Immunization Coalition of Los Angeles County

A Project of Community Partners

Mission: To foster collaborative efforts to prevent vaccine -preventable diseases since 1997

Wendy Berger, MPHICLAC Coordinatorwberger@ph.lacounty.gov

PROJECT WORKGROUP

UPDATES

As of March 9, 2017

Presentation Update

Objectives

• Describe the purpose of the project workgroups.

• Describe goals, objectives, and current activities.

ICLAC PROJECT WORKGROUPS

•Adolescent Immunization

•Adult Immunization

•Vaccine Confidence

Adolescent Workgroup

Adolescent WorkgroupBackground

• Due to privacy concerns, adolescents may avoid using traditional doctors’ offices when seeking sensitive health care services (e.g., STD and Prenatal care).

• The California Health Information Act (CHIA) protects the adolescents’ right to privacy when obtaining sensitive health services.

• CHIA allows the adolescent to self-consent for HPV and HBV immunizations.

Adolescent Workgroup Activity Updates

• Invited ACLU representative to provide an overview of CHIA

• Confidential Communications Request (CCR)

• http://www.myhealthmyinfo.org/

• Invited Essential Access Health to discuss how the CCR is used at FQHC’s and other Title X clinics such as Planned Parenthood.

Adolescent Workgroup

GOAL:

Advocate to increase access to immunizations where adolescents seek care including alternate settings such as family planning clinics, pharmacies, and school-based health centers.

Adolescent Workgroup Objectives

• Assess the confidentiality policies and practices at FQHC’s, family planning clinics, pharmacies, and school-based health centers. Recommend strategies to remove potential barriers .

• Promote all ACIP recommended vaccinations and usage of CAIR at Planned Parenthood clinics.

• Increase community education about VPD’s, the recommended adolescent immunizations, and booster doses.

Adult Workgroup

Adult WorkgroupBackground

• Adult immunization coverage rates nationally are exceedingly below the recommended standards.

• Provider and system barriers contribute to low adult coverage levels

Adult WorkgroupBackground

Provider Barriers • Limited inventory of all the

recommended adult vaccines

System Barriers• Lack of a standardized

pharmacy “carve out” benefit across the different health plan types, e.g., HMO, IPA, PPO.

Adult Workgroup

Goal:Protect pregnant women and seniors (65+) in LA County from vaccine preventable diseases by promoting access to the ACIP recommended vaccinations at physician practices.

Adult Immunization WorkgroupObjectives

• Increase vaccination rates at which vaccines are offered in the clinical setting.

• Increase communication between provider and pharmacist about recommended adult vaccines for patients.

• Increase partnerships with the many different types of health plans such as Health Maintenance Organizations (HMO), Independent Practice Associations (IPA), and Medical Associations (e.g., AMA), to advocate for pharmacy benefit.

Adult WorkgroupActivity Updates

• The California Dept. of Health Care Services (DHCS) approved a pharmacy benefit to expand access to all ACIP recommended adult immunizations for Medi-Cal Managed Care Plan recipients.

• Workgroup members arranged a conference call with DHCS regarding specifics of the benefit and implementation timeline.

Adult WorkgroupActivity Updates

• The pharmacy benefit is not a uniform benefit across all types of health plans, especially commercial health plans (e.g., IPAs PPOs, Senior HMOs).

• Without a pharmacy benefit, access to adult immunizations will remain poor.

Adult WorkgroupNext Actions

• Write an Op-Ed article in various print and social media channels.

• Draft letter to LA County Health Agency Director endorsing the pharmacy benefit to promote health equity among the underinsured.

Adult WorkgroupNext Actions

• Promote enrollment of all licensed pharmacies in LA County not currently participating in the online VaccineFinder resource.

• http://vaccine.healthmap.org/

• By April 30, 2017, pilot test a referral mechanism for providers to use when their medical practice lacks the recommended adult immunizations.

Adult WorkgroupNext Actions

Pilot Test: Nonbranded Immunization Prescription based on CDC recommendations

(MMWR)

Date: Nurse/MA Name:Patient Name: Patient Phone Number: Patient Date of Birth: Patient Age:Patient Insurance:

Pharmacy Name and Location:Physician Name:

Physician Phone Number:

Physician Medical License No: DEA Number:

The patient does not have any contraindications. Please administer the FDA approved vaccine(s) checked with an x or √ for patient 19 years and older, OR,

Please administer

Process

Nurse/

MA

• The patient checks in the providers office

• The nurse/MA/LVN assesses the immunizations needed using the MR and prescription

• The MA fills in the prescription

MD

• The provider approves the prescription

• MA calls in/faxes the prescription to the pharmacy

• The pharmacy assesses the insurance coverage of the vaccine

PharmD

• The pharmacy follows up with the patient and administers the vaccine

• The pharmacy reports back to the provider and to the immunization registry

Vaccine Confidence Workgroup

Vaccine Confidence WorkgroupBackground

• Increased public scrutiny and skepticism over:• Vaccine Safety and Effectiveness

• Timing schedule of childhood vaccinations

• Anti-vaccine sentiment is currently threatening herd immunity levels.

Vaccine Confidence Workgroup

Goal:

Increase and maintain the publics’ confidence in vaccinations.

Vaccine Confidence WorkgroupObjectives

• By September, 2017, assess the vaccine risk/benefit communication resources currently used by ICLAC partners using a web-based survey.

• By December, 2018, compile an ICLAC vaccine confidence communication toolkit and disseminate to ICLAC partners as well as LA County immunization providers.

Vaccine Confidence WorkgroupNext Actions:

• Analyze, select, and categorize the named communication resources by vaccine type, target population, disease type.

• Upload resources to ICLAC web page for use by LA County health providers and ICLAC partners.

Questions