Welcome to the California Immunization Coalition … to the California Immunization Coalition Education Hour . Webinar Objectives Discuss the role of pharmacists in improving access

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Welcome to the California Immunization Coalition

Education Hour

Webinar Objectives

Discuss the role of pharmacists in improving access to immunizations, including in communities with limited access to primary and preventive care services

Describe at least one example of a campaign that has used pharmacists to expand access to immunizations

Discuss recent policy changes in California that relate to the provision of vaccines by pharmacists

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Strategies for Expanding Access to Immunizations: How Pharmacists Can Improve Access to Immunizations in our Communities

Audio Options for the Webinar Today

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Frequently Asked Questions

1. Will I be able to get a copy of the slides after the webinar?

2. Will I receive a copy of the webinar recording?

Yes – a copy will be posted on ImmunizeCA.org site

Yes - a copy will be posted www.ImmunizeCA.org site

Strategies for Expanding Access to Immunizations: How Pharmacists Can Improve Access to Immunizations

in our Communities

Questions for Presenters?

Ask Questions

Here

The Role of Pharmacists as Vaccinators

Jeff Goad, Pharm.D., MPH

Professor and Chair, Department of Pharmacy Practice

Chapman University School of Pharmacy

Pharmacists are Health Care Providers in CA!

4050(c): pharmacists are health care providers who have the authority to provide

health care services

Place of flu vaccination (%) for children and adults, United States, early 2015–16 flu season

National Immunization

Survey-Flu and National

Internet Flu Survey

New Pharmacy Immunization Law

• Existing (B&P 4052 a.11)

• Any IZ and age pursuant to a protocol

• New: Independent (B&P4052.8)

• Initiate and/or administer (IN/IM/SC/ID)

• 3 years and older

• Routine vaccines

• ACIP recommended, published by CDC

Pharmacy Immunization Law (new and old)

• Initiate and/or administer

• Training

• An approved immunization training program

- Endorsed by CDC or ACPE

- Injection technique, indications/CIs, emergency mgmt.

• Maintain IZ training – 1 hr of CE q2 yrs

• BLS - maintain

• May initiate/admin Epi or diphenhydramine

BOP finalized August 26, 2016

Pharmacist Immunization Training

• Pharmacists and Student Pharmacists

• APhA Pharmacy-based Immunization Delivery Program

• 20 hours (8 live/12 self-study)

• 3 assessments

• 2 exams

• 1 observational skill (IM/SC)

• Covers all areas of “Pink Book” training +

• Pharmacy clinic operations

• Reporting, documentation

• BLS, BBP

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Mandatory IZ Law Documentation

• Vaccine administration record

• Pharmacy – readily retrievable

• Patient record (“yellow card”)

• Notification of vaccination

• PCP and/or Pre-natal provider

• Immunization registry (IIS)

• All within 14 days of administration

Documentation

• Screening

• VAR

• Consent

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• PPCP created by the Joint Commission of Pharmacy Practitioners in 2014

• Developed to promote consistency in how patient care is taught and practiced

• Adapted for immunization practice in 2016 at Chapman University

• Consistent with NVAC and CDC Standards for Adult Immunization Practice

• Assess

• Recommend

• Administer

• Document

The PPCP

Joint Commission of Pharmacy Practitioners. Pharmacists’ Patient Care Process. May 29, 2014.

Collect The pharmacist assures the collection of necessary

subjective and objective information about the patient

in order to understand the relevant medical history

and clinical status of the patient.

Information may be gathered and verified from

multiple sources, including existing patient records,

the patient, and other healthcare professionals. This

process includes collecting:

• Demographics

• Immunization records

• A current medication list

• Relevant health data

• Patient lifestyle habits, preferences, beliefs, health

and functional goals, and socioeconomic factors

Sources of Information

• Immunization Information Systems (IIS)

• Personal Immunization Record

• Pharmacy Dispensing System

• Primary Care Providers (PCP)

• Patient-Provided History

Assess The pharmacist assesses the information collected and

analyzes the need for vaccines according to the FDA and

ACIP.

