Indiana Immunization Coalition Date: March 15, 2007 Present: Sheran Allee Barbara Baker Janet Balog Carla Beres Carol Briley Jill Brock Donella Carter Kurt Casper Ann Clamme-Monroe Cynthia Coryea Pam Cox Carolyn Davis Eileen Dvorak Emily Engle Melissa Etchison Patricia Gensic Charlene Graves Bill Hagan Nancy Hoffman Teresa Hope Audrey Howe Kevin Knotts Joan Krogman Pat Lehman Penny Lewis Melissa McMasters Monica Mayer Retired Nurse St. Joseph County Health Department STC Every Child By Two Indiana State Department of Health Jackson County Health Department Tippecanoe County Health Department GlaxoSmithKline Delaware County Health Department Merck Vaccine Division Vigo County School Corporation Elkhart County Health Department Health Ministry Partnership DeKalb County Health Department Indiana Health Centers, Inc. Noble County Health Department Indiana State Department of Health Sanofi Pasteur Hendricks County Health Department Ft.Wayne/Allen County Department of Health LaGrange County Health Department Wyeth Vaccines Tippecanoe School Corporation Indiana State Department of Health Indiana State Department of Health Marion County Health Department Merck – Public Health Policy
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Lauren Mills Cindy Murphy Anne Ray Sarah Renner Gary Rhyne Gloria Roesch Sharon Roosa Kim Sanders Steve Sellers Jennifer Sherer Sherene Skinner Monica Smith Kristy Spurling Bill Spurlock Becky Stoner Jessica T. Stutts Cheryl Sweeney Ann Weatherford Diana Welch Pam Westfall Kelly Zachrich
FSSA Boone County Health Department Jackson County Health Department Indiana State Department of Health Indiana State Department of Health MedImmune Wayne County Health Department GlaxoSmithKline Indiana State Department of Health Marion County Health Department Hendricks County Health Department Hendricks County Health Department Marion County Health Department Sanofi Pasteur Clarian Health FSSA Merck Vaccine Division Putnam County Health Department Porter County Health Department Porter County Health Department Indiana Immunization Coalition/Super Shot, Inc.
Item January Minutes Minutes reviewed.
Discussion
Action Approved as submitted.
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Vaccine Updates - Dr. Graves
Dr. Graves stated that there has been a universal recommendation of the influenza vaccine to be given to pre-school and school age children. Dr. Graves stated that there have been a number of states introducing HPV vaccine as a school requirement. This bill was introduced but amended to only educate girls about the vaccine. See map of states that have introduced HPV bills. Dr. Graves stated that Varicella immunity has waned over time and that is why now they are recommending a second dose. Dr. Graves stated that Hepatitis Advisory Council has been created and the topic for upcoming meeting is immunizations. Kelly will be speaking about the Indiana Immunization Coalition and the Hepatitis B staff from ISDH will also be speaking. The purpose of this council is to develop a statewide strategic plan to address Hepatitis. A question was asked about the CDC statement regarding Rotovirus. Dr. Graves stated that the CDC is stating that intussusceptions does not occur in more children vaccinated with RotaTeq than for those that have not been vaccinated with RotaTeq. There appears to be no association with the vaccine and intussusception. The recommendation to continue to give the vaccine stands.
Immunization Program – Carol Briley/Steve Sellers
Carol stated that the Hep A supply is going to continue to remain constant. She stated that they would be lifting the vaccine rationing. They needed to find out. Now that they do, if you run out you can call by the 25th of the month and order additional vaccine and they will try to get it to you.
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Steve stated that we are going to be part of the first tier of the new ordering system, VMBIP that will start on May 14. Steve stated that they would like to reduce their vaccine inventory before this date. He stated that then everything would run on a tiered ordering frequency (TOF). The large providers will order on a monthly basis, the medium providers on a bi-monthly basis, and the small providers on a quarterly basis. He believes this will run a lot smoother. Steve stated that as it gets closer to May they would let everyone know how it will roll out. Steve stated that if there are any large facilities that could store large quantities of vaccine to let them know they might be using them to store vaccine. The vaccine would be yours to use but if the state needed it for somebody else the state could come and get it and give it to another provider. It was asked how they will determine if you are a large, medium or small provider. Carol stated that VMBIP gives them a tool to use by doses administered. They will let everybody know when it gets closer to time. Carol stated that they have created an email for everyone to use if you have questions about anything to do with vaccines; vaccine availability, storage, use, ect. contact immunize@isdh.IN.gov Carol stated that ISDH would be moving ahead with the “Delegation of Authority”. They now have a contract in place with FQHCs, but it has to be approved at the federal level. She stated that this would increase our VFC dollars this year. The CDC has encouraged states to do create this partnership. There are approximately 14 states currently partnering with FQHC’s. Carol stated that they would move forward with this, with or without the Heatlhy Indiana Plan Bill. Carol stated that they are ordering more HPV vaccine but that the tiering system will not change at this time.
