AT A moment far too early in the day to be convenient for attendance by employed voters in Hayward Unified School District, the proponents of the schools' master plan went into self-described "round two" of public discussion dealing with the need to consolidate schools. The consolidation will occur with or without the passage of the bond issue as proposed.

I am fully aware that the physical conditions found at many schools require our attention and would, in good conscience, recommend to any who ask that they vote yes for bond issuance.

What I am really alarmed about is the matter of student absenteeism, which, if my math is anywhere near being correct, reflects major annual loss.

Nearly $30 per day is paid by the state of California for each student in attendance on a daily basis. It is commonly referred to as ADA money. On each daily absence, $30 is withheld by the state.

At the meeting held at Mt. Eden High School on April 24, I learned that on any given school day, 7percent of HUSD high school students are absent, 5.5 percent of middle school students are absent and 3.7 percent of elementary school students (K-6) are absent.

Would someone please advise how this community is unable to require parents to deal with the value of their children's attendance at school at every moment of all possible days in a school year? I view the reported rates of absenteeism as being outrageous.

I estimate the annual loss to be in excess of $5million! I want to hear an explanation of how that is possible without suspecting parental negligence. What solutions are we able to craft in response to the problem?

John W. Kyle

Hayward

New residents should

acknowledge older communities

IF YOU can print one more letter about the flap over Five Canyons people not wanting to be associated with the older neighborhood into which their development was placed (as Laura Comstock noted, not without a fight!), here is my two cents: It is justification for one of the arguments used against building this huge development in our hills, and it just underscores more problems to come as more and more big, expensive homes are built, many in "gated communities" that close themselves off from the neighborhoods into which they are inserted.

The residents send their children to private schools, refuse to support taxes to improve neighborhood parks and other amenities, and generally do not act as if they are part of a larger community. For example, the residents of Blackstone (a group of custom homes built along Fairview Avenue) object to having people ride horses through their neighborhood, even though an equestrian trail begins at the end of Blackstone Court.

Those of us who have lived in this diverse community for many years and had to put up with the noise and mess of the construction of their lovely homes can't help but feel some resentment toward their elitist attitudes.

JoEllen Rice

Hayward

Let's put the squeeze

on oil companies

JUST STAY home -- don't go anywhere for just three or four weekends. Only police, fire and medical personnel on duty. These six or eight days would back the oil tankers all the way back from where they came -- and down will come gas prices.

THE INVENTOR: Andrew Dewberry, 43, founder of Vancouver Tool Corp. in Vancouver, British Columbia. He runs the business with his wife, Jayne Seagrave, 42.

PRODUCT DESCRIPTION: Dewberry's company specializes in home-renovation products, such as the Caulk-Rite, a tool launched in 1996 that allows users to create a perfect bead of caulk. Subsequent inventions include the Caulk-Away, the Caulk-Injector, Grout-Out and Grout-In.

WHEN YOU DREAM OF running a million-dollar business, chances are you envision employees, cubicles, an HR department and so on. But what if you could have that dream business, without any of the personnel headaches? Andrew Dewberry lives that dream--today, he and his wife, Jayne Seagrave, run a business that sells the home-improvement products he's invented, and they do almost everything themselves. By taking advantage of outsourcing and keeping costs down, this husband-and-wife team is able to focus on running the business without being side tracked by personnel issues. Here's how they made it happen:

1. DO THE EARLY STEPS YOURSELF. Dewberry's first product was made out of an acrylic plastic, and he made all the prototypes himself. According to Dewberry, money-saving measures have always been part of the mix: "I've taught myself how to do the 3-D drawings manufacturers and machinists need, and I can make a model of a steel part out of aluminum first to keep the costs down."

2. PARTNER WITH SOMEONE WHO COMPLEMENTS YOUR TALENTS. Dewberry is an inventor, not a marketer or salesperson. So when it came to selling the Caulk-Rite, he turned to his wife for help. Although she was a criminologist, not a salesperson, she was willing to make those first sales calls. "Jayne started out selling six to 12 Caulk-Rites to a local hardware chain," says Dewberry. "Her big break occurred a few months into the project at a local hardware show, where she sold our entire production [run] to four hardware store chains."

