AIM Annual Survey Review 2015 · 2019. 5. 23. · Support Function- 2015 (located in the...
Transcript of AIM Annual Survey Review 2015 · 2019. 5. 23. · Support Function- 2015 (located in the...
AIM Annual Survey Review 2015
Katelyn Wells Ph.D.
AIM Research and Development Director
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AIM Annual Survey 2014 n = 60 & 2015 n = 63
Purpose: assess and characterize immunization program policy, infrastructure, program activities and priorities and the impact of funding changes (both federal and state) on immunization programs (IP)
• Survey designed by AIM committees CDC and partner feedback
• Administered online January-March 2014 & April – June 2015
2013 and 2014 Grant Year Funds
2013 and 2014 Calendar Year Activities
Current Policies
• Survey responses sent to each IP for verification
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IP Structure: Number of IP with Staff Currently in Position to Support Function- 2015
(located in the immunization program, w/ designated funding, includes contract staff, does not include LHD staff )
13
13
6
10
1
8
26
25
18
14
23
11
22
23
38
38
38
43
0 10 20 30 40 50 60 70
Adult immunization programming
Adolescent immunization programming
School assessments (assures compliancewith school law)
VPD surveillance & reporting
Managing perinatal hepatitis B
Research (program evaluation and/orassessing coverage rates)
No FTEs
.50 FTE
>1 FTE>1 FTE
4
IP Structure: No Staff Person in Position to Support Function 2015 vs. 2014
(located in the immunization program, at least .50 FTE, w/ designated funding, includes contract staff, does not include LHD staff )
3
5
6
13
14
15
18
20
24
1
10
6
13
13
8
0 10 20 30
Vaccine manager/coordinator
Registry manager/coordinator
Managing Perinatal hepatitis B staff (Identification of HBsAg-positive pregnant women; Newborn prophylaxis; Post-…
VPD surveillance & reporting staff
School Assessments coordinator (assures compliance withschool law)
Health educator
Adult coordinator
Adolescent coordinator
Research staff (Program Evaluation and/or Assessing CoverageRates)
2015
20142014
2015
*Question was not asked for 2015
* *
*
*
*
IP Staff Environment: Number of IPs with Change in Leadership in CY2013 vs. CY2014
5
50.0%
30.0%
52.5%
17.5%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
ImmunizationProgram Manager
Epidemiology andSurveillance
Manager/Director
State Health Official Governor
12
20
21
5
11
11
12
15
16
17
18
20
0 5 10 15 20 25
Local Commissioner
Adult manager/coordinator
Epidemiology and surveillance manager
Adolescent manager/coordinator
VFC manager/coordinator
AFIX manager/coordinator
IIS manager/coordinator
Immunization program manager/director
State Health Official
2014
2013
*
*Question was not asked for CY2013
*
IP Staff Environment: Number of IPs with Change in Leadership Positions CY2014 (out of 9 positions)
6
50.0%
30.0%
52.5%
17.5%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
ImmunizationProgram Manager
Epidemiology andSurveillance
Manager/Director
State Health Official Governor
49 of 63 17
11
9 8
3
1
0
2
4
6
8
10
12
14
16
18
1 leadershipchange
2 leadershipchanges
3 leadershipchanges
4 leadershipchanges
5 leadershipchanges
6 leadershipchanges
78% or (49 or 63) IPs had at least one leadership change in CY2014
IP Staff Environment: Impact of state/local policies
CY2014
37 IPs (59%) with hiring delays
28 IPs (44%) with travel restrictions
7 IPs with hiring freezes
9 IPs with pay freezes or reductions
8 IPs with reductions in force Other state policies impacting IPs: - Contract and grant process are cumbersome and lengthy - Centralized IT - Change in Indirect Rate - Cap on FTEs - State budget deficits
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IP Staff Environment: Number of Staff in Leadership Positions Within IPs
Includes those individuals whom immunization in program manager feel have a social influence or are in a position to enlist the aid and support of others in the accomplishment of a common task. These individuals would benefit
from leadership training e.g., change management, communication skills, etc.) and could include supervisors, managers and coordinators.
