What is this Maze Called “VOFA” and How Do I Navigate it?

Definitions

VOFA : Vaccine Ordering and Forecasting Application

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 Managers

ARRA 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 orders

CDC Vaccine Monitors will email and/or call bi-weekly 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 population.

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 RequestsDTaP

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 Grantees

11 8 12 17 8 6 8 17 11 5 13 10

2009 Funding Requests and Purchases

Total Requested (includes flu)

Total Purchases(includes flu)

Difference

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

vaccines 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, state/local

This will also help with prematurely exceeding funding in all sources

Replenishments

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

Questions?

Need more information, please contact:Melissa Ely Moore

404-639-8557

mmoore5@cdc.gov