NYC Vaccines For Children Provider Requirements: Provider Site Visits
Site visits are conducted to ensure that Vaccines For Children (VFC) and other publicly funded vaccines are stored, handled, distributed and administered in accordance with the laws, policies and recommendations of: the VFC Program, the Advisory Committee on Immunization Practices (ACIP) and the Childhood and Adolescent Immunization Schedules, as published by the Centers for Disease Control and Prevention (CDC).
In NYC, the Provider Quality Assurance (PQA) Unit program reviewers are responsible for conducting provider site visits. The PQA unit chief may accompany program reviewers on visits to ensure optimal services.
All providers are visited once every two years at minimum. Additional visits may be scheduled if needed (e.g., practice moving to another location, large order histories or unusual ordering patterns, prior reports of vaccine fraud or abuse, suspected misuse of VFC vaccines, large amount of vaccine loss due to improper storage and handling, and previous unacceptable storage and handling practices).
Your practice’s main physician and vaccine coordinator must be available during site visits. All other staff members involved in the storage, handling, accountability and administration of publicly funded vaccine should also be present for feedback.
There are four types of provider site visits conducted by the NYC VFC program:
VFC New Enrollment site visit
The New Enrollment site visit is conducted as soon as the provider enrolls in the VFC program. This visit must be conducted within two weeks of enrollment and it must be conducted prior to processing the first VFC vaccine order. This visit is to ensure that providers enrolled in the VFC program are meeting the requirements of vaccine storage and handling and to educate providers on VFC requirements so that vaccines are stored, distributed, handled, accounted and administered only to VFC-eligible children in accordance with the laws, polices and recommendations of: the VFC Program, the Advisory Committee on Immunization Practices and the Childhood and Adolescent Immunization Schedules, as published by the CDC. During this visit, PQA program reviewers complete the VFC New Enrollment Site Visit Questionnaire and Checklist.
VFC Compliance site visit
The VFC Compliance site visit is conducted at minimum, once every two years. This visit is to ensure that VFC and other publicly funded vaccines are stored, handled, distributed, and administered in accordance with the laws, policies, and recommendations of: the VFC Program, the Advisory Committee on Immunization Practices, and the Childhood and Adolescent Immunization Schedules, as published by the CDC. During this visit, PQA program reviewers complete the VFC Site Visit Questionnaire and provide feedback.Unannounced Storage and Handling Site Visit
The Unannounced Storage and Handling site visit is conducted as needed. This visit is to follow up on whether providers are meeting requirements that may have been recommended during a previous site visit in terms of storage, handling and accountability. Providers are not alerted about this visit before it is conducted. Unannounced site visits are also considered when a provider fails to adhere to recommended vaccine storage and handling practices (e.g. storing food and drinks in the refrigerator, not rotating vaccine stock or finding expired vaccine in the refrigerator) or when a provider fails to maintain a proper amount of privately purchased vaccine in their refrigerator.
Immunization Quality Improvement for Providers site visit
As part of participation in the VFC program, enrolled provider sites are required to participate in the Immunization Quality Improvement for Providers (IQIP) program if selected. IQIP is CDC’s national VFC provider-level immunization quality improvement (QI) program. The goal of IQIP is to work together to identify opportunities to improve vaccine uptake so that more children and adolescents are vaccinated on time and protected against vaccine-preventable diseases.
IQIP is delivered over 12 months and consists of an initial site visit, 2-month check-in, 6-month check-in and 12-month follow-up. During the initial site visit, which can be conducted virtually or in-person, Program Reviewers from the PQA unit will discuss site-specific childhood and/or adolescent coverage rates, as well as the site’s current immunization delivery practices and strategies for improving these practices. Technical assistance, including Citywide Immunization Registry (CIR) trainings, will also be provided throughout the year-long IQIP cycle. It is strongly encouraged that staff who play a role in immunization processes are available to participate, including a clinician with decision-making authority who is knowledgeable about the facility’s immunization practices. IQIP site visits typically average one hour and check-ins/follow-ups, which are conducted via phone or webinar, average 15-30 minutes. IQIP and VFC Compliance visits will be administered in alternating years. For more information about the IQIP program, please visit CDC: Immunization Quality Improvement for Providers.