Health Care

Community Clinics

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

Public Clinics

County or city-operated outpatient health care facilities that provide a broad range of diagnostic and treatment services including primary adult and pediatric care, prenatal care, dental care and specialty medicine as well as laboratory and radiological services and allied support services like nutrition and health education. Some public clinics may also offer public health services such as immunizations and communicable disease screening and treatment. Services are available on an ability-to-pay basis and target low-income and indigent residents of the community.

CHIP Programs

Organizations that help families obtain health insurance for their children under the State Children's Health Insurance Program (SCHIP), a program that is jointly financed by the federal and state governments and administered by the states. In some states, CHIP is an expansion of the Medicaid program and allows children of parents with higher incomes than were allowable in the past to participate and receive health insurance through Medicaid. In other states, CHIP is a separate program from Medicaid and covers children whose parents have incomes that are higher than the state's Medicaid eligibility levels. Within broad Federal guidelines, each state determines the design of its program, eligibility groups, benefit packages, payment levels for coverage, and administrative and operating procedures. The insurance pays for doctor visits, immunizations, hospitalizations and emergency room visits, but additional services may be available depending on the benefits defined by the state. Depending on the family's income, insurance premiums and co-pays may apply.

General Health Insurance Information/Counseling

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

Medicaid

A combined federal and state program administered by the state that provides medical benefits for individuals and families with limited incomes who fit into an eligibility group that is recognized by federal and state law. Each state sets its own guidelines regarding eligibility and services within parameters established at the federal level. Many people are covered by Medicaid, though within these groups, certain additional requirements must be met. Eligibility factors include people's age, whether they are pregnant, have a disability, are blind, or aged; their income and resources (like bank accounts, real property or other items that can be sold for cash); and whether they are U.S. citizens or lawfully admitted immigrants. Families who are receiving benefits through TANF and individuals who receive SSI as aged, blind and disabled are categorically eligible groups. The rules for counting a person's income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes, for people served under the Medicaid Waiver program, for people served by Program of All-Inclusive Care for the Elderly (PACE) programs and for children with disabilities living at home. Medicaid makes payments directly to a person's health care provider; and some recipients may be asked to pay a small part of the cost (co-payment) for some medical services. Most states have additional "state-only" programs to provide medical assistance for specified low-income persons who do not qualify for the Medicaid program.

Medicaid Information/Counseling

Programs that offer information and guidance for people who may qualify for Medicaid with the objective of empowering them to make informed choices. Included may be information about the eligibility requirements for Medicaid and how to apply; Medicaid Managed Care options, benefits covered (and not covered) by the program including long-term care and home and community-based services; the payment process for co-payments; Medicaid "spend-down" (the process of reducing income and/or assets an individual possesses in order to qualify for Medicaid); and information about Medicare and the linkages between the two programs. The program may also answer questions about Medicaid services available to individuals with disabilities; and some programs may help people who qualify with enrollment and provide referrals to providers who accept State Medicaid health insurance.

Medicare

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

Medicare Information/Counseling

Programs that offer information and guidance for older adults and people with disabilities regarding their health insurance options with the objective of empowering them to make informed choices. Included is information about benefits covered (and not covered); the payment process; the rights of beneficiaries; the process for eligibility determinations, coverage denials and appeals; consumer safeguards; and options for filling the gap in Medicare coverage (Medigap supplement insurance). Also available is information relating to an individual's eligibility for benefits and assistance with evaluating their options and enrolling in a Medicare plan (A, B, C, and/or D) that will best meet their needs. These programs also address coordination of benefits when beneficiaries have other types of health insurance in addition to Medicare (e.g. Medicaid, employer coverage or retiree insurance) and provide counseling and assistance regarding the subsidies that are available to low income beneficiaries enrolled in the Part D Prescription Drug Benefit (which help pay for Part D premiums and reduce the cost of prescriptions at the pharmacy) and the Medicare Savings Programs which help pay for Medicare out-of-pocket costs. They may also provide information about Medicaid and the linkages between the two programs, referrals to appropriate state and local agencies involved in the Medicaid program, information about other Medicare-related entities (such as peer review organizations, Medicare-approved prescription drug plans, Medicare administrative contractors), and assistance in completing related Medicare insurance forms.

