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CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) convenes the May, 2000 EARLY HEARING DETECTION AND INTERVENTION AD HOC GROUP TELECONFERENCE The verbatim transcript of the EHDI Ad Hoc Group Teleconference convened at 2:00 p.m. on Tuesday, May 2, 2000 Table of Contents I. Welcome and Announcements II. National Early Hearing Detection and Intervention Technical Assistance Center III. INPHO II - Systems Integration IV. Newly funded MCHB States V. Web-based tracking system VI. Data Integration in Missouri JUNE HOLSTRUM: Welcome, everyone. I'm June Holstrum from the Centers for Disease Control and Prevention. Welcome to the May teleconference on Early Hearing Detection and Intervention, and thank you for joining us. Please remember to mute your microphone when you're not talking. Today's conference is being recorded and the transcripts will be available on the Internet. Before we begin our scheduled program, are there any announcements or comments that anyone would like to make from our audience? (No response) If not, I'll start out with a brief update on the status of the CDC EHDI RFP's. Our state-based EHDI tracking and surveillance RFP's should be in the Federal Register this week. As soon as we hear that it's signed off on and that it's in the Register I will send each of you on our list an e-mail or a fax. You will be able to download it from our web site which is cdc.gov/nceh/ehdi. A Letter of Intent will be due on June 6th and the application is due July 6th with funding in September. Our next speaker will be Karl White at the National Early Hearing Detection and Intervention Technical Assistance Center. KARL WHITE: June asked me to describe briefly the work we will be doing as a part of the MCHB initiative on universal newborn hearing screening. We've been funded to establish a national technical assistance system for early hearing detection and intervention programs. The purpose of the technical assistance system is to work with hospitals, state agencies, and others to develop a comprehensive sustainable statewide EHDI system in all states in the country. To do that, we've divided the work scope into seven different areas to make sure that all children are screened for hearing loss before they're discharged from the hospital; and for infants who do not have the screening, that they receive diagnostic evaluations before three months of age and are enrolled in early intervention programs, when necessary, by six months of age; and also that those children who receive services are provided it in a way that is culturally competent and includes family support during the entire process and that infants are linked with a medical home; also that states will develop statewide EHDI data tracking systems which are linked with other relevant health data systems; and then, finally, we will be disseminating information about EHDI to various stakeholders and constituencies. We've been involved here at Utah State in providing support and assistance to early hearing detection and intervention programs for sometime. So the work at this Center will expand on some of those activities we've already been doing and will also include some new initiatives. In terms of the expanded activities, we have been adding a number of features to our web site. The address of that web site is www.infanthearing.org., and included in those additions is a bulletin board which is now up and running. There is new information about a research recently conducted related to early hearing detection and intervention programs. There's a new search engine on it. Then there's information about the various state grants that have been funded. We hope, within the next couple of weeks, to actually have copies of those grants on there with the hope that people will be able to get ideas about other things that they could do in their state. We've posted about five or six at this point and the others are coming in now. We will also be continuing our telephone technical assistance line related to EHDI systems. The phone number there is 435/797-3584, and it's staffed from 7:30 in the morning until 5:30 in the afternoon Mountain time with people who are available to answer questions about early hearing detection and intervention programs. We'll also be conducting an annual survey and needs assessment with each of the state agencies related to early hearing detection and intervention programs and then re-introducing the Sound Ideas newsletter that we did several years ago and will be starting again. In addition to those expansion of existing activities, we are -- we'll be doing several new initiatives. The first is that we've developed a national network of EHDI assistants. These are people who are located and live in each of the ten MCHB regions, are all audiologists who have been involved for sometime in implementing early hearing detection and intervention programs, and those people will be available to work with local hospitals and state agencies to provide technical assistance and support in their -- in the local efforts to implement programs. So there's at least one and sometimes two people located in each of the ten MCHB regions. We'll also be sponsoring an annual EHDI