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Home My WebLink AboutResolutions - 1983.12.08 - 11487REPORT TO HEALTH AND HUMAN RESOURCES COMMITTEE BY: FINANCE COMMITTEE, G. WILLIAM CADDELL, CHAIRPERSON IN RE: FAMILY PLANNING GRANT RENEWAL APPLICATION-JANUARY 1, 1984 THROUGH DECEMBER 31, 1984 The Finance Committee has reviewed the proposed grant and finds: 1) This is an ongoing grant in its twelfth (12th) year, 2) The grant covers the period of January 1, 1984 through December 31, 1984, 3) The total program is in the amount of $263,159, of which $178,659 is State funded; $10,000 estimated Title XIX third party reimburse- ments; $32,000 fees for service; and $42,500 from 1983 award, 4) The grant application calls for salaries, $165,390; fringe benefits, $38,806; operating expenses, $47,551; and indirect cost of $11,412, consistent with the attached schedule, 5) Application or acceptance of the grant does not obligate the County to any future commitments, 6) All personnel changes will have to be approved by the Personnel Committee. Mr. Chairperson, on behalf of the Finance Committee, I move the acceptance of the foregoing report, and the referral of the information contained therein to the Health and Human Resources Committee in accordance with Miscellaneous Resolution #8145 Revised Federal and State Grant Application Procedures. FINANCE COMMITTEE Operating Building Space Cost Personal Mileage Travel & Conference Medical Supplies Office Supplies Communications Professional Services Laboratory Fees Total Operating Indirect Cost TOTAL PROGRAM 3,400 100 48,372 2,500 900 16,000 11,250 82,522 9,872 2) 268,760 Program Coordinator P. H. Nurse P. H. Nurse P. H. Nurse Clerk III Clerk II PTNE Student Total Salaries Fringe Benefits Total Sal. & F.B. 1.00 28,233 III 1.00 27,658 II P.T.E. .50 11,064 II P.T.N.E. 1.75 38,722 1.00 14,397 1.50 19,518 .50 3,484 7.25 143,076 33,290 1) 7.25 176,366 220,356 35,000 10,000 3,404 268,760 263,159 178,659 32,000 10,000 42,500 (41,697) (3,000) 42,500 (3,404) (5,601) FINANCIAL ANALYSIS FAMILY PLANNING GRANT APPLICATION AWARD-APPLICATION COMPARISON Award 1/1/83-12/31/83 No. of Pos. Amount Personnel Application .1/1/84-12/31/84 Increase/(Decrease) No. of Pos. Amount No. of Pos. Amount 1.0 30,677 1.0 29,856 .5 11,943 2.5 56,550 1.0 16,090 1.2 16,790 .5 3,484 7.7 165,390 38,806 1) 7.7 204,196 .45 4,387 3,400 100 6,014 2,500 1,500 18,400 11,250 47,551 11,412 2) 263,159 2,444 2,198 879 17,828 1,693 (2,728) 22,314 5,516 27,830 4,387 (42,358) 600 2,400 (34,971) 1,540 (5,601) .75 (.30) .45 Funding Source State Fees for Service Title XIX 1983 Encumbrance Insurance Reimbursement 1) Actual Fringe Benefits 2) Indirect Cost Rate 1983 6.9% 1984 6.9% (Estimate) Miscellaneous Resolution 83367 DecE—, BY: HEALTH AND HUMAN RESOURCES COMMITTEE - Marilynn E. Goding, Chon IN RE: FAMILY PLANNING GRANT RENEWAL APPLICATION - 1984 TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS Mr. Chairperson, Ladies and Gentlemen: WHEREAS the Oakland County Health Division began Family Planning Clinic services in 1973 via a grant from the Michigan Department of Public Health; and WHEREAS the program provides family planning services to sexually active teens and low-income females -(i50% of poverty level) with emphasis on outreach community clinics; and WHEREAS clinic patients are treated with respect for their privacy and dignity and all records are kept confidential; and WHEREAS there is no charge for this service but the patient is encouraged to make a donation to the program to partially defray program expenses. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners authorize the 1934 Family Planning grant renewal application in the amount of 5178,659. Mr. Chairperson, on behalf of the Health and Human Resources Committee, I move the adoption of the foregoing resolution. COUNTY OF OAKLAND DANIEL T. MURPHY, COUNTY EXECUTIVE MEMORANDUM November 1, 1983 TO: Jean Willoughby, Federal State Aid Coordinator (7— s'O • FROM: Robert Zigler, Admin. Asst., Public Health Administration Services PE: 1984 Family Planning Grant - Approval to Submit Please schedule the attached 1984, Family Planning Grant Proposal for the "approval tosubmit" process. /rer cc:- Dr. Thomas Gordon Elaine Bevan Joan Ceglarek Jackie Davis v/L. A. Volberding Joe Matkosky Oakland County Health Division 1200 NORTIA TKLEGRAPII ItOAD, PONTIAC, 1,41CIII0 AN 4t1051 COUNTY OF OAKLAND DANIEL T. MURPHY, COUNTY EXECUTIVE November 1, 1983 Mr. Don Pangborn, Section Chief Family Planning Section • Michigan .Department of Public Health 3500 N. Logan, Box 30035 . Lansing, Michigan 48909 Dear Don: Enclosed is a copy of our 1984 Family Planning Grant Proposal. Please process as soon as possible in order that we may submit to the Oakland County Board of Commissioners for acceptance. If you have any questions, please contact Elaine Bevan or myself. Thank you. Sincerely, gc_,:c- 4 • Robert L. Zigler • Administrative Assistant Public Health Administrative Services OAKLAND MUM' HEALTH DIVISION Department of Institutional & Human Services RLZ/rer Enclosure CC: Elaine Bevan Jackie Davis Joan Ceglarek Dr. Thomas Gordon L. A. Volberding Joe Matkosky Oakland County Health Division 11)() 1\101-{'C1E 'VELE1111-{APIL /1(1A D, 11'()NT I AC. MEC rac; AN 4805:1 PROGRAM BUDG ET SUNIMAM NIOPH • FtN-110 4/74 - 7: Budget Period 1/1/84 To 12 Dare Prepared 10/28/83 1/84 Program FAN1.ILY I3LANNING Code Oripinal Budget Rev,sed Budget Local Agency OAKLAND COUNTY HEALTH DIVISION Rev n imn NumUer TOTAL BUDGET CATEGORY Salaries & Wages Fringe Benefits Contractual (Sub-Contracts)_ Equipment 165,390 8,806 3,500 8,514 Physician's Fees Lab El Diagnostic Rent - Office Space TOTAL DIRECT Indirect Costs: 1983=6 .9% Subs TOTAL EXPENDITURES 18,400 11,250 4,387 251,747 11,412 263,159 JLess: Estimated Title XIX 19011 111 Less: Fees & Collections )- 0U 7.L7ss.L.m.771-1777 Y - 12 FUNDS REQUIRED I 178.659 2 5 6 31 Travel 41 Supplies & Materials Other 'Expenses: Communications 1,500 7 8 9 10 20 TOTAL FUNDING 178.659 AGREEMENT BUDGET CURRENT YEAR SUBSEQUENT PORTION YEAR PORTION LOCAL BUDGET CURRENT SUBSEQUENT YEAR 19_ YEAR 19 FUND SOURCES 131 State Agreement 100% 178,659 State Formula PHS 314(d) 16 I'vl&CH 17 Federal 181 Local 191 Other 010010.1.8.81 .101111111111MNINSIN AMMIONSIMINIIRMIPSMISHSta CERTIFICATION: I certify that I am authorized to sign on behalf of the local agency. This budget represents cost necessary for the administration and operation of the program. Adequate documentation and records will be maintained to support all required program expenditures. TITLE: DATE: PROGRAM BUDGET - POSITION SCHEDULE MDF'Hb FIN 114 2/74 Pc of Budget Period DatePrep71,ed 1/1/84 To 12/31/8 10/28/S5 FP-rograrn FAMILY PLANNING Code DIRECT MAN YEARS SUPPORT.MAN YEARS Total Direct Time (hours) One Man Year (hours) Program Administration and Support Time POSITION DESCRIPTION Jackie Davis Program Coordinator Marian Barrett PUN III Jan Novara PUN II (P.T. Dig.) Several P.T. Non-Elig. Person PENH Janie Decker Clerk III TOTAL MAN YEARS REQUIRED POSITIONS )'(. ANNUAL L TOTAL 'STAFF EQUIV. REQUIRED I SALARY L SALARY NON-ADM. .00 9,856 I 1.00 2.50 16,090 1 .50 30,677 30,677 .80 22,620 I 56,550 1 2.50 1.00 1 16,090 Filled with different student Co-op Several P.T. Non-Elig. Person Clerk II .50 968 3.484 1.20 13,992 16,790 I 1.50 Man Years Man Years COMNIENTS 1.00 29,856 7.70 165,390 7.3 TrITAI Local Agency OAKLAND COUNTY HEALTH DIVISION Original Revised ri Revision Budget Budget Number STAFFING ANALYSIS h SUB-CATEGORY/ CATEGORY TOTAL 38,806 3,400 100 3,500 6,014 2,500 8,514 1,500 18,400 11,250 4,387 Btic1,34z Peri° ;Liza Prer.,,,o,) 1/1/84 _Tr1?