NYS Family Planning Program Annual Program Update

Transcription

1 NYS Family Planning Program Annual Program Update November 14, 2018 RAE ANN AUGLIERA MEAGHAN CARROLL MARLENA CUMMINS NICOLE FURMAN

2 NYSFPP Annual Program Update - Overview NYSDOH Staff Division of Family Health Priorities & Focus Areas NYS Family Planning Program Overview & Impact FY 2018 Title X Program Priorities Program Updates Fiscal Updates IPRO Site Monitoring 2

3 NYSFPP Staff 3

4 NYSFPP Staff Program Staff: Rae Ann Augliera, Director, Family Planning Program Kallyn Alexander Karen Barrett Meaghan Carroll Bernadette Dolen Nicole Furman Nevillene White 4

5 NYSFPP Staff Data Staff: Eileen Shields, Director Data Analysis, Research& Surveillance Victoria VanHoesen 5 Fiscal Staff: Marlena Cummins marlena.cummins@health.ny.gov

6 Division of Family Health Priorities & Focus Areas 6

7 7 NYSDOH Organizational Chart NYSDOH Office of Public Health/CCH Division of Family Health Office of the Medical Director Bureau of Administration Bureau of Women, Infant & Adolescent Health Bureau of Child Health Bureau of Early Intervention

8 8 NYSDOH Organizational Chart BWIAH Perinatal Health Unit Data Research & Surveillance Family Planning Sexual Violence Prevention Adolescent Health Home Visiting

9 9 Lifecourse Model Preconception Prenatal/ Postpartum Interconception Improved Birth Outcomes Reduced Maternal Mortality

10 10 Pregnancy-related Maternal Mortality (n=59) Preliminary Data 88% of pregnancy-related deaths had prenatally identified risk factors Prenatally identified risk factors* 88% Pre-pregnancy weight status Hypertension 15% (n=9) Obesity, BMI>=30 34% (n=20) Anemia 12% (n=7) Overweight, BMI between 25 and 30 12% (n=7) Asthma Psychiatric disorders Cardiac problems Uterine abnormality or incompetent cervix 12% (n=7) 12% (n=7) 12% (n=7) 10% (n=6) Smoking prior to pregnancy 12% Alcohol use prior to pregnancy 12% Drug use prior to pregnancy 14% *Factors identified in less than 6 women not presented.

11 11 Promote Health Equity Increase the intendedness of pregnancy Improve birth outcomes Improve/foster healthy relationships

12 NYSDOH Commissioner s Listening Sessions 12 Focus on maternal health Seven locations across NYS Family Planning services and access Maternal Mortality Task Force Recommendations Replication

13 13 Family Planning is Preventive Care Half of all uninsured women rely on FP clinics as their only source of medical care FP services offers an opportunity to help clients achieve optimum overall health Improving overall health and helping clients plan pregnancy can improve birth outcomes

14 NYS Family Planning Program Overview & Impact 14

15 November 14, NYS Family Planning Program Family Planning Provider Network consists of: 48 Article 28 facilities that operate 173 family planning service sites Family Planning Providers include: NYC Health & Hospitals Corporation Facilities (10) Planned Parenthood Affiliates (9) Local Health Departments (8) Federally Qualified Health Centers (7) Hospital Operated Clinics (6) Teen Focused Health Centers (3) Other Facilities (5)

16 November 14, Family Planning Program Impact 2017 Family Planning Annual Report 301,128 unduplicated clients o 89.4% female o 10.6% male o 16.4% adolescents 470,973 total visits 67% at or below 100% FPL

17 Clients/Visits Over Time 600, , , , , , Clients Visits

18 Strong Investment in Family Planning 18 NYS contributes the majority of our program s funding Title V Title X NY State Title V 16% NY State 63% Title X 21%