conference that will take place probably in either late March or early May of next year for the first one. We haven't finalized that yet, and we'll be getting more information out on that as those plans are finalized. Finally, we are working to collaborate with seventeen different agencies at this point to have an involvement in early hearing detection and intervention programs. There are a number of agencies out there who have as one of their primary goals the promotion of early hearing detection and intervention agencies such as ASHA, the American Academy of Pediatrics, the American Academy of Audiology, and our hope is to be able to coordinate and collaborate with work that those groups are already doing. But there are a number of other agencies who have a broader mandate to serve children with disabilities, such as the National Early Childhood Technical Assistance System, or the 0-to-3 program located there in Washington, D.C., or the National Early Headstart Resource Center, all of whom are people who serve some children with hearing loss, but because of the broader constituency that they serve have not focused their efforts particularly on children with hearing loss. We will be collaborating with those agencies to provide resources and materials and expertise to assist them in including children with hearing loss in the activities that they're already doing. So we invite people to contact us if you have questions; or if you have technical assistance needs, you can reach us through our web site -- There is an e-mail contact there -- or you can e-mail me directly here at Kwhite@coe.usu.edu. Thanks, June. That's it. JUNE HOLSTRUM: Thank you, Karl. Do we have any questions for Karl? RON CALDERONE: Yeah, Karl, this is Ron Calderone from Rhode Island. How are you doing? KARL WHITE: Hi, Ron. RON CALDERONE: Karl, I'm wondering, you mentioned the national associations. Do the mental health associations -- Have we at all looked at them for some help yet? KARL WHITE: You know, we haven't, Ron. I think that's an excellent suggestion. We have -- I didn't mention all of the collaborating agencies, and several of those, like Family Voices, do have some connections with some of those mental health organizations, but it's not a direct affiliation. So that's an excellent idea. If you could e-mail me some of those that you think would be most relevant, that's something we could look into. RON CALDERONE: Very good. I'll do that, Karl. MURIEL GOLDMAN: Karl, this is Muriel Goldman from Oregon. I'm a member of the Newborn Hearing Screening Advisory Council, and I was interested in hearing what you had to say. An organization in my county, (inaudible) county, it's the Local Commission on Children and Families, has taken on as one of its projects promoting literacy and language in young children. And one of the subsets of that is identifying children with hearing loss and getting the insurance companies to be more interested in providing the wherewithal so that parents can take their children to early intervention and also to diagnosis when it isn't covered by their regular insurance. So I think you might be interested in getting in touch with them also and telling them what information you have available. I want to be sure I've got your e-mail address correct. Could you repeat it again? KARL WHITE: Yes. It's kwhite@coe.usu.edu. MURIEL GOLDMAN: Okay, thank you. KARL WHITE: I would very much appreciate it if you would send me the contact information for that group, because this issue of how services are funded for children with hearing loss is a very important issue that I think is going to become even more important over the next several months and years as more and more children are identified early. It's an issue which, as you well know, is extremely complex and which we really don't have very good answers for. So being able to tie into what those people are doing would be very helpful. MURIEL GOLDMAN: Thank you. CINDY INGHAM: Hi. This is Cindy Ingham at Children with Special Health Needs in Vermont. You mentioned stressing cultural competence. I wonder if you could say a little bit more about that and how you suggest we go about doing that. KARL WHITE: One of the groups we're collaborating with is the National Center on Cultural Competence at Georgetown University, and there is a link to their site on our web site. If you go through our web site, all of the collaborating agencies are listed and then links to their individual sites. They have developed some excellent materials for program planners and program operators suggesting guidelines for how people can structure their programs in a way to ensure that they are providing culturally competent services to the families in their constituency. So I would suggest you go to that site and I think that'll give you some excellent guidelines. CINDY INGHAM: All right. Thank you very much. JUNE HOLSTRUM: Brandt Culpepper was supposed to be our next speaker. She called me early this morning and I could almost hear her. She wasn't sounding too well. So we'll postpone her report until the next conference. So let's move on to Tom Lacher from the INPHO II - Systems Integration here at CDC. Tom? TOM LACHER: Good afternoon, everybody. I'm with the Public Health Practice