Melissa Moore by qingyunliuliu


									What is this Maze Called “VOFA” and
        How Do I Navigate it?
       VOFA : Vaccine Ordering and Forecasting
       Spend Plan: An output of VOFA but used
        interchangeably with VOFA.
       Primary Account (line of credit)
         VFC funds for all vaccines,
         317 funds for all vaccines except 317 direct ship
         State or local funds you anticipate spending
       Secondary Account (line of credit)
         317 direct ship (e.g. varicella, zoster)
             VOFA’s Purpose
   A planning tool to help CDC determine and/or
    correct request to OMB for VFC funding
   Helps grantees manage vaccine under
    centralized distribution
       Manage through the doses not the dollars
        (manage the need)
                       VOFA Inputs
       317 Schedule
         317 eligible population from PES
         Adult population from Census
         No predetermination of baseline doses needed
       State/local schedule
         State/local eligible population from PES
         Adult population from Census
         No predetermination of baseline doses needed
       ARRA schedule
            Used 317 eligible population from PES
            Adult population from Census
         VOFA Outputs and Uses
   Contracts and Inventory
       Helps us meet “bona fide needs” test of federal
        appropriations law (ARRA funded vaccines)
       Used to determine how much to put on contracts
       When providers anticipated to order
       Used to determine how much of each brand and
        packaging type to have at McKesson
    VOFA Outputs and Uses (cont.)
       Funding
         How much and when
            “Hard” quarterly targets
            “Soft” annual targets
       Tracking purposes (reports, spend plan)
         How to apportion funds among funding sources
         How much vaccine to replenish
VOFA Focus Areas for Program
       Vaccine funds must be spent by the end of federal
        fiscal year 2010
       Recommend weekly or bi-weekly review by vaccine
        manager and reconciliation of planned to actual
         CDC Vaccine Monitors will email and/or call bi-
         Will begin process of contacting grantees who are
          underspending ARRA in next few weeks
         Have developed protocol for shifting funds to
          grantees that can use ARRA vaccine $
              VFC maximum doses
       VFC doses start with eligible population
         In order to get more than the maximum you need
          to demonstrate an increase in the eligible
     Grantee can request limited catch-up to cover
      VFC eligible population
       Maximum allowable catch-up for VFC
        determined annually
       Consider a variety of things such as expected
        availability of vaccines and whether active
        catch-up campaigns would be going on
    VFC Maximum Doses (cont.)
       2010 monitoring process will include thresholds
        that trigger more intensive follow-up
         based on maximum doses and funding
         important to understand that this will cause faster
          expenditure of 317 funds
  2009 VFC Vaccine Dose Requests
           DTaP   HepA   HepB   Hib    HPV   MCV   MMR   PCV7   Polio   RTV   Tdap   VZV

Mean       4.8    3.8    3.8    3.9    2.7   2.1   2.3   3.9    3.9     2.3   2.3    4.0

Median     4.6    3.1    3.4    3.4    2.5   1.9   2.2   3.7    3.7     2.2   2.1    3.6

Min        3.8    1.9    2.7    3.2    0.9   0.8   1.7   3.3    3.5     1.2   1.0    1.7

Max        10.1   10.6   13.4   10.2   6.4   6.0   3.9   6.2    7.8     5.2   5.2    13.8

Criteria   >5     >5     >4     >4     >4    >3    >3    >4     >4      >3    >3     >5

# of     11       8      12     17     8     6     8     17     11      5     13     10
         2009 Funding Requests and
Total Requested                 Total Purchases                 Difference
(includes flu)                  (includes flu)
VFC              317            VFC              317            VFC            317

$3,156,312,513   $251,847,789   $2,806,405,266   $220,069,503   $349,907 247   $31,778,286
         Updating with actual purchases
            and monthly VOFA updates
       In 2010 VOFA is updated monthly with actual
        purchases from prior month
       Grantees must review and make adjustments in all
        funding sources, including VFC
         remember VFC entitlement is based on eligible children
         grantees that need more VFC vaccine will need to work with
          CDC to review data, including VFC-eligible population
         CDC may need to adjust maximum allowable for certain
         We will work with grantees to review, discuss and make
          adjustments where need is demonstrated and will make every
          effort to be reasonable
     Updating with actual purchases
    and monthly VOFA updates (cont)
   Monitors will be proactive in making sure that
    grantees are contacted before they reach
    dose limits in VFC and funding limits in 317,
       This will also help with prematurely exceeding
        funding in all sources
   Grantees should attend to state replenishments
    and agreed upon replenishment schedules
    established with monitors
       We recognize there is uncertainty
       If there are any changes please notify us ASAP
        and we will work with you
           Changes in budget available
           Changes in ability to actually spend it
         Replenishments (cont.)
   Where possible, grantees should use “debit”
    model of replenishment: buy vaccine in
    advance and draw down on credit
       Helps to fully expend state dollars
       Limits possibility of continuing to order beyond
        funding availability
               Monitoring Reports
       Monitoring reports critical to helping you make
        needed changes
       Attend to areas that monitor notes in his/her
        email and adjust
       Reports show funds in various views
         Primary/secondary
         VFC, 317, S/L, ARRA
       Monitoring Reports (Cont.)
     Attending to funds available will ensure you will not run
      out funds
        Remember that while orders are placed in Vacman at
         provider level, the doses roll up to totals by vaccine
        Consider tracking the provide orders placed every
         month against VOFA spend plan
     Attend to direct ship!!!
        Varicella , zoster and other direct ship vaccines are
         assigned funding source at order.
        Fund source is assigned as is planned in VOFA
         spend plan
     Upcoming VOFA Updates
   PedvaxHIB availability
   High Risk Adult Hepatitis B amounts
   MMR-V
   Change in packaging Hepatitis B from 5 dose
    syringes to 10 dose syringes
              Report issues
   Please contact us the moment you find
    monitoring report discrepancies
   System is complex
   Sometimes the only way we know changes
    have been made to data warehouse is missing
    is by hearing from you
   Solution may not be quick because we are
    dependent upon other systems/groups at CDC
          Final Take Home Points
   Please update your VOFA with actual data
    monthly and then make adjustments as
    necessary to ensure you are not overspending
   Make sure you have programmed your ARRA
    funds through August 2010
       Try to purchase all ARRA funded adult
        purchases by June 30, 2010
   Please make sure you have a spend plan for all
    vaccines you intend to order
Need more information, please contact:
           Melissa Ely Moore

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