HHS WEEKLY REPORT
August 1 - 7, 2004
THIS ISSUE AVAILABLE ONLINE WITH EXPANDED INFORMATION AND PHOTOS AT:
http://www.hhs.gov/news/newsletter/weekly
IN THIS ISSUE:
1) Childhood Immunization Rates at Record High Levels
2) HHS Celebrates 14th Anniversary of Americans with Disabilities Act
3) Science in the News: Researchers Identify Better Hepatitis C Treatment for People with HIV
4) Medicare Minute: HHS Proposes New Rules to Deliver Better Benefits and Savings on Drugs for Medicare Beneficiaries and Urges Public Comment
5) Secretary Thompson's Public Schedule
Childhood Immunization Rates at Record High Levels
The U. S. Department of Health and Human Services announced on Thursday that the nation's childhood immunization rates are at record high levels, including significant increases in rates of immunization for chickenpox and pneumococcal pneumonia, the two most recent additions to the childhood immunization schedule.
National coverage with chickenpox vaccine increased from 80.6 percent in 2002 to 84.8 percent in 2003. Coverage for three or more doses of pneumococcal conjugate vaccine increased from 40.9 percent in 2002 to 68.1 percent in 2003. Coverage for four or more doses of pneumococcal conjugate vaccine, reported for the first time this year, was 36.7 percent. Coverage for all other childhood vaccines and series, increased significantly in 2003 compared with 2002.
"We need to thank everyone who has helped put childhood vaccination rates at an all-time high -- and then we all need to get back to work and help make this rate go even higher," HHS Secretary Tommy G. Thompson said. "Childhood vaccination is a key element of equal opportunity for Americans, and we need to reach all children and protect them."
In 2003, as in previous years, urban areas reported lower immunization rates than states mostly due to large concentrations of lower socio-economically displaced persons. Among the 28 urban areas, the highest estimated coverage for the 4:3:1:3:3 series was 88.8 percent in Boston, Massachusetts, and the lowest was 69.2 percent in Houston, Texas. The estimated coverage with the 4:3:1:3:3 series ranged from 94.0 percent in Connecticut to 67.5 percent in Colorado.
The National Immunization Survey (NIS) provides estimates of vaccination coverage among children ages 19-35 months for each of the 50 states and 28 selected urban areas. CDC uses a quarterly random-digit-dialing sample of telephone numbers for each of the 78 survey areas to collect vaccination data for all age-eligible children. In 2003, vaccination data were obtained for 21,210 children.
The findings were reported by the Centers for Disease Control and Prevention (CDC) at a news conference sponsored by The National Partnership for Immunization (NPI) to kick off August as National Immunization Awareness Month. The complete 2003 National Immunization Survey data will be released with the CDC's Morbidity Mortality Weekly Report (MMWR) at the following Web address: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5329a3.htm.
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HHS Celebrates 14th Anniversary of Americans with Disabilities Act
Fourteen years after the signing of the Americans with Disabilities Act (ADA), the importance of this legislation continues to grow. The ADA is an instrument of fairness and equity: it was enacted to help ensure that people with disabilities should not face unnecessary and counterproductive barriers. But it also embodies our commitment to a society in which all Americans can share their talents and knowledge -- that is, their abilities -- to the greatest extent possible.
President Bush's New Freedom Initiative, launched in the very first days of his administration, recognizes both the immediate challenges and the broader-scale significance of the ADA. It seeks to change outdated policies that limit our support to people with disabilities to expensive and constraining institutional approaches. More broadly, it seeks to create a nation in which disabilities can be accommodated and barriers overcome so that abilities can be shared.
The President has proposed a "Money Follows the Individual Rebalancing Demonstration" that would provide states $1.75 billion over five years to support new community-based approaches in place of institutional services. The projects would demonstrate how public funds could be used more effectively by supporting people with disabilities outside of institutional settings. HHS' Centers for Medicare & Medicaid Services (CMS) has already awarded $200 million from 2001 through 2004 under the Real Choice Systems Change Grants for Community Living, to enable individuals with disabilities to reside in their homes and participate fully in community life.
CMS is committed to helping states increase their home and community-based care programs. As of the end of this fiscal year, Medicaid will have spent $68.7 billion on home and community-based waiver services since FY 2001, more than was spent in the previous eight years combined. In 1980, only 4 percent of Medicaid long-term care expenditures were for home and community-based care. By 1990, it was still only still only 13 percent. Today, approximately 30 percent of Medicaid long-term care expenditures go to home and community-based care. This is a testament to the states' conviction that these programs work, and to our commitment to rapidly approve and support home and community-based waivers.
Throughout the Department of Health and Human Services, our agencies are taking a wide variety of other actions to support Americans with Disabilities:
Our new Office on Disability launched a joint public-private effort to encourage physical activity for young people with disabilities through mentor relationships.
Our Administration on Aging (AoA) continues to support family caregivers, by far the largest source of care for our elderly and disabled, through the National Family Caregiver Support program.
CMS has joined with AoA to develop "one-stop" Aging and Disability Resource Centers to help individuals with disabilities of all ages in accessing the full range of long-term support options.
Our Substance Abuse and Mental Health Services Administration (SAMHSA) is developing an action plan for carrying out the ambitious recommendations of the New Freedom Commission on Mental Health.
Our Indian Health Service (IHS) is collaborating with SAMHSA to support persons with disabilities, particularly those with associated drug and alcohol disorders.
Our Health Resources and Services Administration has provided $25 million to support medical services for children and youth with special health needs, to help ensure access to a family-centered medical home for all children.