Program Office at CDC, and with me on the line is Brian Mahoney. I hope Brian is there. Brian, are you there? (NO RESPONSE) Okay. The project that we have been involved in since 1992 we think has got some relevance to the programs that you are ready to get embarked on. I was asked to just spend a few words -- spend a few minutes with you. The INPHO project, standing for the Information Network for Public Health Officials, was an initiative started in 1992, and funded in '94 actually, to provide state health departments with an impetus to develop their information technology infrastructure. Initially, twelve states received funding and they were provided funds, with an average amount of about $500,000 a year for three years to do several things, but to essentially build up the information infrastructure, including wide-area networks, computers on the desktop, things like this. The three focus areas of INPHO I, which ran '94 through '96, a three-year grant program, was the concepts of linkage, information access, and data transfer. We must remember, back in the early days, back in the early '90's, we weren't quite as sophisticated as we are today and we found that many state and most local health departments did not have much capacity in terms of information technology. Those projects were all successful and they helped the states and the counties that they deal with to be able to communicate, to send electronic messages, e-mail, to find a platform for electronic surveillance of data, and access to the World Wide Web. This is all pretty routine stuff now, but back in the early '90's, it certainly wasn't. We fast-forward now to just a couple of years ago, 1997, and we have the second iteration of INPHO, and our assessments and our knowledge of the state health departments is that basically the infrastructure was essentially in place, but another tremendous issue was raising its head and I think this is where we start to connect with our process and your substantive content, and that's the issue of systems integration. We found by working with our state health partners that they were subjected to having to deal with a multiplicity of data and reporting systems. Perhaps it wasn't so ironic that we at CDC were as much a cause of the problem than as a potential solution. Many CDC programs -- Well, I'll use the word -- "force" essentially our state health department partners to use SILO or stand-alone information systems, all from requiring discreet software and sometimes using their own computers in the worst case. Obviously, this runs counter to where we want to be. So the focus of the second INPHO grant awards -- And we funded nine states, and I'll tell you who they are in just a second -- was to address the issue of systems integration, to provide seed money to the states so that they could look at what they have, to assess what information systems they had, and to try to make some sense of it so that there would be a singular system perhaps crafted in a modular fashion that the various information systems of the state health departments and the locals could work together. Well, we funded just nine projects. We decided to make nine big awards instead of a large number of smaller awards. The nine states were Florida, Georgia, Missouri, and New York, and those four were also previously INPHO I projects. So they had a lot of history. And then five smaller projects were also funded and those were Montana, Nevada, Texas, Iowa, and Maryland. I used to be able to say those all real quickly. So in those nine states -- I wanted to give everyone on this phone call an alert -- there is a -- really a smart bunch of people, and in many other states, too, but in those nine states we have operational programs. We've got funding out there, and those should be your allies as you look to develop information systems to meet your particular needs. I hope that's enough of an overview to satisfy you. June, was that about what you needed? JUNE HOLSTRUM: Yes. Thank you, Tom. Are there any questions for Tom?
TOM LACHER: Okay. Well, good luck, everybody. Check our web site. We are now getting involved in bioterrorism and Health Alert Network is the buzzword. Our current funded project, which has very similar outcomes now under the Rubrick Health Alert Network -- UNIDENTIFIED SPEAKER: We have a question from Wisconsin. TOM LACHER: Yes, go ahead, Wisconsin. UNIDENTIFIED SPEAKER: Is there going to be more money for any INPHO-type projects? And the second question from the Public Health Program Office, how does any of this tie into the Health Alert Network and bioterrorism grant money that is coming back? How -- I mean, our SILO system at CDC, you already acknowledged, is (inaudible). How do we even begin to tie in the data systems when we're dealing with (inaudible)? TOM LACHER: That's a very good question. First of all, let me just say that the overall purpose of both INPHO and Health Alert Network are essentially the same. What we're talking about is a different badge on the money. You know, a Ford Taurus and a Mercury Sable would be a good example. You take off the nameplate and you get inside and look under the hood, and what do you have? You've got the same thing. Right? So the funding source was different for