Health

Childhood Immunization

Programs that inoculate infants and young children to prevent them from contracting diseases to which they are particularly susceptible including diphtheria, tetanus (lockjaw), measles, mumps, chicken pox (varicella), rubella (German measles), whooping cough (pertussis), Hib (haemophilus influenzae type B), hepatitis B, pneumococcal infections and polio. Hepatitis A vaccine is recommended for use in selected locales and for certain high-risk groups. Influenza vaccine is recommended annually for children older than six months with specific risk factors. Rotavirus vaccination (to prevent acute gastroenteritis with vomiting and severe diarrhea) is recommended during the first year of infancy. A baby should receive two or three doses depending on the brand used. Some childhood immunizations involve a series of doses at specific intervals.

Covid-19 Immunization Clinics

Programs that provide inoculations that help prevent individuals from contracting the COVID-19 virus, either to the general public or targeting critical workforce personnel and/or higher-risk priority groups. The vaccine is administered as two shots given with a needle, usually in the arm and separated by a period of weeks. The clinics may be walk-in sites (pharmacies, churches, community centers, outdoor tents) or locations in areas with curbside or drive-through options. Most sites require physical distancing, use of personal protective equipment (PPE), and enhanced sanitation efforts.

Flu Vaccines

Programs that inoculate susceptible individuals of all ages, but particularly people who are very young or very old, to prevent them from contracting any of the variant strains of influenza that are prevalent during the winter and spring. The vaccine may be administered as a "shot" that is given with a needle, usually in the arm, or in the form of a nasal mist.

Covid-19 Control

Programs that attempt to control the occurrence and spread of the virus first identified in Wuhan, Hubei Province, China in 2019 that causes the respiratory illness COVID-19, which probably originally emerged from an animal source but has spread from person-to-person in many locales as well as to other countries around the world and has been identified as a pandemic by the World Health Organization (WHO). Coronaviruses are a large family of viruses, some causing illness in people and others that circulate among animals, including camels, cats and bats. SARS, another coronavirus that emerged to infect people, came from civet cats, while MERS (the Middle East Respiratory Syndrome), another coronavirus that emerged to infect people, came from camels. Symptoms of the current infection include mild to severe respiratory illness with fever, cough and difficulty breathing. Those most at risk from the virus are older adults and people with preexisting health conditions. Coronaviruses are generally thought to be spread most often by respiratory droplets. There is no evidence of transmission of the virus associated with imported goods. Strategies for controlling the spread of the virus include testing individuals who have had contact with people with active cases, tracing people who have had contact with people who have tested positively or have contracted the virus, quarantining individuals who have the illness and, in areas that have experienced community transmission, asking residents to engage in social distancing (avoiding large parties, sporting events and other venues where large crowds typically gather). Local authorities may ask that special events like conferences, festivals and concerts be cancelled or rescheduled or may ban large gatherings altogether, for example having sports events take place without on-site spectators.

Covid-19 Diagnostic Tests

Public health laboratories that conduct diagnostic testing for people who have symptoms of the novel coronavirus that causes COVID-19. People who have been in close contact with someone with COVID-19 or are a resident in a community where there is ongoing spread of the virus and develop symptoms are being advised to call their health care provider and tell them about their symptoms and exposure, at which point a decision will be made as to whether they need to be tested. Patients who require a test will have a swab inserted through their nose to reach what is known as the nasopharyngeal region where cells are collected. If the patient is calm, the swabbing takes 10 seconds or so and is not painful. A jittery patient can make things more difficult. Once the sample is taken, it is put into a sterile container and sent to a lab where a chemical pulls the cells off the swab and turn the sample into a liquid form, which is put into a machine that makes multiple copies of the virus' RNA. The machine attempts to match the person's RNA with the coronavirus RNA to determine a positive or negative result.

Covid-19 Immunization Clinics

Programs that provide inoculations that help prevent individuals from contracting the COVID-19 virus, either to the general public or targeting critical workforce personnel and/or higher-risk priority groups. The vaccine is administered as two shots given with a needle, usually in the arm and separated by a period of weeks. The clinics may be walk-in sites (pharmacies, churches, community centers, outdoor tents) or locations in areas with curbside or drive-through options. Most sites require physical distancing, use of personal protective equipment (PPE), and enhanced sanitation efforts.

Telemedicine

Programs that allow health care professionals to evaluate, diagnose and treat patients in remote locations using telecommunications technology. Telemedicine permits two-way, real time interactive communication between the patient, and the physician or other practitioners at a distant site. Some programs may also incorporate other forms of communication including transfer of medical information such as CT scans, MRIs, ultrasound studies, radiographic images and pathology images to medical personnel at another site for review and analysis. The technology is also being used in other related areas of practice (e.g., mental health, substance use disorders, gambling) as well as for teaching and remote caregiving purposes.

Dental Care Referrals

Programs that link people who are in need of care which involves their mouth, teeth, gums or associated structures with dentists, orthodontists, periodontists or other members of the dental profession.

Dental Hygiene

Programs that offer preventive dental care including professional teeth cleaning and information about the proper daily self-care of the teeth to remove plaque, food and other residue that is associated with periodontal disease and tooth decay.

