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Table Of Contents

Applicant:

Planned Parenthood League of Massachusetts, Inc.

Application Number:

FPH2015007161

Project Title:

Title X Family Planning Continuing Grant for Central Massachusetts

Status:

Awarded

Online Forms
1. SF-424 Application for Federal Assistance Version 2
(Upload #1): BudgetNarrativeAttachments-Attachments-1235-PPLM Title X Budget
Narrative.pdf
(Upload #2): Attachments-ATT1-1234-PPLM Title X Appendices Final 2015.pdf
(Upload #3): ProjectNarrativeAttachments-Attachments-1236-PPLM Title X Project
Narrative Final 2015.pdf
(Upload #4): Form Attachments-V1.1.pdf
2. SF-424A Budget Information - Non-Construction
3. SF-424B Assurances - Non-Construction
4. SF-LLL Disclosure of Lobbying Activities
5. Key Personnel
6. Project Abstract Summary
Program Narrative
1. Budget Narrative
2. Program Narrative
Additional Information to be Submitted
1. Negotiated Rate Agreement
Proof of Filing
1. Copy of By-Laws
2. Proof of Non-Profit Status
Note: Upload document(s) printed in order after online forms.

PSC-HHS-000001

Page 1 of 181

DISCLOSURE OF LOBBYING ACTIVITIES

Approved by OMB
0348-0046

Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352


(See reverse for public burden disclosure.)

1. Type of Federal Action:


2. Status of Federal Action:
3. Report Type:
a.
contract
a.
bid/offer/application
a. initial filing
b
b
a
b. grant
b. initial award
b. material change
c. cooperative agreement
c. post-award
d. loan
e. loan guarantee
f. loan insurance
4. Name and Address of Reporting Entity:
5. If Reporting Entity in No. 4 is a Subawardee, Enter Name
and Address of Prime:
Prime
Subawardee
, if known:
Tier
Planned Parenthood League of Massachusetts, Inc.
1055 Commonwealth Avenue
Boston, MA 02215

Congressional District, if known:


6. Federal Department/Agency:
Office of Asst. Sec. for Health, OPA

7. Federal Program Name/Description:


Family Planning_Services
CFDA Number, if applicable:

8. Federal Action Number, if known:

93.217

9. Award Amount, if known:


$

10. a. Name and Address of Lobbying Registrant


(if individual, last name, first name, MI):
Planned Parenthood League of MA, Planned
Parenthood League of MA
1055 Commonwealth Avenue
Boston, MA 02215

11.

Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of
lobbying activities is a material representation of fact upon which reliance was placed by the tier above when
the transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This
information will be reported to the Congress semi-annually and will be available for public inspection. Any
person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and
not more than $100,000 for each such failure.

b. Individuals Performing Services (including address if


different from No. 10a)
(if individual, last name, first name, MI):
Wajda, Patricia

Signature: Susan Lit


Print Name: Lit, Susan
Title: Chief Operating Officer
Telephone No: 617-616-1662

Date: 12/23/2014

PSC-HHS-000002

Page 2 of 181

OMB Approval No. 4040-0006


Expiration Date: 06/30/2014

BUDGET INFORMATION - Non-Construction Programs


SECTION A - BUDGET SUMMARY
Grant Program
Function
or Activity
(a)

Catalog of Federal
Domestic Assistance
Number
(b)

Estimated Unobligated Funds


Federal
(c)

New or Revised Budget

Non-Federal
(d)

Federal
(e)

1 Family Planning Services

Non-Federal
(f)

Total
(g)

$846,378.00

(b) (4)

(b) (4)

$846,378.00

(b) (4)

(b) (4)

2 Family Planning Services


3 Family Planning Services
4 Family Planning Services
5.

Totals
SECTION B - BUDGET CATEGORIES

6. Object Class Categories

GRANT PROGRAM, FUNCTION OR ACTIVITY


(1) Family Planning Services

(2) Family Planning Services

a. Personnel

$514,071.00

(b) (4)

b. Fringe Benefits

$108,212.00

(b) (4)

c. Travel

Total

(3) Family Planning Services (4) Family Planning Services

$4,200.00

(5)

(b) (4)
(b) (4)
$4,200.00

d. Equipment
e. Supplies
f. Contractual

$65,341.00

(b) (4)

(b) (4)
$6,250.00

$6,250.00

g. Construction
h. Other

$148,304.00

i. Total Direct Charges (sum of 6a-6h)

$846,378.00

(b) (4)

$846,378.00

(b) (4)

(b) (4)

(b) (4)
(b) (4)

j. Indirect Charges
k. TOTALS (sum of 6i and 6j)

7. Program Income
Authorized for Local Reproduction
Previous Edition Usable

Page 3 of 181

Standard Form 424A (Rev. 7-97)


Prescribed
by OMB Circular A-102
PSC-HHS-000003

SECTION C - NON-FEDERAL RESOURCES


(b) Applicant
(c) State

(a) Grant Program


8

Family Planning Services

(b) (4)

(d) Other Sources


(b) (4)

(e) TOTALS
(b) (4)

9. Family Planning Services


10. Family Planning Services
11. Family Planning Services
(b) (4)

12. TOTAL (sum of lines 8-11)

SECTION D - FORECASTED CASH NEEDS


Total for 1st Year

13. Federal

$846,378.00

(b) (4)

14. Non-Federal
15. TOTAL (sum of lines 13 and 14)

1st Quarter

2nd Quarter

3rd Quarter

4th Quarter

$211,595.00

$211,595.00

$211,594.00

$211,594.00

(b) (4)

(b) (4)

(b) (4)

(b) (4)

(b) (4)

SECTION E - BUDGET ESTIMATES OF FEDERAL FUNDS NEEDED FOR BALANCE OF THE PROJECT
(a) Grant Program
(b) First
16. Family Planning Services

FUTURE FUNDING PERIODS (Years)


(c) Second
(d) Third

$846,378.00

$869,983.00

$893,587.00

$846,378.00

$869,983.00

$893,587.00

(e) Fourth

17. Family Planning Services


18. Family Planning Services
19. Family Planning Services
20. TOTAL (sum of lines 16-19)

SECTION F - OTHER BUDGET INFORMATION


21. Direct Charges:

22. Indirect Charges:

23. Remarks:
Authorized for Local Reproduction
Page 4 of 181

Standard Form
424A (Rev. 7-97) Page 2
PSC-HHS-000004

OMB Number: 0980 0204


Expiration Date: 08/31/2012

Project Abstract Summary


Program Announcement (CFDA)

93.217
* Program Announcement (Funding Opportunity Number)

PA-FPH-15-003
* Closing Date

12/31/2014
* Applicant Name

Planned Parenthood League of Massachusetts, Inc.


* Length of Proposed Project:

36

Application Control No.

EIN: 04-2698497
Federal Share Requested (for each year)
* Federal Share 1st Year

* Federal Share 2nd Year

* Federal Share 3rd Year

846,378.00

869,983.00

* Federal Share 4th Year

* Federal Share 5th Year

0.00

893,587.00

0.00

Non-Federal Share Requested (for each year)


* Non-Federal Share 1st Year

* Non-Federal Share 2nd Year

* Non-Federal Share 3rd Year

$ (b) (4)

* Non-Federal Share 4th Year

* Non-Federal Share 5th Year

0.00

(b) (4)

(b) (4)

0.00

* Project Title

Title X Family Planning Continuing Grant for Central Massachusetts

PSC-HHS-000005

Page 5 of 181

OMB Number: 0980 0204


Expiration Date: 08/31/2012

Project Abstract Summary


* Project Summary

Planned Parenthood League of Massachusetts (PPLM) provides high-quality family planning and related preventive health
services, as well as evidence-based information, education, and counseling services. At four Title X health centers in
Central Massachusetts (MA), PPLM integrates all program requirements and incorporates feedback after each Title X
program review. PPLM is poised to continue its administration of the Title X grant and will work toward decreasing
unintended pregnancy, preventing and treating STDs and HIV/AIDS, and increasing preventive services, including breast
and cervical cancer screenings, in Central MA.
Continued funding will enable PPLM???s strong clinical capacity to provide at least 8,500 client visits in the grant???s first
year (2015). In addition to focusing on providing access to a broad range of family planning services, PPLM will provide
education and community outreach, especially to vulnerable and hard to reach populations. PPLM???s education programs
for adolescents and parents will serve hundreds more and increase awareness about the services provided at the Title X
centers in Central MA. In addition, community events and advertising campaigns will generate knowledge of the services
available. PPLM will focus additional efforts on forging vital partnerships with primary care providers, other health care
agencies, and community-based organizations to help clients connect with a broader range of services and care.
To meet clients??? full health care needs, PPLM will strengthen its work to connect more clients to health care insurance
coverage, and will continue to further increase its efficiency through its partnerships, infrastructure, and staffing priorities.

* Estimated number of people to be served as a result of the award of this grant.:

8500

PSC-HHS-000006

Page 6 of 181

OMB Approval No.: 4040-0007


Expiration Date: 06/30/2014

ASSURANCES - NON-CONSTRUCTION PROGRAMS


Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0040), Washington, DC 20503.

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND
IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
NOTE:

Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the
awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such
is the case, you will be notified.

As the duly authorized representative of the applicant, I certify that the applicant:
1.

Has the legal authority to apply for Federal assistance and


the institutional, managerial and financial capability
(including funds sufficient to pay the non-Federal share of
project cost) to ensure proper planning, management and
completion of the project described in this application.

2.

Will give the awarding agency, the Comptroller General of


the United States and, if appropriate, the State, through
any authorized representative, access to and the right to
examine all records, books, papers, or documents related
to the award; and will establish a proper accounting
system in accordance with generally accepted accounting
standards or agency directives.

3.

Will establish safeguards to prohibit employees from


using their positions for a purpose that constitutes or
presents the appearance of personal or organizational
conflict of interest, or personal gain.

4.

Will initiate and complete the work within the applicable


time frame after receipt of approval of the awarding
agency.

5.

Will comply with the Intergovernmental Personnel Act of


1970 (42 U.S.C. 4728-4763) relating to prescribed
standards for merit systems for programs funded under
one of the 19 statutes or regulations specified in Appendix
A of OPM's Standards for a Merit System of Personnel
Administration (5 C.F.R. 900, Subpart F).

6.

Will comply with all Federal statutes relating to


nondiscrimination. These include but are not limited to: (a)
Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which
prohibits discrimination on the basis of race, color or
national origin; (b) Title IX of the Education Amendments
of 1972, as amended (20 U.S.C.1681- 1683, and 16851686), which prohibits discrimination on the basis of sex;
(c) Section 504 of the Rehabilitation

Act of 1973, as amended (29 U.S.C. 794), which


prohibits discrimination on the basis of handicaps; (d)
the Age Discrimination Act of 1975, as amended (42 U.
S.C. 6101-6107), which prohibits discrimination on the
basis of age; (e) the Drug Abuse Office and Treatment
Act of 1972 (P.L. 92-255), as amended, relating to
nondiscrimination on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism
Prevention, Treatment and Rehabilitation Act of 1970
(P.L. 91-616), as amended, relating to nondiscrimination
on the basis of alcohol abuse or alcoholism; (g) 523
and 527 of the Public Health Service Act of 1912 (42
U.S.C. 290 dd-3 and 290 ee- 3), as amended, relating
to confidentiality of alcohol and drug abuse patient
records; (h) Title VIII of the Civil Rights Act of 1968 (42
U.S.C. 3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of
housing; (i) any other nondiscrimination provisions in the
specific statute(s) under which application for Federal
assistance is being made; and, (j) the requirements of
any other nondiscrimination statute(s) which may apply
to the application.
7.

Will comply, or has already complied, with the


requirements of Titles II and III of the Uniform
Relocation Assistance and Real Property Acquisition
Policies Act of 1970 (P.L. 91-646) which provide for fair
and equitable treatment of persons displaced or whose
property is acquired as a result of Federal or federallyassisted programs. These requirements apply to all
interests in real property acquired for project purposes
regardless of Federal participation in purchases.

8.

Will comply, as applicable, with provisions of the Hatch


Act (5 U.S.C. 1501-1508 and 7324-7328) which limit
the political activities of employees whose principal
employment activities are funded in whole or in part
with Federal funds.

Previous Edition Usable


Authorized for Local Reproduction

Standard Form 424B (Rev. 7-97)


Prescribed by OMB Circular A-102

PSC-HHS-000007

Page 7 of 181

9.

Will comply, as applicable, with the provisions of the DavisBacon Act (40 U.S.C. 276a to 276a-7), the Copeland Act
(40 U.S.C. 276c and 18 U.S.C. 874), and the Contract Work
Hours and Safety Standards Act (40 U.S.C. 327- 333),
regarding labor standards for federally-assisted construction
subagreements.

13.

Will assist the awarding agency in assuring compliance with


Section 106 of the National Historic Preservation Act of
1966, as amended (16 U.S.C. 470), EO 11593
(identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16
U.S.C. 469a-1 et seq.).

10.

Will comply, if applicable, with flood insurance purchase


requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients
in a special flood hazard area to participate in the program and
to purchase flood insurance if the total cost of insurable
construction and acquisition is $10,000 or more.

14.

Will comply with P.L. 93-348 regarding the protection of


human subjects involved in research, development, and
related activities supported by this award of assistance.

15.

Will comply with the Laboratory Animal Welfare Act of 1966


(P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.)
pertaining to the care, handling, and treatment of warm
blooded animals held for research, teaching, or other
activities supported by this award of assistance.

11.

12.

Will comply with environmental standards which may be


prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National
Environmental Policy Act of 1969 (P.L. 91-190) and Executive
Order (EO) 11514; (b) notification of violating facilities
pursuant to EO 11738; (c) protection of wetlands pursuant to
EO 11990; (d) evaluation of flood hazards in floodplains in
accordance with EO 11988; (e) assurance of project
consistency with the approved State management program
developed under the Coastal Zone Management Act of 1972
(16 U.S.C. 1451 et seq.); (f) conformity of Federal actions
to State (Clean Air) Implementation Plans under Section
176(c) of the Clean Air Act of 1955, as amended (42 U.S.C.
7401 et seq.); (g) protection of underground sources of
drinking water under the Safe Drinking Water Act of 1974, as
amended (P.L. 93-523); and, (h) protection of endangered
species under the Endangered Species Act of 1973, as
amended (P.L. 93- 205).
Will comply with the Wild and Scenic Rivers Act of 1968 (16
U.S.C. 1271 et seq.) related to protecting components or
potential components of the national wild and scenic rivers
system.

* SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL


Susan Lit
* APPLICATION ORGANIZATION
Planned Parenthood League of Massachusetts, Inc.

16. Will comply with the Lead-Based Paint Poisoning


Prevention Act (42 U.S.C. 4801 et seq.) which prohibits
the use of lead-based paint in construction or rehabilitation
of residence structures.
17.

Will cause to be performed the required financial and


compliance audits in accordance with the Single Audit Act
Amendments of 1996 and OMB Circular No. A-133, "Audits
of States, Local Governments, and Non-Profit
Organizations."

18.

Will comply with all applicable requirements of all other


Federal laws, executive orders, regulations, and policies
governing this program.

19.

Will comply with the requirements of Section 106(g) of the


Trafficking Victims Protection Act (TVPA) of 2000, as
amended (22 U.S.C. 7104) which prohibits grant award
recipients or a sub-recipient from (1) Engaging in severe
forms of trafficking in persons during the period of time that
the award is in effect (2) Procuring a commercial sex act
during the period of time that the award is in effect or (3)
Using forced labor in the performance of the award or
subawards under the award.

* TITLE
CEO

* DATE SUBMITTED
12/23/2014
Standard Form 424B (Rev. 7-97) Back

PSC-HHS-000008

Page 8 of 181

Key Personnel
Name

Position Title

Annual Salary

No.Months
Budget

%
Time

Fed
Amount

Non-Fed
Amount

Total Amount
Requested

PSC-HHS-000009

Page 9 of 181

OMB Number: 4040-0004


Expiration Date: 03/31/2012

Version 02

Application for Federal Assistance SF-424


* 1. Type of Submission:

* 2. Type of Application:

Preapplication

New

Application

Continuation

Changed/Corrected Application

Revision

* 3. Date Received:

* If Revision, select appropriate letter(s):

* Other (Specify)

4. Applicant Identifier:

12/23/2014
5a. Federal Entity Identifier:

* 5b. Federal Award Identifier:

EIN: 04-2698497
State Use Only:
6. Date Received by State:

7. State Application Identifier:

8. APPLICANT INFORMATION:
* a. Legal Name:

Planned Parenthood League of Massachusetts, Inc.

* b. Employer/Taxpayer Identification Number (EIN/TIN):

* c. Organizational DUNS:

04-2698497

0308126480000

d. Address:
* Street1:

1055 Commonwealth Avenue

Street2:
* City:

Boston

County:
* State:

Massachusetts

Province:
* Country:

UNITED STATES

* Zip / Postal Code:

02215-1001

e. Organizational Unit:
Division Name:

Department Name:

Planned Parenthood League of M


f. Name and contact information of person to be contacted on matters involving this application:
Prefix:

* First Name:

Susan

Middle Name:
* Last Name:

Lit

Suffix:
Title:

Chief Operating Officer

Organizational Affiliation:

* Telephone Number:
* Email:

617-616-1662

Fax Number:

617-616-1665

slit@pplm.org
PSC-HHS-000010

Page 10 of 181

OMB Number: 4040-0004


Expiration Date: 03/31/2012

Application for Federal Assistance SF-424

Version 02

9. Type of Applicant 1: Select Applicant Type:

Nonprofit with 501C3 IRS Status (Other than Institution of Higher Education)
Type of Applicant 2: Select Applicant Type:

Type of Applicant 3: Select Applicant Type:

* Other (specify):

* 10. Name of Federal Agency:

Office of the Assistant Secretary for Health


11. Catalog of Federal Domestic Assistance Number:

93.217
CFDA Title:

Family Planning Services


* 12. Funding Opportunity Number:

PA-FPH-15-003
* Title:

FY15 Announcement of Anticipated Availability of Funds for Family Planning Services Grants Region 1 Massachusetts
(entire state)

13. Competition Identification Number:

PA-FPH-15-003-049962
Title:

FY15 Announcement of Anticipated Availability of Funds for Family Planning Services Grants Region 1 Massachusetts
(entire state)

14. Areas Affected by Project (Cities, Counties, States, etc.):

* 15. Descriptive Title of Applicant's Project:

Title X Family Planning Continuing Grant for Central Massachusetts

Attach supporting documents as specified in agency instructions.

PSC-HHS-000011

Page 11 of 181

OMB Number: 4040-0004


Expiration Date: 03/31/2012

Version 02

Application for Federal Assistance SF-424


16. Congressional Districts Of:
* a. Applicant

* b. Program/Project

2-5

2-5

Attach an additional list of Program/Project Congressional Districts if needed.

17. Proposed Project:


* a. Start Date:

* b. End Date:

04/01/2015

03/31/2018

18. Estimated Funding ($):


* a. Federal

846378

* b. Applicant

* c. State

(b) (4)

* d. Local

(b) (4)

* e. Other

* f. Program Income

* g. TOTAL

2483927

* 19. Is Application Subject to Review By State Under Executive Order 12372 Process?
a. This application was made available to the State under the Executive Order 12372 Process for review on
b. Program is subject to E.O. 12372 but has not been selected by the State for review.
c. Program is not covered by E.O. 12372.
* 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes", provide explanation.)
Yes

No

21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements
herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to com
ply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may
subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001)
** I AGREE
** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency
specific instructions.
Authorized Representative:
* First Name:

Prefix:
Middle Name:

* Last Name:

Walz

Martha

Suffix:
* Title:

CEO

* Telephone Number:
* Email:

Fax Number:

617-616-1651

617-616-1665

mwalz@pplm.org

* Signature of Authorized Representative:


Authorized for Local Reproduction

Susan Lit

* Date Signed:

12/23/2014
Standard Form 424 (Revised 10/2005)
Prescr bed by OMB Circular A-102

PSC-HHS-000012

Page 12 of 181

OMB Number: 4040-0004

Expiration Date: 03/31/2012

Version 02

Application for Federal Assistance SF-424


* Applicant Federal Debt Delinquency Explanation
The following field should contain an explanation if the Applicant organization is delinquent on any Federal Debt. Maximum number of
characters that can be entered is 4,000. Try and avoid extra spaces and carriage returns to maximize the availability of space.

PSC-HHS-000013

Page 13 of 181

Upload #1
Applicant:

Planned Parenthood League of Massachusetts, Inc.

