1. Introduction by attendees (See attached).

2. Opening statements by Ron Williams.
A. Review of minutes from November 12, 1996 TAG meeting.
B. Activity status review, site contacts.
C. OVR Workshop, concepts of interdependency.
D. Review LRD quality control procedures, esp. duplicates
E. Explains AVSS AMR factors, stress consistency and standardization.

3. AMR review and discussion.
96100: Deborah Martin to follow up. LRD's are divided (Pro=C19,C37, Con=C01,C24).
96118: Not discussed. Option #2 has been implemented with SENTDMR.
96130: C37 wants this to keep their data clean. Rod Palmieri: This needs further discussion, will look into it.
96138: Rod Palmieri: Rescinding POP form does not remove name from certificate; a court order is needed.
96143: OK to implement, check field 30 also.
96148: Get this information from another source. Withdraw.
96150: OK to implement, separate POB and COD input checks.
96151: OK, see 96150.
96153: OK to add comment field (length=255); uses explained by Gail Gannon, Peaches Grant, Claudia Favors.
96154: OK, see 96150.
96160: OK, Rod Palmieri approved removal of both entries.
96162: OK, Peter Chen provided additional values; consensus was to remove current abbreviations and use full text.
97004: OK, C19 submitted original request.
97009: OK, easy to do.
97010: OK, Peter Chen explains.
97011: OK to update even though we aren't currently using this information.
97014: OK, affected sites already updated, Peter Chen explains. Note: 27C and 27F should also be checked.
97105: OK, Peter Chen explains.
97016: OK, Peter Chen explains, affected sites already updated.
97017: OK, Peter Chen explains leading digit of LFN format.
97018: OK to implement both changes, John Marinko explains.
97020: OK, needed for AIDS surveillance.
97024: OK, Peter Chen explains.
97027: OK, Ron Williams explains, difficult but high priority.
97028: OK, John Marinko explains, minor report fix.
97030: OK, Peter Chen explains, check all other standard reports.
97034/063: Peaches Grant gives background history, Stanley Bissell reviews year-end processing problems, Pat Anderson wants to send CDC notification to DCDC, Larry Portigal explains LA system. OK to implement, John Williamson: add appropriate DMR reports, Ron Williams suggests the state host an AVSS-CMR meeting in fall.
97042: Peaches to send list of problematical diseases to AVSS. Status=pending.
97044: Alan Oppenheim explains. OK to implement. Pat Anderson reminds that a supplemental name report must be issued by LRD for no name births.
97045: Postpone, Status=pending.
97046: Postpone, Status=pending.
97047: Withdrawn by Les Fujitani.
97048: John Marinko explains, OK to implement.
97049: Ron Williams explains, OK to implement.
97056: Peter Chen explains, OK to implement.
97062: OK to implement as a warning. Hard edits require state mandate. Note that DATDX may be < DOB for newborns.
97064: Ron Williams gives background, John Williamson: Serotype determines level of follow up. OK to implement, waiting for finalized list. John Williamson to send list to all LRDs.
97065: OK, See 97034.
97066: Problem: OUTDIS not being used properly. Need procedure information for handling outbreaks. Status: training issue, withdraw.
97067: Training and guidelines needed, status=pending, discuss at AVSS-CMR meeting.
97068: Ron Williams: difficult to select right date, withdraw.
97070: Rod Palmieri: The paper rules, need examples of problem. Status: pending.
97071: OK, Peter Chen explains.
97073: OK, Liz Touhey explains.
97075: Ok, Peter Chen explains.
97077-97088: OK: approved by a large majority vote but with three nays (see discussion immediately below).

Lunch Break

4. EDRS Status Report
Deborah Martin: AVSS and JK Systems to do simultaneous pilot project with system evaluation to occur next year.
AVSS to be piloted in Santa Barbara, JK in San Bernardino.
Rod Palmieri: Who does the AVSS-EDRI development and what will the development impact be?
Pat Anderson: What is the time frame?
Alan Oppenheim: Background information and system requirements. Draw information directly from funeral directors, electronic Cause Of Death. Most challenges relate to the number of parties involved.
Margaret DeLano: Concerned about system they already developed, foreign import
Rod Palmieri: Import/export necessary, must handle partial participation, must be able to print the death certificate at any point in the process. Normally funeral director does print cert. Electronic signatures? Not yet.
Deborah Martin: 50% - 70% total electronic collection is a reasonable goal. Incremental implementation.
Ron Williams: History, funding issues, fits within current workload, seeking TAG support to program related AMRs.
Mary Ellen Garcia Green: Local support structure necessary, technical support to hospitals/funeral dirs is important.
Margaret DeLano: Fax authorization: will there be statewide access? Fax reg: no cost to county as it would be subsidized by the state.
Mary Ellen Garcia Green: Their funeral directors are very interested.
Deborah Martin: Quality of data should increase. CFDA could provide funeral dir support.
Rod Palmieri: Legislation exists for no-cost fax registration. Need to account for electronic and non-electronic records.
Alan Oppenheim/Mary Ellen Garcia Green: Anticipates an evolutionary process (step by step).
Rod Palmieri: If state funding used, they expect electronic death records to be submitted to the state in return.
Deborah Martin: That was not discussed by EDRS committee.
Margaret DeLano: Their system uses OCR with visual error correction, also collects additional information.
Claudia Favors: Fresno has a coroner system that interfaces with AVSS. Counties should have a choice as to whether they wish to participate or not.
Ron Williams: Outline tentative timeline, if funding is available in time, install by 1/98, evaluate summer 98.
Deborah Martin: Peter Abbott has money for EDRS for equipment.
Rod Palmieri: Wanted pilot sites of comparable size.
Ron Williams: Suggested C42: 7 mortuaries, ~2500 deaths/yr. Also good staff capability, admin structure, proximity.
Alan Oppenheim: Also need at least 1 hosp in pilot.
Les Fujitani: How does the paper vs the electronic information movement compare?
Ron Williams: Review AVSS procedure proposal (pg 43). Suggest a drop box at health dept.
Margaret DeLano: Can't endorse AMRs without consulting her superiors.
Yuba County (Cheryl McBride?): This project is of high importance.
Deborah Martin: Not all LRD's use all AVSS features, the same would be true of EDRS.
Rod Palmieri: 24 hour fact of death notification coming within several years. EDRS is a pro-active plan in anticipation of this within the next 5 years.
Peter Crowson: Is using county funds fair for JK? Process not open since they're not here.
Ron Williams: This forum constitutes the most open process available.
Rod Palmieri: AVSS and JK were asked for a pilot budget but the responses are confidential. State money is available to AVSS and JK.
Ron Williams: AVSS Project has not received a budget request for a pilot.
Pam Isaac: TAG's charge is to evaluate and advise regarding AMRs.
John Moehring: The EDRS-related AMRs are worth pursuing, time investment is worthwhile, TAG forum is valuable.
EDRS AMRs were endorsed by a majority vote, but with three nays; Peter Crowson requested his nay to be recorded.

