1. Utilizing Registry Functionality and Data for Statewide School and Childcare Reporting First Year Results Mary Jo Flenner, B.S. Michigan Dept. of Community Health March 5, 2007 National Immunization Conference

2. MICHIGAN SCHOOL/CHILDCARE IMMUNIZATION REPORTING REQUIREMENTS MICHIGAN SCHOOL/CHILDCARE IMMUNIZATION REPORTING REQUIREMENTS

3. MICHIGAN LAW REGARDING SCHOOL IMMUNIZATION REPORTING  Schools are required to report the immunization status of all children in Grades K and 6, plus all new enterers to a school district during the calendar year  Reports are due on November 1 and February 1

4. MICHIGAN LAW REGARDING SCHOOL IMMUNIZATION REPORTING  Public school districts must reach stated compliancy levels on reports or partial funding will be withheld (90% in November / 95% in February)  Vaccines required include: DTaP/Tdap/Td/DT, Polio, MMR, HepB and Varicella (vaccine or immunity)

5. MICHIGAN LAW REGARDING CHILDCARE IMMUNIZATION REPORTING  Licensed childcares are required to report all children attending their site (excluding children who attend school) each year by October 1.  Vaccines required are: DTaP/DT, Polio, MMR, Hib, HepB, Varicella (vaccine or immunity), and pneumococcal conjugate

6. BACKGROUND INFORMATION ON SCHOOL/CHILDCARE IMMUNIZATION REPORTING

7. BASIC STATISTICS FOR 2005/06 REPORTING  Approximately 4800 Schools (public and private) reported immunizations for over 444,000 children  Approximately 4250 licensed childcares reported immunization records for over 162,000 children  45 local health department jurisdictions review immunization reports for 83 counties* * (plus City of Detroit which reports separately)

8. EARLY YEARS OF REPORTING  School/childcare immunization reporting has happened since 1978  Early reports done on IP100 or IP101 triplicate paper forms  Paper forms can still be used today if a site does not use computer functionality for reporting

9. COMPUTERIZED REPORTING  In 1987, the SIRS computer program was created to assist school and childcare staff with immunization reporting  Functionality included the ability to assess the child’s shot record, create letters to parents for overdue students, create summary reports of compliancy levels

10. MCIR HISTORY  1997 – Public Act 540 passed which established the legal basis for the Michigan Childhood Immunization Registry (MCIR)  2003 – MCIR becomes a Web-based system  2006 – Legislation passed which opened the registry to adults, name changed to Michigan Care Improvement Registry (MCIR)

11. MCIR FUNCTIONALITY  Assessment – by Individual Records, Provider Sites, Populations, Sub-Populations (such as WIC, HEDIS reports, by vaccine)  Reminder/Recall  Vaccine Inventory Module  Lead Screening, VAERS reporting, IVEN (Influenza Vaccine Exchange Network)  School/Childcare Immunization Reporting

12. MCIR STATISTICS  Over 4 million children in MCIR  Over 53.7 million doses recorded  Approximately 2000 healthcare providers submitting immunization data –MCIR Statistics as of February 2007

15. ROLL-OUT OF MCIR/SIRS REGISTRY BASED FUNCTIONALITY

16. MCIR/SIRS  Web based immunization reporting system for registered schools and childcares which combines functionality of MCIR with features of SIRS program  Functionality based on school and childcare reporting requirements legislation –Only immunizations required for school or childcare attendance are assessed and reported in MCIR/SIRS

17. ADVANTAGES OF MCIR/SIRS  Utilizes provider data already entered into MCIR  Web-based, so registered user can access the system from any computer  Seamless access to school and childcare summary data for local health departments and state health department  Easy to update functionality throughout the system

18. MCIR/SIRS IN SCHOOLS & CHILDCARES  Schools and Childcares have the ability to: –Create a roster of children to be reported –Add children not already in MCIR (e.g. moved recently from another state) –Receive immediate assessment of child’s immunization status related to school and childcare requirements

19. MCIR/SIRS IN SCHOOLS & CHILDCARES (cont.)  Schools and Childcares have the ability to: –Add any missing shot dates to child’s record for reporting purposes (although not considered clinical data and not visible to healthcare providers) –School/childcare data is visible to local health staff when viewing records in MCIR, but it is highlighted in red to separate it from clinical data –School/childcare data is not included in clinical assessments used by healthcare providers, which indicate if/when next shots are needed

20. MCIR/SIRS IN SCHOOLS & CHILDCARES (cont.)  Schools and childcares have the ability to: –Create letters to parents of non-compliant children who need shots, in either English or Spanish –Create a wide variety of reports including lists of incomplete students, waivers, due for Td/Tdap, compliancy level reports by individual sites and districts, etc.

23. MCIR/SIRS IN LOCAL HEALTH DEPARTMENTS  Local health departments have the ability to: –View a roster of all schools/childcares by county, districts, and individual sites –View number of children reported, number of complete, provisional, and waivers for each grade level –Create reports showing compliancy levels and detailed information for each site, district and entire county

25. MCIR/SIRS AT THE STATE LEVEL  State level staff have the ability to: –View summary data for the entire state, individual counties, individual schools, school districts, and childcares –Create reports showing compliancy levels and summary data for the entire state, individual counties, schools, school districts and childcares

26. MCIR/SIRS ROLL-OUT Released to schools for the November 2005 and February 2006 reports Released to childcares for the October 2005 reports Released to Local Health Departments in the 2004/05 school year (for summary data reporting only – full functionality in 2005/06 school year)

27. What were some of the first year concerns?  Will we be successful with the new MCIR/SIRS reporting?  How will so many schools and childcare centers be trained?  Will fewer children be reported?  Will levels drop?  Will we see more waivers with MCIR/SIRS?

