420.002 Provider Selection Criteria and Requirements for the Texas Infertility Prevention Project

Policy Number 420.002
Effective Date November 2, 2015
Revision Date January 23, 2020
Subject Matter Expert Sydney Minnerly, MA
Approval Authority TB/HIV/STD Section Director
Signed by Felipe Rocha, M.S.S.W.

Public comments on Provider Selection Criteria and Requirements for the Texas Infertility Prevention Project policy

1.0 Purpose

To describe the criteria used to select local programs and providers to participate in the Texas Infertility Prevention Project (TIPP) and the responsibilities of these programs and providers.

2.0 Background

The mission of the Texas Infertility Prevention Project (TIPP) is to increase access to clinical services to diagnose and treat chlamydia (CT) and gonorrhea (GC), two common sexually transmitted diseases (STD), in groups with disproportionate rates or shares of these conditions. TIPP is a collaborative between the Department of State Health Services (DSHS) HIV/STD Prevention and Care Branch, Pharmacy Services Branch and the Laboratory Sciences Section. These DSHS programs partner with programs/providers across the state to carry out the goals of the Project.

TIPP activities include identifying, screening, and treating women and men at high risk for CT and GC infection, counseling infected and at-risk individuals on safer sex/risk reduction practices, treating and counseling partners of infected persons, and referring persons for other medical services, as appropriate. TIPP provides CT and GC screening supplies, laboratory services, medications for treatment, resources for training, and other resources to enhance patient services for the programs/providers to perform these services. In exchange for these resources, programs/providers follow TIPP CT and GC screening and treatment guidelines and submit demographic and behavioral data that is used for local and national project planning. TIPP offers in-kind assistance only; TIPP does not offer direct financial assistance. In-kind assistance is supported by federal funds provided by the Centers for Disease Control and Prevention (CDC) under Section 318 of the Public Health Services Act.

3.0 Policy

Programs/providers that deliver clinical services in order to diagnose and treat sexually transmitted disease (STD) and who meet Project criteria (Section 3.1) are eligible for consideration as a TIPP partner.

3.1 Project Criteria

The following are the core criteria for TIPP. A TIPP partner must:

  1. Be a Texas local health department, juvenile detention center, local city or county jail, community-based clinic, sexual health, family planning, or other essential community provider;
  2. Provide clinical STD services as defined in Section 4.0;
  3. Submit CT/GC specimens to a public health lab or to a private lab with whom the TIPP Administrative Agency has or can obtain a memorandum of agreement;
  4. Follow the most current CDC STD Treatment Guidelines for screening, treatment, follow up, partner management and prevention/risk reduction messages;
  5. Have policies, procedures and standing delegation orders in place for testing, treatment, follow up, referral and patient education;
  6. Have an organizational mission aligned with the TIPP mission;
  7. Agree to follow TIPP Procedures of Collaboration (POC);
  8. Have a level of morbidity and demonstrate an unmet need for TIPP services in the program’s service population/area to warrant inclusion in the Project.
  9. Comply with Healthy Texas Women Services requirements, Texas Administrative Code (TAC) Title 1, Part 15, Chapter 382, Subchapter A., Healthy Texas Women, 382.17 Health-Care Providers (b)-(d).                  

3.2 Requests to Participate in the TIPP

Requests to participate in the TIPP are accepted on a rolling basis. Requests are evaluated by TIPP leadership when received.

3.3 TIPP Project Site Review Process

The addition of a new program/provider is a two-part decision; the first is based on the availability of funds, the second is based on the match between the program/provider characteristics and TIPP site eligibility criteria described in Section 3.1 of this policy.

The addition of new programs/providers to the TIPP is limited by the funds available for the project. When a program/provider submits a request, the TIPP coordinator will determine if there are available funds. If there are available funds, the TIPP coordinator will evaluate the request against the eligibility criteria in Section 3.1 of this policy. If the TIPP has a participating program/provider in the applicant's service area, the TIPP may decline to enroll the applicant even if all other criteria are met. The TIPP coordinator will notify the applicant of the results of the review within 90 days.

3.3.1 Provisional Acceptance

If an applicant meets all criteria except having current policies, procedures and standing delegation orders, the TIPP may provisionally accept the application contingent on TIPP staff capacity to assist the applicant in the development of policies, procedures and standing delegation orders. The TIPP is the sole authority on staff capacity to assist applicants or whether an applicant meets the standards of the TIPP.

3.4 Resources available to Organizations Collaborating with the TIPP

TIPP partners do not receive direct financial assistance. Programs may receive any of the following in-kind resources from the Project:

  1. CT/GC amplified technology test kits* purchased by DSHS for use with patients who meet the Project screening criteria;
  2. CT/GC laboratory processing for specimens from patients who meet the Project screening criteria;
  3. Medications to treat CT/GC;
  4. Training, technical assistance and programmatic consultation via telephone, written correspondence and/or site visit;
  5. Collaborative on-site administrative and clinical site audits, including a clinical record review, to ensure policies, procedures, and practices are in compliance with TIPP guidelines and objectives.

*CT/GC testing supplies are to be used as “payer of last resort.” Supplies are for a specified target population of uninsured or underinsured individuals to assist public health programs/essential community providers maintain screening according to current screening guidelines and to meet community needs based on morbidity data.

3.5 Responsibilities of TIPP Partners

When an applicant has been accepted by the TIPP, it agrees to abide by requirements set out in the TIPP POC.