Navigator Programs

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

Veteran/Military Health Insurance

Programs administered by the Department of Defense (DoD) Health Affairs Office or the U.S. Department of Veterans Affairs that provide health benefits coverage for eligible military personnel, eligible veterans and eligible dependents.

AIDS/HIV Clinics

Programs that provide comprehensive medical services on an inpatient or outpatient basis for people who have symptomatic or asymptomatic HIV infections or full-blown AIDS.

AIDS/HIV Prevention Counseling

Programs that provide counseling services for individuals at risk for contracting or transmitting the HIV virus with the objective of supporting their ability to make behavior changes that will reduce their risk of acquiring or transmitting HIV. Counseling involves a personal risk assessment, development of a personalized action plan and the decision to seek an HIV test. Individuals who have a history of injection drug use, sex with a person with HIV/AIDS, sex with a man who has sex with other men, sex with an injection drug user, a sexually transmitted disease, or exchanging money or drugs for sex are considered to be at high or increased risk and are targets for prevention counseling.

Childhood Immunization

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

COVID-19 Immunization Clinics

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

Flu Vaccines

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

Travel Immunizations

Programs that provide inoculations to prevent individuals who will be traveling outside the U.S., Canada and Europe from contracting infectious diseases such as typhoid, typhus, hepatitis A and B, malaria, dysentery or yellow fever.

Medical Care Expense Assistance

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

Mobile Health Care

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

Pregnancy/Childbirth Support Groups

Mutual support groups whose members are pregnant women or women who have had difficulties in areas relating to family planning, pregnancy and childbirth. Included are groups for individuals who are pregnant for the first time, women who are contemplating a home birth, breastfeeding women, families making decisions relating to birth control, women who have had a cesarean birth, women who are at high risk for a problem pregnancy and parents of premature or high-risk infants. The groups meet in-person, by telephone or via the Internet; and provide an opportunity for participants to share their experience, strengths and hopes, understand their relationships and work through related emotions.

Prenatal Care

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

Women's Health Centers

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

Prescription Drug Discount Cards

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

Prescription Drug Patient Assistance Programs

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

Prescription Expense Assistance

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

Psychiatric Medication Services

Programs that prescribe antidepressants, antianxiety drugs, antimaniacs, sedatives and antipsychotic/neuroleptic medications to control symptoms such as delusions, extreme agitation, panic attacks, manic or depressive episodes, hallucinations or paranoia that are associated with specific forms of mental illness. Services may include a psychiatric evaluation to determine the need for medication; prescription of an appropriate drug; and periodic follow-up to monitor the effectiveness of the medication in modifying the individual's behavior, ensure that undesirable side effects are minimized and verify that medication is, in fact, being taken as prescribed.

Emergency Room Care

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

Hospitals

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

Urgent Care Centers

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

Breast Examinations

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

Mammograms

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

Obstetrics/Gynecology

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

Pap Tests

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

Pregnancy Testing

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

Women's Health Centers

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

Child Abuse Medical Evaluations

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

Childhood Immunization

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

Cleft Lip/Palate Clinics

Programs that provide comprehensive diagnostic and treatment services for children born with cleft lip, cleft palate and other facial anomalies. Services are generally provided by a multidisciplinary team which may include lactation specialists who offer assistance with feeding problems; speech and language pathologists who offer advice on ways to encourage normal speech development and help the child with speech and language problems that may develop; audiologists and ear, nose and throat specialists (otolaryngologists) who provide services related to hearing and ear care; plastic surgeons who perform cleft lip/palate surgery; orthodontists and pediatric dentists who provide information about future dental needs; maxillofacial prosthedontists who replace missing teeth or develop appliances to improve speech; genetic counselors who help the family understand the origins of the problem; and social workers who provide assistance with coordination of services, information about hospitalizations, and referrals for parent-to-parent support.

Pediatrics

Programs that are staffed by specialists who are concerned with the physical, emotional and social health of infants, children and adolescents from birth to young adulthood. Pediatricians have advanced training in the biological, social and environmental factors that have an influence on a developing child and have expertise in diagnosing and treating the acute and chronic diseases that are common to individuals in this age range.

Well Baby Care

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

AIDS/HIV Clinics

Programs that provide comprehensive medical services on an inpatient or outpatient basis for people who have symptomatic or asymptomatic HIV infections or full-blown AIDS.