Application Number:

FPH2015007161

Project Title:

Title X Family Planning Continuing Grant for Central Massachusetts

Status:

Awarded

Document Title:

BudgetNarrativeAttachments-Attachments-1235-PPLM Title X Budget


Narrative.pdf

PSC-HHS-000014

Page 14 of 181

PPLM Budget Narrative


See Budget Summary, SF 424A
Multi-year Budget Overview
1. Personnel
Staff type
Advance Practice Clinicians
Key Personnel
Administrative Staff
Total

Title X Allocation
Year 1

Title X Allocation
Year 2

Title X Allocation
Year 3

(b) (4)
$514,071

$529,216

Title X Allocation
Year 1

Title X Allocation
Year 2

$544,360

2. Fringe Benefits
Type of benefit
FICA
Health and Dental
Retirement
Life insurance
Workers comp
Unemployment
EAP and MBTA
Total

Title X Allocation
Year 3

(b) (4)
$108,212

$111,400

$114,588

Title X Allocation
Year 1
$4,200

Title X Allocation
Year 2
$4,200

Title X Allocation
Year 3
$4,200

Title X Allocation
Year 1

Title X Allocation
Year 2

Title X Allocation
Year 3

3. Travel

4. Equipment $0 no equipment
budgeted.
5. Supplies
Supplies
Contraceptives
Clinic disposables
Medication
Lab Services
Lab Supplies
Office & Program Supplies
Total

(b) (4)
$65,341

$68,608

Title X Allocation
Year 1
(b) (4)

Title X Allocation
Year 2

$71,875

6. Contractual
Contractual
Contracted Services (b) (4)

Page 15 of 181

Title X Allocation
Year 3

PSC-HHS-000015

PPLM Budget Narrative


See Budget Summary, SF 424A
7. Other
Title X Allocation
Year 1
Printing
Telephone
Rent
Repairs/Maintenance
Security
Utilities/Office Expense
Educational Materials/Literature
Outreach Materials/Activity
Translation Services
Computer Services
Subscriptions/Publications
Dues & Fees (incl PPFA)
Postage, Shipping, Freight
Insurance/Malpractice
Total

TOTAL BUDGET

Page 16 of 181

Title X Allocation
Year 2

Title X Allocation
Year 3

(b) (4)
$148,304

$150,310

$152,315

$846,378

$869,983

$893,587

PSC-HHS-000016

PPLM Budget Narrative


See Budget Summary, SF 424A
Budget Narrative for Grant Year 1 (April 1, 2015 - March 31, 2016)
1. Personnel
This covers all staff costs associated with operating PPLM's Title X Central MA health centers
and staff in administration and operations handling Title X management and program operations.
The staff budget is based on percentage of effort associated with each position. Effort is allocated
based on projected Title X client visits and/or estimates based on actual staff time associated
with Title X activities.
Personnel Summary
Following is a staffing summary, including the total to be funded with Title X dollars. Detail for
each line item appears below.
Staff type
Advance Practice Clinicians
Key Personnel
Administrative Staff
Total

Title X Allocation

(b) (4)

Non-Federal

(b) (4)

$514,071

Health Center Personnel


This includes health center licensed and non-licensed staff: Advance Practice Clinicians (NPs,
CNMs, PAs), Registered Nurses (RNs), and Healthcare Assistants (HCAs) who take medical
histories, perform exams and tests, prescribe medication, give injections, provide contraceptive
counseling and handle follow-up care if needed. Also included are Health Center Managers and
Coordinators who manage day-to-day operations in the health centers.

Page 17 of 181

PSC-HHS-000017

PPLM Budget Narrative


See Budget Summary, SF 424A

Staff type
Center Managers and
Coordinators
Advance Practice
Clinicians (APCs)
Health Care Assistants
(HCAs)
Registered Nurses (RNs)
Total

FTEs

Allowable
Annual
Salary

% of
Salary
for
Title X

Salary
Applied
to Grant

%
Allocated
to Title X

Title X
allocation

(b) (4)

(b) (4)
21.20

$896,021

NonFederal

$355,772

$896,021

Key Personnel
Organizational leadership involved in oversight and administration of Title X program.

Name
Martha Walz
Susan Lit
OPEN
(b) (6)
Deb Fenton

(b) (6)
(b) (6)
Total

Position
President/CEO
COO
CFO
Medical Director
VP of HC Ops/
FP Manager
Quality
Assurance
Manager
Director of
Patient Services

Allowable
Annual
Salary

% of
Salary
for
Title X

Salary
Applied
to Grant

(b) (6)
$946,103

$160,838

%
Allocated
to Title X

Title X
allocation

NonFederal

(b) (4)

$49,895 (b) (4)

Administrative Personnel
Administrative staff supporting Title X activities include: call center staff who help clients make
appointments; finance staff, including accounting staff who handle all financial reporting and
auditing, purchasing staff who oversee health center supplies and medication purchasing, and
billing staff who oversee medical billing and claims processing; Information Systems staff
supporting computer systems and Electronic Health Records system; lab staff that perform tests;
and outreach and education staff handling Title X outreach and education-related programs.

Page 18 of 181

PSC-HHS-000018

PPLM Budget Narrative


See Budget Summary, SF 424A

Name
Call Center
(b) (6)

6.0 FTEs
Lab
(b) (6)
(b) (6)
Finance
(b) (6)
(b) (6)
(b) (6)
(b) (6)
(b) (6)
4.0 FTEs
Outreach &
Education

(b) (6)
(b) (6)
Information
Technology
(b) (6)
(b) (6)
Total

Position
Patient Contact
Center Manager
Patient
Engagement
Specialist
Lab Manager
Lab Assistant

Allowable
Annual
Salary

% of
Salary
for
Title X

Salary
Applied
to Grant

%
Allocated
to Title X

Title X
allocation

NonFederal

(b) (4)

(b) (6)

Controller
Accounting
Associate
Purchasing
Manager
Director of
Revenue Cycle
Billing Manager
Medical Billers

Community
Parent Educator
& Outreach
Specialist
VP of Business
Development

(b) (6)

Associate
Director of IST
Applications
Analyst
$1,095,634

$187,404

$108,404

2. Fringe Benefits
Fringe benefits for staff salaries allocated to Title X include FICA, medical/dental insurance, life
insurance, workers' compensation, retirement plan, state unemployment taxes, EAP (Employee
Assistance Program), and reimbursement for monthly public transportation (e.g., MBTA).

Page 19 of 181

PSC-HHS-000019

PPLM Budget Narrative


See Budget Summary, SF 424A
Type of benefit
FICA
Health and Dental
Retirement
Life insurance
Workers comp
Unemployment
EAP and MBTA
Total

% of salary

Title X
Allocation

NonFederal

(b) (4)
21.05%

$108,212

(b) (4)

3. Travel
Travel is 100% of the cost for Title X-related trainings/conferences, including regional/state
conferences and national conferences.
Travel
Location

TBD
TBD
Total

Staff Traveling
VP of HC Ops
(Family Planning
Program Manager)
NP/VP of HC Ops

Purpose of Travel
Regional Grantee
Meeting
Title X Conference

Budgeted
Expense

$2,200
$2,000
$4,200

Title X
Allocation

$2,200
$2,000
$4,200

NonFederal
(b) (4)

4. Equipment
$0 equipment expense

5. Supplies
Supplies include contraceptive methods (IUDs, implants, oral contraceptives, hormonal
injection, patch, ring, and emergency contraception), clinic disposables used during exams,
medications, lab services and supplies, including pregnancy tests, Pap tests, blood tests and STI
tests, and office supplies used for Title X activities.

Page 20 of 181

PSC-HHS-000020

PPLM Budget Narrative


See Budget Summary, SF 424A
Supplies
Contraceptives
Clinic disposables
Medication
Lab Services
Lab Supplies
Office & Program Supplies
Total

Budgeted
Expense

% allocated
to Title X

Title X
allocation

Non-Federal

(b) (4)

(b) (4)
$384,357

$65,341

6. Contractual
Contractual includes (b) (4)

and (b) (4)

for Title X data processing

services.
Contractual
Contracted Services (b) (4)
Total

Budgeted
Expense
(b) (4)

% allocated
to Title X

Title X
allocation

Non-Federal
$0
$0

7. Other
This includes additional costs of operating PPLM's Title X program.
Budgeted
Expense
Printing
Telephone
Rent
Repairs/Maintenance
Security
Utilities/Office Expense
Educational Materials/Literature
Outreach Materials/Activity
Translation Services
Computer Services
Subscriptions/Publications
Dues & Fees (incl PPFA)
Postage, Shipping, Freight
Insurance/Malpractice
Total

Page 21 of 181

% allocated
to Title X

Title X
allocation

(b) (4)

(b) (4)

$582,940

Non-Federal

$148,304

PSC-HHS-000021

PPLM Budget Narrative


See Budget Summary, SF 424A
Budget Narrative for Grant Year 2 (April 1, 2016 - March 31, 2017)
1. Personnel
This covers all staff costs associated with operating PPLM's Central MA Title X health centers
and staff in administration and operations handling Title X management and program operations.
The staff budget is based on percentage of effort associated with each position. Effort is allocated
based on projected Title X client visits and/or estimates based on actual staff time associated
with Title X activities. Grant year 2 includes anticipated 3% increase in salaries based on average
yearly increases.

Personnel Summary
Following is a staffing summary, including the total to be funded with Title X dollars. Detail for
each line item appears below.
Staff type
Advance Practice Clinicians
Key Personnel
Administrative Staff
Total

Title X Allocation

(b) (4)

Non-Federal

(b) (4)

$529,216

Health Center Personnel


This includes health center licensed and non-licensed staff: Advance Practice Clinicians (NPs,
CNMs, PAs), Registered Nurses (RNs), and Healthcare Assistants (HCAs) who take medical
histories, perform exams and tests, prescribe medication, give injections, provide contraceptive
counseling, and handle follow-up care if needed. Also included are Health Center Managers and
Coordinators who manage day-to-day operations in the health centers.

Page 22 of 181

PSC-HHS-000022

PPLM Budget Narrative


See Budget Summary, SF 424A

Staff type
Center Managers and
Coordinators
Advance Practice
Clinicians (APCs)
Health Care Assistants
(HCAs)
Registered Nurses (RNs)
Total

FTEs

Allowable
Annual
Salary

% of
Salary
for
Title X

Salary
Applied
to Grant

%
Allocated
to Title X

Title X
allocation

(b) (4)

(b) (4)
21.20

$922,901

$922,901

NonFederal

$366,445

Key Personnel
Organizational leadership involved in oversight and administration of Title X program.

Name
Martha Walz
Susan Lit
OPEN
(b) (6)
(b) (6)
(b) (6)
(b) (6)
Total

Position
President/CEO
COO
CFO
Medical Director
VP of HC Ops/ FP
Manager
Quality Assurance
Manager
Director of Patient
Services

Allowable
Annual
Salary

% of
Salary
for
Title X

Salary
Applied
to Grant

%
Allocated
to Title X

Title X
allocation

(b) (4)

(b) (6)
$963,596

$163,811

NonFederal

$51,114

Administrative Personnel
Administrative staff supporting Title X activities include: call center staff who help clients make
appointments; finance staff, including accounting staff who handle all financial reporting and
auditing, purchasing staff who oversee health center supplies and medication purchasing, and
billing staff who oversee medical billing and claims processing; Information Systems staff
supporting computer systems and Electronic Health Records system; lab staff that perform tests;

Page 23 of 181

PSC-HHS-000023

PPLM Budget Narrative


See Budget Summary, SF 424A
and outreach and education staff handling Title X outreach and education-related programs.

Name
Call Center
(b) (6)

6.0 FTEs
Lab
(b) (6)
(b) (6)
Finance
(b) (6)
(b) (6)
(b) (6)
(b) (6)
(b) (6)
4.0 FTEs
Outreach &
Education

(b) (6)
(b) (6)
Information
Technology
(b) (6)

(b) (6)
Total

Position
Patient Contact
Center Manager
Patient
Engagement
Specialist
Lab Manager
Lab Assistant

Allowable
Annual
Salary

% of
Salary
for
Title X

Salary
Applied
to Grant

%
Allocated
to Title X

Title X
allocation

NonFederal

(b) (4)

(b) (6)

Controller
Accounting
Associate
Purchasing
Manager
Director of
Revenue Cycle
Billing Manager
Medical Billers

Community Parent
Educator &
Outreach
Specialist
VP of Business
Development

(b) (4)

(b) (6)

Associate Director
of IST
Applications
Analyst
$1,128,503

$193,027

$111,656

2. Fringe Benefits
Fringe benefits for staff salaries allocated to Title X include FICA, medical/dental insurance, life
insurance, workers' compensation, retirement plan, state unemployment taxes, EAP (Employee
Assistance Program), and reimbursement for monthly public transportation (e.g., MBTA). Grant

Page 24 of 181

PSC-HHS-000024

PPLM Budget Narrative


See Budget Summary, SF 424A
year 2 includes increases based on increased salary expense.
Type of benefit
FICA
Health and Dental
Retirement
Life insurance
Workers comp
Unemployment
EAP and MBTA
Total

% of salary

Title X
Allocation

NonFederal

(b) (4)
21.05%

$111,400

(b) (4)

3. Travel
Travel is 100% of the cost for Title X-related trainings/conferences, including regional/state
conferences and national conferences. No anticipated change in expense for grant year 2.
Travel
Location

TBD
TBD
Total

Staff Traveling
VP of HC Ops
(Family Planning
Program Manager)
NP/VP of HC Ops

Purpose of Travel
Regional Grantee
Meeting
Title X Conference

Budgeted
Expense

$2,200
$2,000
$4,200

Title X
Allocation

$2,200
$2,000
$4,200

NonFederal

(b) (4)

4. Equipment
$0 equipment expense

5. Supplies
Supplies include contraceptive methods (IUDs, implants, oral contraceptives, hormonal
injection, patch, ring, and emergency contraception), clinic disposables used during exams,
medications, lab services and supplies, including pregnancy tests, Pap tests, blood tests and STI
tests, and office supplies used for Title X activities. Grant year 2 includes a 5% increase in
supply expenses, based on projected increase in visits.

Page 25 of 181

PSC-HHS-000025

PPLM Budget Narrative


See Budget Summary, SF 424A
Budgeted
Expense

Supplies
Contraceptives
Clinic disposables
Medication
Lab Services
Lab Supplies
Office & Program Supplies
Total

% allocated
to Title X

Title X
allocation

Non-Federal

(b) (4)
$403,575

$68,608

(b) (4)

6. Contractual
Contractual includes (b) (4)

and (b) (4)

for Title X data processing

services. There is no anticipated increase in expense for grant year 2.


Contractual
Contracted Services (b) (4)
Total

Budgeted
Expense
(b) (4)

% allocated
to Title X

Title X
allocation

Non-Federal
$0
$0

7. Other
Includes additional costs of operating PPLM's Title X program. Grant year 2 includes an
anticipated 2% increase in expenses.
Budgeted
Expense
Printing
Telephone
Rent
Repairs/Maintenance
Security
Utilities/Office Expense
Educational Materials/Literature
Outreach Materials/Activity
Translation Services
Computer Services
Subscriptions/Publications
Dues & Fees (incl PPFA)
Postage, Shipping, Freight
Insurance/Malpractice
Total

Page 26 of 181

% allocated
to Title X

Title X
allocation

Non-Federal

(b) (4)
$590,157

$150,310

(b) (4)

PSC-HHS-000026

PPLM Budget Narrative


See Budget Summary, SF 424A
Budget Narrative for Grant Year 3 (April 1, 2017 - March 31, 2018)
1. Personnel
This covers all staff costs associated with operating PPLM's Title X health centers and staff in
administration and operations handling Title X management and program operations. The staff
budget is based on percentage of effort associated with each position. Effort is allocated based on
projected Title X client visits and/or estimates based on actual staff time associated with Title X
activities. Grant year 3 includes anticipated 3% increase in salaries based on average yearly
increases.

Personnel Summary
Following is a staffing summary, including total to be funded with Title X dollars. Detail for
each line item appears below.
Staff type
Advance Practice Clinicians
Key Personnel
Administrative Staff
Total

Title X Allocation

(b) (4)

Non-Federal

(b) (4)

$544,360

Health Center Personnel


This includes health center licensed and non-licensed staff: Advance Practice Clinicians (NPs,
CNMs, PAs), Registered Nurses (RNs), and Healthcare Assistants (HCAs) who take medical
histories, perform exams and tests, prescribe medication, give injections, provide contraceptive
counseling, and handle follow-up care if needed. Also included are Health Center Managers and
Coordinators who manage day-to-day operations in the health centers.

Page 27 of 181

PSC-HHS-000027

PPLM Budget Narrative


See Budget Summary, SF 424A

Staff type
Center Managers and
Coordinators
Advance Practice
Clinicians (APCs)
Health Care Assistants
(HCAs)
Registered Nurses (RNs)
Total

FTEs

Allowable
Annual
Salary

% of
Salary
for
Title X

Salary
Applied
to Grant

%
Allocated
to Title X

Title X
allocation

NonFederal

(b) (4)
21.20

$949,782

$949,782

$377,118

(b) (4)

Key Personnel
Organizational leadership involved in oversight and administration of Title X program.

Name
Martha Walz
Susan Lit
OPEN
(b) (6)
(b) (6)

(b) (6)
(b) (6)
Total

Position
President/CEO
COO
CFO
Medical Director
VP of HC Ops/
FP Manager
Quality
Assurance
Manager
Director of
Patient Services

Allowable
Annual
Salary

% of
Salary
for
Title X

Salary
Applied
to Grant

%
Allocated
to Title X

Title X
allocation

(b) (6)
$981,089

$166,785

NonFederal

(b) (4)

$52,334

Administrative Personnel
Administrative staff supporting Title X activities includes: call center staff who help clients
make appointments; finance staff, including accounting staff who handle all financial reporting
and auditing, purchasing staff who oversee health center supplies and medication purchasing,
and billing staff who oversee medical billing and claims processing; Information Systems staff
supporting computer systems and Electronic Health Records system; lab staff that perform tests;

Page 28 of 181

PSC-HHS-000028

PPLM Budget Narrative


See Budget Summary, SF 424A
and outreach and education staff handling Title X outreach and education-related programs.

Name
Call Center
(b) (6)

6.0 FTEs
Lab
(b) (6)
(b) (6)
Finance
(b) (6)
(b) (6)
(b) (6)
(b) (6)
(b) (6)
4.0 FTEs
Outreach &
Education

(b) (6)
(b) (6)
Information
Technology

Position
Patient Contact
Center Manager
Patient
Engagement
Specialist
Lab Manager
Lab Assistant

Allowable
Annual
Salary

% of
Salary
for
Title X

Salary
Applied
to Grant

%
Allocated
to Title X

Title X
allocation

NonFederal
(b) (4)

(b) (6)

Controller
Accounting
Associate
Purchasing
Manager
Director of
Revenue Cycle
Billing Manager
Medical Billers

Community Parent
Educator &
Outreach Specialist
VP of Business
Development

(b) (6)

(b) (4)

Associate Director
of IST
Applications
Analyst

(b) (6)
(b) (6)
Total

$1,161,372

$198,649

$114,908

2. Fringe Benefits
Fringe benefits for staff salaries allocated to Title X include FICA, medical/dental insurance, life
insurance, workers' compensation, retirement plan, state unemployment taxes, EAP (Employee
Assistance Program), and reimbursement for monthly public transportation (e.g., MBTA). Grant

Page 29 of 181

PSC-HHS-000029

PPLM Budget Narrative


See Budget Summary, SF 424A
year 3 includes increases based on increased salary expense.
Type of benefit
FICA
Health and Dental
Retirement
Life insurance
Workers comp
Unemployment
EAP and MBTA
Total

% of salary

Title X
Allocation

NonFederal

(b) (4)
21.05%

$114,588

(b) (4)

3. Travel
Travel is 100% of the cost for Title X-related trainings/conferences, including regional/state
conferences and national conferences. No anticipated change in expense for grant year 3.
Travel
Location

TBD
TBD
Total

Staff Traveling
VP of HC Ops
(Family Planning
Program
Manager)
NP/VP of HC
Ops

Purpose of Travel

Regional Grantee
Mtg
Title X Conference

Budgeted
Expense

Title X
Allocation

$2,200

$2,200

$2,000
$4,200

$2,000
$4,200

NonFederal

(b) (4)

4. Equipment
$0 equipment expense

5. Supplies
Supplies include contraceptive methods (IUDs, implants, oral contraceptives, hormonal
injection, patch, ring, and emergency contraception), clinic disposables used during exams,
medications, lab services and supplies, including pregnancy tests, Pap tests, blood tests and STI
tests, and office supplies used for Title X activities. Grant year 3 includes a 5% increase in
supply expenses, based on projected increase in visits.

Page 30 of 181

PSC-HHS-000030

PPLM Budget Narrative


See Budget Summary, SF 424A
Budgeted
Expense

Supplies
Contraceptives
Clinic disposables
Medication
Lab Services
Lab Supplies
Office & Program Supplies
Total

% allocated
to Title X

Title X
allocation

Non-Federal

(b) (4)
$422,793

$71,875

(b) (4)

6. Contractual
Contractual includes (b) (4)

and (b) (4)

for Title X data processing

services. There is no anticipated increase in expense for grant year 3.


Contractual
Contracted Services (b) (4)
Total

Budgeted
Expense
(b) (4)

% allocated
to Title X

Title X
allocation

Non-Federal
$0
$0

7. Other
Includes additional costs of operating PPLM's Title X program. Grant year 3 includes an
anticipated 2% increase in expenses.
Budgeted
Expense
Printing
Telephone
Rent
Repairs/Maintenance
Security
Utilities/Office Expense
Educational Materials/Literature
Outreach Materials/Activity
Translation Services
Computer Services
Subscriptions/Publications
Dues & Fees (incl PPFA)
Postage, Shipping, Freight
Insurance/Malpractice
Total

Page 31 of 181

% allocated
to Title X

Title X
allocation

Non-Federal

(b) (4)
$597,375

$152,315

(b) (4)

PSC-HHS-000031

Upload #2
Applicant:

Planned Parenthood League of Massachusetts, Inc.

Application Number:

FPH2015007161

Project Title:

Title X Family Planning Continuing Grant for Central Massachusetts

Status:

Awarded

Document Title:

Attachments-ATT1-1234-PPLM Title X Appendices Final 2015.pdf

PSC-HHS-000032

Page 32 of 181

APPENDIX A: Project Work Plan


PPLM will continue to provide comprehensive family planning services at its Central MA Title
X centers. PPLM provides patients with unbiased, confidential, medically accurate, culturally
and age-appropriate information and services that meet their unique needs. Patients receive
information and education on topics including: abstinence; pregnancy testing and full-options
counseling; chlamydia, gonorrhea, and syphilis testing; rapid HIV testing; cancer screening
through breast exams and Pap smears; birth control methods (male and female condoms, pills,
patches, rings, IUDs, implants, diaphragms, hormonal injections); emergency contraception;
HPV vaccine; colposcopy; LEEP; reproductive life planning; referrals for treatment of HIV and
health care and social service needs beyond the scope of services PPLM offers. PPLM projects it
will serve 6,375 unique clients through 8,500 client visits in the first year of the grant.
PPLMs Central MA Title X Location, Hours and Projected Client Visits

Fitchburg
Health Center

Location

Hours

391 Main Street


Fitchburg, MA 01420

67 Family Planning Hours/ Month


Monday: 10:00am 4:00pm
Thursday: 10:00am 7:30pm
69 Family Planning Hours/Month
Wednesday: 10:00pm 7:30pm
Saturday: 8:00am 12:00pm
69 Family Planning Hours/Month
Tuesday: 10:00am 7:30pm
Friday: 10:00am 4:00pm
244 Family Planning Hours/Month
Monday: 8:00am 7:15pm
Tuesday: 7:30am 3:45pm
Wednesday: 8:00am 7:15pm
Thursday: 8:00am 7:15pm
Friday: 8:00am 5:00pm
Saturday: 8:00am 2:00pm
Walk-in services available

91 Main Street
Ste. 103
Marlborough, MA 01752
Milford
208 Main Street
Health Center Ste. 101
Milford, MA 01757
Central
470 Pleasant Street
Massachusetts Worcester MA 01609
Health Center
Marlborough
Health Center

Projected Client
Visits/Year
Year 1: 1289
Year 2: 1350
Year 3: 1,417
Year 1: 950
Year 2: 998
Year 3: 1,047
Year 1: 1160
Year 2: 1,218
Year 3: 1,278
Year 2: 5101
Year 2: 5,356
Year 3: 5,623

PSC-HHS-000033

Page 33 of 181

Problem/Need: Individuals and families in Central MA need greater access to quality family
planning services. Many low-income, culturally diverse community members may need
specialized outreach activities to learn about and access family planning services.

