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HomeMy WebLinkAboutMINUTES - 06151993 - 1.46 1 _46 r� TO: BOARD OF SUPERVISORS FROM: Mark Finucane, Health Sh Services Director Ulf ,C Contra By: Elizabeth A. Spooner, Contracts Administrator WSL� DATE: June 3, 1993 10 County SUBJECT: Approve submission of Funding Application #29-208-44 to the State Department of Health Services for the Immunization Assistance Program SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION I. RECOMMENDED ACTION: Approve and authorize submission of Funding Application #29-208-44 to the State Department of Health Services in the amount of $204,663, for the period July 1, 1993 through June 30, 1994, for continuation of the Immunization Assistance Program. II. FINANCIAL IMPACT: Approval of this application will result in $204,663 of State funding for the Immunization Assistance Program during FY 1993-94. No County match is required. III. REASONS FOR RECOMMENDATIONS/BACKGROUND: On August 11, 1992, the Board approved Standard Agreement #29-208-42 (as amended by Standard Agreement Amendment #29-208-43) , with the State Department of Health Services to provide funds for County's long-standing Immunization Assistance Program, for the period July 1, 1992 through June 30, 1993. This program, operated by the Public Health Division of the Health Services Department, makes immunizations available to all persons in need of these services in order to prevent the occurrence and transmission of childhood diseases. Approval of Funding Application #29-208-44 will provide State funding for continuation of the program during FY 1993-94. The program will continue to monitor the compliance of preschools, elementary schools, and secondary schools, in order to meet State-mandated immunization requirements through inservice programs and limited technical assistance. Program staff will continue to maintain an adverse reaction monitoring system and outbreak control team. This application must be approved in order for the County to continue to receive free vaccine from the State. In order to meet the deadline for submission, a draft copy of the application has been forwarded to the State, but subject to Board approval. After Board approval, seven certified copies of the Board Order should be returned to the Contracts and Grants Unit for submission to the State Department of Health Services. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATORRECOMME - ATI NOF BOARD C MMITTEE APPROVE OTHER SIGNATURE(S) ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS _4L�_ UNANIMOUS (ABSENT ) 1 HEREBY CERTIFY THAT THIS IS A TRUE AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD Contact: Wendel Brunner, M.D. (313-6712) OF SUPERVISORS ON THE DATE SHOWN. JUN 15 1993 CC: Health Services (Contract) ATTESTED Auditor-Controller (Claims) Phil Batchelor, Clerk of the Board of State Deptartment of Health Services Supenl*rs 0d GoullV Administramr M3e2/7-83 BY DEPUTY 1 -46 EXHIBIT A - TERMS SECTION I. TERMS AND CONDITIONS The Contractor must agree to the following inclusive objectives and conduct the following activities. Please note that many of these Terms and Conditions are also objectives and activities required by the Federal Government and are conditions for funding of the California Immunization Program and/or statutory requirements of State and local health departments. The level of subvention contract funding to be awarded is not represented as sufficient for support of all the required activities; a significant amount of local support and funding is expected. Subvention contract funds must not be used to supplant (i.e., replace) local funds currently being expended for routine immunization services and activities. Subvention funds can only be used for the activities outlined in the budget justification. A. Objectives: 1.) Raise to (or maintain) immunization levels of 98% or greater for each of the legally required immunizations among all kindergarten entrants and incoming transfer students to schools within the Contractor's jurisdiction. 2.) Raise age-appropriate immunization levels to 95% or greater among infants and preschool-age children residing within the Contractor's jurisdiction. 3.) During the twelve-month (12) period of this agreement, the number of fourth doses of DTP administered in public clinics to children before their second birthday will increase by ten percentage (10%) points compared to the number administered to children of the identical age during the preceding twelve-month (12) period. 