Dental Prosthodontics

Programs that specialize in the esthetic restoration or replacement of teeth. Prosthodontic procedures include crowns, bridges, veneers, inlays, onlays and complete and partial dentures. Dental implants are the preferred method for replacing missing teeth, so many prosthodontic procedures are done with implants as the support instead of the natural teeth or gums. Prosthodontic care is provided by both general dentists and prosthodontic specialists called prosthodontists.

Dental Restoration

Programs that are staffed by specialists who are concerned with the repair, replacement or reimplantation of broken or missing teeth.

Emergency Dental Care

Programs that provide immediate, short-term assistance for people who have lost a filling, broken or lost a tooth or dental prosthesis or who have other dental emergencies and are unable to wait for treatment on an appointment basis.

General Dentistry

Programs that provide primary oral health care for patients of all ages. General dentists are responsible for the diagnosis, treatment, management and overall coordination of specialized services related to the patient's oral health needs. Services generally include an oral health history, preventive dental cleanings, dental radiographs, oral cancer screening, an examination of the teeth to detect tooth decay or other problems, a periodontal examination to detect gum disease, dental restorations (e.g., fillings, crowns and implants), cosmetic dentistry, and other procedures such as fluoride treatment.

Mobile Dental Care

Programs that provide dental services to patients in rural communities, skilled nursing facilities, assisted living facilities, group homes, housing projects, private residences or other similar settings using portable equipment or large, specially equipped motorized vans or mobile trailers (non-motorized). Mobile dental services bring dental hygiene, preventive care and limited treatment services to people in remote areas who do not have immediate access to a dentist or dental clinic or are unable to leave their homes to seek care at a fixed clinic facility.

Pediatric Dentistry

Programs that specialize in providing oral health care for infants, children and adolescents.

Assistive Technology Expense Assistance

Programs that pay all or a portion of the costs associated with acquiring assistive technology products and/or obtaining support services such as customization, fit/modification services or repairs.

Health Insurance Premium Assistance

Programs that make health insurance payments for individuals who are at risk for losing their health, dental and/or vision care coverage and who meet age, income, disability, need or other requirements. Some programs may also provide assistance with deductibles and co-pays.

Incidental Medical Expense Assistance

Programs that provide financial assistance that helps individuals who have a designated health condition or disability or who require a transplant pay for non-medical but related expenses which may include travel expenses to and from treatment, home and child care expenses, housing costs and/or related transplantation costs such as donor search, compatibility testing, bone marrow harvesting, unrelated stem cell procurement, and transportation and housing costs associated with the transplant.

Medical Care Expense Assistance

Programs that pay the hospital bills, doctor bills, rehabilitation service bills, laboratory expenses or other health care expenses of people who are unable to obtain necessary health care without assistance. Also included are programs that provide vouchers which enable eligible individuals to obtain medical care. Medical bill payment assistance programs may have age, income, disability, need or other eligibility requirements.

Medical Equipment Expense Assistance

Programs that provide financial assistance that helps patients whose care is being managed in the home (or other private facility managed by a nonprofessional caregiver or family member) obtain required medical equipment and supplies.

Patient/Family Housing

Programs that provide temporary living quarters for people who are ill and for their families while the individual who is ill receives treatment or care. Included are programs that make it possible for family members to stay in local hotels, motels or other settings at no cost or a reduced cost, hotels and motels that provide discounts for people who are visiting an ill family member and programs that maintain special facilities for this purpose.

Personal Health Care Advocate Services

Programs that help people navigate through the maze of doctors' offices, clinics, hospitals, outpatient centers, insurance and payment systems, patient-support organizations and other components of the health care system with the objective of supporting timely delivery of quality care and ensuring that patients, survivors and families are satisfied with their encounters with the health care system. Personal health care advocates are trained health care workers, often nurses, or volunteers familiar with the health care system who work independently of any health care institution. They help patients identify specialists, coordinate appointments with providers to assure timely delivery of diagnostic and treatment services, provide cheat sheets of questions, and lay out the choices patients have in plain English. They may also ensure that appropriate medical records are available at scheduled appointments, accompany patients to medical appointments, arrange language translation or interpretation services, facilitate financial support and help with paperwork, negotiate insurance claims, arrange transportation and/or child/elder care, provide access to clinical trials and facilitate linkages to follow-up services. Some programs contract with employers to serve as personal advocates for employees who are ill. Others work exclusively with individuals who have specific illnesses, e.g., cancer.

Prescription Drug Discount Cards

Private organizations that issue cards that offer discounts on prescriptions at participating network pharmacies including chain and independent retail outlets, generally for an annual enrollment fee. Also included are programs that maintain lists of these types of programs for referral purposes.

Prescription Drug Patient Assistance Programs

Pharmaceutical companies or pharmacies that make brand name or generic prescription drugs available to patients who are uninsured or underinsured or, for other reasons, cannot afford to pay the market price. Also included are organizations that help qualifying patients complete and file paperwork for submission to drug manufacturers to request such medication or which maintain lists of these types of programs for referral purposes.

