Common use of Contraceptive Services and Supplies Clause in Contracts

Contraceptive Services and Supplies. Reference: “Contraceptive services and supplies that are made available off-site through a community medical provider are: Offered in conjunction with care coordination; Available through a community medical provider with which the community-based program has formal linkages; Meets all patient privacy and confidentiality requirements that patients require; Available in a timely manner; Follow XX-XX/RH standards of practice (including US-MEC guidelines), and standards of practice; Follow other applicable program requirements, including privacy protections under HIPAA” (Page 37) XX-XX/RH Programs ensure and verify that the level of privacy protection and confidentiality safeguards that each patient requires and expects will be met through all external referral providers to which patients are referred. XX-XX/RH Programs have the capacity to ensure confidential contraceptive management (such as LARC), cytology screening and management (including colposcopy services), and other clinical services following XX-XX/RH Guidelines If (or when) services are not provided by program staff on-site. (Page 123) Describe how patient privacy and confidentiality requirements are assured through off-site services and referrals. (What agreements and mechanisms are in place to assure all points of confidentiality potential breech are safeguarded when services are provided off-site or a referral is made? Address areas in which disclosure and release can occur, including release of health care information, patient scheduling, appointment reminders, laboratory testing, after visit summary and EOBs.)  The Kenosha County Division of Health (KCDOH) has the usual and customary methods of maintaining patient privacy protection and confidentiality safeguards using HIPAA mandate. KC RH-FP clinical services ensures workplace environmental measures are in place to maintain patient confidentiality safeguards throughout every aspect of program operations, communications, and information management. This including verification when scheduling or providing laboratory tests results (i.e. use of patient identifiers over the phone). Patients also have the option of accepting their after- patient summary through electronic medical records. To further ensure client privacy and confidentiality, the EMR system has a reproductive location with specific staff rights designated to staff ‘assigned’ to the KC RH-FP clinical services program. The release of information must be complete and accurate prior to information being released, including demographic information, name, date of birth, telephone and address; the place where the information is to be sent; what information should be sent; what dates of information are needed; the completed expiration date of the document (or the release is deemed invalid in 6 months from signature date). The release must also be signed by a KCDOH staff member and include the client’s signature and date. If any of the above is missing, the document is deemed invalid. Contact information and whether RH-FP staff, or designate, can contact the client is established and documented during the initial visit. Contact information and contact/no contact status is verified at each visit to assure client centered care, and to help staff determine whether appointment reminders (generic) can be texted or emailed. Explanation of benefits are mailed through State FPOS program in accordance to the guidelines established. Upon initial application, if the client expresses the desire for no contact, RH-FP will use the clinic address to receive mail. The client will then be contacted according to their predetermined instructions. One of our key improvements will be to better problem solve follow-up to continued enrollment.

Contraceptive Services and Supplies. Reference: “Contraceptive services and supplies that are made available off-site through a community medical provider are: Offered in conjunction with care coordination; Available through a community medical provider with which the community-based program has formal linkages; Meets all patient privacy and confidentiality requirements that patients require; Available in a timely manner; Follow XX-XX/RH standards of practice (including US-MEC guidelines), and standards of practice; Follow other applicable program requirements, including privacy protections under HIPAA” (Page 37) XX-XX/RH Programs ensure and verify that the level of privacy protection and confidentiality safeguards that each patient requires and expects will be met through all external referral providers to which patients are referred. XX-XX/RH Programs have the capacity to ensure confidential contraceptive management (such as LARC), cytology screening and management (including colposcopy services), and other clinical services following XX-XX/RH Guidelines If (or when) services are not provided by program staff on-site. (Page 123) Describe how patient privacy and confidentiality requirements are assured through off-site services and referrals. (What agreements and mechanisms are in place to assure all points of confidentiality potential breech are safeguarded when services are provided off-site or a referral is made? Address areas in which disclosure and release can occur, including release of health care information, patient scheduling, appointment reminders, laboratory testing, after visit summary and EOBs.)  The Kenosha County Division As a community-based, reproductive health clinic within a Department of Health and Human Services (KCDOHDHHS) has Agency, Healthy Connections adhers to the usual policies and customary methods procedures of maintaining patient privacy protection and confidentiality safeguards using HIPAA mandate. KC RH-FP clinical services ensures workplace environmental measures are in place to maintain patient confidentiality safeguards throughout every aspect of program operations, communications, and information managementthe Agency. This including verification when scheduling includes all written and verbal confidential information. Clinic staff review policy and procedures yearly. Clients of Healthy Connections identify at the time of their first appointment the most confidential means for contact. This includes phone calls, letters, text or providing laboratory tests results email. Clients also indicate if we can identify who we are. Arrangments are made with clients before leaving the clinic for specific instructions on how they would like to receive any follow-up test results. Clients