3. OUTSOURCE AS MUCH AS YOU CAN. According to Dewberry, Vancouver Tool saves money by outsourcing "the production, the blister-pack manufacturing and the assembly. We outsource everything but the paperwork and billing."

4. HAVE MULTIPLE SUPPLY SOURCES. "We have three vendors that make the product, two that assemble it, two that do the shipping, and one that makes the blister pack," Dewberry says. Having several vendors keeps prices down and protects you if one vendor goes out of business or has production or quality problem Dewberry uses Canadian vendors: "[They] might not be as inexpensive as overseas manufacturers, but they allow me more control over my business."

5. CONSOLIDATE DISTRIBUTION. The cost and effort involved in selling to an independent retailer can be every bit as big as selling to a large company. You'll have far fewer headaches and costs if you sell direct only to big customers and sell to everyone else through distribution. Dewberry made this move in 2002. "There was a lot of consolidation going on in the industry, so [our] customers were not upset," says Dewberry. "This move significantly cut both our number of shipments and our paperwork."

Lessons Learned

1. OUTSOURCING ALLOWS YOU TO DO WHAT YOU DO BEST. Dewberry is an inventor, and what he does best is create new products for his target market. Outsourcing allows him to focus on new products, rather than spending most of his time hiring new workers, putting quality control systems in place, or worrying about the day's shipments.

2. WHEN YOU OUTSOURCE, YOU ALMOST ALWAYS HAVE A LOWER MARGIN. Businesses make a profit from every unit they sell--generally called margin. From that margin, they must subtract their administrative overhead and selling costs, also referred to as SGA (Selling, General and Administrative) expenses, to generate their EBIT (Earnings Before Interest and Taxes). Outsourcing usually leads to a lower margin, because your outsourced vendor makes a profit. But at the same time, you should have much lower SGA expenses, as you can probably run your business from home or a small office. So there's a good chance you'll have a similar EBIT whether you outsource or make the product yourself.

3. KEEP YOUR OFFICE EXPENSE LOW. The benefit of outsourcing your production is that you don't need a big staff. But because you'll have a lower margin, you also need to keep your office expenses low, or those expenses might wipe out all your profits. The best situation is to set up an office at home if you can. If that doesn't work for you, be sure to go with low-rent office space.

4. KEEP YOUR MARKETING AND SALES EXPENSES LOW. Sales and marketing expenses can run 10 to 20 percent for many manufacturers. That's probably too much of a burden if you're outsourcing all your production, packaging and shipping. To keep costs down, focus on just a few customers and a few marketing activities. Trade shows are typically the most cost-effective marketing activity.

Question: I'm still in college and have about two years to go. Should I refinance the student loans I already have even though I will be getting other loans to finish school?

Answer: Yes, by all means consolidate your loans right away.

Interest rates on outstanding Stafford loans will rise substantially on July 1. Start the consolidation process before then so that you can lock in the current rate -- 4.7 percent for students who are still in school or for new grads who are in the six-month post-graduation grace period, and 5.3 percent for borrowers already in repayment.

If all your loans are held by a single lender, contact that lender to get information about consolidating. If your loans are held by a number of lenders, go to ConsolidationComparison.com or FinAid.com for information and help in choosing a lender.

Question: I'm 21 and will soon be graduating from nursing school. I want to buy a car, but I don't have any credit. Will I be able to finance a car, or should I keep saving my money to pay for one in full?

Answer: Even if you had a credit record, it could be tough for you to finance a car. Whether justified or not, dealers often assume that young, first-time car buyers are a flighty bunch. "They change jobs, move around and have no history for lenders to gauge how they'll repay," says one dealer.

Even using a credit card responsibly for a few years may not be enough. If you've never had a car loan, a dealer might still turn you down.

Check into special programs offered by automakers to help recent or soon-to-be graduates purchase a new or used car. Or check with your own bank or credit union (or your parents') to see if you can arrange financing before you hit the dealerships. Then you can compare rates.

