Vaccine Choice Update: Texas Legislation & Ordering Process

1. TISWG Vaccine Choice Update May 20, 2010

2. Agenda Choice Legislation Current Ordering/Reporting Process Choice Strategies Timeline

3. Choice Legislation HB448 requires vaccine choice in Texas Vaccines for Children and Adult safety net programs Recommended through ACIP Available through CDC Adult safety net vaccine available from DSHS Includes 115% cost containment clause Choice not applicable in emergencies August 31, 2010 implementation

4. DSHS Guiding Principles • Offer Choice by September 1, 2010 • Minimize impact on providers • Manage Choice with existing public health personnel • Maintain existing vaccine delivery timeframes

5. Vaccine Ordering/Reporting Current Process Texas Infrastructure Choice in a Paper System

7. Distributor Austin Office CDC Health Service Regions Local Health Department Provider Provider Provider Provider Provider Provider Provider Provider Electronic Paper Current Ordering/Reporting Process

8. Choice in a Paper System • Approximately 70 products • Providers • Increase in paperwork (C-33 example) • Additional time to complete • Likely increase in reporting errors

9. Choice in a Paper System • LHD/HSR and Austin Office • Additional staff to maintain existing workload and timeframes • Likely increase in order entry errors (AO) • Impact on other business needs • Customer support • Training • Promotions • Quality

10. Choice in a Paper System : Vaccine Delivery

11. DSHS Choice Strategies • Electronic Vaccine Inventory • Operating Procedures • Communication Plan • Resources and Training

12. Electronic Vaccine Inventory (EVI) Benefits • Providers/LHD/HSR/AO • Reduce paperwork • Reduce processing time • Potentially decrease delivery time • Simplify Ordering/Reporting and Improve Quality • Create “recommended order” • Automated reminders and exceptions • Auto mathematical calculation features • Pre-population of previously entered inventory information (lot number, NDC, expiration dates) • Allow to Texas to Interface with CDC System

13. Ordering/Reporting Possibilities Current Situation • Existing Paper System with 70 choices added (necessary for providers without internet access) Long Term Goal • Fully Electronic System – (could take through 2011 to fully develop) Reality for the Next year • Interim System that includes some electronic and some paper (using current IT resources)

14. Interim Ordering/Reporting Process Distributor Electronic Paper CDC Approval Approval Health Service Regions Local Health Department Austin Office EVI Database Provider Provider Provider Provider Provider Provider Provider Provider

15. Choice Operating Procedures TVFC/Provider Manuals Stand Alone Documents • Outline legislative requirements • Day-to-day operations under electronic system • How to order and report • How to report vaccine losses • How to receive vaccines • Provide answers to the implementation questions

16. Choice Operating ProceduresImplementation Question Tools • FAQ • New Vaccines • Unavailable Vaccines (shortages) • How to handle existing vaccine inventory (Can it be returned?) • Provider fails to choose • Initial Vaccine Choice Duration • Provider Vaccine Information Sheet • Storage Calculator • Survey, Tips, and Instructions

17. Communication Plan • Providers and other Internal (HSR, AO) • Memos on updates • Training – group and individual • Conference Calls • Tools such as FAQ and Storage Calculator • External Stakeholder • Input from Choice subcommittee of TISWG • Presentations on Choice to TISWG, Texas Association of Local Health Officials (TALHO), and other agencies • Choice Website Development • Call Center

18. Resources and Training Roles • AO Roles • Develop messaging, tools and other communications as necessary • Kick-off Training for LHD/HSR to introduce training materials • Develop Online or web-based trainings • Manage the helpdesk after Sept 1

19. Resources and Training Roles • LHD/HSR Roles • Conduct group presentations and/or individualized training for providers in jurisdiction • Negotiate storage space and Tiered Ordering Frequency • Primary resource for general questions on choice processes • Manufacturer Roles • Education on vaccines • Communicate with Providers

20. Provider Responsibilities • Survey of Choices • Internet/Email Access • Provider Agreement

21. Provider Choice Agreement • Ensure that enrolled provider has been notified of choice options • Inform provider about their right to choose brand and presentation • Limitations • 115% cost containment, and • not applicable in public health emergency • Choice fundamentals • use all brands prior to expiration date • duration of choices • Sign Form and fax to 512-458-7346 prior to the July 31, 2010

22. Timeline for Vaccine Choice Implementation

23. Vaccine Choice Texas Vaccines For Children Current Status • Survey up getting responses • Next week HSR/LHD Meeting • Website www.immunizetexas.com Select “Providers” Click on • Communications • Provider information • Training • EVI • Other Resources

24. Thank you

25. Provider next steps • Go online to the survey at http://tvfcchoice.questionpro.com/and select preferred vaccines. • Review email confirmation when received (same week) • Look for the Provider Agreement, sign and fax back to 512-458-7346 • Await an email notifying you of your User name and password (August) • Look for memo announcing online training and ensure all appropriate staff take prior to September 1. • Beginning September 1, go online to enter information from Biological Report and Order (C-33, C-68). • Fax temperature log to HSR or LHD as usual.