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N. C. Dept. .of Environment, Health, and Natural Resources <br />Division of Maternal and Child Health <br />CONTRACT ADDENDUM <br />WH /Women's Prev. Health <br />Office, Section, or Branch <br />Orange Oounty Health Deparfixnt <br />Contractor <br />Page 2 of 2 <br />FY 1991 -92 <br />SISI <br />92 -439 -068 <br />.Contract Number <br />Family Planning <br />Activity <br />PY91 -92 OBJECTIVES FY91 -92 ASSESSMENTS* <br />3. TOTAL PERSONS TO BE SERVED (CON.) TOTAL PERSONS SERVED (CON.) <br />B. 900 PERSONS AGED 20 AND ABOVE PERSONS AGED 20 AND-ABOVE <br />WILL BE SERVED IN FAMILY PLANNING. WERE SERVED IN FAMILY PLANNING. <br />4. QUALITY_ASS_URANCE <br />A. 95 Y OF PERSONS SERVED WILL RE- <br />CEIVE MEDICAL FAMILY PLANNING SER- <br />VICES IN ACCORDANCE WITH THE GUIDE- <br />LINES FOR MEDICAL SERVICES. <br />B. AN ANNUAL SELF - ASSESSMENT WILL BE <br />CONDUCTED USING THE FAMILY PLANNING <br />QUALITY ASSURANCE TOOL. ** <br />SOURCE: FY92 CHARACTERISTICS REPORT <br />HBS 085, SUM OF TOTALS, COLUMNS 4 -9. <br />QUALITY ASSURANCE <br />A REPRESENTATIVE SAMPLE OF RECORDS <br />WERE REVIEWED USING PART II OF THE <br />FAMILY PLANNING QUALITY ASSURANCE <br />TOOL. <br />YES <br />NO <br />A SELF - ASSESSMENT WAS CONDUCTED <br />USING PART I OF THE FAMILY PLANNING <br />QUALITY ASSURANCE TOOL. <br />YES <br />NO <br />* ASSESSMENTS TO BE CONDUCTED BY DEHNR REGIONAL OFFICE STAFF WHEN FY91 -92 <br />HSIS REPORTS ARE AVAILABLE, ON OR ABOUT AUGUST 17, 1992. . <br />** LOCAL HEALTH DEPARTMENTS THAT DO NOT CURRENTLY RECEIVE TITLE X'GRANT FUNDS <br />(REFER TO FY92 FAMILY PLANNING BUDGETARY GUIDANCE) SHOULD CONTACT REGIONAL PRO- <br />GRAM STAFF WITH ANY QUESTIONS REGARDING THE APPLICABILITY OF ASSESSMENT ITEMS. <br />DEHNR 3300 (02 -91) <br />General Services (Review 02 -92) <br />Regional Review <br />. N m.6) 1 <br />Initial Date <br />DEHNR P & C <br />APR 2 21991 <br />