Surviving the Economic Armageddon: Simple Changes for Lasting Impacts

Background:  When the 2010 California state budget was signed, the regional immunization registry budgets were cut by 70%.   After experiencing a major reduction in staffing, it became necessary to rethink program operations to find options that would allow CAIR Inland Empire to thrive, not just survive.

Setting:  Inland Empire, CA

Population:  CAIR Inland Empire staff, partners and providers

Project Description:  CAIR Inland Empire covers over 27,000 square miles and serves almost 1,000 enrolled providers.  In order to maintain essential services in spite of budget cuts, the principles of Continuity of Operations Planning used in emergency preparedness planning were used to streamline registry operations.  The goal was to maintain existing provider participation while increasing the number of children with immunizations in CAIR.   Registry staff project focused on three areas as essential to achieving our goals: training, communication and data exchange.  Providers were given the option of participating in on-line and web-based training, when on-site training was unavailable.  Registry partners (large health plans, local immunization coalitions, etc.) assisted CAIR staff by publicizing changes, training opportunities and other important information via fax blast and newsletters.  Partners also joined registry staff in promoting electronic data exchange with CAIR.

Results/Lessons Learned:  In the first month that the budget cuts took effect, CAIR Inland Empire experienced a 150% increase in applications for electronic data exchange.  When completed, this will account for immunization data from an additional 56 physicians.  The number of trainings provided has remained constant, with more than 80% of providers opting to attend a centralized training.  Fax blasts scheduled to be sent by the two Medicaid managed care plans serving the region will reach more than 90% of enrolled immunization providers.