7.1 Delegate Agency Health Care Plans and Protocols

Part II: Guidelines for Client Services and Clinic Management


The health care plan, developed by the delegate agency's medical director and clinical staff, identifies the clinical services to be provided as well as the plan for client education. Plans must be written in accordance with Title X program guidelines and current medical practice and must cover the services provided at initial visits, annual visits, and other visits, including supply and problem revisits. The health care plan is periodically requested as part of the annual grant application process.

The health care plan should include a description of the facility, including its location, accessibility and general description. Refer to Section 6.4 for items to be included. The plan should also include a facility floor plan and description of the pattern of clinic flow.

All delegate agencies must have written protocols, which detail specific procedures for the provision of each service offered. The service/clinical protocols must be signed and reviewed annually by the medical director, and must include, but are not limited to the following:

  1. Client education and counseling
  2. Client eligibility
  3. Confidentiality
  4. Informed consent and method specific consent
  5. Contraceptive education and counseling for all FDA approved methods, (including permanent and temporary methods and emergency contraception)
  6. Specialized adolescent services
  7. Mandatory reporting of child abuse
  8. History and/or physical examination procedures for each type of visit (e.g. specific procedures to be performed for the initial visit; annual visit; deferred exam and other revisits, including supply visits, medical problem visit and education visits such as pregnancy testing/counseling or provision of emergency contraception)
  9. Laboratory testing
  10. Pregnancy diagnosis and options counseling
  11. HIV/AIDS education and counseling, including risk assessment
  12. Sexually transmitted diseases counseling, screening, and treatment
  13. Management of contraceptive services including emergency contraception
  14. Management of reproductive diseases/disorder and abnormal test follow-up, including the management cervical cancer screening
  15. Colorectal cancer screening
  16. Management of high-risk contraceptive clients
  17. Level I Infertility services
  18. Special counseling on topics such as sexual coercion, sexual abuse, sexual concerns, domestic violence, genetics, nutrition, preconception health, and substance abuse
  19. Medical follow-up
  20. Referral procedures
  21. Supply distribution
  22. Emergency procedures, both medical and environmental
  23. Management of medical records and release of records
  24. Medical supervision
  25. Pharmaceuticals management
  26. Clinic Management, including appointment and scheduling standards and clinic flow procedures
  27. Telephone procedures
  28. Equipment and supplies management and inventory
  29. Facilities requirements
  30. Quality assurance
  31. Standing orders
  32. Clinic personnel policies, job descriptions and responsibilities
  33. Additional protocols dictated by the services that are provided by the program

As clinical issues, research findings and standards of care evolve over time, the IDHS distributes either mandatory protocols or guidelines for protocol development.


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