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Science in the News
Researchers Identify Better Hepatitis C Treatment for People with HIV
The preferred treatment for hepatitis C, peg-interferon and ribavirin, is safe for people who are also infected with HIV, according to a new study in the July 29 issue of The New England Journal of Medicine. Moreover, this treatment proved superior for the treatment of hepatitis C virus (HCV) in HIV-coinfected persons when compared with the previously accepted treatment, standard interferon and ribavirin.
The study compared the effectiveness of two forms of interferon: a once-weekly dose of peg-interferon and standard interferon taken three times weekly. Peg-interferon with ribavirin is currently the approved treatment for hepatitis C in persons without HIV. Prior to this study, limited data were available on the benefit and safety of peg-interferon and ribavirin in HIV-infected people.
"We are pleased to see such a clear and definitive result from this study," NIAID Director Anthony S. Fauci, M.D. said. "Just a decade ago treatment of HCV in persons infected with HIV was not a priority because they died from AIDS before developing serious complications of hepatitis C infection. As new anti-HIV drug treatments extend the lives of HIV-positive individuals, studies like this one provide essential guidance on treating other serious health problems affecting people living with HIV."
HCV is primarily spread through infected blood. Most people with the virus have no signs of illness, but in some the infection progresses to chronic liver disease, liver failure or liver cancer. The disease progresses more rapidly in people who have HIV. It is estimated that of the 1 million HIV-infected Americans, about 300,000 are also infected with HCV. HCV infects approximately 25,000 Americans annually and is responsible for 8,000 to 10,000 deaths per year.
The 133 HIV-positive study volunteers were randomly assigned to take peg-interferon or interferon for 48 weeks. All study volunteers also took ribavirin, an antiviral drug that is also part of standard therapy for hepatitis C. Study volunteers who completed the treatments — 16 withdrew early for various reasons — were followed for 24 more weeks to evaluate long term treatment success.
In the group that took peg-interferon, 27 percent of patients had no detectable HCV in their blood 24 weeks after completing treatment (sustained response). In contrast, of those who took interferon, only 12 percent had a sustained response. Importantly, more than one third of those volunteers who failed to clear HCV appeared to experience improvement in their liver biopsies, suggesting the treatment was beneficial in this group as well. Researchers also found that the volunteers whose HCV levels failed to fall substantially within the first 12 weeks never experienced a sustained response.
To learn more, please go to: http://www.nih.gov/news/pr/jul2004/niaid-28.htm
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Medicare Minute
HHS Proposes New Rules to Deliver Better Benefits and Savings on Drugs for Medicare Beneficiaries and Urges Public Comment
HHS Secretary Tommy G. Thompson announced on Monday, July 26 the proposed regulations to deliver on a new law that provides better benefits -- including prescription drug savings of more than 50 percent for the average senior without coverage -- and improved access to health care services through Medicare.
The proposed regulations, which are now available for public comment, implement the essence of the Medicare Modernization Act that creates a new voluntary prescription drug benefit under Medicare, as well as new health plan choices, improved health care for rural America and improved preventive care benefits.
The new prescription drug benefit will allow all Medicare beneficiaries to enroll in drug coverage through a prescription drug plan or Medicare health plan with Medicare paying for 75 percent of the premium. Additional benefits for Medicare beneficiaries who have limited means will cover, on average, 95 percent of their drug costs. The new benefits also will provide new protections for retirees who currently receive drug coverage through their employers or unions. All the new Medicare benefits are voluntary as seniors can choose to keep their existing traditional coverage.
"We're delivering on our promise to America's seniors to provide better benefits and real savings on their prescription drugs," Secretary Thompson said. "For the first time, all Medicare beneficiaries will have access to prescription drug coverage. Seniors currently without coverage could see their drug costs cut by more than half, with lower-income seniors getting even greater savings."
The Medicare prescription drug benefit is a key element of the Medicare Modernization Act signed into law on Dec. 8, 2003. The Centers for Medicare & Medicaid Services (CMS) also proposed rules to implement another key element of the law: strengthening and improving the Medicare Advantage program, including making regional preferred provider organizations (PPOs) available to all Medicare beneficiaries. These provisions will give beneficiaries broad and more secure access to coordinated-care health plans that provide additional benefits and significantly lower out-of-pocket costs. Though over 60 million Americans in all 50 states including rural areas get their health insurance coverage through PPOs today, they have generally not been available to Medicare beneficiaries. The proposed rules would also implement new, less costly options for Medigap coverage.
"As we move closer to providing affordable drug coverage, access to popular health plans, and more secure retirement coverage, we need input from the public," said CMS Administrator Mark B. McClellan, M.D., Ph.D. "We are taking special steps to encourage comments and dialogue on these proposed rules, and implement them together, to assure that the key elements of the new law work together to give seniors and people with disabilities the best Medicare possible."
The rule will be published in the Federal Register on Aug. 3, 2004. The comment period on the proposed regulations lasts 60 days, closing on Oct. 4, 2004. Final rules are expected to be issued early in 2005. Enrollment for the new Prescription drug plans will begin in the fall of 2005 for benefits starting in on Jan. 1, 2006.
CMS and many organizations involved in health care and Medicare will be hosting meetings all across the country to gather information and comments until the comment period closes on Oct. 4, 2004. CMS will also host a series of national phone calls for additional comment, input and information. Comments can also be sent electronically to www.cms.hhs.gov/regulations/ecomments.
A fact sheet and other information on this new rule is available at www.cms.hhs.gov/medicarereform.
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Secretary Thompson's Public Schedule:
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August is National Immunization Awareness Month. Be sure you and your children are up-to-date on your vaccinations.
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Last updated: August 2, 2004
United States Department of Health and Human Services
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