VACCINE FOR CHILDREN (VFC) PROGRAM Tennessee Robert H. Brown Vaccine For Children Program Manager 2010 Annual Immunization Spring Review 13-16 April 2010

VACCINE FOR CHILDREN (VFC) PROGRAM Tennessee

Robert H. BrownVaccine For Children Program Manager

2010 Annual Immunization Spring Review13-16 April 2010

VFC Highlights and Updates

VACCINE FOR CHILDREN (VFC) PROGRAM

VFC Protocol

Tennessee

VACCINE FOR CHILDREN (VFC) PROGRAM VFC Protocol Highlights

Section A - Enrollment/ Annual Re-Enrollment:

NOTE: PRACTICES WITH MULTIPLE SITES MUST ENROLL EACH SITE AS A SEPARATE VFC PROGRAM PROVIDER.

To enroll/re-enroll (annually) as a VFC program provider, the following forms must be completed:

-VFC Provider Enrollment form (PH-3349, Revised 11/08), which has two pages

-VFC Provider Profile form (PH-3348, Revised 10/08)

-Emergency Vaccine Storage and Handling Plan form (PH-3800, Revised 10/08)

-Initial (One-Time Only) Varicella Order and Provider Survey (Enrollment Only)

This area summarizes the VFC Protocol in which the provider acknowledges the program requirements and agrees to abide by them.

VFC Provider Enrollment form (PH-3349, Revised 11/09), which has two pages

Identifies the status of the provider in the VFC Program

The provider estimates the number of patients served in their facility for a one year period

The provider indicates the source used to determine the number of VFC eligible children

VFC Provider Profile form (PH-3348, Revised 11/09)


VFC Protocol Highlights

Section B - Requirements to Participate in the VFC Program:

All provider changes must be communicated to the VFC Program:

- Change of address, telephone, or fax

- Change in VFC contact person

- Change in the number of VFC eligible children

- Additions/deletions of physicians to provider site

All changes can be faxed or emailed to Becky Loveless


Section C - Eligibility Criteria Categories:

(a) Uninsured (b) Enrolled in or eligible for TennCare (Medicaid) (c) American Indian or Alaskan Native


Persons who are 18 years of age or younger, and meet one or more of the following categories:

Note: CoverKids are fully insured and NOT VFC eligible.

IN ALL VFC Sites:


Section C - Eligibility Criteria Categories cont:

(d) Underinsured Children are eligible only in FQHCs, RHCs and Health Departments

The following conditions are defined as “underinsured”

• A child who has commercial (private) health insurance but the coverage does not include vaccines,

• A child whose insurance covers only selected vaccines (VFC-eligible for non-covered vaccines only)

• A child whose insurance caps vaccine coverage at a certain amount. Once that coverage amount is reached, the child is categorized as underinsured.


ONLY IN VFC FQHCs, RHCs and Health Departments Sites:


Section D - Vaccine Accountability:

• Vaccine Doses Accountability Report (VDAR) (PH-3350 Rev 10/08): Submit monthly even if vaccines were not administered during month.

• Report must be completely filled out with all the proper information.

• The VFC Program no longer has the ability to ship vaccine as an “emergency” rush order but additional orders can be requested, if necessary.





• As of January 1, 2010 Tennessee’s Vaccines for Children (VFC) has fully adopted the CDC policy for “Two Directional Borrowing” which means the borrowing of VFC vaccines for private patients or privately purchased vaccines for VFC patients.

• Borrowing should only occur when there is a lack of appropriate stock vaccine due to unexpected circumstances such as:

- Delayed vaccine shipment

- New staff that calculated ordering time incorrectly

- Vaccine spoiled in-transit to provider

Note: VFC vaccine cannot be used as a replacement system for a provider’s privately purchased vaccine inventory.




• When borrowing vaccines the provider must follow these guidelines:

- Providers must notify VFC Program

- Document all borrowed vaccine on the CDC VFC Vaccine Borrowing Report Form

- The borrowing reports must be kept as part of the VFC program records and be made available to the VFC staff during the VFC Site Visit.

Note: VFC-enrolled providers are expected to maintain an adequate inventory of vaccine for both their VFC and non-VFC-eligible patients.

VFC Vaccine Borrowing Report

The Guidelines and Direction for use of this form must be followed

The provider must document all borrowed vaccine on the CDC VFC Vaccine Borrowing Report Form


Section E - Proper Vaccine Storage and Handling:

• After January 1, 2009, all VFC providers can no longer use dorm style units or combination units with single thermostats as the primary storage unit. Providers may use separate refrigerators and freezers or combination unit with separate thermostats for refrigerator and freezer section.



Section H- Non-Compliance with VFC Program Protocols:

Section I - Request for Inactivation in the VFC Program:

• TIP has adopted CDC guidelines for responding to provider non-compliance with VFC Program Protocol identified during VFC site visits.

• A VFC provider may request to withdraw from the VFC Program at any time by submitting the request in writing along with a completed Vaccine Transfer Form (PH-4023). Vaccines will be picked up by a regional VFC representative.



Vaccine Management

Tennessee

Pre-filled (PF) syringe gives the provider a

choice

Allows provider to order the

amount vaccine requested

Vaccine Doses Accountability Report (PH-3350, Rev 11/09) must be submitted monthly.

Recipient must

complete the transfer

section and fax to the

VFC Program

Section B for Health

Department Staff Only

Vaccine Transfer Form (PH-4023)

This area was updated with the corrected NDC# for Flu Vaccine and New Vaccines

Return to McKesson only spoiled or expired vaccines, in their original vials or pre-filled syringes.

Expired or Wasted Vaccine Report (PH-3589, Rev 11/09)

Vaccine Inventory Management (VIM)


Economic Order Quantity (EOQ)

Updates

• In 2010 the Tennessee Vaccines For Children (VFC) Program will began implementing the next phase of vaccine distribution, Economic Order Quantity (EOQ). EOQ is an effort by CDC to implement best practices for vaccine ordering.

• It strives to balance order size, order frequency, and storage & handling costs with a goal of improving vaccine flow nationwide.

• EOQ assigns ordering tiers for providers based on annual volume of publicly–funded vaccine ordered.


Economic Order Quantity (EOQ)

The EOQ guidelines places providers in four categories based on their annual volume of doses ordered per year to determine the number of times a provider should order vaccine.

High volume 6000 doses/year Monthly 12 times a year

Med volume 800-5999 doses/year Bi-monthly 6 times a year

Low volume 200-799 doses/year Quarterly 4 times a year

Very low volume 0-199 doses/year As is no change

Ordering Guidelines of EOQ


• The goal of EOQ is to improve vaccine flow and NOT to run out of vaccines.

• To help ensure you do not run out of vaccines.

Goals of EOQ

Note: No matter when your scheduled order date is, if you are running out of vaccines, place an order.


Vaccine Inventory Management (VIM)


• VFC vaccine Ordering

• Inventory control and Reconciliation

VACCINE FOR CHILDREN (VFC) PROGRAM Tennessee

VFC Program OperationsRobert Brown(615) [email protected]

Vaccine replenishment status requestsMadelyn Ragland(615) [email protected]

Provider Enrollment and Short-Dated Vaccines ReportingBecky Loveless(615) [email protected]

Documents

VACCINE FOR CHILDREN (VFC) PROGRAM Tennessee Robert H. Brown Vaccine For Children Program Manager 2010 Annual Immunization Spring Review 13-16 April 2010