FY 20 LHD Contract Training Public Health Prenatal Program

1. FY 20 LHD Contract TrainingPublic Health Prenatal Program Trina Miller, RN 3/15/19

2. Public Health Prenatal Program (PHPP) The PHPP has been revised to align with the implementation of the KY Public Health Transformation model. This includes the transition from direct patient services to population health. LHDs do not have to do or assure prenatal care. LHDs have 4 key roles and responsibilities.

3. Key Roles and Responsibilities of the LHDs • LHDs should assist with Pregnancy Presumptive Eligibility (PE) Enrollmentin Medicaid. • LHDs should be aware of prenatal providers within their community, and be able to provide pregnant women with list of providers and contact information. • LHDs should refer pregnant women to wraparound services such as HANDS, WIC, and referrals for smoking cessation, substance use, depression, domestic violence, etc. • LHDs will need to complete the Public Health Prenatal Program Reporting.

4. Funding • MCH will not provide funding for direct patient prenatal services. LHDs will need to identify a funding source other than MCH funds. • LHDs may choose to use Core Public Health Block Grant funds or other funding sources to provide direct services through an in-house prenatal clinic or to pay a contracted prenatal providerwhom they refer women to.

5. Optional LHD Services - Contracts • LHDs will not be required to contract with a prenatal provider. • If a LHD identifies prenatal services as a local public health priority, they may choose to provide services through an in-house prenatal clinic or contract with a prenatal provider to refer women to.

6. Contracts – DPH Recommendations • LHDs are encouraged to refer to ACOG guidelines and the current edition of Guidelines for Perinatal Carefor the provision of prenatal services. • The ACOG Antepartum and Discharge/Postpartum Form provide standardized documentation. • The ACOG website is https://www.acog.org/.

7. Contracts – DPH Recommendations • Standard Clinical Requirements • Facilities, supplies, and equipment align with the ambulatory obstetrical care standards as specified in the current edition of Guidelines for Perinatal Care. • Clinical equipment used at an in-house prenatal clinic is in proper working order, maintained and calibrated according to manufacturer’s directions, and is sufficient to provide basic screening tests.

8. Contracts – DPH Recommendations • Staff Requirements • Prenatal care must be provided by appropriately licensed or certified personnel acting within their legal scope of practice. ACOG recommends high-risk patients be seen by an obstetrician. • Advanced practice registered nurses caring for pregnant women operate within their scope of practice. • Registered nurses are not acceptable providers of medical care for the prenatal client, but may provide adjunct or support care in accordance with the Scope and Standards of the Kentucky Nurse Practice Act.

9. Contracts – DPH Recommendations • If a contracted provider utilizes staff from his/her own office for assistance while at the LHD working an in-house prenatal clinic: • The staff member should maintain a current professional license and be educated/trained to perform the designated functions in the LHD. • The functions, which the individual performs, should be clearly enumerated within the private physician's contract.

10. Contracts – DPH Recommendations • Billing and coding • The LHD is not required to pay for prenatal services. • If the LHD provides prenatal services or refers a woman to a prenatal provider, the LHD should inform the pregnant women in the language/manner (verbal, written) they understand, of what services she will be expected to pay for, if and what services the LHD will pay for, or if she should work with the prenatal provider for all billing matters. • The LHD should contact the Local Health Operations branch for coding questions.

11. chfs.ky.gov Trina Miller, RN Perinatal Nurse Consultant Phone: (502) 564-2154 ext. 4406