4.) Through prevention, surveillance and outbreak control, reduce, and if possible eliminate, illness, disability and death due to vaccine preventable diseases such as polio, diphtheria, tetanus, pertussis, measles, rubella, mumps, hepatitis B, and Haemophilus Influenzae Type b within the Contractor's jurisdiction. B. Specific Pediatric Activities: 1.) Immunization Clinic Services a.) Augment staffing in existing regularly scheduled public immunization clinics and/or expand clinics in more locations on more days with longer hours which are reasonably accessible to parents of children who reside within the Contractor's jurisdiction. b.) Clinic policies must allow for the immunization of all susceptible infants, children, adolescents and adults who visit within the scheduled hours of operation regardless of their city, county or state of residence. c.) Public immunization clinic policies and practices must be in general accordance with the current recommendations approved by the U.S. Public Health Service and endorsed by the American Academy of Pediatrics (AAP) as specified in the 'Standards for Pediatric Immunization Practices. (Note: ' The ,Standards represent the consensus of the National Vaccine Advisory Committee (NVAC) and of a broad group of medical and public health experts about what constitute the most desirable immunization practices. The Standards are expected to be useful as a means of assisting providers to identify needed changes,to obtain resources if necessary, and to actually implement the desirable immunization practices.) Accordingly, appropriate in-service training shall be instituted to assure compliance with the Standards. d.) Each patient (or patient's parents) receiving"pediatric"immunizations through the Contractor's public clinics must be provided a new or updated California Immunization Record (CIR). The month, day and year of each immunization must be recorded on the CIR. EXHIBIT A(Pediatric-IAP Continued) FY 1993-94 Page 2 e.) Assure that the importance of completing the recommended schedule of immunizations is discussed with all patients (or parents of patients) receiving immunizations at the public clinics. f.) Assure that the date the next vaccine dose(s) are due is given in writing to the patient or parent. The appropriate space on the CIR may be used for this purpose. g.) Within the health jurisdiction, the Contractor will strive to implement and maintain public immunization clinic reminder/recall systems among all medical providers, who receive state- supplied vaccines,to improve age-appropriate immunizations of preschool-age children. h.) In accordance with current Immunization Branch guidelines, which were furnished to the contractor by the State,the Contractor must participate in the national Vaccine Adverse Events Reporting System (VAERS)for adverse events following immunization. 2.) Immunization Assessment Levels a.) In accordance with the guidelines and timetables provided by the Immunization Branch, the Contractor must coordinate the assessment of the immunization levels of child care centers, Head Start Centers, and kindergarten entrants. b.) Through coordination with Immunization Branch Representatives, county health authorities and local child care center and school authorities, the Contractor must make efforts to ensure that all (100%) child care centers, Head Start centers and schools fully enforce existing regulations pertaining to the immunization of children admitted to such institutions. c.) Annually,within the health jurisdiction,the Contractor shall select at least a 20%representative random sample of public clinics who receive state-supplied vaccine. Of the public clinics selected, the Contractor shall conduct immunization record audits of children (24 months -35 months old) who are served by the clinics. The sampling technique and immunization clinic record methodology must be compatible with the methodology of the Immunization Branch (formerly Immunization Unit) of the California Department of Health Services. The record audit specifications (with additional detailed guidelines), if requested, will be provided to the Contractor by the CDHS Immunization Branch. 3.) Immunization of Infants and Preschool Children In addition to the above stated activities,the Contractor agrees to the following activities intended to assure the age-appropriate immunization of infants and preschoolers who reside within the Contractor's jurisdiction. a.) Make efforts to ensure that the immunization status of infants and children receiving services through programs such as CHDP, MCH, AFDC, and WIC is assessed and that a system is established to ensure age-appropriate immunization. b.) Promote immunization information and education of parents with newborn children through all hospitals with maternity services within the Contractor's jurisdiction. 4.) Vaccine Preventable Disease Surveillance and Outbreak Control a.) Establish and maintain an effective system for identification and reporting of suspect, probable and confirmed cases of vaccine preventable diseases. Sources of surveillance information should include practicing physicians, outpatient clinics, hospitals, schools, child care centers and Head Start centers. Active surveillance is only required during outbreaks of measles. b.) Investigation and Control of Measles 1.) Investigation of.all reported suspect, probable and confirmed cases of measles must be EXHIBIT A(Pediatric-IAP Continued) FY 1993-94 Page 3 initiated within one working day of receipt of a report by the Contractor. 