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Task <br />Number Task! Activity/Description <br />management, reconciliation, compliance with <br />storage and handling, and reporting of all <br />vaccine incidents and returns). <br />5 Provide communication, technical assistance, <br />consultation, and education to providers about <br />vaccine quality assurance, accountability, <br />program participation and vaccine management. <br />6 Conduct VFC compliance site visits at two (2) <br />enrolled provider site(s) within your jurisdiction. <br />Site visits should address all requirements <br />outlined in the Provider Agreement, the CDC <br />Vaccines for Children (VFC) Operations Guide, <br />and as directed by the state administrators of the <br />Vaccines for Children program. <br />Conduct VFC Compliance Site Visit Follow-Up <br />to assure providers resolve all corrective actions <br />identified during the initial VFC compliance site <br />visit. Follow-up may include another physical <br />site visit or verification by email, phone, fax, or <br />Exhibit A, Statements of Work <br />Revised as of November 16,2015 <br />*May Support PHAB <br />Standards/Measures Deliverables/Outcomes <br />b) Inclusion in the online ordering <br />system of doses used in the last <br />month and inventory on hand. <br />c) Report of Vaccine Storage <br />Incidents (DOH 348-154) <br />complete with reason and <br />corrective action as needed . <br />d) Report all cases (or suspected <br />cases) of vaccine fraud or <br />abuse. <br />Summary of LHJ Technical <br />Assistance Form (DOH 348-257) <br />a) VFC Site Visit Selection <br />Planning tool (will be supplied <br />by DOH) <br />b) Enter responses from the VFC <br />Provider Compliance Site Visit <br />questionnaire into the VFC <br />Provider Education, <br />Assessment, and Reporting <br />(VFC-PEAR) online system for <br />each provider site visit. Follow <br />all corrective action and follow- <br />up guidance provided by VFC- <br />Page 5 of 10 <br />AMENDMENT #5 <br />Payment <br />Due Date/Time Frame Information and/or <br />Amount <br />b) based on provider amount. <br />order schedules <br />Funds available for <br />this task*: <br />c) within seven (7) days <br />of the incident FFYI6 AFIX, <br />74110265 <br />*See Restrictions on <br />d) within seven (7) days Funds below <br />of the incident <br />December 31 st Reimbursement for <br />actual costs incurred, <br />not to exceed total <br />funding consideration : <br />amount. <br />Funds available for <br />this task*: <br />FFY 16 VFC Ops <br />74110263 <br />FFYI6 317 Ops <br />74110261 <br />*See Restrictions on <br />Funds below <br />a) January 15th Reimbursement for <br />actual costs incurred, <br />not to exceed total <br />funding consideration <br />b) At the time of the amount. <br />VFC Compliance <br />Site Visit or within Funds available for <br />ten (10) business this task*: <br />days of the site visit. <br />(NOTE: All VFC FFYI6 AFIX, <br />compliance site 74110265 <br />visits and the <br />required site visit <br />Contract Number C17114-5