Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.38 - Healthy Start Program
Section 10.09.38.04 - Covered Services
Universal Citation: MD Code Reg 10.09.38.04
Current through Register Vol. 51, No. 19, September 20, 2024
Effective July 1, 2006, the Program shall reimburse for the following services:
A. Risk Assessment-Plan of Care.
(1) One unit of
service is to be reimbursed for each pregnancy.
(2) A risk assessment is an appraisal of the
participant's medical history and current health, nutritional, psychological,
and social status, as specified in the Healthy Start Risk Assessment
Instrument. It results in the identification of problems having an impact on
the outcome of the pregnancy and the subsequent health care status of the
child. Based on the assessment, an appropriate plan of care is drafted and
appropriate referrals are made. A copy of the completed Healthy Start Risk
Assessment Instrument will be sent by the provider to the participant's local
health department within 10 working days of the risk assessment.
(3) A plan of care is a description of the
services and resources required to meet the participant's needs identified
through the risk assessment. An individual participant's plan of care:
(a) Includes a description of the specific
action steps necessary to address each identified need;
(b) Matches the risk status of the
participant to the appropriate intensity and breadth of care;
(c) Describes the elements of care, provider
or providers, and facilities to be utilized by the participant;
(d) Is subject to modification as new
information arises during the course of care, including information
communicated from the provider of home-visiting services;
(e) Is individualized and is developed in
consultation with the participant; and
(f) Encompasses the continuum of care from
the prenatal period through postpartum.
B. Enriched Maternity Service. A maximum of one unit of service is to be reimbursed in conjunction with each prenatal and postpartum clinical visit of the participant. The following components comprise enriched maternity service:
(1) Prenatal and
postpartum counseling and education. This component shall include, but not be
limited to, the following topics:
(a) The
benefits and recommended schedule of prenatal visits, including routine
laboratory and radiological services;
(b) Danger signs of pre-term labor, including
how to differentiate between normal and abnormal signs and symptoms related to
pregnancy and what actions the individual should take;
(c) Preparation for labor and delivery,
including hospital registration procedures;
(d) The risks of using prescription and
over-the-counter medicines during pregnancy;
(e) The risks of alcohol, tobacco, and
controlled substance use;
(f) The
benefits of proper dental care;
(g)
The benefits of seat belt and infant car seat use;
(h) The importance of postpartum care and
continuing family planning services; and
(i) Arrangements for pediatric
care.
(2) Nutrition
education for pregnant and postpartum participants. This component shall
include, but not be limited to, the following topics:
(a) The relation of proper nutrition to a
healthy pregnancy and to a successful pregnancy outcome;
(b) Kinds and amounts of foods needed to meet
nutritional requirements during pregnancy;
(c) Appropriate weight gain during pregnancy,
and components of gain;
(d) Early
decisions about infant feeding practices;
(e) Benefits of, and preparation for,
breastfeeding;
(f) Appropriate use
of nutritional supplements, if prescribed;
(g) A postpartum woman's nutritional needs;
and
(h) The benefits of the Special
Supplemental Nutrition Program for Women, Infants, and Children
(WIC).
(3) Case
coordination and referral for pregnant participants. This component shall
include, but not be limited to, the following activities:
(a) Telephone reminders before prenatal and
postpartum appointments and follow-up telephone contact if the participant
misses an appointment;
(b) Referral
of the participant to the Special Supplemental Nutrition Program for Women,
Infants, and Children (WIC);
(c)
Referral of the participant to specialty services as indicated;
(d) Referral of the participant to high-risk
nutrition counseling as indicated;
(e) Referral of the participant to high-risk
obstetrician-gynecologist specialists, perinatologists, or other specialists
based on the client's medical needs;
(f) Arrangements for hospital delivery,
including delivery at a tertiary care maternity center as indicated;
(g) Arrangements for pediatric care;
and
(h) Assistance in arranging for
transportation to and from clinical services.
C. High-Risk Nutrition Counseling Services. These services are provided to nutritionally high-risk pregnant participants. Nutritionally high-risk pregnant participants are identified to the high-risk nutrition counseling services provider through the Healthy Start High-Risk Nutrition Instrument. The services include, but are not limited to, the following:
(1) Making a nutritional
assessment including the recording and interpretation of anthropometric
measurements, clinical and laboratory findings, medical conditions, nutrient
and drug interactions, diet history, and psychological, social, cultural,
religious, and economic factors affecting food intake;
(2) Developing a nutritional care plan based
on problems identified through the assessment and integrated into the total
plan of care;
(3) Determining
appropriate interventions to achieve care plan goals consistent with the
participant's culture, family composition, and restrictions imposed by income,
transportation availability, and neighborhood food resources, including, but
not limited to, counseling for food habit and behavior change, diet
modifications for medical conditions, and referral for food assistance;
and
(4) Monitoring and recording
participant's progress toward goal achievement.
Disclaimer: These regulations may not be the most recent version. Maryland may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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