enrolling in Badger Care-Family Planning Only Services (i.e. use BC-FPOS) receive information on the confidentially of patient identifiers over their application, the phone)ability to have information sent to an alternative address and for minors, how billing statements are coded to assure that nothing will be sent home to their parents. Patients Healthy Connections clients in need of off-site services are care managed on an individual basis. The current contracted NP is also the community partner referral source. If at all possible (based on need and timeliness of referral) clients are scheduled to meet with the NP prior to being seen off-site. If not feesible, clients have the option to schedule their own appointment or request the assistance of accepting their after- patient summary through electronic clinic staff. A signed medical recordsrelease form is requested of all clients being referred off-site. To further ensure client privacy and confidentialityFor minor clients in need of off-site referrals, the EMR system has a reproductive location with specific staff rights designated to staff ‘assigned’ to the KC RH-FP clinical services program. The release of information must be complete and accurate prior to information being released, including demographic information, name, date of birth, telephone and address; the place where the information is to be sent; what information should be sent; what dates of information are needed; the completed expiration date of the document (or the release is deemed invalid in 6 months from signature date). The release must also be signed by a KCDOH staff member and include the client’s signature and date. If any of the same procedure outlined above is missingfollowed, the document is deemed invalid. Contact information and whether RH-FP staff, or designate, can contact the client is established and documented during the initial visit. Contact information and contact/no contact status is verified at each visit to assure client centered care, and to help staff determine whether appointment reminders (generic) can be texted or emailed. Explanation of benefits are mailed through State FPOS program in accordance to the guidelines established. Upon initial applicationhowever, if the client expresses is unable to meet in house prior to a NP referral, appointments are scheduled with the desire community partner staff familiar with the services of Healthy Connections. This includes specific requests to the scheduler to change the phone number to the client's cell phone (if applicable) for no contact, RH-FP will use automatic reminder phone calls and informed that the clinic address client has their own insurance and the MA number (copies of their information and MA number are given to receive mailthe client to bring along to the appointment). The client will then Client's are reminded to explain at the time of their appointment registration that they have their own insurance and that the appointment should not be contacted according billed to their predetermined instructionsparents insurance. One Minor clients are also asked to sign a medical release form for release of our key improvements will specific health information. Clients in need of services who request referral to a different community health provider are also care managed individually based on need. All clients sign a medical release form for release of health care information for medcial coordination and continuity of care. All requests for medical information for Healthy Connection clients requires a signed release of information form. Each time information is released, it must be noted in the clients medical record disclosure tracking log and includes the following information: to better problem solve follow-up to continued enrollmentwhom, what information was released, purpose and date.

Contraceptive Services and Supplies. Reference: “Contraceptive services and supplies that are made available off-site through a community medical provider are: Offered in conjunction with care coordination; Available through a community medical provider with which the community-based program has formal linkages; Meets all patient privacy and confidentiality requirements that patients require; Available in a timely manner; Follow XX-XX/RH standards of practice (including US-MEC guidelines), and standards of practice; Follow other applicable program requirements, including privacy protections under HIPAA” (Page 37) XX-XX/RH Programs ensure and verify that the level of privacy protection and confidentiality safeguards that each patient requires and expects will be met through all external referral providers to which patients are referred. XX-XX/RH Programs have the capacity to ensure confidential contraceptive management (such as LARC), cytology screening and management (including colposcopy services), and other clinical services following XX-XX/RH Guidelines If (or when) services are not provided by program staff on-site. (Page 123) Describe how patient privacy and confidentiality requirements are assured through off-site services and referrals. (What agreements and mechanisms are in place to assure all points of confidentiality potential breech are safeguarded when services are provided off-site or a referral is made? Address areas in which disclosure and release can occur, including release of health care information, patient scheduling, appointment reminders, laboratory testing, after visit summary and EOBs.)  The Kenosha County Division of Health (KCDOH) has the usual Iron County’s XX-XX/RH program works hard to protect and customary methods of maintaining maintain patient privacy protection and confidentiality safeguards using for our patients on-site as well as when contraceptive services and supplies are referred off- site through a community healthcare provider. The program maintains agency HIPAA mandate. KC RH-FP clinical services ensures workplace environmental measures are in place policy and procedures to maintain protect patient confidentiality safeguards throughout every aspect of program operations, communications, and information management. This including verification when scheduling or providing laboratory tests results (i.e. use of patient identifiers over the phone)privacy. Patients who seek contraception services off-site are confidentially refered to community healthcare providers who also have the option capacity to ensure patient protection and confidentially. Community healthcare providers that patients are most commonly referred to include Aspirus System, Marshfield Clinic and Essentia Health. Patient