Every Woman’s Life

PROGRAM MANUAL UPDATE

2012-2013

RECRUITMENT

• No Changes

RECRUITMENT

ATTACHMENTS:• None

ELIGIBILITY & ENROLLMENT

• Eligibility – no change• Federal Poverty

Guidelines – no change• Client Participation

Agreement – added info on “What you need to know about Every Woman’s Life”

• Client Transfer – no change

ELIGIBILITY & ENROLLMENT

ATTACHMENTS:• Client Participation Agreement – no

change

• Client Transfer – no change

SERVICES

• Client Education – no change

• Cervical 18-39 – no change

• Breast 18-39 – New NCCN Breast Cancer Screening and Diagnosis Guidelines

SERVICES

• Cervical 40-64 – New USPHS Cervical Screening Guidelines

• Breast 40-64 – New NCCN Breast Cancer Screening and Diagnosis Guidelines

SERVICES

• Managing Abnormal Cervical – New USPHS Cervical Screening Guidelines

• Managing Abnormal Breast – updated NCCN version

• Over Age 65 – no change

SERVICES

• Rescreening – no change

• Referrals – no change

• Cancellation of Services – no change

SERVICES

ATTACHMENTS:• EWL Screening Guidelines – no change• CBE Core Competencies – no change• Cervical Diagnostic Guidelines – no

change• Breast Diagnostic Guidelines – no change• QuitNow Virginia Order Form – no change

CASE MANAGEMENT

• CM for Women with Abnormal Screening Results – no change

• CM Needs Assessment – no change• CM Care Plan – no change• Tracking System – added clarification to

patient confidentiality• Tracking & Follow-up – added clarification

for inactivating patients

CASE MANAGEMENT

ATTACHMENTS:• Needs Assessment & Care Plan – no

change

• Tracking & Follow-up Diagram – no change

DATA COLLECTION, REPORTING & RETENTION

• Data Collection Forms – no changes to policy (Forms Changes will be discussed at the end of this presentation)

• Reporting Requirements – removed section on Community Health Worker Annual Work Plan

• Medical Record Management – no change

DATA COLLECTION, REPORTING & RETENTION

ATTACHMENTS:• Forms Changes will be discussed at the

end of this presentation • Monthly Screening Log – no change• Match Form – no change

REIMBURSEMENT

• Reimbursement for EWL Services – added:– Clarifications on the forms needed to submit

for reimbursement– Removed section on Community Health

Workers– Updated the state EWL address

REIMBURSEMENTChanges to Federal Forms

REIMBURSEMENTChanges to State Forms

TREATMENT

• BCCPTA – Updated policy to include information on

Project Wish

TREATMENT

ATTACHMENTS:• BCCPTA Application – no change• BCCPTA Policy – no change• Medicaid FAQ – Added question 22• DSS Regional Consultants – no change

QUALITY ASSURANCE & IMPROVEMENT

• Federal Performance Indicators – no change

• State Performance Indicators – no change

QUALITY ASSURANCE & IMPROVEMENT

• Observational Site Visit – No changes

– No changes

QUALITY ASSURANCE & IMPROVEMENT

• Problem-Focused Visit– No changes

QUALITY ASSURANCE & IMPROVEMENT

ATTACHMENTS:• None

STAFFING

• EWL Provider Site Staff – removed the section on Community Health Workers

• Training & Technical Assistance – no changes

STAFFING

ATTACHMENTS:• None

EWL Data: Overview and Update

Changes to the Data Forms

Why does EWL collect data?

• To monitor program– Quality

• Timeliness of screening to diagnosis and diagnosis to treatment…

– Outcomes• Number of women served, number of cancer

diagnosis…

– Cost• Cost of screening per women served, estimated

cost to serve projected number of women…

What does EWL do with the data?

• Submit to CDC in the form of MDEs– Sent to the CDC in April and October each year– Analyzed by CDC for performance indicators, trends,

and missing/erroneous data• Analyze for trends and problem areas

– By provider site, by year, etc.• Collaborate with partners to provide information and

conduct research– Local universities, community organizations, other

VDH agencies, other provider sites

How do we ensure data quality?

• Accurately complete all necessary fields on data forms

• Be aware of changes in data requirements• Use the most current forms• Submit data in a timely manner

Why are we changing the data forms….again?

• Reflect the new changes in the cervical guidelines

• To more accurately reflect the MDEs• To better capture currently clinical

practices• To provide more accurate information to

the CDC

Client Eligibility Form

Removed the breast symptom questions from the Breast Screening and Diagnostic Form.

The client self reports any abnormal breast symptoms.

Change #1

Client Eligibility Form

Removed “Unknown” as a choice in order to better capture race data. If a patient truly does not know their race please call the State office for guidance.

Change #2

Client Eligibility Form

*A referral includes offering clients Virginia Quit Line or other tobacco information

Change #3

Check “Yes” even if the client refuses the referral information

Breast Screening and Diagnostic Form

Change #1

Asterisk (*) procedures require further diagnostic evaluation

Moved the breast symptom question to the Eligibility form

Breast Screening and Diagnostic Form

Added Unilateral/Bilateral to mammogram type.

Please use this box for all Diagnostic mammograms and not Additional Mammogram Views.

Change #2

Breast Screening and Diagnostic FormChange #3

Asterisk (*) results require further diagnostic evaluation

Breast Screening and Diagnostic FormChange #4

• Assessment is incomplete (BI-RADS 0) should only be used in instances were the radiologist/clinician does not feel comfortable determining whether there is cancer present. All other instances should use Unsatisfactory, if the film cannot be interpreted, or Unknown if the results are not known.

• Instances of Assessment is incomplete should have additional imaging done or a film comparison only if required by the radiologist• Film comparisons as part of a routine visit should NOT be documented.

Breast Screening and Diagnostic FormChange #5

Added new result options for an Ultrasound to be reflect CDC data collection requirements.

Breast Screening and Diagnostic Form

Change #6

Added the result Atypical Ductal Hyperplasia, to better reflect CDC data collection requirements

Breast Screening and Diagnostic Form

Separated Repeat CBE from Surgical Consult for clarity.

Please only use the choices under each procedure as results.

Change #7

Breast Screening and Diagnostic FormChange #8

• Added Deceased to more accurately capture data• Added short-term follow up options for when clinicians/radiologists

recommend short-term follow up in lieu of immediate diagnostic work.

Please use the short term follow up check boxes rather than hand writing in notes.

Cervical Screening and Diagnostic Forms

Change #1

Added 3 year (without HPV test) and 5 year (with HPV test) to the data forms to reflect the new changes in cervical guidelines.

Cervical Screening and Diagnostic Form

Change #2

Asterisk (*) results require further diagnostic evaluation

Cervical Screening and Diagnostic Form

Change #3

Removed “Clearly defined lesion of CIN” as per the CDC

Cervical Screening and Diagnostic Form

Change #4

Added No tissue presentThis should only be used for ECC

Cervical Screening and Diagnostic Form

Change #5

• Added Deceased to more accurately capture data• Added short-term follow up options for when clinicians/radiologists

recommend short-term follow up in lieu of immediate diagnostic work.

Please use the short term follow up check boxes rather than hand writing in notes.

These new forms will go into effect

January 1, 2013.