19 Unique Components of the NYS FPP Include: Family Planning Benefit Program and FPBP Coordinators Standard NYS FPP workplan Chlamydia/HIV testing and counseling free for anyone at or below 200% FPL Annual review of schedule of discounts Performance Measure Initiatives Site Monitoring conducted by IPRO NYS Family Planning Training Center 19

20 Things to Consider How your agency data compares to statewide program data QIR report available in Ahlers Possible CQI projects Technical Assistance from NYS Family Planning Training Center and NYSDOH Learning Collaborative Opportunities 20

21 Title X Updates 21

22 Title X Grant Award 22 Funded for period September 1, 2018 through March 31, 2019 FY 2018 Program Priorities

23 23 Title X FY 2018 Program Priorities Available on HHS website at:

24 24 Performance Measures Voluntary/ Separate Title X FY 2018 Title X Program Priorities Positive family relationships Comprehensive Primary Care Family Participation Compliance with State Laws Promoting Optimal Health Outcomes

25 25 1. Efficient & Effective Program Management 2. Management and Decision-Making and Accountability for Outcomes 3. Cooperation with community and faith based organizations 4. Meaningful collaboration with subrecipients and documented partners 5. Education & Counseling on Healthy Relationships & Avoiding Sexual Risk/Returning to a Sexually Risk Free Status 6. Sexual Risk Avoidance for Adolescents 7. Voluntary Services 8. Data Collection & Performance Management

26 Program Updates 26

27 Review & Reminders OPA Database Updates Responsibility of subrecipient agency Used to verify 340B eligibility Notification of Changes in Programs/Service Sites Annual Report Request forthcoming, due in January 2019 CVR Updates ed 10/15/18

28 28 Upcoming in 2019 NYS FPP Program Manual & Training Guidance Contract Extension Documents BWIAH Joint Provider Day May 2019 Integration into Well-Woman Care NYSDOH Contract Manager Site Visits IPRO Site Monitoring Visits Completed

29 Fiscal Updates 29

30 Division of Family Health Bureau of Administration (518)

31 31 General Reminders on Claims Claims are due 30 days after the end of each quarter. (i.e. 7/1/18 9/30/18 due 10/30/18) The following documentation must be included with your claim: - Claim for Payment form (AC3253-S) - Budget Statement and Report of Expenditures (BSROE) - Expenditure and Revenue Report All claims are to be signed and submitted electronically to: DFH.BOA@health.ny.gov Subject line should contain the following information: Contract # / Organization / Claim Period / Program Name / Indicate Claim Type (i.e. Q1, Supplemental, Advance, or FINAL) C12345GG / ABC Company / Family Planning / 7/1-9/30/18 / Q3

32 Contract Period Contracts are in place through December 31, Advance payment up to 25% of the 2019 budget value may be requested by submitting a claim to DFH.BOA@health.ny.gov prior to January 1, *Advance claims cannot be paid until after the start of the budget period (January 1 st ). The approved 2019 budget can be found in the executed contract. A budget modification request must be submitted if changes are required. Budget modification requests must be submitted to DFH.BOA@health.ny.gov for review. Please use the following naming convention in the subject line on budget modification request s: Contract # / Organization / Program Name / Budget Period / Bud Mod. C12345GG / ABC Company / Family Planning / 2019 / Bud Mod

33 33 Forms All forms are available upon written request to Please use the following naming convention in the subject line on s: Contract # / Organization / Program Name / Budget Period / Request Type. C12345GG / ABC Company / Family Planning / 2019 / Form Request The following forms will contain prepopulated information: Budget Statement and Report of Expenditure (BSROE) Contains current approved budget and prior period expenditures Budget Modification Request Contains current approved budget

34 34 Supporting Documentation Although supporting documentation is NOT required at the time of claim submission, you may be requested to provide appropriate supporting documentation at any time for any or all of the expenses included on the claim. The Division of Family Health, Bureau of Administration performs routine claim traces and OSC performs audits on some claims prior to approval. In general we are looking for: Proof the expense was incurred (i.e. payroll records/invoices/bills/purchase orders), Proof the expense was paid (cancelled checks (front and back) or copies of bank statements to demonstrate electronic funds transfers), Documentation of how the expense was allocated to this contract (i.e. check request form demonstrating how the expense was allocated). Other proof of allocation is also acceptable, and If Out-of-State Travel costs are claimed, proof that prior approval was obtained.

