1. ©2016 MFMER | slide-1 School Located Immunization Program (SLIP) Vijay Chawla, MD, FFAP Deb Goodew, RN BSN 2015-2016 Influenza Season May 6, 2016 Mayo Clinic Health System in Austin Austin

2. ©2016 MFMER | slide-2 Disclosure We have no disclosures and off label use

3. ©2016 MFMER | slide-3 Healthy People 2020 Goal Increase the percentage of children and adults vaccinated annually against influenza to 80% o In 2013 55% of elementary school age children nationally received flu vaccine. o On average, influenza leads to more than 200,000 hospitalizations and 36,000 deaths each year. (Healthy People 2020)

4. ©2016 MFMER | slide-4 MCHS Austin Goal of 2015-2016 Influenza Season Taking the influenza vaccination to the school age population in their school will help to increase the rates of immunization in our community

5. ©2016 MFMER | slide-5 Acceptance by Public School and Community 2009 - Mower County Public Health received a grant to offer seasonal influenza vaccine in the Austin School District School located immunization program ( SLIP) was well received in the community Parents and Austin Public School staff have requested program be repeated

6. ©2016 MFMER | slide-6 Plan MCHS Austin will implement a program similar to the Rochester SLIP MCHS Austin 2015-2016 SLIP - Woodson Kindergarten Center School census 360 October 21, 2015 Expand to other Austin Public Schools – 2016- 2017

7. ©2016 MFMER | slide-7 Planning Austin Public Schools School Nurse IT Principal IT access at site Computer charting/ID children Communication Letter to parents Information at school conferences

8. ©2016 MFMER | slide-8 Planning (cont’d) Registration Forms English and Spanish/school to interpret other language(s) Staff SLIP Nurses – 4/100 children Check in and ID Coordinator/runner IT support

9. ©2016 MFMER | slide-9 Posters and flyers Displayed at school Distributed at school conference table

10. ©2016 MFMER | slide-10 Registration Form

11. ©2016 MFMER | slide-11 Children will not be vaccinated IF: Their screening form was not complete Child refuses Medical issues are identified on the day of the SLIP All children will receive a form to take home stating: Your child was vaccinated or Your child did not receive the Flu vaccine

12. ©2016 MFMER | slide-12 SLIP implementation October 21, 2015 Provider and Nurse Mgr./Sup saw the implementation MCHS Austin nurses went into the schools with their supplies, including computers with VPN access and vaccine All registration and screening were completed by parents at least 48 hours prior to vaccination Immunizations were entered into the medical record via remote access and billed per registration form with insurance information The billing experience was similar to that of the patient coming into our facility

13. ©2016 MFMER | slide-13 Revenue and Billing considerations VFC vaccine Commercial insurance billed Request for Charitable Giving funds to help cover any unpaid vaccine administration fees for the population unable to pay.

14. ©2016 MFMER | slide-14 Results The SLIP program vaccinated 94/357 students, 26.3% of the population at Woodson kindergarten Immunizations were entered in our EMR at site Process for billing was similar to process at the clinic

15. ©2016 MFMER | slide-15 Increased of 9.5%

16. ©2016 MFMER | slide-16 Distribution by insurance Woodson kindergarten: 54% Commercial plans 43% Medicaid plans 3% No insurance (charitable giving) All were paid Gerard Summary: 38% Commercial plans 62% Medicaid plans

17. ©2016 MFMER | slide-17 Mower County Public Health 1 st to 4 th Grade Southgate19%(97 students) Banfield22%(101 students) Sumner25%(69 students) Neveln25%(88 students) Pacelli32%(37 students)

18. ©2016 MFMER | slide-18 Acceptance by community Gerard Academy Facility requested onsite immunizations 53 immunizations Request from outlying schools Declined 2015-2016 Proceeding with SLIP 2016-2017

19. ©2016 MFMER | slide-19 Benefits Able to reach the children where they’re located Provides convenience to parents Increases “herd immunity” by vaccinating children who are most likely to spread disease Increases first time vaccinations for populations not seen in clinic Decreases influenza like illnesses for students, teachers, and community

20. ©2016 MFMER | slide-20 Lessons we learned Need to keep check-in process and children organized Picture ID helpful in younger age group Registration form Public awareness

21. ©2016 MFMER | slide-21 Questions & Discussion