Family Planning Service Providers
Protocol
Documents
- Table of Contents
- Protocol Approval Signature Pages
- Title X Expectations
- Protocol Change Sheet
- PHD Staff Roles in the Provision of FP Services
- Summary of Protocol Revisions
Sections
- Section 1 - Guidelines for Clinical Services
- Section 2 - Contraceptive Methods
- Section 3 - Pharmacy PA Formulary
- Section 3 - Pharmacy PHO Formulary
- Section 4 - Laboratory
- Section 5 - Special Populations
Appendices
- Appendix A - PHD Emergency Medical Response Protocol
- Appendix B - Fee Collection Protocol
- Appendix C - Education Resources
- Appendix D - Staff Orientation
- Appendix E - Language ID Flashcard
- Appendix F - Referrals
- Appendix G- Part 1 - Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use, 2024
- Appendix G - Part 2 – MMWR U.S. Medical Eligibility Criteria for Contraceptive Use, 2024
- Appendix H- Part 1- U.S. Selected Practice Recommendations for Contraceptive Use, 2024
- Appendix I - Part 1 - MMWR Providing Quality Family Planning Services 2014 (QFP)
- Appendix I - Part 2 - QFP Update 2015
- Appendix I – Part 3 – QFP Update 2017
Forms
New Mexico Department of Health Family Planning Program forms can be found in the list below. All client handouts and information sheets are in English and Spanish.
NOTE: These forms are effective 10/2023.
Long-Acting Reversible Contraceptive Methods (LARCs):
- Contraceptive Implant – Consent Form
- Contraceptive Implant – Counseling Handout
- Contraceptive Implant – Post Insertion and Removal Instructions
- Paragard IUD – Consent Form
- Paragard IUD – Counseling Handout
- Levonorgestrel IUD – Consent Form
- Levonorgestrel IUD – Counseling Handout
Sterilization:
- Sterilization – Request Form
- Sterilization – Consent Form (scroll to bottom of webpage for current forms)
- Sterilization – Instructions for Request and Consent Forms
- Sterilization – Protocol and Review Form
- Sterilization – Counseling Handout
- Sterilization – Evaluation
Depo Provera (DMPA):
- DMPA – Counseling Handout
- DMPA – Perpetual Calendar
- DMPA – Sub-Q Disposal of Needles and Unused Medication Handout
- DMPA – Sub-Q Self-Injection Handout
Birth Control Pills and Combined Hormonal Methods:
- Birth Control Pills COCs – Counseling Handout
- Birth Control Pills COCs – Missed Pill Instructions
- Birth Control Pills – How to Start Taking Birth Control Pills
- Birth Control Pills POPs – Counseling Handout
- Birth Control Pills POPs – Missed Pill Instructions
- Vaginal Contraceptive Ring – Counseling Handout
Other Contraceptive Methods:
- ECP – Ulipristal Acetate Counseling Handout
- ECP – Progestin-Only Products Counseling Handout
- Condoms (External) – Counseling Handout
- Condoms (Internal) – Counseling Handout
- Lactational Amenorrhea Method (LAM) – Counseling Handout
- Contraceptive Spermicide (Film and Gel) – Counseling Handout
- Contraceptive Spermicide (Film and Gel) – Instructions
- Abstinence – Counseling Handout
Preconception and Pregnancy Handouts:
Other Clinic Forms:
- Educational Resources Order Form
- Educational Materials Sample 2022
- Documentation of Observed Family Planning Procedures
- Pregnancy Occurrences Report
- Acknowledgement of Abnormal Medical Condition
- Language Identification Flashcard
- Pharmacist Telehealth Consent Form
Fee Collection and Consent Forms:
New Mexico Title X Family Planning Updates & Reproductive Health teleECHO
Please see the 2023 Title X Protocol Update video for October 23, 2023.
Please see the 2023 Title X Protocol slides for October 23, 2023: 2023 Title X protocol slides, CDC's Contraceptive Guidelines, RHNTC Fee Collections
Please see the 2022 Title X Regulation and Protocol Update video for October 24, 2022.
Please see the 2022 Title X Regulation and Protocol Update slides for October 24, 2022.
Please see the 2021 Title X Regulation and Protocol Update video for December 13, 2021.