„/31/84 Budgez 10/28/S3 Re,i5ioo Numbar Ix] Code Ornginal Budgat FAMILY PLANNING UAL AC“iNc•y• - OAKLAND COUNTY HEALTH DIVISION D ESC R I PT I N Fringe Benefits (See Attachment "A") Travel Mileage - 13,600 Miles 0 .25/mi1e Conference and Meetings ,Supplies and Materials Medical Supplies - Contraceptives, JellieTraper Sheets, etc. - Office _Supplies - File Folders, Pens, Pencils, etc. Other Expenses Communications - $125.00/month Patient Care - Physicians' Fees - 230 sessions 9 $80.00 Lab Ei Diagnostic - 3,000 Pap Smears @ $3.75 Rental - Office Space - 370.5 sq. ft. V$11.84 Indirect Costs 6.9% of Salaries and Wages of $165,390 I I 11,412 NOTE: The 1983 approved rate of 6.9% is used for the entire grant period. When the 1984 indirect cost rate has been approved, that rate will be used. fit 9L'OZ -- It'SI TS'S XITYP'S polnd .11toD 91709 cCOS:7, 117 [N, ,L9S9 'L 7177-177-1-T- T:= , 97:S 4 8 0VL'Ll 98 -rZE -- 89 -c76 S9'114:Z S0'8Z 88'4:VZ OC'9ZI'IL'SI6'Z OS'RS6' I -- 917'99I'Z 6 .6S(J‘(7, i 88'SIt'S WLWZ 118'fi7V-7- tcr I lS'9V S9'6 Z6'9LLZ LS't17 L,S'ZLZ Z6'9LL'7, I L,S'LS t6rs:t1 t0 -1J65-Z I 98 L17 rgc-9T1 06L'91(1H°N*I'd)111. UHT:, d0-0D INAdniS ! 060 °91 I II N2ITE-7,. I OSS'9S ('H'N'I'd) II NIld (2t6 T II (*Ti'd) II NUJ 9S8'6C I iii NHd L.L9'H 'DOM ZL•09PL LYL SS:SOT9T. ssoD, .1.T :Touog ofuTJ.d I 00J VavirS Jo ',509C .) sul 'oul/ST'OSS -c 'cui/1761,Z$-Z '01u/OCLTS -1: s@;,-c'd kr,:qq-uciq woaanD uo posug xeo,k /T-enlov Tuquoc (Xxeus 966Z -E .) %9L1°) uoTaun .sui -uTquoD .dutoun dauTuS (ou'Lss qs.T.TJ: og; jo %O .C) X;Tan-,-,os TI)I 30S (XxoTus :To %VI'81.) pund .oar4ozi .am/LI'913-Z (s 0 :1 1-721 ('PoltoS quoa,zilD uo pos ..I.A/TunlDv) .dsoi.1 1 tOk WISVN 01 178/TA IIVHA WDSILI INVB V „IMIIKIDV,IIV s'IJENaa dONIU DNINNVld KIINVd OAKLAND COUNTY HEALTH DIVISION FAMILY PIANNING PROGRAM PLAN AND BUDGET - 1984 I. NARRATIVE A. Introduction 1. Oakland County Health Division, Family Planning Program 1200 North Telegraph Road, Pontiac, Michigan 48053 Date Submitted - October 28, 1933 2. Problem Statement -- Providing family planning services to sexually active teens and low income adult females who meet the D.H.E.W. guidelines for 150% of poverty or who have other barriers to family planning services. B. Organizational Overview The Family Planning Program is sponsored and supervised by the Oakland County Health Division. Organizational charts showing departments and programs are attached. C. Needs Assessment This program provides family planning services to Oakland County residents. Michigan Department of Public Health (MDPH) statistics show that in Oakland Countyin 1982 there were 264,142 women between the ages of 13 and 44. Of that number, 12,592 have incomes under the 150% of CSA Poverty Guidelines who are at risk of unwanted pregnancy and ages 20-44. There are 20,496 women ages 13-19 who are at risk. MDPH statistics show that 1,660 teenage women, age 19 and under, and 1,186 women 20-44 years of age, received services in 1932 or 8.6% of the population in need. D. Resources Identification Oakland County Health Division MUD) Family Planning Program is in a unique situation, in that a wide variety of clinical and educational services are available through OCHD. These range from Diabetic and Expectant Parent Classes through Child Health Conferences, Nutrition Consultants, Immunization Clinics, Breast Cancer Detection and Edu- cation Clinics, STD Clinics, Tuberculosis Control, EPSDT, WIG, Services to the Aging, and Substance Abuse. More than 100 Public Health Nurses from the agency are working in schools and homes throughout Oakland County. In addition, there are outpatient clinics and emergency room services at seven hospitals in Oakland County, plus those in Detroit and adjacent Macomb County. • Physicians servicing our clinic patients are on staff at William