Become an ASN Provider - Adult Safety Net Program


About the Program

Currently, there are significant numbers of adults in Texas who are not immunized for recommended vaccinations, meaning that they are at an increased risk of developing vaccine-preventable diseases. Your participation in the ASN Program would help to address this important public health issue by providing access to vaccines for uninsured adults. Also, since ASN Program vaccines are of no cost to your facility, and you may charge an administration fee of up to $25 per vaccine, joining the ASN Program is both beneficial to your business, as well as to the health of Texans.


Provider Eligibility

Currently, providers at the following types of public facilities are eligible to enroll in the ASN Program:

  • DSHS Health Service Region Offices
  • Local Health Departments
  • Federally Qualified Health Centers (FQHC)
  • Rural Health Clinics (RHC)
  • HIV Clinics
  • STD Clinics
  • Family Planning Clinics
  • Substance Abuse Clinics (Opioid Replacement Clinics)

Enrollment

New Providers

If you are not currently enrolled in the Texas Vaccines for Children (TVFC) Program, please contact the Adult and Adolescent Immunization coordinator for your health service region.

Texas Vaccines for Children Providers

If you are currently enrolled in the Texas Vaccines for Children (TVFC) Program and are interested in becoming an Adult Safety Net Program provider, please contact your local TVFC representative for assistance to complete the Adult Safety Net Provider Enrollment Form (Publication F11-14143). The TVFC representative will submit the form on your behalf and will contact you once it's processed regarding next steps.


Vaccines Offered

The current DSHS Adult Safety Net vaccine formulary includes the following vaccines:

  • Hepatitis A vaccine
  • Hepatitis B vaccine
  • Combination hepatitis A-hepatitis B vaccine
  • Human papillomavirus (HPV) vaccine
  • Measles, mumps, & rubella (MMR) vaccine
  • Meningococcal vaccine
  • Pneumococcal polysaccharide vaccine (PPSV23)
  • Pneumococcal conjugate vaccine (PCV13)
  • Tetanus, diphtheria, & pertussis (Tdap) vaccine
  • Tetanus-diphtheria (Td) vaccine
  • Varicella vaccine
  • Zoster vaccine

Additional Questions

For further questions, please contact the Adult Safety Net Program Coordinator at ASNInfo@dshs.texas.gov.

Last updated February 3, 2017