these two cooperative agreement programs. The funding source for the initial INPHO program we expect to end this next year. We are in its third and final funding year. Things change, but we suspect that that source of funding will end for the INPHO project. We are very happy, though, the Health Alert Network came along under the umbrella of bioterrorism, and a substantial amount of money has been made available. We have now forty funded Health Alert Network projects which include thirty-seven states and three large cities. In addition, three local health departments were given funding outside those numbers. So a total of forty-three awards, actually. But the purpose is the same. The difference is the Health Alert Network, we got that funding from Congress to be able to respond to bioterrorism threats. However, in the congressional language it's very clear that the money was not to be developed -- not to be used to develop a SILO system, a separate system that deals with only health alert and bioterrorism events. It's designed to improve the infrastructure of the local and state health departments -- Notice I say "local and state" now instead of "state and local" -- local and state health departments so that it could be used for their everyday use and have it in place and have the equipment operative so that in that one-in-a-million chance that something horrible happens and the health departments need ready access, high-speed activity, broadband with broadcast/fax capacity, trained operators, broadcast alert capabilities, all those things, that the equipment and the trained personnel would be in place. And we are in the first of a three-year budget cycle, we hope, for Health Alert Network and we were able to reach almost every state in the first year, and our goal is to get every state. Right now we have thirty-seven states funded, three large cities and, on top of that, three local health departments. Does that answer your question, Wisconsin? UNIDENTIFIED SPEAKER: Kind of. TOM LACHER: Well, consider it this way, consider the umbrella an information technology umbrella with one of the ribs being INPHO, another rib being INPHO II, another third rib being Health Alert Network, all supporting an umbrella of information technology. UNIDENTIFIED SPEAKER: Okay. TOM LACHER: Okay. JUNE HOLSTRUM: Thank you, Tom. TOM LACHER: Okay, June, I have to ring off now. If any of you have any questions in the future, be sure to share my name and e-mail and we'll be happy to talk with them. JUNE HOLSTRUM: Thanks, Tom. We appreciate your joining us. Has Irene been able to join us since we started? IRENE FORSMAN: I'm here. JUNE HOLSTRUM: Good. We'll go back to you then, Irene. Tell us about the new cooperative agreement. IRENE FORSMAN: There were forty-five applications and twenty-two states have been funded. There are a number of disapprovals, but there are also a dozen or so that are approved and not funded because we ran out of money. But let me just go through the list, and I'll try not to go too quickly: Rhode Island, Iowa, Colorado, Alaska, Hawaii, Illinois, Ohio, Utah, Louisiana, Kentucky, New York, North Carolina, New Mexico, Massachusetts, Georgia, North Dakota, Idaho, Wisconsin, New Hampshire, South Dakota, Minnesota, South Carolina. Now, we're hoping that we're going to get some more money in, that we'll have another round next year, but there are no funds in the President's budget this year over and above what we have for continuation. We're in the throws of preparing the HRSA preview, which is our version of the federal register. The newborn screening announcement has been withdrawn because there are no new funds identified at the present time. If it comes along later, we will do something, probably a real federal register notice. Are there any questions? UNKNOWN SPEAKER: You went through the states too fast. I got lost in Hawaii. KARL WHITE: Actually, Irene there is on our web site a list of those states and the principal investigator for each grant. IRENE FORSMAN: Okay, good. JIM POTTER: Irene, this is Jim Potter. Is information available on the approximately twelve that were approved but not funded? IRENE FORSMAN: No, I'm afraid not. JIM POTTER: Okay, thank you. RON CALDERONE: Excuse me, Karl, when you were speaking earlier, this is Ron Calderone from Rhode Island. Karl, do you want an abstract or do you want our whole grant? KARL WHITE: We would like the whole grant. RON CALDERONE: Okay. KARL WHITE: Actually, I was going to get back to you on that. Yeah, so we will lift the entire grant after you take out any proprietary or budget information. CINDY INGHAM: Irene, this is Cindy in Vermont. I was wondering if there is a new funding cycle, if those states which were approved but not funded would get priority and if they would have to resubmit or if they would automatically be funded? IRENE FORSMAN: Well, I tell you what, there is a clause in the letter which you may have seen in the past that says that anybody that's approved but not funded may remain in the competition for a year with the same rank score or they can submit a new application. I think that if I were in that position, I would certainly look at the reviewer's comments and try to sort of beef up the application to get a higher