Effective Date: Upon approval by the Centers for Medicare and Medicaid Services (CMS).

     Description: TAKE CHARGE family planning services are available to men and women with incomes at or below two hundred fifty percent of the federal poverty level, with a goal of reducing unintended pregnancy.

     The objectives of TAKE CHARGE are:

•	Decrease the number of unintended pregnancies;

•	Increase the use of contraceptive methods;

•	Increase the availability of family planning services for low-income men and women; and

•	Raise the providers' awareness regarding the importance of client-centered education, counseling, and risk reduction to increase successful use of contraceptive methods.

     The TAKE CHARGE program is for both men and women. To be eligible, an applicant must:

•	Be a United States citizen;

•	Be a resident of Washington state;

•	Have an income at or below two hundred fifty percent of the federal poverty level;

•	Apply voluntarily for family planning services at the office or clinic of a TAKE CHARGE provider; and

•	Need family planning services but have no family planning coverage through a medicaid program.

     Clients who are pregnant, sterilized, in the military on active duty, or incarcerated are not eligible for TAKE CHARGE.

     Covered services for women:

•	An initial or annual comprehensive family planning preventive medicine visit with some limited STD screening.

•	Cervical, vaginal, and breast cancer screening at the time of the annual exam or as medically necessary.

•	Office visits directly related to a family planning problem, when medically necessary.

•	FDA-approved prescription and nonprescription contraceptives.

•	Sterilization.

     Covered services for men:

•	FDA-approved nonprescription contraceptive methods, including condoms and spermicides.

•	Education and counseling for risk reduction for those men whose female partners are at risk for unintended pregnancy.

•	Vasectomy.

     If you would like to provide official written comments or would like more information regarding the TAKE CHARGE waiver renewal, please contact the person named below by June 30, 2013.

     For additional information, contact Maureen Considine, ARNP, TAKE CHARGE Family Planning, P.O. Box 45530, Olympia, WA 98504-5530, phone (360) 725-1652, TDD/TTY 1-800-848-5429, fax (360) 664-4371, e-mail address Maureen.considine@hca.wa.gov.