Goal I: Provide high-quality family planning clinical services in Central MA to reduce


unplanned pregnancy and STD/HIV infection with an emphasis on providing services to low
income individuals and families while providing community education and outreach to
vulnerable, hard-to-reach and at-risk populations.
Objective
I.A.1) Achieve client visit
volume goals

I.B.1) Market the


availability of Title X
family planning services
in Central MA to reach
volume goal.

Key Action Steps


Maintain a monthly
minimum of 449 family
planning clinical hours
in Central MA:
Worcester, 244
Fitchburg, 67
Marlborough, Milford,
69
Increase community
awareness of PPLM
Title X services
through at least 2
marketing campaigns
through social media,
transit online or radio
ads yearly.

Timeline
April 2015
March 2018

Responsibility
VP of Health
Center
Operations

Evaluation Plan
Volume data

April 2015
March 2018

VP of Business
Development

Volume and
market data
reports.

PSC-HHS-000034

Page 34 of 181

I.C.1) Build robust


referral relationships to
assist clients in locating
primary health care to
help reach volume goal.

Develop at least 4
robust community
partnerships with PCPs
to develop mutually
beneficial referral
relationships to assist
patients in locating
family planning
services and primary
health care.

Sept. 2015
March 2016

I.D.1) Provide training to


providers about PPLM
Title X services to
encourage client referral
to reach volume goals.

Dissemination of
PPLM materials
and replacement
requests.
Volume data.

Develop at least 2 new


referral relationships
with high schools to
insure school-based
health centers know
about and can refer
adolescents to PPLM.
Provide PPLM
materials and an inperson overview of our
Title X services to staff
at referring provider
locations.
Train 12 new external
provider partners about
PPLM health services
and provide referral
materials for their
clients. Including a
focus on the
importance of HIV and
STD testing/treatment.

Center
Managers

Parent Educator
and Community
Outreach
Specialist

April 2015
March 2016

Community
Parent Educator
and Outreach
Specialist

Participants
understanding of
services
including
confidentiality/
sliding fee scale.

Promote Rapid HIV


test option to external
provider partners, and
the availability and
effectiveness of
contraceptive options
including LARC, all
available on site at our
Title X locations in
Central MA.

PSC-HHS-000035

Page 35 of 181

I.E.1) Expand Outreach


Committee of the Central
MA Advisory Committee
and continue to seek its
guidance on outreach
opportunities.

I.F.1) Provide on-site


health center tours and
open houses to reach
volume goals.

I.G.1) Educate bi-lingual


parents, guardians or other
caring adults about PPLM
family planning services
and how to talk with their
children about sexuality,
relationships, and decision
making.

I.H.1) Utilize the newly


developed Get Real Teen
Council (GRTC) to
educate teens about
sexuality, healthy decision
making and PPLM/Title X
services, to help reach
volume/outreach goals.

Expand Outreach
Committee by inviting
three additional/new
members representative
of our priority
populations to help
with client-facing
materials review and
outreach suggestions.
Provide at least 2 open
house/health center
tours to local providers
to educate them about
PPLM and Title X
services each year.
Teach 450 in year 1
and 475 in year 2 and
500 in year 3 bi-lingual
parents or other caring
adults in Central MA
through Seamos
Honestos parent
workshops to increase
their confidence in
being a go-to resource
for their children/teens.
The workshops
increase parental
awareness of Title X
services at PPLM.
13 PPLM trained (bilingual and culturally
diverse) tenth and
twelfth grade teens will
offer sexual health
training to at least 500
of their peers in year 1
and 525 in year 2 and
550 in year 3. Includes
information about Title
X free/confidential
health services that do
not require parental
consent.

April 2015
March 2016

Worcester
Health Center
Manager

Meeting minutes

Yearly, April
2015
March 2018

Community
Parent Educator
and Outreach
Specialist

April 2015
March 2018

Community
Parent Educator
and Outreach
Specialist

Participants
understanding of
PPLM services
including
confidentiality/
slide fee scale
Post workshop
surveys.

April 2015
March 2018

Get Real
Trainer

Pre/post-test of
trainers about
their knowledge
of STDs,
protection
methods, consent
and healthy
relationships and
comfort as a
PPLM
ambassador and
comfort with
their facilitation
skills.
4

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Problem/Need: Clients should have high quality family planning care that provides all of the
information necessary to make the best choice of a contraceptive method that meets their needs.
Clients also need factual information to make decisions about STD/HIV testing, as well as access
to testing services that provide accurate and confidential results to insure they receive
appropriate care.

Goal II. Insure that staff providing education and information about contraceptives are welltrained to provide appropriate client-centered care that focuses on the efficacy of the full range of
contraceptive choices available including side-effect management. Ensure staff is well-trained to
provide education and information about the importance of STD/HIV testing, including accurate
test results and follow up care as needed.

Objective
II.A.1) Improve client
outcomes by training staff
through annually revised
scripts on contraceptive
counseling and the
importance of STD/HIV
testing.

II.B.2) Improve outcomes


for adolescent clients by
providing client care that
is youth-friendly,
accessible, appropriate,
effective and efficient for
youth as recommended by
the WHO.

Key Action Steps


Train 75% of HCAs through
the Jumpstart 2 program to
insure staff develop the
skills to address
contraceptive tiering, client
preference, ease of use, and
side effect profile. Insure
staff is appropriately trained
to educate clients about the
benefits of STD/HIV
testing.
Develop staff training that
insures staff are teen-ready
at all times. Staff will
understand how to work
with adolescents in a
manner that is effective,
accessible, appropriate and
youth friendly

Timeline
April 2015
March 2016

Responsibility
Director of
Patient
Services

Training
VP of
materials will Education and
be used on an Training
ongoing
basis from
April 2015
March 2018

Evaluation Plan
Staff post training
assessment. Staff
observation.

Staff observation
using a youthfriendly
assessment tool.

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II.C.2) Staff will assist


clients with their
reproductive life plans by
offering the full range of
contraceptive methods and
emergency contraception.

Each year, 100% of staff


April 2015
receive training at New Hire March 2018
Orientation, Jumpstart 1 and
75% of staff receive more
in-depth training at
Jumpstart 2.

Staff will document


discussion of reproductive
life planning 98% of the
time.
II.D.2) All staff will
receive orientation and inservice training as part of
their 90-day introductory
period.

Staff successfully document


discussion of reproductive
life planning in the EHR
98% of the time.
Each year, new staff will
attend multiple days of
orientation and in-service
training as part of their
onboarding process. These
training days are referred to
as New Hire Orientation
and Jumpstart.
Trainings include:
Introduction to Title X;
Mandatory Reporting Laws;
Human Trafficking;
Services to Minors State
and Federal Laws; HIPAA:
Protecting Patient Privacy;
Medical Records
Documentation; Birth
Control Methods; STDs.
Each year, all staff receive
Mandated Reporting and
Human Trafficking Training
on an annual basis during
All Health Center Meetings
and other staff meetings.

II.E.2) 100% of staff will


receive annual trainings
on Federal/State
requirement for reporting
or notification of child
abuse, child molestation,
sexual abuse, rape or
incest, as well as on
human trafficking.
II.F.2) Improve HIV
outcomes by offering
rapid HIV testing and
provide timely referral of
clients with positive
results for treatment.

Increase HIV testing by 5%


each year across Central
MA sites.

April 2015March 2018

Heath Services
Director

Staff observation
and chart audit.

Manager of
Internal
Training

All trainings are


tracked within a
learning
management
system called the

(b) (4)
Training
compliance is
audited on a
quarterly basis by
the Manager of
Internal Training.

April 2015March 2018

Manager of
Internal
Training

Post-Training
assessments

April 2015
March 2018

Health
Services
Director

Point of Care
audits

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II.G.2) Continuously
improve chlamydia and
gonorrhea testing by
routinely testing clients
within routine and
standalone visits.

Increase chlamydia and


gonorrhea testing from 51%
of total family planning
visits in 2014 receiving tests
to 53% of total visits. Plan
for increases in years 2 and
3 based on year 1 results
II.H.2) Insure that PPLM
Increase audits of breast
APCs are providing up-to- related visits from once a
date evidenced-based care year to twice a year.
to promote breast cancer
screening and risk
assessment.
II.I.2) Continue to meet or Semi-annual review of
exceed the cervical cancer benchmarking data and
screening benchmark of
share results with all health
the NCQA.
center staff.
II.J.2) Improve client
All APCs have access to
outcomes by insuring that clinical protocols in
care is provided within the electronic and print format.
guidelines of nationally
All clinicians will review
recognized standards for
annual updates/changes and
care outlined in PPFA
documentation of this
clinical protocols that are review by clinician will be
updated and reviewed
recorded.
annually with all
clinicians.

April 2015
March 2018

Health
Services
Director

Visit stats

April 2015
March 2018

Quality
Assurance
Manager

Review audit
results with
clinicians.

April 2015
March 2018

Quality
Assurance
Manager

Review of
benchmarking
results

April 2015
March 2018

Patient
Services
Director

Documentation of
protocol review
within internal
training staff
documentation
system.
Training
compliance is
audited on a
quarterly basis by
the Manager of
Internal Training.

Problem/Need: As a Title X grantee, PPLM must comply with all Title X administrative
standards to ensure prudently managed resources and adherence to Title X regulations regarding
project administration of quality health care, planning and evaluation.

Goal III. PPLM will address all Title X administrative standards regarding resource
management, quality health care, planning and evaluation by insuring efficiency and quality
through ongoing program evaluation. PPLM is committed to employing rigorous nationally
recognized programs or processes for achieving quality health care improvement.

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Objective
III.A.3) Ensure that Patient
Contact Center staff (the
call center) and Patient
Services Specialists
(reception staff) are welltrained regarding clients
rights to care, charges,
billing and collection
requirements to insure
proper use of Title X
funding.

Key Action Steps


Each year, 100% of Patient
Contact Center and Patient
Services Specialists
(reception staff) complete a
full day Revenue Cycle
Training to review and
understand Title X
regulations including sliding
fee scale, income
verification, third party
billing and waiver of copay
for clients below 250% of
FPL if applicable.
III.B.3) Clients right to
Develop a workflow and
Waiver of Insurance Copay procedures for income
if income guidelines are
verification and waiver of
met will be communicated third party billing copays for
to all reception staff.
clients under 250% of FPL.
III.C.3) PPLM will
PPLM staff will document
accurately document
income verification
income verification in the
accurately 98% of the time.
electronic practice
management system
routinely.
III.D.3) PPLM will
PPLM will ensure that there
maintain staffing that is
is culturally and
culturally and linguistically linguistically diverse staff at
diverse to insure sensitivity each health center. Staff will
and ability to serve a
successfully pass a
diverse population of
translation assessment before
clients.
beginning to provide
translation services to clients.
III.E.3) PPLM will assist
PPLM will partner with
clients to access health
certified health insurance
insurance enrollment.
enrollment specialists to
provide clients with access to
educational materials and
enrollment opportunities.
In year 2, PPLM will assess
ability for PPLM staff to
become certified enrollment
specialists and determine
need for additional staff to
handle client enrollment.

Timeline
March
2015
April 2016

Responsibility
Center
Managers

Evaluation Plan
Training
assessments and
ongoing
observation and
audits.

April 2015
June
2015

VP of Health
Center
Operations

EPM audit and


review

April 2015
March
2018

Center
Mangers

Documentation
audit

April 2015- Center


March
Mangers
2018

HR
documentation

April 2015
March
2016

Documentation
of enrollment
effort in
Electronic
Practice
Management
system.

Center
Managers

April 2016March
2017

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III.F.3) PPLM tracks


occurrences including
near misses to identify
areas for quality
improvement and training
in providing client care.
The tracking system will
be efficient, transparent
and reportable.
III.G.3) PPLM health
center staff understand the
value and requirement to
report and track
occurrences to insure
quality services.
III.H.3) In recognition of
the CDC guidelines for
quality improvement
PPLM will use client
satisfaction surveys to
develop a PDSA (plan, do
study, act) to improve
client satisfaction in
Central MA.

Current hybrid paper and


electronic occurrence
reporting system will be
converted to the (b) (4)
electronic management
system.
Yearly, data entered into
database.
Each year, 100 % of health
center staff will receive
occurrence reporting training
and a 5% increase in the
number of occurrences
reported will be the result.

April 2015
March
2018

Quality
Assurance
Manger

(b) (4)

April 2015
March
2018

Quality
Assurance
Manger

September
2015
April 2016

Center Manger

Internal Training
assessment and
documentation in
database of
successful staff
training
completion.
Client
satisfaction
survey responses
and review both
pre and post
PDSA.

(b) (4)

Review client satisfaction


survey with staff and select
one area for improvement.
PDSA will address the area
and client satisfaction will be
measured to determine if
improvement has been made.

Problem/Need: To meet Title X requirements, clinical services must be effective, efficiently


delivered in a client-centered, equitable, and accessible manner. Staff must be well-trained in all
areas of client care through a consistently delivered and documented training plan to insure Title
X requirements are met or exceeded.

Goal IV. Provide and maintain quality training for all project staff to insure the delivery of
quality protocol-driven client care, community outreach and education in Central MA.

Objective
IV.A.4) Ensure that 100% of
staff who work at reception or
in PPLMs Call Center

Key Action Steps


All call center and
reception staff and their
managers will receive a

Timeline
April
2015
March

Responsibility
Director of
Revenue Cycle

Evaluation Plan
Skills assessment
checklist

PSC-HHS-000041

Page 41 of 181

understand Title X charges,


billing and collection
requirements; third party
payment collection including
the need for income
assessment before collecting
co-pays, and eligibility for
discounts for minors who
receive confidential services.
IV.B.4) 100% of clinical staff
will complete annual protocol
review and revisions training.

full-day revenue cycle


training.

IV.C.4) 100% of licensed


staff complete annual training
on follow up and referral
procedures.
IV.D.4) 100% of project staff
will successfully complete an
annual Title X training.

Staff review follow-up and


referral procedures

IV.E.4) 100% of APCs will


complete quarterly coding
training, including ICD-10
training in 2015.

IV.F.4) 100% licensed staff


will successfully complete
CPR training bi-annually.
IV.G.4) In recognition of the
CDC guidelines for quality
improvement, PPLM will
institute a nationallyrecognized team training
(TeamSTEPPS) to reduce
medical errors, enhance client
safety, improve clinical
outcomes, and increase
medical and liability cost
savings.

2018
initial
training,
training of
new staff
each year

Staff will be assessed


yearly by management
using a skills checklist.

All protocols will be


reviewed annually during
clinicians meetings. New
protocols are available in
print and electronic form
for ease of reference.

December
2015
March
2018

Medical
Director

Quarterly chart
review by visit
type.

May 2015
July
2015 and
yearly
Training is provided in
Yearly
health center staff meetings each
October
2015-2018
Clinicians will receive
April,
coding review and training October,
at mandatory quarterly
January
clinician meetings.
training
each year
2015-2018
Staff participate in training October
arranged at the health
2016/2017
center with an outside
/2018
vendor.
Institute one TeamSTEPPS April
concept at all four Title X
2015
Central MA sites by March March
2016.
2016

Patient
Services
Director

Quarterly chart
review/audits.

Center
Manager

Internal Training
Documentation

Director of
Revenue Cycle

Billing reviews
and coding
audits.

Health
Services
Directors

Successful
completion of
test at end of
training.
Internal Training
assessment and
documentation.

Assess and plan for


activities in 2017 and 2018.

Quality
Assurance
Manager

Client
satisfaction
surveys.

10

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APPENDIX B: PPLM Articles of Organization

11

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(b) (6)

12

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13

PSC-HHS-000045

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15

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PSC-HHS-000048

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17

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PSC-HHS-000055

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26

PSC-HHS-000058

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PSC-HHS-000059

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28

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(b)
(4)

(b) (4)
(b) (4)

33

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34

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PSC-HHS-000067

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TABLE OF CONTENTS
ARTICLEI NAME,PURPOSES,POWERSANDRELATEDMATTERS 38
ARTICLEII DIRECTORS 38
1. Powers ........................................................................................................................................................... 38
2. Number, Election and Term of Office .................................................................................................... 38
3. Annual Meeting ............................................................................................................................................ 38
4. Regular Meetings .......................................................................................................................................... 38
5. Special Meetings ........................................................................................................................................... 39
6. Notice of Meetings ...................................................................................................................................... 39
7. Action at Meetings ....................................................................................................................................... 39
8. Action Without Meeting ............................................................................................................................. 39
9. Resignation .................................................................................................................................................... 39
10. Removal ....................................................................................................................................................... 39
11. Vacancies ..................................................................................................................................................... 40
12. Disqualification .......................................................................................................................................... 40
13. Compensation ............................................................................................................................................ 40

ARTICLEIII MEMBERS 6
ARTICLEIV COMMITTEES

41

1. Standing Committees .................................................................................................................................. 41


2. Chairpersons, Members and Meetings ..................................................................................................... 41
3. Executive Committee .................................................................................................................................. 41
4. Finance and Audit Committee ................................................................................................................... 42
5. Risk Management and Compliance Committee
6. Medical Quality and Patient Service Committee ..................................................................................... 43
7. Education Committee
8. Development Committee
9. Governance Committee .............................................................................................................................. 43
10. Other Committees ..................................................................................................................................... 44

ARTICLEV OFFICERS
1.
2.
4.
5.
6.
7.
8.

44

Powers ........................................................................................................................................................... 44
Chair ............................................................................................................................................................... 44
Vice Chair ...................................................................................................................................................... 45
Treasurer........................................................................................................................................................ 45
Clerk... ............................................................................................................................................................ 45
Resignation .................................................................................................................................................... 45
Removal ......................................................................................................................................................... 46

ARTICLEVI PRESIDENT/CEO

46

1. Powers ........................................................................................................................................................... 46
2. Duties ............................................................................................................................................................. 46

ARTICLEVII MISCELLANEOUSPROVISIONS
1.
2.
3.
4.
5.
6.
7.

46

Fiscal Year ..................................................................................................................................................... 46


Annual Audit ................................................................................................................................................ 46
Execution of Instruments ........................................................................................................................... 46
Voting of Securities ..................................................................................................................................... 46
Charitable Contributions ............................................................................................................................ 47
Evidence of Authority ................................................................................................................................. 47
Amendments................................................................................................................................................. 47

ARTICLEVIIIINDEMNIFICATION 47

36

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PSC-HHS-000069

ARTICLE I: NAME, PURPOSES, POWERS AND RELATED MATTERS


The name of Planned Parenthood League of Massachusetts, Inc. (hereinafter in these By-laws
referred to as the Corporation), the location of its principal office and its purposes shall be as set
forth in the Articles of Organization and these By-laws. The powers of the Corporation and of its
directors, officers, committees, and members, and all matters concerning the conduct and regulation
of the affairs of the Corporation and the manner in which and the officers and agents by whom its
purposes may be accomplished shall be governed by such provisions in regard thereto, if any, as are
set forth in the Articles of Organization and these By-laws.
All references in these By-laws to the Articles of Organization shall be construed to mean the
Articles of Organization as from time to time amended.
ARTICLE II: DIRECTORS
1. Powers
The Board of Directors shall have and may exercise all of the powers of the Corporation as
conferred by law upon the members of a nonprofit corporation.
2. Number, Election and Term of Office
The governing body of the Corporation shall be a Board of Directors consisting of not less than
fifteen (15) nor more than thirty-five (35) persons. Directors shall be elected at the annual meeting
of the Board of Directors from the slate presented by the Governance Committee in accordance
with Article IV(6), and they shall serve in accordance with the provisions of this Article II.
Directors elected to a full term shall hold office until the third annual meeting after that meeting at
which they are elected, except that any director elected to fill a vacancy shall hold office in
accordance with Section 11 of this Article II. No person shall be elected a director for more than
two consecutive three-year terms. Thereafter, an elected director shall not be eligible for election to
the Board of Directors until the annual meeting following the annual meeting at which his or her
term expired.
3. Annual Meeting
The annual meeting of the Board of Directors of the Corporation shall be held at the principal
office of the Corporation in Boston, or at such other place within the Commonwealth of
Massachusetts as designated in the notice of annual meeting, on any date between April 1 and June
30 of each year. If such annual meeting is omitted on a day herein provided therefor, a special
meeting may be held in place thereof, and any business transacted or elections held at such meeting
shall have the same effect as if transacted or held at the annual meeting.
4. Regular Meetings
Regular meetings of the Board of Directors may be held without call or notice at such places and at
such times as the Board or Executive Committee may from time to time determine. A regular
meeting shall be held without call or notice at the same place as the annual meeting of the Board of
Directors or the special meeting held in lieu thereof, after the election of a new Board of Directors,
for the purpose of electing officers and the Executive Committee of the Corporation.
Any meeting of the Board of Directors, Executive Committee or any other committee of the Board
of Directors may take place by conference call in which those participating whether in person or by

Page 70 of 181

38

PSC-HHS-000070

PSC-HHS-000071

11. Vacancies
Any vacancy on the Board of Directors may be filled by vote of the remaining directors, provided
that a director so elected shall serve until the next annual meeting, at which time the Board of
Directors shall elect a director for the remainder of the unexpired term. Service of a partial term to
fill a vacancy shall not preclude eligibility to serve two full terms.
The position of any member of the Board of Directors who shall be absent from three (3) or more
consecutive meetings without giving valid reason may, at the recommendation of the Executive
Committee and subject to the approval of the Board, be declared vacant and shall be filled in
accordance with the provision of this Section. Board members so affected shall be notified by the
Clerk. In the event of any vacancy in the Board of Directors, the remaining directors may exercise
the powers of the full Board until successors are elected.
12. Disqualification
No paid member of the Corporations staff shall serve as a member of the Board of Directors. No
close relative of the Corporations staff shall serve as a member of the Board of Directors nor shall
any close relative of a member of the Board of Directors be an employee of the Corporation.
No employee of Planned Parenthood Federation of America (PPFA) or any of the Corporations
affiliates may serve on the Board of Directors of the Corporation.
13. Compensation
No director shall receive any compensation for his or her services as a member of the Board of
Directors as such; provided, however, that any director may, if authorized by the Board of Directors,
be reimbursed for necessary expenses, including travel expenses, reasonably incurred by a director in
the performance of duties as a director.
ARTICLE III: MEMBERS
1.