2.) Outbreak control procedures in accordance with the guidelines of the Immunization Branch must be initiated by the Contractor within two working days of determination of a probable or confirmed measles case. C. Requlred Reports 1.) Reports of Local Program Progress and Activities In accordance with the guidelines and format provided by the Immunization Branch, the Contractor shall submit, through his/her Immunization Branch District Field Representative. to the Branch identified in paragraph 6 of Section I in this Exhibit, by the 15th of the month following the end of each quarter, a written quarterly report of progress and activlties. In addition to the written report the Contractor and Project Liaison,or his designee, may meet and discuss the above matters in person. 2.) Upon completion of the investigation of each probable or confirmed measles case, a completed investigation form must be submitted to the Immunization Branch. 3.) Contractor agrees that itemized personnel positions listed in said Exhibit B shall not be subject to Contractor's personnel policy decisions to refrain from filling vacant positions. The total amount of the contract will be indicated as either some part, or all, of the total operations budget. If the total amount of the contract is less than the total operations budget, the Contractor will be responsible for providing the difference between the total amount of the contract and the total operations budget. Further, all invoices to the State which request reimbursements for positions included in Exhibit "B" must include the name and Social Security number of the persons that have performed in these positions. 4.) The Contractor shall provide for any personnel or operating expenses that are'necessary to meet the provisions included herein but are not provided for in the Budget included as Exhibit "B". 5.) The Contractor shall submit through his/her Immunization Branch District Field Redresentative.to the Branch identified in paragraph 6 of Section I in this Exhibit, on or before the 3rd of the month following the report month, a written Monthly Vaccine Usage Report in the form prescribed by the State Department of Health Services, Immunization Branch. 6.) All reports, other than those required to be directed to the District Field Representatives, invoices, and other written communications are to be addressed and delivered to the State Department of Health Services, Immunization Branch, 2151 Berkeley Way, Berkeley, California 94704. 7.) The State reserves the right to use and reproduce all reports and data produced and delivered pursuant to this Contract and reserves the right to authorize others to use or reproduce such materials, provided that the confidentiality of patient information and records are protected pursuant to Caldomia State laws and regulations. 8.) This Contract may be terminated by either party upon 30 days' written notice to the other party. Further, this Contract may be terminated or suspended upon written notification by the State at any time for failure on the part of the Contractor to comply with any of the provisions contained herein. 9.) In consideration of the above services, performed in a manner acceptable to the State, the State shall reimburse the Contractor quarterly, in arrears, upon submission of a quarterly invoice by Contractor on Contractor's letterhead, in quadruplicate stating the time period covered, stating the contract number, for actual expenditures in accordance with the budget (attached hereto and shown as Exhibit "B"), to: Department of Health Services, Immunization Branch, 2151 Berkeley Way, Room 712, Berkeley, CA 94704. The Contractor may make changes in any individual line item in the budget, provided that such changes in the sum total does not exceed $10,000 that the EXHIBIT A(Pediatric-IAP Continued) FY 1993-94 Page 4 Contractor submit an explanation of the need for such excess with the claim for reimbursement and to specifically identify the line Rem(s) to be reduced in order to increase the excess items) and provided further that the State reserves the right to deny any such claim for any excess reimbursement on any item. It is further understood that in no event shall the maximum amount payable under this agreement exceed the maximum amount specified in paragraph of the Standard Agreement. 