EWL Providers

Who is eligible for services?

Every Woman's Life Provider Site Information

To view the map of Provider Sites click here.

To locate a Provider Site by city or county click here.

To view contact information for all EWL sites and the areas they serve click here.

Fact Sheets

• EWL Program Fact Sheet
• Breast Cancer Fact Sheet
• Cervical Cancer Fact Sheet

Forms/Manuals/Tools

• EWL Audit Tool
  • To access the EWL Audit Tool on Survey Gizmo click here.
  • To view and print the EWL Audit Tool PDF document click here.
  • To view and print the EWL Audit Tool Word document click here.
• Publication Order Form
• EWL Program Manual
  Click here to view and print the entire Program Manual
  

Recruitment

• Priority Populations
• Toll Free Referral Line

Eligibility and Enrollment

• Eligibility
• Federal Poverty Guidelines
• Client Participation Agreement
  • Attachment A_Client Participation Agreement_ENG
  • Attachment A_Client Participation Agreement_SP
  • Attachment A_Client Participation Agreement_KOR
  • Attachment A_Client Participation Agreement_VIET
• Client Transfers
  • Attachment B_Client Transfer Form

Services

• Client Education
• Cervical Services 18-39
• Breast Services 18-39
• Cervical Services 40-64
  • Attachment A_Breast & Cervical Screening Guidelines
• Breast Services 40-64
  • Attachment A_Breast & Cervical Screening Guidelines
  • Attachment D_CBE Core Competencies
• Managing Abnormal Cervical Results
• Managing Abnormal Breast Results
• Services for Women 65 Years of Age and Older
• Rescreening
• Referrals
  • Attachment E_Quit Line Fax Referral and Instructions
• Cancellation of Services

Case Management

• Case Management Needs Assessment
  • Attachment A_Case Management Assessment & Care Plan
• Case Management Care Plan
  • Attachment A_Case Management Assessment & Care Plan
• Tracking System
• Tracking and Follow-Up
  • Attachment B_Case Management Process Flow

Data Collection, Retention and Reporting

• Data Collection Forms
  • Attachment A_Breast Form
  • Attachment A_Breast Form Instructions
  • Attachment A_Cervical Form
  • Attachment A_Cervical Form Instructions
  • Attachment A_Eligibility Form
  • Attachment A_Eligibility Form_Spanish
  • Attachment A_Eligibility Form Instructions
• Technical Reporting Requirements
  • Attachment B_Monthly Screening Log
  • Attachment C_Matching Funds Form
• Medical Record Management

Reimbursement

• Reimbursement for EWL services
  • Attachment A_EWL Invoice

Treatment

• Breast and Cervical Cancer Prevention and Treatment Act (BCCPTA)
  • Attachment A_BCCPTA Application
  • Attachment B_Medicaid BCCPTA Policy
  • Attachment C_Medicaid FAQ Sheet
  • Attachment D_DSS Regional Program Consultants

Quality Assurance & Improvement

• Federal Performance Indicators
• State Performance Indicators
• Observational Site Visit
• Problem-Focused Site Visit/Call

Staffing

• EWL Provider Site Staff
• Training and Technical Assistance
• Community Health Worker Manual

Outreach and Education

Outreach Flyers

• EWL Outreach Brochure - 1, 2, Free
• EWL Outreach Brochure – 1, 2, Free - Spanish
• EWL Outreach Brochure – Of Course
• EWL Outreach Brochure – Of Course - Spanish
• EWL Outreach Flyer (black and white)
• EWL Outreach Flyer- Spanish (black and white)

Patient Recruitment Tool

EWL Clinic Flow Survey Results: Spring 2011

Patient Education Materials

• Common Breast Changes, Things to Know
• Common Breast Changes, Things to Know (Spanish)
• Screening Mammograms: Questions and Answers
• Breast Density FAQs
• Understanding Breast Changes
• Do It For Yourself, Do It For Your Family (Vietnamese)
• Cervical Cancer Fact Sheet

Provider Training

2012 EWL Orientation PowerPoint Presentation

Post-orientation assessment

Becoming an EWL Provider

How can I become a provider?