Women's FP and Cervical Cancer Screening Services
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Title/Eligibility of program |
Services/reimbursement (FFS=fee for service) |
Funding source/outreach and public education |
Sites involved |
comments |
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SAGE Colposcopy program: for un- or under women 'under' (not specificed) insured and < 40 y/o and <= 250% FPL. Proof of income NOT required. Minor confidentiality protected (if minors are on parents insurance). Proof of citizenship NOT required. |
FFS colposcopies - reimbursement at Medicare rates. Clinics are allowed to charge co-pay, but all have opted not to do this b/c in the end it they still get the same reimbursement.
Transport/Interpreter services available in Metro area |
mostly CDC money; some state money (from the same 'pot' as SAGE money, but separated from SAGE and also LIMITED to $400,000 per year or about 1200 colposcopies).
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1) Planned Parenthood in Mankato, Rochester, Bemidji, St. Cloud, MPLS, Centro
2) Community/ Tribal clinics: White Earth, Family Tree, St. Paul Public Health, Family Medical Clinic, Westside Community Clinic |
No funds for educational material per say, however the SAGE program has developed a cervical/HPV brochure. Health Care providers find out about program either b/c they are a SAGE clinic, or because they call SAGE for more information - no active 'advertising' of this service; limited funds could quickly run out |
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SAGE program: un- or 'under'(not specified) insured women ages 40 and above. Proof of income NOT required. Proof of citizenship NOT required. Yearly reconfirmation of eligibility necessary. |
FFS: Yearly breast and cervical Cancer screening (conven- tional/liquid based Paps, Hi-risk panel HPV testing on ASCUS Paps) and diagnosis (colposcopies/endometrial biopsies); includes pelvic exam, but not family planning or STI testing. Participating sites bill SAGE - reimburse-ment at Medicare rates minus nsurance payment. SAGE acts as payor of last resort. Transport/ Interpreter services in Metro |
Mostly CDC money; some state money (unlimited).Outreach: MN Outreach Coalition, outreach to 8 programs for minority groups through office the MDH-OMH, ACS - Friend to Friend, direct mailings to low income women, toll-free hotline, radio/television/TV ads, three lay recruiters: urban Hispanic Ramsey Co, Urban Hispanic Mpls., & rural Hispanic in a 9 county area in West central MN |
Multiple: see SAGE website* |
Non-screening mammograms, ultrasounds, and breast biopsies also funded through separate source from Susan G. Komen Foundation -Race for the Cure |
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Title/Eligibility of program |
Services/reimbursement (FFS=fee for service) |
Funding source/outreach and public education |
Sites involved |
comments |
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Family Planning Special Projects Grant: poor/high risk women and men of reproductive age at <= 200% FPL. Proof of income NOT required. Mi-nor confidentiality protected (if minors are on parents insurance). Proof of citizenship NOT required. |
Public information, outreach, methods counseling, clinical services (complete physical, pap smear, STI testing, hematocrit, urine test for protein and glucose), family planning methods and follow-up. NO COLPOS; grant components include education/outreach and/or clinical services - grantees decide which component they want to cover in their grant application.
Reimbursement: This is grant program, so services limited by available funds. |
State funded grant since 1978- budget to be reduced by 50% by 2008. This is state fiscal year 2008, so the reduction starts July 1, 2007 or later if the Waiver is not yet fully implemented.
Outreach varies by clinic. Examples: mother/daughter groups, educational programs for incarcerated women (Family Tree). |
Clinical services provided at 41 grantee sites |
FPSP, unlike the Medicaid Waver, is able to serve non-refugee, non-asylum seeking legal immigrants who must wait five years before being eligible for federal medical programs like Medicaid and Medicare. Also, they have no age restrictions (i.e. under 15 years of age). |
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Title/Eligibility of program |
Services/reimbursement (FFS=fee for service) |
Funding source/outreach and public education |
Sites involved |
comments |
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Title X: women and men of reproductive age at 250% FPL |
FFS: Family Planning counseling, clinical services including pap smears, STI checks and family planning methods. Colpsocopies at St. Paul Public Health and TAMS, also available through SAGE at some sites (see SAGE description above). This is a grant program, so services limited by available funds. |
Federal Title program - has been flat-funded for years.
Outreach: Teen-aged Medical Services (TAMS) has an outreach worker who does work with teen son birth control, STDs, healthy sexuality, abstinence, etc., in schools, parks, and other youth serving agencies |
Planned Parenthood is the main recipient in Minnesota. Saint Paul Public Health is the other federal recipient. MDH is a Title X grantee who in turn award fund to Teen-aged Medical Services (in MPLS) |
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Title/Eligibility of program |
Services/reimbursement (FFS=fee for service) |
Funding source/outreach and public education |
Sites involved |
comments |
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MN Family Planning Program (Medicaid Waver) - starts in 6/06: women and men <= 200% FPL ages 15-50 y/o who are not eligible for other federal medical programs. Enrollees w/o SSN are only eligible for 60 days of services via presumtive eligibility. Yearly reapp for those covered under continuous eligibility. |
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'budget neutral' federal fee for service program.
NO FUNDS FOR OUTREACH AND PUBLIC EDUCATION.
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Any health provider who takes Medicaid patients may also enroll patients into Medicaid waver program. |
It will be very important to have someone familiar with this option at sites that offer Medicaid in order to insure that eligible women are enrolled. Help with getting out the word is appreciated from any source possible! |
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Title/Eligibility of program |
Services/reimbursement (FFS=fee for service) |
Funding source/outreach and public education |
Sites involved |
comments |
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Medicaid waiver for breast and cervical cancer (MABC ): women requiring breast or cervical ca treatment who have diagnosis through SAGE programs ONLY, age 40-64 y/o, at <= 250% FPL and NO insurance. Yearly reapplication necessary. Presumptive eligibility for undocumented clients only for 30 days |
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Federal Program - MN legislature chose option 1 restricting access to clients already enrolled in SAGE program (other states have chosen less restrictive option). NO FUNDS FOR OUTREACH AND PUBLIC EDUCATION |
SAGE SITES ONLY |
SAGE sites must know to refer enroll clients in this program (this took much effort). In rare cases, someone previously diagnosed elsewhere but without resources for treatment could get re-diagnosed through SAGE program and become eligible for treatment through MABC. |
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Assured Care: Hennepin County residents who go to health care providers directly (or loosely) affiliated with HCMC, at 200-250% of FPL. SSN NOT required |
Any required services are covered. Clients pay premium and may also pay up to 25% of the cost of medical care. |
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HCMC and affiliated clinics. |
A potential source of cervical or breast cancer treatment for women not eligible for the Medicaid Breast and Cervical Cancer Coverage Program. |
*http://www.health.state.mn.us/divs/hpcd/ccs/mbcccp/providers.htm
Other issues identified:
1) Potential to use different resources to spread word about both family planning and cervical cancer screening: CHS mailbag, SAGE, Women's Health Website, Cancer Plan Minnesota Website (being developed - Iowa has a model, Neighborhood Healthcare Network
2) It IS possible for women to use both SAGE (for breast and cervical screening) and FPSP (for family planning) in those clinics that offer both programs (which clinic are these?)
3) Providing services to women without insurance has the potential to be very challenging. For instance, a woman might seek have a Pap smear though the Medicaid waiver, then might require a colposcopy which she could get through the SAGE colposcopy program. If the colposcopy showed cancer, she would have to drop the Medicaid waiver and apply for the Medicaid Breast and Cervical Cancer Coverage Program. Guiding a client through these options would take very a knowledgeable clinic staff person.
4) What are MDH-STD programs doing around HPV education?
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