The Immunization Unit at the Texas Department of State Health Services (DSHS) and the University of Texas Southwestern engaged ISF to study and analyze the Texas Vaccines for Children (TVFC) and Adult Safety Net (ASN) programs. ISF conducted an analysis of the cost effectiveness, administration processes, access to services, accountability metrics, and potential options for expansion of the programs. ISF worked closely with providers in various regions and with stakeholders in the Immunization Unit to summarize the current structures in place and identify barriers, streamline processes, and encourage growth within the programs.
TVFC and ASN providers across the state are required to meet various standards, metrics, and program goals in order to receive and maintain inventories of vaccines, and report status to the state. The Unit sought details of how to ensure buy-in from the providers while also achieving the accountability necessary to ensure vaccines are reaching Texas citizens efficiently.
ISF conducted an analysis of the current state of the two immunization programs, worked with leadership to determine the desired outcomes and future goals, developed profiles of the providers, and analyzed each program. Key challenges and areas reviewed included the following:
- Accumulation of immunization data
- Inventory management
- Human capital
- Financial, time, and other resource investments required to participate in the programs
- Efficiencies and effective business processes
- Change management practices and stakeholder communication for new metrics and processes
- Expansion of provider participation
In addition, ISF conducted an online survey for providers who dropped out of the programs because the requirements were too onerous. Based on this research, ISF developed a final report that addressed the following key factors:
- Cost effectiveness and quality of the program
- Administration process for DSHS and participating providers in the program
- Ability to expand the number and types of providers in the program
- Access to program services for eligible individuals and can it be expanded
- Options and mechanisms for including stakeholder feedback in the program
- Mechanisms for accountability in the program
ISF provided an evaluation of the various processes and requirements related to the immunization programs and their impact on providers and other stakeholders, analyzed the overall cost effectiveness and quality of the programs, identified the factors that discouraged participation, and provided specific observations to be used by the Department to make improvements across both programs.