Members
1.1
The Corporation shall have no statutory members. Any action or vote required or
permitted by law to be taken by members of the Corporation shall be taken by action
or vote of the same percentage of the directors. The members described in Article III,
Section 1.2 are not statutory members.
1.2

The members of the Corporation shall include Donor Members, Network Members,
and National Members (collectively, the Associate Members). Associate Members
are not statutory members and shall have no voting or other rights with respect to the
Corporation.
Donor Members shall include any individual who has made a contribution of $25.00 or
more to the Corporation during any of the preceding three calendar years.
Network Members shall include any individual registered as a member of the
Corporations Legislative Alert Network.

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PSC-HHS-000072

National Members shall include any resident of the Commonwealth of


Massachusetts who has made a contribution of $25.00 or more to PPFA during any
of the preceding three calendar years.
ARTICLE IV: COMMITTEES
1. Standing Committees
There shall be seven (7) standing committees of the Board of Directors: Executive Committee,
Finance and Audit Committee, Risk Management and Compliance Committee, Medical Quality and
Patient Service Committee, Education Committee, Development Committee, and Governance
Committee.
2. Chairpersons, Members and Meetings
The Chair of the Corporation shall be the Chairperson of the Executive Committee. The Treasurer
of the Corporation shall be the Chairperson of the Finance and Audit Committee. The Chair shall
appoint, with the approval of the Board, the Chairperson of each of the Risk Management and
Compliance, Medical Quality and Patient Service, Education, and Development Committees. The
Chairperson of the Governance Committee shall be elected by the Board of Directors. Each
Chairperson of a standing Committee must be a member of the Board of Directors.
The Chair shall, in consultation with the Chairperson of each standing Committee, the Chairperson
of the Governance Committee, and the President/CEO, select the members of each standing
committee (with the exception of the Executive, Finance and Audit, and Governance Committees),
provided, however, that each standing committee shall include no less than two (2) members of the
Board of Directors. Chairpersons of committees are responsible for the keeping of minutes of their
meetings and furnishing reports as may be requested by the Chair or the Board of Directors.
The President/CEO shall be an ex officio member (without vote) of all committees. The Chair
shall be an ex officio member (without vote) of the Governance Committee and shall be an ex
officio member (with vote) of all other committees.
Regular meetings of all committees except the Governance Committee shall be open to all members
of the Board of Directors. The Chairperson of each committee, including the Chairperson of the
Governance Committee, shall have the authority to call a meeting in executive session. Attendance
at a committee meeting in executive session shall be open only to the voting members of that
committee.
3. Executive Committee
The Executive Committee shall consist of no fewer than seven (7) nor more than eleven (11)
persons, who shall include the Chair, Vice Chair, Treasurer, Clerk, the Chairperson of each of the
standing committees of the Board, and others as may be appointed by the Chair. The Chair shall
serve as the Chairperson of the Executive Committee. The Executive Committee shall have and
may exercise all of the powers of the Corporation between meetings of the Board of Directors and
shall be vested with the management of the current and ordinary business of the Corporation on
behalf of the Board of Directors. In addition, the Executive Committee shall exercise any right or
power or make any decision delegated to it by the Board of Directors.

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PSC-HHS-000074

PSC-HHS-000075

to the Corporations Board of Directors as to which persons the Corporation should appoint as
directors of The Advocacy Fund.
In making its nominations, the Governance Committee shall work affirmatively to include diversity
among the Board of Directors and officers and shall not discriminate on the basis of race, color,
religion, sex, national origin, age, sexual orientation, disability, income, marital status, or other bases
protected by applicable law.
10. Other Committees
The Board of Directors or the Executive Committee may appoint other committees including
Regional Advisory Committees, and delegate such responsibilities to any such committee so
appointed as shall be considered desirable from time to time. The Executive Committee shall not
delegate to any Committee which is appointed by it, responsibilities which conflict with any
responsibilities previously delegated by the Board of Directors to a committee then functioning.
The Board of Directors or the Executive Committee may delegate to the Chairperson of any
committee so appointed the responsibility to appoint the members of such committee, subject to the
approval of such appointments by the Chair.
ARTICLE V: OFFICERS
1. Powers
The officers of the Corporation shall be a Chair, a Vice Chair, a Treasurer, a Clerk and such other
officers as the Board of Directors may from time to time elect, including a Chair Elect. All officers
shall be elected by the Board of Directors from among the directors. Two or more offices may be
held by the same person. The Board of Directors may elect co-holders of an office, each of whom
may from time to time perform the duties of such office. A vacancy in any duly constituted office
may be filled by vote of the Board of Directors.
Subject to these By-laws, in addition to the duties and powers specifically set forth in these By-laws,
each officer shall have such duties and powers as are customarily incident to his or her office, and
such duties and powers as the Board of Directors or the Executive Committee may from time to
time designate.
2. Chair
The Chair shall preside at all meetings of the Board of Directors and meetings of the Executive
Committee. The Chair shall, with the approval of the Board, appoint the chairpersons of all
committees except the Executive Committee, the Finance and Audit Committee and the
Governance Committee.
The Chair of the Corporation shall hold office for a two-year term until the second annual meeting
following his or her election and thereafter until his or her successor is chosen and qualified. The
Chair may be re-elected for a consecutive one (1) year term but no Chair shall serve for more than a
total of three (3) consecutive years. Service of a partial term to fill a vacancy shall not preclude
eligibility to serve a full two-year term. Notwithstanding the provisions of Article II, Section 2, in the
circumstance where the Chair of the Corporation is required to rotate off of the Board of Directors
because his or her term as a director coincides with the end of his or her term as Chair, such
immediate past Chair may serve an additional year on the Board of Directors. Thereafter, the Chair

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PSC-HHS-000077

receipt, unless it is specified to be effective upon its acceptance by the Board of Directors or by the
Executive Committee, as the case may be.
7. Removal
The Board of Directors may remove from office any officer by vote of a majority of its entire
number then in office.
ARTICLE VI: PRESIDENT/CEO
1. Powers
The President/CEO is the chief executive and senior staff person of the Corporation.
The Board of Directors shall appoint the President/CEO, who shall be responsible to the Board of
Directors for all aspects of the Corporations operations in accordance with Board policies and
directives. The Board of Directors shall undertake an annual review of job performance of the
President/CEO.
2. Duties
The President/CEO shall be responsible to the Board of Directors through the Chair. He or she
shall have full responsibility for the general management and administration of the day-to-day
business of the Corporation. He or she shall also have additional duties and responsibilities as the
officers or directors of the Corporation may from time to time delegate.
ARTICLE VII: MISCELLANEOUS PROVISIONS
1. Fiscal Year
Except as from time to time otherwise determined by the Board of Directors or by the Executive
Committee, the fiscal year of the Corporation shall be the twelve (12) months ending June 30.
2. Annual Audit
The account books of the Corporation shall be audited annually by an independent certified public
accountant retained with the approval of the Board of Directors upon the recommendation of the
Finance and Audit Committee and the report of such accountant shall be filed with the records of
the Corporation.
3. Execution of Instruments
All deeds, leases, transfers, contracts, bonds, notes and other instruments authorized to be executed
by an officer of the Corporation on its behalf shall be signed by the Chair or the Treasurer except as
the Board of Directors or the Executive Committee may generally or in particular cases otherwise
determine. The Chair may delegate this authorization to the President/CEO.
4. Voting of Securities
Except as the Board of Directors or the Executive Committee may otherwise designate, the Chair or
Treasurer may waive notice of, and appoint any person or persons to act as proxy or attorney-in-fact
for this Corporation (with or without power of substitution) at any meeting of stockholders or

Page 78 of 181

46

PSC-HHS-000078

shareholders of any other corporation or organization, the securities of which may be held by this
Corporation.
5. Charitable Contributions
The Board of Directors or the Executive Committee may authorize from time to time contributions
to be made by the Corporation in such amounts as it may determine to be reasonable to
corporations, trusts, funds or foundations organized and operated exclusively for charitable, scientific
or educational purposes, no part of the net earnings of which inures to the benefit of a member of
the Board of Directors.
6. Evidence of Authority
A certificate by the Clerk or by a Temporary Clerk as to any action taken by the Board of Directors,
Executive Committee or any officer or representative of the Corporation shall, as to all persons who
rely thereon in good faith, be conclusive evidence of such action. The exercise of any power which
by law, by the Articles of Organization or by these By-laws, or under any vote of the Board of
Directors or the Executive Committee, may be exercised by an officer of the Corporation only in the
event of the absence of another officer or any other contingency, and shall bind the Corporation in
favor of anyone relying thereon in good faith, whether or not such absence or contingency existed.
7. Amendments
Any part or all of these By-laws may be altered, amended or repealed from time to time by a majority
vote of the directors present at a regular or special meeting of the Board duly called for the purpose,
provided that notice of the substance of the proposed alteration, amendment or repeal shall be stated
in a notice for such meeting given no less than seven (7) days before such meeting.
ARTICLE VIII: INDEMNIFICATION
The Corporation shall, to the extent legally permissible, indemnify each of its directors and officers
(including persons who serve at its request as directors and officers of another organization in which
it has an interest) against all liabilities and expenses, including amounts paid in satisfaction of
judgments, in compromise or as fines and penalties, and counsel fees, reasonably incurred by him or
her in connection with the defense or disposition of any action, suit or other proceeding, whether
civil or criminal, in which he or she may be involved or with which he or she may be threatened,
while in office or thereafter, by reason of being or having been such a director or officer, except
with respect to any matter as to which he or she shall have been adjudicated not to have acted in
good faith in the reasonable belief that his or her action was in the best interests of the Corporation;
provided, however, that as to any matter disposed of by a compromise payment by such director or
officer pursuant to a consent decree or otherwise, no indemnification either for said payment or for
any other expenses shall be provided unless (a) such indemnification shall be ordered by a court; (b)
such compromise shall be approved as being in the best interests of the Corporation by a majority
of the directors then in office exclusive of any interested director; or (c) the Corporation has
received an opinion in writing of independent legal counsel to the effect that such director or officer
appears to have acted in good faith in the reasonable belief that his or her action was in the best
interests of the Corporation. Expenses, including counsel fees, reasonably incurred by any such
director or officer in connection with the defense or disposition of any such action, suit or other
proceeding may be paid from time to time by the Corporation in advance of the final disposition
thereof upon receipt of an undertaking by such individual to repay the amounts so paid to the

Page 79 of 181

47

PSC-HHS-000079

PSC-HHS-000080

APPENDIX D: Proof of Nonprofit Status

Page 81 of 181

49

PSC-HHS-000081


Page 82 of 181

50

PSC-HHS-000082

Page 83 of 181
(b) (4)

(b) (4)

(b) (4)

(b) (4)

(b) (4)

(b) (4)

(b) (4)

(b) (4)

(b) (4)

(b) (4)
(b) (4)

PSC-HHS-000083

(b) (4)
PSC-HHS-000084

Page 84 of 181

(b) (4)

(b) (4)

PSC-HHS-000085

Page 85 of 181

(b) (4)

(b) (4)

PSC-HHS-000086

Page 86 of 181

APPENDIX G: Vice President of Health Center Operations Job Description

Job Title: Vice President Health Center Operations Department: Health Center (860000)
Manager: Chief Operations Officer

Location: Springfield

Job Summary:
The Vice President of Health Center Operations will direct and manage the daily operation of PPLMs
health centers, providing leadership and assuring a focus on patient satisfaction and efficiency. S/he will
work collaboratively with the Medical Director and Director of Patient Services to assure that all services
conform to professional standards, PPFA protocols, PPLM quality standards, and are consistent with all
regulatory requirements and monitoring agencies. This position also oversees the implementation and
management of PPLM government and any private grants supporting health care services, including Title
X and State DPH Family Planning Grants.

(b) (4)

Page 87 of 181

55

PSC-HHS-000087

(b) (4)

(b) (4)

PSC-HHS-000088

Page 88 of 181

APPENDIX H: PPLM Board of Directors, 2014-2015


Residence

Occupation/
Background

Alicia L. Abad

TERM
DATES
2012-2015

Kathryn Beaumont Murphy, Esq.*

2014-2017

David Bechhofer

2013-2016

Jill Block

2013-2016

Susan Brown, Esq.*

2014-2017

Health care law

Nonnie S. Burnes

2011-2017

Law, Public Policy,


Governmental Regulation

Magnolia Contreras

2013-2016

Andrea Edlow, M.D.*


Dan Ginsburg, Board Chair
Toni Golen, M.D.
Emily Greenstein*
Frank F. Herron
Eve T. Horwitz, Esq.

2014-2017
2012-2015
2013-2016
2014-2017
2013-2016
2011-2017

Susan L. Kaufman

2011-2017

NAME

Atsuko Koyama, M.D., M.P.H., Clerk


2011-2017
PattiKraft,Esq.
2013-2016
Rene M. Landers, Esq.
2011-2017
Margaret Lawrence, Treasurer
2013-2016
Linette G. Liebling
2012-2015
Johanna (Jojo) Longnecker
2012-2015
Eli H. Newberger, M.D.
2012-2015
Jan Nyquist
2013-2016
Julia H. Owens
2011-2017
Alison Swift Packard, M.D., Vice Chair
2011-2017
Lois C. Russell
2011-2017
Jamie Sabino
2013-2016
Mark A. Schuster*
2014-2017
Carol H. Sharer
2013-2016
Elaine R. Smith
2013-2016
Catherine West
2013-2016
*Indicates New Board Member

Page 89 of 181

(b) (6)

Philanthropy, consulting

Law
Strategic planning,
Finance
Prevention Programs,
Community Health, Public
Health

Health Care Policy and


Community relations
OB/GYN
Health care consulting
OB/GYN
Finance
Media, marketing
Health care law
Health care policy,
finance

Pediatrics
Philanthropy, law

Law
Finance
Public health consulting
Finance, philanthropy

Pediatrics
Strategy, Finance
Philanthropy
OB GYN
Marketing, philanthropy

Law
Pediatrics
Marketing, philanthropy
Health care, finance

Health care strategy

57

PSC-HHS-000089

APPENDIX I: PPLM Central MA Advisory Committee,


2014-2015 Committee Members and Staff

Name

Residence

(b) (4)
(b) (4)

Occupation Background
M.D., Adolescent Medicine Specialty
Commercial Painting Business Owner
Retired Attorney
Non-Profit Consultant
Volunteer
Attorney
Human Resources Professional
Pathologist
Graphic Design Professional
Health and Human Services Consultant
Attorney
Social Worker
Middle School Teacher
Insurance Enrollment Specialists
Dean of Students, Community College

VP of Health Center Operations


Central MA Center Manager
Fitchburg, Marlborough and Milford Center Manager
Senior Parent Educator
Government Relations Manager
Central MA Bilingual Parent Educator and Community
Outreach Specialist
Health Care Assistant (Spanish bilingual)

* Indicates members of I&E Committee

Page 90 of 181

58

PSC-HHS-000090

APPENDIX J: Central MA Approved Health Care and Social Services Referral List
Sterilization
OB/GYN
Adoption

Abortion
Reproductive endocrinology
Reproductive cancer screening
and treatment
Adult primary care

Pediatric primary care


Dental
Vision
Behavioral health

Substance abuse

Domestic violence

Sexual assault

Housing

Food insecurity

Page 91 of 181

Planned Parenthood Central Massachusetts


UMass Memorial Womens Center
Family Health Center
Edward M Kennedy Community Health Center
Childrens Friend Socity
Jewish Child Family Service
Lutheran Community Services
Catholic Charities
Provided on-site in Worcester or at Boston and
Springfield PPLM locations
UMass Memorial Womens Center
UMass Memorial Womens Center
UMass Breast Center
UMass Genetic Counseling
Hahnemann Family Health Center
Family Health Center
Edward M Kennedy Community Health Center
See Adult Primary Care
See Adult Primary Care
See Adult Primary Care
Valley Psychiatric Services
Community Healthlink
Arbour Counseling Services of Worcester
Wayside Youth and Family Support
Community Healthlink
Motivating Youth Recovery
Highland Grace House
LUK Program
You, Inc
SAFELINK
YWCA Central Mass
National Domestic Violence Hotline
SAFELINK
YWCA Central Mass
Sexual Assault Hotline
Worcester Community Action Council
Central Mass Housing Alliance
Abbys House
Women, Infants, and Children (WIC)
Worcester County Food Bank
SNAP

59

PSC-HHS-000091

(b) (4)

PSC-HHS-000092

Page 92 of 181

(b) (4)

PSC-HHS-000093

Page 93 of 181

APPENDIX L: PPLM General Personnel Policies


(Selection of relevant Personnel Policies from PPLMs Employee Handbook).
Recruitment and Selection: (b) (4)

(b) (4)

Page 94 of 181

62

PSC-HHS-000094

(b) (4)

Page 95 of 181

63

PSC-HHS-000095

(b) (4)

Page 96 of 181

64

PSC-HHS-000096

(b) (4)

Page 97 of 181

65

PSC-HHS-000097

(b) (4)

Page 98 of 181

66

PSC-HHS-000098

(b) (4)

Page 99 of 181

67

PSC-HHS-000099

(b) (4)

Page 100 of 181

68

PSC-HHS-000100

(b) (4)

Page 101 of 181

69

PSC-HHS-000101

PSC-HHS-000102

Page 102 of 181

Clinician Skills Checklist: Proctoring Form


Name/Title:
Date of Hire:
*The proctor should date and initial each category observed.
Demonstrates

Area of Competence

Competence

Needs
Supervision

Desires
Training

Not trained or
observed

Medical Records
Interviewing/Hx taking
Charting
Informed Consent
Client Education
Referral/Follow-up system
Other
Lab Microscopy
Venipuncture
Wet Mounts/KOH/pH
Dipstick
Hematocrit
Obtaining STD tests
Exposure control procedures
Other
Procedures/Treatments
# of procedures observed
Vital signs
IUC insertion (CU IUD/LNG IUS)
IUC removal (CU IUD/LNG IUS)
Implant insertion
Implant removal
Endometrial biopsy
Ultrasound
TCA/BCA application
Vulvar Biopsy
IM injection
Diaphragm fitting
FemCap fitting
Emergency plans/drugs
Skin Biopsy
MVA
Other

Education
Hormonal Contraceptives
-General

Page 103 of 181

71

PSC-HHS-000103

Demonstrates

Area of Competence

Competence

Needs
Supervision

Desires
Training

Not trained or
observed

-Initiation
-Problem Management
Emergency contraception
IUC
Barrier Contraceptives
Spermicide and Condoms
Reproductive Life Planning
Pregnancy Options
Abortion
-Medication
-Surgical
Other
STDs/Vaginitis/UTI
Bacterial Vaginosis
Bartholinitis
Candidiasis
Cervicitis
Chlamydia
Gonorrhea
HSV
HIV counseling
HPV
Molluscum
Pediculosis
Syphilis
Trichomonas
UTI
Other
GYN Conditions
Abnormal cytology/HPV follow up
Abnormal Bleeding
Amenorrhea
Dysmenorrhea
PID
Galactorrhea
Abnormal breast conditions
Infertility
Gestational Sizing
HT/ET
Other
Other
Other
Cancer Screening

Page 104 of 181

72

PSC-HHS-000104

Demonstrates

Area of Competence

Needs
Supervision

Competence

Desires
Training

Not trained or
observed

Obtaining a Pap/HPV test


Colposcopy
Cryotherapy
LEEP
Abortion Services
Surgical Abortion
Medication Abortion
Post-abortion check-up
Recovery Room
Management of complications
High Alert Follow-up
Other
Referral Follow-up

Proctor Signature:

Date:

RECOMMENDATION:
Approved to provide services as checked in Column I above.
Needs supervised clinical practice in the following areas:

Plan for providing supervised clinical practice:

Needs additional training in:

Plan for providing additional training (Journal review, In-service training, On-line
training, CEU/Conference)

Signature of Clinician:

Date:

Signature of MD or Physician Designee:

Date:

Page 105 of 181

73

PSC-HHS-000105

APPENDIX N: PPLM Provider Credentialing and Licensing Policy

PPLM Provider Credentialing Policy

(b) (4)

Page 106 of 181

74

PSC-HHS-000106

Provider Proctoring Policy

(b) (4)

Page 107 of 181

75

PSC-HHS-000107

Provider Privileging for Specialized Services Policy

(b) (4)

Page 108 of 181

76

PSC-HHS-000108

PSC-HHS-000109

Page 109 of 181

Have you had the following Immunizations?