Prescription Expense Assistance

Programs that provide financial assistance to purchase necessary prescription drugs for people who would be in an emergency situation without assistance. Also included are programs that reimburse individuals for their prescription expenses, usually on an annual basis. Prescription expense assistance programs may have age, income, disability, need or other eligibility requirements.

Community Clinics

Consumer-based, community-controlled, nonprofit outpatient facilities that provide basic health care including physical examinations, immunizations, family planning, nutrition assistance and diagnosis and treatment of common ailments for low income people, people who are homeless or uninsured/underinsured or other medically underserved populations that are geographically, economically and culturally challenged. Services are generally provided on an ability-to-pay basis. In the U.S., most community clinics are part of the network of Federally Qualified Health Centers, and many are known as "free clinics".

Emergency Room Care

Hospitals and other health care facilities that provide 24-hour diagnostic and treatment services for people who have acute, life-threatening injuries or severe illnesses.

Hospital Based Outpatient Services

Departments within hospitals or freestanding clinics operated by hospitals or hospital systems that provide basic and/or specialized diagnostic and treatment services for the community on a walk-in, walk-out basis.

Hospitals

Medical institutions that provide diagnostic and treatment services for people whose illnesses or injuries require that they occupy a bed for at least one night. Hospitals can be distinguished by the level of care they offer (general acute, subacute, extended acute care), the auspices under which they operate which also, in some cases, defines the patients they serve (city/county, state, Veteran's Affairs, military hospitals), and the medical conditions they specialize in treating (specialty hospitals).

Mobile Health Care

Programs that use specially equipped mobile vehicles to deliver basic health care services to vulnerable and/or remote populations that are unable to access a community health care facility. The mobile clinics make scheduled stops in different neighborhoods and offer a wide variety of services which may include general physical examinations, pediatric services, health screening, vision screening, flu shots, childhood immunizations, laboratory services, WIC certification, STD screening and treatment, family planning services, pregnancy testing and treatment for minor illnesses. Included are street medicine programs that use outreach workers to seek out and provide primary health care services for unsheltered homeless people living on the streets, under bridges, in abandoned buildings or wherever else they stay.

Pharmacies

Organizations that are involved in the business of preparing, storing, compounding and dispensing drugs in accordance with prescriptions prepared by licensed physicians. Pharmacies also counsel patients on proper use of their medication and verify that new treatments are compatible with other medicines they may be taking.

Urgent Care Centers

Programs, which may be available on a 24-hour basis, that provide walk-in treatment services for people who have minor illnesses or injuries. Urgent care centers serve as an alternative to hospital emergency departments for episodic care that can not be delayed until an appointment at a physician's office is available; and are often equipped to provide services not generally available in primary care physician offices, e.g., have x-ray facilities that allow for treatment of minor fractures and foreign bodies such as nail gun injuries and/or minor care trauma rooms that facilitate the repair of minor and moderate to severe lacerations that can be treated in an urgent care center.

Veteran Outpatient Clinics

Outpatient medical facilities operated by the U.S. Department of Veterans Affairs that provide routine primary medical care for eligible veterans. Services generally include x-rays, general health check ups, blood pressure checks, treatment for basic illnesses and laboratory tests.

Women's Health Centers

Programs that provide comprehensive diagnostic and treatment services which focus on conditions that are typically seen in women. Women's health centers provide services in an emotionally supportive and safe environment, and place emphasis on educational programs that encourage women to take personal responsibility for their own health and wellness.

Covid-19 Control

Programs that attempt to control the occurrence and spread of the virus first identified in Wuhan, Hubei Province, China in 2019 that causes the respiratory illness COVID-19, which probably originally emerged from an animal source but has spread from person-to-person in many locales as well as to other countries around the world and has been identified as a pandemic by the World Health Organization (WHO). Coronaviruses are a large family of viruses, some causing illness in people and others that circulate among animals, including camels, cats and bats. SARS, another coronavirus that emerged to infect people, came from civet cats, while MERS (the Middle East Respiratory Syndrome), another coronavirus that emerged to infect people, came from camels. Symptoms of the current infection include mild to severe respiratory illness with fever, cough and difficulty breathing. Those most at risk from the virus are older adults and people with preexisting health conditions. Coronaviruses are generally thought to be spread most often by respiratory droplets. There is no evidence of transmission of the virus associated with imported goods. Strategies for controlling the spread of the virus include testing individuals who have had contact with people with active cases, tracing people who have had contact with people who have tested positively or have contracted the virus, quarantining individuals who have the illness and, in areas that have experienced community transmission, asking residents to engage in social distancing (avoiding large parties, sporting events and other venues where large crowds typically gather). Local authorities may ask that special events like conferences, festivals and concerts be cancelled or rescheduled or may ban large gatherings altogether, for example having sports events take place without on-site spectators.