35 IPRO Site Monitoring 35

36 Site Monitoring Process IPRO conducts site monitoring reviews on behalf of NYSDOH Reviews completed from July 2017 to September Subrecipient Agencies 56 Service Sites Review includes: Pre-review submissions, on-site observations, staff interviews, and document review DOH contract staff conduct Desk Audit of fiscal, data, and administrative indicators 36

37 Site Monitoring Process IPRO issues monitoring report, detailing all findings from site review Immediate Action Reports issued if IPRO identifies major finding, especially related to health and safety Provider has 45 days to submit Corrective Action Plan (CAP) DOH reviews/requests revisions and/or approves CAP Provider implements changes outlined in CAP This may require ongoing updates to DOH demonstrating CAP has been implemented 37

38 38 12 Month Review Summary Range of scores: 38% to 100% (average 67%) Summary of reviews conducted from 7/1/17 6/30/18

39 12 Month Review Summary Average Scores by Provider Type Provider group discussion tomorrow Figure 2 - Family Planning Reviews Completed, by Program Type (N=36) 39 Program Type # Site Reviewed Average Score % CAPS Passing First Screen Federally Qualified Health Center (FQHC) 7 59% Hospital Operated (HO - excluding NYC H&H) 7 75% Local Health Department (LHD) 7 57% New York City Health & Hospitals (NYC H&H) 4 60% Planned Parenthood (PP) 6 83% Teen Focused (TF) 2 82% Other (O) 3 55% 29% 83% 60% 67% 40% 100% 67% (July 1, 2017 June 30, 2018)

40 12 Month Review Summary Top 5 Findings Most Frequently Assessed as Not Met 40 Figure 3 - Five Findings Most Frequently Assessed Not Met (N=36) Indicator Criteria % Not Met Determination of waived fees made by site director (6a) 96% Staff have been trained in pregnancy counseling (22h) 69% Staff have been trained in Providing QFP Services (19a) 67% Adolescents are counseled on resisting coercion (23b) 67% Pregnant clients are assessed re: social supports (22c) 66% (July 1, 2017 June 30, 2018)

41 Indicator Detail: 6a) Determination of waived fees made by the site director and the determination is documented and that the client is informed of the determination (Title X Program Requirement 8.4.3). Five common findings associated with this indicator: No documentation at all No documentation that the client was informed Decision made by registration staff Decision made by finance or billing staff Other 41

42 42 Corrective Action Plans (CAPs) CAP submission and review process Each indicator not met/finding requires its own CAP CAP components most frequently missing or not complete: Staff Training & TA plans Policies & Procedures Documentation Follow Up

43 12 Month Review Summary Figure 3 - Five Findings Assessed Met in 100% of Site Reviews 43 (July 1, 2017 June 30, 2018) Indicator Criteria Upon interview, select staff did demonstrate an understanding of the principles of client-centered care and quality counseling (1c) Observation did demonstrate that clinic procedures protect client privacy (15a) Documentation did demonstrate that a referral directory of health care providers is maintained for services determined to be necessary but beyond the scope of the project (18b) Projects must have written policies in place that address legislative mandates, including policies stating that minors are provided counseling on how to resist attempts to coerce them into engaging in sexual activity (37a23) Project provides an opportunity for participation in development of a community engagement plan by persons broadly representative of the populations to be served (38h)

44 44 Successes Over 35 indicators were met 100% during site reviews Strengths and similarities identified by provider type Encourage sharing/collaboration of successes

45 45 Contact Information Family Planning Program mailbox:

46 NYS Family Planning Program Data Trends and Other Related Information Eileen Shields & Victoria VanHoesen November 14, 2018

47 November 14, Data Trends and Issues Contents Five-Year Trends for Review of Changes in the CVR for 2019 Review of Family Planning Encounter Definition Updates

48 November 14, Five-Year Trends for

49 November 14, NYS Family Planning Program Number of Clients Served and Visits by Year , , , , , , , ,973 Number 300, , , , , , , , Year Number of Visits Number of Clients Source: NYS FPP Clinic Visit Record Data

50 November 14, NYS Family Planning Program Unduplicated Number of Clients Served by Year , , ,540 Total 308,190 Total 304,297 Total 301,061Ttotal 301,128 Total Number of Clients 250, , , ,000 50, , , , , , , , , , , Year New Continuing Source: NYS FPP Clinic Visit Record Data

51 November 14, Percent of Clients 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 53.8% 51.6% 46.2% 48.4% NYS Family Planning Program Type of Clients Served by Year % 55.6% 57.3% 43.6% 44.4% 42.7% Year New Clients Continuing Clients Source: NYS FPP Clinic Visit Record Data

52 November 14, NYS Family Planning Program Number of Clients Served by Gender by Year Number of Clients 350, , , , , ,000 50, ,540 Total 308,190 Total 304,297 Total 301,061 Total 301,128 Total 27,251 26,867 28,162 29,449 31, , , , , , Year Females Males Source: NYS FPP Clinic Visit Record Data

53 November 14, NYS Family Planning Program Female Clients Served by Year Number of Female Clients 95% 94% 93% 92% 91% 90% 89% 88% 87% 86% 85% 91.8% 91.3% 90.7% 90.2% 91.8% 91.2% 89.4% 89.8% 88.7% 88.4% Year NYS National Source: NYS FPP Clinic Visit Record Data

54 November 14, NYS Family Planning Program Male Clients Served by Year Number of Male Clients 12% 12% 11% 11% 10% 10% 9% 9% 8% 8% 7% 11.3% 11.6% 10.2% 10.6% 8.8% 9.8% 8.2% 9.3% 8.7% 8.2% NYS Year National Source: NYS FPP Clinic Visit Record Data

55 November 14, NYS Family Planning Program Client Visits by Type by Year % Year % 5.4% 5.3% 6.2% 6.2% 13.6% 14.1% 14.7% 14.5% 14.5% 29.1% 29.6% 29.6% 28.4% 25.9% 42.2% 41.4% 40.6% 40.3% 41.3% 8.0% 1.6% 8.0% 1.6% 8.2% 2.1% 8.6% 3.0% 9.1% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Percent of Visits by Type of Visit Initial Medical Annual Medical Method Check Medical Problem Counseling Pregnancy Test Source: NYS FPP Clinic Visit Record Data

56 November 14, NYS Family Planning Program Percentage of Clients Served by Age Category by Year % 25.4% 22.6% 15.4% 19.9% % 25.9% 23.2% 15.5% 19.0% Year % 26.5% 23.2% 15.2% 18.5% % 27.0% 23.2% 14.9% 17.7% % 27.7% 22.8% 14.2% 17.2% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Percent of Clients by Age Category < >=35 Source: NYS FPP Clinic Visit Record Data

57 November 14, NYS Family Planning Program Percentage of Clients Served by Race/Ethnicity by Year % 24.1% 32.2% 9.5% % 22.2% 32.5% 10.1% Year % 23.7% 31.1% 12.2% % 23.4% 29.8% 13.9% % 24.5% 33.2% 11.0% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Percentage of Clients Hispanic Black Non-Hispanic White Non-Hispanic Other Non-Hispanic Non-Hispanic Other includes Asians, Alaskan Natives, Hawaiian and other Pacific Islanders, those of multiple races, and those with unknown or unreported races. Source: NYS FPP Clinic Visit Record Data

