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<br />'. <br /> <br />DOCUMENT NO. 7560022067-2005 <br />ATTACHMENT NO. 01 <br />PURCHASE ORDER NO. 0000001782 <br /> <br />PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT <br /> <br />RECEIVING AGENCY PROGRAM: IMMUNIZATION DIVISION <br /> <br />TERM: January 01,2004 THRU: December 31,2004 <br /> <br />SECTION 1. SCOPE OF WORK: <br /> <br />PERFORMING AGENCY will provide essential public health services as specified in <br />PERFORMING AGENCY'S approved 2004 Interlocal Application for Immunization Services, <br />dated June 16, 2003, incorporated herein and made part of this contract Attachment. <br />Immunization public health services include one or more of the following eight immunization <br />core component areas: <br /> <br />1. Program management activities to include program planning, staffing and training, and <br />partnerships and collaborations. <br />2. Vaccine management activities to include ordering, storage, and vaccine accountability. <br />3. Immunization registry activities to include provider participation and training. <br />4. Provider quality assurance activities to include provider education, site visits, and access <br />to information on perinatal hepatitis B prevention. <br />5. Service delivery activities to include targeting under-served populations and promoting a <br />medical home. <br />6. Consumer information to include information development and dissemination and <br />vaccine benefit and risk education. <br />7. Surveillance activities of vaccine preventable diseases to include surveillance, response, <br />and reporting, screening for perinatal hepatitis B, and vaccine safety. <br />8. Population assessment activities to include assessment of communities, child-care <br />facilities, Head Start Programs, Kindergarten, and 7th grade entrants. <br /> <br />PERFORMING AGENCY shall perform the following activities to comply with the National <br />Childhood Vaccine Injury Act of 1986, and the Omnibus Budget Reconciliation Act of 1993 and <br />Section 1928 of the Social Security Act: <br /> <br />1. Distribute Vaccine Information Statements (VIS) to clients. <br />2. Record required information regarding vaccine administration m permanent medical <br />record. <br />3. Report adverse events relating to vaccine administration. <br />4. Recruit and enroll providers into the Texas Vaccines For Children (TVFC) program. <br />5. Obtain a signed provider enrollment form from each provider participating in the TVFC <br />program that includes name, medical license number and Medicaid provider number (if <br />applicable) of each provider practicing at an enrolled site. <br />6. Maintain TVFC provider enrollment records and provider profiles for at least three (3) <br />years. <br /> <br />ATTACHMENT - Page 1 <br />