AIDS/HIV Prevention Counseling

Programs that provide counseling services for individuals at risk for contracting or transmitting the HIV virus with the objective of supporting their ability to make behavior changes that will reduce their risk of acquiring or transmitting HIV. Counseling involves a personal risk assessment, development of a personalized action plan and the decision to seek an HIV test. Individuals who have a history of injection drug use, sex with a person with HIV/AIDS, sex with a man who has sex with other men, sex with an injection drug user, a sexually transmitted disease, or exchanging money or drugs for sex are considered to be at high or increased risk and are targets for prevention counseling.

Blood Pressure Screening

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

Diabetes Screening

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

Genetic Testing and Screening

Programs that conduct tests of an individual's genetic material (DNA, RNA, chromosomes, proteins, and certain metabolites) to establish whether there are risk factors associated with particular diseases or disabilities, to help identify or exonerate individuals involved in criminal matters based on DNA evidence, or to establish paternity or maternity for legal or immigration purposes. Genetic testing generally involves individuals suspected of criminal activity or being at high risk for a disease or disability whereas genetic screening is conducted with a broader population about which risk factors are unknown.

Hepatitis Testing

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

HIV Testing

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

Pregnancy Testing

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

Tuberculosis Screening

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

Adoption Services

Programs that participate in arranging permanent homes under new legal parentage for individuals whose birth parents are unable or unwilling to provide for their care. Included are programs that provide counseling and assistance for people who decide to relinquish their children for adoption or arrange for an independent adoption; which recruit, select, counsel and match suitable adoptive parents with children who have been relinquished; which assist in the adoption of stepchildren, adults or foreign-born children; which provide foster care for children who have been relinquished for adoption but not yet placed; and/or which assist people who are adopted to locate their birth parents and birth parents to locate the children they relinquished.

Breast Examinations

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

Breast Self Examination Instruction

Programs that instruct women in the appropriate techniques for examining their breasts to detect changes that may be indicative of breast cancer.

Breastfeeding Support Programs

Programs that provide information and instruction concerning appropriate techniques for nursing an infant for expectant parents or new mothers.

Childbirth Education

Programs that offer classes or other educational experiences which prepare prospective mothers and their birth partners emotionally and physically for the labor and birth process. Topics covered include anatomy and physiology of birth, relaxation and breathing techniques, different types of labors, birthing/delivery options and postpartum care. Also included are programs that prepare other members of the family (grandparents and siblings) for the arrival of a new family member.

Crisis Pregnancy Hotlines

Programs that provide immediate assistance for pregnant women who are hiding their pregnancies, considering abandonment or experiencing other pregnancy related issues. Included may be short-term emotional support, an opportunity to discuss alternatives, adoption referrals if wanted, information about Safe Haven programs and other resources. Hotline staff are generally available via telephone, email, chat and/or text.

Genetic Counseling

Programs that apply what is known about human genetics to advise prospective parents who are concerned about the recurrence of hereditary problems or abnormalities in their offspring or for others (adults and children) who may be at risk for a variety of inherited conditions and need information about their own prospects for health. Genetic counseling is also routinely offered to women, usually age 35 and older, who are considering a first pregnancy. Genetic counselors identify families at risk, investigate the problem present in the family, interpret information about the disorder, analyze inheritance patterns and risks of recurrence and review available options with the family. They also provide supportive counseling to families, serve as patient advocates and refer individuals and families to community or state support services.

Genetic Testing and Screening

Programs that conduct tests of an individual's genetic material (DNA, RNA, chromosomes, proteins, and certain metabolites) to establish whether there are risk factors associated with particular diseases or disabilities, to help identify or exonerate individuals involved in criminal matters based on DNA evidence, or to establish paternity or maternity for legal or immigration purposes. Genetic testing generally involves individuals suspected of criminal activity or being at high risk for a disease or disability whereas genetic screening is conducted with a broader population about which risk factors are unknown.

Hepatitis Testing

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

HIV Testing

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

Obstetrics/Gynecology

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

Pap Tests

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

Perinatal Substance Use Disorder Treatment

Programs that provide comprehensive treatment services on a residential, outpatient or day treatment basis for pregnant women who have a substance use disorder, women who are parenting children, generally age three or younger, and/or women who have babies who were exposed to drugs and/or alcohol during pregnancy. Services may include individual and group counseling, 12-step meetings, social and recreational activities, educational and vocational services, life skills training, primary health care, perinatal health care, HIV testing and counseling, AIDS prevention, a program for family members, relapse prevention services, a continuing care program and a wide array of supportive services such as child care, transportation and parenting skills development. The objective of the program is to help these women restructure their lives so that they can handle their parenting responsibilities as well as remain alcohol and/or drug free.