As a last resort, you could ask a parent to co-sign a loan with you. That's something the two of you should negotiate, but it's not my favorite option. I don't like the idea of parents and kids mixing credit histories, and your parents would be on the hook if you were late making payments or defaulted on the loan.

If you have trouble borrowing, seek a less expensive car and keep saving until you have a down payment of at least 20 percent and preferably more. You may find it easier to get a loan.

Collegiate Funding Services is a leading education finance company dedicated to providing students and their families with the practical advice and loan solutions they need to help pay for and manage the cost of higher education. Collegiate Funding Services also offers a comprehensive portfolio of education loan products and services--including loan origination, loan servicing and campus-based scholarship and affinity marketing tools-to the higher education community. Since 1998, Collegiate Funding Services has facilitated the origination of over $20 billion in education loans and currently manages $12 billion in student loans for more than 460,000 borrowers.

We offer STAFFORD and PLUS loan programs that reward borrowers for automatic withdrawals and consecutive on-time payments. Our PLUS loan programs also offer parents the option to delay payments for up to 48 months while their son or daughter is attending school. CERTIFIED and NON-CERTIFIED PRIVATE EDUCATION loan programs are available to finance up to 100% of a student's higher education. Our beneficial programs are for undergraduates, graduate students, continuing education students, and K-12 students. For online entrance and exit counseling, COLLEGEXIT is an easy way for students to complete required counseling sessions and for campus professionals, it cuts down on the paperwork and increases counseling completion rates. Registered students are also entered to win monthly $1,000 scholarship drawings. Visit www.collegexit.com or ask for details.

Our FEDERAL CONSOLIDATION loan program is one of the nation's leading student loan refinance products, offering graduates the ability to lock in the lowest rates in the history of the student loan program. Graduates may also qualify for additional money-saving interest rate discounts of up to 1.25% *. We offer our graduates the benefit of combining multiple loans into a single monthly payment and bill, repayment flexibility, and no application fees or charges. Graduates can apply easily over the telephone or online, and pay no prepayment penalties.

Our PRIVATE CONSOLIDATION loan program is one of the few consolidation products available to the growing number of graduates with privately insured student loans. Graduates will benefit from refinancing their multiple privately insured student loans into one refinanced loan with lower monthly payments and one simple billing statement. Graduates can apply easily over the telephone or online and there are no out-of-pocket expenses.

As forecast in my April 15 column, student loan rates will increase dramatically on July 1. Based on the May auction of Treasury bills, rates on Stafford Loans for those in school, in grace or in deferment will jump to 6.54 percent a year from 4.7 percent. Stafford Loans already in repayment will jump to 7.14 percent from 5.3 percent. And rates on PLUS loans (for parents) will jump to 7.94 percent from 6.1 percent.

Let me put my advice in bold type: If you have a student loan and have not consolidated and locked in current low rates, you must do it now -- today. This advice applies to graduates and current students, even though you may take out other loans in the future.

In order to lock in the current lower rates, you must have a "substantially completed" loan consolidation application on file by midnight, June 30.

When you consolidate your loan, the rate will be a weighted average of your existing loans. Current students could potentially lock in a consolidation rate as low as 4.75 percent, compared with a rate of 6.625 percent after July 1. Older loans might result in a higher consolidated rate.

A special note for student borrowers who are still in school: This will be the last opportunity to consolidate existing loans while you're in school. Changes in the law mean that all future consolidations must be done after graduation.

QUESTIONS AND ANSWERS

Where do I consolidate? If you have only one lender, you must consolidate with that lender. If you have loans from different lenders, you can consolidate with any lender approved by the Department of Education.

uHow do I compare? By law, all lenders and consolidators must charge the same rate, and may not charge additional fees. But many lenders do offer additional special deals.

For example, Sallie Mae, a private company that is the largest lender and consolidator, will shave one-quarter of a percent off your loan rate if you agree to have your monthly payments directly debited from your checking account. Many other lenders offer this same deal.