health care records cannot be disclosed from the program without prior written informed consent for release of accepting confidential information from the patient only. All requests for Medical Records received from off-site community providers must conform to all legally required elements for release. In the event that a patient will be transporting their after- patient summary through electronic personal medical records. To further ensure client privacy and confidentialityrecords off-site, the EMR system has a reproductive location with specific staff rights designated to staff ‘assigned’ to the KC RH-FP clinical services program. The release of information must be complete and accurate prior to information being released, including demographic information, name, date of birth, telephone and address; the place where the information patient is to be sent; what information should be sent; what dates sign a release to assume responsibility for the confidentiality of information are needed; the completed expiration date of the document (or the release is deemed invalid in 6 months from signature date). The release must also be signed by a KCDOH staff member and include the client’s signature and date. If any of the above is missing, the document is deemed invalid. Contact information and whether RH-FP staff, or designate, can contact the client is established and documented during the initial visit. Contact information and contact/no contact status is verified at each visit to assure client centered care, and to help staff determine whether appointment reminders (generic) can be texted or emailed. Explanation of benefits are mailed through State FPOS program in accordance to the guidelines established. Upon initial application, if the client expresses the desire for no contact, RH-FP will use the clinic address to receive mail. The client will then be contacted according to their predetermined instructions. One of our key improvements will be to better problem solve follow-up to continued enrollmentrecords.

Contraceptive Services and Supplies. Reference: “Contraceptive services and supplies that are made available off-site through a community medical provider are: Offered in conjunction with care coordination; Available through a community medical provider with which the community-based program has formal linkages; Meets all patient privacy and confidentiality requirements that patients require; Available in a timely manner; Follow XX-XX/RH standards of practice (including US-MEC guidelines), and standards of practice; Follow other applicable program requirements, including privacy protections under HIPAA” (Page 37) XX-XX/RH Programs ensure and verify that the level of privacy protection and confidentiality safeguards that each patient requires and expects will be met through all external referral providers to which patients are referred. XX-XX/RH Programs have the capacity to ensure confidential contraceptive management (such as LARC), cytology screening and management (including colposcopy services), and other clinical services following XX-XX/RH Guidelines If (or when) services are not provided by program staff on-site. (Page 123) Describe how patient privacy and confidentiality requirements are assured through off-site services and referrals. (What agreements and mechanisms are in place to assure all points of confidentiality potential breech are safeguarded when services are provided off-site or a referral is made? Address areas in which disclosure and release can occur, including release of health care information, patient scheduling, appointment reminders, laboratory testing, after visit summary and EOBs.)  When an off-site referral is made, the RN calls and identifies the patient is confidential, the pay source is only FPOS, no phone calls or mailing (bills, surveys, reminders, etc.) to the home address. The Kenosha County Division of Health (KCDOH) has RN documents the usual and customary methods of maintaining patient privacy protection and confidentiality call in her notes. By educating the the local clinic administrative staff, safeguards using HIPAA mandate. KC RH-FP clinical services ensures workplace environmental measures are have been put in place to maintain patient confidentiality safeguards throughout every aspect of program operations, communications, and information management. This including verification when scheduling or providing laboratory tests results (i.e. use of patient identifiers over the phone). Patients also have the option of accepting their after- patient summary through electronic medical records. To further ensure client privacy and protect confidentiality, the EMR system has a reproductive location with specific staff rights designated to staff ‘assigned’ to the KC RH-FP clinical services program. The clinic uses a distinct color coded billing sheet to ensure the billing staff is aware this client is FPOS only and not to bill any other insurance on file. Disclosure and release of information must be complete and accurate prior can occur when a client signs an authorization to information being released, including demographic release medical information, name, date of birth, telephone and address; the place where the information is to be sent; what information should be sent; what dates of information are needed; the completed expiration date of the document (or the release is deemed invalid in 6 months from signature date). The release must also be signed by authorization is used only if needed to discuss a KCDOH staff member and include the client’s signature and date. If any of the above is missing, the document is deemed invalid. Contact information and whether RH-FP staff, or designate, can contact the client is established and documented during the initial visit. Contact information and contact/no contact status is verified at each visit to assure client centered care, medical condition with another provider and to help staff determine whether appointment reminders (generic) can be texted or emailedobtain office notes, labs, & cytology results. Explanation of benefits are mailed through State Badgercare and FPOS program in accordance do not send EOB’s to the guidelines established. Upon initial application, if the client expresses the desire for no contact, RH-FP will use the clients and our clinic address to receive mail. The client will then be contacted according to their predetermined instructions. One of our key improvements will be to better problem solve follow-up to continued enrollmentdoes not bill other insurance companies that send EOB’s.