28. How many sites registered for MCIR/SIRS in 2005/06?  4284 out of 4844 schools =  4284 out of 4844 schools = 88% (as of 4/14/06)  3156 out of 4247 childcares =  3156 out of 4247 childcares = 74% (as of 4/14/06)

29. How was training accomplished?  www.mcir.org Website www.mcir.org  MCIR/SIRS Help Desk  County-wide Trainings  School District Trainings  LHD Staff Efforts  MDCH and MCIR Regional Staff Efforts

30. Will fewer children be reported? School Comparison  Total # of children reported in the February 2005 Report: 427,633  Total # of children reported in the February 2006 Report: 444,273  16,640 more children reported!

31. Complete Status by Grade  Grade K in Feb05 = 93% Grade K in Feb06 = 94% Grade K in Feb06 = 94%  Other Grades in Feb05 = 87% Other Grades in Feb06 = 90% Other Grades in Feb06 = 90%  Grade 6 in Feb05 = 94% Grade 6 in Feb06 = 94% Grade 6 in Feb06 = 94% Number of children with complete status increased!

32. Will we have more waivers submitted with MCIR/SIRS? School Waiver Totals Total # of school waivers in Feb2005 report = 18,611 Total # of school waivers in Feb2006 report =16,762 2049 fewer waivers!

33. Will fewer children be reported? Childcare Comparison  Total # of children reported in Michigan in the October 2004 Report: 156,725  Total # of children reported in Michigan in the October 2005 Report: 162,788  6063 more children reported!

34. Will levels drop? Childcare Comparison  October 2004 Level: 92% compliant*  October 2005 Level: 93% compliant*  Overall 1% increase in levels  Head Start Levels increased from 93% to 95% compliant! * % Compliant = % Complete + % Provisional + % Waiver

35. Childcare Children With Complete Status  October 2004 Report – 85% Complete (133,285 out of 156,725)  October 2005 Report – 87% Complete (141,302 out of 162,788) Number of children with Number of children with complete status increased! complete status increased!

36. Will we have more waivers submitted with MCIR/SIRS? Childcare Waiver Totals # of Childcare Waivers in 2004 = 4921 # of Childcare Waivers in 2005 = 4346 575 fewer waivers with MCIR/SIRS!

37. OVERALL RESULTS SCHOOLS - 2005/06  Over 85% of schools using MCIR/SIRS  More Children Reported  Fewer Waivers  “Complete” status levels higher

38. OVERALL RESULTS CHILDCARE – 2005/06  Nearly 75% of licensed childcares using MCIR/SIRS  More Children Reported  Fewer Waivers  Compliancy levels higher  “Complete” status levels higher

39. PROJECTIONS FOR 2006/07 Although report data is not yet finalized:  95% of schools now registered for MCIR/SIRS  89% of childcares now registered  # of children reported continues to increase  Compliancy levels continue to climb  # of waivers continues to decrease

40. SUPPLEMENTAL INFORMATION SHOWING MCIR/SIRS REPORTING FUNCTIONALITY

42. SCHOOL INFORMATION SCREEN School Name, District, License #, Address, Phone, Email, Grades, Contact Info, etc.

44. CREATING A ROSTER  Student names and birthdates are added to the “Build Roster” list, then submitted to MCIR.  Matched names are added to site’s roster, which shows child’s immunization status (complete, provisional, incomplete)

48. Things To Keep In Mind About MCIR/SIRS  Schools/childcares can add children to MCIR who were born out of state and not added to MCIR at birth or by their healthcare provider  The majority of children born since 1994 are already in MCIR  Most shot dates for children born since 1994 are in MCIR

49. Another Thing to Keep In Mind About MCIR/SIRS  Shot dates added by school or childcare sites are not considered clinical data and are not visible to private providers – (Shots dates added by school/childcare staff is visible to health department staff, but is highlighted in red to differentiate it from clinical data).  School/childcare data is not included in clinical assessments.

53. MODIFYING THE ROSTER Making changes to grades, report periods, other information

56. CHILD INFORMATION SCREEN Name, Address, Phone, Grade, Language Spoken, Other Info

58. CREATING REPORTS FROM THE ROSTER Staff has the ability to create many useful reports, including lists of students, summary data reports, lists of incompletes, waivers, provisionals, due for Td, and more

62. LOCAL HEALTH DEPARTMENT VIEWS AND FUNCTIONALITY News Screens, Roster of Schools, Reports by School, District or County

63. MCIR/SIRS News Screen

68. Supplemental Data  On the following six slides, you will find detailed information from MCIR/SIRS on annual immunization reporting: –Reports showing statewide results of IP101 October Childcare Reports for 2004, 2005, and 2006 –Reports showing statewide results of IP100 February School Reports for 2004/05, 2005/06 and 2006/07 school years  Please note: February 2007 results for the 2006/07 school year are not final as of 02/17/07

71. Not Final Data