58 November 14, NYS Family Planning Program Percentage of Clients by Federal Poverty Level (FPL) by Year % 11.1% 7.6% 14.2% 0.1% % 12.1% 7.8% 17.4% 2.7% Year % 62.2% 13.4% 13.1% 8.0% 7.3% 16.1% 13.1% 2.9% 4.4% % 14.2% 6.9% 12.4% 0.0% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Percentage of Clients <= 100% % FPL % FPL > 200% FPL Unknown Source: NYS FPP Clinic Visit Record Data

59 November 14, NYS Family Planning Program Percentage of Clients by Source of Payment by Year Year % 13.7% 13.9% 15.9% 17.8% 4.2% 4.9% 6.2% 8.5% 11.2% 52.3% 53.4% 54.4% 52.1% 46.8% 3.1% 3.0% 2.9% 3.0% 3.9% 25.3% 23.2% 21.0% 19.0% 17.6% 1.8% 1.7% 1.6% 1.5% 2.8% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Percentage of Clients No Charge Partial Fee Medicaid* Full Fee Private Insurance Other** *Medicaid includes Title XIX Fee for Service and Managed Care, Family Planning Extension Program (FPEP), Family Planning Benefit Program (FPBP), and FPBP Presumptive Eligibility (PE). **Other includes Medicare and other government Source: NYS FPP Clinic Visit Record Data

60 November 14, NYS Family Planning Program Percentage of Clients by Medicaid* Coverage Type by Year % 23.3% 60.9% 61.3% 0.5% 4.5% 0.8% 5.4% 8.8% 9.2% Year % 23.5% 22.4% 61.8% 58.2% 55.5% 1.4% 5.5% 1.9% 9.0% 3.0% 10.9% 8.4% 7.3% 8.2% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Percentage of Clients Fee for Service Managed Care FPEP FPBP FPBP PE *Medicaid includes Title XIX fee for service, managed care, Family Planning Extension Program (FPEP), Family Planning Benefit Program (FPBP), and FPBP Presumptive Eligibility (PE). Source: NYS FPP Clinic Visit Record Data

61 November 14, Percentage 80% 75% 70% 65% 60% 55% 50% NYS Family Planning Program Percentage of Female Clients Leaving with Effective* Contraceptives^ by Race/Ethnicity by Year % 63.3% 56.4% 55.7% 77.2% 68.6% 68.8% 62.8% 62.3% 76.2% 75.9% 63.6% 63.2% 75.0% 66.9% 66.4% 61.6% 64.6% 64.3% 59.7% Race/ Ethnicity Hispanic White Non-Hispanic Black Non-Hispanic Other Non-Hispanic^^ * ORAL, HORMONAL INJECTION, IMPLANT, IUD, HORMONAL PATCH, VAGINAL RING OR STERILIZATION ^ CLIENTS USING NO CONTRACEPTIVE METHOD DUE TO INFERTILITY, PREGNANCY, OR SEEKING PREGNANCY ARE EXCLUDED FROM PERCENTAGE DENOMINATORS ^^ AMERICAN INDIAN, ALASKAN NATIVE, ASIAN, PACIFIC ISLANDER/HAWAIIAN NATIVE, OTHER, MULTI-RACIAL Source: NYS FPP Clinic Visit Record Data

62 November 14, Percentage 25% 23% 21% 19% 17% 15% 13% 11% 9% 7% 5% NYS Family Planning Program Percentage of Female Clients Leaving with Highly Effective** Contraceptives^ by Race/Ethnicity by Year % 11.3% 9.5% 10.7% 20.2% 15.4% 12.7% 14.3% 22.6% 19.7% 17.7% 23.4% 20.8% 20.0% 24.2% 22.2% 15.6% 15.9% 16.3% 22.3% Race/ Ethnicity Hispanic White Non-Hispanic Black Non-Hispanic Other Non-Hispanic^^ ** IUD OR IMPLANT ^ CLIENTS USING NO CONTRACEPTIVE METHOD DUE TO INFERTILITY, PREGNANCY, OR SEEKING PREGNANCY ARE EXCLUDED FROM PERCENTAGE DENOMINATORS ^^ AMERICAN INDIAN, ALASKAN NATIVE, ASIAN, PACIFIC ISLANDER/HAWAIIAN NATIVE, OTHER, MULTI-RACIAL Source: NYS FPP Clinic Visit Record Data