And many lenders offer a full percentage point drop in your interest rate after you've paid your loan on time for 36 months. You'll want to find a lender that offers these benefits.

uIs there anything to watch out for? Yes, you need to watch out for several key points when choosing a place to consolidate your loan.

Make sure your loan is eligible. Some lenders will not consolidate loans of less than $5,000 and others have maximum consolidation limits. Find out before you apply, since the deadline is fast approaching.

Make sure the lender is eligible. The lender must be approved by the Department of Education, and before applying, confirm that it can consolidate loans from all of your original lenders.

Ask about minimums or caps on the discount deals. A typical requirement is at least a $7,500 loan balance for automatic debit, and a $10,000 original loan balance to qualify for the prompt payment discount after 36 months.

uWhat if I have both subsidized and unsubsidized federal student loans? You can, and should, consolidate both types of loans. In fact, you can consolidate them into one loan without losing the benefit of the federal subsidy that not only defers interest while you are in school, but actually pays your interest for that period.

uWhat if I have private student loans? Private student loans can also be consolidated. These loans must be consolidated separately, and the rate will be variable and based on the student or co- signer's credit.

uWhat if my parents have PLUS loans? Parents can consolidate PLUS loans and lock in current rates of 6.125 percent for as long as 30 years. The same rules apply regarding where you can consolidate.

uWhich lender should I choose? Student loan consolidation has become a big business, with billions in loans outstanding. Since the loans are federally guaranteed to the lender, it is also a profitable, low-risk business. That's why you're seeing

so many advertisements, and e-mails on the subject.

With time running short, you want a company that will let you apply online and efficiently to make sure you beat the deadline.

As long as you follow the guidelines above, and don't procrastinate, you'll save a small fortune in interest over the life of your loan. And that's The Savage Truth.

Education Finance Leader Allows Eligible Recent Grads to Obtain 2.25%

Interest Rate, Save Money in Tight Job Market with HALO Rewards

Program

Today's college students graduate with a degree -- and also with debt, carrying an average of nearly $29,000 in student loans.

And, with today's uncertain job market, recent grads are having to tighten their purse strings more than ever. Education finance leader FinancialAid.com today announced a new student loan consolidation program that could help alleviate the student loan burden for millions of college graduates: The HALO Rewards Program.

This student loan consolidation program will allow eligible recent graduates to reduce their monthly student loan payments by up to 54 percent and reach an interest rate as low as 2.25 percent faster than ever.

Developed by the education finance experts at FinancialAid.com, the HALO Rewards Program is available to most student loan borrowers with federal loan balances over $10,000. When they consolidate their student loans with FinancialAid.com's HALO Rewards Program, under current federal rates, most borrowers will receive an immediate low interest rate of 3.25 percent and those with loan balances over $20,000 will be eligible for a one percent rate reduction after 36 months of on-time payments. This 2.25 percent rate represents the lowest student loan consolidation rate currently available in the industry.

"Our new HALO Rewards Program allows many recent graduates to reduce the interest rate on their new student consolidation loan to 2.25 percent," said Mike C. O'Brien, CEO of FinancialAid.com. "Simply stated, this means students can start saving money faster with HALO than with any other federal consolidation loan program."

By consolidating their student loans with FinancialAid.com's HALO Rewards Program, recent grads may save hundreds of dollars in student loan payments each month by reducing their monthly payments up to 54 percent. The money saved with student loan consolidation may be used to alleviate credit card debt, help with living expenses or provide grads the option to save money for the future.

Nick Jimenez of Fresno, Calif. -- a recent graduate and new father -- recently consolidated his student loans. "I've reduced my monthly student loan payments by $200 with FinancialAid.com's HALO Program," said Jimenez. "Now, I'm able to put that money away to save for my daughter's college education."

In addition to offering the industry's best student loan consolidation rates, FinancialAid.com boasts the simplest online loan application process, as well as the assistance of highly trained loan counselors. Borrowers and potential borrowers receive the benefit of free one-on-one advice about their educational loan repayment options.

About FinancialAid.com

FinancialAid.com (www.FinancialAid.com) was established in March 2000 with the aim of guiding students and their parents through the college selection and education funding process. Today, FinancialAid.com has expanded to serve life's financial needs by providing a comprehensive range of financial services under one, Web-based "roof."

