Efforts to develop an evaluation plan have also served as a starting point for program implementation. The pneumonia and influenza death rate reduction for Native Americans in New Mexico initiative has since met with and garnered support from the Albuquerque Area Indian Health Services Immunization program, Managed Care Organizations, Johns Hopkins University, NMDOH Public Health Division’s Immunization program as well as members of tribal communities in the affected areas. New Mexico passed legislation in 2017 that requires hospitals to ask and offer the pneumococcal vaccine to patients aged 65 years and older prior to discharge.