10.) It is agreed by the Contractor that in the event that a significant portion of the Contract objectives for the initial four months of the Contract are not met by that time; and in the event that the State determines from quarterly invoices, performance reports, and other sources of information that the Contractor will not perform the total quantity of services contracted for; and that therefore, the total budget allocation will not be depleted; the State and/or Contractor may make an equitable adjustment in the original Contract budget and Contract objectives in order to decrease the total quantity of services and commensurate Contract amount. Any adjustment shall be by amendment only and duly executed by both parties and approved by the Department of General Services (if applicable). SECTION 11. TERMS AND CONDITIONS FOR RECEIPT OF VACCINE PURCHASED WITH STATE OF CALIFORNIA OR FEDERAL FUNDS The local health department receiving vaccine purchased with State of Caldomia/Federal funds, herein called State purchased vaccines, agrees to the following terms and conditions. 1.) Prior to receipt of an immunization,all patients(or their parents or legal guardians) must be: a.) provided a copy of the current "Important Information" statement and/or "Vaccine Information Pamphlet"for each vaccine dose to be administered (in the case of hepatitis B vaccine given to newborn infants this can be provided to the mother during prenatal care or within 12 hours after delivery); b.) provided a reasonable opportunity to read the "Important Information" statement(s) and/or "Vaccine Information Pamphlets)"; c.) provided an opportunity to ask questions and have questions answered concerning the benefits and risks of each immunization; d.) specifically asked N they understand the information provided to them and if they have any questions; e.) given a telephone number to call should the patient become ill and have to visit a physician, clinic or hospital within the 28 days following the immunization; f.) provided the authorized appropriate translations of the "Important Information" statements and/or "Vaccine Information Pamphlets" if English is not their first language and their language is one for which the State has made translations available. The Immunization Branch will supply to all local health departments camera-ready copies of the current "Important Information" statements and a supply of the "Vaccine Information Pamphlets" in English and Spanish. In addition, should a sufficient need exist, the Immunization Branch will arrange for authorized translations and provide camera-ready copies of the "Important Information" statements and a supply of"Vaccine Information Pamphlets"in other languages. 2.) If a signature card or clinic log is used in lieu of the bottom portion of the "Important Information" statement and/or"Vaccine Information Pamphlet", the patient (or parent or legal guardian) must read the following statement which is required to appear at the top of the signature record card or EXHIBIT A(Pediatric-IAP Continued) FY 1993-94 Page 5 log sheet and then sign for each antigen administered: "I have been given a copy,and have read, or have had explained to me the information contained in the Vaccine Information Pamphlet(s) or the appropriate Important Information Statement(s) about the disease(s) and vaccines(s) indicated below. I have had a chance to ask questions which were answered to my satisfaction. I believe I understand the benefits and the risks of vaccine(s) and request that the vaccine(s) indicated below be given to me or to the person named below for whom I am authorized to make this request." The record card or log sheet must include as a minimum the following information: a.) patient name b.) address c.) date of birth d.) age at time of immunization e.) type of vaccine(s) given f.) clinic identification g.) date of immunization h.) site of immunization i.) name and title of person administering the vaccine (e.g., S. Smith, R.N.) j.) vaccine manufacturer k.) vaccine lot number I.) signature of patient or parent/guardian authorizing immunization m.) date of signature n.) date(s) printed on the "Important Information"statement(s) and/or"Vaccine Information Pamphlets"provided to the patient or parent/guardian NO ALTERATION, VARIATIONS OR ADDITIONS TO THE IMPORTANT INFORMATION STATEMENTS, VACCINE INFORMATION PAMPHLETS, OR VACCINE AGREEMENT MAY BE MADE WITHOUT THE PRIOR WRITTEN APPROVAL OF THE CHIEF OF THE IMMUNIZATION BRANCH OF THE CALIFORNIA DEPARTMENT OF HEALTH SERVICES. 3.) The agreement/signature portion of the "Important Information" statement and/or "Vaccine Information Pamphlet" or the authorized signature record card or authorized clinic log sheets must be stored by the local health department in a retrievable file for a minimum of 10 years following the end of the calendar year in which the statement/pamphlet was signed. In addition, if a notice of a claim or lawsuit has been made, the record must be retained until after a final disposition has been made. 4.) In the case of a school-based program, or other programs where the "Important Information" statement(s) and/or "Vaccine Information Pamphlet(s)"are to be read and signed in advance of the immunization by the patient or parent/guardian or other authorized person who will not be present at the site where the immunizations are to be given, procedures shall be established and made known for answering questions by telephone. 