Beaumont; Providence; St. Joseph Mercy Hospitals; and, as of April 1983, Pontiac General HOspital. E. Delivery of Family Planning Services 1. a. Clinic Program - We operate family planning clinics at various locations in Oakland County. Although a large portion of services are given to teens, we do not have special days or times for them. We operate age-integrated clinics which permit appointments to meet the convenience of the client. Each patient is treated as an individual, no group or rap sessions are held. We feel that private individual history- taking, teaching, and counseling gives the patient the oppor- tunity to ask questions - and reveal information that she may hesitate to do in a group situation. b. Locations and Clinic Sessions - Clinic locations and schedules follow: Pontiac, Michigan Lakeside Community Health Center 132 Franklin Boulevard Mondays and Thursdays - 8:30 a.m, to 5:00 p.m. Wednesday twice a month 8:30 to 5:00 (Ids of June 1983) Oakland County Health Division 1200 North Telegraph Tuesdays 1:00 - 4:00 Tuesdays and Wednesdays 5:00 - 10:00 p.m. Thursday 5:00 - 10:00 p.m. (as of 10/4/83) Royal Oak, Michigan • Oakland County Fourth Street Building 2401 East Fourth Street First Wednesday - 8:30 a.m. to 5:00 p.m, Third Wednesday - 8:30 a.m. to 12:30 p.m. Southfield, Michigan Oakland County Health Division 27725 Greenfield Road Every Tuesday, Wednesday and Thursday 5:00 - 10:00 p.m. Every Friday 8:30 a.m. to 5:00 p.m. c. Facilities - Exam room tables, lamps, scales, disposable equip- ment, etc. are provided by this family planning program at each site. Contraceptive supplies, medical supplies, and equipment are stored in locked cupboards owned by this family planning program at each site. Each clinic site was chosen for barrier free environments and geographic convenience for the patient, space for private counseling, and exam areas. PHEW Guidelines for safety, comfort, and cleanliness are met. d. Administration - All patient records are kept in the Family Planning Office at 27725 Greenfield, Southfield, Michigan. All appointments are made through this office. The Family Planning Program Coordinator and/or a member of the clinic staff and a secretary arc available by phone at this office 8:30 a.m. to 5:00 p.m., Monday through Friday to answer questions and give aid to patients, the general public, and other Health Division staff. e. Staffing - OB-Gyn resident physicians are assigned to our clinics by the Hospital Education Department as follows: OCHD, Pontiac - Tuesdays evenings - St. Joseph Mercy Hospital, Pontiac OCHD, Pontiac - Wednesday and Thursday evenings - Pontiac General Hospital, Pontiac -- GOLD, Southfield - Wednesday and Thursday evenings Hospital -, Southfield - Providence Royal Oak - Wednesday =flings - Beaumont Hospital, Royal Oak The daytime clinics at Lakeside; the afternoon clinics on Tuesday at the Pontiac Office of OCHD; and the Tuesday evening and the Friday daytime clinics at the Southfield Office of OCHD and one Wednesday afternoon at Royal Oak have the services of a Family Planning NUTS0 Practitioner who added to her celLification in 1931 and now includes the title, Obstetric-Gynocology Nurse Practitioner. There are two Public Health Nurses and a clerk at each of the physician clinics and one or two Public Health Nurses (depending on the patient load) and a clerk at each of the 0.C.N.P. clinics, except for the Tuesday afternoon Pontiac clinics, The 0.G.N.P. works with just a clerk at this time. The Oakland County Health Division Family Planning Program employs. public health prepared nurses, the majority of whom are former full-time employees of this Division. This results in compre- hensive services to the patients because the staff is informed as to additional services provided by this agency and by agencies to which