!Measles, Mumps and Rubella Vaccine (MMR) !Hepatitis B Vaccine !HPV Vaccine

Contraceptive History
What methods of birth control have you used in the past? _____________________________________________________________
Any problems with these methods? _________________________________________________________________
_____________________________________________________________________________________________________________

Menstrual History
How old were you when your period started? ___________
How often do you get a period now? !more than once a month !once a month !less than once a month
Are your periods? !Regular
!Irregular
How many days does your period usually last? ________________
Overall, is your flow? !Light
!Moderate
!Heavy

Pregnancy History
! Never pregnant (skip to the next section) ! Currently pregnant ___Total number of times pregnant
#Births ___ # C-sections ____ #Miscarriages ____ #Abortions ____ #Ectopics (tubal pregnancies) ____ #Living Children ______
st
Are you currently breastfeeding?
!Yes !No
Age at 1 pregnancy: ____ Age at last pregnancy: ____
Any problems with pregnancy, birth or abortion?
!Yes !No
If yes, please describe the problem(s):

Sexual Practices/STD Risk


!No
!No
!No
!No

!Yes
!Yes
!Yes
!Yes

Have you had sexual intercourse?


Are you currently using a birth control method?
Any new partners in the past year?
Any new partners in the past 90 days?

Are your partner(s):


Are your partners partners:
!No

!Yes !Unknown

!Male !Female !Both


!Male !Female !Both
Does your partner have other partners?

What kind of sex do you have? !Oral


!No
!No
!No
!No
!No
!No

!Yes !Sometimes
!Yes !Unknown
!Yes !Unknown
!Yes
!Yes !Unknown
!Yes

If yes, age at first intercourse? _____________


If yes, what kind? _______________________
# of sex partners in the past year ___________

!Vaginal !Anal (receptive) !Anal (insertive)

I use condoms
Have you been exposed to any STIs (sexually transmitted infections)?
Have you had a partner with any STI symptoms in the past 90 days
Have you used any IV drugs? If yes, have you shared needles? _____
Do your partners use IV drugs?
Have you had a blood transfusion before the year 1985?

Substance Use
!No
!No
!No
!No

!Yes
!Yes
!Yes
!Yes

Have you used street drugs in the past?


Do you currently use any street drugs?
Do you smoke or use tobacco?
Do you drink alcohol?

If yes, what? _________________


What? _______________________
If yes, how much per day? ______ How long? ________
If yes, how many drinks per day, week or month? __________________

Life Style/Support
!No
!No
!No
!No
!No
!No
!No
!No
!No
!No
!No
!No
!No
!No

!Yes
!Yes
!Yes
!Yes
!Yes
!Yes
!Yes
!Yes
!Yes
!Yes
!Yes
!Yes
!Yes
!Yes

Any recent life changes? __________________________________


Concerns about Weight? __________________________________
Concerns about Abuse? __________________________________
Concerns about Coercion (being forced)? _____________________
Do you feel you have a good support system with your friends and/or family?
Would you say you have a healthy diet?
Do you exercise regularly?
Do you use a seat belt regularly?
Do you experience any health hazards at home/work/in your free time?
Do you take folic acid?
Do you take calcium?
Do you take vitamin D?
Are you working? If yes, !full time !part time
Are you a student? If yes, !full time !part time

Please turn the page

Page 110 of 181

78

PSC-HHS-000110

Review of Systems If you have recently had any of the following problems, please check
q Weight gain
q Weight loss
q Fever
q Hot flashes
q Fatigue, lethargy, malaise
q Chronic cough
q Shortness of breath
qDifficulty breathing on exertion
q Painful breathing
q Wheezing
q Spitting up blood
q Chest pain
q Irregular heartbeat/palpitations
q Syncope (fainting)
q Abdominal pain
q Constipation
q Diarrhea
q Nausea/Vomi ing
q Rectal bleeding
q Bloody stool
qInvoluntary loss of gas/stool
q Diminished interest or pleasure
in normal ac ivities
q Depressed mood
q Suicidal
q Seeing a therapist
qAnxiety
qAlopecia
q Cold or heat intolerance
q Excessive hunger, thirst or urina ion

q Dysuria (pain with urina ion)


q Incon inence
q Urinary Frequency
q Pain with IC or other sexual problems
q Abnormal vaginal bleeding
q Vaginal discharge
q Vulvo-vaginal itching
q Pelvic pain
q Dysmenorrhea
q Bleeding/spotting between periods
qBlood in urine
qIncomplete emptying
qUrine loss when coughing/lifting
qPMS
q Rash
q Skin lesions/bumps
q Breast lump
q Breast pain
q Nipple discharge
q Dry skin
q Moles (growth/changes)
q Headache
q Visual disturbance
q Weakness
q Dizziness
q Seizures
q Numbness
q Migraine/aura

he box.

q Problems seeing that is not corrected by


glasses or contacts
q Eye burning, discharge, itching or pain
q Vision changes
q Glasses/contacts
q Hearing problems
q Frequent nose bleeds
q Tooth or gum problems
q Frequent sore throats
q Ringing in ears
q Earaches
q Sinus problems
q Mouth sores
qBack Pain
q Bone/Joint symptoms
q Myalgias (muscle pain)
q Muscle weakness
q Easy bruising
q Easy bleeding
q Enlarged lymph nodes
qCuts do not stop bleeding
q Hay fever
q Hives/Itching
q Contact dermatitis

Reproductive Life Planning


Do you hope to have any (more) children? !No !Yes
How many children do you hope to have? _________
How long to you plan to wait until you next become pregnant? ______________
How much space do you plan to have between your pregnancies?____________
How do you plan to prevent pregnancy until you are ready? or What will you do to prevent pregnancy until you are ready?
___________________________________________________________________________________________________________

Pharmacy Information
Please list the name of your preferred pharmacy _____________________ and the address, including zip code:
Updated 4.16.2014 http://i/x/6YCl (EMR Trainings & Workflows)

Page 111 of 181

79

PSC-HHS-000111

APPENDIX P: Household Income Sliding Scale Fee Schedule

HOUSEHOLD INCOME SLIDING SCALE FEE SCHEDULE - ANNUAL INCOME

Persons in
Family
1
2
3
4
5
6
7
8
For each
additional
person, add

Slide 1

Slide 2

Slide 3

Slide 4

ANNUAL
INCOME

100% or less

101-150% of Income

151-200% of Income

201-300% of Income

$11,670
$15,730
$19,790
$23,850
$27,910
$31,970
$36,030
$40,090

Up to $11,670
Up to $15,730
Up to $19,790
Up to $23,850
Up to $27,910
Up to $31,970
Up to $36,030
Up to $40,090

$11,671 - 17,505
$15,731 - 23,595
$19,791 - 29,685
$23,851 - 35,775
$27,911 - 41,865
$31,971 - 47,955
$36,031 - 54,045
$40,091 - 60,135

$17,506 - 23,340
$23,596 - 31,460
$29,686 - 39,580
$35,776 - 47,700
$41,866 - 55,820
$47,956- 63,940
$54,046 - 72,060
$60,136 - 80,180

$23,341 - 35,010
$31,461 - 47,190
$39,581 - 59,370
$47,701 - 71,550
$55,821 - 83,730
$63,941 - 95,910
$72,061- 108,090
$80,181 - 120,270

$4,060
Updated 1/31/2014

HOUSEHOLD INCOME SLIDING SCALE FEE SCHEDULE - WEEKLY INCOME

Persons in
Family
1
2
3
4
5
6
7
8
For each
additional
person, add

Slide 1

Slide 2

Slide 3

Slide 4

WEEKLY
INCOME

100% or less

101-150% of Income

151-200% of Income

201-300% of Income

$224
$303
$381
$459
$537
$615
$693
$771

Up to $224
Up to $303
Up to $381
Up to $459
Up to $537
Up to $615
Up to $693
Up to $771

$225 - 337
$304 - 454
$382 - 571
$460 - 688
$538 - 805
$616 - 922
$694 - 1,039
$772 - 1,156

$338 - 449
$455 - 605
$572 - 761
$689 - 917
$806 - 1,073
$923 - 1,230
$1,040 - 1,386
$1,157 - 1,542

$450 - 673
$606 - 908
$762 - 1,142
$918 - 1,376
$1,074 - 1,610
$1,231 - 1,844
$1,387 - 2,079
$1,543 - 2,313

$78
Updated 1/31/2014

Page 112 of 181

80

PSC-HHS-000112

Title X Services Fee Schedule by CPT Code

CPT CODE

VISIT DESCRIPTION

Sliding Scale 1 Sliding Scale 2 Sliding Scale 3 Sliding Scale 4


<100% FPL
101-150% FPL 151-200% FPL 201-300% FPL
Level 0
Level 25
Level 50
Level 75

Self Pay
>300% FPL
Level 100

OFFICE VISIT - NEW PT


65

99201

LEVEL 1

17

33

49

99202

LEVEL 2

23

45

68

90

99203

LEVEL 3

30

60

90

120

99204

LEVEL 4

40

80

120

160

99205

LEVEL 5

50

100

150

200

OFFICE VISIT - EST. PT


99211

LEVEL 1

15

30

45

60

99212

LEVEL 2

15

30

45

60

99213

LEVEL 3

22

43

64

85

99214

LEVEL 4

33

65

98

130

LEVEL 5

44

88

132

175

99215

PREVENTIVE VISIT - NEW PT


99384

AGE 12 - 17

38

75

113

150

99385

AGE 18 - 39

38

75

113

150

99386

AGE 40 - 64

44

88

132

175

PREVENTIVE VISIT - EST. PT


99394

AGE 12 - 17

34

68

102

135

99395

AGE 18 - 39

35

70

105

140

99396

AGE 40 - 64

44

88

132

175

10

15

20

OTHER VISITS
96372

IM INJECTION
GYN PROCEDURES-CONTRACEPTIVE

57170

DIAPHRAGM, CAP FIT

38

75

112

149

58300

IUC INSERTION

50

100

150

200

58301

IUC REMOVAL

34

68

102

135

11981

NEXPLANON INSERTION

63

125

188

250

11982

NEXPLANON REMOVAL

75

150

225

300

11983

NEXPLANON REMOVAL W/ RE-INSERTION

113

225

338

450

GYN PROCEDURES-OTHER
57452

COLPOSCOPY EVALUATION

50

100

100

150

200

57454

COLPOSCOPY w/ BIOPSY

50

100

100

150

215

54050

CONDYLOMA TX, MALE

11

25

35

75

150

56501

CONDYLOMA TX, SIMPLE

11

25

35

75

150

57061

CONDYLOMA TX, VAGINA

25

50

50

100

150

57522

CONIZATION W/ LEEP

88

175

175

300

360

57511

CRYOTHERAPY

63

125

125

200

250

17110

DESTRUCT LESION, 1-14

11

25

35

75

150

17111

DESTRUCT LESION, 15+

11

25

35

75

150

58100

ENDOMETRIAL BIOPSY

45

90

125

150

180

56605

VULVA BIOPSY (INCL 1 LESION)

38

75

75

95

150

56606

VULVA BIOPSY (ADDITIONAL LESION)

13

13

25

25

50

CONTRACEPTIVE SUPPLIES
APRI

APRI

15

23

30

AVIA

AVIANE

15

23

30

A4267,C

CONDOMS (6 units)

A4269

CONTRACEPTIVE JELLY

J1050

DMPA (DEPO PROVERA)

18

30

39

A4266

DIAPHRAGM

13

19

25

J7304

EVRA PATCH (1 box = 3 patches)

15

24

30

Page 1 of 3
Updated 11/03/2014

Page 113 of 181

81

PSC-HHS-000113

Title X Services Fee Schedule by CPT Code

CPT CODE

VISIT DESCRIPTION

Sliding Scale 1 Sliding Scale 2 Sliding Scale 3 Sliding Scale 4


<100% FPL
101-150% FPL 151-200% FPL 201-300% FPL
Level 0
Level 25
Level 50
Level 75

Self Pay
>300% FPL
Level 100

99070,F

FEMALE CONDOM (3 units) -DPH

J7307

NEXPLANON

75

150

225

300

JOLE

JOLESSA (3 month supply)

23

45

68

90

KARI

KARIVA

15

23

30

LEVOR

LEVORA

15

23

30

99070,L

LUBRICANT -DPH

99070,8

LUBRICANT 8 OZ

LUT

LUTERA

15

23

30

MC1 5

MICROGESTIN 1.5/30

15

23

30

MC20

MICROGESTIN FE 1/20

15

23

30

MICRO

MICRONOR

15

23

30

NORA

NORA-BE

15

23

30

J7302

MIRENA IUC

118

235

353

470
4

A4267,3

NON-LATEX CONDOMS (3 units)

A4267,6

NON-LATEX CONDOMS (6 units)

J7303

NUVA RING

18

26

35

S4993

OCELLA

15

23

30

ORCYC

ORTHOCYCLEN

15

23

30

ORTRI

ORTHOTRICYCLEN

15

23

30

ORTLO

ORTHOTRICYCLEN-LO

15

23

30

J7300

PARAGARD IUC

90

180

270

360

SPRI

SPR NTEC

15

23

30

TRIS

TRISPRINTEC

15

23

30

99070,V

VAGINAL CONTRACEPTIVE FILM (3)

YAZ

YAZ

50

50

50

50

50

EMERGENCY CONTRACEPTION
J3490,ELLA

ELLA

18

26

35

J3490,NC

Next Choice

18

26

35

MEDICATIONS
ACYC

Acyclovir

10

15

20

AZIT

Azithromicin

10

15

20

DOXY

Doxycycline

J0696

Rocephin (Injection)

26

35

ZITHROMAX

Zithromax

14

20

27

HPV VACCINE
90471

Immunization Administration

25

25

25

25

25

90649

HPV Vaccine

150

150

150

150

150

LABORATORY (OFF-SITE)
88305

BIOPSY, LEVEL IV CERVIX

65

65

65

65

65

88307

BIOPSY, LEVEL V, CERVIX (LEEP)

75

75

75

75

75
130

BVVPAN

BVV Panel

130

130

130

130

85025

CBC W/DIFFERENTIAL

87491

CHLAMYDIA, AMPLIFIED DNA

13

19

25

87081

CULTURE

11

17

22

80051

ELECTROLYTES

82670

ESTRADIOL

13

19

25

82274

FECAL BLOOD TEST

60

83001

FSH

10

15

20

87070

GENITAL CULTURE

10

87591

GONORRHEA, AMPLIFIED DNA

13

19

25

Page 2 of 3
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Page 114 of 181

82

PSC-HHS-000114

Title X Services Fee Schedule by CPT Code

CPT CODE

VISIT DESCRIPTION

Sliding Scale 1 Sliding Scale 2 Sliding Scale 3 Sliding Scale 4


<100% FPL
101-150% FPL 151-200% FPL 201-300% FPL
Level 0
Level 25
Level 50
Level 75

Self Pay
>300% FPL
Level 100

82947

GLUCOSE

84702

HCG QUANT BSU

13

19

25

86706

HEP B sAB

12

12

20

86803

HEP C sAB

12

12

20

87340

HEP B sAG

15

20

87252

HERPES CULTURE

12

17

23

87255

HERPES CULTURE W/ REFLEX

19

38

56

75

86701

HIV I ANTIBODY

18

26

35

86702

HIV II ANTIBODY

25

50

75

100

86695

HSV TYPE I ANT BODY

13

19

25

86696

HSV TYPE II ANTIBODY

13

19

25

86790

HSV TYPE I & II

13

20

26

80061

LIPID PROFILE

12

80076

LIVER PROFILE

12

85595

PLATELET COUNT

84146

PROLACTIN

13

17

85610

PT

85730

PTT

86592

RPR WITH REFLEX

10

86762

RUBELLA SCREEN

85651

(ESR) SED MENTATION RATE

88142

PAP, THIN PREP REFLEX

10

20

29

39

87621

HPV, HIGH RISK

14

28

41

55

84443

TSH

11

15

87086

URINE CULTURE & SENSITIVITY

13

25

38

50

YEAST CULTURE

11

15

87102

LABORATORY (ON-SITE)
87480

CANDIDA SPECIES

10

87491,IH

CHLAMYDIA, AMPLIFIED DNA

13

19

25
25

87591,IH

GONORRHEA, AMPLIFIED DNA

13

19

87164

GRAM STAIN

84702, IH

HCG QUANT BSU

25

25

25

25

25

85018

HEMOGLOBIN

99000

LAB COLLECTION FEE

81025,N

NON-SENSITIVE UCG

83986

PH TESTING

86901

RH TYPING

81025,S

SENSITIVE UCG (PREG. TEST)

10

15

20

87660

TRICHOMONAS VAGINALIS

10

86701,R

UNIGOLD - HIV TEST

35

81002

URINE DIPSTICK

36415

VENIPUNCTURE

81025,WI

WALK-IN PREGNANCY TEST

10

15

20

87210

WET MOUNT

Page 3 of 3
Updated 11/03/2014

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83

PSC-HHS-000115

APPENDIX Q: Summary of Insurance Coverage


Medical Professional Liability: Provides Medial Professional Liability Insurance for PPLM and other
affiliates, staff, volunteers and all medical professionals who provide approved services to patients. In
general, coverage is provided for on-site activities only. Emergency off-premise aftercare coverage is
available to enable a PPLM clinician to follow up with patients that have complications arising from
treatment provided by PPLM. Limits of liability: $1 million per occurrence; $3 million aggregate
Company: (b) (4)
Excess Professional Liability: Provides coverage only for excess medical malpractice. Provides Medical
Professional Liability Insurance for staff, volunteers, and all medical professionals who provide services
to patients. Limits of liability: Difference between $1 million for any one occurrence/$3 million annual
aggregate and total limits of $3 million for any one occurrence/$6 million annual aggregate. Company:
(b) (4)

Commercial General Liability (CGL): Protects against liability claims for bodily injury and property
damage arising out of premises, operations, products as well as advertising and personal injury liability.
Limits of liability: $1 million per occurrence; $2 million general aggregate limit. Company: (b) (4)
Umbrella Liability: Provides broader coverage and higher limits over other underlying policies: Nonowned and hired Automobile Liability, General Liability and Employers' Liability. Limits of liability: $25
million per occurrence/annual aggregate excess of scheduled underlying coverages. Company: (b) (4)
Directors and Officers Liability (D&O) Insures directors, officers, employees, volunteers and/or
members of duly organized committees against allegations of wrongful conduct when they are acting in
their capacity as company executives. Also insures affiliates to the extent they indemnify the individual
insureds for covered loss. Limits of liability: $2 million per occurrence each insured; $4 million annual
aggregate. Company: (b) (4)
Data Security Liability: Provides coverage for network security, privacy liability, privacy breaches,
cyber extortion threats, digital asset replacement, and business income loss. $500,000 to $1 million per
occurrence. Company: (b) (4)
Employment Practices Liability (EPL): Provides coverage for liability arising out of employment
related exposures, such wrongful termination, discrimination, sexual harassment and workplace torts
liability. Limits of liability: $350,000 each claim; $700,000 annual aggregate to each affiliate; $4 million
annual policy aggregate. Company: (b) (4)
Media Special Perils Policy (Media): Liability for claims arising out of publications including books,
newsletters, newspapers, magazines, brochures, monographs, electronically transmitted information and
databases, films, video cassettes, advertising materials and other materials related directly to such
scheduled media. Limits of Liability: $5 million each loss/aggregate. Company: (b) (4)
(b) (4)

Group Travel Accident Insurance: Provides coverage for accidental death and dismemberment for staff
and volunteers traveling on business on behalf of an affiliate. Limits of liability: $5 million aggregate
limit per accident. $1 million emergency medical evacuation and repatriation Company: (b) (4)
(b) (4)

In addition, PPLM maintains Property Insurance and Workers Compensation Insurance policies.

Page 116 of 181

84

PSC-HHS-000116

Upload #3
Applicant:

Planned Parenthood League of Massachusetts, Inc.

Application Number:

FPH2015007161

Project Title:

Title X Family Planning Continuing Grant for Central Massachusetts

Status:

Awarded

Document Title:

ProjectNarrativeAttachments-Attachments-1236-PPLM Title X Project


Narrative Final 2015.pdf

PSC-HHS-000117

Page 117 of 181

I.

NEEDS ASSESSMENT

PPLMs Central Massachusetts (MA) Title X health centers serve more than 900,000 people,
approximately 14% of the Commonwealths population. Numerous family planning health status
indicators, including higher teen pregnancy rates, increased numbers of people living in poverty
and more people living with STDs, HIV, and AIDS, reveal a real need for continued and
additional services in Central MA. These indicators are particularly troubling given the
significant health disparities found among racial and ethnic populations. PPLMs long history of
providing services in Massachusetts, in addition to its success in implementing the Title X
program at its health centers in Fitchburg, Marlborough, Milford, and Worcester, make it poised
to continue to deliver high-quality care in the area.

A.

Geographic Description of Service Area

PPLMs four Title X health centers in Central MA serve Worcester County and western
Middlesex County, and are located in the more populous cities of Fitchburg (Worcester County),
Marlborough (Middlesex County), Milford (Worcester County) and Worcester (Worcester
County) (See Map 1). Fitchburgs population is greater than 40,000,1 Marlboroughs population
is greater than 39,400,2 Milfords population is greater than 25,0003 and Worcesters population
is greater than 182,500.4 Worcester County is the largest county in Massachusetts based on area5

U.S. Census Bureau (2013). State and County QuickFacts: Fitchburg, MA. Retrieved
November 1, 2014, from http://quickfacts.census.gov/qfd/states/25/2523875.html.
2
U.S. Census Bureau (2013). State and County QuickFacts; Marlborough, MA. Retrieved
November 1, 2014, from http://quickfacts.census.gov/qfd/states/25/2538715.html.
3
U.S. Census Bureau (2013). State and County QuickFacts: Milford, MA. Retrieved November
1, 2014, from http://quickfacts.census.gov/qfd/states/25/2541200.html.
4
See footnote 3.
5
U.S. Census Bureau (2014). U.S. Gazetteer Files. Retrieved October 5, 2014, from
http://www.census.gov/geo/maps-data/data/docs/gazetteer/counties_list_25.txt.
1

PPLM
Page 118 of 181

PSC-HHS-000118

and the second-most populous county in the Commonwealth after Middlesex County.6 Worcester
County includes more than 60 cities and towns, and when combined with Marlborough in
Middlesex County, includes a population of more than 900,000, which represents nearly 14% of
the population in Massachusetts. Although this region contains communities that are rural and/or
have lower population densities (mainly in the western and southwestern sections of the region),
the majority of Central MA's residents live in or adjacent to urban areas like those where
PPLMs health centers are located.
Map 1: Map of Massachusetts7

Many residents must travel considerable distances to access family planning services. Major
highways cross the county east-west (I-90/MassTurnpike) and north-south (Routes 190, 290 and
395). Modest bus service is provided in Worcester and adjacent communities by the Worcester

U.S. Census Bureau (2013). State and County QuickFacts. Retrieved October 5, 2014, from
http://quickfacts.census.gov/qfd/states/25/25027.html.
7
Galvin, W.F., Secretary of the Commonwealth (2014). Map of Massachusetts Counties.
Retrieved October 5, 2014, from http://www.sec.state.ma.us/cis/cispdf/County_Map.pdf.
Highlighting added to cities where PPLMs Title X health centers are located.
6

PPLM
Page 119 of 181

PSC-HHS-000119

Regional Transit Authority, in Marlborough and Milford by the Metro West Regional Transit
Authority and in Fitchburg by the Montachusett Regional Transit Authority.