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Gary Rhyne stated that the ACIP statement released last week continues to recommend the 11-12 year olds are still the primary group to vaccinate for HPV. Medicaid – Sarah Renner
Sarah said the state sent out a survey asking local health departments about Medicaid. A couple of the questions on the survey were: What services are you billing for? If you are not billing would you like to? Sarah stated that approximately 55 health departments participated, and most of them stated that they would like to become a Medicaid provider. A few of the issue brought up were: that you can’t just be a Medicaid provider; you would have to bill other insurance companies too. Also that you would have to create a billing department and a billing system. Sarah stated that the next step after this survey would be to create a group to find a contract to help health departments create a billing department. She stated the benefit to the health departments is to bring in a new source of revenue. She stated that other states are doing this successfully, so we would like to model this.
HIP Coalition Update – Lawren Mills and Jessica Stults
Lawren stated that they are trying to work with the HIP coalition to get the cigarette tax passed. It didn’t pass in the Senate. The Senate bill 503 has passed in the Senate and has been sent over to the House. It has no funding source attached to it. They would like to get the cigarette tax attached to it and this contains $11,000 to given to immunizations. Lawren stated some of the reason the legislators don’t want to vote for it are: some won’t vote for anything that is a tax increase, some didn’t like the first Health Plan that the cigarette tax was attached to, and some like
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entitlement programs and this is not an entitlement program. Lawren stated that this bill needs a hearing. The legislators need to have pressure and encouragement, especially the Democrats, from all of you so that they vote to get this bill a hearing. She suggested that maybe we all change our focus. Instead of just keep hearing from the same people that maybe you encourage other people like approaching your hospitals staff or people from your church. Try to focus on it as a health package not just a cigarette tax. Lawren and Jessica suggested that our “Call to Action” be to call your representatives and push for bill 503 to get a hearing. Call your legislators and ask them to support bill 503, and they also encourage if you can to stop at the State House and have a face to face meetings with them. Legislative Advocacy – Janet Balog CHIRP – Penny Lewis
See report.
Penny stated that CHIRP staff is working on the hardware side of CHIRP. The 2:30pm crash will no longer happen, they have installed top of the line hardware. Penny stated that in the end this will allow us to expand CHIRP and allow us to accept more interfaces into CHIRP Penny stated that Regenstrief, a depository in Central Indiana where private providers put there data, is working on interfacing with CHIRP. They are about four to five months away from the first test of this process. She stated that this could possible increase CHIRP by 50%. In addition
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we may have the school nurse module by 2008. This is where school nurses will be putting in historical data from there students. Then from there hopefully in about six to eight months they should be ale to start processing reports. She stated that we are starting to connect CHIRP with other state registries. Right now we can connect to Louisiana. In six to eight months Wisconsin and Michigan and in another 11 to 12 months Illinois, Kentucky, and Ohio and hopefully on and on. A question was asked if STD clinics enter immunizations into CHIRP. Due to privacy Steve stated that they have been advised that they should not because it is a breach of confidentiality. Kelly stated that the coalition is always looking for “volunteers” for all of our sub-committees. If anyone is interested please let her know Kelly stated that the Adolescent sub-committee met today to look at how we have doing. They came up with some decisions. They would like to move the focus to the Middle School level. They also decided to change the name from” Vaccinate Before You Graduate” to “Vaccinate Before Grade Eight” Kelly stated that Sheran Allee has retired. She will still be staying involved with the coalition and the Adolescent subcommittee. Kelly presented her with a Thank you gift for all she has done for us. Sheran Allee stated that they presented VBYG at the NIC. She stated that it was well received and they had very good attendance. Next Meeting Thursday, May 17
Sharing what works
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