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HomeMy WebLinkAboutC12-293 DTaP Winnable Battle Project EAGLE COUNTY HEALTH AND HUMAN SERVICES
Colorado Department of Public Health and Environment
Colorado Immunization Program
Statement of Work
Agency Name: Eagle County Public Health Agency
Project Name: 2012 -13 DTaP Winnable Battle Project (DTaP WB)
Funding Period: September 17, 2012 through June 30, 2013
I. Project Description: The Colorado Immunization Program (CIP) at the CDPHE has funds available
to support the DTaP Winnable Battle and other local efforts to decrease the burden of Pertussis disease
and improve childhood immunization rates in our communities.
Project Goal: To increase the number of infant and school -aged children in Colorado who are
protected against Pertussis.
II. Definitions:
CDPHE Colorado Department of Public Health and Environment
CHP Child Health Plan
CIIS Colorado Immunization Information System
CIP Colorado Immunization Program
DTaP Diphtheria, Tetanus and acellular Pertussis
DTaP WB DTaP Winnable Battle
IZ Immunization
LPHA Local public health agency
RFA Request for application
SOW Scope of work
Tdap Tetanus, Diphtheria and acellular Pertussis
III: Performance Requirements /Deliverables:
Work is not to begin on the proposed project until the grantee receives an approved purchase order from
the CIP.
Goal #1 Increase immunization rates of school age children in Eagle County.
Objective #1 - 1: Increase the percentage of Eagle County children, ages 4 to 6 years, who have
received 5 valid doses of DTaP (4 if 4th dose administered after age 4) from 27%
to 70% by June 30, 2013. Steps to achieve this objective:
1. Attend the CIIS reminder /recall webinar training by September 21, 2012.
2. Run a CIIS reminder /recall report for children ages 4 years to 18 years by
October 1, 2012.
551 Broadway I P.O. Box 660 I Eagle, CO 81631 1 970.328.8840
3. Send immunization reminder /recall postcards to families not up -to -date
with immunizations by November 1, 2012.
4. Hold walk -in immunization clinics specific for school aged children by
September 20, 2012 at the Avon and Eagle Public Health locations to
increase access to back to school immunizations with a focus on
efficiency and convenience for families.
5. Eagle County Public Health staff will be present at Eagle County
elementary schools on kindergarten orientation day(s) to review
immunization records with parents and administer DTaP and all other
required and recommended vaccines by September 20, 2012.
6. Eagle County Public Health staff will be present at all Eagle County
School District's 2013 Kindergarten Round -ups for incoming 2013 -2014
school year students to review immunization records with parents and
provide DTaP and all other required and recommended vaccines on -site
by May 1, 2013.
Performance • Number of reminder /recalls sent.
measures • Number of reminder /recalls returned undeliverable.
• 70% of Eagle County children, ages 4 to 6 years, will receive 5 valid
doses of DTaP (4 if 4th dose administered after age 4) by June 30, 2013
from a current 27% baseline (based on CIIS report for Eagle County).
• 100% of students /parents present at kindergarten orientation and round up
will have their immunization records reviewed by Eagle County Public
Health staff.
• 100% of kindergartners whose parents consent to vaccine receipt at
kindergarten orientation and round up will receive the requested
vaccinations. _
Objective #1 -2: Increase public awareness of the burden of pertussis and importance of being
up -to -date with immunizations prior to school entry by September 20, 2012.
Steps to achieve this objective:
1. Develop a bilingual multimedia campaign to increase awareness of
pertussis and recommended immunizations for school entry by September
20, 2012.
2. Implement the month -long immunization media campaign by September
20, 2012.
Performance 1. 50% increase in school aged client volume from 139 clients seen in same
measures time period in 2011 for DTaP, Tdap, and back -to- school immunizations
from September 1, 2012 — October 1, 2012.
Goal #2 Build partnerships with the Eagle County School District (ECSD) to
promote childhood immunizations and reduce vaccine preventable
diseases among school age children. _
Objective #2 -1: Collaborate with ECSD to enhance the immunization tracking of over 6,000
pre -K through 12th grade students attending 16 schools by June 1, 2013. Steps
to achieve this objective:
1. Receive permission from Eagle County School District to oversee school
district's immunization tracking process and perform immunization record
keeping and data entry into CIIS for all students by September 17, 2012.
2. Assist school nurses in verifying that student immunization records are
entered into CIIS by October 1, 2012.
3. Work with school health staff to develop rosters of incoming students to
determine required and recommended vaccines to enhance preparedness
for ongoing on -site clinics by October 1, 2012.
4. Run monthly reminder /recall reports by school, beginning October 1,
2012.
5. Notify parents of children not -up -to date with recommended and required
immunizations using the monthly reminder /recall reports beginning
October 15th, 2012.
6. Conduct on -site school immunization clinics as needed based on school
reminder /recall reports from November 1, 2012 - May 1, 2013.