5. Birth Certificate Form Problems
Alan Oppenheim: 650,000 bad certificates were printed, 100,000 were sent out to 14 LRDs.
State Printing Office notified, 750,000 new ones were printed.
Quick problem resolution, state will accept any problem certificates submitted.
Rod Palmieri: OVR will not reject any of these certificates based on print problems.

6. Microfiche Problems
Alan Oppenheim: 12 pitch font not recording properly at Yolo, Tulare, Napa.
Factors: Printer age/quality, fiche reader quality, using copy/original.
Solution: Update printer or temporarily use non-bold font for problem hospitals and test.

7. Birth-Death Matching
Ron Williams: Review process and results, automatic matching installed.
Margaret DeLano: Fetal death matches? No.
Pat Anderson: Reallocations: Yes, except for non-res/non-occ.
Ron Williams proposed to add LFNDC to CBC file and LFNBC to CDC file.
Margaret DeLano: DC without matching BC? Yes, refer to listing reports.
Les Fujitani: What is cohort base? Answer: all deaths during a specific time period are matched to live births.
Ron Williams: The only (few) false matches occurred as a result of insufficient twin information.

8. Confidential Morbidity Report
John Williamson: New form being developed, current card hard to fax, hard to get consensus for new form.
Guidelines: Start with core items then add extensions, basics=STD,TB,Hepatitis.
Many fields are not being used, need to rethink the basics, need more input.
CMR requirements change constantly.
Use: AVSS feeds data to UNIX server, case mgmt, vaccine program, NETSS for CDC. Export into other systems for separate surveillance programs.
Next step: GUI interface, possible Internet access (i.e. Oregon).
INPO: Program to strengthen public health infrastructure.
Electronic lab reporting: to the state, distributed/centralized? Integration with county systems?
Pam Isaac: What about surveillance redundancy?
Peaches Grant: Coming changes? No major changes for this year, proposed form available soon.
Ron Williams: AVSS was not designed to be a case mgmt system; consensus building is necessary.
Pam Isaac: What should be done for year-end processing problems?
Margaret DeLano: Use WPR annual report and missing LFN report for year-end cross check.
Public health nursing interested in quality data.

9. Year 2000 Processing/Computer Systems
Ron Williams: AVSS is expected to work in Year 2000 with no changes, but LRDs should test.
Gail Gannon: Interested in export/connectivity/compatibility, have their own system for PH aid.
Jerry Sharp: Explains dual computer setup (1 for collection, 1 for backup/analysis: could be used to test YR 2000).

10. Hardware/Arnet-Digi Boards
Ron Williams: Buy Arnet spares if possible. Digi to put out new boards soon, but MSM upgrade may be necessary.
Advantage of mirror system as in San Bernardino; Humboldt problems; Santa Clara problems. Review equipment list.
11. Bar Coding
Deborah Martin: Working well, time saver. Scanner price down to about $205.
Ed Hernandez: Bar code generation problem: reverse printer feed.
Larry Portigal: Works well with occasional shadowing, lines, printer problems --- try replacing cartridge.

12. Census Tracting
Workshop postponed until fall. Ron Williams combined funds to get CT data for the smaller counties.
Margaret DeLano: Try not to use planning department: poor data.
Les Fujitani: Check CBC tape for correct census tract data.

13. Technical Assistance Status
Ron Williams: Review. TAG: LRDs would like automatic invoicing 3rd quarter for following year.

14. Internet
Ron Williams: Discussed AVSS home page, resources, electronic AMR submission.

15. Birthnet
Rod Palmieri: Will submit AMR for blank form printing of certificates.
Alan Oppenheim: CHS providing training for Birthnet access.
Rod Palmieri: Health officer approval needed for security access.
IZ export: Larry Portigal using County CBC Tape export. Also C36.
New law allows IZ DB creation from BC.
Consent form not needed, but parents need to get a disclosure statement.

16. New Business
Rod Palmieri: 60 day recession of POP form does not imply name removal, only POP form removal. Name removal requires a court order.

Updated June 24, 1997 by RL Williams
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