Diabetes Management Clinics

Programs that help people of all ages who have juvenile or adult diabetes understand and manage their illness. Services may include screening programs for early identification of the condition and associated complications; establishment of a treatment regimen; patient education; and self-management skills development assistance which may focus on use of insulin and drugs to control blood sugar levels, blood glucose monitoring, dietary management in different environments (at home, at work, in school, while dining out), menu planning, the role of exercise in relation to food intake, hygienic measures such as foot care and ways to reduce the likelihood of diabetes-related complications which may include heart disease, kidney failure, amputation, nerve damage and blindness. Included are programs that provide comprehensive preventive, diagnostic and treatment services on an inpatient or outpatient basis as well as less formal programs that emphasize education and may provide any combination of supportive services such as case management, assistance in obtaining needed products and services, and assistance in following the prescribed treatment regimen. Diabetes is a chronic, incurable disease in which the pancreas fails to produce enough insulin to allow the body to adequately metabolize sugar.

Disease/Disability Information

Programs that provide information about the causes and origins, preventive measures, symptoms, screening/diagnostic procedures, and/or methods of treatment or management including the latest research for specific illnesses or disabling conditions.

First Aid Instruction

Programs that instruct the public in the basic lifesaving techniques involved in the administration of emergency assistance to individuals who have been injured or otherwise disabled prior to the arrival of trained medical personnel.

General Health Education Programs

Programs that provide information that helps the public make choices which promote personal health, prevent illness and disability, take advantage of opportunities for early detection, and support their ability to deal effectively with health problems when they arise. General health education programs provide information about a wide variety of health related topics rather than specializing in a particular area.

Medical Information Services

Programs that provide information about specific health and health-related topics including diseases and conditions, birth control, alcohol and drug abuse, mental health, safety and other similar topics that interested individuals can access on a website or in person, or by telephone, email, chat, text or other communication channel. Information may be in a self-serve, browsable format (for example a web resource directory or library of audio recordings) or provided by live agents with expertise in the field.

Nutrition Education

Programs that provide information concerning the basic principles of healthful eating, food handling, food preparation and shopping skills. Included is information about the basic food groups, vitamin and mineral requirements, the relationship of nutrition to the preservation of good health and the prevention of illness, and dietary choices such as vegetarianism.

Sexuality/Reproductive Health Education

Programs that provide information about the physiological and emotional aspects of human sexuality including anatomy and physiology, puberty, pregnancy, birth control, sexually transmitted disease and the subsequent risk of infertility, menopause and the attitudes, feelings and behaviors that are related to sexuality for people of all ages.

Wellness Programs

Programs that offer individual and/or group sessions which assist participants to understand how their lifestyle impacts their physical and mental health and to develop personal practices that enhance their total well-being. Wellness programs are holistic and combine a variety of components which may include a general physical examination that is tailored to the individual's needs; an evaluation of the person's pattern of exercise, eating habits, sources of stress and other lifestyle elements that are potential risk factors; and the development and implementation of an individualized plan for prevention management and early intervention to optimize health and performance which may include physical fitness sessions, nutrition counseling, stress reduction techniques, biofeedback, practice in assuming responsibility for one's choices, and other specific measures for avoiding physical and mental health problems.

General Health Insurance Information/Counseling

Programs that help people in need of health insurance evaluate the full range of alternatives available to them and select the coverage that best meets their needs.

In Person Assister Programs

Programs permitted by the Affordable Care Act (ACA) that provide in-person assistance personnel (also known as non-navigator assistance personnel) to help people understand and access insurance coverage through the marketplace. In a state-based marketplace, in-person assistance personnel may serve as a part of an optional, transitional program that the state can set up before its marketplace is economically self sustaining, and before its navigator program is fully functional. Though they perform the same functions as navigators, in-person assistance personnel are funded through separate grants or contracts administered by a state. In person assistance personnel must also complete comprehensive training.

Medicaid Applications

County or state offices that accept applications and determine eligibility for the Medicaid program; and reinstate individuals who have lost their Medicaid benefits due to incarceration, institutionalization, noncompliance or other reasons. Also included are other programs that help people prepare and file Medicaid applications and/or are authorized to do eligibility determinations for the program.

Medicare

A federally funded health insurance program administered by the Centers for Medicare & Medicaid Services (CMS) under the U.S. Department of Health and Human Services for people age 65 and older; for individuals with disabilities younger than age 65 who have received or been determined eligible for Social Security Disability benefits for at least 24 consecutive months; and for insured workers and their dependents who have end stage renal disease and need dialysis or a kidney transplant. As with ESRD, the 24-month waiting period is waived for disability beneficiaries diagnosed with Amyotrophic Lateral Sclerosis (ALS, also called Lou Gehrig's disease). Premiums, deductibles and co-payments or out-of-pocket costs apply to Medicare coverage for most people. Special programs that assist with paying some or all of these costs are available for low income individuals who qualify. Medicare has four parts, but not every Medicare beneficiary has every part. Medicare Part A (Hospital Insurance) covers inpatient hospital stays, care in a skilled nursing facility, hospice care and home health care that meets the program eligibility criteria. Medicare Part B (Medical Insurance) covers services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, preventive services and more. Together, Medicare Part A and Part B are called Original Medicare. Medicare Part C enables private insurance companies to offer Medicare Advantage (MA) Plans under contract with CMS that provide all Part A and Part B benefits to plan enrollees. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans and Medicare Medical Savings Account Plans. Some plans offer extra benefits and services that aren't covered by Original Medicare, sometimes for an extra cost; and most (but not all) include Medicare prescription drug coverage. Medicare Part D (Medicare prescription drug coverage) is an optional benefit that helps beneficiaries cover the cost of prescription drugs. The plans are offered by insurance companies and other private companies approved by Medicare and add prescription drug coverage to Original Medicare, some Medicare Private-Fee-for-Service Plans and Medicare Medical Savings Account Plans.

