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1 The Immunization Nurse Educator Program's purpose is to provide educational presentations to physicians, physician assistants, nurse practitioners, RNs, LPNs, medical assistants, and other practice staff. Presentations focus on current recommendations and information related to immunization. Immunization Nurse Educators (INE) must meet the approval of the Michigan Department of Community Health (MDCH) in order to become an approved Immunization Educator. MDCH reserves the right to remove an Immunization Nurse Educator if she or he does not adhere to the guidelines or if presentation evaluations are unfavorable. All Immunization Nurse Educators must meet and/or exceed the qualifications and requirements outlined on the Immunization Nurse Educator Qualifications and Requirements document datedglllllz. All Immunization Nurse Educators must complete orientation conducted by MDCH staffprior to offering Immunization Update presentations. They must also attend regularly scheduled Immunization Nurse Educator meetings, remain current on vaccine recommendations, and be knowledgeable on changes to the INE program policies. Immunization Nurse Educators are expected to be able to answer questions about the materials being presented at the inservices. The Michigan Department of Community Health has allocated funding to help support the activities of Immunization Nurse Educators in providing immunization education to private practice staff in their jurisdictions. The reimbursement fee per in-service is $ The exception will be the Vaccines across the Lifespan module which will be reimbursed at $ per in-service. Each local health department iurisdiction with a qualified Immunization Nurse Educator who has a signed agreement in place with MDCH will be allotted payment for two private provider in-services and payment for one local health department in-service per fiscal year. These may be scheduled at any time during the fiscal year, October 1, 2012 through September 30, The remaining funds will be paid in the order Provider Contact and Report Forms for a) any in-services to private providers who administer vaccines and b) one additional inservice (per jurisdiction) to local health department staff are received and until the funds are fully expended. Payments for approved in-services will be made to the local health department jurisdiction on a quarterly basis. The Michigan Department of Community Health will keep on file an agreement, biographical form, disclosure form and current nusing license for each Immunization Nurse Educator. Each year's agreement must be received by MDCH no later than October 1st of the current year. Agreements will be reissued on an annual basis. Biographical and disclosure forms will be requested as needed. The Michigan Department of Community Health will provide Immunization Nurse Educators with Immunization Update module and materials (a copy ofparticipant handouts, overhead hansparencies or PowerPoint, and speaker's notes with presentation tips) for conducting presentations. Exception: Copies ofparticipant handouts for the Pediatric and Adult Influenza Update will be the responsibility of the INE. MDCH will provide each INE with an electronic copy of materials that may be included in the handouts. Septembcr 10, 2012

2 Vaccinating Women across the Lifespan/ OB/Gyn Update Vaccines across the Lifespan Update Vaccine Administration Vaccine Management: (Storage & Handling) 2.0 contact hours 1.0 contact hours 1.0 contact hours 120 minutes 60 minutes 60 minutes Vaccines for Children Program Pediatric and Adult lnfluenza I.0 contact hours 60 minutes 12. All Provider contact forms and any additional required documentation as appropriate (e.g. documentation for CME credit: faxed copies of Sign-in sheets and CUp gvauation Summary Form) must be received at MDCH within 5 days of the in-service date. 13' To ensure reimbursement, each INE is responsible for completing and submitting a copy of the,.fixed Fees Quarterly Worksheet Summary" to their local health department/ financial person at thi end of each fiscal quarter' Only include in-services that are eligible for reimbursement under these INE guidelines. Seplembet 10, 2012

3 FW: Important Information: INE Reimbursement Guidelines From: Date: To: )an 2, 2O!3 1:34:57 PM 'Lockwood, Carlene (DCH)' fi rnecuiaelines o91o12.doc 54 KB This memo is being sent to IAPs and INEs. There have been some issues with reconciling INE in-services at the end of each quafter. Please review these steps and note a couple ofchanges (3-4) 1. All in-services completed must meet the criteria set forth in the current'ine Guidelines" (attached) to be eligible for reimbursement. Any deviations from the guidelines must be approved by the INE Coordinator/designated staff prior to the in-services to be considered for reimbursement. 2. All Provider Contact Forms (whether or not they qualiff for reimbursement) are to be submitted within 5 days of the in-services date to MDCH, attention Carlene Lockwood. 3. Within 5 working days of the end of a quarter (Jan/Feb/Mar; Aprl\aY/June; Jul/Aug/Sep; Oct/Nov/Dec) a spreadsheet of al INE Provider Contact Forms received at MDCH will be sent out to the INEs. Non-reimbursable in-seruices will be designated as "no" on the spreadsheet. 4. Each INE should review the spreadsheet within 5 days a. If there are any discrepancies/concerns, the INE should contact Carlene Lockwood with details/missing Provider Contact Forms. The INE will be notified by or phone of a decision and if indicated, the spreadsheet will be changed. b. If an INE has not responded with concerns within 5 days, it will be considered that their list is correct. S. Each INE should fill out a FSR worksheet listing the mutually agreed reimbursable INE in-seruices. a. Remember, non-reimbursable in-services should not be put on the FSR worksheet 6. Forward the FSR worksheet to the designated person(s) within your LHD. Please note: At this time, we have about B0 INEs--at least one in most, but not all LHDs. To streamline the process, the quafterly spieadsheets will only be sent to INEs. Other LHD staff should coordinate with their INE(s) to receive a copy. Let me know if yoir have questions or concerns at this time. Barbara Wolicki Immunization Nurse Consultant INE Program Coordinator MDCH-Divsion of Immunization wolickib@michigan.gov Fax:

4 J.nnlt.r. Or.nhotm, 6o!.rno. J...i O,.ar.il. Dthctor Agreement Between (Print or type Immunization Nurse Educator name and countyy and The Michigan Department of Community Health ' The Michigan Departrnent of Community Health (MDCH) shall reimburse an established fee to the Local Health Department (LHD) according to the Immunization Update for provider Offi ce Staff 2OlZ-2013 Guidilines. In order to be eligible for reimbursement, the Immunization Nurse Educator must: l. Submit-to MDCH the appropriate documentation within 5 days after the conclusion ofeach presentation. This includes a completed provider contact and Report Form and the appropriate continuing education credit documentation. 2. Provide a minimum of two in-service presentations per year 3. Meet or exc eed the Immunization Nurse Educator program Guidelines In addition,_i agree to use all INE program materials (powerpoint presentations, transparencies, participant handouts) as issued and not make arry "hang", (additions or deletions) to the text. This letter ofunderstanding expires on October l, Signature of Immunization Nurse Educator Date

5 W XffiCH Immunization Nurse Educator Qualifications andrequirements Education - Registered nurse licensed in the State of Michigan - BSN or MSN preferred, but not required ExDerience - Current or recent experience administering vaccines in a clinical setting - Current knowledge of the Standards of Pediatric/Adult Immunization Practices - Broad knowledge of immunizations tkoughout the lifespan - Current knowledge of MCIR (Michigan Care Improvement Registry) including Vaccine lnventory Module (VIM), VFC (Vaccines for Children) and AFIX (Assessment, Feedback, Incentives and exchange of information) programs. - Public health nursing experience desirable - Adult teaching experience desirable Approval Requirements - Successful completion of Michigan Depa(ment of Community Health (MDCH) Orientation for new Immunization Nurse Educators (INE) - Review ofthe most current Epidemiology and Prevention of Vaccine-Preventable Diseases course offered by CDC (Centers for Disease Control) - Successful completion of an in-service observed by an MDCH INE within 4 months of orientation. This in-service must be conducted using one of the following modules:. Infant and Early Childhood (lec). Older Children and Adolescents (OCA). Adult. Vaccines across the Lifespan (VAL) - Successful approval by the Ohio Nurses Association and Michigan State Medical Society as faculty for all modules developed and maintained by MDCH under Immunization Nurse Educator Program - Sign an INE agreement with MDCH Reouirements to Maintain INE Certification er ltt of each calendar year - Provide at least 2 in-services per year - Attend semi-annual INE meetings - Conduct in-services in compliance with CME and CNE guidelines - Provide timely scheduling (within 48 hours) ofrequested updates at the provider's convenience or a referral to a state-based INE to accommodate the request - Maintain accurate record keeping for each in-service delivered to include copies ofprovider Contact and Report Form, In-service Evaluations, Evaluation Summary and SignJn Sheet as applicable. Records must be retained for 5 years. - Submit a completed Provider Contact and Report Form and applicable documentation for participant continuing education credits to MDCH within 5 days of completing each in-service - Provide timely follow-up (within one week) to unanswered questions and request for information encountered during the in-service - Complete an observation and evaluation ofan in-service presentation at the discretion of the INE Program Coordinator

6 - View and submit copy of contact hour credit for annual updates provided by CDC to include but not limited to: 'Epidemiology and Prevention of Vaccine-Preventable Diseases course (TBD). Immunization Update (TBD) - Attend annual MDCH regional immunization conference (oct/nov) - Read immunization materials/communications using but not limited to the following resources: 'MDCH communications via IAP/INE list-serves (all INEs will be added) 'MDCH Division of Immunization's Timely Tips (sent electronically to all INEs). MDCH website at gov/immunize 'CDC and ACIP (Advisory Committee on ImmunizationPractices) recommendations at http ://cdc. gov/vaccines. Mortality and Morbidity Weekly Reports (MMWR): sign up at. IAC Express: sign up at 'communication with LHD (local health department) IAp coordinator September I0,2012

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