Revision 23-2; Effective Sept. 8, 2023

The following change(s) were made:

Revised	Title	Change
1100	Contact Information	Removes helpline information and phone number.
1200	Purpose of Manual	Updates language.
2100	Program Authorization and Services	Updates language. Updates date for national Healthy People objectives.
2200	Definitions	Updates definitions throughout.
3100	Administrative Policies	Updates language. Revises civil rights requirements. Adds requirement to maintain appropriate exterior signage.
3200	Abuse and Neglect Reporting	Updates language. Revises abuse, neglect and exploitation requirements.
3300	Confidentiality	Updates language. Adds requirement to display certain civil rights posters.
3400	Client Records Management	Updates language.
3500	Personnel Policies and Procedures	Updates language. Revises immunization guidance.
3600	Facilities and Equipment	Updates language. Revises facility requirements. Adds laboratory standards. Removes Disaster Response Plan.
3700	Emergency Responsiveness	Updates language. Adds Disaster Response Plan.
3800	Quality Management	Updates language. Revises Quality Management requirements.
4100	Eligibility and Assessment of Copay and Fees	Updates language. Adds a process to apply for approval to use an Alternate Eligibility Tool. Revises client eligibility screening for postpartum services. Adds procedures and terminology when determining eligibility. Changes form for employer verification. Adds eligibility forms.
5100	General Consent	Updates language.
5200	Clinical Policy	Updates language. Defines case management requirements.
5300	Perinatal Clinical Guidelines	Updates language. Reorganizes information. Includes quit line information.
5310	Initial Prenatal Visit Requirements	Creates new section to reorganize existing requirements. Updates language.
5320	Return Prenatal Visit Requirements	Creates new section to reorganize existing requirements. Updates language.
5330	Postpartum Visit Requirements	Creates new section to reorganize existing requirements. Updates language.
5340	Perinatal Dental Services	Creates new section to reorganize existing requirements. Updates language.
5400	Child and Adolescent Clinical Guidelines	Updates language. Revises service and billing requirements. Adds anticipatory guidance resource.
5410	Child and Adolescent Dental Services	Creates new section to reorganize existing requirements. Updates language.
5500	Prescriptive Authority Agreements, Clinical Protocols and Standing Delegation Orders	Updates language. Revises PAA and SDO requirements.
6100	Reimbursement, Data Collection and Reports	Updates language. Removes guidance. Revises submission, reconciliation and invoice requirements.
Appendix I	Definition of Income	Updates language.
Forms	Forms	Updates form titles.

Revision 23-1; Effective Mar. 31, 2023

The following change(s) were made:

Revised	Title	Change
Appendix II	Optional Co-Pay Table Based on Monthly Federal Poverty Level (FPL)	Adds Appendix II, Optional Co-Pay Table Based on Monthly Federal Poverty Level (FPL)

Revision 22-4; Effective Dec. 12, 2022

The following change(s) were made:

Revised	Title	Change
4000	Eligibility and Fees	Adds section description.
4100	Eligibility and Assessment of Co-pay/Fees	Adds hyperlink to Form 3047, Office of Primary and Specialty Health Notice of Ineligibility.