63 November 14, Percentage 75% 70% 65% 60% NYS Family Planning Program Percentage of Female Clients Leaving with Effective* Contraceptives^ by Age Category by Year % 67.4% 67.6% 72.6% 72.6% 72.1% 74.3% 73.7% 73.2% 71.7% 63.8% 63.5% 73.1% 71.8% 71.1% 62.4% 69.5% 61.6% 71.6% 55% 57.7% Age Category * ORAL, HORMONAL INJECTION, IMPLANT, IUD, HORMONAL PATCH, VAGINAL RING OR STERILIZATION ^ CLIENTS USING NO CONTRACEPTIVE METHOD DUE TO INFERTILITY, PREGNANCY, OR SEEKING PREGNANCY ARE EXCLUDED FROM PERCENTAGE DENOMINATORS Source: NYS FPP Clinic Visit Record Data

64 November 14, Percentage 25% 23% 21% 19% 17% 15% 13% 11% 9% 7% 5% NYS Family Planning Program Percentage of Female Clients Leaving with Highly Effective** Contraceptives^ by Age Category by Year % 14.4% 12.0% 7.9% 18.6% 15.7% 11.6% 19.5% 21.3% 16.8% 19.0% 16.3% 22.8% 17.8% 20.6% 19.8% 24.2% 19.4% Age Category % 20.1% ** IUD OR IMPLANT, IUD ^ CLIENTS USING NO CONTRACEPTIVE METHOD DUE TO INFERTILITY, PREGNANCY, OR SEEKING PREGNANCY ARE EXCLUDED FROM PERCENTAGE DENOMINATORS Source: NYS FPP Clinic Visit Record Data

65 November 14, ,000 NYS Family Planning Program Number of Client Visits with STD Services by Client Visit Number of Services 200, , ,000 50, Chlamydia Test 220, , , , ,060 Gonorrhea Test 219, , , , ,690 Syphilis Test 49,951 45,076 35,091 33,771 34,470 HPV Diagnosis 7,403 6,936 5,721 5,426 4,383 Herpes Diagnosis 5,278 4,843 4,592 3,697 3,630 Source: NYS FPP Clinic Visit Record Data

66 November 14, Percentage of Client Visits 50% 40% 30% 20% 10% 0% NYS Family Planning Program Percentage of STD Services per Client Visit Chlamydia Test 38.6% 39.6% 41.8% 43.2% 42.7% Gonorrhea Test 38.4% 39.5% 41.7% 43.2% 42.6% Syphilis Test 8.8% 8.7% 7.1% 6.9% 7.3% HPV Diagnosis 1.3% 1.3% 1.1% 1.1% 0.9% Herpes Diagnosis 0.9% 0.9% 0.9% 0.8% 0.8% Source: NYS FPP Clinic Visit Record Data

67 November 14, NYS Family Planning Program Number and Percentage of Chlamydia Tests for Client Visits Under Age # of Chlamydia Tests < Age ,000 80,000 60,000 40,000 20,000 60% 41% 112,616 58% 59% 61% 61% 43% 46% 47% 47% 102, , ,562 97,114 60% 50% 40% 30% 20% 10% % of Chlamydia Tests < Age Year 0% # of Chlamydia tests < Age 25 (NYS) % Chlamydia test < Age 25 (NYS) % Chlamydia test < Age 25 (Nationally) Source: NYS FPP Clinic Visit Record Data