Contraceptive Services and Supplies. Reference: “Contraceptive services and supplies that are made available off-site through a community medical provider are: Offered in conjunction with care coordination; Available through a community medical provider with which the community-based program has formal linkages; Meets all patient privacy and confidentiality requirements that patients require; Available in a timely manner; Follow XX-XX/RH standards of practice (including US-MEC guidelines), and standards of practice; Follow other applicable program requirements, including privacy protections under HIPAA” (Page 37) XX-XX/RH Programs ensure and verify that the level of privacy protection and confidentiality safeguards that each patient requires and expects will be met through all external referral providers to which patients are referred. XX-XX/RH Programs have the capacity to ensure confidential contraceptive management (such as LARC), cytology screening and management (including colposcopy services), and other clinical services following XX-XX/RH Guidelines If (or when) services are not provided by program staff on-site. (Page 123) Describe how patient privacy and confidentiality requirements are assured through off-site services and referrals. (What agreements and mechanisms are in place to assure all points of confidentiality potential breech are safeguarded when services are provided off-site or a referral is made? Address areas in which disclosure and release can occur, including release of health care information, patient scheduling, appointment reminders, laboratory testing, after visit summary and EOBs.)  The Kenosha County Division of All statewide Women’s Health (KCDOHWH)/Family Planning (FP)clinics, including the OCHD-RHC program,that recieves Title V state grant fund follows the states statute in regard to minors seeking confidential reproductive health services (s.48.981 2m). All Title V Family Planning Clinics will guarantee that our adolescents clients will be assured that their services are confidential if we need to refer them to another WH/FP clinic for medical services beyond our scope, such as IUD insertions. We actively promote and collaborate with other statewide FP programs for our clients who are leaving the area to go to college in a different part of the state. We use FIND A CLINIC links and current FP address list. Confidential billing for all clients who are on BadgerCare+ or WFPOS is assured in the Wisconsin Family Planning Administrative Rules (DHS 105.36 (2) has (f); and the usual Wisconsin Medicaid Family Planning Medicaid Rules (DHS 151.03 (2) (d); and customary methods of maintaining patient privacy protection all clinics are HIPAA compliant. Private Clinic also follow Federal HIPAA regulations. We will provide written referrals to private clinic and confidentiality safeguards using HIPAA mandate. KC RH-FP clinical discuss with the client what services ensures workplace environmental measures are in place covered under WFPOS and what are not (to maintain patient confidentiality safeguards throughout every aspect of program operations, communications, and information managementavoid extra lab charges). This including verification when scheduling or providing laboratory tests results (i.e. use of patient identifiers over the phone). Patients also have the option of accepting their after- patient summary through electronic medical records. To further ensure client privacy and confidentiality, the EMR system has a reproductive location with specific staff rights designated to staff ‘assigned’ to the KC RH-FP clinical services program. The release of information must way they will be complete and accurate prior to information being released, including demographic information, name, date of birth, telephone and address; the place where the information is to be sent; what information should be sent; what dates of information are needed; the completed expiration date aware of the document (or the release is deemed invalid in 6 months from signature date). The release must also be signed by a KCDOH staff member and include the client’s signature and date. If any of the above is missing, the document is deemed invalid. Contact information and whether RH-FP staff, or designate, can contact the client is established and documented during the initial visit. Contact information and contact/no contact status is verified at each visit private clinic required procedures to assure client centered care, and to help staff determine whether appointment reminders (generic) can be texted or emailed. Explanation of benefits are mailed through State FPOS program in accordance to the guidelines established. Upon initial application, if the client expresses the desire for no contact, RH-FP will use the clinic address to receive mail. The client will then be contacted according to their predetermined instructions. One of our key improvements will be to better problem solve follow-up to continued enrollmentbill third party insurance before billing Medicaid.