we refer. See Resources Identification, T.D. With the influx of Asian, Arabic, • and other immigrants to this area, language problems have become apparent in teaching and assessing the understanding of contraceptive methods. We have been fortunate in that some of the full-time Health Division employees speak a second language in addition to English. All of these have agreed to be available by telephone, if needed. One of the Family Planning Program clinic nurses is also adept at sign language and has used this in our clinics with hearing impaired patients. Follow-up - Any patient who is found to have a positive culture for gonorrhea is contacted, in a manner to insure confidentiality, by the Family Planning Coordinator who explains the test result, the disease, its transmission, the need for immediate treatment, and the STD Clinic locations and hours. The Coordinator then gives the pertinent information to the STD Clinic staff. The - clinic is contacted 24 hours later to verify that the patient has arrived at the clinic for treatment. In some instances, a second contact must be made to convince the patient of the seriousness of the infection. As of October, 1983,- 10 cases of gonorrhea were identified and Were brought under treatment with their partner. As of -October, 1983, no cases of syphillis have been diagnosed. Class III pap smear reports are followed up within three weeks time. Patients with Class II pap reports have a repeat pap at the next visit. F. Accomplishments and/or Shortfalls 1. Program Component: Family planning services for women 15-19 and 20- 44 who are under 150% of poverty level. Please note: An error was made in the 1983 program projectives de- scribing how many clients in the 20-44 age group would be serviced. The correct projection is 2,200 not 3,200 as typed. Therefore, the total nunber of clients to be serviced should be 3,200 not 4,200 as typed.- 1982 - Actually Served 1983 - Projected Initial Patients - 1,563 Total Patients - 3,155 Initial Patients - 1,200 Total Patients - 3,200 We have projected 1,200 initial patient visits for 1983. As of September 30, 1983, we have already done 1,043 initial exams. In addition to this, 457 women who were given appointments to receive family planning services as new patients failed to keep these appointments. Former patients are continuing to return to this agency for service due to the family financial situation.' During the first nine months of 1983, 136 women were reactivated after periods ranging from 18 months to 6 years since the last visit. There have been 333 family planning patient clinic visits by Medicaid- recipients during the first nine months of 1983. We hope to continue to increase our services to Medicaid recipients by reminding DSS workers, WIC, EPSDT, and Oakland County Health Division staff of our services. We feel the cost for each medical encounter will continue to decrease as the patient load climbs. OCHD FAMILY PLANNING SUGGES4LD SLIDING FEE SCILLIJULE FOR AGE 13 AND OVER (DONATIONS REQUESTED FROM TEENS UNDERAGE 18) GROSS INCOME PER WEEK Pay Birth Pay Birth Control Method !ay Method + ?ay Birth Control Method+ Eontrol Met1 + Initial & Annual nitial Exam- Initial Exam=$30.007$50.00 + Initial Exam=S5.00-$10.00 $15.00-$25.00 Annual Exam=$25.00-$35.00 Exam=$53.00 Vaginal Smear-$2.00+ A ual Exam= Vaginal Smear=$10.00 + Annual Exam,- *Vaginal Medication w10.00-$20.00 *Vaginal Medication S38.00 Pay for Birth IUD Insert - $5.00 iaginal Smear IUD Insert= 15.00 Vaginal Sme Donation for Control Method $5.00 +*Vaginal $15.00+ * Exams .