5.) Outside non-profit providers of immunization services must sign the State provided "Outside Provider Agreement for Receipt of State-Supplied Vaccines" terms prepared by the State Immunization Branch before they may receive State purchased vaccine. Medical providers of immunization services who sign the agreement must agree to use the "Important Information" statements and/or"Vaccine Information Pamphlets"and must be provided as many copies of the statements/pamphlets as vaccine doses distributed, or at least one camera-ready copy of each vaccine statement. The "Outside Provider Agreement..." and the use of the "Important Information" statements and/or "Vaccine Information Pamphlets" are required in clinic settings even if the clinics are supervised by a physician in attendance. The "Outside Provider EXHIBIT A(Pediatric-IAP Continued) FY 1993-94 Page 6 Agreement..." shall be signed annually by non-health department medical providers and retained by the local health department for a minimum of ten years following the last calendar year in which the State Immunization Branch purchased vaccine was provided. 6.) Local health departments receiving State-supplied vaccines are required to provide State- supplied vaccines to Community Health Centers (e.g., Federal and/or State-Funded Community Health Centers, including Migrant, Rural and Indian Health Centers, etc.) if state vaccine funding resources are sufficient and if the Community Health Centers maintain compliance with the terms and conditions listed in the State provided "Outside Provider Agreement for Receipt of State- Supplied Vaccines". 7.) No charge may be made to the patient, parent, guardian or third party payer for the cost of State purchased vaccine provided to local health departments by the Immunization Branch. In addition, outside, non-profit providers of immunization services receiving State purchased vaccine may not charge patients or parents for the cost of vaccine. Charges made by local health departments for the direct costs incurred for administration or injection of the vaccine are discouraged but are not specifically prohibited. Should the health department or outside medical provider receiving state vaccine establish an administration fee for an injection of vaccine, information, e.g., sign/poster, IDEM be prominently displayed which indicates that no one receiving an immunization in a public clinic may be denied vaccine provided through public funds for failure to pay the administration fee or failure to make a donation to the provider. 8.) Local health departments and other private and public providers utilizing State purchased vaccine and/or hepatitis B immune globulin (HBIG) must report quarterly the vaccine and HBIG doses administered, by vaccine type and age group of patient, and dose in series (for multiple- dose vaccines) in a format provided by the Immunization Branch. Reports should be submitted to the Immunization Branch by the third day of the following month. 9.) Each quarter, the local health department must report a current vaccine inventory including all sites within the county or local jurisdiction. The Immunization Branch will supply the reporting forms. All local health departments are to notify their Immunization Branch Field Representative of any vaccine which is unlikely to be used not later than three months prior to its date of expiration. 10.) The local health department agrees to ensure that the storage and handling of State purchased vaccine within its facilities is in accordance with the manufacturers' specifications. The local health department also agrees to inform other providers who receive Immunization Branch purchased vaccine of the manufacturers'specifications for vaccine storage and handling. State of California•Health and Welfare Agency Department of Health Services immunization Branch Exhibit B Budget Application For Immunization Project Subvention Funds Contra Costa County Health Services 2. Director of Project: Applicant's Name Name -Dottie Lanp-thorn Public H,=,q1fh/TmrninJmeati nye I-I-Qif- Organizational Unit Title Immunization Program Coordinator 597 Center Ave. #200A De.gree Street address - P. O. Box B.S.N./P.H.N. Martinez, Ca 94553 City County Zip Code 3. Budget Period: 4. Type of Application: From: 7-1-93 TO: 6-30-94 ❑ New [3Renewal El Continuation ❑ Supplement Q Revision 5. Amount Requested: 6. Financial Management Official: Name Alan Abreu $ 204.663 Public Health Title Finance Manager Address 20 Allen Street Martinez, CA 94553 Phone --510-370-5025 DHS 8312 (9/92) DHS 8312 (9/92) EXHIBIT B BUDGET PAGE 1 OF 4 APPLICATION FOR IMMUNIZATION PROJECT SUBVENTION FUNDS Applicant : Contra Costa Count Budget Period From: 7/1/93 to 6/30/94 DETAILED LINE ITEM BUDGET FOR THIS PROJECT %of time and/or Monthly salary range Dollars required 1. Personal Services hours