Contraceptive Services and Supplies. Reference: “Contraceptive services and supplies that are made available off-site through a community medical provider are: Offered in conjunction with care coordination; Available through a community medical provider with which the community-based program has formal linkages; Meets all patient privacy and confidentiality requirements that patients require; Available in a timely manner; Follow XX-XX/RH standards of practice (including US-MEC guidelines), and standards of practice; Follow other applicable program requirements, including privacy protections under HIPAA” (Page 37) XX-XX/RH Programs ensure and verify that the level of privacy protection and confidentiality safeguards that each patient requires and expects will be met through all external referral providers to which patients are referred. XX-XX/RH Programs have the capacity to ensure confidential contraceptive management (such as LARC), cytology screening and management (including colposcopy services), and other clinical services following XX-XX/RH Guidelines If (or when) services are not provided by program staff on-site. (Page 123) Describe how patient privacy and confidentiality requirements are assured through off-site services and referrals. (What agreements and mechanisms are in place to assure all points of confidentiality potential breech are safeguarded when services are provided off-site or a referral is made? Address areas in which disclosure and release can occur, including release of health care information, patient scheduling, appointment reminders, laboratory testing, after visit summary and EOBs.)  Safeguarding privacy practices is an area of focus within our program. As previously mentioned, the Xxxxx County Health Department is under transition when looking at our referral network. Currently we refer out for LARCs and have two local clinics that do insertions. These local clinics are most convenient for clients, however, there is some concern for confidentiality with these appointments. Knowing this, it places PCHD in a tough situation. The Kenosha County Division complexities involved include, but are not limited to, small town familiarity, limited awareness about the confidential standards for RHFP clientele and limited access to local providers who are not already “Family Provider”. For clients with heightened concern for confidentiality, we refer to peer Reproductive Health/Family Planning providers. These sites are 30 plus miles away, but in our family planning ‘family’ and understand utmost importance of Health (KCDOH) has the usual and customary methods of maintaining patient privacy protection and practices. Discussions have occurred with our contracted NP who is on-site one half day per month. Options for increasing on- site services are being considered. As with all medical information, confidentiality safeguards using HIPAA mandate. KC RH-FP clinical services ensures workplace environmental measures releases are in place to maintain patient confidentiality safeguards throughout every aspect of program operations, communications, and information management. This including verification when scheduling or providing laboratory tests results (i.e. use of patient identifiers over the phone). Patients also have the option of accepting their after- patient summary through electronic medical records. To further ensure client privacy and confidentiality, the EMR system has a reproductive location with specific staff rights designated to staff ‘assigned’ to the KC RH-FP clinical services program. The release of information must be complete and accurate prior to information being released, including demographic information, name, date of birth, telephone and address; the place where the information is to be sent; what information should be sent; what dates of information are needed; the completed expiration date of the document (or the release is deemed invalid in 6 months from signature date). The release must also be signed by a KCDOH staff member and include the client’s signature and date. If any of the above is missing, the document is deemed invalid. Contact information and whether RH-FP staff, or designate, can contact the client is established only disclosed to those who can present a signed release. Our records are kept in locked cabinets and documented during our clinic area is private, within the initial visithealth department. Contact information and contact/no contact status We hope to continue to improve in adolescent friendly initiatives, as this is verified at each visit also an important aspect to assure client centered care, and to help staff determine whether appointment reminders (generic) can be texted or emailed. Explanation of benefits are mailed through State FPOS program in accordance to consider; knowing adolescents make up the guidelines established. Upon initial application, if the client expresses the desire for no contact, RH-FP will use the clinic address to receive mail. The client will then be contacted according to their predetermined instructions. One majority of our key improvements will be to better problem solve follow-up to continued enrollmentclient volume.