This process includes assessing:

• Age

• Current and past health conditions, medications

• e.g. level of immunocompetence

• Pregnancy status

• Lifestyle

• Occupation

• Travel

• Current health status

• Allergies

• Vaccination history

Plan • Patient specific

• PCP collaboration

• Determine education needs

• Dispel myths

• Minimize financial barriers

• State scope of practice

• Make strong vaccine recommendations

• Integrate motivational interviewing

Proactive Vaccination

• Reactive vaccination: patients ask for a vaccine

• Proactive vaccination: pharmacist identifies patients in need of a vaccine

• Use Collect and Assess steps to identify patients

• Use Strong Recommendations and Motivational Interviewing to persuade people to get vaccinated

Implement The pharmacist implements the care plan in collaboration

with other health care professionals, as needed, and the

patient or caregiver. During the process of implementing

the care plan, the pharmacist:

• Consider state law

• Administer vaccines

• Consider workflow and space

• Supplies and storage

• Documentation

• VAR, screening form, consent, IZ record, PMS

record, provider communication

• Coordination of care

• Referrals

• Communication with other providers

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APhA-NASPA Pharmacist Immunizer Survey, 2015

Follow-Up: Monitor and Evaluate The pharmacist should have systems in place and training for

appropriate monitoring and management of possible adverse

reactions.

This process includes the continuous monitoring and

evaluation of:

Having a written emergency plan

Stocking epinephrine and diphenhydramine

Report to VAERS and VERP

Establish a system for boosters and completion of series

Great opportunity to improve access of care

Many retail pharmacies offer off-site clinic

Types of clinics ◦ Workplace

◦ Community

◦ In Store

Workplace clinics for private and public facilities

Health fairs in local counties

Homeless shelters

Nursing Homes

Social gatherings organized by HOA

Airports

5k Walk/Runs

Types of vaccines offered ◦ Flu, Tdap, Td, Pneumonia, MMR, Hepatitis A/B,

Meningitis, and many others

Available throughout the year ◦ 1 month minimum notice with the exception of an

outbreak

Accepts private insurance except for Kaiser Accepts Medicaid and Medicare except for adolescents

All immunizers are APhA Certified

Update to CAIR

No Set Up Fee

All payments are processed via patients insurance

We provide vendor insurance for incidents

Flexible dates

Large outreach potential in large and small counties throughout the country ◦ Over 4,000 stores nationally

Triage table to

distribute paperwork

and determine whose

supply to use

Patient will follow

organizers guidelines

to receive vaccine

Patient will follow

Walmart’s guidelines to

receive vaccine

Can Walmart pharmacists use the counties vaccine supply? ◦ Unfortunately we cannot. Walmart pharmacists can only

immunize using supplies brought in by Walmart associates

Can Walmart staff the table? ◦ We can bring additional personnel to staff the triage table to

help guide patients to the correct immunizer

Does Walmart donate vaccines to clinics? ◦ At this time Walmart does not

Are there any events coming up that simulate these clinics? ◦ We have an event on Saturday September 23rd from 10am to

2pm called Walmart Wellness Day

Contact your local pharmacy and see what opportunities they can offer

See what their process and procedures are to establish a clinic

Establish dates, times, and locations

For additional information or to find a local Walmart to setup a clinic

Bill Huynh

916-834-2007

[email protected]

Strategies for Expanding Access to Immunization

August 24, 2017

Moving Your Brand and Message into the Community Moving Your Brand and Message into the Community

2011 NIVDP Launched

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Need to eliminate flu vaccination coverage disparities Partnership has grown to 1,266 Vaccination clinics in 95 cities Over 1.4 million uninsured

people vaccinated

Moving Your Brand and Message into the Community

Collaborations with Pharmacies and

Pharmacists

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Moving Your Brand and Message into the Community

Leveraging with Community Partners

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Moving Your Brand and Message into the Community Moving Your Brand and Message into the Community 39

Lessons Learned Relationships matter Trust is essential Coordination is ongoing

J. Carlos Velázquez, MA President

HMA Associates, Inc. [email protected]

(202) 342-0676 @jclatino

Frequently Asked Questions

1. Will I be able to get a copy of the slides after the webinar?

2. Will I receive a copy of the webinar recording?

Yes – a copy will be posted on ImmunizeCA.org site

Yes - a copy will be posted www.ImmunizeCA.org site

Question and Answer Session

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Please Complete Online Evaluation!

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Thank you

Chapman University

Walmart

National Influenza Vaccination Disparities Partnership