Navigator Programs

Programs mandated by the Affordable Care Act (ACA) that help individuals who want to purchase insurance, and small businesses that need to provide health insurance for their employees, understand the qualified private health plans that are available within the marketplace and guide them through the enrollment process. The navigator conducts public education activities to raise awareness about the marketplace; distributes fair, accurate and impartial information concerning enrollment including information that acknowledges other health programs such as Medicaid and the Children’s Health Insurance Program (CHIP), and the availability of premium tax credits and cost-sharing reductions; provides referrals for consumers with a grievance, question or complaint; and offers information that is culturally and linguistically appropriate to meet the needs of the population served by the marketplace. Navigators are trained to offer expertise on each health insurance plan with the objective of empowering individuals to make informed choices and to facilitate selection of a qualified health plan; and either have or can easily establish relationships with the target population.

Personal Health Care Advocate Services

Programs that help people navigate through the maze of doctors' offices, clinics, hospitals, outpatient centers, insurance and payment systems, patient-support organizations and other components of the health care system with the objective of supporting timely delivery of quality care and ensuring that patients, survivors and families are satisfied with their encounters with the health care system. Personal health care advocates are trained health care workers, often nurses, or volunteers familiar with the health care system who work independently of any health care institution. They help patients identify specialists, coordinate appointments with providers to assure timely delivery of diagnostic and treatment services, provide cheat sheets of questions, and lay out the choices patients have in plain English. They may also ensure that appropriate medical records are available at scheduled appointments, accompany patients to medical appointments, arrange language translation or interpretation services, facilitate financial support and help with paperwork, negotiate insurance claims, arrange transportation and/or child/elder care, provide access to clinical trials and facilitate linkages to follow-up services. Some programs contract with employers to serve as personal advocates for employees who are ill. Others work exclusively with individuals who have specific illnesses, e.g., cancer.

State Health Insurance Marketplace Call Centers/Websites

Call centers operated by state-based health insurance marketplaces under the Affordable Care Act (ACA) that provide assistance for individuals and/or small businesses wanting to purchase private insurance through the marketplaces for themselves or, in the case of employers, for their employees. The call centers are staffed by individuals who have been trained to help callers with application navigation (both online and paper); comparison shopping and health plan enrollment (and re-enrollment), e.g., calls to confirm enrollment start date or reinstatement of coverage for late payment; health plan issuer questions (status of enrollment or identification cards, general health plan inquiries, provider network inquiries); billing questions; case updates (income changes, insurance status changes, address changes); assistance with the self-service Web portal; SHOP support; assister support (questions from navigators, in-person assisters, agents and brokers); assistance with appeals, grievances and referrals, e.g., to navigators, in-person assisters, agents and brokers, health plan issuers, state agencies including Medicaid; and general inquiries, e.g., general education, health reform questions and inquiries from providers, state legislatures and the media.

State/Local Health Insurance Information/Counseling

Programs that offer information and guidance for people who do not qualify for Medicaid, do not have access to insurance provided by an employer or cannot afford privately purchased health insurance regarding their state and/or local government health insurance options (including insurance programs administered by the state or at the local level and public/private partnerships between state and/or local government entities and health insurance companies or other private organizations) with the objective of empowering them to make informed choices. Some programs may also help people who qualify with enrollment.

Assistive Technology Expense Assistance

Programs that pay all or a portion of the costs associated with acquiring assistive technology products and/or obtaining support services such as customization, fit/modification services or repairs.

Medical Equipment Expense Assistance

Programs that provide financial assistance that helps patients whose care is being managed in the home (or other private facility managed by a nonprofessional caregiver or family member) obtain required medical equipment and supplies.

Medical Equipment/Supplies

Programs that pay for or provide necessary in-home hospital equipment, monitoring devices, respiratory aids, prevention kits and other medical supplies that are required by people who want to prevent the transmission of an infectious disease, are coping with the effects of a chronic health condition or disability or are convalescing following surgery or illness. Included are programs that provide medical equipment on a loan basis as well as those that provide equipment that people can keep.

Medical Supplies Donation Programs

Programs that accept first aid kits, bandages and other medical dressing, ostomy supplies, incontinence supplies, compression hosiery, hernia supports, bed pans and other medical supplies and keep them for use in their own program or donate them to other community-based organizations for their own use or for distribution to the people they serve.

Emergency Medical Transportation

Programs that provide rapid transportation to health care facilities for accident victims and acutely ill or injured individuals who need immediate medical intervention both on the scene and en route.