4
20
16
22 1 to 2 leaders
3 to 4 leaders
5 leaders
more than 5 leaders
Approximately 400+ leaders
2015
Yes 57%
No 43%
Advisory Committee
No 27%
Yes 73%
Immunization Coalition
IP Structure: Percentage of IPs with a Coalition or Advisory Board
Fiscal Environment: GY2014
0
31
23
4
3
3
0
2
13
8
9
9
6
16
30
44
25
3
5
27
26
19
12
4
25
20
25
22
27
24
20
9
0 20 40 60
PanFlu
State/Local Operations Funding
State/Local Vaccine Funding
VFC AFIX Funding
VFC Ordering Funding
VFC Operations Funding
Section 317 Operations/InfrastructureFunding
Section 317 Vaccine Funding
N/A-We donot have thisfunding type
Funding wascut orreduced
Funding wasincreased orrestored
Funding waslevel, nochange from2013
0%
10%
20%
30%
40%
50%
60%
70%
80%
2013 2014
State/Local VaccineFunding
State/Local OperationsFunding
Section 317 VaccineFunding
Section 317Operations/InfrastructureFundingVFC AFIX Funding
VFC Operations Funding
VFC Ordering Funding
Fiscal Environment: Percentage of IPs with Cuts GY2013 vs.GY2014
2
2
2
3
3
5
5
5
5
6
6
6
7
7
8
8 8 8
9 9
13 14
22
0 5 10 15 20 25
VFC provider recruitment/training for IIS
Implementing Meaningful Use
Daycare/school assessments
Pharmacy recruitment/training for IIS
Provider VFC site visits
Childhood vaccine purchase
School located vaccination clinics
Enhancement of IIS
Adult provider recruitment/training for IIS
Adolescent vaccine purchase
Provider education
Provider AFIX site visits
Funding for local health departments
Staffing/administrative support
Adolescent programming
Provider VFC/AFIX combined visits
Purchase of vaccine storage and handling equipment for providers
Pan Flu exercises
Public education
Purchase of provider incentives
Supply of provider education materials
Adult programming
Adult vaccine purchase
Fiscal Environment: Number of IPs with Reduction/Cut in Specific Activities - GY2014 (All Funding Sources)
Fiscal Environment: Number of IPs Use of 317 Vaccine Funds
GY2014
53
28 14
32 28
6
27
43
25 29
0
10
20
30
40
50
60
70
No, Section 317vaccine fundingwas not used
Yes, Section 317vaccine fundingwas used
13
49
27
15 17
28
8
2 2 0 1
8 10
0 0 0 0
10
20
30
40
50
60
317 purchase for ongoingactivity (over multipleyears)
317 purchase for planneddemo or pilot project
Ad hoc or end-of-year 317purchase
Fiscal Environment: Percent of IPs using 317 Vaccine Funds
(GY2013 vs. GY2014)
53
28 14
32 28
6
27
43
25 29
0
10
20
30
40
50
60
70
No, Section 317vaccine fundingwas not used
Yes, Section 317vaccine fundingwas used
14
90%
52%
26%
50%
89%
64%
31%
47%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Adults Outbreaks School-locatedvaccination clinics
Hepatitis B birthdose
2013
2014
IP Effort: Percent of IPs Reporting Current Activity 2014 vs. 2015
15
42%
58%
63%
47%
53%
65%
60%
84%
82%
23%
44%
51%
57%
61%
64%
64%
66%
66%
66%
72%
75%
84%
89%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Check for provider invoices to private insurance
Complete separate VFC site visit and AFIX > 25% of providers
Requiring VFC providers to use digital data loggers
Require providers to use IIS
Require providers to submit templogs with orders
Require providers to track doses administered by funding source
Host regional provider trainings
Require providers to reimburse the program for wasted vaccine
Conduct provider training online
Assess provider education needs and identify resources to meetneeds
Conduct adolescent AFIX visits (stand alone or routine childhoodvisit)
Visit new providers more than once in the first year
Require providers to submit doses administered
Conduct compliance site visits to > CDC-required 50% of VFCproviders
2015
2014
IP Effort: Percentage of IPs with Non-traditional Providers Enrolled in VFC
CY2013 vs. CY2014
16
28% 27% 27%
63%
25%
35% 36%
62%
44%
54%
0%
10%
20%
30%
40%
50%
60%
70%
Pharmacists CommunityVaccinators
OB/GYNs STD/FamilyPlanning Clinics
Internists College/schoolbased health
service
2014 20152014 2013
IPs Current Activities for NON-VFC Enrolled - 2015
26
21
32
28
26
32
34
26
32
30
25
31
13
11
14
11
12
13
7
6
11
9
7
5
0 20 40 60 80 100
Pharmacists
Community Vaccinators
OB-GYNs
STD and/or Family PlanningClinics
Internists
College/school based healthservice
Distribution ofinformation/educationalmaterials aboutimmunizations
IIS enrollment/training
Virtual training forimmunizations
On-site training forimmunizations
8
11
11
14
14
15
18
23
20
26
25
29
30
33
33
33
13
18
18
16
20
28
30
26
31
28
35
32
40
39
42
45
0 10 20 30 40 50 60 70 80 90
Racial and ethnic specific
Adult-Pneumococcal specific
Healthcare worker vaccination specific
Chronic medical condition specific, e.g.diabetes.
Adult-MMR specific
Adult-Tdap specific
Child-Pertussis specific
Pregnant women specific
General Adult Vaccines
HPV with cancer prevention focus
Child-Measles specific
Adolescent-HPV specific
General Adolescent Vaccines
Child-Influenza specific
Adult-Influenza specific
General Childhood Vaccines
Social Media(e.g.,Facebook, Twitter,Youtube, Texting)
General Media (e.g.,Website, Radio, TV,Newsletters,Newspapers, etc.)