B.

Demographic Description of Service Area

Between 2000 and 2010, Central MA has experienced the greatest population increase in the
Commonwealth.8 In Worcester County, Framingham and Marlborough, the total population
increased 5.7% (from 854,128 in 20009 to 905,369 in 201010). This rate of population growth is
expected to continue in the region well through 2030.11 Growth is attributed to a higher birth
than death rate and an increase in number of people moving to the area.12 In particular, there are
approximately 15% more 15 to 19 year olds coming to the region, which is partially attributed to
the many large institutions of higher education in the region.13 There is also a greater percentage
of people in their 30s, often families with young children, moving to the area.14

Populations of Focus
Based on the needs analysis and a review of the health disparities PPLM observes at its health
centers and in the community, PPLM will continue to direct attention and resources to serve and

Executive Office of Housing and Economic Development, Commonwealth of Massachusetts


(2014.). Central. Retrieved November 1, 2014, from
http://www.mass.gov/hed/economic/profiles/central.html.
9
U.S. Census Bureau (2000). Census. Retrieved November 1, 2014, from
http://factfinder2.census.gov.
10
U.S. Census Bureau (2010). Census. Retrieved November 1, 2014, from
http://factfinder2.census.gov.
11
Renski, H., Koshgarian, L. and Strate, S. (2013). Long-term Population Projections for
Massachusetts regions and Municipalities: Prepared for the Office of the Secretary of the
Commonwealth, UMASS Donahue Institute. Retrieved November 1, 2014, from
http://pep.donahue-institute.org/UMDI LongTermPopulationProjectionsReport 2013.11.pdf.
12
See footnote 11.
13
See footnote 11.
14
See footnote 11.
8

PPLM
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PSC-HHS-000120

connect with individuals with low- and limited income, diverse populations based on race,
ethnicity and English language proficiency, and adolescents. In Worcester County, Framingham
and Marlborough, nearly 51% of the population is female and 20% of these women are of
reproductive age (between the ages of 15 and 44 years of age).15 As the overall population is
increasing, the highest rate of growth is amongst 15 to 25 year olds, Blacks, Asians and
Hispanics/Latinos,16 and it is imperative PPLM focus on these communities as well as those who
have difficulty accessing and affording family planning services due to their limited income.

Individuals from Low-Income Households: PPLM will continue to reach out to and serve
those in need of family planning services who are living below the Federal Poverty Level (FPL)
and near poverty. More than 20% of all Worcester residents and 19% of Fitchburg residents live
below the FPL versus 11% of state residents overall.17 Poverty is disproportionately high among
Hispanics/Latinos, Blacks, and Asians. (See Table 1). In addition, in many towns and cities in
Central MA, more women are living below the FPL than the state average. (See Table 2).

2.8%

9.9%

7.5%

10.1%

4.5%

16.1%

14.0%

3.1%

6.5%

2.8%

8.6%

6.7%

8.0%

3.7%

13.2%

12.6%

2.4%

% Black

21.4%

16.6%

1.9%

41.1%

28.7%

30.9%

16.8%

1.5%

8.6%

4.7%

26.6%

2.0%

11.4%

15.9%

6.9%

% Asian

14.1%

20.8%

0.0%

12.2%

3.8%

0.2%

0.0%

1.1%

17.2%

8.0%

0.9%

6.2%

8.8%

21.9%

1.1%

% Hispanic

30.0%

41.1%

2.8%

32.8%

22.6%

9.0%

27.6%

6.2%

19.8%

18.3%

31.6%

12.5%

26.6%

37.7%

25.9%

Fitchburg

Webster

6.3%

12.8%

Southbridge

Marlborough

13.0%

7.1%

Shrewsbury

Leominster

9.6%

15.6%

Milford

Holden

19.1%

5.9%

Gardner

6.2%

18.8%

Framingham

20.1%

8.6%

Auburn

11.0%

% White

Worcester

% Total

MA

Grafton

Westborough

Table 1: Percentage of Population Living Below FPL in Past 12 Months by Race/Ethnicity


(2008-2012 American Community Survey 5-Year Estimates)18

See footnote 10.


16
See footnote 10.
17
See footnote 10.
18
See footnote 10.
15

PPLM
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PSC-HHS-000121

MA

Worcester

Auburn

Fitchburg

Framingham

Gardner

Grafton

Holden

Leominster

Marlborough

Milford

Shrewsbury

Southbridge

Webster

Westborough

Table 2: Percentage of Female Population Living Below FPL in Past 12 Months (2008-2012
American Community Survey 5-Year Estimates)19

% Total

11.0%

20.1%

6.2%

19.1%

9.6%

13.0%

6.3%

2.8%

9.9%

7.5%

10.1%

4.5%

16.1%

14.0%

3.1%

% Women

12.1%

22.0%

6.0%

18.2%

11.4%

15.7%

7.2%

3.1%

11.8%

8.0%

12.3%

5.1%

19.5%

1.7%

3.1%

Health Insurance Coverage: PPLM is fully committed to serving low-income clients,


consistent with all Title X requirements, and works to help clients enroll for health care
coverage. Despite Massachusetts health reform efforts and the implementation of the Affordable
Care Act, some residents of Central MA still lack health insurance or are in high-deductible
plans essentially rendering them self-pay clients for family planning services. In 2013, 19.4% of
PPLMs Title X clients reported to be uninsured, 35.7% reported to be covered by private
insurance, and 23.4% reported to be covered by public insurance. The rate of uninsured clients
has decreased over the years, and it is likely the percentage of clients lacking insurance may be
inflated by clients who report they do not have insurance due to confidentiality concerns.

Race and Ethnicity: The population growth among Asians, Blacks and Hispanics/Latinos, as
well as increases in immigrant populations in Fitchburg, Marlborough, Milford, and Worcester,
make reaching and serving diverse populations a priority. The percentage of the population that
identified as Black was 7.1% in 2000 and increased to 9.8% in 2010.20 The percentage of the
population that identified as Asian was 2.9% in 2000 and increased to 4.3% in 2010.21 Similarly,
the percentage of people who identified as Hispanic/Latino was 2.9% in 2000 and increased to

See footnote 10.


20
See footnote 10.
21
See footnote 10.
19

PPLM
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PSC-HHS-000122

4.3% in 2010.22 PPLMs Central MA clients reflect a similar diversity (see Table 3).
Table 3: PPLM Title X Health Centers Clients by Self-Identified Race and Ethnicity,
Client Demographics, 2010 and 2013

White
Black
Asian
Hispanic

2010
69.2%
6.6%
2.4%
19.7%

2013
66.8%
9.3%
3.5%
16.3%

There are many robust immigrant communities in Central MA as well. In both Marlborough and
Milford, there is a large population of people from Puerto Rico, Portugal, Ecuador, and Brazil.
Persons of Puerto Rican descent are the dominant Latino group in Central MA. Many
Hispanic/Latino, Black and Asian populations are also foreign-born. These population groups
face special barriers to learning how to navigate the U.S. health care system and may lack
language skills to do so. These immigrant populations are more likely to be living in poverty. For
example, in Worcester County, 12.4% of the foreign born population lives below the FPL versus
10.3% of the total population, and 18.8% of the foreign born population is between 100% and
199% of FPL versus 13.2% of the total population.23 In addition, cultural differences in
acceptance of family planning services often exist among certain communities, making it even
more important for appropriate education and outreach activities.

Limited English Proficiency: PPLM serves all people, regardless of English proficiency. In
many Central MA communities, many residents primarily speak a language other than English.
For example, in Framingham, 34.3% of residents do not speak English at home, and only 51.2%

22
See footnote 10.
23
See footnote 10.
PPLM
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PSC-HHS-000123

of these residents speak English well.24 Many of these residents live in linguistically isolated
households, as 11.6% of households do not include anyone aged 14 or older who speaks English
well.25 Similarly, in Marlborough, 23.5% of residents do not speak English at home, and 57.5%
of these residents speak English well.26 PPLMs Central MA health centers welcomes clients
whose primary language is Spanish (2.5%), Portuguese (2%) or other (2.25%). (See Table 4).
Table 4: PPLM Fiscal Year 2014 Clients by Primary Language, Client Demographics for
January 1, 2014 June 16, 2014
Fitchburg

Marlborough

Milford

Worcester

Total

English

98%

91%

84%

95%

92%

Spanish

1%

1%

7%

1%

2.5%

Portuguese

0%

4%

3%

1%

2%

Other

0%

1%

6%

2%

2.25%

Unknown

1%

3%

0%

1%

1.25%

Adolescents: The continued population growth among 15 to 25 year olds in Central MA makes
serving adolescents a priority for PPLM. The percentage of the population in the area aged 15 to
25 years increased from 12.3% in 2000 to 13.8% in 2010.27 Adolescents face unique challenges
in accessing family planning services and need confidential and affordable resources.

C.

Need for Family Planning Services

To continue serving high-need communities and reach even more vulnerable communities and
hard-to-reach people, PPLM will expand its educational outreach regarding its Title X services.

24
MetroWest Health Foundation (Summer 2012). Community Health Profiles. Retrieved
November 2, 2014, from
http://www.mwhealth.org/Portals/0/Uploads/Documents/Public/Special_Reports/Community_
Health_Profiles_Sept_2012.pdf.
25
See footnote 24.
26
See footnote 24.
27

See footnote 10.

PPLM
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PSC-HHS-000124

In particular, PPLM will provide services and education for:

more than 100,100 women in Worcester County who are in need of contraceptive
services, especially those who have low-incomes, are un- or underinsured, are
adolescents and/or are Black and/or Hispanic/Latino;

adolescents to reduce the high rates of teen pregnancy in Fitchburg, Marlborough,


Milford, and Worcester, especially amongst Hispanics/Latinos;

breast and cervical cancer screenings to help women seek treatment early;

all Central MA residents to reduce the high rates of STDs and HIV/AIDS, especially in
towns with higher incidences and among populations known to be at-risk.

Family Planning
While there has been a considerable decline in unintended pregnancy rates in the U.S., at least
37% of pregnancies are unintended.28 Unintended pregnancy rates for women with incomes at or
below the FPL are five times that of women at the highest income level.29 In Massachusetts, the
percentage of unintended pregnancies in 2010 was 18.6%, which is below the national rate and
within the Healthy People 2020 benchmarks.30 Despite this, great disparities exist for women
based on their age, income level and race/ethnicity. For example, 62% of unintended pregnancies
occurred for women aged 18 to 24 whereas only 14% of unintended pregnancies were to women

28
Kost K. (2013). Unintended Pregnancy Rates at the State Level: Estimates for 2002, 2004,
2006 and 2008. New York: Guttmacher Institute. Retrieved November 20, 2014, from
http://www.guttmacher.org/pubs/StateUP08.pdf.
29
Finer LB and Zolna MR (2014). Shifts in intended and unintended pregnancies in the United
States, 20012008, American Journal of Public Health, 2014, 104(S1): S44-S48. Retrieved
November 20, 2014, from http://www.guttmacher.org/pubs/journals/ajph.2013.301416.pdf.
30
Health Survey Program, Division of Research and Epidemiology Bureau for Health
Information, Statistics, Research, and Evaluation, Massachusetts Department of Public
Health. (March 2014). A Profile of Family Planning Among Massachusetts Adults, 20082010. Retrieved November 20, 2014, from http://www.mass.gov/eohhs/docs/dph/behavioralrisk/profile-family-planning-among-adults.pdf.
PPLM
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PSC-HHS-000125

aged 35 to 44.31 The unintended pregnancy rates were much higher for women aged 18 to 44
considered to be low-income: 31% of unintended pregnancies occurred to low-income women
versus 13% to women with higher-incomes.32 Black women experienced 39% of unintended
pregnancies, Hispanic/Latino women experienced 37% of unintended pregnancies and white
women experienced only 16% of unintended pregnancies.33

In Worcester County, there are an estimated 100,140 women aged 13 to 44 in need of


contraceptive services and supplies.34 Of these women, 4,860 are younger than 18 years old,
6,770 are aged 18 to 19, 40,050 are aged 20 to 29, and 48,470 are aged 30 to 44.35 Of the 88,510
women ages 20 to 44 who are in need of contraceptive services and supplies, 35% are below
250% of the FPL, and 15% are below the FPL.36 (See Table 5).
Table 5: Number of women aged 20 to 44 in need of contraceptive services and supplies, by
poverty status, 201037
State and
county

Total women needing


contraceptive supplies

<100% FPL

100-137%
FPL

138-199%
FPL

200-249%
FPL

Greater than
250% FPL

Massachusetts

778,300

108,140

34,520

61,750

51,780

522,110

Worcester

88,510

13,140

3,290

7,910

6,260

57,910

Teen birth rates have decreased over the years, but there are still significant disparities. For
example, Black and Hispanic/Latino teen birth continue to be more than two times higher than
the rate for white teens. 38 This remains true in Massachusetts where the teen birth rate is one of

See footnote 30.


32
See footnote 30.
33
See footnote 30.
34
Alan Guttmacher Institute (2014). Contraceptive Needs and Services, 2010 County-level Table
Maker. Retrieved November 20, 2014, from http://www.guttmacher.org/pubs/win/counties/#.
35
See footnote 34.
36
See footnote 34.
37
See footnote 34.
38
Centers for Disease Control and Prevention (June 9, 2014). About Teen Pregnancy. Retrieved
November 20, 2014, from http://www.cdc.gov/teenpregnancy/aboutteenpreg.htm.
31

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the lowest in the country yet the number of teen births in Central MA and for Black and
Hispanic/Latino teens is disproportionately higher. For Black teens in Massachusetts, the teen
birth rate was three times greater than white teens.39 For Hispanic/Latino teens, the rate was
almost seven times greater than white teens.40 In 2013, Massachusetts overall teen birth rate was
12 per 1,000 females aged 15 to 19, but the rate was significantly higher in many Central MA
towns.41 (See Table 6). In Framingham, 65.6% of teen births were to Hispanic/Latino mothers,
and in Worcester, 56.4% of teen births were to Hispanic/Latino mothers.42
Table 6: Trends in Teen Birth Rates (per 1,000 females ages 15-19 per city/town), Ranked
by 2013 Teen Birth Rate, Massachusetts, 2003, 2011, 201343

State
Rank

Municipality

Number
of Teen
Births

2003
Teen
Birth
Rate

Number
of Teen
Births

2011
Teen
Birth
Rate

Number
of Teen
Births

2013
Teen
Birth
Rate

State Total

4,639

23.0

3,480

15.4

2,732

12

Southbridge

37

68.6

28

49.0

25

43.8

14

Worcester

263

38.7

193

25.0

179

23.2

15

Leominster

43

35.5

27

20.6

30

22.9

17

Marlborough

24

27.7

22.4

26

22

21.4

18

Fitchburg

75

49.9

56

31.5

38

21.4

21

Framingham

38

19.9

31

13.2

32

13.6

PPLM is dedicated to providing high-quality family planning services to adolescents. Pregnancy


and giving birth cause many girls to drop out of high school. Approximately 50% of teen birth
mothers graduated from high school by 22 years of age compared to 90% who did not give birth

Freyer, Felice J. (December 12, 2014). Mass. teen birth rate at all-time low. The Boston Globe.
Retrieved December 19, 2014, from http://www.bostonglobe.com/metro/2014/12/12/teenbirth-rate-mass-reaches-historic-low-state-officialssay/C4wDQWGL1Os2wSlRvydXTN/story.html.
40
See footnote 39.
41
Massachusetts Alliance on Teen Pregnancy (2014). Trends in Teen Birth Rates for Selected
Massachusetts Communities, 2012. Retrieved November 18, 2014, from
http://www.massteenpregnancy.org/research/teen-pregnancy-and-birthrates?start=2011&end=2012.
42
See footnote 42.
43
See footnote 42.
39

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PSC-HHS-000127

during their teen years.44 Addressing teen pregnancy rates will address school dropout rates, a
significant contributor to cycles of poverty.

Over the years PPLM has served Central MA residents as a Title X provider, PPLM has been a
trusted provider, especially for adolescents. In the first half of 2014, 18.25% of PPLMs female
clients are between the ages of 15 and 19, and 14.5% of PPLMs male clients are between the
ages of 15 and 19. (See Table 7).
Table 7: PPLM Fiscal Year 2014 Female and Male Clients by Age, Client Demographics
for January 1, 2014 June 16, 2014
Female
15-17
18-19
20-24
25-29
30-34
35-39
40-44
45-49
Male
15-17
18-19
20-24
25-29
30-34
35-39
40-44
45-49

Fitchburg

Marlborough

Milford

Worcester

Total

10%
12%
37%
19%
10%
5%
4%
1%

7%
9%
32%
27%
13%
6%
2%
2%

6%
12%
27%
28%
13%
8%
3%
1%

6%
11%
38%
23%
11%
6%
2%
1%

7.25%
11%
33.5%
24.25%
11.75%
6.25%
2.75%
1.25%

2%
8%
29%
22%
12%
9%
5%
5%

2%
2%
27%
24%
17%
8%
4%
8%

1%
4%
35%
25%
16%
6%
4%
5%

5%
34%
26%
25%
6%
5%
3%
2%

2.5%
12%
29.25%
24%
12.75%
7%
4%
5%

Breast and Cervical Cancer


Breast and cervical cancer, if screened early and often, can be life saving for many women.
Breast cancer is the most common cancer for women. It is also the most common lethal cancer
for Hispanic/Latino women and the second most lethal cancer for white, Black, and Asian

See footnote 38.

44

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PSC-HHS-000128

women.45 Massachusetts has the third highest breast cancer incidence rates. In 2011, there were
135.5 incidences per 100,000 women compared to the national rate of 122 incidences per
100,000 women.46 While incidents and mortality trends for cervical cancer have decreased,47
screening is vitally important for prevention and treatment. Massachusetts has a cervical cancer
incidence rate of 5.2 per 100,000 women compared to the national rate of 7.5.48 Still, cervical
cancer screening rates remains low for many populations.49

STDs and HIV/AIDS


In many areas in Central MA, the rates of HIV/AIDS, chlamydia, and gonorrhea are significantly
higher than the state average rate. For example, the rate of those living with HIV and AIDS in
Worcester is 92% higher than the state average.50 The rate of those with chlamydia is more than
93% higher in Worcester than the state average, and the rate of those with gonorrhea is 111%
higher in Worcester than the state average. (See Table 8). Amongst 15 to 19 year olds, the rate of
those living with chlamydia is 61% higher in Worcester than the state average. (See Table 9).

45
Centers for Disease Control and Prevention (2014). Breast Cancer Statistics. Retrieved
November 18, 2014, from http://www.cdc.gov/cancer/breast/statistics/index.htm.
46
Centers for Disease Control and Prevention (2014). U.S. Cancer Statistics; 2011 Selected
cancers ranked by state. Retrieved November 18, 2014, from
http://apps.nccd.cdc.gov/uscs/cancersrankedbystate.aspx.
47
Centers for Disease Control and Prevention (2014). Cervical Cancer Trends. Retrieved
November 18, 2014, from http://www.cdc.gov/cancer/cervical/statistics/trends.htm.
48
See footnote 46.
49
Centers for Disease Control and Prevention (2014). Cervical Cancer Screening Rates.
Retrieved November 18, 2014, from
http://www.cdc.gov/cancer/cervical/statistics/screening.htm.
50
MassCHIP, Massachusetts Executive Office of Health and Human Services (2014). Health
Status Indicators. Retrieved October 6, 2014, from
http://www.mass.gov/eohhs/researcher/community-health/masschip/health-statusindicators.html#cities_towns.
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Auburn

Fitchburg

Framingham

Gardner

Grafton

Holden

Leominster

Milford

Shrewsbury

Southbridge

Webster

Westborough

HIV/AIDS

261

501.6

115.9

246.8

295.5

143.2

83.4

NA

163.8

131.9

79.9

81.4

177.1

172.1

85.2

Chlamydia
Gonorrhea

322.1
37.9

622.8
80.1

128.1
NA

286.3
22.2

330.5
24.4

200.4
23.9

208.5
NA

90.5
0

455.8
26.1

145.3
18.8

141.8
NA

150.7
NA

108.6
NA

326.4
NA

117.1
NA

Syphilis

11.7

9.4

NA

NA

9.1

NA

NA

NA

NA

MA

Worcester

Marlborough

Table 8: HIV/AIDS, Chlamydia and Gonorrhea rates51

*crude rates are per 100,000 persons

Fitchburg

Gardner

Grafton

Holden

Leominster

Marlborough

Milford

Shrewsbury

Southbridge

Webster

Westborough

1310.9

2109.6

NA

902.6

1901.3

698.7

1309.5

NA

1741.2

797

557.9

684.9

NA

2132.5

707.5

Gonorrhea

76.6

76.8

NA

NA

NA

NA

Framingham

Auburn

Chlamydia

MA

Worcester

Table 9: HIV/AIDS, Chlamydia and Gonorrhea rates, 15-19 year olds52

*crude rates are per 100,000 persons aged 15-19

STDs disproportionately impact Blacks and Hispanics/Latinos. In 2010, the rate of chlamydia
infection was 18 times higher in Blacks and 13 times higher in Hispanics/Latinos compared to
whites.53 Similarly, the rate of gonorrhea incidence was 16 times higher in Blacks and seven
times higher in Hispanics/Latinos compared to whites.54 A disproportionate number of people
living with HIV/AIDS are Hispanic/Latino and Black (See Table 10).