Mercy Transportation

Programs, usually staffed by volunteer private pilots, that provide flight services for medical missions which may include transporting human organs and tissue for transplants; plasma or whole blood; anatomical specimens for medical research; medical personnel, equipment and supplies; and, in instances of medical and financial need, individual patients who require services from health care facilities that they would be unable to access without assistance. Also included are programs that provide compassionate, non-emergency long-distance ground transportation for patients in need, usually by bus.

Non-Emergency Medical Transportation

Programs that provide transportation for medical appointments, trips from and between hospitals, to nursing homes or other special-care centers or for other non-emergency medical needs for individuals who, because of financial problems or their physical condition, are unable to use other means of local transportation. NEMT service providers are able to transport riders who require a wheelchair lift equipped vehicle with appropriate protective restraints or a van that is designed for gurney/stretcher transportation, or has other types of features to meet their safety needs.

Paramedic/EMT Services

Programs that utilize trained medical technicians who assist in rescue operations and provide preliminary emergency medical treatment for individuals who are acutely ill or injured on the scene and/or during transit to a health care facility. There are four levels of EMTs, the highest being paramedics who are permitted to administer drugs orally and intravenously, interpret electrocardiograms (EKGs), perform endotracheal intubations and use monitors and other complex equipment. In most communities, paramedic/EMT services are structured as separate entities on a par with police and fire departments, are organized as a branch of another municipal department, such as the public health department, or are integrated into the operations of another municipal emergency service such as the local fire department or police department. Under the latter model, personnel may be cross-trained to perform both functions. Paramedics/EMTs are dispatched when residents contact 911 with a medical emergency and are not accessed directly.

Blood Pressure Screening

Programs that measure the pressure existing in the large arteries at the height of a pulse wave and identify individuals whose blood pressure is higher than normal, and who are thereby susceptible to strokes and other conditions that are related to hypertension.

Breast Examinations

Programs that offer the screening procedure for the early detection of breast cancer which involves a manual examination of the breasts for lumps, thickening or other abnormalities.

Child Abuse Medical Evaluations

Hospitals and clinics with multidisciplinary teams that conduct historical interviews and physical examinations of children to determine whether there are injuries or other forms of physical evidence that are consistent with neglect, emotional deprivation/failure to thrive, or physical or sexual abuse that constitute the battered child syndrome. Historical information supplied by the child in the medical interview may be used to establish a case for child abuse even in the absence of physical evidence.

Covid-19 Diagnostic Tests

Public health laboratories that conduct diagnostic testing for people who have symptoms of the novel coronavirus that causes COVID-19. People who have been in close contact with someone with COVID-19 or are a resident in a community where there is ongoing spread of the virus and develop symptoms are being advised to call their health care provider and tell them about their symptoms and exposure, at which point a decision will be made as to whether they need to be tested. Patients who require a test will have a swab inserted through their nose to reach what is known as the nasopharyngeal region where cells are collected. If the patient is calm, the swabbing takes 10 seconds or so and is not painful. A jittery patient can make things more difficult. Once the sample is taken, it is put into a sterile container and sent to a lab where a chemical pulls the cells off the swab and turn the sample into a liquid form, which is put into a machine that makes multiple copies of the virus' RNA. The machine attempts to match the person's RNA with the coronavirus RNA to determine a positive or negative result.

Diabetes Screening

Programs that administer tests which determine whether an individual has diabetes, a disorder in which the pancreas produces too little insulin with the result that the body in unable to adequately metabolize sugar.

Eye Screening

Programs that offer screening procedures that identify people who have targeted eye diseases or vision deficiencies that may require further examination.

General Physical Examinations

Routine examinations conducted on an annual basis to assess the general physical condition of an individual and detect abnormalities. General physicals vary, but most involve a discussion of any concerns the patient may be having; checking vital signs (temperature, blood pressure, heart rate and respiration rate), weight and general appearance; heart and lung exams using a stethoscope; a head and neck exam that looks at the throat, teeth and gums, ears, sinuses, eyes, lymph nodes, thyroid and carotid arteries; an abdominal exam that uses palpation to detect liver size, the presence of abdominal fluid or tenderness; a visual examination of the extremities; and breast and pelvic exams for women, testicular and prostate exams for men. The annual physical exam also provides an opportunity to refocus attention on prevention and screening and routine laboratory tests may be suggested.

Hearing Screening

Programs that offer hearing threshold tests for the purpose of identifying individuals whose ability to perceive sound falls outside the normal range. People who fail the screening test need an in-depth evaluation by an audiologist.

Hepatitis Testing

Programs that administer tests which identify individuals who have been exposed to hepatitis A, B or C by detecting the presence of associated antigens, antibodies or genetic material (DNA). Hepatitis is an inflammation of the liver caused by a variety of agents including viral infection (hepatitis A virus, hepatitis B virus, hepatitis C virus and delta agents), bacterial invasion and physical and chemical agents. Hepatitis A and delta agent hepatitis are spread primarily from person to person via the fecal-oral route, but may occur by contact with water or food contaminated by the virus. Hepatitis B and C are spread by blood and serum-derived fluids and by direct contact with body fluids. Depending on the type of hepatitis involved, screening may be particularly recommended for persons who have traveled or worked in countries with high rates of infection, sexually active homosexual men, injecting and non-injecting illegal drug users, persons who work with infected primates in a laboratory setting, persons with chronic liver disease, persons with clotting disorders, blood bank and dialysis workers, dental hygienists, and other members of health care teams who come into contact with blood, body fluids or body tissue.

