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Association of Immunization Managers Corporate Alliance Presentation April 24, 2018
Association of Immunization
Managers
Corporate Alliance
Presentation
April 24, 2018
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Claire HannanExecutive Director
Immunization Program Management 101Presentation Overview
• U.S Immunization System: Public-Private partnership
• Operationalizing at the State/Territorial/Local Level
• Hot Topics, Priorities in 2018 for Program Managers
• AIM Organization and Conference Preview
Public-Private Partnership: At a Glance
Section 317 Program
0.4%
Vaccines for Children Program
(VFC)45.7%
State Purchases4.4%
Other including Private Sector
49.5%
Pediatric Vaccines Recommended for Children 0-6 Years of AgeDoses Distributed by Funding Source
Calendar Year 2016
Source: Biologics Surveillance Data 2016. Represents a national summary of self-reported distribution data by the vaccine manufacturers. The data are an estimate of the
annual national distribution and does not equal administration. Reported data may be incomplete and include possible over-reporting or under-reporting of distribution data
and may not reflect all vaccines or manufacturers.
“Other” represents all purchases not on CDC contracts, including private, health insurance, and government purchases through other mechanisms.
A proportion of MMR, Varicella and PCV13 vaccines may be utilized in adults older than age 18 years.
Data do not include influenza vaccine doses.
Updated April 20, 2018
Vaccines for Children (VFC) Program
Vaccines for Children Program ✓ Diphtheria✓ Haemophilus influenzae type b✓ Hepatitis A✓ Hepatitis B✓ Human papillomavirus✓ Influenza✓ Measles✓ Meningococcal✓ Mumps✓ Pertussis (whooping cough)✓ Pneumococcal✓ Poliomyelitis✓ Rotavirus✓ Rubella✓ Tetanus✓ Varicella
1. https://www.cdc.gov/vaccines/programs/vfc/downloads/resolutions/0606-vaccines.pdf
Vaccines for Children Program Eligibility
Children under the age of 19 that are:✓ Medicaid-eligible✓ Uninsured✓ American Indian or Alaska Native✓ Underinsured* (FQHC, RHC)
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Cities: New York City, Philadelphia, Washington, D.C., Chicago, Houston & San AntonioTerritories: American Samoa, Guam, the Republic of Marshall Islands, Micronesia, the Northern Mariana Islands, Palau, Puerto Rico, the Virgin Islands
MP
MH FM
AS
PL
GU
PR
VI
Section 317 Program
Section 317 Grants ProgramVaccines/Operations
Supports Immunization infrastructure: IIS, outreach, disease surveillance, outbreak control, and education.
Supplemental funding to assist awardees in implementing activities.
Funding amount awarded varies & depends on the annual amount appropriated by Congress & carryover funds from the prior year.
Section 317-purchased vaccine has been directed towards meeting the needs of priority populations including underinsured children not eligible for VFC, and uninsured adults.
Source: Centers for Disease Control and Prevention
FY 2017 Final FY 2018 Omnibus
FY2019 President’s Budget
FY2019 +/-FY2018
Immunization Program
$606.1 M $610.8M $520.8M -$90.0M
Budget Authority $281.8M $286.5 $520.8 +$234.3M
PPHF $324.2M $324.4M $0M -$324.4M
State Funds
37, 70%
16, 30%
Programs that received State/Local funds for Vaccine Purchase in Grant Year 2016 (n=53)
Vaccine purchase - Yes
Vaccine purchase - No
27, 51%26, 49%
Programs that received State/Local funds for Operations/Infrastructure in Grant Year 2016 (n=53)
Operations/Infrastructure - Yes
Operations/Infrastructure - No
2017 AIM Annual Survey State Vaccines/Operations Funding
Operationalizing….Section 317 and VFC Programs
at the awardee level
VFC VFC & Underinsured Select
VFC & Underinsured Universal Select Universal
• Program provides all ACIP-recommended vaccines to private providers only for use among VFC-eligible children. The private providers do not receive 317* or state/local funded vaccine for non-VFC eligible children.
• Underinsured children with respect to vaccines are served by the immunization program using 317* and/or state/local funding to cover selected vaccines for the underinsured.
• Underinsured children must be referred to an FQHC, RHC, or deputized local health department to receive the selectedvaccines that are covered using 317* and/or state/local funding.
• Underinsured children with respect to vaccines are treated like VFC-eligible children because the immunization program uses 317* and/or state/local funding to cover all ACIP-recommended vaccines.
• This enables underinsured children to receive all ACIP-recommended vaccines from any VFC-enrolled provider (instead of having to refer underinsured children to an FQHC, RHC, or deputized local health department for vaccinations).
• All children, regardless of insurance status, receive almost all ACIP-recommended vaccines free of charge via the state/local immunization program, with the exception of one or more selected vaccines.
• In universal-select states, only VFC-eligible children receive all the selected vaccines free of charge at any VFC-enrolled provider (public or private).
• The program covers the non-VFC children with 317* and state/local funds as best as they can. Or parents of will pay for these selected vaccines out-of-pocket.
All children, regardless of insurance status, receive all ACIP-recommended vaccines free of charge via the state/local immunization program. The immunization program uses a combination of VFC, 317*, and state/local funds to purchase vaccine for all children in thestate. Children may be vaccinated by any VFC-enrolled provider (public and private).
Vaccine Purchase Policies
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Section 317 Program
✓Vaccine purchase awards: ➢Uninsured adults➢Underinsured children (meeting federal definition)➢Children/adults through mass clinic exercise
✓Operation/infrastructure awards:➢ Cooperative agreements funding IIS, education,
outbreak control, etc (staff, contractors, IT)➢ 5 year grant periods, renewed annually, July 1 through
June 30➢ Governed by requirements and mandatory reporting
Immunization Program Operations Manual
(IPOM)✓ Includes core documentation regarding their funding and federal
personnel (public health advisors, project officers, and vaccine advisors).
