SUMMARY OF DISCUSSION - AVSS TAG MEETING
Sacramento, California
June 13, 2002

1. Introduction By Attendees and Opening Statements.
   
   A. Review of summary from December 5, 2001 TAG meeting. Note: TAG summaries are available on the Web at: http://www.avss.ucsb.edu/tag.htm
   B. Ron asked meeting participants to update contact information on the member roster, which was distributed in the meeting packet.
   
   2. Version 4.11 Update.
   
   A. Version 4.11 Release Notes were distributed at the meeting. 4.11 is the name for the 2001 version, but it was released in 2002.
   B. A significant change in Version 4.11 was reported. Version 4.11 changed the parameters for passwords. Passwords must now have at least seven characters, contain both alpha and non-alpha characters, and at least one non-alpha character must be embedded within the password (e.g. REMBR9/11).
   C. This is the first time that e-mail was used to distribute an AVSS update. Some counties received updates via e-mail, while others received updates via disks. Please check e-mail addresses for accuracy to ensure timely distribution of the next update.
   
   3. AVSS Modification Requests (AMRs): Review and Discussion.
   
   02-002: Danita Wallace of Los Angeles County presented her request to use ICD-10 codes for the underlying cause of death (UCOD). The new codes as well as their descriptions would need to be added in AVSS. After discussion, meeting participants agreed this AMR needs further research. Efforts are underway to acquire a computerized file of ICD-10 codes. Participants were advised that use of different coding structures could make longitudinal research projects more difficult, but Mike Rodrian noted that NCHS has developed a conversion table to link ICD-9 and ICD-10 codes. Los Angeles and Kern counties agreed to be beta test sites for this AMR.
   
   02-007: Dan Peak of Sacramento County presented his request to reincorporate the test certificate into the LFN ASSIGNMENT under the DEATH CERTIFICATE option. Meeting participants agreed this AMR should be implemented in the next release, but will be available upon request to Ron before then, on an individual county basis.
   
   02-019: Danita Wallace of Los Angeles County suggested that the LIST TO BE SENT TO HEALTH DEPARTMENT be allowed only for non-remote (dial-in) hospitals (AMR 01-066). This AMR was implemented in Version 4.11. Danita now asks for additional changes to require a warning to ensure that hospitals again add birth records to LIST TO BE SENT TO HEALTH DEPARTMENT when PROCESS REGISTRAR REFUSED RECORDS is used.
   
   02-022: Danita Wallace of Los Angeles County suggested that LIST TO BE SENT TO HEALTH DEPARTMENT be modified to allow selection of the record by file number, in addition to the current selection by name. It was also suggested that this change would make the OLD LIST TO BE SENT TO HEALTH DEPARTMENT function unnecessary and therefore, it could be deleted. Both actions in this AMR were approved and will be implemented in the next update.
   
   4. AVSS Technical Assistance.
   
   A. Ron Williams distributed a table displaying amounts paid by each county in 2001 to UC Santa Barbara for AVSS technical assistance.
   
   B. Anita Zachery of Los Angeles County requested that UCSB subdivide Los Angeles County’s technical assistance charges into three trimester invoices, rather than a single, annual invoice. Ron Williams agreed to this arrangement.
   
   C. Ron Williams requested comment on the invoice letter to county Health Officers for technical assistance charges for FY 2002-03. A suggestion was made that a statement be included in the letter indicating that these costs may be paid from VRIP funds, if the county has established a VRIP account pursuant to Health and Safety Code §103625.
   
   D. Ron Williams noted that the AVSS project encourages users to request assistance by using the AVSS Online Help Desk at http://help.avss.ucsb.edu/ . He advised meeting participants that the Online Help Desk can also be used for submitting AMRs. In response to a question about hospital access to the Online Help Desk function, Ron said that all users, including hospitals and counties, can log job tickets, and counties can view hospital-submitted job tickets.
   
   5. The Future Of AVSS.
   
   A. Ron Williams is planning to continue working with AVSS on a part-time basis, beginning July 1, 2002. It was reiterated that the long-term plan is to have OVR assume the major responsibility for AVSS, but due to State funding shortfalls, implementation of the next steps in this plan (hire UCSB AVSS staff as state employees) has been postponed until July 2003.
   