HIV Testing

Programs that offer HIV tests which are used to identify individuals who have been infected with the Human Immunodeficiency Virus (HIV) and are at risk for developing AIDS (acquired immune deficiency syndrome) or which are used to measure progression of the disease in people known to be infected. The most common HIV screening test is the enzyme immunoassay (EIA) which most frequently uses peripheral blood drawn from the arm or a finger as a sample, but can also be conducted using serum, oral fluids or urine. Repeatedly reactive EIA tests are confirmed using the Western blot or the immunofluorescence assay (IFA). The most common test that is used to measure disease progression is the PCR (polymeraise chain reaction) or viral load test. Many programs that provide HIV testing also provide pre-testing and post-test counseling which includes information about AIDS/HIV, reducing risks for HIV transmission, emotional support to help the individual deal with the testing process and test results, and information about and referral to other AIDS-related services.

Lead Poisoning Screening

Programs that take blood samples from young children to identify individuals who have ingested paint or other materials containing lead and have absorbed an undue amount of the substance. Results may lead to continued surveillance, testing, referrals for medical evaluation, and/or housing inspection to identify lead hazards and prevent further occurrences of lead poisoning. Included are screenings conducted during home visits and clinic-based screening.

Mammograms

Programs that offer the screening procedure for the early detection of breast cancer which involves an X-ray picture of the breast area which can be studied for abnormalities.

Pap Tests

Programs that conduct microscopic studies of tissue samples from the cervix or vagina as a means of early cancer detection in women.

Pregnancy Testing

Programs that utilize laboratory procedures to determine whether an individual is pregnant or which provide access to devices for establishing pregnancy that people can use at home.

Sexually Transmitted Disease Screening

Programs that identify individuals who have contracted gonorrhea, syphilis, genital herpes or other diseases that are spread by sexual contact and diagnose their conditions. The procedure includes visual examinations, blood tests and analyses of discharge or samples taken from lesions.

Tuberculosis Screening

Programs that identify individuals who have contracted tuberculosis by administering chest x-rays; the Mantoux test, the von Pirquet test or the Vollmer patch test, all of which determine the presence of a tuberculosis infection based on a local inflammatory reaction to a sample of the bacillus which has been injected or rubbed into the skin; or other screening tools.

Birth Control

Programs that provide permanent or temporary measures by which an individual can prevent conception.

Blood Supply Services

Programs that are responsible for acquiring and maintaining supplies of donated blood and blood products that support the needs of patients who require a transfusion.

Cancer Clinics

Programs that provide comprehensive preventive, diagnostic and treatment services on an inpatient or outpatient basis for individuals who have cancer.

Diabetes Management Clinics

Programs that help people of all ages who have juvenile or adult diabetes understand and manage their illness. Services may include screening programs for early identification of the condition and associated complications; establishment of a treatment regimen; patient education; and self-management skills development assistance which may focus on use of insulin and drugs to control blood sugar levels, blood glucose monitoring, dietary management in different environments (at home, at work, in school, while dining out), menu planning, the role of exercise in relation to food intake, hygienic measures such as foot care and ways to reduce the likelihood of diabetes-related complications which may include heart disease, kidney failure, amputation, nerve damage and blindness. Included are programs that provide comprehensive preventive, diagnostic and treatment services on an inpatient or outpatient basis as well as less formal programs that emphasize education and may provide any combination of supportive services such as case management, assistance in obtaining needed products and services, and assistance in following the prescribed treatment regimen. Diabetes is a chronic, incurable disease in which the pancreas fails to produce enough insulin to allow the body to adequately metabolize sugar.

Family and Community Medicine

Programs that are staffed by specialists in the field of medicine that is concerned with the total health of the individual within the home environment and in the community. Practitioners of family and community medicine provide comprehensive medical care including preventive services with particular emphasis on the family unit, in which the physician's continuing responsibility for health care is not limited by the patient's age or gender, nor by a particular organ system or disease entity.

General Physical Examinations

Routine examinations conducted on an annual basis to assess the general physical condition of an individual and detect abnormalities. General physicals vary, but most involve a discussion of any concerns the patient may be having; checking vital signs (temperature, blood pressure, heart rate and respiration rate), weight and general appearance; heart and lung exams using a stethoscope; a head and neck exam that looks at the throat, teeth and gums, ears, sinuses, eyes, lymph nodes, thyroid and carotid arteries; an abdominal exam that uses palpation to detect liver size, the presence of abdominal fluid or tenderness; a visual examination of the extremities; and breast and pelvic exams for women, testicular and prostate exams for men. The annual physical exam also provides an opportunity to refocus attention on prevention and screening and routine laboratory tests may be suggested.