In addition to matching students with colleges, student loans and scholarships, FinancialAid.com helps consumers take charge of their finances by consolidating student loans and credit card debt and securing mortgage financing/refinancing and car loans.

Beyond offering the most competitive rates for these financial services, FinancialAid.com provides the best customer service in the business. The company's highly skilled loan representatives share the founders' commitment to matching clients with the best loan products for their needs, while educating them about the process every step of the way. FinancialAid.com is a limited liability company based in San Diego.

This news release is not an offer to lend and is merely provided for informational purposes. Interest rates are subject to change and will depend on market conditions and the specific loan involved.

Higher education is on hold for Max Hunsaker.

It's not that the 24-year-old Brigham Young University graduate doesn't want to get a master's degree. He simply can't afford it.

And while he dreams of someday working in public policy, he's now putting in his hours as a business consultant to get a jump on the $15,000 in student debt he has accrued in the past four years.

Like Hunsaker, the average Utah student is also carrying thousands of dollars in debt after earning a four-year degree. Student debt is at an all-time high in Utah, and students are in for another shock come July 1 when interest rates on existing loans jump by 1.84 percent.

Rates on new loans issued after July 1 will also climb, to a fixed 6.8 percent from the current 5.3 percent.

That pending hike has Utah education leaders worried that the growing student-debt burden may be forcing students to bypass lower- income careers like teaching and social work to more quickly pay off their loans.

Perhaps even more worrisome, the rising interest rates, coupled with higher tuition, may be enough to price some Utah students out of an education altogether.

"You have to go on to get a graduate degree to be marketable, but I didn't feel comfortable with the debt I already had to get further into debt," Hunsaker said. "I want to have it paid off. It's kind of the motivation for all the decisions I'm making right now."

Nationally, about two-thirds of students at four-year colleges have student debt, averaging around $19,000, according to the national Project on Student Debt. In Utah, the average for a bachelor's degree is about $14,790 -- a 45 percent increase since 1995.

"There's some growing trends that because of the costs, people have to look at what is the major that's going to help me pay this back, which is not especially good for society," said David Feitz, associate executive director of the Utah Higher Education Assistance Authority. "If somebody has $80,000 in debt and they have an MBA degree, we don't worry too much about them. But if they're going into elementary education, those borrowers are the ones we have concerns about."

At the same time, the number of loans processed through Utah's Higher Education Assistance Authority has grown by more than 85 percent in the past decade, to a high of 100,760 loans in 2005. While that number does not indicate individual borrowers, it does show a surge in the volume of loans, Feitz added.

Feitz attributes that increase mostly to annual tuition hikes. Total tuition and fees at the University of Utah, for example, have shot up more than 60 percent in the past 10 years.

At the same time, the amount of aid money offered through federal grants has remained stagnant. The maximum Pell Grant of $4,050 per year has not increased in the past four years.

For Utah students, that means the buying power of the Pell Grant has eroded to the point that aid money makes only a small dent in tuition costs, Feitz said. In the end, students are forced to turn to loans.

The loan-volume increase also has some students taking longer to repay their debt, added John Curl, financial aid director at the U. The 10-year payoff periods of the past are now being stretched to more than 30 years, cutting into family budgets and forcing students to make life decisions based on student debt.

Hunsaker plans to put off his hopes of working in the public sector until he can get his loans paid off, a feat that will require him to pay much more than the minimum payment each month.

"I don't want my education to be a burden for me in the future and the family I'd like to have," he said. "Loans are so easy to get, and it puts students in a tough situation later on. A lot of people are caught off guard."

The July 1 interest-rate hikes are only going to paint a bleaker picture for most Utah students, Feitz added. They can, however, take a few steps to avoid paying that higher interest.

Consolidating student loans and locking them in under the current 5.3 percent interest rate could save students up to $5,000 in interest payments over the life of a $20,000 loan, he said.

"We're encouraging students to act now, don't delay," he said. "We want this consolidation application to get right to the top of their summer reading list so they don't ace themselves out."