68 November 14, NYS Family Planning Program Number of HIV Services per Client Visit ,000 Number of Services 200, , ,000 50, HIV Pretest Counseling 214, , , , ,447 HIV Test 121, , , , ,137 HIV Posttest Counseling 92,830 90,052 94,366 90,244 83,893 Source: NYS FPP Clinic Visit Record Data

69 November 14, NYS Family Planning Program Percentage of HIV Services per Client Visit % Percentage of Services 40% 30% 20% 10% 0% HIV Pretest Counseling 37.6% 42.9% 50.3% 50.1% 50.6% HIV Test 21.3% 22.6% 23.3% 22.6% 22.1% HIV Posttest Counseling 16.3% 17.4% 19.0% 18.5% 17.8% Source: NYS FPP Clinic Visit Record Data

70 November 14, Percent of Visits 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% CONTRACEPTI VE Percentage of Visits with Select* Counseling Services Provided Source: NYS FPP CVR Data STD/HIV UNSPECIFIED OTHER NUTRITION BREAST SELF EXAM PREGNANCY ABSTINENCE PRE/INTERCO NCEPTION % 66.0% 51.7% 29.5% 15.0% 13.5% 6.4% 0.9% % 68.6% 47.9% 30.6% 15.7% 11.9% 8.6% 2.7% % 70.1% 45.0% 30.4% 14.5% 10.4% 11.6% 3.5% % 67.9% 44.2% 24.2% 12.6% 10.0% 12.8% 4.3% % 63.1% 45.8% 23.2% 11.8% 10.2% 7.9% 4.2% Source: NYS FPP Clinic Visit Record Data

71 November 14, Percent of Visits 80% 70% 60% 50% 40% 30% 20% 10% 0% Contraceptive STD/HIV Select* Counseling Visits by Age Category Source NYS FPP CVR Data 2017 Unspecified Other Nutrition Breast Self Exam Pregnancy Abstinence/Ab st.skills Pre/Interconce ption < % 38.7% 34.3% 16.2% 3.0% 6.1% 20.2% 2.0% % 66.5% 43.6% 21.8% 5.6% 11.5% 11.4% 4.6% % 67.7% 46.9% 22.7% 9.4% 11.4% 8.1% 4.3% % 64.1% 46.4% 23.2% 12.0% 10.6% 6.4% 4.2% % 61.2% 46.1% 24.8% 14.9% 10.4% 6.4% 4.6% % 58.9% 45.7% 25.6% 16.9% 9.4% 6.6% 4.2% % 55.9% 48.6% 24.3% 20.0% 5.4% 7.6% 3.0% Source: NYS FPP Clinic Visit Record Data

72 November 14, Pre/Interconception Care Key Components (QFP 2014): - Reproductive Life Plan* - Medical History* - Sexual health assessment* - Intimate Partner Violence - Alcohol & Other Drug Use - Tobacco Use* - Immunizations - Folic Acid - Depression - Height, Weight, & Body Mass Index* - Blood Pressure* - Diabetes *Overlap with contraceptive services

73 November 14, Review of Changes in the CVR for 2019

74 November 14, Clinic Visit Record (CVR) Changes

75 November 14, CVR Change Descriptions Hispanic Field No changed to No/Unknown To better accommodate instances when clients do not know or decline to respond concerning their Hispanic ethnicity. Box 12A Counseling Services Item 13-Family Engagement Added To document efforts in line with the federal Title X legislative mandate to: Encourage family participation in the decision of minors to seek family planning services, and Provide counseling to minors on how to resist attempts to coerce minors into engaging in sexual activities.

76 November 14, Guidance for Coding Sex on the CVR For purposes of reporting visit data to the NYS Family Planning Program, client sex should be coded on the CVR to correspond with their reproductive health service needs, in particular their medical services and contraceptive methods.

