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Immunization Branch California Department of Public Health Prenatal Tdap Workgroup February 25, 2020 These slides will be posted on the EZIZ Prenatal Tdap Toolkit Page: http://eziz.org/resources/pertussis- promo-materials/prenatal-tdap/

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Page 1: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Immunization BranchCalifornia Department of Public Health

Prenatal Tdap Workgroup February 25, 2020

These slides will be posted on the EZIZ Prenatal Tdap Toolkit Page:

http://eziz.org/resources/pertussis-promo-materials/prenatal-tdap/

http://eziz.org/resources/pertussis-promo-materials/prenatal-tdap/
Page 2: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Agenda

I. Changes to the Prenatal Tdap Starter Kit–Rebeca BoyteII. DHCS’s Value Based Payment Program- Amber Christiansen III. How are pertussis cases reported?- Sarah NewIV. Announcements & Feedback

• FREE ACOG Antepartum Records still available!• Prenatal care providers can order materials directly from Genetic Disease

Program• Coming soon! Prenatal Tdap Action Plan for prenatal care providers • Prenatal HEDIS Measure/CMS Core Set Updates

Page 3: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Zoom

Use chat to:

• Ask your question/comment

• Request to open your line

Page 4: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Prenatal Tdap Starter Kit

Page 5: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

SGF Prenatal Tdap Overview • ~ 14,000 doses of Tdap (Adacel®, single dose vials) to

jumpstart prenatal care provider offices not offering Tdap

– Can providers who already stock Tdap onsite sign up?

• No. This This program is only for providers who do NOT stock Tdap.

– Can doses be shipped directly to providers?

• CDPH can ship to non-profit providers only. For-profit providers must get their Tdap from the local health department.

– Can local health departments (LHD) order Tdap for their own clinics?

• Yes! BUT LHDs must agree to send a letter to referring prenatal care providers.

http://izcoordinators.org/web_assets/files/TemplateLettertoReferringPrenatalCareProviders6_1.docx
Page 6: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Provider Requirements (same as 2019)1. Must maintain proper documentation

2. Not charge for vaccine but can bill payer for administration costs

3. Follow CDC and VFC standards for vaccine management

4. Use Tdap doses only for pregnant women

5. Have protocols in place to ID & counsel patients, administer Tdap and record and report doses given

6. Must report adverse reactions within 4 weeks of administration

7. Before placing 2nd order for Tdap doses, must contact health plans to better understand billing

Page 7: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Provider Requirements (New for 2020)

8. Before placing a 2nd order for State Tdap, they need to purchase at least 10 doses of Tdap

– The change: no need to “match” supply; just buy 10 doses!

9. Must assign a clinic liaison to LHD, so he/she can provide feedback 6 months after 1st order or when placing 2nd order

– The change: now it’s just 1 survey; not 3! For download only

Page 8: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

All materials available on IZ Coordinators’ Website

Page 9: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

DHCS Value Based Payment Program

Page 10: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

DHCS Value Based Payment Program

• VBP program applies to Medi-Cal managed care health plans (MCPs)

• VBP program provides incentive payments to providers for meeting specific measures aimed at improving care for certain high-cost or high-need populations

• Targeted areas:– behavioral health integration

– chronic disease management

– prenatal/post-partum care

– early childhood prevention

Page 11: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

VBP Program Implementation

• Started July 1, 2019

• Will be implemented for at least three years in the Medi-Cal Managed Care delivery system

• Does not apply to FQHCs

• DHCS VBP Program website -https://www.dhcs.ca.gov/provgovpart/Pages/VBP_Measures_19.aspx

https://www.dhcs.ca.gov/provgovpart/Pages/VBP_Measures_19.aspx
Page 12: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

VBP Program Incentive Payments Select Measures

Domain Measure Add-On

Amount

At-Risk Add-

OnAmount

Prenatal/Postpartum Care Bundle Prenatal Pertussis (‘Whooping Cough’) Vaccine $ 25.00 $ 37.50

Prenatal/Postpartum Care Bundle Prenatal Care Visit $ 70.00 $ 105.00

Prenatal/Postpartum Care Bundle Postpartum Care Visits $ 70.00 $ 105.00

Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50

Early Childhood Bundle Well Child Visits in First 15 Months of Life $ 70.00 $ 105.00

