WIXLIB

TVFC and ASNProviderEnrollmentDenise Starkey, MPH, MAVaccine Operations GroupImmunization Unit

Provider EnrollmentOverview 2018 TVFC/ASN Provider Re-enrollmentOverview TVFC and ASN New Providerenrollment process SurveyGizmo Texas Vaccines for Children NewProvider Enrollment Checklist DSHS HSR/LHD Responsibilities DSHS Central Office Responsibilities

2018 TCFV/ASN ProviderRe-enrollmentOverview Started: November 1, 2017 Ended: November 30, 2017Extended until December 8, 2017 SurveyGizmo HSR validation process completion:December 15, 2017 DSHS validation process completion:January 3, 2018 Total TVFC/ASN providers enrolled:3,053

TVFC/ASN New ProviderEnrollmentSurveyGizmo New Provider Enrollment for-providers.aspx

TVFC/ASN New ProviderEnrollment ProcessNew Provider Enrollment Completed(SurveyGizmo)DSHS Central Office notified of newenrollment via emailDSHS Central Office sends New ProviderEnrollment to HSR via emailHSR sends New Provider Enrollment toresponsible entity (HSR/LHD)Responsible entity (HSR/LHD) contactsprovider within 2 weeks

TVFC/ASN New ProviderChecklistSuppliesSupplies and resources available to order andtake on the initial visit:From VOG Staff: plug guardsdata loggersroom thermometervaccine traysFrom DSHS electronic order ault.asp): Storage and Handling poster, stock no. 6-26P Laminated immunization schedules: children (6105L) and adults (6-104L) “Do not disconnect”, “Do not unplug”sign/stickers (Refrigerator Warning Signs forVaccine Storage), stock no. 6-180

TVFC/ASN New ProviderChecklistRequired Provider Training

TVFC/ASN New ProviderChecklistRequired Provider Training Training certificates validation: Correct certificates for the primary andback-up vaccine coordinators Correct year Correct training Ensure the proper certificates aresubmitted for a new provider andexisting provider with new staff.

TVFC New ProviderChecklistInitial Contact/Visit Responsible entity is to provideeducation to the new/returning clinicstaff about the TVFC/ASN Program(s) Using the DSHS TVFC Provider Manual.All new or returning clinics to the TVFCProgram must receive an initialcontact/visit prior to receiving vaccine.

Initial Contact/VisitCommunication and Staff TrainingProvider Enrollment: Assist in filling out the enrollment form forTVFC. Review each bullet on the enrollment form withthe staff to facilitate understanding. Identify staff that will serve as a primary and aback-up coordinator. Provide guidance for collecting information forthe patient population section of the enrollmentform. Assist with filling out an EC-68-1, biologicalorder form. Inform staff about site reviews (by contractorand unannounced).

Initial Contact/VisitScreening and Eligibility: Describe TVFC eligibility criteria. Maximum TVFC administrative fee tocharge a non-Medicaid and non-CHIP clientis 14.85/dose of vaccine. Maximum ASN administrative fee to chargean uninsured client is 25.00/dose ofvaccine. Inform staff Medicaid or CHIP patientsmust not be charged any out-of-pocketexpenses. Stress CHIP patients cannot be seenunless the clinic bills CHIP for theadministration fee.

Initial Contact/VisitReporting: Educate staff on the requirement of submitting alltemperature recording forms, EC-105s, monthly toresponsible entity. Explain VAERS and how to report. Describe TVFC record retention requirement (5years). Suggest staff bookmark:www.immunizetexas.com - TVFC provider manual, TVFC forms,and other information.www.cdc.gov - contraindications and precautions.www.immunize.org - immunization questions.www.immtrac.com - ImmTrac2 website Discuss the importance and benefits of ImmTrac2. Educate staff on reporting requirements toImmTrac2 from vaccinating clinics to patientsyounger than 18 years of age.

Initial Contact/Visit Describe fraud & abuse.Fraud - An intentional deception ormisrepresentation made by a person with theknowledge that the deception could result in anunauthorized benefit to himself or another person.Abuse - Provider practices that are inconsistentwith sound fiscal, business, or medical practicesand result in an unnecessary cost to the MedicaidProgram (and/or including actions that result in anunnecessary cost to the TVFC Program, a healthinsurance company, or a patient) or inreimbursement for services that are not medicallynecessary, or that fail to meet professionallyrecognized standards for health care.

Initial Contact/VisitStorage and Handling: Inspect the type of units in place (refrigeratorand freezer) Data logger: Review the data logger (including a back-up) toensure they meet compliance requirements.Explain the importance of a back-up data loggerand when it should be used. Requirement of water bottles in the fridge &freezer. Ice packs are not allowed in the refrigerator orfreezer. Flat, hard-sided “water containers” are notallowed. Requirement that food is not allowed in unitsthat contain TVFC vaccine. Show the provider the proper placement ofvaccines in the units.

