• Annual birth cohort: 45,000
• Geographic area: State of Oregon
• Legislation: 1993 legislation authorizes registry and waives consent requirement
• Percentage of immunizations given in private sector: 82 percent
• Other sources of funding: State, Oregon Health Systems in Collaboration

A Unique Funding Partnership: A unique partnership of public and private health care organizations in Oregon was a driving force behind the success of the Oregon immunization registry, ALERT. Operational funding for the registry derived from three sources: Oregon Health Systems in Collaboration (OHSIC), a private nonprofit organization representing the major health plans and hospital clinics in the state; Oregon Office of Medical Assistance Programs; and the Oregon Health Division. Each contributed a percentage reflecting the proportion of the children who are insured, uninsured, or covered by Medicaid, respectively. The greatest share was contributed by OHSIC, since more than 50 percent of the immunizations are delivered in the private sector. In 2000, however, OHSIC members, under pressure to reduce costs, stated they would not contribute to ALERT without clear evidence that other plans that benefit from the registry also contribute. Legislation was introduced that would equitably distribute costs among all health insurers in Oregon for that portion of the population served by private insurance, approximately 55 percent. All health plans eventually agreed that they would contribute in proportion to the share of immunizations they provide, obviating the need for legislation.