score. CINDY INGHAM: Thank you. IRENE FORSMAN: Okay. JUNE HOLSTRUM: Thank you, Irene. Anymore questions for Irene? UNIDENTIFIED SPEAKER: How much are each of those grants? IRENE FORSMAN: They're between $100,000 and $200,000. JUNE HOLSTRUM: Our next speaker is Marty Wolfson, and he's going to give us some information about Web-based tracking systems. Marty? MARTY WOLFSON: Good afternoon. Thank you for inviting me, June. I'm actually speaking in behalf of Pam Atkinson, who is enjoying her son's wedding in Australia, and I was asked to talk today about Web-based tracking systems. What I would like to do is basically provide a short tutorial where the Web technology has emerged to at the present time. Web-based technology has experienced a maturing process, whereas today the use of Web-based systems are more applicable to handle the performance and security concerns affecting the transmission and reporting of patient medical information. Web-based tracking systems are made up of the following components: access, security, input, reporting, and query. Access, as you know, is provided by attaching to what they call an ISP, or an Internet Service Provider, and is usually available within the individual state systems or through a variety of private sector services like AOL. A browser like Netscape or Microsoft Explorer are used once the connection is made to navigate the Internet. A standard set of protocols (address names) is used to locate an Internet URL or, as we all heard today, the various web site addresses. At this point, anyone in the universe can locate and access an Internet site. The most important thing now is how far has security come where everybody is now competent where they can access a site and transmit and receive medical information. At this point, elaborate security systems can be invoked. In the event a state-supplied ISP is provided, passwords and pin numbers can be used to admit an authorized user to the URL site. A similar schema can be using a private sector (public available site) ISP. The information being sent from the individual's computer to the ISP can be encrypted so as to prohibit the password and pin from being intercepted and decoded. Once at the state's information data system site, additional passwords and pin are required to access a specific application. For instance, newborn screening, birth registration, immunization, hearing screening and intervention, registry systems (like malformation or prenatal), death registration systems, et cetera. Based on the password and pin, license numbers, et cetera, the individual can either select an application or be directed to an application for a specific activity. This activity could be data entry, data retrieval, data editing, data reporting. The next level of security is then invoked called digital certification. This is the real new technology that has emerged just recently. What this allows you to do is this is a new technique that can be purchased from the private sector and embedded into a statewide set of applications. The way the system works is the sensitive data, like patient information and test results and outcome data, is first encrypted and then the key is sent to the private sector. The encrypted information without the key is sent to the user or to the state system requiring the data. The private sector then forwards the key to the authorized recipient where it's recombined to produce the complete data set. This new technology makes it feasible now to implement the passing of medical-sensitive data without developing internal costly security firewalls. Relative to the input, the application software presented on the Web uses standard Graphical User Interfaces for entry and validation. In addition, the users can have access to extensive current libraries and data sets from other systems like TIGER, GIS codes, special spelling checkers which are widely used in birth registrations for improved data validation. These libraries can easily be integrated to ensure accuracy and validation while inputting data. In addition, data gathering can be directed to the most knowledgeable user, whether it is a nurse, attending physician, medical registrar, et cetera. Also, version control and updating of data elements can be made instantly and telegraphed immediately to all users. Paper forms and form revisions as currently implemented are now eliminated. Reporting, based on the security noted above, reports, letters, and notifications can be distributed via the Web using e-mail or published on a secure web site. Return receipts are automatically logged and audited. The application software can contain a detailed decision tree for extensive notification and reporting schema using the application's availability of shared libraries. Query: the Web-based application allows secure users to query the application database or the state's warehouse of data-specific needs. Ad hoc report generation tools are provided in a user-friendly Web environment for online report generation. Downloads of specific data sets can also be made available for report generation on the individual's computing system. Variable data formats and industry standards like HL-7 can be adopted for data transmission on the Web. Benefits: with an