Postabortion Support Groups

Mutual support groups whose members are women who are experiencing unresolved feelings including remorse, grief, guilt or anger as a result of having an abortion and want to talk about their physical and emotional issues in a supportive setting that enables them to benefit from the insights and companionship of others who have struggled with the same issue. Groups that have a religious context may stress prayer, Bible study and forgiveness as the path to healing. Others strive to provide a neutral, non-political, non-religious environment in which participants are free to discuss the abortion experience without fear of judgment or rejection. The groups may be open only to women who have had an abortion or may include their male partners, parents, grandparents, siblings, friends and others whose lives have been impacted by an abortion. Some groups also include women who are considering an abortion. Meeting formats may include in-person, telephone or Internet options.

Pregnancy Testing

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

Pregnancy/Childbirth Support Groups

Mutual support groups whose members are pregnant women or women who have had difficulties in areas relating to family planning, pregnancy and childbirth. Included are groups for individuals who are pregnant for the first time, women who are contemplating a home birth, breastfeeding women, families making decisions relating to birth control, women who have had a cesarean birth, women who are at high risk for a problem pregnancy and parents of premature or high-risk infants. The groups meet in-person, by telephone or via the Internet; and provide an opportunity for participants to share their experience, strengths and hopes, understand their relationships and work through related emotions.

Prenatal Care

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

Safe Havens for Abandoned Newborns

Hospitals, health centers, police stations, fire houses and other facilities that are willing to accept, without questions, newborn babies delivered by mothers who are unwilling or unable to care for an infant and are thereby at risk for abandonment. Police reports are generally not filed and no attempt is made to contact the mother's family, even in situations where her identity is known. Infant safe haven statutes vary by jurisdiction with regard to who may leave a baby at a safe haven, the age of the baby at the time of relinquishment, the facilities that can be designated as safe havens, the responsibilities of safe haven providers, anonymity protection for parents and the consequences of relinquishment.

Women's Health Centers

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

Dental Care Expense Assistance

Programs that pay the dental bills of people who are unable to obtain necessary dental care without assistance. Also included are programs that provide vouchers which enable eligible individuals to obtain dental care. Dental bill payment assistance programs may have age, income, disability, need or other eligibility requirements.

Dental Care Referrals

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

Dental Hygiene

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

Dental Prosthodontics

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

Dental Restoration

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

Dental Screening

Programs that provide dental examinations to detect tooth decay and periodontal problems, and oral hygiene information; but which refer out for cleaning, fillings, extractions and other necessary dental care.

Emergency Dental Care

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

Eye Care

Programs that are concerned with maintaining or improving the health of the eyes and their appropriate functioning as the organs of sight.

Eye Care Expense Assistance

Programs that pay the optometric or ophthalmologic bills of people who are unable to obtain necessary eye care without assistance. Eye care bill payment assistance programs may have age, income, disability, need or other eligibility requirements.

Eye Examinations

Programs that conduct a series of tests which measure an individual's visual acuity, identify refractive errors that cause poor vision and check for eye diseases such as glaucoma; and prescribe corrective lenses in situations where there are vision problems. Eye examinations are offered by optometrists and ophthalmologists and are usually available through mobile eye clinics.

Eye Screening

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

General Dentistry

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

Mobile Dental Care

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

Pediatric Dentistry

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

Special Care Dentistry

Programs that specialize in providing oral health care for individuals with medical conditions or disabilities who may require more than routine dental care to achieve and maintain good oral health. People who require special care may have genetic or systemic disorders that affect their oral health; may be undergoing medical treatments that cause oral problems; or may have mental or physical disabilities that complicate oral hygiene or treatment. The dental team may need to transfer a patient with cerebral palsy from the wheelchair to the dental chair, use some sign language to communicate with deaf patients, adapt oral hygiene devices so a patient can use them, develop a treatment strategy for a patient who has received an organ transplant, determine the best anesthetic alternative for a patient who has heart disease, or develop an oral health plan for a patient who must undergo treatment for cancer. Special care dentistry encompasses preventive, diagnostic, and treatment services.