IP Effort: Number of IPs with Targeted Communication Campaigns CY2014
IP Effort: Percent of IP Addressing Vaccine Confidence/Hesitancy CY2014
19 19%
26%
42%
46%
47%
47%
53%
56%
60%
60%
63%
63%
67%
81%
83%
83%
84%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Check for provider invoices to private insurance
Require providers to use VTrckS
Complete separate VFC site visit and AFIX visits >25% of…
Conduct validation audits of provider profile information
Require providers - track doses administered by funding source
Evaluate the effectiveness of VSH provided to provider staff
Host regional provider trainings
Evaluate the effectiveness of VSH education/training provided…
Visit new providers more than once in the first year
Require providers to use IIS
Require providers to submit templogs with orders
Conduct adolescent AFIX
Require reimbursement for wasted vaccine
provider training online or in-person class room style…
Conduct compliance site visits for more 50% of VFC-enrolled…
Check provider profile info against provider orders
Require providers to submit doses administered
5%
5%
10%
11%
14%
21%
24%
25%
37%
41%
46%
46%
47%
47%
48%
53% 61%
76% 79%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Passed laws or regulations to strengthen exemption laws
Conducted focus groups/surveys of schools
Used IIS to determine vaccine refusal and target intervention by…
Conducted focus groups/surveys of Parents
Conducted focus groups/surveys of Providers
Identified schools with high exemption rates and targeted…
Disseminated coverage and exemption rate “report cards” to …
Disseminated toolkit/resources to schools
Encouraged providers to document in IIS vaccine refusals and/or…
Sponsored or promoted web based Provider training
Sent messages to Providers via website and/or social media
Disseminated Provider toolkit/resources
Provided school coverage and exemption rate reports for public…
Sent messages to Parents via mass media (website, print, TV,…
Sent messages to Parents via social media (Facebook, Twitter, etc.)
Collaborated with AAP
Collaborated with immunization coalition
Addressed at in person Provider training (meetings, conferences,…
Addressed during AFIX or VFC site visit
11% of IPs did not conduct any of the provided activities to address vaccine confidence/ hesitancy
IP Effort: Percent of IPs use of Funding to Address Vaccine Confidence/ Hesitancy CY2014
20 19%
26%
42%
46%
47%
47%
53%
56%
60%
60%
63%
63%
67%
81%
83%
83%
84%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Check for provider invoices to private insurance
Require providers to use VTrckS
Complete separate VFC site visit and AFIX visits >25% of…
Conduct validation audits of provider profile information
Require providers - track doses administered by funding source
Evaluate the effectiveness of VSH provided to provider staff
Host regional provider trainings
Evaluate the effectiveness of VSH education/training provided…
Visit new providers more than once in the first year
Require providers to use IIS
Require providers to submit templogs with orders
Conduct adolescent AFIX
Require reimbursement for wasted vaccine
provider training online or in-person class room style…
Conduct compliance site visits for more 50% of VFC-enrolled…
Check provider profile info against provider orders
Require providers to submit doses administered65%
38%
33%
29%
21%
0%
10%
20%
30%
40%
50%
60%
70%
Section 317 VFC AFIX VFC Operations State/local Categorical PPHF
IP Effort: Priority Level CY2015 vs. CY2014
21
1.8
1.9
3.3
2.5
3
3.8
4.1
4.2
4.2
4.3
4.3
4.4
1.0 2.0 3.0 4.0 5.0
Change vaccine financing policy
Enroll pharmacists as VFC providers
Increase the number of school located vaccination clinics
Work with payers to expand reimbursement for…
Partner with community vaccinators
Increase the number of pharmacists using IIS
Address vaccine safety/hesitancy
Implement/enhance billing at local health departments
Improve pandemic preparedness
Increase implementation of the adult immunization standards
Increase adult rates
Increase the number of adult providers using IIS
Support upcoming legislative activities
Work with coalitions
Implement PPHF grants
Increase the number of VFC providers using IIS
Implement Meaningful Use/Interoperability
Increase HPV rates
Identify and address low coverage rates
Improve vaccine storage and handling
Improve VFC accountability
2015 2014
1= Not a Priority 2= Low Priority 3= Mod. Priority 4= High Priority 5= High Priority
AIM Next Steps Send aggregate results to AIM Members (10/23 Weekly Update)
Publish Policy Maps (October 2015)
- Available on AIM and vaccinefactsandpolicy.org websites
Present AIM 2015 Data Review to Partners at 2016 Partner Meeting (AIM Leadership in Action Conference)
Present HPV Related Data on HPV Call to Action
Present Vaccine Confidence/Hesitancy Data at Texas Immunization Conference
Conduct a research project further analyzing Vaccine Confidence/ Hesitancy Data (Partners Dr. Saad Omer and Dr. Dan Salmon, Ed Marcuse)
Decide/Prioritize how to further analyze and publish results Student Practicums Insight/Direction from Research Committee Decision from Executive Committee
Add select data to www. vaccinefactsandpolicy.org 22
“A Comprehensive Database of U.S. Immunization Information”
www.vaccinefactsandpolicy.org
Key Features: Printable Profile Reports
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Key Features: Printable Reports by Topic
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