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AFIX Quarterly Conference Call Minutes

July 17, 2013

Awardee Attendance

Present:Alaska, Arizona, Arkansas, Austin, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri,  Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York,  North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, San Antonio, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Virgin Islands, Washington, West Virginia, Wisconsin. 

 

Outline

AFIX - Assessment, Feedback, Incentives, eXchange,

Update on the movement toward IIS-based AFIX coverage assessments

  • Update by IISSB
  • Q&A – IISSB / POB (added under questions in the minutes)

 

Update to the AFIX tools development timeline

 

AFIX Policies and Procedures Guide

  • Two (2) additional calls will be scheduled to answer questions about the Guide. Dates and times will be sent to you within 2 weeks.

 

2013 AFIX quarterly call schedule

 

Questions and comments

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Minutes

Update on the movement toward IIS-based AFIX coverage assessments

  • Update by IISSB
    • The IIS community has a long history of using consensus based approaches with CDC, IIS, and other partners to develop best practices and guidance for IIS operations. We are looking into supporting a similar community-based consensus process to develop guidance for generating AFIX assessment reports from IIS. This will likely address high-level issues like which reports should the IIS generate, and very detailed issues like how to determine which vaccinations are or are not included in the reports.
    • We are aware that many programs are anxious to get started preparing for this transition but, it is important that programs not move too far down the path of developing and coding AFIX assessment reports from the IIS, as CDC would prefer for all programs to use the generated guidance so that results are consistent across programs. Many people have asked about the timeframe for this guidance. We are working to ensure that you’ll have that as quickly as possible, but, also recognize that system and program changes take time. So, CDC will work with individual programs to help ensure they can achieve these objectives by the end of the cooperative agreement.
    • Lastly, many programs have also asked about funding for this activity. CDC will be investigating opportunity for supplemental funding for programs to support this transition. However, as we all know, many factors influence the availability of supplemental funds so we encourage each program to consider how it can leverage its own 317, VFC/AFIX, and other program funds to support the initiative.

 

Update to the AFIX tools development timeline

  1. AFIX Site Visit Questionnaire is ready in its final format. CDC is requesting that the document be used with every site visit beginning in January 2014.  More information about its content, its use, and reporting is provided in the AFIX Policies and Procedures Guide.
  2. AFIX Policies and Procedures Guide. The document is ready in draft form. It will be your “go to guide on all CDC AFIX Standards” beginning January 2014.
    • The release date of this draft document was intended to be in-line with the proposal work your programs are preparing for the 2014 Cooperative Agreement. 
    • The final P&P Guide document will be shared in October (10/7).
  3. IIS Logic Guidance. Laura shared the update under the first agenda item. Our plan is to continue providing more updates as they become available.
  4. CoCASA 9.0 and PAPA online tool: Both currently in development. Testing will begin in September and the programs will be available for us in January 2014.
    *CDC will continue to provide updates on the timeline when/if necessary.

 

AFIX Policies and Procedures Guide

All updates in the Guide go into effect January 2014. 

General overview was provided in the slides and more details are available in the Guide:

  1. What will be new?
    • IIS based assessments are the new AFIX standard not chart-based assessments
    • The “X” in AFIX will represent follow up with providers beginning January 2014.
    • AFIX site visit questionnaire use (see notes above).
    • AFIX checklists for reference as quick reminders for assessors. The lists are intended as helpful tools and may be altered as needed.
  2. What will be dropped?
    • The Hybrid Method. No longer will be an acceptable assessment method and CDC will not accept data generated through the use of this method. In addition, the size of a practice (among other criteria) helps prioritize the visits but does not exclude any provider from AFIX.
    • AFIX Qualitative Only Visits. No longer will be an acceptable assessment method and CDC will not accept data generated through the use of this method. Every AFIX assessment will include a quantitative component (coverage reports) and a  qualitative component (site visit questionnaire)
  3. What will be replaced?
    • The VFC Management Survey (for AFIX) replaced by AFIX Annual Report
      • Reported via CoCASA and submitted in PAPA
      • Reported directly in PAPA using AFIX online tool
    • The Standards Guide and Core Elements replaced by AFIX Policies and Procedures Guide
      • To function as your standard guide in implementing AFIX and preparing your program’s P&P Guide.
      • Use this document when updating and submitting your P&P Guides in June 2014.
  4. Additional Notes.
    To be added to the Guide once ready (currently “under development”):
    • The IIS logic guidance
    • The answer key to the AFIX Site Visit Questionnaire
    • The AFIX Annual Report Template
    • Two (2) additional calls will be scheduled to answer questions about the Guide.

      Awardees are encouraged to review the draft and participate in the first, second, or both calls intended for Q&A. Awardees may also send any questions or requests for information directly to CDC (wgn5@cdc.gov).

      The dates and times of the calls are:
      • Date: 8/14/2013               Time: 2-3 PM ET
      • Date: 8/21/2013               Time: 2-3 PM ET

        **Call-in numbers will be provided 1 week prior to each call.

 

2013 AFIX quarterly call schedule

 

Questions and comments

  1. One awardee asked about those sites that have already been doing IIS-based AFIX assessment reports and how the logic guidance will impact them. Hanan and Laura both responded that those circumstances will be handled individually between the program and CDC. There are variances that are natural and unavoidable across programs. But, once the logic guidance is developed, CDC will be in the best position to work with programs to determine if their existing practices that are different from the guidelines are acceptable variances, or if they will need to modify reports / procedures.
  2. One awardee asked for more information about the consensus-building process. Laura described the MIROW-like process of a select group of program representatives participating in intensive discussions, the broader community having the opportunity to provide feedback, and the iterative process that’s utilized. The awardee expressed that having that information and being kept abreast of progress is really beneficial from their perspective. They think CDC has done a pretty good job of keeping them in the loop but they’d love more information as things progress.
  3. A number of other questions were brought up regarding the following issues:
    1. The requirement to audit 50-200 charts during AFIX visits.
    2. The challenge with implementing follow-up with certain providers and the suggested possibility of phasing-in the follow up process.
    3. The grouping of children in the age range 4-6 into their own assessment group.

      Note: These issues pertain to a number of SMEs within ISD. The AFIX lead will follow up on these questions and provide responses in the Q&A document under development.

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