{"id":229,"date":"2016-09-07T18:25:16","date_gmt":"2016-09-07T18:25:16","guid":{"rendered":"https:\/\/www.vdh.virginia.gov\/three-rivers\/?page_id=229"},"modified":"2026-04-27T15:34:57","modified_gmt":"2026-04-27T15:34:57","slug":"clinical-services","status":"publish","type":"page","link":"https:\/\/www.vdh.virginia.gov\/three-rivers\/clinical-services\/","title":{"rendered":"Clinical Services"},"content":{"rendered":"
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CALL FOR AN APPOINTMENT NOW!<\/a>\u00a0<\/strong><\/p>\n

Three Rivers Health offers immunization services for children, preteen\/teens, and adults at each county health department. Please call for an appointment and bring current immunization records, insurance cards, and proof of income to your appointment. Costs vary by vaccine depending upon any insurance coverage and income level. Providing proof of income level may reduce or eliminate your need to pay. (Proof of income = three months of pay stubs, a letter from employer stating salary, tax return from previous year.)<\/p>\n

Vaccinations play a critical role in\u00a0protecting the health of children,\u00a0families,\u00a0and\u00a0communities.\u00a0<\/span>VDH\u00a0strongly recommends that all children in the Commonwealth\u00a0be\u00a0vaccinated\u00a0in accordance with\u00a0the\u00a0<\/span><\/b>American Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule<\/span><\/b><\/a>.<\/span><\/b>\u00a0After thorough review of the\u00a0various schedules, our agency\u00a0believes\u00a0that\u00a0AAP\u2019s recommended\u00a0schedule\u00a0best\u00a0reflects the\u00a0existing\u00a0science\u00a0on\u00a0how to\u00a0optimally protect\u00a0Virginia\u2019s children and adolescents against\u00a018\u00a0vaccine-preventable diseases.\u00a0<\/span>\u00a0<\/span><\/p>\n

VDH\u00a0expects\u00a0healthcare providers to continue relying on their clinical training and professional judgement, and to\u00a0consult information published by\u00a0the\u00a0<\/span>American Academy of Pediatrics<\/span><\/a>\u202fand the\u202f<\/span>American Academy of Family Physicians<\/span><\/a>\u202fwhen engaging in shared clinical decision-making with parents, caregivers, and patients.\u202fVaccines\u00a0remain\u00a0widely accessible in Virginia\u00a0and\u00a0VDH expects Virginia healthcare providers to continue to offer these vaccines to children and adolescents.\u00a0As you know, a healthcare provider\u2019s recommendation\u00a0remains\u00a0one of the most powerful factors in a person\u2019s decision to receive a vaccine.<\/span>\u00a0<\/span><\/p>\n

INFANT\/PRE-SCHOOL\/SCHOOL AGE<\/strong><\/p>\n

Certain vaccines are\u00a0required<\/strong>\u00a0by the Code of Virginia for day care and school entry. These vaccines are provided by the health department without charge regardless of insurance status.<\/p>\n

School and Day Care Immunization Requirements in Virginia<\/a><\/p>\n

RABIES PRE-EXPOSURE AND POST-EXPOSURE VACCINE<\/a><\/strong><\/p>\n

Rabies is a preventable viral disease of mammals most often transmitted through the bite of a rabid animal. The vast majority of rabies cases reported to the Centers for Disease Control and Prevention (CDC) each year occur in wild animals like raccoons, skunks, bats, and foxes.<\/p>\n

The rabies virus infects the central nervous system, ultimately causing disease in the brain and death; therefore, any exposures should be evaluated promptly.<\/p>\n

PRE-EXPOSURE PREVENTION INFORMATION<\/strong><\/p>\n

Rabies pre-exposure vaccinations are recommended for certain people according to their risk of exposure which is often related to their job or hobbies. The series consists of three shots given in the arm. Contact your physician or local Health Department if you are interested in obtaining pre-exposure vaccine. The Health Department charges a fee for this service. Call for current prices.<\/p>\n

Rabies - CDC<\/a><\/p>\n

Rabies Prevention - Environmental Health<\/a><\/p>\n

POST-EXPOSURE INFORMATION<\/strong><\/p>\n

If you think you may have been exposed to rabies through a bite or scratch of an infected animal, consult your physician or the local health department as soon as possible. If it is determined that rabies post-exposure treatment is necessary, your doctor or the local Emergency Department will administer Human Rabies Immune Globulin at the site of the bite or exposure (not administered at the Health Department) and the first of four doses of Rabies Vaccine will be administered in your arm. You may also need a tetanus shot. You will then need to make arrangements for your next three shots. These shots are spaced out over the next two weeks.<\/p>\n