Please see the 2021 Title X Regulation and Protocol Update slides for December 13, 2021.
Staff Training
There are three Title X specific trainings that are required by the New Mexico Department of Health Family Planning Program (NMDOH FPP) for public health office staff and provider agreement staff depending on their function/license.
The term “all staff” refers to every person who works or has contact with Title X clients. This can include:
- Receptionists and Clerks
- Administrative Staff
- Clinic Staff (Medical Assistants, Medical/Medication Technicians)
- Licensed Staff (Clinicians, Nurses)
- Volunteers and Students
NOTE: Certificates of Completion/Training records must be maintained at each Public Health Office (PHO) and Provider Agreement (PA) site where the staff member works. Certificates/Training records may be requested for all Title X staff by NMDOH FPP during site visits.
| Required Training for all Title X staff | ||||
|---|---|---|---|---|
| Training Location and Organization | Course ID# | Course Number / Name | Timeframe for Initial Completion | Recertification Period |
| Train - NMDOH | 1110500 | Serving Minors and Mandatory Reporting | 30 Days of hire or delivering Title X services. | Annually |
| TRAIN - RHNTC | 1064964 | Title X Orientation: Program Requirements for Title X Funded Family Planning Projects | 30 Days of hire or delivering Title X services. | Every 5 Years |
| TRAIN - RHNTC | 109397 | Cultural Competency in Family Planning Care | 90 Days of hire or delivering Title X services. | Every 5 Years |
To access Train NM training (“Serving Minors and Mandatory Reporting”):
- Create an account on TRAIN New Mexico
- After creating the account, enroll and complete the “Serving Minors and Mandatory Reporting” training: Serving Minors and Mandatory Reporting training page
- Contact TRAIN NM directly if you have difficulties. TRAIN New Mexico Help
To access RHNTC trainings (“Title X Orientation” and “Cultural Competency” courses):
Instructions to link RHNTC Title X required trainings to your NMTRAIN account
- Create an account on Reproductive Health National Training Center (rhntc.org)
- After creating the account, follow the steps to enroll for:
- “Title X Orientation” eLearning page here: Title X Orientation: Program Requirements for Title X Funded Family Planning Projects eLearning
- “Cultural Competency” eLearning page here: Cultural Competency in Family Planning Care eLearning
- Again, be sure you are logged into your RHNTC account, prior to enrolling and completing the courses.
- Contact RHNTC directly if you have difficulties. Contact RHNTC
| Recommended Educational Resources for Title X Staff |
|---|
| NMDOH FPP 2021 Title X Orientation Non-Clinical Training (PHO Fee Collection information) |
| Putting the QFP into Practice Series Toolkit (rhtnc.org) |
| Reproductive Health National Training Center (rhntc.org) The Reproductive Health National Training Center is your go-to source for family planning and adolescent health training and technical assistance. |
| Clinical Training Center for Sexual and Reproductive Health (Formerly the NCTCFP-National Clinical Training Center for Family Planning) Since 2006, the Clinical Training Center for Sexual and Reproductive Health (CTC-SRH) has developed and delivered high-quality, evidence-based clinical training and shared skill development resources to Title X service providers. We have been funded by the Office of Population Affairs at the Department of Health and Human Services since inception. |
| Reproductive Health: teleECHO Clinic The Family Planning Program collaborates with the University of New Mexico Project ECHO and Department of Obstetrics and Gynecology to provide biweekly one-hour sessions, using interactive case-based learning and a 10-to-15-minute educational presentation with no-cost continuing educational credits. For more information (curriculum of topics and case submission form) and to sign up for webinar emails, please visit the Reproductive Health ECHO website link above. |
| Health Screening Resource Guide The Health Screening Resource Guide serves to provide clinical staff with an overview of screening tools, resources, and trainings that will promote equitable, inclusive, client-centered and trauma-informed care. It provides the opportunity for staff to become familiar with the various programs and resources within the New Mexico Department of Health and other state and national resources. The Resource Guide includes the following topics: Trauma-Informed Care, Alcohol Use, Substance Use, Tobacco, E-Cigarette and Vape Use, Motivational Interviewing, Interpersonal and Intimate Partner Violence, Mental Health and Depression, Suicide, LGBTQ+, and Pregnancy-Related Resources. |