TVFC and ASN Re-Enrollment Center
Welcome to the 2024 Texas Vaccines for Children (TVFC) and Adult Safety Net (ASN) Programs Re-Enrollment Center.
The Texas Department of State Health Services requires all re-enrolling TVFC/ASN sites to complete and submit all sections of the re-enrollment form. If you fail to complete this re-enrollment form in its entirety, your ordering privileges may be suspended.
If you are ready to begin your re-enrollment, start here:
Prior to starting your re-enrollment, gather the following information:
- TVFC/ASN PIN: This information is required to begin your re-enrollment form. If you do not know your TVFC/ASN Program PIN, contact your Responsible Entity (RE).
- Primary and back-up vaccine coordinator’s information
- First and last name
- Unique email address
- Phone number
- Training Requirements: Before completing the TVFC/ASN Program Re-Enrollment, the DSHS requires that your primary and back-up vaccine coordinators complete and submit training certificates.
The following training must be completed annually:
- Most current Provider Policy Training
- Primary and back-up vaccine coordinators must complete the following trainings only once in their vaccine coordinator roles:
- Once the modules are completed, save copies of the Certificates of Completion as PDF files. You will be prompted to upload these certificates as you progress through the re-enrollment process.
- Patient Population:
- For TVFC: Number of children that were vaccinated in your facility in the previous 12 months in the following categories, separated by age groups (under 1 year of age, 1 to 3 years of age, 4 to 6 years of age and 7 to 18 years of age). This information can be collected from your
doses administered data, Medicaid claims, encounter data or your billing system.
- Enrolled in Medicaid or Medicaid-eligible
- American Indian/Alaskan Native
- Enrolled in CHIP
- Insured – This information services as verification for accountability of the TVFC/ASN Program to ensure federal-or state-supplied vaccines are not administered to ineligible clients.
- For ASN: Number of Uninsured and Insured adults that were vaccinated in your facility in the previous 12 months.
Vaccine Storage Units
- Number of refrigerators and freezers that store TVFC and/or ASN vaccine.
- Information on the make and model of each storage unit.
- Number of data loggers, including a backup, that monitors the temperatures of the refrigerators and freezers.
- Calibration Certificates or Reports of Calibration: Before completing this re-enrollment, DSHS requires all re-enrolling providers to upload current and valid certificates for all data loggers that are used to monitor the temperatures of the storage units, including the backup.
- Data logger calibration certificates must have unexpired calibration dates and a serial number that MATCHES the corresponding data logger.
- Dual-probe: Please indicate if your data loggers are “dual-probe” loggers by stating in writing that this device is a dual probe data logger.
- Facilities that are Federally Qualified Health Center (FQHC) and a Rural Health Center (RHC) must also submit a copy of the Centers for Medicare & Medicaid Services (CMS) letter designating the sites as such.
The letter should have the following components:
- CMS letterhead
- The name of your facility with address
- The type of facility (RHC or FQHC)
- Indication of your facility’s approval as a FQHC or RHC
- The following phrase: “This is to inform you that your FQHC/RHC meets the requirements for participation in the Medicare program, effective [x date].”
Thank you for your continued support of the TVFC and ASN Programs. You help keep Texans healthy by preventing and controlling vaccine-preventable disease.
If you have any questions, please contact your TVFC/ASN Responsible Entity (RE). For technical assistance, email the Vac Call Center at VacCallCenter@dshs.texas.gov.