& Method and *Vaginal Medication Vaginal Me(- Pay for Vaginal Medication IUD Insert=$10.00 IUD AmILY SIZE Medications - $RIsmt- : l(Living /Parents) Up to $25.00 $25.00-$99.00 100-$145.00 $150-$205.00 $210-$230.00 $233.65 , l(Living t Own) Up to $80.00 $90.00-$120.00 $125-$140.00 $145-$195.00 $200-$230.00 $233.65 Encourage to Pay For Method) Up to S135.00 $136-$180.00 S181-S225.00 226-$270.00 $271-$313.00 $314.42 3 Up to $195.00 $196-S245.00 $246-$295.00 $296-$345.00 $346-$394.00 $395.19 4 up to $200.00 $201-$270.00 $271-$345.00 $345-$415.00 $416-$475.00 $475.96 5 'Up to $255.00 $256-$335.00 $336-$415.00 $416-$485.00 $486-,556.00 $556.75 6 Up to $275.00 $276-S365.00 $365-$460.00 $461-S550.00 $551-S637.00 $637.50 BIRTH CONTROL METHODS iBCP - $3/cycle Diaphragm + 1 tube jelly = $10.00 $20.00 at Insert Jelly - $2.00 / Tube NO ONE WILL BE DENIED SERVICE OR SUPPLIES DUE TO LACK *Vaginal Infection Treatment is not part of the Family 'Planning mandate. All patients will be charged for the medication Sultrin $6.00 Monistat Protostat Check Prices Antibiotics -- $5.00 -Condvioma Treatment is $5.00 per visit. Earlier this year the Michigan Department of Health Family Planning consultant helped the program coordinator revise the sliding scale on which we base fees for adult patients. This has resulted in a slight increase in income from those adults attending our program whose income permits them to be charged. A copy of this sliding scale is attached. 2. Program Component: Education. As of December 1983 the number of planned talks given by the Family Planning Coordinator will be ten (10). The audiences include teachers being certified in reproductive health content through the workshop held twice a year at Oakland Schools, student nurses from three uni- versities doing their clinical field experience in public health at Oakland County, orientation of new PHN staff (twice a year), and school or community groups requesting a speaker on family planning. Additionally, family planning brochures are available in all clinic sites including WIC,-CIT, and EPSDT and are distributed by PHN's assigned to the field. 3. Program Component: Male involvement in family planning services. Males accompanying their partners to family planning clinics are included in the teaching and counseling segment of the clinic visit. Individual male encounters are not recorded separately, so the exact count of males receiving service is not available. 4. Program Component:. Rubella immunity. Since December 1977 the program has been drawing blood for rubella titer on every new client. All women with a titer of 1:8 or less and in need of a. rubella vaccine are provided information sheets ex- plaining the risks which are involved when there is no immunity present. Michigan law prohibits giving immunization to anyone under 18 without parental permission. It has been our practice to inform minors with low titers that the risk of rubella infection is present, but we wait until the 18th birthday to offer them immunization in our Family Planning Program Clinics. In 1983, 39 women received the rubella vaccine. Twenty-one were ages 15-19, and 18 were ages 20-39. - G. Our goal for 1984 is to have a total caseload of 4,200 clients, 1,200 of which will be new, 2,200 of which will be between 13-19 years of age, and 2,000 of which will be between 20-44 years of age. Oakland County has an abundance of gynecologists, as well as Beaumont and Pontiac General Hospital Outpatient Gyn Departments, which provide care on an ability to pay. This somewhat reduces the number of women who depend on this agency. This family planning program has always followed the DNEW Guidelines in restricting service to teens, low income adult females, or adult females who may be over the HEN Guidelines but have other financial, health, or social reasons which restrict her from private care. We have seen an increase in the numbers of married women with children who are not eligible for free care and supplies. An unplanned pregnancy at this time would be devastating. We hope to be able to help all who