Hospice Care

Programs that provide a full range of supportive services for terminally ill individuals who are in the final stages of their illnesses and for their families. Services may include medical care, pain and symptom management, home nurse visitation, case management, emotional and spiritual support, and bereavement services for the patient and members of the family. Hospice care may be provided at home, in a freestanding hospice facility, a hospice unit of a hospital or in long-term care facilities such as nursing homes. In order to qualify for Medicaid or Medicare reimbursement, an individual must have a life threatening illness and must be certified by their physician to have entered the last six months of life.

Obstetrics/Gynecology

Programs that are staffed by specialists who provide comprehensive preventive, diagnostic and treatment services that focus on women's reproductive health and care for women during pregnancy, childbirth and the period immediately following childbirth as well as the health of the fetus.

Ophthalmology

Programs that are staffed by specialists who provide comprehensive preventive, diagnostic and treatment services for individuals who have diseases or injuries which affect the eyes.

Optometry

Programs that are staffed by health care professionals who are licensed to provide primary eye care services including comprehensive eye health and vision examinations; diagnosis and treatment of disease and vision disorders; and prescriptions for glasses, contact lenses, low vision rehabilitation, vision therapy and medications. Optometrists check patient vision using eye charts; measure patient nearsightedness, farsightedness, depth perception and other vision problems using optical instruments; prescribe and fit corrective lenses or other corrective treatments to conserve, improve and correct vision; prescribe training exercises to strengthen weak eye muscles; and counsel patients on contact lens use and care, visual hygiene, lighting arrangements, working distances and safety factors. They may also examine eyes for glaucoma and other diseases and refer patients to ophthalmologists or other physicians and surgeons when ocular or other diseases are found. Optometrists may specialize in fitting visual aids for people who are partially blind, fitting contact lenses or correcting special vision problems.

Pain Management

Multidisciplinary programs that specialize in the treatment of individuals who have chronic, severe pain of organic origin that has not responded to medical or surgical therapy. Treatment is individualized and may include occupational therapy, muscle relaxation, behavior modification, stress management, biofeedback, psychological and psychosocial counseling, nutrition counseling, food allergy testing, exercise programs and a variety of physical intervention techniques including electrical stimulation of selected peripheral nerves and laser biostimulation.

Physician Referrals

Programs that link people who are in need of primary or specialized medical care with qualified medical practitioners.

Poison Control

Programs that provide emergency information, usually on a 24-hour basis, for medical personnel or others who may need to take immediate corrective action to treat an individual who has been poisoned or to prevent such an occurrence.

Pregnancy Counseling

Programs that help people who are experiencing a crisis pregnancy resolve any social or personal problems that have arisen as a result of their pregnancy or the prospect of parenthood, and help them understand their conflicting emotions, put their feelings in perspective, evaluate their options and make a decision that right is for them.

Prenatal Care

Programs that provide medical care for expectant mothers from the time of conception to the onset of labor to ensure their own physical well-being and the healthy development and birth of their child. Services generally include identification of risk factors based on age, health and/or personal and family history that may affect a woman's pregnancy; diet and lifestyle advice; routine checkups to look for signs of problems associated with pregnancy (such as edema, preeclampsia, or gestational diabetes) and to assure that the pregnancy is progressing well; ultrasound and other forms of prenatal testing to monitor fetal development and check for possible birth defects; and general information about being pregnant, e.g., what is normal and what is cause for concern, remedies for morning sickness or sleeplessness, managing weight gain and other common issues.

Sexual Assault Treatment

Programs that provide specialized medical care for adults and/or children who have been sexually assaulted. Treatment includes an examination for internal and external injuries, collection of physical evidence of the assault, and preventive care and/or treatment in case of venereal disease or pregnancy. Treatment is generally confidential and physical evidence of the assault is not shared with investigating authorities without the consent of the patient. Services are often provided by emergency room staff at a hospital or other health care facility and may include other crisis advocates/representatives.

Sexually Transmitted Disease Treatment

Programs that provide comprehensive preventive, diagnostic and treatment services for people who have contracted gonorrhea, syphilis, genital herpes or another disease that is transmitted by sexual contact. Treatment usually involves an investigation of recent contacts of people who have been infected to stop the spread of the disease.

Telemedicine

Programs that allow health care professionals to evaluate, diagnose and treat patients in remote locations using telecommunications technology. Telemedicine permits two-way, real time interactive communication between the patient, and the physician or other practitioners at a distant site. Some programs may also incorporate other forms of communication including transfer of medical information such as CT scans, MRIs, ultrasound studies, radiographic images and pathology images to medical personnel at another site for review and analysis. The technology is also being used in other related areas of practice (e.g., mental health, substance use disorders, gambling) as well as for teaching and remote caregiving purposes.

Weight Management

Programs that utilize one or a variety of techniques including nutrition education, exercise, special diets, protein sparing fasting, behavior modification, hypnosis, medication or surgery to help individuals who have a weight control problem gain or lose weight to achieve a more healthful body weight and develop a lifestyle that allows them to maintain that weight.

Well Baby Care

Programs that provide health screening and immunization services for infants and toddlers to ensure their physical well-being and healthy development. Preschool aged children are also eligible in some areas.