Early Childhood Bundle Well Child Visits in 3rd – 6th Years of Life $ 70.00 $ 105.00

Early Childhood Bundle All Childhood Vaccines for Two Year Olds $ 25.00 $ 37.50

Early Childhood Bundle Blood Lead Screening $ 25.00 $ 37.50

Early Childhood Bundle Dental Fluoride Varnish $ 25.00 $ 37.50

Chronic Disease Management

Bundle

Adult Influenza ('Flu') Vaccine $ 25.00 $ 37.50

Page 13: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Pertussis Cases

Page 14: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Epidemiologist at the state review reportable data and monitor incidence trends

state-wide

STATE MONITORS TRENDS

The infected person seeks medical care or is part of an

outbreak.

CASE INFECTED

Providers submit case report forms (CRF) to CalREDIE or

local health jurisdiction (LHJ); or electronic laboratory

results (ELR) for positive test results are imported in

CalREDIE

PROVIDER REPORTS DISEASE

Local Health Jurisdictions investigate all cases; Suspect, Probable, and Confirmed are

reportable in California

LOCAL HEALTH JURISDICTION INVESTIGATES

Pertussis Disease Surveillance

Page 15: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Case Report Form Example

https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph8258.pdf

Other resources for this information: prenatal medical records, birth certificate data, and the California Immunization Registry (CAIR)

Page 16: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Announcements

Page 17: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Reminder: ACOG Antepartum Records

Would you like FREE copies?

• Please send request to: [email protected] desired quantity.

• Include your mailing info

mailto:[email protected]
Page 18: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Provider Order Form

“Flu and Whooping Cough Brochure”

“Pregnancy Immunization Brochure”

Order Form now in Prenatal Tdap Toolkit (under “Provider Resources”)

https://www.cdph.ca.gov/Programs/CFH/DGDS/CDPH%20Document%20Library/PNS%20Documents/PNS%20Order%20Form%20WEB%20revised%2001_19.pdf
Page 19: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Action Plan for Prenatal Care Providers

Coming soon! Action Plan to help provide technical assistance to prenatal care providers is under review

Page 20: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Other Resources

http://www.acphd.org/media/540904/best-practices-la-clinica-advice.pdfhttp://immunizationforwomen.org/uploads/Strategies%20for%20Integrating%20Immunizations.pdf

http://www.acphd.org/media/540904/best-practices-la-clinica-advice.pdf
http://immunizationforwomen.org/uploads/Strategies%20for%20Integrating%20Immunizations.pdf
Page 21: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Prenatal HEDIS Measure/CMS Core Set Updates

• Background:

– Prenatal measure included as HEDIS measure in 2019

– Numerous private health plans report on measure voluntarily

– For maximum impact, measure should be reported by Medicaid agencies (who look at HEDIS measures)

• CMS Core Set Committee will be reviewing measures in the upcoming months for 2021 measurement year

• Workgroup will recommend measures to add and remove

Page 22: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Criteria for Suggesting Measures for Addition

• Measure must be fully developed and detailed technical specifications

• Measure must be tested in state Medicaid/CHIP programs or in use by one or more state Medicaid agencies

• Available data source or validated survey instrument exists

• Specifications and data source must allow for consistent calculations across states

Page 23: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of
Page 24: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Take Action!

• Download materials for the Prenatal Tdap Starter Kit!

• Order FREE copies of ACOG’s antepartum records for site visits.

• Promote the GDSP material order form to prenatal care providers.

• Ask your Medi-Cal Managed Care Plans:

– how you can help support the roll out of the Value-Based Payment Program.

– to run the HEDIS prenatal immunization measure and report findings to NCQA.

Page 25: Prenatal Tdap Workgroup February 25, 2020 · Prenatal/Postpartum Care Bundle Postpartum Birth Control $ 25.00 $ 37.50 Early Childhood Bundle Well Child Visits in First 15 Months of

Questions?

As always, these slides will be posted on Prenatal Tdap Toolkit page: http://eziz.org/resources/pertussis-promo-materials/prenatal-tdap/.

Rebeca Montealegre Boyte510-620-3762 [email protected]

http://eziz.org/resources/pertussis-promo-materials/prenatal-tdap/
mailto:[email protected]

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