Prenatal Tdap Workgroup February 25, 2020

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Prenatal Tdap WorkgroupFebruary 25, 2020These slides will be posted on theEZIZ Prenatal Tdap Toolkit rials/prenatal-tdap/Immunization BranchCalifornia Department of Public Health

AgendaI.II.III.IV.Changes to the Prenatal Tdap Starter Kit–Rebeca BoyteDHCS’s Value Based Payment Program- Amber ChristiansenHow are pertussis cases reported?- Sarah NewAnnouncements & Feedback FREE ACOG Antepartum Records still available! Prenatal care providers can order materials directly from Genetic DiseaseProgram Coming soon! Prenatal Tdap Action Plan for prenatal care providers Prenatal HEDIS Measure/CMS Core Set Updates

ZoomUse chat to: Ask your question/comment Request to open your line

Prenatal Tdap Starter Kit

SGF Prenatal Tdap Overview 14,000 doses of Tdap (Adacel , single dose vials) tojumpstart 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 theirTdap from the local health department.– Can local health departments (LHD) order Tdap for their ownclinics? Yes! BUT LHDs must agree to send a letter to referring prenatal care providers.

Provider Requirements (same as 2019)1. Must maintain proper documentation2. Not charge for vaccine but can bill payer foradministration costs3. Follow CDC and VFC standards for vaccinemanagement4. Use Tdap doses only for pregnant women5. Have protocols in place to ID & counsel patients,administer Tdap and record and report doses given6. Must report adverse reactions within 4 weeks ofadministration7. Before placing 2nd order for Tdap doses, must contacthealth plans to better understand billing

Provider Requirements (New for 2020)8. Before placing a 2nd order for State Tdap, theyneed to purchase at least 10 doses of Tdap– The change: no need to “match” supply; just buy10 doses!9. Must assign a clinic liaison to LHD, so he/shecan provide feedback 6 months after 1st order orwhen placing 2nd order– The change: now it’s just 1 survey; not 3!For download only

All materials available on IZ Coordinators’ Website

DHCS Value Based Payment Program

DHCS Value Based Payment Program VBP program applies to Medi-Cal managed care health plans(MCPs) VBP program provides incentive payments to providers formeeting specific measures aimed at improving care for certainhigh-cost or high-need populations Targeted areas:––––behavioral health integrationchronic disease managementprenatal/post-partum careearly childhood prevention

VBP Program Implementation Started July 1, 2019 Will be implemented for at least three years in the Medi-CalManaged Care delivery system Does not apply to FQHCs DHCS VBP Program website Measures19.aspx

VBP Program Incentive PaymentsSelect um Care BundlePrenatal Pertussis (‘Whooping Cough’) Vaccine 25.00At-Risk AddOnAmount 37.50Prenatal/Postpartum Care BundlePrenatal Care Visit 70.00 105.00Prenatal/Postpartum Care BundlePostpartum Care Visits 70.00 105.00Prenatal/Postpartum Care BundlePostpartum Birth Control 25.00 37.50Early Childhood BundleWell Child Visits in First 15 Months of Life 70.00 105.00Early Childhood BundleWell Child Visits in 3rd – 6th Years of Life 70.00 105.00Early Childhood BundleAll Childhood Vaccines for Two Year Olds 25.00 37.50Early Childhood BundleBlood Lead Screening 25.00 37.50Early Childhood BundleDental Fluoride Varnish 25.00 37.50Chronic Disease ManagementBundleAdult Influenza ('Flu') Vaccine 25.00 37.50

Pertussis Cases

Pertussis Disease SurveillanceCASE INFECTEDLOCAL HEALTH JURISDICTION INVESTIGATESThe infected person seeksmedical care or is part of anoutbreak.Local Health Jurisdictionsinvestigate all cases; Suspect,Probable, and Confirmed arereportable in CaliforniaPROVIDER REPORTS DISEASESTATE MONITORS TRENDSProviders submit case reportforms (CRF) to CalREDIE orlocal health jurisdiction (LHJ);or electronic laboratoryresults (ELR) for positive testresults are imported inCalREDIEEpidemiologist at the statereview reportable data andmonitor incidence trendsstate-wide

Case Report Form ExampleOther resources for this information: prenatal medical records,birth certificate data, and the California Immunization ent%20Library/ControlledForms/cdph8258.pdf


Reminder: ACOG Antepartum RecordsWould you like FREE copies? Please send request desired quantity. Include your mailing info

Provider Order Form“Flu and WhoopingCough Brochure”“PregnancyImmunization Brochure”Order Form now in Prenatal Tdap Toolkit(under “Provider Resources”)

Action Plan for Prenatal Care ProvidersComing soon! Action Plan tohelp provide technicalassistance to prenatal careproviders is under review

Other 20Immunizations.pdf

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 Medicaidagencies (who look at HEDIS measures) CMS Core Set Committee will be reviewing measures in theupcoming months for 2021 measurement year Workgroup will recommend measures to add and remove

Criteria for Suggesting Measures for Addition Measure must be fully developed and detailed technicalspecifications Measure must be tested in state Medicaid/CHIP programs or inuse by one or more state Medicaid agencies Available data source or validated survey instrument exists Specifications and data source must allow for consistentcalculations across states

Take Action! Download materials for the Prenatal Tdap Starter Kit! Order FREE copies of ACOG’s antepartum records for sitevisits. Promote the GDSP material order form to prenatal careproviders. Ask your Medi-Cal Managed Care Plans:– how you can help support the roll out of the ValueBased Payment Program.– to run the HEDIS prenatal immunization measure andreport findings to NCQA.

Questions?As always, these slides will be posted on Prenatal TdapToolkit page: /prenatal-tdap/.Rebeca Montealegre

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 . administer Tdap and record and report doses given 6. Must rep

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