on 12I41ect and/or hourly rate from California S S Immunization Coordinator 100 386-5331 31,986 (l) Registered Nurse 100 9-4962 59,544 .. . Registered Nurse 20 9-4962 11,909 Communicable Disease 50 925-2340 14,100 Technician Clerk Experienced Level 100 849-2248 13,398 (l) Clerk Experienced Level 25 1849-2248 6,699 State lunds cover approximatel 50% of Immunization Coordinator and 50% f the Clerk personnel aenses. Total Salaries& Wages $137,636 Staff Benefits 30 %/% TOTAL PERSONAL SERVICES DHS 8312(9/92) EXHIBIT B BUDGET PAGE 2 OF 4 APPLICATION FOR IMMUNIZATION PROJECT SUBVENTION FUNDS Applicant Budget Period From: to DETAILED LINE ITEM BUDGET FOR THIS PROJECT Required from 11. Operating Expenses California A. Supplies 1) Office Mailing, stationary supplies $1000 2) Clinic Syringes, alcohol, needle disposal boxes, etc. $1500 B. Health Education Materials Printing and reproduction $3000 C. Laboratory Screening (Hepatitis B only) D.Travel 1) In-State 1500 miles @ $0.28 per mile $ 420 2) Out-of-State National Conference $1200 E. Equipment Computer hardware and software $3617 F.Subcontracts (description(s)on Exhibit B Budget,Subcontract page(s) $15,000 TOTAL OPERATING EXPENSES $ $25,737 TOTAL BUDGET = (I Personal Services + II. Operatina Ex e� $ $204,663 DHS 8312(9/92) EXHIBIT B BUDGET PAGE 3 OF 4 APPLICATION FOR IMMUNIZATION PROJECT SUBVENTION FUNDS Applicant : Contra Costa County Budget Period From: to F.Subcontracts (List the name of the contractor or consultant and the time period of the contract, Also,Indicate the hourty/weekly/monthly rate of reimbursement and total contract amount) Name of Subcontractor: Neighborhood House of North Richmond Address: 305 Chesley Ave. City, State,&Zip Code: Richmond, Ca. 94801 Telephone#: •510-215-4770 " Dollar Amount I.Personal Services Rate of Required from (List cositfons) Time Period Reimbursement Califomia Community Outreach 7/1/93-6/30/9 $10 per hour $7500 Worker for a total of 750 hours Personal Services Subtotal $ 7500 Il. Operating Expenses Supplies Health Education Materials Travel (in-state) Equipment Operating Expenses Subtotal $ F.Subcontracts Total = (I. Personal Services +11. Operating Expenses) $ (Include amount on Operating Expenses, Exhibit B, Budget,page 2) Note: A written Justification of the above Contractor service(s)and-expected completed work product(s) must be included in Exhibit C Budget Justification of this agreement. DHS 8312(9/92) EXHIBIT B BUDGET PAGE 4 OF 4 APPLICATION FOR IMMUNIZATION PROJECT SUBVENTION FUNDS Applicant : Contra Costa County Budget Period From: 7/1/93 to 6/30/94 F.Subcontracts (List the name of the contractor or consultant and the time period of the contras. Also,Indicate the hourty/weekly/monthly rate of reimbursement and total contract amount) Name of Subcontractor: Pittsburg Preschool Coordinating Council Address: 1760 Chester Drive City, State, &Zip Code: Pittsburg, Ca. 94565 Telephone# 510-439-29061 Dollar Amount I. Personal Services Rate of Required from (List cositions) Time Period Reimbursement California Community Outreach 7/1/93-6/30/94 $10/hr. for a $7500 Worker total of 750 houis Personal Services Subtotal r$--7500 ll. Operating Expenses Supplies Health Education Materials Travel (in-state) Equipment Operating Expenses Subtotal $ F.Subcontracts Total = (I. Personal Services +11.Operating Expenses) $ 00 75 (Include amount on Operating Expenses, Exhibit B, Budget,page 2) Note: A written justification of the above Contractor service(s)and expected completed work product(s) must be included in Exhibit C Budget Justification of this agreement. (DHS 8312(9/92) - Exhibit C Project Summary and Budget Justification Page 1 of 3 APPLICATION FOR IMMUNIZATION PROJECT SUBVENTION SHORT SUMMARY OF PROJECT (Not to exceed 200 words) The purpose of the Immunization Program is to prevent the occurrence and transmission of vaccine preventable diseases through immunizations, surveillance and outbreak control. The program will provide immunization services, promote immunization awareness, encourage families to keep permanent immunization records, and assure that schools maintain a-permanent record keeping system. Program activities will be coordinated with local school officials and community agencies. These activities will be carried out in an attempt to: (1) raise immunization levels above 98% for all school age children and 95% for all infants and preschool children and (2) increase the number of 4th doses of DTP administered in public health clinics to children 15 months to 2 years by 10% over the prior fiscal year. Surveillance and outbreak control measures are incorporated into the program which include measles, pertussis, rubella, Hepatitis'B,Haemophilus Influenzae Type b and other vaccine preventable disease. Priority will be given to the: 1) annual kindergarten and preschool immunization assessments and selective review audits, 2) distribution of immunization materials to all public and private schools and preschools with inservice/consultation visits maintained, 3) expanded outreach efforts to infants and toddlers 4) on-site clinics at WIC, State Preschool and Headstart sites, 4) toddler immunization campaign, 5) measles elimination program, 6) provision of regularly scheduled public immunization clinics with special clinics as needed, ') a reminder/recall system for children who attend the monthly immunization clinics, WIC, and State Preschool/Headstart on site clinics 8) outbreak control measures to contain/stop vaccine preventable disease. 