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   Eligibility Changes 2006

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New FPEP eligibility requirements

Tools and Resources

Oregon Family Planning Program Manual

The Oregon Family Planning Program Manual is divided into six sections. Clinics may need some or all of them, depending on whether they are FPEP-only or FPEP and Title X, and if they participate in the IPP project. All clinics should have:

 

          The Cover, Table of Contents, and Introduction

          Section A - The Oregon Family Planning Program

          Section D - The Oregon CVR Guide, and

          Section F - Appendices

 

as well as the sections relevant to their program participation:

 

          Section B - Title X Regulations and Requirements

          Section C - FPEP

          Section E - Region X Infertility Prevention Project (IPP)

 

The different sections and their Exhibits will be updated periodically, and will be available for download at that time.

Cover, Table of Contents, and Introduction   (PDF, 8pp 287KB)

 

Section A: The Oregon Family Planning Program (PDF, 34pp, 319KB)

 

Section A Exhibits

Exhibit 1 - DMAP Family Planning Codes

Exhibit 2 - Multnomah County Central Stores Family Planning Supplies Catalogue

Exhibit 3 - FPEP Vasectomy Implementation Flow Chart

Exhibit 4 - Title X Oregon Vasectomy Project Flow Chart

Exhibit 5 - Title X Oregon Vasectomy Project Authorization Request

Exhibit 6 - Title X Oregon Vasectomy Project Enrollment & Billing Form

Exhibit 7 - Federal Consent for Sterilization

 

Section B: Federal Title X Regulations and Requirements (PDF, 91pp, 626KB)

 

Section B Exhibits

Exhibit 1 - Program Element #41

Exhibit 2 - DHS Revenue & Expenditure Report

Exhibit 3 - Title X Service and Supply Discount Schedule

Exhibit 4 - 2008 Family Planning Sliding Fee Schedule

Exhibit 5 - Family Planning Program Review Schedule

Exhibit 6 - Agency Review Tools

Exhibit 7 - Budget Projection Worksheet & Instructions

 

Section C: FPEP (PDF, 33pp, 317KB)

 

Section C Exhibits  

Exhibit 1 - FPEP Eligibility Database Instructions

Exhibit 2 - FPEP Enrollment Form

Exhibit 3 - FPEP Citizenship and ID Document Checklist

Exhibit 4 - SSN Statement

Exhibit 5 - FPEP Oregon Birth Information Form

Exhibit 6 - Requesting Out-of-State Birth Certificates

Exhibit 7 - FPEP Billable Visits

Exhibit 8 - Maximum FPEP Reimbursement for Supplies

Exhibit 9 - CVR Submission Deadlines 2008 and 2009

Exhibit 10 - CVR Rejection Messages

Exhibit 11 - Sample CVR Error Report & Billing Register

Exhibit 12 - Primary Care Referral Brochure

Exhibit 13 - FPEP Reimbursement Rates

 

Section D: Oregon Clinic Visit Record (CVR) Guide (PDF, 36pp, 1,249KB)

 

Section D Exhibits  

Exhibit 1 - Project/Site Number Request Form

Exhibit 2 - Ahlers Web Security Application

Exhibit 3 - Sample Reports from CVR Data

Exhibit 4 - Accessing Ahlers Data online

Exhibit 5 - HIPAA letter from Ahlers

Exhibit 6 - Oregon CVR

Exhibit 7 - File Format for electronic submission of CVR data

 

Section E: Region X Infertility Prevention Program Guidelines (PDF, 21pp, 287 KB)

 

Section E Exhibits

Exhibit 1 - Sample protocol

Exhibit 2 - Chlamydia follow-up

Exhibit 3 - Confidential STD case report

 

Section F: Appendices

Appendix A - Directory of Oregon Family Planning Clinics

Appendix B - Family Planning Program Contacts

Appendix C - Department of Human Services Organization Chart

Appendix D - Office of Family Health Organization Chart

Appendix E - Women's & Reproductive Health Section Organization Chart

Appendix F - Monthly Income Guidlines for Medicaid Coverage

 

1. To start the enrollment process, read through the Provider Enrollment Memo (PDF) and the Prospective Provider Packet (PDF) to determine if your clinic can comply with FPEP program requirements.  If so, then download and complete these forms:
   
   
   • Family Planning Provider Application (PDF)
   • Project/Site Number Request Form (Word)
     
     
2. Mail or deliver the completed Application and Project/Site Form to the address on the Application.
   
   
3. Next, download and read through the FPEP Manual  and FPEP Administrative Rules (PDF)