IZ Section

Resources

Please remember that the PHEP-IZ Deliverables are due by the 15th each quarter to PHEP. These deliverables are submitted within the Progress Report for each quarter.

Below are resources to refer to for each deliverable. For questions, please contact 406-444-5580.

2024-2025 Immunization-PHEP Deliverables

IZ1: Off-Site Vaccination Clinics (Due Every Quarter). Optional tracking spreadsheet available here: IZ1 Worksheet. Report every quarter, even if you conducted zero off-site vaccination clinics. 

IZ2: Vaccination Partners & Communication (Due Every Quarter). Optional tracking spreadsheet available here; IZ2 Worksheet Report activity every quarter, even if you report zero. 

CM1: Off-Site Point-of-Dispensing (POD) (Due Any Quarter)

  • The Checklist for Best Practices for Vaccination Clinics Health at Satellite, Temporary, or Off-Site Locations (Due Any Quarter) REQUIRED
  •  Report Total Vaccinations Populations Groups (Due Any Quarter) REQUIRED

Checklist for Best Practices for Vaccination Clinics Held at Satellite, Temporary, or Off-Site Locations

The Checklist for Best Practices for Vaccination Clinics Held at Satellite, Temporary, or Off-Site Locations Guidance: Use the checklist to ensure protocols and best practices of an off-site clinic are being followed. The checklist may highlight any gaps in the planning stage or assist in strengthening processes already in place. This tool should serve as a best-practice guidance resource, however, in some cases an item on the checklist may not be feasible to attain or applicable to your jurisdiction. We are asking jurisdictions to simply be aware of the "stop signs", if any are marked. Once complete, the checklist will be uploaded as part of the Progress Report. Jurisdictions can complete the checklist by hand and scan/upload the document into the Progress Report or fill the checklist out electronically and upload the completed version.
Population Group Screening Questions and Reporting of Aggregate Totals Guidance: Vaccination Population Group Screening Questions.
Option 1: Indicate if you fit into one or more of the groups below: (check all that apply)
  • Pregnant woman
  • Infant or toddler 6-35 months old
  • Household contact of infant <6 months old
  • Person aged 3-64 years old who is at higher risk for influenza-related complications (for the
  • vaccine-preventable dieses(s))
  • Person aged 3-64 years old not at higher risk for influenza-related complications (for the vaccine preventable disease(s))
  • Adults 65+ years old



Option 2: Determine vaccination population group screening questions specific to an off-site vaccination clinic.
Screening questions may be entirely unique or be a combination of unique screening questions and some of the groups found in Option1. There must be a minimum of 3 screening group questions, and they may not all be age defined. 

Examples include but are not limited to:

  • Person experiencing homelessness
  • Person reporting history of injection drug use
  • Person currently in a correctional or transitional setting
  • Person is a refugee


When you audit your patient intake, total each of these categories for reporting purposes.

Upload a document that outlines the population screening group questions and the number of persons that fell into each group.

Please remember that your IAP deliverable attachments are due on or before the 15th of each quarter.  Please remember that we now use Formstack and all deliverables are submitted that way.  If you are still having issues, please don’t hesitate to call 444-1613 or e-mail kgrady@mt.gov.

Attachment A: 24-25 IZ Clinic Information-Attachment A - Formstack      

Attachment B: 24-25 IZ WIC Collaboration-Attachment B - Formstack   

Attachment C: 24-25 IZ Quality Improvement-Attachment C - Formstack

Attachment D: 24-25 IZ Promote Partnerships-Attachment D - Formstack    

Attachment E: 24-25 Complementary Immunization Partners- Attachment E - Formstack

Attachment F: 24-25 Childcare Progress Review-Attachment F - Formstack