77 November 14, Review of Family Planning Encounter Definition

78 November 14, Title X Definitions*: Family Planning Users & Encounters A Family Planning Encounter is a face-to-face, documented encounter between a family planning client and a provider that takes place in a Title X service site Laboratory tests and related counseling and education, in and of themselves, do not constitute a family planning encounter unless there is face-to-face contact between the client and provider, the provider documents the encounter in the client s record, and the tests are accompanied by family planning counseling and education *US Department of Health & Human Services, Office of Population Affairs, Title X Family Planning Annual Report, Forms and Instructions, January 2005, Reissued October 2013, pp. 7-8.

79 November 14, Title X Definitions*: Family Planning Users & Encounters If a client is an ongoing family planning user who visits the service site to obtain any type of family planning or related preventive health services, the encounter is considered a family planning encounter and the client is considered a family planning user. *US Department of Health & Human Services, Office of Population Affairs, Title X Family Planning Annual Report, Forms and Instructions, January 2005, Reissued October 2013, p. 9.

80 November 14, Title X Definitions*: Family Planning Users & Encounters If a client of reproductive age is sterilized under the service site s Title X- funded project, or is an ongoing Title X user who was sterilized elsewhere but continues to receive gynecological or related preventive health services from the site, the encounter is considered a family planning encounter and the agency may continue to count the client as a family planning user. *US Department of Health & Human Services, Office of Population Affairs, Title X Family Planning Annual Report, Forms and Instructions, January 2005, Reissued October 2013, p. 9.

81 November 14, Title X Client/Encounter Definition*: Exceptions If a post-menopausal client obtains gynecological or related preventive health services, the encounter is not a family planning encounter and the client is not a family planning user. If a client is not an ongoing family planning user and obtains a service that does not include counseling, education, or clinical services related to achieving intended pregnancy or avoiding unintended pregnancy, the encounter is not a family planning encounter and the client is not a family planning user. *US Department of Health & Human Services, Office of Population Affairs, Title X Family Planning Annual Report, Forms and Instructions, January 2005, Reissued October 2013, p. 9.

82 November 14, Title X Client/Encounter Definition*: Exceptions Example 1: A new client who receives STD services, but no counseling, education, or clinical services aimed at avoiding an unintended pregnancy or achieving an intended pregnancy, is not a family planning user, and the encounter is not a family planning encounter. *US Department of Health & Human Services, Office of Population Affairs, Title X Family Planning Annual Report, Forms and Instructions, January 2005, Reissued October 2013, p. 9.

83 November 14, Title X Client/Encounter Definition*: Exceptions Example 2: If, in addition to STD testing, this same client receives condoms or counseling about using condoms to prevent STD transmission, but does not receive counseling, education, or clinical services aimed at avoiding an unintended pregnancy, the client is not a family planning user and the encounter is not a family planning encounter. *US Department of Health & Human Services, Office of Population Affairs, Title X Family Planning Annual Report, Forms and Instructions, January 2005, Reissued October 2013, p. 9.

84 November 14, Title X Client/Encounter Definition*: Exceptions Example 3: If, in addition to STD testing, this same client receives condoms or counseling about using condoms to prevent STD transmission AND counseling and education aimed at avoiding an unintended pregnancy, the client is a family planning user and the encounter is a family planning encounter. *US Department of Health & Human Services, Office of Population Affairs, Title X Family Planning Annual Report, Forms and Instructions, January 2005, Reissued October 2013, p. 9.

85 November 14, Updates

86 November 14, Updates Documentation: o We are updating the data manual and the training documentation, which will be posted on the Ahlers website. o The training documentation will include instructions for the Client/Visit Quality Improvement Report (QIR), which allows agencies to compare their own performance indicators with statewide measures for two periods, all in one report. FPAR: o Instructions and Tables will be forthcoming at the end of this month, and will be due as usual by the end of December. o Please make sure your CVR data is up to date.

87 November 14, Contacts NYS Family Planning Program Phone: Program Director Rae Ann Augliera: Data Director: Eileen Shields: