Each clinic shall make provision for a medical back-up for patients who experience family planning related problems at a time when the clinic staff is unavailable.
Clinic staff, either paid or volunteer, shall perform the following functions:
Outreach workers or community health personnel shall have primary responsibility to contact individuals in need of family planning services, initiate family planning counseling, and assist in receiving, successfully using and continuing medical services;
The secretary or receptionist shall greet patients at the clinic, arrange for services and perform a variety of necessary clerical duties;
The interviewer or counselor shall take social histories, provide family planning information to patients and counsel patients regarding their family planning and related problems;
The nurse or clinic aide shall assist the physician in providing medical services to the patient;
The physician shall be responsible for providing or exercising supervision over all medical and related services provided to patients; and
Training programs shall be developed for new staff, and time shall be made available periodically for their training.
For existing staff, time shall be made available for staff conferences and for inservice training in new techniques and procedures.
For volunteers, time shall be made available for staff to coordinate, train, and supervise them to be an effective, integral part of the clinic.
Patient and community outreach.
Each clinic shall have an active outreach effort aimed at:
Recruiting and retaining patients in the family planning clinic, through:
Procedures for family planning counseling and motivating appropriate persons to avail themselves of family planning medical services;
Assisting individuals in receiving family planning medical services;
Activities designed to follow-up potential and actual family planning patients as indicated; and
Meeting all human needs through appropriate and effective referral to other community resources; and
Increasing community awareness and acceptance of the family planning clinic through:
Public information campaigns utilizing all channels of communication;
Development of formal referral arrangements with community resources; and
Involvement of appropriate community residents in the operation of the family planning clinic.
Patient education and counseling.
At the time the patient is to receive family planning medical services, the following components of social services shall be provided:
An intake interview designed to obtain pertinent information regarding the patient, to explain the conditions under which services are provided and to create the opportunity for a discussion of the patient's problems;
Methods of contraception, including how they work, side effects and effectiveness;
An opportunity for patients to ask questions and discuss their concerns; and
An optional discussion of such topics as breast and cervical cancer, venereal disease, human sexuality or vaginopathies; and
Clarify any areas of concern or questions regarding medical services;
Elicit from the patient evidence of a complete understanding of the use of family planning methods;
Effectively inform the patient what procedures are to be followed if problems are experienced;
Inform the patient about the clinic's follow-up procedures and possible referral to other community resources; and
All medical and related services shall be provided by or under the supervision and responsibility of a physician.
Prescription of the family planning method selected by the patient unless medically contraindicated;
Instructions on the use of the chosen method, provision of supplies and schedule for revisits; and
Referral to inpatient service when necessary to treat complications of contraceptive services provided by the clinic.
Equipment and supplies in the clinic shall be commensurate with the services offered. Sufficient first aid equipment shall be available for use when needed.
Treatment for minor vaginal infections and venereal disease may be made available either by the clinic or through referral.
The family planning clinic shall be designed to provide comfort and dignity for the patients and to facilitate the work of the staff. A clinic facility shall be adequate for the quantity of services provided, and shall include:
A comfortable waiting room with an area for patient reception, record processing and children's play;
A group conference room for staff meetings and patient education;
A work room or laboratory area with sufficient equipment and nearby storage space, none of which is accessible to the patient;
A sufficient number of private and well-equipped examining rooms with proximal dressing areas which ensure the dignity of the patient;
Adequate toilet facilities, preferably near the dressing room; and
Arrangements for routine and restorative facility maintenance.
DHS 105.36 Note
For covered family planning services, see s. DHS 107.21
DHS 105.36 History
Cr. Register, February, 1986, No. 362
, eff. 3-1-86; r. (2) (e), (7) (b) 6., renum. (2) (f) and (g) to be (2) (e) and (f), (7) (b) 7. to be (7) (b) 6., Register, January, 1997, No. 493
, eff. 2-1-97; correction in (1) (b) made under s. 13.93 (2m) (b) 7., Stats., Register, December, 1999, No. 528
DHS 105.37 Early and periodic screening, diagnosis and treatment (EPSDT) providers. DHS 105.37(1)(1)
EPSDT health assessment and evaluation services. DHS 105.37(1)(a)
(a) Eligible providers.
The following providers are eligible for certification as providers of EPSDT health assessment and evaluation services:
EPSDT providers shall provide periodic comprehensive child health assessments and evaluations of the general health, growth, development and nutritional status of infants, children and youth. Immunizations shall be administered at the time of the screening if determined medically necessary and appropriate. The results of a health assessment and evaluation shall be explained to the recipient's parent or guardian and to the recipient if appropriate.
EPSDT health assessment and evaluation services shall be delivered under the supervision of skilled medical personnel. In this section “skilled medical personnel" means physicians, physician assistants, nurse practitioners, public health nurses or registered nurses. Skilled medical personnel who perform physical assessment screening procedures shall have successfully completed either a formal pediatric assessment or an inservice training course on physical assessments approved by the department. Individual procedures may be completed by paraprofessional staff who are supervised by skilled medical personnel. Registered nurses who perform EPSDT physical assessments shall have satisfactorily completed a curriculum for pediatric physical assessments approved by the department.
All conditions uncovered which warrant further care shall be diagnosed or treated or both by the provider, if appropriate, or referred to other appropriate providers. A referral may either be a direct referral to the appropriate health care provider or a referral recommendation submitted through the agency responsible for the patient's case management and advocacy.
Health maintenance organizations and prepaid health plans providing EPSDT services shall meet all requirements of 42 CFR 441.60
in addition to the requirements under subds. 1.
Complete the department's EPSDT claim form and an individual health and developmental history for each client; and
Maintain a file on each client receiving EPSDT services which includes a copy of the EPSDT claim form, individual health and developmental history and follow-up for necessary diagnosis and treatment services.
The EPSDT provider shall release information on the results of the health assessment to appropriate health care providers and health authorities when authorized by the patient or the patient's parent or guardian to do so.
(a) Case management reimbursement.
Providers certified under sub. (1)
as providers of EPSDT health assessment and evaluation services shall be eligible to receive reimbursement for EPSDT case management in accordance with the limitations contained in the case management agreement between the provider and the department.