05-F Health Contr Chg Ntc 01 - Laserfiche WebLink

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Maternal and Child Health, 1994); Guidelines for Adolescent Preventive Services (GAPS) (American Medical Association, 1995); Guidelines for Health Supervision III (American Academy of Pediatrics, 1997); • American Dental Association, Regulatory Compliance Manual, 1992; and, • Changes in income guidelines as determined by RECENING AGENCY. Within thirty (30) days of receipt of an amended standazd(s) or guideline(s), PERFORMING AGENCY shall inform RECENING AGENCY Program, in writing, if it will not continue performance under this Attachment in compliance with the amended standard(s) or guideline(s). RECENING AGENCY may terminate the Attachment immediately or within a reasonable period of time as determined by RECENING AGENCY. PERFORMANCE MEASLTRES The following performance measures will be used to assess, in part, PERFORMING AGENCY'S effectiveness in providing the services described in this contract Attachment, without waiving the enforceability of any of the other terms of the contract. PERFORMING AGENCY shall report on: • Screening, refenal and PHC eligibility services (PHC-200) • Client intake - new and recertified clients (PHC-200) • Number of PHC eligible clients receiving medical services (PHC-200) • Clients served by quarter (PHC-200) • Cost and type of services provided (PHC-200) • Client demographic data (PHC-300) (annual) PERFORMING AGENCY shall report quality measures on the: • Clinical Process = Outcome Measures report (PHC-301) • Client Satisfaction Survey (PHC-302) (annual) PERFORMING AGENCY shall use the required eligibility system as described in the PHC Handbook or other system designated by RECEIVING AGENCY as the initial step. CO-PAY PERFORMING AGENCY may, except PERFORMING AGENCIES that are Loca] Health Departments, assess a co-pay from clients provided services by RECEIVING AGENCY under this Attachment if the co-pay is assessed according to the established fee schedule adjusted for family size and income as published in the Primary Health Care (PHC) Handbook. A co-pay assessment may not exceed 25% of the amount RECEIVING AGENCY pays PERFORMING AGENCY for the provision of a given service. A client shall not be denied services due to inability to pay. Local Health Departments shall comply with RECEIVING AGENCY fee collection policies detailed in 25 TAC § 191. ATTACHMENT - Page 2