1. Mary Koslap-Petraco DNP, PNP-BC, CPNP Coordinator-Suffolk County Department of Health Services Hauppauge, NY

2.  New York State Department of Health ◦ New program implemented to provide Hepatitis B/A vaccine to local health departments ◦ All adults who meet CDC ACIP recommendations for receipt of vaccine/s are eligible  All patients treated for STIs  Sex partners of HBsAg-positive persons  Sexually active persons not in a long-term, mutually monogamous relationship  Current or recent intravenous drug users  Persons with HIV

3.  Previously SCDHS received Hepatitis B/A vaccine at no cost from NYSDOH ◦ Offered vaccine in STI, drug treatment, correctional facility, and prenatal programs  Without institution of NEW policy SCDHS would no longer receive free Hepatitis B/A vaccine ◦ SCDHS faced loss of important Public Health program  Needed new policy to comply with NYSDOH requirements

4.  SCDHS needed new adult HepB/A vaccine policy ◦ Needed to develop new policy expeditiously ◦ Collaboration between SCDHS and NYSDOH ◦ Based on standing orders  Loss of free vaccine would cause fiscal crisis for SCDHS ◦ Adult immunization program would be lost ◦ Potential for increase in vaccine preventable hepatitis

5.  Facilities run by SCDHS ◦ Primary health care centers  Prenatal clinics ◦ Correctional facilities ◦ Migrant health program ◦ Immunization Action Program ◦ BOCES school based health center ◦ Drug treatment program facilities  Located in a suburban county in New York

6.  All adults were screened ◦ Age 19 or older ◦ Who fell into one of ACIP’s high risk group  Patients attend one of SCDHS facilities or programs

7.  Policy for immunizations for adult ◦ Used NYS Board of Nursing template for standing orders ◦ Allows RNs to offer and administer immunizations  All eligible individuals are more likely to be immunized with the use of standing orders  NYSDOH facilitated procurement of individual PIN numbers for each facility and program  NYSDOH expedited review and approval process ◦ Minimized interruption of Hepatitis B/A vaccine

8.  Local Health Unit partnered with its State Health Department ◦ Quickly developed and implemented standing orders policy for adult immunization ◦ Program had to be acceptable to state health department  Policy developed by SCDHS is being used as template by NYSDOH for other health departments

9.  Linda Mermelstein, MD, MPH ◦ Acting Commissioner Suffolk County Department of Health Services  Debra Blog, MD, MPH ◦ Medical Director Immunization Program New York State Department of Health  David Lynch ◦ Director New York State Immunization Program  Staff of New York State Immunization Adult Hepatitis B program