(1) Family planning services may be provided by a physician in accordance with ARM 37.86.101 through 37.86.105, a nurse-practitioner in accordance with ARM 37.86.201 through 37.86.205 or a local delegate agency of the Family Planning program of the Department of Public Health and Human Services. Family planning services provided by a local delegate agency may include:

(a) annual visit;

(b) comprehensive history;

(c) initial physical examination;

(d) initial visit;

(e) laboratory services;

(f) medical counseling; and

(g) routine visit.

(2) "Annual visit" means a return visit at least once per year, following the initial visit, for a physical examination, laboratory services, and health history. The physical will include all examinations and services required for the initial physical. The laboratory services may include a urinalysis, hematocrit, and Pap test.

(3) "Comprehensive history" means a complete history of obstetrical/gynecological conditions, significant illnesses, disease, hospitalization, problems relating to previous contraceptive use, and relevant family health, psychiatric or social information which is recorded and maintained in the recipient's medical record.

(4) "Contraceptive supplies" means FDA approved intrauterine devices (IUD), spermicidals, barrier methods, implants, and oral contraceptives.

(5) "Local delegate agency" means a clinic receiving funding through the department under Title X, the Family Planning Services and Population Research Act of 1970, under the Public Health Services Act, 42 USC 300 et seq.

(6) "Initial physical examination" means an examination that may include the following procedures conducted at the initial visit of the recipient:

(a) thyroid palpation;

(b) inspection and palpation of breasts and axillary glands, with instruction to the recipient for self-examination;

(c) auscultation of heart and lungs;

(d) blood pressure;

(e) weight and height;

(f) abdominal examination;

(g) pelvic, including speculum, bimanual, and recto vaginal examination;

(h) insertion, fitting, or removal of an IUD or diaphragm; and

(i) implantation or removal of subcutaneous contraceptives.

(7) "Initial visit" means the first contact of the recipient and may include:

(a) initial comprehensive review of medical history;

(b) physical examination;

(c) information and education regarding contraceptive methods;

(d) ordering of laboratory services;

(e) prescription for contraceptive supplies;

(f) postexamination interview;

(g) any counseling rendered the day of the visit;

(h) insertion fitting or removal of an IUD or diaphragm; and

(i) implantation or removal of subcutaneous contraceptives.

(8) "Laboratory services" means the delegate agency ordered tests with specimen collection carried out by the provider.

(9) "Medical counseling" means counseling services provided by a physician, mid-level practitioner, or other medical professional under the supervision of the clinic's medical director regarding:

(a) preconceptual problems;

(b) problem pregnancies;

(c) HIV sexuality issues;

(d) sexually transmitted diseases;

(e) abnormal Pap smears;

(f) sexuality and the developmentally disabled client; and

(g) sterilization.

(10) "Routine visit" means a visit to provide contraceptive follow-up and monitoring and to correct any problems associated with utilization of medical services including treatment for vaginal infections. Medical revisit may be used for a return visit for a diaphragm, IUD, or subcutaneous device and includes the insertion, fitting, implantation, or removal of the device.