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Children and Youth <br />Office, Section, or Branch <br />N.C. Department of Environment. Health, and Natural Resources Page 2 of <br />Division of General Services <br />CONTRACT ADDENDUM Fy 1992 <br />33x1 <br />9234-21-068 <br />Contract Number <br />QoMe_ k= Health Departuent <br />Conrractor <br />Child Health <br />Activiry <br />5. Persons enrolled in the Health Department's Child Health Program will be <br />provided the following services each time they receive a screening <br />assessment as documented in the medical records: <br />(a) An estimated 95 % will receive a health history (initial or interim) <br />which consists of at least 4 of the following 6 components: medical; <br />family; developmental /social; interim including review of systems; <br />immunizations, and present illness detail. <br />(b) An estimated 95 % will receive a physical examination which consists <br />of at least 14 of the following 16 components: blood pressure <br />(4 years of age); eyes (Red Reflex /Pupils); acuity; eye muscle <br />balance; ears (canals /drums); hearing; mouth; teeth /gums; heart; <br />lungs; abdomen; genitalia; extremities /hips; back /spine; skin, and <br />lymph nodes. <br />(c) An estimated 98 X will receive an age appropriate developmental <br />evaluation recommended in the attached SCHEDULE OF HEALTH SERVICES <br />FOR CHILDREN. <br />(d) An estimated 98 % of children will have weight for age, length /height <br />for age and weight for length /height plotted on an age and sex <br />specific growth chart. (Note: It is only appropriate to plot weight <br />for length /height for children less than 11 years of age.) <br />(e) An estimated 95 X will have a dietary recall or food frequency. <br />(f) An estimated 95 x will receive age appropriate laboratory services as <br />recommended in the attached SCHEDULE OF HEALTH SERVICES FOR CHILDREN. <br />(g) An estimated 90 X of those children that are high risk as defined on <br />page D--42 of the Child health Manual will be screened for lead <br />toxicity. <br />(h) An estimated 100 % of those children with suspected /identified <br />problems will be referred or receive consultation from an appropriate <br />source. <br />(i) An estimated 100 2 will receive appropriate counseling /anticipatory <br />guidance which consists of at least 3 of the following 7 components: <br />nutrition; dental; safety; emergency care; hygiene; signs and symptoms <br />of illness and behavior /developmental. <br />Reviewed by <br />DEHNR 3300 (Revised 2/90) elri L <br />General Sarvicea Division (Review 1/95) Initials Date <br />