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Adult Vacci ne Program I nUn <br />STEP 2: Agree to, and maintain compliance wíth, the following program policies. <br />Provider <br />Agreement <br />A. Renew Provider Agreement yearly and update Agreement if there are any changes. <br />B. Notify the program immediately regarding changes to address or delívery information <br />C. ldentify desÍgnated primary and secondary staff members to perform the <br />responsibilitíes of vaccine coordinator: ordering, receipt of vaccine, storage and <br />handlÍng, and temperature monitorÍng. <br />Program <br />Eligibility <br />A. Ensure AVP vaccine is used for adults 19+ years of age, who are uninsured or <br />underinsured. <br />B. Fulfill all requirements for vaccine ordering and accountabilÍty, operate ín a manner that <br />avoids fraud and abuse, and administer vaccine according to the recommendations of <br />the Advisory Committee of lmmunization Practices (ACIP). <br />Storage & <br />Handling <br />A. Have appropriate, approved storage unit(s) to store vaccine while maintaining proper <br />storage conditions (dorm-style storage units are not allowed). <br />B. Have a primary and back-up thermometer with current certificates of calibration in <br />accordance with National lnstitute of Standards and Technology (NIST) or the American <br />Society for Testing and Materials (ASTM) standards for each unit that stores vaccine. <br />C. Ensure thermometers are calibrated and meet the requirements of the program. <br />D. New unit temperatures should be monitored for three to five (3-5) days prior to receipt <br />of vaccine to ensure temperature stabil¡ty. <br />E. To monitor and ensure vaccine viability: <br />a. Check temperatures manually twice a day, at least three (3) times a week. Confirm <br />refrigerator temperatures are between 36"F and 46"F (2"C and 8"C). Confirm <br />freezer ternperatures are between -58"F and 5"F (-50"C and -15"C) <br />b. Check the Minimum and Maximum temperatures once a day <br />c. Check thermometer data weekly to confirm temperatures are in range. <br />F. Ensure vaccines in all storage units are properly labeled. <br />G. Maintain accurate and complete temperature logs. Store completed logs for three (3) <br />years. Be able to submit logs for units storing AVP vaccine upon request. <br />H. Have a written emergency back-up plan and use it ín the event of power outage or <br />equípment failure. Notify DOH within 24 hours of vaccíne incidents and complete a <br />wrítten report including the reasons for the vaccine loss and measures taken to correct <br />the cause of the loss and to prevent reoccurrence. <br />l. Have the capacity to store vaccine in addition to existing refrigerator/freezer stable <br />pharmaceuticals (e.g. other childhood/adult vaccínes, seasonal flu vaccines, etc.). <br />J. Store and handle vaccine in accordance with the package insert and follow storage and <br />handling best practices. <br />K. Guarantee your facility will not function as a depot for AVP vaccine. <br />Accountability A. Ensure that staff administering and handlíng vaccine are properly trained and will <br />receive ongoing education and training on best practices in vaccine storage and <br />handling, and current immunization recommendations. <br />B. Notify the AVP of all vaccine that will expire three (3) months before expiration. <br />For people with disabilities, this document is available upon request in other formats. <br />To submít a request, please call 1-800-525-0127 (TÐD/TW call77tl. DOH 348-637. January 2019. <br />Page 2 of 3