Vaccine Accountability What did I do with that vaccine

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Vaccine AccountabilityWhat did I do with that
vaccine?
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Introduction

• Understand the importance of child specific
  documentation
• Understand vaccine accountability
• Understand the effects of non-reporting of
  wasted, spoiled and unaccounted for vaccine

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Vaccine Funding

• Vaccine for Children (VFC)/317 Grant 2/3
• State 1/3

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Objectives

• Importance of completing the Vaccines
  Administered Log
• How to complete the Vaccine Administered Log
  (VAL)
• How to use a VAL for VFC documentation

• How to use a VAL for vaccine ordering
• What is your vaccine accountability?

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Why VAL?

• General Assembly mandate
• Rules
• Child-specific information
• Local health departments
• North Carolina Immunization Registry (NCIR)
• Private Providers

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vaccine acCOUNTability

• Carole Watson, RN, BSN
• Immunization Program Manager
• Forsyth County Department of Public Health
• 10/2/03

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what are you COUNTing?

• All doses of any State vaccine
• That you administer
• That fall on the floor and break
• That you draw up but dont need
• That you transfer to or from another vaccine
  provider
• That you have to waste due to aspiration of blood
  before administering, squirming 5 yr. olds,
  etc.
• That expire before you can use them

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who COUNTs your vaccine doses?

• Person who orders your vaccine
• Person who receives stores your vaccine
• Nurses/Medical Assistants who administer your
  vaccine
• Person who records doses given on VAL
• Data entry person in LHD

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Id better get these doses entered correctly!
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These Hepatitis B doses have got to get to the
State!
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how do your doses get COUNTed?

• Private Providers
• Vaccines Administered Log (VAL)
• Wasted/Expired Vaccine Report (DHHS 3974)
• Vaccine Transfers
• Local Health Departments
• Batch downloads from vendor to Immunization
  Branch
• Direct entry into NCIR
• Wasted/Expired Vaccine Report (DHHS 3974)
• Vaccine Transfers

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why do we need to be acCOUNTable?

• Vaccines cost a lot of money,
  i.e. TAX DOLLARS (!)
• All doses must be counted in order to be included
  in the NC Immunization Registry (NCIR)

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tools to insure acCOUNTability

• Information Make sure everyone in your
• office/clinic knows vaccine process (Vaccine
• Agreement with Immunization Branch), cost, and
• consequences of errors (Restitution Policy)
• Training Teach all staff procedures for
  handling
• storing vaccines (Temperature Logs), as well as
• reporting/recording wasted or expired doses
• (Policy and Procedures)

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Thank goodness, this temperature is
staying within range!
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(continued)tools to insure acCOUNTability

• Communication Post in a prominent place
• Copy of Vaccine Disaster Recovery Plan and
  review with all staff
• Each vaccine order and let all staff know to
  expect delivery
• Clarification Make sure everyone who
  administers vaccines is thoroughly familiar with
  the NC UCVDP Coverage Criteria

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Vaccine Disaster Recovery Plan
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Latest vaccine order
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Hmm, let me check the UCVDP Coverage Criteria...
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why are doses COUNTed on the VAL so important?

• Doses entered by private providers create the
  data base for that childs immunization record
  in the NCIR
• Accuracy insures that child does not have extra
  (unneeded) doses or missed opportunities
• Health departments use doses on VAL to help with
  annual immunization assessment
  (more data higher rate!)
• Doses entered in NCIR by LHD can be useful to you
  when you see a child with an incomplete record!

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Let me present the VAL filing cabinets!
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Tips for completing VAL

• Write or print clearly!
• Use both last names for child whose name is
  hyphenated
• Be sure Date of Birth Service Date are correct
• Bubble correctly!
• Use Notes section to list private Prevnar TM
  (PCV7)
• Always keep in mind that somebody is having to
  read what you wrote!

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Ive got to find that 4th DTaP!
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Please, help us get all our kids records right!
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How to complete the VAL

• Record on every page
• Month and year
• Federal identification number
• Official name of facility
• Record on first page only
• Street address and city
• Contact person
• Contact phone
• Zero doses given

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How to complete the VAL (contd)

• Notes section
• Record privately purchased vaccine
• Document lot , manufacturer, expiration date of
  vaccine
• Vaccine Information Statement (VIS)
• Chart number
• Other important or identifying information

• Column Totals
• Preparation
• Due date
• Disposition
• Mistakes

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Instructions for VAL
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Importance of accurate VAL reporting

• Data quality review
• PCV 7 review
• Age review for vaccines
• Birth date, service date, eligibility, vaccine
  type and dose number
• Administer more vaccine than shipped
• Administer expired OPV
• Current form (VAL116 dated 4/10/01)
• Date received
• Accurate column totals

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Data Quality Memo
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Importance of accurate VAL reporting (cont)

• Monthly doses administered
• NCIR
• Vaccine allowance
• Non-reporting - unaccounted for vaccine
• Under reporting of vaccine
• Over reporting of vaccine

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Using the VAL for Vaccine for Children (VFC)
documentation

• Children through 18 years of age that meet at
  least one of the following criteria are eligible
  for VFC vaccine
• Medicaid eligible
• Uninsured
• American Indian or Alaskan Native
• Underinsured - receives immunizations at a
  Federally Qualified Health Center (FQHC) or Rural
  Health Clinic (RHC)

• Vaccine Agreement obligations
• Keep for 3 years

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How to use the VAL for vaccine ordering

• VAL doses administered versus clinic doses
  administered
• Superbill
• Medicaid billing
• Private insurance billing
• Appointment book

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How to order vaccines

• Order once every other month
• Stock enough vaccine to maintain a three-month
  inventory
• Order all vaccines needed
• Use the Monthly Vaccine Requisition/Inventory
  Form DHHS 1227 revised 9/03
• Compare last years doses administered to the
  most current month

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Vaccine Order form
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Instructions
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Review of Objectives

• Importance of completing the Vaccines
  Administered Log
• How to complete the Vaccine Administered Log
  (VAL)
• How to use a VAL for VFC documentation

• How to use a VAL for vaccine ordering

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What is your facilitys vaccine accountability?