Contraceptive Services and Supplies. Reference: “Contraceptive services and supplies that are made available off-site through a community medical provider are: Offered in conjunction with care coordination; Available through a community medical provider with which the community-based program has formal linkages; Meets all patient privacy and confidentiality requirements that patients require; Available in a timely manner; Follow XX-XX/RH standards of practice (including US-MEC guidelines), and standards of practice; Follow other applicable program requirements, including privacy protections under HIPAA” (Page 37) XX-XX/RH Programs ensure and verify that the level of privacy protection and confidentiality safeguards that each patient requires and expects will be met through all external referral providers to which patients are referred. XX-XX/RH Programs have the capacity to ensure confidential contraceptive management (such as LARC), cytology screening and management (including colposcopy services), and other clinical services following XX-XX/RH Guidelines If (or when) services are not provided by program staff on-site. (Page 123) Describe how patient privacy and confidentiality requirements are assured through off-site services and referrals. (What agreements and mechanisms are in place to assure all points of confidentiality potential breech are safeguarded when services are provided off-site or a referral is made? Address areas in which disclosure and release can occur, including release of health care information, patient scheduling, appointment reminders, laboratory testing, after visit summary and EOBs.)  The Kenosha County Division Given that the Family Planning Clinic is located within Memorial Medical Center (MMC), a provider is readily available to offer reproductive health care services to client’s needing an exam or a procedure. Typically, a referral is made to the primary Nurse Practitioner at MMC who regularly works out of Health (KCDOH) has the usual and customary methods of maintaining patient privacy protection and confidentiality safeguards using HIPAA mandateGreenwood Clinic. KC RH-FP clinical services ensures workplace environmental measures are in place Prior to maintain patient confidentiality safeguards throughout every aspect of program operations, communications, and information management. This including verification when scheduling or providing laboratory tests results (i.e. use of patient identifiers over the phone). Patients also have the option of accepting their after- patient summary through electronic medical records. To further ensure client privacy and confidentialityinitiating a referral, the EMR system has a reproductive location with specific staff rights designated Family Planning Nurse ensures an “Authorization to staff ‘assigned’ to the KC RH-FP clinical services program. The release of information must be complete Disclose and accurate prior to information being released, including demographic information, name, date of birth, telephone Release” consent form is current and address; the place where the information is to be sent; what information should be sent; what dates of information are needed; the completed expiration date of the document (or the release is deemed invalid in 6 months from signature date). The release must also be signed by a KCDOH staff member the client. When health records are requested by the MMC provider, the Family Planning Nurse is able to provide these records and include discus the client’s signature and dateReproductive Health Care needs on a face-to-face basis. If any of the above When a referral is missingindicated, the document is deemed invalidFamily Planning Nurse will present the MMC’s scheduling desk and schedule the appointment for the Family Planning client. Contact information and whether RH-FP staffThe Nurse ensures that MMC staff enters a note into the appointment description, or designate, can contact noting that the client is established a confidential Family Planning client. The client’s phone number is updated to ensure it’s the client’s personal cell phone number versus a home number. The Nurse also requests that MMC staff make a note of the client’s Medicaid (BC-FPOS) number and documented during reminds the initial visitstaff to bill Medicaid. Contact information and contact/no contact status Most appointments are scheduled the day-of, which eliminates the need for an appointment reminder. On occasion, a referral is verified made to a MMC provider at each visit the Neillsville Center (off-site). In this case, the Nurse will schedule this appointment with the MMC staff in Greenwood to assure client centered care, and to help staff determine whether appointment reminders (generic) can be texted or emailed. Explanation of benefits are mailed through State FPOS program sure a note is entered in accordance regards to the guidelines establishedclient’s confidentiality status, insurance status, etc. Upon initial application, if the client expresses the desire for There is no contact, RH-FP will use formal agreement made with the clinic address at this time, however we are working with the billing department to receive mail. The client will then be contacted according ensure statements are not being sent to their predetermined instructions. One of our key improvements will be to better problem solve follow-up to continued enrollmentthe client’s home before Medicaid is billed.