Performance • Eagle County Public Health will be granted oversight for the
measures immunization compliance program for Eagle County School District
starting September 17, 2012.
• School rosters will be created in CIIS for 100% of Eagle County Schools
by October 1, 2012.
• 90% of Eagle County School District student immunization records will
be entered into CIIS by January 1, 2013 ensuring the school field is
entered (to look at rates by school).
• CIIS reminder /recall reports for each school will demonstrate an
improvement in number of students up -to -date on immunizations from
baseline (October 1, 2012) to project completion (June 30, 2012).
• 70% of Eagle County children, ages 4 to 6 years, will receive 5 valid
doses of DTaP (4 if 4th dose administered after age 4) by June 30, 2013
from 27% (based on CIIS report for Eagle County).
Goal #3 Collaborate with local health care providers on evidence -based practices
regarding immunization administration and safe injection practices.
Objective #3 -1: Increase health care worker knowledge of vaccine preventable diseases,
immunization schedules, safe - injection practices, and vaccine storage and
handling by assessing baseline knowledge and providing education and
training by June 1, 2013. Steps to achieve this objective:
1. Analyze the results of the June 2012 Eagle County health care worker
safe - injection self - assessment by September 20, 2012.
2. Provide training for school district health staff on infection control and
prevention, vaccine preventable diseases, and safe injection practices by
November 30, 2012.
3. Communicate results of assessment to participating health care practices
and provide targeted education on vaccine preventable diseases,
immunization schedules, vaccine storage and handling, and safe injection
practices by January 1, 2013.
4. Ask industry representative to invite a speaker from their speakers' bureau
to host a discussion for providers on immunization practices, or other
immunization related topic by June 30, 2013.
Performance • 60% of health care provider practices, including school health staff, will
measures participate in the self - assessment.
• 100% of participating health care provider practices will receive targeted
education materials on vaccine preventable diseases, immunization
schedules, vaccine storage and handling, and injection safety.
• There will be >90% participation by school health staff at on -site infection
control and prevention and vaccine preventable disease education
sessions.
Project activities will follow the timeline listed here:
Description of the planned activities
Sept Attend CIIS reminder /recall webinar.
Receive permission from school district to oversee student immunization
tracking.
Develop pertussis and back -to- school media campaign.
Implement media campaign for pertussis and back -to- school immunizations.
Analyze county wide health care worker injection safety self - assessment
results.
Back -to- School walk -in immunization week in Avon & Eagle locations.
Kindergarten orientation on -site immunization clinics at Eagle County
elementary schools.
Collaborate with Eagle County School nurses and health aides to verify
student immunizations are entered into CIIS and school rosters are developed
in CIIS.
Oct Run a CIIS reminder /recall report.
Reminder /recall notices sent to Eagle County school students not up -to -date
with school immunization requirements.
Nov Reminder /recall notices sent to Eagle County school students not up -to -date
with school immunization requirements.
On -site school immunization clinics as needed.
Provide on -site training to school health staff on vaccine preventable diseases
and infection control and prevention.
Dec Reminder /recall of Eagle County school students not up -to -date with school
immunization requirements.
Jan .013 Reminder /recall of Eagle County school students not up -to -date with school
immunization requirements.
On -site school immunization clinics as needed.
Communicate results of safe injection practice assessment to participating
healthcare practices and provide targeted education on vaccine preventable
diseases, immunization schedules, vaccine storage and handling, and safe
injection practices
Feb Reminder /recall of Eagle County school students not up -to -date with school
immunization requirements.
On -site school immunization clinics as needed.
Collaborate with each elementary school to schedule and prepare for
kindergarten round -up clinics.
Mar Kindergarten round -up on -site immunization clinics at Eagle County
elementary schools.
Reminder /recall of Eagle County school students not up -to -date with school
immunization requirements.
On -site school immunization clinics as needed.
Ask industry representative to invite a speaker from their speakers' bureau to
host a discussion for providers on immunization practices, or other
immunization related topic
Apr Kindergarten round -up on -site immunization clinics at Eagle County
elementary schools.
Reminder /recall of Eagle County school students not up -to -date with school
immunization requirements.
On -site school immunization clinics as needed.
May Reminder /recall of Eagle County school students not up -to -date with school
immunization requirements.
On -site school immunization clinics as needed.
June Evaluate immunization rates for school age children utilizing CIIS.
Complete a comprehensive project evaluation report to disseminate to key
stakeholders.
Additional deliverables:
a) Quarterly online project reports will be completed using this link:
http: / /fs9. formsite. com/ ColoradoIMMprogram /DTaPWBQuarterly Report/index.html
b) Online report due dates are:
July -Sept 2012 due by Oct 15, 2012
Oct -Dec 2012 due by Jan 15, 2013
Jan -March 2013 due by April 15, 2013
April -June 2013 due by July 15, 2013
c) A final, comprehensive Project evaluation report will be due to the CIP by July 30, 2013.
d) All state supplied vaccine must be entered into the Colorado Immunization Information
Registry (CIIS).