See footnote 50.


52
See footnote 50.
53
Massachusetts Executive Office of Health and Human Services (2010). STD Surveillance
Slides. Retrieved November 22, 2014, from http://www.mass.gov/eohhs/docs/dph/cdc/aids/stdsurveillance-slides-2010.pdf.
54
See footnote 53.
51

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PSC-HHS-000130

Table 10: People living with HIV/AIDS on December 31, 2012 by gender and
race/ethnicity55
Central MA

D.

MetroWest MA

Number

Number

Male
Female

983
615

62%
38%

1,886
742

72%
28%

White

675

42%

1,322

50%

Black

405

25%

907

35%

Hispanic/Latino

490

31%

330

13%

Current Services and Resources

Local Providers and Resources


The Massachusetts Department of Public Health (DPH) provides family planning funding to
PPLM to provide services in Central MA. Outside of Worcester, family planning services in the
area are fragmented and offer limited service hours, making it difficult to access for working
adults and adolescents who require more flexible evening and weekend hours.

Community and Statewide Networks, Partners and Resources


In addition to PPLMs four Central MA health centers, there are only six Community-based
Health Centers (CHCs) and a few other clinics providing primary care in the larger communities
in the region. (See Table 11). Additional family planning, reproductive health, and/or STD
resources and services in these communities include:

55
Massachusetts Executive Office of Health and Human Services (2013). Regional HIV/AIDS
Epidemiologic Profile of Central Health Service Region (HSR), Massachusetts. Retrieved
November 22, 2014, from http://www.mass.gov/eohhs/docs/dph/aids/2013-profiles/hsrcentral.pdf; Massachusetts Executive Office of Health and Human Services (2013). Regional
HIV/AIDS Epidemiologic Profile of MetroWest Health Service Region (HSR), Massachusetts.
Retrieved November 22, 2014, from http://www.mass.gov/eohhs/docs/dph/aids/2013profiles/hsr-metrowest.pdf.

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Framingham/Marlborough: Framingham Teen Pregnancy Prevention Coalition,


MetroWest Community Health Care Foundation, Marlborough Hospital; Marlborough
and Framingham Boys and Girls Clubs Smart Girls Program

Southbridge: Voices with Choices (You, Inc.)

Worcester: Girls Inc.s Preventing Teen Pregnancy Program, AIDS Project Worcester,
UMass Medical Center, DPH-funded family planning programs, United Ways Womens
Initiative, Common Pathways, and Edward M. Kennedy CHC
Table 11: Family Planning Services in Central MA

City/Town
Fitchburg

Framingham
Gardner
Leominster
Marlborough

Milford

Worcester

PPLM
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Family Planning Clinic(s)


PPLM Fitchburg Health Center
391 Main Street Fitchburg, MA 01420
67 Family Planning Hours Per Month
Hours: Monday: 10:00am 4:00pm
Thursday: 10:00am 7:30pm
1289 client visits projected
Montachusett Opportunity Council (funded
by Massachusetts DPH)
None
None
None
PPLM Marlborough Health Center
91 Main Street Ste. 103 Marlborough, MA
01752
69 Family Planning Hours Per Month
Hours: Wednesday: 10:00pm 7:30pm
Saturday: 8:00am 12:00pm
950 client visits projected
PPLM Milford Health Center
208 Main Street Ste. 101 Milford, MA 01757
69 Family Planning Hours Per Month
Hours: Tuesday: 10:00am 7:30pm
Friday: 10:00am 4:00pm
1160 client visits projected
PPLM Central Massachusetts Health Center
470 Pleasant Street Worcester MA 01609
244 Family Planning Hours Per Month
Hours: Monday: 8:00am 7:15pm

Community Health Centers


Fitchburg CHC

Edward M. Kennedy CHC Framingham


Greater Gardner CHC
Leominster CHC
None

Edward M. Kennedy CHC

Family Health Services


Edward M. Kennedy CHC Framingham
Hahneman Family Health Center
15

PSC-HHS-000132

Tuesday: 7:30am 3:45pm


Wednesday: 8:00am 7:15pm
Thursday: 8:00am 7:15pm
Friday: 8:00am 5:00pm
Saturday: 8:00am 2:00pm
Walk-in services available
5101 client visits projected

Plumley Village Health Services

Statewide services, which are available to residents in Central MA, include:

Massachusetts Alliance on Teen Pregnancy

AIDS Action Committee and Fenway Healths website and hotline (Maria Talks)

Massachusetts STD and HIV hotline (www.std411.org, 800-235-2331)

Massachusetts EC Network (www.massecnetwork.org)

Massachusetts Division of STD Prevention (www.mass.gov/dph/cdc/std)

Massachusetts Teen Health Resources website (www.urhealthstyle.com)

II.

ORGANIZATIONAL COMMITMENT, INFRASTRUCTURE, AND


SUSTAINABILITY

A.

Organizational Description and History

Founded in 1928 as the Birth Control League of Massachusetts, PPLM is a private, non-profit
organization and a statewide affiliate of Planned Parenthood Federation of America (PPFA).
PPLMs mission is to protect and promote sexual and reproductive health and freedom of choice
by providing clinical services, education and advocacy. (Appendix B: PPLM Articles of
Organization; Appendix C: PPLM By-Laws; Appendix D: Proof of Nonprofit Status). Last year,
PPLM provided more than 48,000 client visits at its seven health centers around the
Commonwealth; 25% of those visits were in Central MA. PPLMs Sexual Health Matters

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PSC-HHS-000133

PSC-HHS-000134

2020, the National HIV/AIDS Strategy (NHAS) and the CDCs Revised Recommendations for
HIV Testing of Adults, Adolescents and Pregnant Women in Health Care Settings. In addition
to clinical services, PPLM is committed to fulfilling its medical education and teaching mission.
PPLM, in partnership with Brigham & Womens Hospital, serves as a training site for a family
planning fellowship program.

PPLM is a leader in providing comprehensive sexual health education throughout the


Commonwealth. In 2014, PPLMs education programs are reaching a total of 36,000 young
people, parents and educators. The Get Real: Comprehensive Sex Education that Works is an
effective middle and high school program with a curriculum that delivers accurate, ageappropriate information and emphasizes healthy relationship skills and family involvement. To
date, it has been taught in 189 schools and organizations in Massachusetts and three additional
states. The program underwent a three-year evaluation by the Wellesley Centers for Women at
Wellesley College and the study was published in the Journal of School Health.56 It found that
16% fewer boys and 15% fewer girls had sex compared to their peers who were not in the Get
Real program. The program has been commended recently for being one of a few middle
school programs that reduces risky sexual behavior for both boys and girls.57

Grossman, J. M., Tracy, A. J., Charmaraman, L., Ceder, I. and Erkut, S. (2014).Protective
Effects of Middle School Comprehensive Sex Education With Family Involvement. Journal of
School Health, 84: 739747. doi:10.1111/josh.12199.
57
For recent press about the results of the Get Real program, see:
https://time.com/3525125/planned-parenthood-sex-education/;
http://www.youthhealthmag.com/articles/1574/20141026/sex-among-teens-get-realprogram.htm; http://www.bustle.com/articles/45718-planned-parenthoods-sex-ed-program-getreal-has-some-of-the-best-results-around-and-thats;
http://www.latinpost.com/articles/24232/20141026/real-comprehensive-sex-education-worksproves-delay-activity-teens.htm; https://time.com/3525125/planned-parenthood-sex-education/;
http://www.slate.com/blogs/xx_factor/2014/10/22/get_real_planned_parenthood_s_sex_ed_is_
better_than_abstinence_only_programs.html;
56

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18

PSC-HHS-000135

PSC-HHS-000136

PSC-HHS-000137

comprehensive and age-appropriate health education, and education reform. She is also
the author of the states anti-bullying law. In addition to her legislative experience, Ms.
Walz has held leadership positions at non-profit and public organizations including
Jumpstart for Young Children and Boston Public Schools. Her volunteer positions have
included serving on the Charles River Water Quality Commission, the Kingsley
Montessori School Advisory Council, the Womens Lunch Place Board of Directors and
Advisory Committee, and seven years on the NARAL Pro-Choice Massachusetts Board
of Directors. She holds a MPA from Harvard Universitys John F. Kennedy School of
Government, where she was a Kennedy Fellow and a Lucius N. Littaur Fellow. Ms. Walz
has a JD from New York University School of Law and a BA from Colgate University.
Ms. Walz regularly convenes an Executive Team comprised of the Chief Operating
Officer (COO), Chief Financial Officer (CFO), Chief Information Officer (CIO), Medical
Director, Vice President (VP) for Education and Internal Training, Chief Development
Officer (CDO), Director for Clinical Research and Training, VP of Human Resources and
Organizational Effectiveness, VP of Business Development and Director for Public
Affairs. The Executive Team implements the strategic and operational plans of the
organization and oversees management of day-to-day operations of health services,
education, advocacy, and clinical research and training.

Susan Lit, Chief Operating Officer: Susan previously served as the organizations
CFO. As CFO, Ms. Lit worked closely with medical and administrative staff, helping
them to navigate the complex world of health care finance. She developed new finance
dashboards for management reporting, managed a reorganization of billing operations
and introduced new processes for improving revenue cycle results. In November 2013,

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PSC-HHS-000138

Ms. Lit was promoted to COO and she oversees PPLMs Health Services and Clinical
Research and Training, Education and Internal Training, Information Systems and
Technology, and Business Development and Marketing. She oversees Title X financial
management and compliance, and works closely with (b) (4)

PPLMs

Controller, who manages accounting and financial reporting. She prepares documents for
the Board of Directors Finance Committee and Risk Management and Compliance
Committee, which hosts quarterly meetings. Both Ms. Lit and Ms. Chandler prepare for
PPLMs annual financial audit. Prior to joining PPLM, Susan contributed more than 20
years to publishing management.

(b) (4)

Medical Director: (b) (4)

joined PPLM in September

2011 as the Associate Medical Director. She assumed the position of Medical Director in
October 2012. (b) (4)

received her M.D. from the University of Miami School of

Medicine and completed her residency training in Obstetrics and Gynecology at Tufts
Medical Center. She then completed a fellowship in Family Planning at Boston
University where she received her MPH degree. (b) (4)

is an Assistant Professor in

Obstetrics and Gynecology at Tufts University School of Medicine where she serves as
the Director of Family Planning. Among her clinical expertise is second trimester
abortion provision, complex first trimester abortion, and contraception provision for
medically complicated women. (See Appendix F: Medical Director Job Description).

Deb Fenton, VP of Health Center Operations: Ms. Fenton joined PPLM in March
2005 as the Western Mass. Center Director. In October 2011, Ms. Fenton was promoted
to Regional Director of Central and Western Massachusetts overseeing five health
centers. In 2014, Ms. Fenton was promoted to VP of Health Center Operations

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PSC-HHS-000139

overseeing operations for all seven PPLM health centers. Prior to PPLM, she was the VP
of Community Services at the United Way of Pioneer Valley. In that capacity, she ran the
Volunteer Center and First Call for Help. Ms. Fenton also served as the chair of
Springfields Public Health Council during her tenure at the United Way. (See Appendix
G: VP of Health Center Operations Job Description).

(b) (4)

VP of Business Development: PPLMs recently completed strategic

plan identified the need for this new position begun in November 2014. Directly
responsible for developing more robust partnerships with primary care providers (PCPs),
higher education institutions, and other community-based organization, (b) (4)
joined PPLM from Health Leads, a non-profitorganizationthataddressesclients
socialdeterminationsofhealthbyprovidingcasemanagementservicestohospitals,
healthcenters,andhealthplans.Since2006,(b) (4)

helpeddevelopHealth

LeadsvisionandstrategyandestablishedlocationsinBaltimoreandBoston.He
wasresponsiblefornegotiatingpartnershipswithCHCsandhospitalsandsecured
governmentcontracts.HedevelopedaHealthLeadssponsoreduniversitycourse
andmanagedstrategicpartnerships.Duringhistenure,clientvolumegrewby50%
inthreeyearsinBoston.(b) (4)

volunteeredatPlannedParenthoodinOhio

duringhighschoolandcollegeandthenworkedasaLabTechnicianandthen
conductedhealtheducationtrainingforthePeaceCorps.

Leadership: Board of Directors PPLMs leadership is strengthened by its 30-member Board of


Directors. (See Appendix H: PPLM Board of Directors). Directors serve for three years, for up to
two terms, and participate in many active committees, including the following standing

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PSC-HHS-000140

committees: Finance and Audit; Risk Management and Compliance; Medical Quality and Patient
Service; Governance; Education; Development; and Executive. The Boards Governance
Committee actively recruits members for the Board of Directors based on the organizations
annual operating goals and strives to achieve a mix of gender, age, ethnicity, geography, and
professional expertise. Incoming Board Members receive an orientation, which is hosted on an
annual basis. A comprehensive review of Title X is incorporated into new Board members
orientations and the Board of Directors receive updates on Title X on at least an annual basis.

Leadership: Central MA Advisory Committee and Governing Board


The Central MA Advisory Committee (CMAC) is an advisory committee to PPLMs Board of
Directors. Members work with PPLM staff and volunteers to increase visibility in the region,
improve and expand reproductive health services, and advance comprehensive sexual education
and advocacy in Central MA. The full CMAC meets four times during the year and its subcommittees meet between meetings to advance the groups agreed upon objectives. (See
Appendix I: PPLM Central MA Advisory Committee).

Responsibilities of CMAC members include: attending quarterly CMAC meetings; participating


on one of four working subcommittees (Advocacy, Events, Nominating, or Outreach/I&E);
working with staff to identify and prioritize committee issues and objectives; recruiting new
PPLM supporters and volunteers; acting as an ambassador for PPLM in the community; making
an annual contribution to PPLM at a personally meaningful level; and supporting CMAC events.

Especially important for PPLMs Title X health centers is the Outreach Committee, which works
with PPLMs Central MA Health Center Director, (b) (4)

PPLM
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and the Fitchburg,

24

PSC-HHS-000141

Marlborough and Milford Center Manager, (b) (4)

The group builds and strengthens

relationships with community stakeholders to increase client volume, promote comprehensive


sex education in schools, and fulfill PPLMs Title X obligations related to materials review and
recruitment of new clients from the Title X priority populations.

III.

TITLE X SERVICES AND PROGRAM MANAGEMENT

PPLM built and continues to improve its organizational structure and program management
practices to ensure high-quality services that meet the Title X program requirements. In 2010,
PPLM leveraged its nearly 30 years of experience as a family planning provider in Central MA
to establish itself as a Title X service provider. Since the summer of 2010, PPLMs three new
health centers have reached an increasing number of clients each year and raised awareness
about the services offered in the communities where they are located.

PPLM projects 8,500 client visits (6,375 unique clients) in Grant Year 1 (2015-2016). (See Table
12). PPLM estimates a continued increase in the number of clients and visits based on its
experience in Central MA, population and demographic projections, its demonstrated ability to
provide high-quality family planning services, and its expanded plan for community outreach.
Table 12: Projected Number of PPLM Clients Visits, (April 2015 March 2018)
PPLM Title X Health
Center Location

Family Planning
Hours/Month

Projected Client
Visits/Year
Grant year 1 (April
2015-March 2016)

Projected Client
Visits/Year

Projected Client
Visits/Year

Grant year 2 (April


2016-March 2017)

Grant year 3 (April


2017-March 2018)

Fitchburg

67

1289

1350

1417

Marlborough

69

950

998

1047

Milford

69

1160

1218

1278

Worcester

244

5101

5356

5623

Total

449

8,500

8,922

9,365

45%

45%

45%

% of low income
(below 100% FPL)

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PSC-HHS-000142

PSC-HHS-000143

PSC-HHS-000144

PSC-HHS-000145

unresolved follow-up speaks with PPLM staff about next steps to resolve any issues. In this case,
PPLMs Patient Contact Center staff, Health Care Assistants (HCAs) or clinicians who have
contact with the client will try to address the issue(s).

In 2013, to further increase proficiency in breast health, PPLM participated in a PPFA-sponsored


Breast Health Initiative that was required for all APCs. This training addressed and reinforced
how to perform a breast cancer risk assessment and comprehensive clinical breast exam, how to
best document abnormal breast exam findings, and how to understand and interpret the BIRADS system of reporting breast imaging results. In-person trainings were delivered to all
PPLM APCs, and these trainings consisted of a five-course webinar and a related 30-minute
power point presentation from (b) (4)

a nationally recognized expert in breast care.

In addition, PPFA provided APCs with a self-study Breast Health Initiative Workbook. These
workbooks provided information on Breast Cancer Screening and Risk Assessment; Clinical
Breast Exam; Exam Documentation; and Interpretation of Mammogram findings. The workbook
contained resources such as algorithms to help in the management of breast conditions; an exam
competency checklist; a guide on establishing referral relationships; breast cancer information
resources; and client education principles.

Beginning in 2014, PPLM updated its audit calendar to increase the frequency with which breast
related visits are audited from once to twice a year in recognition of the importance of ensuring
PPLMs clinicians are providing the most up-to-date evidence-based care.

This past year, PPLMs health centers also participated in a benchmarking project in partnership
with PPFAs Clinical Quality Improvement department to increase cervical cancer screening
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Forty percent of PPLMs Call Center staff who make the initial appointment is bilingual. PPLM
has access to American Sign Language and language interpreters through the American
Translation Association and the Massachusetts Medical Interpreters Association. Bilingual staff
complete a language assessment for medical interpretation prior to acting as a medical
interpreter. Every effort is made to match LEP clients with staff who speaks their native
language. Documentation of interpreter services by staff is placed in the clients record. If a
client requests a friend or family interpret for her/him, then the client and friend or family
member must complete the Interpreter Consent Form which a PPLM staff member witnesses. Per
PPLM policy, a family or friend interpreter can only attend a visit at the recommendation of the
client. PPLMs Central MA Bilingual Parent Educator and Community Outreach Specialist,
(b) (4)

speaks Spanish proficiently and provides parent education and community

outreach to insure that PPLM reaches communities that can most benefit from family planning
services. Because of her strong ties to the Central MA community and non-profit providers, she
is an important internal resource for staff and clients.

4.

Laboratory Services

PPLM opened a high-complexity in-house laboratory in August 2009 to decrease client costs and
improve turnaround time for results. It processes chlamydia, gonorrhea, bacterial vaginitis, and
HCG blood tests for all PPLM centers, presenting a cost savings of 30% over PPLMs former lab
services provider. PPLM recently contracted for new lab equipment for chlamydia and gonorrhea
testing called (b) (4)

This new equipment speeds PPLMs turnaround time for testing by 50%

and increases capacity to handle more testing in the future. The health centers perform rapid
HIV, rapid pregnancy testing, urinalysis, hemoglobin, Rh, and glucose tests for clients on-site.

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is PPLMs Medical Director for the Laboratory and (b) (4)

(b) (4)

MT

(ASCP) serves as the Manager.

Quality control checks are conducted daily and weekly. All equipment is maintained and
inspected regularly. PPLM is enrolled in the American Proficiency Institute, which provides
proficiency testing to determine the performance of individual laboratories for specific tests or
measurements and is used to monitor laboratories continuing performance. PPLM also has lab
safety and infection control guidelines. PPLM complies with Occupational Safety and Health
Administration (OSHA) blood-borne pathogen standards and chemical hazard communication
standards. PPLM contracts with (b) (4) to provide laboratory analysis for syphilis, Pap smears,
herpes, Beta, and HCG. Criteria used to select and monitor outside labs includes quality,
references, reputation, efficiency, and cost. PPLMs lab manual includes training and orientation
of new personnel, procedures, quality control, tracking systems, and specimen collection.

5.

Pharmacy Services

PPLM provides clients the option to pick up birth control supplies and medications directly at the
health centers, including birth control pills, emergency contraception, patch, and ring.
Pharmaceuticals are packaged and labeled according to state law by licensed personnel including
mid-level clinicians and nurses with the requisite credentials. The Central MA Health Center
purchases contraceptives and pharmaceuticals based on an automated replenishment system
and/or a manual request through PPLMs centralized purchasing department, maintaining
quantities equal to 45 days usage. All pharmaceuticals used at each center location are approved
for use through a formulary system controlled by PPLM. All drugs and medical devices used are

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PSC-HHS-000151

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shows; reaches out to community partners, including school nurses, adolescent programs,
YWCA, WIC, (b) (4)

hosts forum nights at health

centers and community partners; and partners with (b) (4)

where PPLM

provided bags, along with Title X brochures, for customers making purchases and who might
benefit from PPLM family planning services. Other specific initiatives include:

Get Real Teen Council: PPLM engages teens and offers sexual health training to a
bilingual and culturally diverse group of 10th and 11th grade students who, in turn, train
their peers. In addition to educating teens about sexuality and healthy decision-making,
they learn about PPLM and Title Xs free and confidential health services. This year,
PPLM will train 13 teens from Central MA for this program who will train at least 500 of
their peers.

Parent Educators: PPLM conducts workshops parents to raise awareness about the
importance of family planning. In 2015, PPLMs parent educators training will include
an overview of PPLMs health services including contraceptive methods, emergency
contraception, STD and HIV/AIDS prevention testing and treatment, breast and cervical
cancer prevention screenings, and the HPV vaccine. Workshops will reach 900 parents
throughout Central MA through collaborations with social service agencies, health
centers, faith-based organizations, and schools. Also, PPLMs Manager of Parent
Education will conduct a two-hour professional training for 10 new Counseling and
Referral Hotline volunteers on how to talk with parents and teens who call the hotline
including explaining services for minors, the importance of parent-child communication,
and how to offer additional resources in family communication. PPLMs Seamos
Honestos parent workshops will also educate 450 bilingual parents and other caring

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cultural background of individuals served. Material review occurs annually and written
records of the committees determinations are kept in a signed binder.

