10 Colo. Code Regs. § 2505-10-8.749
Current through Register Vol. 47, No. 24, December 25, 2024
Section 10 CCR 2505-10-8.749 - NURSE HOME VISITOR PROGRAM8.749.1DEFINITIONSNurse means a person licensed as a professional nurse pursuant to § 12-38-102,C.R.S., et seq., or accredited by another state or voluntary agency that the state board of nursing has identified by rule pursuant to § 12-38-108(1)(a),C.R.S., as one whose accreditation may be accepted in lieu of board approval.
Nurse Home Visitors means registered nurses who provide targeted case management services.
Provider Agency means an agency that has met the Nurse Home Visiting Program provider requirements and has been certified by the Department of Public Health and Environment.
Targeted Case Management means services which will assist individuals in gaining access to needed medical, social, education and other services to promote healthy first pregnancies, improve the health and development of a woman's first child and to encourage self-sufficiency.
8.749.2PROGRAM DESCRIPTIONNurse Home Visitor Program (NHVP) means a program established pursuant to § 25-31-101,C.R.S. et seq., including the provision of targeted case management services to first-time pregnant women or whose first child is less than one month old and who are at or below 200% of the Federal Poverty Level. Services are offered through the child's second birthday plus one month.
8.749.3CLIENT ELIGIBILITYFirst-time (defined as no previous live births), pregnant women or whose first child is less than one month old and who are at or below 200% of the Federal Poverty Level are eligible for the NHVP.
8.749.4PROVIDER REQUIREMENTS8.749.4.A. A participating provider shall be: 1. Certified by the Colorado Department of Public Health and Environment; and2. Allowed to bill as a clinic including, but not limited to Certified Public Health Clinics, Federally Qualified Health Centers and Rural Health Centers.8.749.5PROVIDER RESPONSIBILITIES8.749.5.A. Targeted Case Management Services1. Providers shall provide Targeted Case Management services including: a. Assessment of the first time pregnant woman and her first child's needs for health, mental health, social services, education, housing, childcare and related services.b. Development of care plans to obtain the needed services.c. Referral to resources to obtain the needed services including medical providers who provide care to a first time pregnant woman and her first child.d. Routine monitoring and follow-up visits with the women where progress in obtaining the needed services is monitored, problem-solving assistance is provided and the care plans are revised to reflect the women and children's current needs.2. Providers shall document and chart Targeted Case Management activities and complete assessment and referral forms.8.749.6REIMBURSEMENT8.749.6.A. Monthly payments for Targeted Case Management shall be made for each child/family visited under the program. 1. Services to the mother shall be limited to 3 units per month with a lifetime maximum limit of 30 units.2. Services to the child shall be limited to 3 units per month with a lifetime maximum of 75 units.3. A different rate shall be calculated for each provider agency based on their actual historical cost and their projected budget for the next fiscal year.4. At the end of the fiscal year, payments will be reconciled with the actual costs for each agency based on agency cost reports, to assure that payment was not more than the actual cost of providing services. Overages shall be recovered.