If you do not have insurance<\/u>\u00a0you can receive the remaining three doses of Rabies Vaccine at the Health Department. You will need to call for an appointment.\u00a0 The fee will be based on your income.<\/p>\n

If you have\u00a0previously received post-exposure vaccinations or received pre-exposure vaccinations\u00a0and have another exposure, only two doses of vaccine (one on the day of exposure and another 3 days later) are needed. Human rabies immune globulin is not required. Your doctor or local health department will be able to guide you through the process.<\/p>\n

When should I seek medical attention?<\/a><\/p>\n

What is the treatment if I\u2019ve been exposed to a rabid animal?<\/a><\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t

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Three Rivers' nursing team provides education and counseling about reproductive health including clinical assessment and birth control services to male and female clients using a client-centered approach. Services are available for insured and uninsured
\npatients on sliding scale income basis. Preexposure Prophylaxis services are offered to those clients at high risk for HIV.\u00a0 To access family planning services,\u00a0please contact your local health department<\/a>.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t

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The health department performs school entrance physical examinations for medically indigent children without charge. These examinations are done by appointment only.<\/p>\n

Enrollment in Virginia Public Schools and guidelines for school physicals<\/a><\/p>\n

Commonwealth of Virginia School Health Form<\/a><\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t

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Nursing Home and Community Based Care Pre-Admission Screening is a Virginia Medical Assistance funded program (Medicaid). It is a program designed to provide services in the home and\/or community for adults and children who would otherwise require nursing facility placement. If you or someone in your family needs nursing facility care or personal care in the home and cannot afford the cost, you may be eligible to have this service covered by Medicaid. For financial eligibility contact your local social services (DSS) for an application or apply for Medicaid online.<\/p>\n

Adult Screenings<\/strong><\/p>\n

Inquiries and requests for adult screenings should be directed to the Department of Social Services (DSS) in your county. A DSS intake worker will collect information concerning the request. A nurse from the local Health Department and an adult service worker from the local DSS office will then schedule a visit with the patient at their home to determine if they meet Medicaid\u2019s nursing facility criteria then this information is given to the local Health Department director. A decision is made as to whether or not nursing facility placement or personal care services in the home is the appropriate level of care to meet the patient\u2019s needs. The preadmission screening process may also be completed by a hospital screening committee if the person is in an acute care hospital at the time the placement is needed.<\/p>\n

Screenings for Children<\/strong><\/p>\n

Effective June 1, 2016, inquiries and requests for children\u2019s screenings should be directed to the Health Department. A Public Health Nurse will collect information and schedule a visit with the patient at their home. Medicaid assessment will be completed to determine the level of care the patient needs. If the level of care the patient needs meets Medicaid\u2019s nursing facility criteria then this information is given to the local Health Department director. A decision is made as to whether or not nursing facility placement or personal care services in the home is the appropriate level of care to meet the patient\u2019s needs.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t

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Tuberculosis (TB) is an infectious disease caused by germs that are spread from person to person through the air. TB usually affects the lungs; but it can also affect other parts of the body, such as the brain, the kidneys, or the spine.<\/p>\n

If you have symptoms that could be TB or have been in close contact with someone who has active TB disease, you should call your healthcare provider or\u00a0your local health department<\/a>.<\/p>\n

In addition to screening and testing individuals who may have been exposed to TB, the local health departments also investigate reports of suspected or verified TB cases within their jurisdiction. We provide case management services involving the patient, family, the managing physician, and the state TB Control and Prevention Program to ensure timely and appropriate treatment of TB disease in order to protect our communities.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t

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Supported by\u00a0CDC HIV Prevention<\/a>\u00a0and\u00a0Ryan White HIV\/AIDS Program<\/a>\u00a0Funds<\/h3>\n
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HIV\/AIDS MEDICAL CARE<\/h3>\n

Three Rivers Health partners with Eastern Virginia Medical School to provide medical care at the Gloucester health department. For eligibility information or an enrollment packet.<\/p>\n

Contact Gloucester Health Department
\n804-693-2194
\n<\/a>PO Box 663
\nGloucester, VA 23061<\/p>\n

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SUPPORT SERVICES<\/h3>\n

Three Rivers Health offers qualifying HIV+ individuals a variety of supportive services and resources to keep people living with HIV healthy and engaged in treatment. Services include:<\/p>\n