Community Involvement and Input: To focus on community involvement, reflection,


and input, PPLMs Public Affairs and Health Center leadership integrated the previous
Information and Education (I & E) Advisory Committee responsibilities into the CMAC
Outreach Committees work. The Committee is comprised of PPLM staff (including
bilingual staff), community representatives, and Central MA Advisory Committee
members. The Committee currently has nine members and meets quarterly to discuss
ongoing efforts as well as discuss and brainstorm ways to improve access to populations
in need. They discuss and plan community activities, such as education open houses for
local agency staff members and tabling at health fairs. The Committee brainstorms what
community initiatives and agencies it should partner with, such as the Investing in Girls
Initiative in Worcester where PPLM has educated its outreach staff.

Community Partnerships: PPLM has established many relationships with PCPs, CHCs,
and other community partners and will continue to strengthen these under the leadership
of the new VP of Business Development. PPLM partners with the (b) (4)
(b) (4)
(b) (4)

PPLM is working with

(b) (4)

and planning to reach

out to (b) (4)

Recently, PPLM created partnerships with other organizations,

including (b) (4)


(b) (4)

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In addition, PPLM is leading an (b) (4)

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Commission on Accreditation of Allied Health Education Programs, and passing the National
Commission for Certification of PAs examination. PAs must have a supervising physician with
final responsibility for care, a State Controlled Substances registration number, and a DEA
registration number to prescribe controlled substances.

2.

Title X Program Management

PPLMs infrastructure for Title X program management will continue to support PPLMs
compliance with all Title X requirements. Responsible for all health center operations, the COO
oversees the program and the VP of Health Center Operations, who serves as the Family
Planning Manager, and co-chairs the Health Center Management Team (HCMT) with the
Medical Director. These staff ensure high-quality services are provided to all Central MA clients
and PPLM works to reach the goals outlined in the Project Work Plan.

Medical Directors Role, Function and Responsibilities


(b) (4)

serves as PPLMs Medical Director. (b) (4)

a board-certified

OB/GYN, leads PPLMs medical practice and is responsible for clinical care provided at all
PPLM health centers, including the four Title X centers located in Central MA. She advises the
President/CEO, COO, Medical Quality and Patient Service Committee of the Board of Directors,
and works in partnership with the COO to ensure safe, effective, and client-focused medical
services. (b) (4)

oversees all medical aspects of PPLMs clinical programs, including the

provision of Title X services. She also serves as the Director for the colposcopy and LEEP
programs; she supervises and advises the Director of Patient Services who supervises the Health
Services Directors (including the Central MA Title X Health Services Director) regarding the

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medical program, protocol development, and quality improvement; provides medical


consultation to clinicians regarding the clinical management of specific clients; and participates
in ongoing clinician in-service training. (b) (4)

provides client care at the Boston,

Worcester, and Springfield health centers, practicing alongside clinicians and reviewing cases.
(b) (4)

holds mandatory quarterly all-clinician meetings to discuss clinical and operational

issues, and she performs structured annual clinician observations. (b) (4)

acts as an in-house

consultant to clinicians and is available via phone and email anytime she is not available in
person, with clinical backup from on-call physicians and the Director of Patient Services. She is
responsible for ensuring PPLMs clinical practice guidelines and care are consistent with PPFA
medical standards and guidelines, as well as Title X regulations and guidelines. (b) (4)
leads PPLMs Quality Assurance program, performs direct observation at PPLMs health
centers, and completes periodic chart review. (b) (4)

is responsible for oversight of ongoing

management of quality efforts, including audits, compliance, and improving clinical practice.
(See Appendix F: Medical Director Job Description).

Title X Health Center Staff


In addition to the leadership noted above, many staff help lead PPLMs services in Central MA:

Director of Patient Services: (b) (4)

joined PPLM in May

2008 as a clinician in the Boston Health Center. In 2010, she began work as one of two
Quality Assurance Managers, while continuing to provide clinical services. In June 2013,
(b) (4)
(b) (4)

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assumed the position of Director of Patient Services. Previously, (b) (4)


worked as a full scope nurse-midwife at Cambridge Health Alliance and the

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Indian Health Service. She received her Masters Degree in Nursing from Yale
University School of Nursing with a specialty in nurse-midwifery.

Health Services Director: (b) (4)

serves as the Health

Services Director at the Central MA Health Center located in Worcester. She has been
employed with PPLM for 25 years and oversees services and Advance Practice Clinicians
at all of PPLMs centers in Central and Western Massachusetts. In conjunction with the
Medical Director, she has clinical oversight for clinical services in both regions. (b) (4)
(b) (4)

brings extensive family planning experience, has continuity with many clients

due to her tenure at PPLM and managed PPLMs previous Massachusetts DPH STD
grant. (See Appendix K: Health Services Director Job Description).

Central MA Health Center Manager, (b) (4)

joined

PPLM in January 2012 as the Center Manager for the Central MA Health Center.
Previously, she was the Center Director with Planned Parenthood of the Gulf Coast in
New Orleans and Baton Rouge and as a Family Planning Intern with Marie Stopes
International Pacific.

Health Center Manager: (b) (4)

joined PPLM in 2010 to supervise the

Fitchburg, Marlborough. Milford Title X health centers and in 2013, she began to oversee
the Title X FPER/FPAR data submission, including screening for accuracy. Prior to
PPLM, (b) (4)

worked at Cascap, Inc. where she managed clinical/rehabilitative

practices for residential group homes, including several independent housing units, for
chronically mentally ill adults. (b) (4)

also worked for the Devereux Foundation

where she ran two residential programs for adolescent males aged 14 to 22 with dually
diagnosed disorders (mental health and substance abuse).

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Quality Assurance Manager: (b) (4)

leads PPLMs quality

management, assurance, and evaluation activities. Prior to working at PPLM, (b) (4)
was a RN in Labor and Delivery as well as an OB/GYN practice at Beth Israel Deaconess
Medical Center in Boston. She joined PPLM in March 2009 as a RN in the Boston Health
Center. In 2010, she was hired as an APC and soon assumed a part-time role as one of
two Quality Assurance Managers while working as an APC. In June 2013, (b) (4)
became the full-time Quality Assurance Manager while continuing to practice as an APC.

Central MA Bilingual Parent Educator and Community Outreach Specialist: (b) (4)
(b) (4)

speaks Spanish proficiently and has strong ties to the Central MA

community. She joined PPLM in March 2014, and provides parent education and
community outreach to reach communities that can benefit from family planning
services. She also teaches PPLMs parent education program Lets Be Honest in
English and Spanish and directs outreach to agencies and organizations throughout
Central MA. She presents the Services Overview Training and provides information
about health services, education, and advocacy programs. (b) (4)

previously worked

as a Community Advocate and Case Manager at Friendly House Inc. in Worcester.

3.

Personnel Policies

General Personnel Policies


PPLMs position as a leader in providing high-quality family planning services is a result of its
employees' dedication, commitment, and experience. PPLM employs 236 full- and part-time and
per diem staff members. PPLMs four-person Human Resources Department is led by Nancy
Meegan, VP of Human Resources & Organizational Effectiveness. PPLM is very committed to

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recruiting and retaining staff that represent PPLMs diverse client base. PPLM participates in a
national Planned Parenthood affiliate applicant-tracking database, (b) (4)

that aids in

recruitment of qualified candidates. In addition, PPLM uses ADP as the organizations Human
Resources Information System (HRIS). PPLM also has a contract with labor attorney, (b) (4)
(b) (4)

of Mintz Levin, to consult on employment-related matters. PPLM reviews the

employee handbook and personnel policies at least annually and, if law or regulation mandates a
revision outside of the review cycle, makes an immediate adjustment. The employee handbook is
provided electronically to all employees, and all new employees participate in an extensive
orientation program to PPLM. (See Appendix L: PPLM General Personnel Policies).

New Hire Orientation, Trainings and Professional Development


PPLM invests considerable resources in training and education on its mission, clinical and
educational programs, and customer service approach. All new employees participate in PPLMs
New Hire Orientation and receive training on HIPAA, OSHA, diversity, Title X, and preventing
sexual harassment. PPLM added a six-hour training, called Jumpstart, for all new clinical staff.
Jumpstart is facilitated by PPLMs Internal Training Program, in partnership with subject matter
experts from the health center, and covers topics such as anatomy, protection methods, STDs,
and client safety. Jumpstart Day 2 is an additional six-hour training to ensure staff develop the
skills to address contraceptive efficacy, client preference, ease of use, and side effect profile.

PPLM employs (b) (4)

Manager of Internal Training, who oversees training and

professional development needs for the whole organization. Opportunities for learning on family
planning regulations and clinical protocols, including Title X, are priorities for staff. PPLM also

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utilizes the resources of the Regional Training Center, John Snow, Inc. (b) (4) in reviewing annual
staff needs, in addition to the wide range of information and resources available through their
website at www.famplan.org.

Clinical staff participate in regular case review to learn from real-life scenarios. On an annual
basis, they also receive updated training on STDs, CPR, and contraceptive methods. In addition,
PPFA and PPLMs insurance and risk management company, (b) (4)
(b) (4)

has extensive on-line training and webinars on a variety of topic areas

specifically developed for reproductive health practices. New clinicians undergo a period of
proctoring during which a supervisor monitors the clinicians skills and recommends specific
follow-up trainings. (See Appendix M: Clinician Skills Checklist). Trainings are available for all
checklist items and include a period of observation, supervised practice, and independent work
with chart review. As with all employees, clinicians undergo an annual performance evaluation.

Likewise, HCA training includes a period of observation, supervised practice and independent
work. Required HCA skills are documented in the HCA competency-training checklist. PPLM
has a career ladder for HCAs has been created to provide them with the opportunity to acquire
specific and advanced skills.

Professional Credentials and Licensure


PPLM is extremely proud of the quality, experience, and capability of its clinical staff, which
includes experienced physicians, Advance Practice Clinicians (NPs, Certified Nurse Midwives,
and PAs) and Registered Nurses (RNs). Both staff physicians at PPLM are board certified in
OB/GYN. Upon hire, and prior to being scheduled in the health center, physicians and mid-level

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clinicians must submit an active Massachusetts medical license, State-Controlled Substances


license, documentation of BCLS or Advanced Cardiovascular Life Support (ACLS) certification,
a federal Drug Enforcement Agency (DEA) registration number and other items required to be
cleared for clinical practice. RNs must maintain an active Massachusetts Nursing license and
certification in Basic Life Support.

Credentialing physicians and clinicians is handled through (b) (4)


verification service, and administered by (b) (4)

credentialing and

Hard copies of credentials are kept on file at

PPLMs Boston headquarters. PPLMs Senior Health Center Operations Coordinator tracks
license expirations and notifies the clinician whose license is coming up for renewal in advance
of license expiration. (See Appendix N: Provider Credentialing and Licensing Policy).

E.

Service Plans and Protocols

PPLM adheres to PPFAs medical protocols, which meet Title X guidelines, to ensure highquality, comprehensive, client-focused care for women, men, and adolescents. Education and
information are provided in an age-appropriate, confidential, non-judgmental manner. Clients
first point of contact when making an appointment at PPLM is often through the Patient Contact
Center where appointments and online appointment requests are centrally handled. The Center is
open six days a week and 40% of the staff is bilingual. Walk-in clients are welcome at all of
PPLMs health centers. Once clients enter the health center, they proceed to the receptionist to
check in for their appointment.

PPLM takes pride in the health center facilities, which are inviting and fully stocked with a

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Reporting is based on Massachusettss law and was recently updated to include human
trafficking. If indicated, PPLM staff consult with the Health Center Manager or lead clinician,
who files the formal report, at which time the COO is notified. The Massachusetts Department of
Children & Families receives the reports for any suspected abuse and neglect of a minor. The
National Human Trafficking Resource Center is also contacted if human trafficking is suspected
for a minor or an adult. PPLM adheres to state guidelines requiring an oral report be given within
the same day and a written filing within 48 hours. Every staff person is trained on this law at hire
and retrained annually. Copies of reports of suspected negligence or abuse (called 51As in
Massachusetts) are kept on file at PPLM.

Section 1008 Compliance


PPLM complies with Section 1008 and all other Title X rules and does not allocate any Title X
funds to the abortion practice at any of its three full-service health centers (located in Boston,
Springfield, and Worcester). PPLM utilizes the (b) (4)

Accounting System

and allocates and separates all expenses to cost codes designated as specific to abortion or family
planning/GYN services. PPLM can accurately track all cost center expenses and maintains
separate inventory for abortion and non-abortion services.

PPLMs Board of Directors has two committees (Finance and Audit and Risk Management and
Compliance) that oversee compliance with Section 1008 on behalf of PPLM. Risk Management
and Compliance Committee meets at least three times a year and receives reports on compliance
with PPLMs Title X program requirements. The Finance Committee meets at least quarterly and
reviews the Federal OMB A-133 audit and receives any reports on non-compliance in the Title X
program. The CFO reviews general ledger records monthly with regards to reimbursement and

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PSC-HHS-000170

PSC-HHS-000171

PSC-HHS-000172

and administrative systems are evaluated for necessary updates and changes based on the best
available clinical evidence, advances in systems management theory research, auditing and
monitoring techniques, and regulatory/medical/legal changes. PPLM developed its proprietary
Health Center Log System software to track clients from registration through completion of their
visits, allowing PPLM to set goals for staff efficiency at each point of the client visit. Throughput
time is monitored to establish goals for particular visit types and to ensure that staff are providing
consistent, efficient high-quality care. EHRs are also improving the quality of client care,
enabling clients to be seen at any PPLM health center, facilitating chart review and reporting,
and allowing for the capture of population-based data to improve services and identify trends.

PPLM health centers utilize a collaborative team approach that includes physicians, Advance
Practice Clinicians (NPs, nurse midwives, and PAs), RNs, and other staff who provide medical
services. New staff attend multiple days of orientation and in-service training, referred to as New
Hire Orientation and Jumpstart 1 & 2, as part of their onboarding process. During their
introductory period, staff receive trainings on topics including: Introduction to Title X;
Mandatory Reporting Laws; Human Trafficking; Services to Minors State and Federal Laws;
HIPAA: Protecting Patient Privacy; Medical Records Documentation; Birth Control Methods
and Contraceptive Efficacy including understanding client preference, ease of use and side effect
profile; and STDs.

In addition to this basic training, licensed staff undergo a period of supervised practice. To
ensure ongoing clinical quality, PPLM performs periodic chart audits using both PPLM designed
audits as well as (b) (4)
used by PPFAs (b) (4)

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a data collection/occurrence reporting/claim management tool


for over 10 years. These audits include, but are not limited to, Pap

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follow-up, colposcopy, and breast mass referral. PPLM supplements use of the (b) (4)

tool with

PPLM specific audit points determined by the Medical Director, Patient Services Director, and
the Manager of Quality Assurance based on areas identified for improvement of client care. One
of PPLMs goals is to revisit the (b) (4)

system to determine if it is possible to customize the

system to include the audit points during 2015.

Communication and Resolution of Identified Quality Issues and Documentation of Quality


Activities
A key communication venue for the Health Center Management Team (HCMT) is the monthly
meeting where PPLMs clinical and operation leaders discuss quality issues and determine
necessary changes. All changes are documented and communicated to the health center staff at
Site Management meetings that are held monthly within a day or two of the HCMT meeting.
This process insures timely, consistent communication about identified issues with a plan of
action communicated and operationalized at each center. Each health center holds a morning
brief and, when necessary, a mid-day brief to communicate important information to frontline
staff. At the end of the shift, staff debrief to communicate what went well and what could be
improved upon to increase client or staff satisfaction and overall workflow efficiency.

G.

Financial Management

1.

Billing and Collection Process

PPLM is committed to efficiently and effectively using public funds. PPLM collects fees for
family planning services from third party payers when applicable. PPLM receives reimbursement
for its family planning services by private insurance companies, Medicaid, Medicaid managed
care programs, state subsidized plans, the Massachusetts DPH, and clients.

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PSC-HHS-000175

Cost Analysis
PPLM analyzes cost of service by allocating costs to CPT codes. This includes analyzing the cost
of direct labor based on visit length; direct materials used based on actual usage; and overhead
and malpractice based on the appropriate relative value unit component promulgated by
Medicare. The cost per CPT code is multiplied by the visit volume and compared to the total
health center cost to validate the process. Charges are reviewed annually and updated as needed.

Sliding Scale Fees


PPLM creates its sliding scale fee schedules using the FPL guidelines published by HHS.58
PPLMs Patient Financial Services Department reviews the sliding fee scale on a semi-annual
basis and updates poverty levels annually. (See Appendix P: Household Income Sliding Scale
Fee Schedule). PPLM will remain out of compliance for discounts for clients in excess of 250%
of the FPL because PPLMs funding from the Massachusetts DPH requires the scale to be up to
300% of FPL. PPLMs current sliding fee scale is: Scale 1 (100% of FPL), the fee is zero; Scale
2 is 25% of the self-pay rate (up to 150% of FPL); Scale 3 is 50% of the self-pay rate (up to
200% of FPL) and Scale 4 is 75% of self-pay (up to 300%). With Title X funding, no one will be
refused services based on an inability to pay.

Clients receive a bill for services rendered at the end of their appointment. When considering
charges to minors, the following conditions are taken into account.

If the minor is not emancipated and confidentiality of services is not a concern, the
familys income is considered in determining the charge. If, however, the minor does not
know his/her familys income, PPLM assigns an estimated income to determine charges.

http://aspe.hhs.gov/poverty (22 November 2014)

58

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All clients with insurance are counseled that an explanation of benefits from the insurance
company may be sent to the insured. If the client is concerned about confidentiality, s/he is
advised that confidentiality is not assured when using insurance and clients have the option to
self-pay. Clients also sign an insurance waiver acknowledging they may receive a bill for
services if their insurance plan denies their claim for services.

2.

Financial Audit and Monitoring

PPLMs Board of Directors annually hires an independent accounting firm to audit PPLMs
financial records as of the June 30 fiscal year-end, in compliance with OMB Circular A-133.
(b) (4)

currently conducts PPLMs audit. At the conclusion of the

audit, the auditor reports the results to the Finance and Audit Committee of PPLMs Board. The
most recent A-133 financial audit for PPLM was completed in November 2014, and covers the
time period of July 1, 2013 to June 30, 2014 which encompasses the previous Title X grant
awarded to PPLM. It has been approved by the PPLM Board of Directors on December 2, 2014
and submitted to the Federal Audit Clearinghouse.

3.

Insurance and Risk Management

PPLM's insurance coverage is provided by (b) (4)

which is

designed to meet the many insurance needs of the affiliates. (See Appendix Q: Summary of
Insurance Coverage).

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Upload #4
Applicant:

Planned Parenthood League of Massachusetts, Inc.

Application Number:

FPH2015007161

Project Title:

Title X Family Planning Continuing Grant for Central Massachusetts

Status:

Awarded

Document Title:

Form Attachments-V1.1.pdf

PSC-HHS-000180

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ATTACHMENTS FORM
Instructions: On this form, you will attach the various files that make up your grant application. Please consult with the appropriate
Agency Guidelines for more information about each needed file. Please remember that any files you attach must be in the document format
and named as specified in the Guidelines.
Important: Please attach your files in the proper sequence. See the appropriate Agency Guidelines for details.
1) Please attach Attachment 1

PPLM Title X Appendices Final

Add Attachment

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2) Please attach Attachment 2

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3) Please attach Attachment 3

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4) Please attach Attachment 4

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5) Please attach Attachment 5

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6) Please attach Attachment 6

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7) Please attach Attachment 7

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8) Please attach Attachment 8

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9) Please attach Attachment 9

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10) Please attach Attachment 10

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11) Please attach Attachment 11

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12) Please attach Attachment 12

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15) Please attach Attachment 15

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PSC-HHS-000181

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(b) (4)

(b) (4)

PSC-HHS-000182

(b) (4)

(b) (4)

(b) (4)

PSC-HHS-000183

PSC-HHS-000184

PSC-HHS-000185

PSC-HHS-000186

PSC-HHS-000187

PSC-HHS-000188

PSC-HHS-000189

PSC-HHS-000190

PSC-HHS-000191

PSC-HHS-000192

(b) (4)

(b) (4)
(b) (4)

(b) (4)
(b) (4)

(b) (4)

PSC-HHS-000193

(b) (4)

PSC-HHS-000194

(b) (4)
(b) (4)

PSC-HHS-000195

(b) (4)
(b) (4)

(b) (6)
(b) (6)

(b) (6)

(b) (4)

(b) (6)
(b) (6)

PSC-HHS-000196

(b) (6)

(b) (6)

(b) (6)

(b) (4)

(b) (6)

(b) (4)

(b) (6)

(b) (6)

(b) (6)

PSC-HHS-000197

(b) (4)
(b) (4)

(b) (4)

PSC-HHS-000198

(b) (4)
(b) (4)

(b) (4)

(b) (4)

(b) (4)

(b) (4)

(b) (4)
(b) (4)

PSC-HHS-000199

(b) (4)
(b) (4)

PSC-HHS-000200

(b) (4)
(b) (4)

(b) (6)

(b) (4)
(b) (4)

PSC-HHS-000201

(b) (6)

(b) (6)

(b) (6)

(b) (4)

(b) (6)

(b) (4)

(b) (6)

(b) (6)

(b) (6)

PSC-HHS-000202

(b) (4)
(b) (4)

(b) (4)

PSC-HHS-000203

(b) (4)
(b) (4)

(b) (4)

(b) (4)

(b) (4)

(b) (4)

(b) (4)
(b) (4)

PSC-HHS-000204

(b) (4)
(b) (4)

PSC-HHS-000205

(b) (4)
(b) (4)

(b) (6)

(b) (4)
(b) (4)

PSC-HHS-000206

(b) (6)

(b) (6)

(b) (4)

(b) (6)

(b) (6)

(b) (4)

(b) (6)

(b) (4)

PSC-HHS-000207

(b) (4)
(b) (4)

(b) (4)

PSC-HHS-000208

(b) (4)
(b) (4)

(b) (4)

(b) (4)

(b) (4)

(b) (4)

(b) (4)
(b) (4)

PSC-HHS-000209

PSC-HHS-000210

PSC-HHS-000211

PSC-HHS-000212

PSC-HHS-000213

PSC-HHS-000214

(b) (4)

PSC-HHS-000215

PSC-HHS-000216

PSC-HHS-000217

(b) (4)

(b) (4)

(b) (4)

PSC-HHS-000218

PSC-HHS-000219

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