emphasis on integrated data systems for sharing and warehousing of common data sets between programs, Web technology offers the following: It provides the ability to design application-specific programs with unique business rules while sharing the data elements in a state-designated warehouse. It allows a diverse community of practitioners, service providers, and service coordinators to obtain and share more accurate information. It improves turnaround time for follow-up and intervention. It lowers the cost of communications compared to mail, phone, or other electronic communications. It's available 7X24 hours every day. It allows for centralized use of resources for follow-up and intervention at the state level. It provides a lower cost for software maintenance and upgrades. That should do it. Any questions? UNIDENTIFIED SPEAKER: Is that item going to be anywhere available so if we didn't catch the whole thing over the phone, we can get back to it? It would be helpful to have that for future reference if that's already sort of written up. MARTY WOLFSON: Yes, it is all written up. UNIDENTIFIED SPEAKER: Is there a place where we can tell you where to fax it or -- MARTY WOLFSON: Absolutely. Let me give you my e-mail address. It's mwolfson@neometrics.com. RICHARD MILLER: This is Richard Miller in Wisconsin. Can I ask you a question? Do you site a Web-based query system that's in the (inaudible) being purchased? MARTY WOLFSON: Well, right now there are a number of Web-based query systems. Most of them have been developed specifically for unique applications in the business world, but I can get that information to you in terms of what's available in the general arena if I could have your e-mail address. RICHARD MILLER: I'll send you a note. Thank you. UNIDENTIFIED SPEAKER: Marty, I didn't catch where you are from, where you work. MARTY WOLFSON: I work at a company called Neometrics, Incorporated. UNIDENTIFIED SPEAKER: And there's a phone number there? MARTY WOLFSON: 1-800-645-3616. UNIDENTIFIED SPEAKER: Thank you. JACKIE CUNDALL: Marty, this is Jackie Cundall in Tennessee, and we use Neometrics in our metabolic screening and we plan to incorporate our hearing screening into that system. Do you work with that piece of the Neometrics? MARTY WOLFSON: Yes, we do. Matter of fact, we were just talking to Lee Fletcher yesterday regarding some of the specifications. JACKIE CUNDALL: Well, we're working hard. JUNE HOLSTRUM: Thank you, Marty. Any other questions for Marty before we go on?
Next we would like to hear from one of our states that maybe has some practical information from a state perspective.. So we'll go to Garland Land in Missouri. GARLAND LAND: Hi. Missouri is one of the INPHO states that Tom had referred to earlier, and we are one of the states that is looking into the idea of integrating information systems. We, like most states, have supported many different categorical systems for many years based upon those given to us by CDC or those that we developed. There are really two different approaches. One is to try and link these systems together in some way and the other approach is to scrap those systems and go to a new system which integrates the data into a single database. We've chosen the latter approach, which is the more difficult approach than just trying to keep single systems going and linking them. What we have found in our analysis stage is there are three different functions that go on in the health department. One is surveillance, which relates to communicative disease, STD, HIV, lead, TB, all the notifiable diseases. The next functional area is regulation which includes many different things, hospital licensing, home health, child care, emergency medical services, and so forth. And then our third functional area is what we have termed health management which is basically the personal service delivery system in the Department of Health and our local health agencies. We're developing a system for all three areas. I'll just briefly talk about the health management area which pertains most to your subject here. Our health management area is built upon a single record for an individual. So if the individual is receiving services from multiple programs, then all that data is tied together. It's tied together through a single numbering system which happens to be the same numbering system which our Medicaid agency uses and our TANIF agency uses. So we have a direct link now between the Medicaid data and TANIF data, food stamps, all of the data that's within the Department of Social Services which is a separate agency from the Department of Health. We've started building our system around our immunization registry. We populate the system with our birth records and then add immunization histories to that. We load Medicaid immunization encounters. We also load commercial managed care encounters into that database. We have expanded the system to include family planning encounters and now we are in the process of expanding it to include all of our case management activity in the Department of Health, which is a wide variety of programs, not the least of which are special health care needs, head injury, and what we call First Steps. We're now looking into developing a Web-based system