Application Narrative Template (doc)

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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?
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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.
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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.
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Minnesota Department of Health
MIIC Regional Services RFP
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b. Who will perform the visits and follow up with clinics? Who will be responsible for
submitting required paperwork and data elements to MDH?
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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
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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
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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.
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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.
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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.
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