Contraceptive Services and Supplies. Reference: “Contraceptive services and supplies that are made available off-site through a community medical provider are: Offered in conjunction with care coordination; Available through a community medical provider with which the community-based program has formal linkages; Meets all patient privacy and confidentiality requirements that patients require; Available in a timely manner; Follow XX-XX/RH standards of practice (including US-MEC guidelines), and standards of practice; Follow other applicable program requirements, including privacy protections under HIPAA” (Page 37) XX-XX/RH Programs ensure and verify that the level of privacy protection and confidentiality safeguards that each patient requires and expects will be met through all external referral providers to which patients are referred. XX-XX/RH Programs have the capacity to ensure confidential contraceptive management (such as LARC), cytology screening and management (including colposcopy services), and other clinical services following XX-XX/RH Guidelines If (or when) services are not provided by program staff on-site. (Page 123) Describe how patient privacy and confidentiality requirements are assured through off-site services and referrals. (What agreements and mechanisms are in place to assure all points of confidentiality potential breech are safeguarded when services are provided off-site or a referral is made? Address areas in which disclosure and release can occur, including release of health care information, patient scheduling, appointment reminders, laboratory testing, after visit summary and EOBs.)  Xxxxxx County Health Department complies with all HIPAA privacy laws and regulations in addition to all staff completing confidentiality and HIPAA compliance agreements upon their hire/start date. All clients complete a demographic form created by PCRH which identify how a client would wish to be contacted if needed, as well as assesses client confidentiality needs. This is then completed at initial appointments and annual visits. The Kenosha client confidentiality needs are indicated into our EMR system and allows all pertinent staff that have contact with the individual to have access to those confidentiality requests. If there are issues with mail, any confidential teens and/or a possibility for breach in confidentiality, clinic staff will make arrangements for the clients to pick up their mail at our office. PCRH is the only local reproductive health clinic to provide confidential services to adolescents. All adolescents are counseled regarding their confidential reproductive health rights, PCRH policies, coercion and abuse screening (ASVAST). Clients may leave clinic staff messages on our voice mail system during off hours; only Reproductive Health staff members have access to and the ability to retrieve these messages. Clients also are able to contact PCRH Staff via email as staff email addresses are available on the Xxxxxx County Division Public Health web page. Clients are cautioned regarding confidentiality issues with using email to communicate with staff. If a client chooses to communicate by electronic means (e.g., email or text messaging), an electronic communication agreement form must be signed and scanned in the client’s file. All clients are given PCRH contact information and strongly encouraged to call back with any further questions or concerns they may have. In order to disclose or transfer client records to other care providers each client is required to complete a “Release of Health (KCDOH) has Information” form that outlines the usual and customary methods of maintaining patient privacy protection and confidentiality safeguards using HIPAA mandate. KC RH-FP clinical services ensures workplace environmental measures are in place to maintain patient confidentiality safeguards throughout every aspect of program operations, communications, dates and information managementrequested. This including verification when scheduling If a client does not have a ROI on file for the clinic requesting client records, such information will not be released. All client and visit information is archived under the specific client in our Electronic Medical Record, Nightingale Notes. Staff members that participate or providing laboratory tests results (i.e. use of patient identifiers over the phone). Patients also work within a Public Health Department program have the option of accepting their after- patient summary through electronic medical records. To further ensure client privacy and confidentiality, the EMR system has a reproductive location with access only to files enrolled in that specific staff rights designated to staff ‘assigned’ to the KC RH-FP clinical services program. The release of information must be complete and accurate prior to information being releasedAll client laboratory results are given by phone or by letter if requested. Patient identification is verified upon contact, including demographic information, name, such as date of birth. No results are left on voicemail systems, telephone in the event that a client does not answer their phone, a voice message is left requesting a return phone call to the clinic. Clients are offered appointment reminders a day or two prior to their scheduled appointment time. These are done based upon client preferences, if there is an electronic agreement signed and address; the place where the information is to be sent; what information should be sent; what dates of information are needed; the completed expiration date of the document (or the release is deemed invalid in 6 months from signature date). The release must also be signed by a KCDOH staff member and include the client’s signature and datefile, an email or text reminder will go out. If any of the above there is missingno agreement found, the document is deemed invalid. Contact information and whether RH-FP staff, or designate, can contact the client is established and documented during the initial visit. Contact information and contact/no contact status is verified at each visit to assure client centered care, and to help staff determine whether appointment reminders (generic) can be texted or emailed. Explanation of benefits are mailed through State FPOS program in accordance to the guidelines established. Upon initial application, if the client expresses the desire for no contact, RH-FP will use the clinic address to receive mail. The client will then be contacted according to their predetermined instructions. One of our key improvements client’s will be given a phone call reminder for their appointment. When there is no identifying information provided on the client’s voice messaging system, a generic message is left to better problem solve follow-up to continued enrollmentreturn call.