funds back to work here in New York helps to keep New Yorkers healthier.”
About the Medicaid Redesign Team:
Established by Governor Cuomo in January 2011, the MRT brought together stakeholders and experts from throughout the state to work cooperatively to both reform New York State’s health care system and reduce costs. In January and February 2011, the MRT held a series of public meetings across the State, which provided New Yorkers valuable opportunities to share their ideas and comments. Meetings were also broadcast on the Internet and informational materials were posted on the MRT web page. In all, the MRT received more than 4,000 ideas from citizens and stakeholders.
The MRT worked in two phases. Phase 1 provided a blueprint for lowering Medicaid spending in State fiscal year 2011-12 by $2.3 billion. Phase 1 was completed in February 2011 when the MRT submitted an initial report in line with the Governor’s Medicaid spending target contained in his 2011-2012 budget. The report included 79 recommendations to redesign and restructure the Medicaid program by bringing efficiencies and by generating better health outcomes for patients. The Legislature, as part of the budget process, approved 78 of the 79 recommendations it considered; these initiatives are now being implemented.
In Phase 2, to address additional issues and to monitor the implementation of key recommendations enacted in Phase 1, the MRT divided into 10 work groups. As part of their work, the groups provided 175 additional stakeholders the opportunity to participate in the MRT process. A number of public hearings were held across the state. Following these sessions, MRT recommendations were compiled and included in a final report. The report is available at http://www.health.ny.gov/health_care/medicaid/redesign/docs/mrtfinalreport 
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