✓Each Core Component has:26 Required Awardee Objective
>40 Required Reporting Elements>35 Required Performance Measures
✓Required/suggested: activities, performance measure.✓Reporting requirements and suggested reporting elements.
Immunization Program Operations Manual (IPOM) outlines requirements and recommendations focused on five core components of an
immunization program:
Immunization Program Operations Manual
(IPOM)
Section 317: Important Things to Know
✓Cooperative Agreement✓Funding Methodology ✓NOFO✓Annual Report✓IIS Annual Report (ISAR)✓e-GRATIS
Vaccines for Children Program
✓Vaccine ✓Operations ✓AFIX
VFC Operations Guide
.
Module 1- Eligibility
.
Module 2- Provider Recruitment
and Enrollment.
.
Module 3- Quality Assurance and Program Accountability
.
Source: Washington State Immunization Program
Module 4- Vaccine Management
.
Source: VT Immunization Program
Module 5- Fraud and Abuse
. • All awardees are required to implement a written fraud and abuse policy for the VFC program. The policy MUST address:
prevention, detection, investigation, and resolution of fraud and abuse allegations.
Module 6- Program Improvement
AFIX: Assessment, Feedback, Incentives & eXchange
• AFIX Annual Report• Annual CDC Site Visit• Annual Federal Financial Report (FFR, SF-425)• AR: (AI/AN)• AR: (IISAR)• AR: Adolescent• AR: Adult• AR: Highlights• AR: Perinatal Hep B• AR: Preparedness-Pandemic FLU• AR: Surveillance• AR: Vaccine Safety• Cost and Affordability Tool• eGrATIS Cooperative Agreement
• eGrATIS End of Year Report• eGrATIS Post Award Management (PAM)• FFY Vaccine Spend Plan• Flu-Pre-Book• IIS Business Plan• Immunization Program Evaluation (IPE)• IP13-1301 Budget Year Financial Report (FFR)• Monthly Vaccine Spend Plan Updates• Population Estimate Survey• PPHF Quarterly Reports• School Coverage Reports• VFC Compliance PEAR Reports
AR: Annual Report
Requirement Recap
Org Charts
Q&A
2018 Program Manager OutlookHot Topics & Priorities
Informed Consent
Bills introduced in 2018 related to Immunization Exemptions, etc:
o 15 States o 46 Bills
✓Allowing Philosophical Exemptions
✓Requiring Written Consent before Vaccination
✓Prohibiting Health Department from denying an exemption
✓Prohibiting implementation of new vaccine mandates or requirements
0 1 2 3 4 5
Change vaccine financing policy
Work with payers to expand reimbursement for complimentary immunization services
Enroll pharmacists as VFC providers
Increase the number of school located vaccination clinics
Implement/enhance billing at local health departments
Increase the number of pharmacists using IIS
Support upcoming legislative activities
Partner with community vaccinators
Address vaccine safety/hesitancy
Increase implementation of the adult immunization standards
Improve pandemic preparedness
Increase adult rates
Increase the number of adult providers using IIS
Increase coverage rates for pregnant women
Work with coalitions
Increase coverage rates for older adolescents (16-18 yrs)
Increase the number of VFC providers using IIS
Improve vaccine storage and handling
Implement Meaningful Use/Interoperability
Identify and address low coverage rates
Improve VFC accountability
Implement PPHF grants
Increase HPV rates
Increase the number of providers using digital data loggers
2017 AIM Annual Survey Upcoming Priorities for the next 12 months
ACIP Recommendations
✓ Inclusion of live attenuated influenza vaccine(LAIV) for the upcoming flu season.
✓ Two dose Hepatitis B Vaccine with a adjuvant.Prevention of Hepatitis B Virus Infection in theUnited States.
✓Use of Herpes Zoster Vaccine.
✓Use of a Third Dose of Mumps Virus-ContainingVaccine in Persons at Increased Risk for MumpsDuring an Outbreak.
Corporate Alliance Benefits/ Upcoming 2018 Benefits
Katelyn Wells, PhDResearch & Development Director
• Monday, May 14 2018
• 5:30PM - 7:30PM
• Max Lager’s : Walking distance
• https://www.surveymonkey.com/r/AIM_AIRA_NIC
NIC Networking Reception
AIM Leadership in Action Conference June 4-7, 2018 San Diego, California
• Please note the following conference events that involve Corporate Alliance Members:
✓Monday, June 4th 5:30-8:00 PM: AIM Executive Committee/Corporate Alliance Member Meeting
✓Tuesday, June 5th 5:30-8:00 PM: AIM Business Reception (note: this is only for Platinum and Gold members)
✓Tuesday and Wednesday, June 5-6th: Exhibits
✓Wednesday, June 6th 3:30-5:00: Partner & Exhibit Reception
AIM Leadership in Action Conference Corporate Alliance Check List
Register on AIM website – Complementary registrations based on member level
Consider donating raffle item
Plan for exhibit set-up and break-down
✓Set-up: Monday, June 4th, 2018 7:00 pm – 9:00 pm and Tuesday, June 5th, 2018 7:00 am - 8:00am
✓Tear-down: 5:30 pm – 10:00 pm on Wednesday, June 6th
Plan exhibit space accordingly
Coordinate shipping and receiving with hotel – boxes should not arrive before June 1st.
Plan for your AV and electricity needs
Know your audience – review the provided attendee list
Q&A