3.6 Continuation and Discontinuation of TIPP Participation

Programs/providers participating in the TIPP do not need to re-enroll.

Once accepted, programs/providers will continue to receive in-kind resources unless:

  1. Clinical and administrative reviews demonstrate the program/provider is not following the TIPP POC.
  2. Data indicate the program/provider is not serving a high-morbidity population.
  3. There is a reduction in Project funding that requires a reduction or discontinuation of in-kind support.
  4. The collaborating program/provider decides to separate from the Project.

Programs/providers will be given 90 days' written notice before separation from the Project.

4.0 Definitions

Centers for Disease Control and Prevention (CDC) – A component of the federal Department of Health and Human Services that has funding agreements with state, local, and territorial STD programs for STD prevention and control projects. The Texas Infertility Prevention Project (TIPP) receives 318 funds from the CDC.

Clinical STD services – Direct sexual health care that includes testing, physical examination and treatment for sexually transmitted infections, referral and patient education.

Collaboration – A partnership between STD programs/providers and the TIPP that includes provision of certain in-kind supports such as testing supplies, medications, technical assistance, quality audits and/or data collection.

Essential Community Provider (ECP) – Providers that serve predominately low-income, medically underserved individuals.

Texas Department of State Health Services (DSHS) – The agency responsible for administering 318 funds from the CDC that support TIPP.

In-Kind Support – For the purposes of this policy, in-kind support is defined as non-cash contributions provided by TIPP and directly benefiting an STD program. In-kind contributions consist of testing supplies and medications that are purchased with 318 funds. Other in-kind support includes laboratory support, technical assistance, quality audits, and resources for training. (Based on the definition found in the Health Resources and Services Administration Dictionary of Grant Terms)

Procedures of Collaboration – A collaborative agreement between TIPP programs/providers that guides and defines the relationship, expectations, and roles and responsibilities. Eligible TIPP partners include but are not limited to: HIV/STD and sexual health clinics, community-based clinics, family planning, essential community providers, juvenile detention facilities, state and local public health laboratories, and private laboratories.

Texas Infertility Prevention Project – A state project funded by the CDC with 318 dollars; a partnership between DSHS HIV/STD Prevention and Care Branch and the DSHS Pharmacy Branch and the DSHS Laboratory Sciences Section. TIPP furnishes screening supplies, laboratory services, medications, training, and technical assistance to public health and safety net providers to serve specific target populations to prevent and control STDs.

TIPP Administrative Agency – The agency contracted by the DSHS HIV/STD Prevention and Care Branch to administer and coordinate oversight of the Project.

Underinsured – A patient who experiences any circumstance that might influence or restrict access to necessary preventive health care services or medication. These circumstances might include, but are not limited to, patients who are concerned about privacy to use their insurance or have a financial burden due to high deductibles or co-pays, any patient whose provider would not be able to provide timely treatment, or any partner of a contact identified through disease intervention specialist (DIS)/contact tracing

318 Funds – Project funding under Section 318 of the Public Health Service Act awarded by the Centers for Disease Control and Prevention (CDC) to state and local health departments for STD prevention and control programs.

340B Drug Pricing Program (340B Program) – A program administered by the Health Resources and Services Administration. The program provides access to prices lower than typical market prices. The goal of the 340B Program is to provide patients access to affordable medications and to enable eligible safety net providers to stretch scarce Federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.

5.0 Persons Affected

  • TIPP Coordinator
  • STD care programs
  • TIPP Program Leadership

6.0 Responsibilities

STD care programs – will ensure compliance with the TIPP POC.

TIPP Coordinator – will track the availability of TIPP funds to add new partners, identify and assess the suitability of potential TIPP partners, train and orient new programs/providers, and provide technical assistance and audits to ensure compliance with TIPP POC. Once a year, the Coordinator will submit a list of eligible TIPP partners to the TIPP leadership.

TIPP Leadership – will provide project oversight and approve the initiation and continuation of project sites.

7.0 Procedures to Determine TIPP Eligibility

7.1 Funding

The TIPP coordinator will determine if there are sufficient funds to add another program/provider to the Project.

7.2 Eligibility

The criteria that will be used to determine the applicant’s eligibility for TIPP are listed in Section 3.1.

7.3 Substitute Criteria

If there are any NO answers to criteria outlined in Section 3.1, the following criteria will apply:

  1. Does the applicant provide any clinical services?
  2. Does TIPP already have a partnership with a similar program/provider in the area?
  3. Is the applicant able to put in place policies, procedures and standing delegation orders for testing, treatment, follow up, referral and patient education?
  4. Does TIPP have the capacity to assist the applicant in developing policies, procedures, standing delegation orders and provide staff training and orientation?
  5. Does the applicant use a public health lab or a private lab that will enter into an agreement with the TIPP Administrative Agency?

7.4 Monitoring

The TIPP will monitor partners on a periodic basis to assess quality of care and program compliance.

7.5 Limits of TIPP Collaboration

Collaboration with the TIPP does not provide automatic access to the 340B Drug Pricing Program. TIPP partners may qualify for program participation but must comply with all requirements of the 340B Program.

8.0 Revision History

Date Action Section
8/20/2019 Added TIPP partner project criteria; added definition of underinsured and specified use of in-kind testing supplies for uninsured/underinsured individuals per STD PCHD NOFO requirement, removed Procedures Collaboration 
9/1/2017 Changed "TB/HIV/STD Unit" to "TB/HIV/STD Section" to reflect new program designation -
11/2/2015 This is a new policy All