9) increased provider outreach efforts to adopt the "The No Barriers to Immunization Policy'to reduce missed opportunities with programs for continuing education units for professionals. A computerized immunization system with a 386 PC and Green Lira software is updated monthly to maintain: 1) permanent retrievable record keeping system for persons given immunizations in the immunization-only clinics and special outreach clinics 2) vaccine usage and inventory activities, and 3)- communi- cations to schools, health care providers, hospitals, and community organizations. Other software programs will be investigated this year in an effort to establish a computerized immunization link to public and private immunization providers. Name of Project Director Name and Address of Applicant Including Organizational Unit Responsible for Project Activity Dottie Langthorn Immunization Program 597 Center Ave.. #200A Martinez, CA 94553 (DHS 8312(9/92) Exhibit C Project Summary and Budget Justification Page 2 of APPLICATION FOR IMMUNIZATION PROJECT SUBVENTION BUDGET JUSTIFICATION (Please provide written justifications for all positions and operating expenses requested on Exhibit B Budget pages 1 &2. h additional space is required,attach additional pages.) I. PERSONNEL SERVICES: Immunization Coordinator Coordinates activities to meet program goals: conducts immunization assessments and provides consultation and technical assistance to school and child care facilities to raise and/or maintain immunization levels of at least 98% in school age children and 95% in infants and preschool children, participates in newborn and toddler outreach efforts, provides immunization information to the medical and lay communities, coordinates programs for continuing education for professionals, works to reduce/eliminate vaccine preventable disease (ie., measles, mumps, rubella, pertussis, hemophilus influenza type b), provides the operational link between schools and preschools and the State IAP office, supervises the computerized record keeping system, manages vaccine and vaccine accountability, Registered Nurse WIC clinics operate throughout the county 15-29 times a month. There are an average of 22000-5000 children seen in each area of the county per month. The nurse will provide immunizations, information on immunizations and health referrals for other needed medical care. The nurse will also staff the special clinics in targeted areas, assist with health education information development and assist with evaluation of Day Home assessments. Clerk-Experienced Level Provides clerical support to accomplish the goals and objectives of the program. The activities include: typing and filing reports and letters, xeroxing, preparing kindergarten and preschool registration packets, filling orders, tabulating audit results, mailing materials to schools, child care facilities, family day homes and health care providers, maintaining the computerized retrievable immunization record system and manual reminder system, and providing clerical support to clinic and the Immunization Program Coordinator. Communicable Disease Technician Will provide door to door outreach and information giving. Will give information classes in clinics and to community groups in appropriate languages. Will work with migrant workers to determine needed times for clinics and best access. Project Summary and Budget Justification Page 3 of 3 APPLICATION FOR IMMUNIZATION PROJECT SUBVENTION H. OPERATIONAL EXPENSES A. Supplies 1. Office - Pens, paper, envelopes, postage for mass mailings and reminder/recall postcards, phone for computer fax/modem. 2. Clinic - syringes, alcohol, drapes, cotton, bandaids, needle disposal-boxes. B. Health Education Materials . Printing reminder/recall postcards to remind parents when their child's next immunization is due; developing, printing and/or ordering of culturally sensitive brochures, fliers, posters, videos. C. Travel 1. Out-of-State: National Immunization Conference Air fare, room and meals for 5 days. 2. In-State: Local program related activities. D. Equipment Computer software and associated hardware to establish a computer network system with multi-provider access and reminder/recall. F. Subcontract Services Will provide community door-to-door outreach workers in high risk neighborhoods with poor immunization compliance. III. TOTAL BUDGET- $204,663