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Programs and Services

Information for Contracted Sites



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Counseling, Testing, and Referral Program

The following policies, procedures and program forms are applicable to all contracted counseling, testing, and referral (CTR) sites receiving reimbursement through the North Dakota Department of Health for HIV testing activities. These policies may or may not be applicable to other agencies involved in HIV testing.

Policies and Procedures

Supplemental Materials

Forms - All Paper Versions of Forms are Optional

  1. Risk Assessment Example

  2. Consent Form

Required Data Submission

  • Required Data Elements and MAVEN Guide - Coming Soon

  • MAVEN Website

  • PEMS Form - PDF -Coming Soon

 

Ordering Prevention Supplies

Please allow 1-2 weeks for delivery of prevention materials. Rapid tests will take longer, so allow 3-4 weeks when ordering these. Include your name since multiple orders may be received from your agency. Call 701.328.2376 if you have any questions.

Supplies Order Form

Mail or fax your order to:

RJ Jansen
2635 E. Main Avenue
Bismarck, ND 58506-5520
Fax: 701.328.2499

Request for Reimbursement

Beginning in January 2014, HIV counseling, testing and referral sites must submit for contract reimbursements using the North Dakota Department of Health Program Reporting System, or PRS. The PRS Reporting System is located at https://secure.apps.nd.gov/doh/prs/. If you do not have a login to the system, you will have to request one before access is granted.

 Call 701.328.4555 if you have any questions regarding the reimbursement.

HIV/Viral Hepatitis Prevention Reimbursement Form
Viral Hepatitis Linkage to Care and Vaccine Reimbursement

Current Staff
Title Current Staff Phone Number Roles and Responsibilities
HIV.STD.TB.Viral Hepatitits Program Manager Lindsey VanderBusch 701.328.4555 Contracts, Reimbursement
HIV.STD.Viral Hepatitis Prevention Coordinator Sarah Weninger 701.328.2366 Operations, Procedures & Policies
HIV.STD.Viral Hepatitis Surveillance Coordinator Lexie Barber 701.328.1059 Case Management, Data Reports
HIV.Viral Hepatitis Administrative Assitant RJ Jansen 701.328.2376 Ordering Supplies
MAVEN Coordinator Alicia Lepp 701.328.2385 MAVEN Passwords