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New VFC Order Form: Why do I have to do this? How do I fill it out? By Laura Harrod, KVP Coordinator

New VFC Order Form: Why do I have to do this? How do I fill it out? By Laura Harrod, KVP Coordinator. Why do we have to do this form?. Part of CDC’s Vaccine Management Business Improvement Plan or VMBIP CDC is requiring more accountability of vaccines

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New VFC Order Form: Why do I have to do this? How do I fill it out? By Laura Harrod, KVP Coordinator

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  1. New VFC Order Form:Why do I have to do this?How do I fill it out?By Laura Harrod, KVP Coordinator

  2. Why do we have to do this form? • Part of CDC’s Vaccine Management Business Improvement Plan or VMBIP • CDC is requiring more accountability of vaccines • New system called VTrckS or Vaccine Tracking System requires all information on this form to be able to order any vaccines • This information will need to be input for VFC as well as adult vaccines (Leslee Minch will send the Adult form sometime before January)

  3. How do I fill it out? • Current form was sent out in PDF • Fill out by hand then fax or scan & email it to the program • Working on getting in a fillable PDF form so you can fill in electronically and send

  4. Identification Information • Date, the actual date you are filling in form • Correct VFC PIN that starts with H • Prepared by…this is actual person filling in form. It may not be VFC contact • Provider Name: actual name of your clinic, if there is more than one in your county you might need to add city: Bell Co HD-Middlesboro & Bell Co HD-Pineville; initials do not help ex. BCHC • Check if new address; you should have already discussed with us before submitting

  5. Identification Information continued: • NEW FOR THIS FORM: • Put in office hours (If you want to leave off Friday that is ok since we do not deliver on Friday’s unless it is an emergency.) • Dates closed in next 30 days

  6. Order Form • Left column is actual vaccine. • Ex is “DTAP.” This form uses all CAPS rather than DTaP. These are the only brands & presentation we carry • If you do not want us to substitute brand you must write it in on your form somewhere near vaccine, we will do our best but as always cannot guarantee brand • DO NOT start on left columns but in the “current stock” column. Write down EXACT VFC doses you have in your frig. • If you have more than 2 lot numbers go to the back page (example on next slide)

  7. This is page 4 of the order form – use page 4 to record lot numbers if you have more than 2 lot #s of any vaccine.

  8. NDC# • After current stock fill in NDC or National Drug Code • Usually on front of box

  9. Lot # and expiration date • Fill in for each lot you have of each specific vaccine • One line per lot #

  10. Doses Given • To find out how many doses given you can pull a CDP report but must make sure it is all VFC and not private stock or use Activity Worksheet (see example in the next slide)

  11. Activity worksheet • This form is available for your use and is to be completed by hand (we are working on making it a fillable PDF form) • Put on frig or freezer and check off each vaccine as you pull vaccine dose out of unit • Fill one out monthly • Age of patient is to left, in that box put: • M – Medicaid or one of MCO • U – Uninsured or no insurance • N – Underinsured • K – KCHIP • I – American Indian or • A – Alaska Native

  12. Activity Worksheet continue • Put x or check on line with shot given • Many will have more than one shot • Doses given will be how many x’s or check marks are in the column for that specific vaccine • Be sure to include flu doses administered as we use these data to determine how much to send the next year

  13. Transfer/Expired doses • If you fill out a Return and Adjustment form you must fill in that column • It would be a good idea to send Return form at the same time you send order

  14. Orders received • Since you sent in your last order, put in all VFC doses received by your site

  15. Previous Stock • Get “previous stock” from your last order form where it says “current stock” • This will be the number of doses you had after you submitted the previous order • Do each vaccine the same way

  16. In a perfect world, which we are going towards…your order form should add up.

  17. Eligibility • On page 4 of 4. • Use either a CDP report or the Activity Worksheet to get number of patients. • This will be much smaller than the number of doses given since some patients can get 5 or 6 doses of vaccine. You are reporting patients not doses. • Eligibility category are the same as on the Activity Worksheet

  18. Questions? • Contact Kentucky Vaccine Program • 502-564-4478 and put in our extension (do not press 1 for Immunization since that goes to LaKeta Ritchie) • (these will all change in November) • Rita Lathrem x3914 does HD orders • Judy Baker x3518 • Laura Harrod x3855 • Clarissa Wilson x3734 • Email inbox is dph.kvp@ky.gov • Fax 502-696-4923

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