Few things are as important in life as an education. In that sense, it can be smart to borrow money in order to get one. But as in all financial decisions, students are best served if they take out loans only as a last resort and only with the thought in mind that they will have to pay the money back, with interest.

As this newspaper reported this week, student debt in Utah is at an all-time high. The average graduate here leaves school having to pay off nearly $15,000. That's hardly the best way to begin life in the working world, but it can be managed if graduates avoid other national trends regarding debt.

In fact, we're guessing many families could pay for their child's college education without debt if they didn't have huge car payments and credit card bills. Family finances involve the setting of priorities. But too often, family purchases defy logic. A new car never can rival an education in importance.

Meanwhile, low-income students could take better advantage of scholarships and grants available to them.

Until July 1, students who already have accumulated loans will have the opportunity to consolidate and refinance them at a fixed rate. On that date, the rates on existing loans will jump by 1.84 percent. A consolidation -- made possible by a bill the president just signed into law -- could save students thousands of dollars over time.

Nationally, about two of every three college students has a loan to pay for tuition and expenses. Many graduates with loans have told pollsters they are putting off important decisions, such as buying a house or having children, until they can retire the debt. Others (nearly one-third, according to one survey) have moved back with their parents. In addition, educators worry students will forgo rewarding but low-paying careers, because of this money crunch.

These are real concerns. In Utah and elsewhere, public officials always need to worry about the balance between the need to keep taxes low and the need to make higher education affordable. In this case, they need to do so with an eye toward India, China and other emerging nations whose college graduation rates are climbing.

This crisis isn't as bad as the one more than 10 years ago, when student loan default rates topped 20 percent (it's about 4 percent now). But Americans can't afford to fall behind in the race to educate the next generation.

Students who graduated in May with student loans may be facing six-month grace periods that are ending sometime this month. Once those grace periods end, graduates will be entering repayment on those loans. With multiple student loans in repayment, graduates will likely be juggling multiple bills, multiple due dates, and multiple monthly payments. To help make their student loan repayment easier to manage, NextStudent, a leading Phoenix-based education funding company, encourages May graduates to consider consolidating their eligible federal student loans with a Federal Consolidation Loan.

With the student loan consolidation program, graduates can bundle all their eligible federal student loans into one single consolidation loan with one lender, one monthly bill, and one monthly payment. Besides offering convenience and less hassle, a Federal Consolidation Loan gives graduates the security of a fixed interest rate -- they won't have to worry about variable interest rates going higher, leaving them guessing about their monthly payment amount. And because a student loan consolidation could extend the repayment term on their student loans by up to 20 years, graduates may be able to lower their monthly student loan payment amount, cutting their monthly payments by up to 50 percent.

To be eligible for student loan consolidation , a federal student loan must be in repayment, in a grace period, or in an authorized forbearance or deferment period. Graduates consolidating their student loans cannot currently be attending school more than half time. Parents with Federal PLUS Loans may also consolidate their parent loans with a Federal Consolidation Loan. However, parents and students may not consolidate parent loans in the parent's name with student loans in the student's name.

There's never any cost to apply for a Federal Consolidation Loan with NextStudent, and there are no fees, no credit checks, and no co-signers required. There are also no prepayment penalties, so graduates who consolidate their student loans will never be charged for paying more than the minimum each month or for paying off their student consolidation loan early.

Graduates who have private student loans in addition to (or instead of) federal student loans won't be able to consolidate their private loans with the federal student loan consolidation program. But graduates looking for the same convenience of a single consolidated loan for their private student loans may be eligible to consolidate their private loans separately with a NextStudent Private Consolidation Loan .