as was previously described that will be the basis for our birth record. The birth record will be created through the World Wide Web, and the newborn screening and newborn hearing information will be built around that single system, that data is still part of the same database for the immunization and everything else that was previously described. So we will have a single database for all public health encounters so that the information can be shared across programs if allowed, based upon certain confidentiality rules. Those have to be very stringent, but if there is permission to share, then the data that comes through from the hospital to the lab can be shared with special health care needs or any other program that needs to have the information for follow-up purposes. So we're deeply immersed in this system. We haven't started the birth record system. Let me just stop there and see if there's any questions. MARTIN LAUER: Yeah, Martin Lauer from the Oregon Health Division. How are you going to link the newborn hearing screening information? Who is going to be answering the information, where, when, what format? GARLAND LAND: We haven't done any of the analysis on that yet. But, the data would be coming from the hospital entered through the Web-based system. UNIDENTIFIED SPEAKER: Garland, do you have some description of what you have done that's available by e-mail or on the Web? GARLAND LAND: Yes, there's been a couple of descriptions. There was a paper that was published in the journal of Public Health Management several years ago and then there is a description that was in the Lewin Report. If you'll send me an e-mail, then I can give you the documentation. I'm in the process right now of writing our whole story up. There's an informatic book that is being developed through the sponsorship of CDC and we're going to be a chapter in that book that will describe our experience of how we went about developing this. So that will be a much more comprehensive description than these two documents that I have right now. But for anybody interested, my e-mail address is landg@mail.health.state.mo.us. AUDREY (INAUDIBLE): Garland, this is Audrey (inaudible) from the State of Vermont. I'm wondering, you mentioned you also used some commercial systems. Would one of those be OZ or the HI*Track? GARLAND LAND: No. When I mentioned commercial, I was talking about the commercial managed care. We get commercial managed care data for immunizations. The system that we have designed is being designed in-house either with my staff or with contractors that we brought in to assist us. It's a homegrown system to date. We may be contracting out the birth system and the newborn hearing screening. AUDREY (INAUDIBLE): Thank you. JUNE HOLSTRUM: Anymore questions for Garland? (NO RESPONSE) If not, we'll go on to Rhode Island. Amy Zimmerman is going to talk about the Rhode Island system. [Amy asked that her presentation not be included in the transcript but said if anyone wanted more information, please contact her (mailto:(AmyZ@doh.state.ri.us) or Ron Calderone (mailto:(ronc@doh.state.ri.us) JUNE HOLSTRUM: Do we have any other questions? And before we close, are there any last comments, questions, or announcements from anyone listening? JACKIE CUNDALL: This is Jackie in Tennessee. I was just wondering -- A question for Karl if he's still on the line? Are there some specific plans for technical assistance for states or is it really aimed at just what we think we need? I didn't really hear any specific kinds to be offered. KARL WHITE: Yeah, the specific plan is that the person who is the network person in your region -- So Faye should be contacting you and there are -- we wanted to target technical assistance needs to what states needed rather than trying to decide ourselves what they needed. So that runs a gamut from helping you do workshops for hospitals or for state-level people, to providing you with materials, to helping design needs assessments and evaluations. We are collecting various materials that various states have used, and a part of our role is to act as a clearinghouse to share information with other states from what people have already been doing. Does that answer the question? JACKIE CUNDALL: Yes. KEN ROSENBERG: I have a quick question. I came on late. If this has been answered, somebody else can fill me in. Was there an update on what's going on with CDC's decisions about their priorities for (inaudible) money? JUNE HOLSTRUM: The RFP should be out this week. It should be in the Federal Register. As soon as we get word that it's actually in the Federal Register, we'll be putting it on our web site and I'll send an e-mail or fax to everyone on our list so that they'll know that it's available. You can just keep checking our web site. UNIDENTIFIED SPEAKER: Can you give us the tentative due dates that you announced earlier, too? JUNE HOLSTRUM: Sure. The Letter of Intent will due June 6th, and then the application is due July 6th. Funding will be sometime in September. That's our program for today. Our next meeting would be July 4th, but that might not be a good time. So we'll switch it to the next week which will be July 11th. Again, thank you for joining us and we'll talk to you in July. Bye-bye. |