contact our office. We plan to continue the current clinic schedules as described in Section E.1.b. . Fees and Collections When each appointment is set up, the individual is asked about her or her family's (if married) current financial situation. She is told at that time what to expect in the line of cost for the service and supplies. She is always told that if she does not have the money on hand, she may mail it later. No one is ever denied service for lack of money. All teens are encouraged to make donations toward our costs. Some are unable, but many are able and do so. III. PROPOSED PROGRAM OBJECTIVES - 1984 PROGRAM COMPONENT: Family planning services for women 20-44. PROBLEM: OBJECTIVE: In 1982 approximately 12,592 women, ages 20-44, under 150% of poverty, residing in Oakland County in need of family planning services. The number will increase if the economic picture worsens. To provide service to 2,000 women, all of whom are below 150% of poverty or who have barriers to service from private physicians, private agencies, or hospital out- patient family planning services. ACTIVITIES: A. Conduct 15 clinic .sessions„ per week at four loca- tions now established. B. Stimulate service delivery by Continuing to make the program known to area agencies, Church staff, area physicians, and the Department of Social Services. C. Stimulate service delivery to Medicaid eligible and low income women, ages 20-14, by continuing contact with DSS personnel, EPSDT staff, WIC staff, and Head Start Programs. D. Encourage continuing patients who can now afford private care to seek services from private physicians. This will make openings for new patients. E. Evaluate current and potential sites to make them accessible to the target population. MEASURE OF ACHIM/LAMENT: Number of patients served who are under 150 96 of poverty, ages 20-44, or otherwise restricted from private care. PROGRAM COMPONENT: Family planning services for teens (13-19) . • PROBLEM: - In 1982 approximately 20,496 women ages 13-19 are in need of family planning services. Lack of accessibility and acceptability to women, ages 13-19, of family planning services. OBJECTIVE: Maintain or increase number of clients, ages 13-19, served to 2,200 in 1984. ACTIVITIES: A. By locating family planning clinics in areas which are acceptable and accessible to the 13-19 year old population. B. By reviewing materials and participating in school and_community programs that: 1. Increase teen receptivity to family planning methods; 2. Increase knowledge of safe and dependable family planning methods; and 3. Increase awareness of responsibility for conception. and contraception. C. By recommending purchase of high quality educational materials to Oakland County Health Division and/or Oakland Schools. D. To presentalternatives to conception for teens from specific cultural backgrounds. MEASURE OF ACHIEVEMENT: The number of 13-19 year old clients who use family planning services and continue as users of contraception_ PROGRAM COONENT: Education. PROBLEM: OBJECTIVE: ACTIVITIES: To provide information on human sexuality and birth control methods and services to school personnel and others who request it. To offer training and information to teachers and counselors and to provide above infolmation as needed to them and others. A. Participation in workshops for teacher certification in reproductive health offered through Oakland Schools. B. Participation in human sexuality workshops, contra- ceptive classes, and programs offered by churches, adult education, and various social agencies. C. Periodic displays of contraceptive methods including philosophy, method of use, and effectiveness in Oakland County Health Division buildings. D. Talks to participants of alternate education program for pregnant girls and teen mothers. E. Pamphlets