One of the national health objectives for 2010 is to increase to at least 95% the proportion of children aged <6 years who participate * in fully operational, population-based immunization registries (objective 14-26) (1). Immunization registries are confidential, computerized information systems that collect and consolidate vaccination data from multiple health-care providers, generate reminder and recall notifications, and assess vaccination coverage (2,3). A registry with added capabilities, such as vaccine management, adverse event reporting, lifespan vaccination histories, and interoperability with electronic medical records (EMRs) ([dagger]), is called an immunization information system (IIS). This report summarizes data from CDC's 2003 Immunization Registry Annual Report (IRAR), a survey of IIS grantees in 50 states, five cities, and the District of Columbia (DC) that receive funding under section 317b of the Public Health Service Act. The findings of the 2003 IRAR indicate that approximately 44% of U.S. children aged <6 years participated in an IIS. In addition, 76% of public vaccination provider sites and 36% of private vaccination provider sites submitted immunization data to an IIS during the last 6 months of 2003. Increasing health-care provider participation by linking EMRs to IISs is vital to meeting the national health objective.

The 2003 IRAR, a self-administered, Internet-based questionnaire, was made available to immunization program managers as part of an annual reporting requirement. As in previous years, respondents were asked about the number of children aged <6 years participating in an IIS, health-care provider participation in the IIS, and other programmatic and technical functions (e.g., data linkages with other public health programs, data use, vaccine management, software/hardware capability, and reporting functions) (4). All 56 grantees were asked to complete the questionnaire; 52 reported on the number of children aged <6 years participating in an IIS. Estimates of the total number of children aged <6 years were based on 2003 U.S. Census data.

The findings indicated that, in 2003, approximately 44% of U.S. children aged <6 years participated in an IIS. Nine (16%) IIS grantees (Arkansas, Arizona, Delaware, DC, Michigan, New York City, North Dakota, Oregon, and San Antonio, Texas) had achieved the national health objective of [greater than or equal to] 95% of children aged <6 years participating in an IIS (Figure). An additional eight (14%) grantees were approaching the national health objective, with participation of 81%-94%.

[FIGURE OMITTED]

Nationally, 76% of public vaccination provider sites and 36% of private vaccination provider sites submitted immunization data to an IIS during the last 6 months of 2003. Twenty-five (45%) grantees reported that [greater than or equal to] 95% of public provider sites submitted immunization data to an IIS; four (7%) reported submission of immunization data by 81%94% of public provider sites. Five (9%) grantees (Arkansas, Connecticut, DC, Mississippi, and South Dakota) reported that [greater than or equal to] 95% of private provider sites submitted immunization data to an IIS; six (11%) (Arizona, Hawaii, North Dakota, Oregon, Philadelphia, and Wisconsin) reported data submission by 81%-94% of private provider sites.

A substantial number of grantees reported linkages between an IIS and other information systems or entities. Twenty-two (39%) reported sharing data electronically with a Medicaid Management Information System. Thirty-six (64%) reported data linkages with the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Twenty-six (46%) reported IIS data access by health plans; 14 (25%) reported access by colleges and universities; 14 (25%) reported access by correctional facilities; 29 (52%) reported access by hospitals; and six (11%) reported access by long-term-care facilities. Nineteen (34%) reported that schools accessed an IIS to look up a student's vaccination status, and nine (16%) reported that schools had the ability to read, submit, and exchange data with an IIS.

Editorial Note: In 2003, approximately 44% of U.S. children aged <6 years participated in an IIS; the national health objective for 2010 is to increase this proportion to at least 95%. The findings presented in this report indicate that grantees must overcome substantial challenges to increase child and provider participation rates in IISs. CDC is developing a plan of action to identify and address the barriers to increasing child and provider participation.

Increasing data linkages between IISs and other health-information systems will enable consolidation of large immunization data sets, likely resulting in more complete immunization histories, increased coverage levels, improved support of outbreak containment, and decreased costs associated with over-immunization. Linkages have been developed between certain IISs and their respective state Medicaid Management Information Systems, blood-lead programs, and WIC programs. Such data linkages can improve program effectiveness and efficiency. For example, certain Medicaid programs use IIS data in Medicaid reports; some WIC programs use the IIS for patient look-up and subsequent referrals to immunization providers for children who are behind schedule; and many kindergartens and elementary schools access IIS data to obtain student immunization status. Protection of IIS data is managed through state privacy, confidentiality, and security laws and through compliance with federal privacy rules and regulations.