IV: Personnel:
a) Agency information:
Agency name Eagle County Public Health Agency
Agency mailing address PO Box 660, Eagle CO 81631
Phone number 970- 748 -3281
Fax number 855- 848 -8829
Agency DUNS # 08402447
Agency FEIN # 84- 6000762
b) Agency Project contact person:
Name Rebecca Larson
Phone number 970-748-3281
Email address rebecca.larson @eaglecounty.us
c) CIP Project Manager:
Name Teri Lindsey
Phone number 303 - 692 -2732
Email address Teri.lindsey @state.co.us
•
V: Payment/Invoicing:
Expenses Describe in detail Approved In- Total
funding kind Budget
Personal services Public Health Nurse, 0.10 FTE: immunizations, 2,500 5,000 7,500
including fringe media/communications coordination
benefits
Public Health Nurse, 0.10 FTE: immunizations, 2,500 5,000 7,500
clinic and education/training coordination
Public Health Nurse, 0.10 FTE: immunizations, 2,500 5,000 7,500
CIIS coordination with schools
Bilingual Clinic Assistant, 0.10 FTE - 1,500 2,500 4,000
translation, immunization support, data entry,
recall/reminder coordination
Bilingual Clinic Assistant, 0.05 FTE: 1,000 1,000 2,000
translation, immunization support, data entry
Immunization Manager/Epidemiologist, 0.05 600 4,000 4,600
FTE: evaluation, over site of staff and
programming, and ensuring fiscal responsibility
of budget
Supplies & Medical Supplies for immunization clinics 500 2,000 2,500
operating Paper, envelopes, stamps, copying for 1,400 1,400
exper ses recall/reminder notices, school consents
(include medical
& offce
suppl .es)
Travel Public health staff travel to 16 schools for 700 700
school immunization clinics, school health staff
training, and immunization tracking system set
up _
Other Costs:
Incentives
Equipment
Marketing Pertussis and immunization media campaign 4,000 4,000
Training Training materials for school health staff and 300 300
health care providers
Contractual
Indirect Administrative costs 2,400 2,400
TOTAL 17,500 26,900 44,400
a) Total funding amount is $17,500.00.
b) Funds are 100% state dollars.
c) To r: ceive compensation under this Purchase Order, the Contractor shall submit a signed, quarterly
CDP E Reimbursement Invoice Form. This form is accessible from the CDPHE internet website:
htt . : /www.cd . he.state.co.us/StandardizedInvoice/index.html .
d) Invo ces shall be submitted for the following payment periods:
July . ept 2012 Invoice due by Oct 15, 2012
Oct- • ec 2012 Invoice due by Jan 15, 2013
Jan - arch 2013 Invoice due by April 15, 2013
Apri -June 2013 Invoice due by July 15, 2013
e) The Invoice Form must be submitted within sixty (60) calendar days of the end of the billing period
for which services were rendered. Expenditures shall be in accordance with the Statement of Work
and included budget.
f) Submit the completed CDPHE Reimbursement Invoice Form via email as a PDF document to the
CIP Invoice Mailbox: CDPHE.CISInvoice @state.co.us
g) To be considered for payment, billings for payments pursuant to this Purchase Order must be
received within a reasonable time after the period for which payment is requested, but in no event no
later than sixty (60) calendar days after the relevant performance period has passed.
h) Final billings under this Purchase Order must be received by the State within a reasonable time after
the expiration or termination of this Purchase Order; but in no event no later than sixty (60) calendar
days from the effective expiration or termination date of this Purchase Order.
VI: Monitoring:
CDPHE's monitoring of this contract for compliance with performance requirements will be conducted
throughout the purchase order period by the CIP Project Manager, Contract Monitor and /or Evaluation
Coordinator. Methods used will include review of documentation reflective of performance to include
progress reports and invoices.
VII: Resolution of Non - Compliance:
The Contractor will be notified by email within 15 days of discovery of a compliance issue. Within 30
days of discovery, the Contractor and the State will collaborate, when appropriate, to determine the
action(s) necessary to rectify the compliance issue and determine when the action(s) must be completed.
The action(s) and time line for completion will be documented by email and agreed to by both parties.
If extenuating circumstances arise that require an extension to the time line, the Contractor must email a
request to the CIP Project Manager and receive approval for a new due date. The State will oversee the
completion/implementation of the action(s) to ensure time lines are met and the issue(s) is resolved. If
the Contractor demonstrates inaction or disregard for the agreed upon compliance resolution plan, the
State may exercise its rights under the Terms and Conditions of this Purchase Order.
Contractor Name (Print) and Ti 1:
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