1. 1 Community Partnerships Can Increase Immunization Outreach ® Registered Service Marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans. ®’ Care Van is a Registered Mark of the Caring for Children Foundation of Texas, Inc. Presented by: Gail Anderson RN, BSN Care Van Immunization Outreach Coordinator Melissa Compton RN, BSN Care Van Clinical Coordinator

2. 2 Objectives By the end of the presentation participants will be able to: Apply strategies to create a collaboration with an immunization provider and an area business for immunization outreach Identify appropriate business to establish a collaboration with an immunization provider for immunization outreach Recognize benefits of a collaboration between an immunization provider and an area business for immunization outreach

3. 3 History of the Care Van Program The Care Van is a mobile unit that provides uninsured and medically underserved children age 0 to 18 years with direct access to immunizations Inaugurated by Caring for Children Foundation of Texas,Inc. The Care Van program has a fleet of 10 vans that provides services in various Texas counties Blue Cross Blue Shield of Texas (BCBSTX) is the lead sponsor and covers administrative costs of the program Additional funding comes from –BCBSTX employee payroll deductions, combined Federal Campaigns, private donations and grants  100% of the money raised goes directly to providing immunizations

4. 4 Strategies for Providing Immunization Outreach What are the barriers to obtaining immunizations? Cost of service - large number of uninsured children in the community Availability of services - limited Saturday and after hours clinics Lost wages - missed time from work Transportation issues Language barriers

5. 5 Strategies for Providing Immunization Outreach How can the Care Van Program eliminate the barriers? Become a Vaccine for Children (VFC) provider Charge no fee for administration of immunizations Set up clinics after hours and on Saturdays Strategically set up clinics that are easy to access in the community Establish relationships with VFC and Medicaid/Children’s Health Insurance Program (CHIPs) medical home providers to offer additional resources

6. 6 Strategies for Providing Immunization Outreach Who could the Care Van Program coordinate with to achieve the goal? VFC and Medicaid/CHIPs Medical Home Providers City and county health departments Community businesses Area immunization coalitions School districts County hospital districts

7. 7 Collaborate with VFC and Medicaid/CHIPs medical home providers to increase immunization services in their communities Participate in area immunization coalition Form alliances with school districts to help provide immunization outreach at events such as student enrollment, kindergarten roundup, etc. Establish relationships with family friendly businesses in the following areas Implementation Amarillo Abilene El Paso Houston Dallas Wichita Falls San Antonio Austin

8. 8 Immunization Outreach: McDonald’s and the Dallas Care Van Program In 2001, the Dallas County Health Authority referred the Care Van to McDonald’s Corporation, recognizing that our program would fit with the McDonald’s “Immunize for Healthy Lives” campaign The Dallas Care Van Program collaborated with five McDonald’s business owners in different communities with the following criteria: Active in the community Willing to provide flexible evening hours for outreach in the community Easily accessible in the community Located in communities with limited immunization services

9. 9 Immunization Outreach: McDonald’s and the Dallas Care Van Program Immunization outreach events are scheduled at McDonald’s in the early evening hours Rotating schedules established with individual McDonald’s providing consistency for clients McDonald’s locations distribute flyers listing upcoming events and advertise the events on their leader board Representatives from the Medicaid/CHIPs invited to enroll clients in their programs at immunization outreach events VFC and Medicaid/CHIPs medical home provider information is distributed Representatives from the Medicaid/CHIPs invited to enroll clients in their programs at immunization outreach events VFC and Medicaid/CHIPs medical home provider information is distributed

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11. 11 Immunization Outreach: McDonald’s and the Dallas Care Van Program Event set up: Station I: Registration A registration area is set up inside the McDonald’s restaurant A bilingual clerk is available to assist clients with registration paperwork The state registry is discussed with each client and permission forms are available A portable copier is used to copy all immunization records presented, copies are attached to the registration paperwork for future reference and for data entry into state registry The dining area seating provides convenience for parents completing paperwork while their children play in McDonald’s Playland

12. 12 Immunization Outreach: McDonald’s and the Dallas Care Van Program Station II: Screening and Counseling Nurses seated inside the McDonald’s restaurants - Screen and validate immunization records - Counsel clients on immunizations needed - Counsel clients on possible side effects of immunizations - Distribute VFC forms - Distribute “After the shots information material” with a telephone number for questions after the clinic (the telephone number is answered by a nurse 24-hours-a-day)

13. 13 Immunization Outreach: McDonald’s and the Dallas Care Van Program Station III: Immunization Administration Spaces within the McDonald’s parking lots are provided for the Care Van mobile unit Immunizations are administered in the mobile unit McDonald’s owners provide a reward for clients receiving immunizations such as a coupon for ice cream or cookies, or reduced meal costs

14. 14 Immunization Outreach: McDonald’s and the Dallas Care Van Program After the Immunization Event Data collected at the event is placed in the Texas Wide Integrated Client Encounter System (TWICES) - Patient Information - Immunizations Administered - Immunization Histories - VFC Category Consented data in TWICES migrates automatically into the state registry IMMTRAC

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16. 16 Children Seen & Immunizations Given per Event 0 20 40 60 80 100 120 140 160 180 200 200120022003200420052006 Children seen per event Immunizations given per event

17. 17 Children Seen & Immunizations Given per Year 0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000 20012002200320042005 2006 _ # Children Seen _ # Immunizations Given

18. 18 Results of Collaboration Social mobilization in the community VFC and Medicaid/CHIPs medical home providers donate supplies and staff to increase immunization services for their clients McDonald’s owners experience -Increase in patrons and sales during clinic hours -Receive recognition in the community School districts provide support by distributing clinic schedules - Immunization outreach events offer increased opportunity for compliance in the districts

19. 19 Results of Collaboration BCBSTX employees volunteer their time at immunization outreach events: -Assist with registration -Provide translation services -Help with crowd control Clients have an opportunity to enroll in Medicaid/CHIPs with on site representatives available for assistance In 2005 Chick-fil-A established a relationship and began hosting immunization outreach events as a result of our success with McDonald’s

20. 20 What Are Our Future Plans? Continue existing affiliations within the community Monitor event locations for need and success Coordinate with city and state to retrieve zip code data to assist in identifying communities with low immunization coverage Establish new alliances within communities Pilot reminder recall system

21. 21 Conclusions Strategies applied -Recognized barriers -Recognized ways to eliminate barriers -Recognized relations in the community Identified a family friendly business that was: -Active in the community -Easy to access -Located in an area of need Benefits of the collaboration with an area business -Increased immunization services in the community -Business receives community recognition -Opportunity to collaborate with new businesses in the community

22. 22 Blue Cross and Blue Shield of Texas City of Amarillo Health Department City of El Paso Health Department City of Garland Health Department Clinical Services City of Dallas Environmental Services Patty Hanks Shelton School of Nursing Abilene McDonald’s Dallas owners –Phillips –Ingram –Vanacheck –Skinner’s McDonald’s Houston owners –Paul and Debbie Adams McDonald’s Austin owners –Benton Enterprises, Inc. Community Affiliates

23. 23 Community Affiliates Immunize Kids! Dallas Area Partnership Greater Dallas Community Council North Dallas Shared Ministries Dallas County Health and Human Services Plano Children’s Medical Clinic Parkland Health and Hospital System- Community Oriented Primary Care Clinics Dallas County Medical Society Alliance and Foundation Denton County Medical Society Alliance Taylor Jones Haskell Medical Society Alliance TMAF-Texas Medical Association Foundation, “Be Wise Immunize” Potter Randall County Medical Society Alliance El Paso City Medical Society Alliance

24. Thank You!