   B. Funding for State Fiscal Year 2002-03 was discussed. Ron Williams noted that AVSS will continue to look to local registration districts for reimbursement to UCSB for annual AVSS technical assistance costs, and UCSB will continue to assess AVSS license fees. These amounts will remain at FY 2001-02 levels. Mike Rodrian noted that, for FY 2002-03, State funding for AVSS will come through the Center for Health Statistics’ budget, rather than through Maternal and Child Health Branch. He noted, too, that the funding amounts will remain at FY 2001-02 levels.
   
   C. Mike Rodrian observed that AVSS is now considered a critical State system.
   
   D. Mike Rodrian noted too that pending legislation to require DHS to operate an Electronic Death Registration System is the next step in development of a completely automated vital statistics system. He also commented on pending legislation addressing privacy and confidentiality of vital records.
   
   E. Ron Williams updated the meeting participants on activities to modernize the AVSS computer architecture using the Internet and the AVSS/NET pilot project in Merced County. Ron spoke about efforts in Ventura, Humboldt, San Luis Obispo, and Santa Barbara to implement AVSS/NET in those counties.
   
   F. Joe Quintanilla of Orange County asked about timelines for converting counties to AVSS/NET, with specific reference to Orange County due to their use of a VAC system. Timelines are still under development, and Ron reported that technical research would be needed because he has not converted any VAX systems to an AVSS/NET database.
   
   6. Birth Certificates.
   
   A. Alan Oppenheim reported that he met with staff of the Office of the State Printer (OSP) to discuss methods to improve consistency in production quality for birth certificates. The underlying issue is that printed sheets of birth certificates have been cut in slightly varying paper sizes, and that variation causes alignment problems when the birth certificate is run through a computer printer. OSP agreed to improve consistency in paper cutting and to move perforation line down 1/8 inch on the certificate to allow more room for the BAR code.
   
   B. In response to a question from Mike Rodrian, Ron Williams indicated that AVSS/NET currently does not print the birth certificate form, but rather, will print the birth certificate data. It was suggested that a long-term goal should be development of systems to allow concurrent printing of forms and data on archival paper, as a way to eliminate reliance on printed birth certificates.
   
   7. Death Certificates.
   
   A. Mike Rodrian reported on recent activities regarding the Death Certificate revision project. A draft of the revised certificate has been forwarded to users for comment. CHS has decided to retain a one-page document and not use a two-page document. CHS has also decided to retain standard letter size paper (8 ½ x 11 in.), rather than legal size paper (8 ½ x 14 in.).
   
   B. Pending legislation would add three items to the certificate – information on 1) whether the decedent was pregnant at the time of death, 2) whether smoking contributed to the death, and 3) whether the decedent was homeless. Concerns have been raised about public records availability for death certificates that contain information on pregnancy status. Current CHS plans call for use of the revised death certificate to begin January 1, 2003, but exact scheduling will depend on the outcome of pending legislation.
   
   C. Alan Oppenheim indicated that CHS intends to continue to offer a $1.00 per certificate reimbursement for entering death information into AVSS, but availability of funding for those reimbursements depends on the adopted budget bill.
   
   D. Meeting participants were reminded that Release 4.11 has added an option that allows fetal death data to be added to the AVSS database by means of the FDC form.
   
   8. Confidential Morbidity Report (Discussion Led By Mark Starr: See attached CMR Topics).
   
   A. In response to an inquiry, Mark Starr advised meeting participants that Division of Communicable Disease Control would comply with requirements to not collect race data, if an initiative adopting that requirement were passed.
   
   9. Birth-Infant Death Matching.
   
   A. Ron Williams explained the automated birth-infant death matching process in AVSS and indicated that the number of matches should be improved. He offered recommendations and suggestions on actions LRDs could take to increase the number of matches, including if an LRD receives a death certificate for an infant, then determine if a birth certificate should have been submitted or if a fetal death certificate would have been more appropriate. He also commented that actions to find matches should be undertaken in a timely manner, so that birth certificates can be filed within the one year statutory timeline. OVR will develop policy and instructions on how to revise a death certificate to a fetal death certificate, when appropriate. This topic will probably be included in 2003 annual OVR workshops.
   
   Acknowledgement: This summary was written by Jessica McCarroll.

Updated July 10, 2002 by RL Williams
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