Detailed Client Encounter Data Collection
Submit detailed client encounter data in a timely manner, in either paper or electronic format in accordance with the guidance provided by the Children and Families Section, BFH. In order to meet federal reporting requirements, all calendar year client encounter data shall be submitted to the State Agency within 15 days of the end of the calendar year.
Quarterly Certified Affidavit of Revenues and Expenditures
Submit the "Certified Affidavit of Revenues and Expenditures." Refer to the Fiscal Reporting Section. The source and amount of funds received during the reporting period that support activities within the scope of the grantee´s Title X family planning services grant shall be identified on the Certified Affidavit of Revenues and Expenditures. In order to meet federal reporting requirements, the final Certified Affidavit of Revenues and Expenditures shall be submitted to the State Agency within 60 days of the end of the grant period.
In order to advocate for increased funds, documentation is necessary to reflect pharmaceutical expenses on the "Certified Affidavit of Revenues and Expenditures."
Click the "Submit Form" button or email the "Certified Affidavit of Revenues and Expenditures" to Kevin Shaughnessy at KShaughnessy@kdheks.gov. State grant funds cannot be used to purchase Capitol Equipment.
Submit a completed "Family Planning Semi–Annual Report" covering the first six months of the contract. All sections of this report must be addressed: Encounter Time, Chart Audit, HIV Reporting, and Program Narrative. Include the Clinic Name and the name of staff preparing the report.
Submit the "Family Planning Semi–Annual Report" to Christina Flyntz at CFlyntz@kdheks.gov.
Submit a completed "Family Planning Semi–Annual Report" covering the last six months of the contract (See Mid–year, above for content) and a copy of the current family planning schedule of fees and discounts. The Family Planning schedule of fees and discounts must be established and implemented with sufficient proportional increments so that inability to pay is never a barrier to services. Charges (fees) must be based on a cost analysis of all required (core) family planning services provided by the project. Include the Clinic Name on the schedule of fees and discounts.
The Family Planning Semi Annual Report and schedule of fees and discounts should be submitted directly to the Family Planning Administrative Consultant (listed below).
Distribute a client satisfaction survey card to every 5th client (20 percent). Postage–paid cards are supplied to the local health agency by KDHE. The client completes the card and mails it to KDHE for review and feedback to the agency.
Program Contact Persons
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