Initial Contact/VisitPEAR requirements. DSHS HSR/LHD/Grantees certifythat: There are key TVFC staff in place and theyhave adequate training protocols in place tomaintain the requirements of the TVFCProgram. Staff understands the TVFC eligibilitycategories and billing practices. Staff understands and has appropriateprocesses in place to maintain documentationconsistent with program requirements (5years) for all TVFC-related documents: Eligibility screeningDose documentationBorrowing formsTemperature recording formsVAERS reporting

Initial Contact/VisitPEAR requirements. DSHS HSR/LHD/Grantees certifythat: Vaccine management plan andemergency plan that meet TVFCrequirements are current and complete. The vaccine storage equipment (unitsand data loggers) are consistent withTVFC requirements including: sufficient space proper placement current & valid certificate of calibrationtesting ability to maintain proper temperatures placement of “do not disconnect”, “do notunplug” labels on plugs & circuit breakers

Initial Contact/VisitPEAR requirements. DSHS HSR/LHD/Grantees certifythat: Staff have been educated of what to doin the event of a temperature excursion. There are processes in place to: maintain a separate TVFC inventory fromprivate stock place vaccine orders monthly to maintainappropriate stock to serve population offer all ACIP-recommended vaccines(unless a specialty provider)

Initial Contact/Visit

Initial Contact/Visit

Initial Contact/Visit –PIN AssignmentSubmit the following completeddocuments for a PIN assignment.Copy of the initial contact/visit of the NewProvider Enrollment Checklist showing that atleast: All PEAR requirements (page 15-16) arechecked as completed Primary & back-up coordinators areidentified and have signed the document(page 17) The responsible entity has signed and datedwhen the initial contact/visit was completed(page 18). Enrollment form Biological order form (EC-68-1).

Initial Contact/Visit –PIN AssignmentPIN Assignment Process Once all correct initial contact/visitdocumentation has been received. Via email, the clinic staff will receive a PIN, apassword to EVI along with a link to EVI DSHS Central Office will also forward thePIN assignment to the responsible DSHSHSR. If applicable, HSR forward the PIN andinformation to the responsible LHD. Clinic staff verify monthly: Clinic nameAddressPhone and faxPrimary & back-up coordinator information

TVFC/ASN New ProviderEnrollmentUpdates: New Provider Enrollment form changesmust be made on PDF version(originally sent from DSHS Central Office) No significant date difference betweenthe enrollment form signature date andNew Provider Checklist date.Example: Date of new provider Date of new providerchecklist: 3/15/2017 Date of new provider Date of new providerchecklist: 1/15/2017enrollment: 1/3/2018initial contact/visitenrollment: 1/3/2018initial contact/visit

TVFC New ProviderChecklistSecond Contact/VisitAfter a PIN has been assigned: Training in the Electronic VaccinesInventory system (EVI): Assist staff with changing their password.Explain the importance of verifying andcorrecting the site and primary & back-upcoordinators information.Place first vaccine order using EC-68-1. Verify vaccine management plan andemergency plan has been filled out andare available for review. Verify storage and handling is compliant: Plug guards have been installed.Circuit breaker and outlets are labeled “do notdisconnect”, “do not unplug”.

Second Contact/Visit

Second Contact/Visit

TVFC New ProviderChecklistThird Contact/VisitVaccine arrival at the clinic site How to receive the vaccine in EVI. The importance of verifying the dosesreceived to the packing slip. Educate on how to print a tally sheet fromEVI. Encouraging staff to post the tally sheetfrom EVI in the area of the units thatcontain TVFC vaccine. Educating staff to use the tally sheet fromEVI to document doses administered topatients by lot numbers. Inform staff to unpack the vaccine andstore it appropriately immediately.

Third Contact/Visit

Third Contact/Visit

TVFC New ProviderChecklistFourth Contact/VisitBeginning of the first month on the program: Provide hands-on training on the properuse of EVI, explaining each tab. Encourage staff to NOT adjust inventorybut instead to contact responsible entitywhen the doses in EVI do not equal thedoses on hand. Explain vaccine choice (opened quarterly). Complete monthly reporting by the 5th ofevery month. EVI reporting is required monthly even ifvaccine is not ordered.

Fourth Contact/VisitExplain vaccine loss:Negligent losses Drew up dose and parent/patient refused (ifcounseling did not take place before vaccinewas drawn up) Drew up wrong vaccine Dropped dose Expired (excluding flu, DT, pediatric PPSV23, &pediatric Td) Did not provide a 90-day notification to responsibleentityVaccine loss report was not generated within 4days of expiration or upon discovery Failure to store properly Product left out of required storageImproper monitoring of temperaturesVaccine transported inappropriatelyVaccine not stored properly upon receipt

Fourth Contact/VisitNon-negligent losses Damaged needle/seal, particulate invial, discolored liquid, etc. Drew up dose and parent/patientrefused (if counseling took place beforevaccine was drawn up) Expired (including flu, DT, pediatricPPSV23, & pediatric Td) Provided a 90-day notification toresponsible entity Vaccine loss report was generatedwithin 4 days of an incident Mechanical failure of unit

Fourth Contact/Visit Steps to take when vaccine isruined/expired. Contact responsible entity and vaccinemanufacturer. Remove vaccine from storage unit. Mark it clearly so others won’t inadvertentlyadminister. Store it in a vaccine quarantine bag. Process of how a return shipping labelwill be distributed to returnruined/expired vaccine to thedistributor. Explain the label will expire in 30 days.

Fourth Contact/Visit

Fourth Contact/Visit

TVFC/ASN New ProviderChecklist Keep the new provider checklist documentationfor 5 years. Continue to partner and provide training withTVFC/ASN Providers Future provider changes: Patient population – Patient populationsection of the pdf form and submit it via emailto vaccallcenter@dshs.texas.gov. Primary/Backup Vaccine Coordinator –Document the change themselves in EVI. Submit a pdf version of the applicable sectionfor these changes: The signing clinician changesThere are new prescribing authorities to addto the listThere are any changes to the patientpopulation

Questions?

Thank you!Denise Starkey, MPH, MADenise.Starkey@dshs.texas.gov

Enrollment Updates: New Provider Enrollment form changes must be made on PDF version (originally sent from DSHS Central Office) No significant date difference between the enrollment form signature date and New Provider Checklist date. Example: Date of new provider enrollment: 1/3/2018 Date of new provider initial contact/visit .