Minnesota Department of Health MIIC Regional Services RFP Application Narrative Template Instructions Answer the following questions on each area of MIIC work as completely as possible. Present as complete a picture as you can of your plans for each main proposed regional entity duty. Limit your response for each question to a 2 page maximum. Submit with other required Proposal forms to MDH by 4:00 p.m., October 15, 2015. Applicant Information Agency Name: Address: Contact: Title: Phone: Email: Fax: Duties and Questions 1. Conduct Active Outreach and Training and Provide Technical Assistance to Primary Care Clinics on Immunization Assessment, Outreach, and Improvement using MIIC Data and Tools a. Describe your relationships with primary care clinics and clinic staff in the region. Describe your regional entity’s plan to perform regular outreach to and maintain contacts at primary care clinics in your area. How do you plan to inform, educate, and train them of useful MIIC data and tools to support their immunization practice? Click here to enter text. b. One of the tasks in this category is to engage clinics on maintaining good data quality in MIIC. What are some of the outreach ideas your region has to engage clinic staff in this issue and help ensure clinics have high quality data in the system? Tip: To answer this question, think about how your region will use MDH reports on provider participation, provider activity, report usage, and onboarding status to inform your data quality outreach and troubleshooting efforts. Click here to enter text. 2. Administer the Federal Assessment, Feedback, Incentives, and Information Exchange (AFIX) Program to AFIX-Eligible Primary Care Clinics in the Region, According to State and Federal Guidelines. a. Describe your regional entity’s plan to administer the AFIX program in your area. How will you ensure that at least 30% of the primary care clinics in your area receive a complete AFIX visit every year? Tip: To answer this question, think about how your region will promote the AFIX program as a tool for improvement for providers. 1|P a g e Minnesota Department of Health MIIC Regional Services RFP Click here to enter text. b. Who will perform the visits and follow up with clinics? Who will be responsible for submitting required paperwork and data elements to MDH? Click here to enter text. 3. Conduct Active Outreach and Training and Provide Technical Assistance to Local Public Health and CHBs on Immunization Assessment, Outreach, and Improvement for PH Immunization Clinics as well as County/CHB Population Immunization Rates using MIIC Data and Tools. a. How does your region plan to work with member county/CHB immunization staff on immunization issues for clients they serve? Please address the following categories in your answer: i. Communication with your region’s LPH/CHB staff users ii. AFIX site visit troubleshooting and support to LPH site visitors iii. Plans for taking action on MDH data quality, report usage, and MIIC participation reports Click here to enter text. b. How does your region plan to work with member county/CHB staff on issues related to population-based immunization coverage and improvement and vaccine preventable disease outbreak response? Please address the following issues in your answer: i. MIIC support for LPH/CHB mass vaccination clinics ii. MIIC support for LPH/CHB during a vaccine preventable disease outbreak iii. Plan for MIIC training for your region’s LPH/CHB staff users on applicable functionality Click here to enter text. 4. Participate in the Regional and State Management of MIIC. a. Describe the region’s current or planned governance structure/model to oversee MIIC grant agreement duties. Describe: board membership, meeting frequency, etc. Click here to enter text. b. Provide a high level summary for the next 3 years of your MIIC work. Describe: How the region’s work is expected to evolve over the time of the grant cycle? Describe how you will continually work to develop the capacity of your staff and your partners to advance the work. Click here to enter text. 2|P a g e Minnesota Department of Health MIIC Regional Services RFP 6. Conduct Regional, Population-Based Immunization Reminder Recall to Medical Assistance (MA)Eligible Clients Using MIIC Data and Tools. a. Describe your region’s plans for conducting reminder/recall with this population. Include: the planned workflow, partners you will engage in the process to ensure successful mailings and data updates. Click here to enter text. 3|P a g e