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

6. RegionJan-10 1189 2/3855 4/5322 6468 COH357 7415 8232 SAM215 9/10249 11501 Total3803

7. Austin Office Health Service Regions Local Health Department Provider Distributor CDC 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)  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 Benefits

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

15. Choice Operating Procedures TVFC/Provider Manuals Stand Alone Documents 1. Outline legislative requirements 2. Day-to-day operations under electronic system  How to order and report  How to report vaccine losses  How to receive vaccines 3. Provide answers to the implementation questions

16. Choice Operating Procedures Implementation 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. 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 Vaccine Choice Texas Vaccines For Children

24. Thank you

25. Provider next steps  Go online to the survey at http://tvfcchoice.questionpro.com/ and select preferred vaccines. http://tvfcchoice.questionpro.com/  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.