on contraceptives and effectiveness of each method when properly used to be provided to teens who come for free pregnancy testing which is offered by the Oakland County Health Division. F. Distribution of family planning information to parti- cipants of WIC, EPSDT, and Child Health Conferences. MEASME OF ACHIEVEMENT: The number of talks given in schools, churches, and social agencies who request this service. PROGRAM COMPONENT: Male involvement in family planning services. PROBLEM: OBJECTIVE: • Limited participation by males in Family Planning Pro- gram for decision on the method of contraception which is acceptable to both partners. To encourage male participation during counseling and teaching segment of family planning clinic appointment as related to human sexuality discussion, birth control instruction, and selection of method to be used by the couple involved. - ACTIVITIES: A. To continue to encourage family planning patients to invite partner to accompany her to the clinic. B. To make booklets on family planning methods avail- able to clients in Oakland County Health Division walk-in Venereal Disease Clinic. C. To continue to make available limited supplies of foam and condoms to be offered to patients under age 18 who come to Oakland County Health Division for pregnancy screening. D. When making presentations to schools, church, or other groups, the speaker will stress the importance of male involvement in decision-making and follow through on use of the method chosen. MEASURE OF ACHIEVEMENT: Notation on client record of males who accompany partners to Family Planning Clinics. Specific nuinbers for males are not currently tabulated, nor is an audit of records feasible to obtain this. PROGRAM COMPONENT: Rubella Immunity PROBLEM: There continues to be a number of women, ages 13-44, who have little or no immunity to Rubella. OBJECTIVES: A. To determine the Rubella immunity status of all patients enrolled in the Family Planning Program. B. To offer Rubella immunization to all women with a. titer of less than 1:8. ACTIVITIES: A. Draw a sample of blood on each initial patient for a Rubella titer. B. Inform those patients who have a titer of less than 1:8 -that the risk of Rubella infection is present. C. Inform those patients at risk about the potential fetal damage if the infection should occur to any woman in the first trimester of pregnancy. D. Offer, Rubella immunization in our Family Planning clinics to those at risk who arc 18 years of age or older and for whom it is medically safe. MEASURE OF ACHIEVEMENT: The number of patients, age 18 or older, identified with Rubella titer of less than 1:8 and who receive Rubella immunization. . #83 3 67 December 8, 1983 8th_ day o ecembeT . 19 83 ALLE Counity Clerk/Register of Deeds Moved by Gosling supported by Susan Kuhn the Finance Committee Report be accepted. A sufficient majority having voted therefor, the motion carried. Moved by Gosling supported by Nelson the resolution be adopted. AYES: Foley, Fortino, Gosling, Hobart, Jackson, R. Kuhn, S. Kuhn, Lanni, Law, McConnell, McDonald, McPherson, Moffitt, Moore, Nelson, Olsen, Page, Perinoff, Pernick, Price, Rewold, Wilcox, Aaron, Caddell, Calandro, Doyon. 26) NAYS: None, (0) A sufficient majority having voted therefor, the resolution was adopted. STATE OF MICHIGAN) COUNTY OF OAKLAND) I, Lynn D. Allen, Clerk of the County of Oakland and having a seal, do hereby certify that I have compared the annexed copy of Miscell ,qneous Recolutinn 1/8_3_367 adopted by the Oakland Launty BoDr0 of Commissioners at their meeting held on December 8, 1983 with the orginial record thereof now remaining in my office, and that it is a true and correct transcript therefrom, and of the whole thereof. In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County at Pontiac, Michigan this