Specifications include, but are not limited to: 5.1.1 Outpatient/Ambulatory Health Services (OAHS) Description: Outpatient/Ambulatory Health Services are diagnostic and therapeutic services provided directly to a client by a licensed healthcare provider in an outpatient medical setting. Outpatient medical settings include clinics, medical offices, and mobile vans where clients do not stay overnight. Emergency room or urgent care services are not considered outpatient settings. Allowable activities include: • Medical history taking; • Physical examination; • Diagnostic testing, including laboratory testing; • Treatment and management of physical and behavioral health conditions; • Behavioral risk assessment, subsequent counseling, and referral; • Preventive care and screening; • Pediatric developmental assessment; 5.1.2 Oral Health Care (OHC) Description: Oral Health Care services provide outpatient diagnostic, preventive, and therapeutic services by dental health care professionals, including general dental practitioners, dental specialists, dental hygienists, and licensed dental assistants.; 5.1.3 Early Intervention Services (EIS) Description: The elements of EIS often overlap with other service category descriptions; however, EIS is the combination of such services rather than a stand-alone service. RWHAP recipients should be aware of programmatic expectations that stipulate the allocation of funds into specific service categories. RWHAP Parts A and B EIS services must include the following four components: • Targeted HIV testing to help the unaware learn of their HIV status and receive referral to HIV care and treatment services if found to be HIV-infected; o Recipients must coordinate these testing services with other HIV prevention and testing programs to avoid duplication of efforts.; o HIV testing paid for by EIS cannot supplant testing efforts paid for by other sources; • Referral services to improve HIV care and treatment services at key points of entry; • Access and linkage to HIV care and treatment services such as HIV Outpatient/Ambulatory Health Services, Medical Case Management, and Substance Abuse Care; and • Outreach Services and Health Education/Risk Reduction related to HIV diagnosis; 5.1.4 Health Insurance Premium and Cost Sharing Assistance for Low-Income Individuals (HIP-CS) Description: Health Insurance Premium and Cost Sharing Assistance provides financial assistance for eligible clients living with HIV to maintain continuity of health insurance or to receive medical and pharmacy benefits under a health care coverage program. The service provision consists of either or both of the following:; • Paying health insurance premiums to provide comprehensive HIV Outpatient/Ambulatory Health Services and pharmacy benefits that provide a full range of HIV medications for eligible clients, not currently covered by Part B; • Paying cost-sharing (copay, co-insurance, deductible) on behalf of the client for Physician appointments and labs.; 5.1.5 Medical Nutrition Therapy (MNT) Description: Medical Nutrition Therapy includes: • Nutrition assessment and screening; • Dietary/nutritional evaluation; • Food and/or nutritional supplements per medical provider’s recommendation; • Nutrition education and/or counseling; These services can be provided in individual and/or group settings and outside of HIV Outpatient/Ambulatory Health Services. All services performed under this service category must be pursuant to a medical provider’s referral and based on a nutritional plan developed by the registered dietitian or other licensed nutrition professional.
