N.H. Admin. Code § He-W 547.04

Current through Register No. 45, November 7, 2024

Section He-W 547.04 - Covered Services

The following services shall be covered when provided during a home visit:

(a) Newborn health assessment of the:

(1) Skin, including color, condition and birthmarks;

(2) Head, including fontanelles;

(3) Neck, including mobility;

(4) Eyes, including appearance, movement and evidence of sight;

(5) Ears, including evidence of hearing;

(6) Nose, including patency and septum;

(7) Mouth, including lips, mucosa, palate, and gums;

(8) Chest and lungs, including appearance, respiration, auscultation, and breasts;

(9) Heart, including rate and rhythm;

(10) Abdomen, including appearance, palpation, umbilicus, and femoral pulses;

(11) Skeleton, including upper and lower structure, and range of upper and lower motion;

(12) Genitourinary system, including genitalia, urine stream and circumcision;

(13) Back, including spine and anus;

(14) Neurological and behavioral systems, including general appearance, cry, motor system, reflexes, signs and symptoms of neonatal abstinence syndrome; and

(15) Weight;

(b) Maternal postpartum assessment services including:

(1) A determination of whether the following health characteristics and functions are within normal limits:

a. Diet;

b. Rest, activity, and exercise;

c. Breast feeding;

d. Abdominal cramping and tenderness;

e. Urinating and bowels;

f. Emotional response, including postpartum depression screening;

g. Bonding;

h. General appearance;

i. Blood pressure;

j. Temperature;

k. Heart and lungs;

l. Breasts and nipples;

m. Abdomen and fundus;

n. Perineum and episiotomy;

o. Lochia;

p. Wound care and healing; and

q. Substance use, including:

1.Alcohol;

2.Tobacco; and

3.Illicit and illegal drug use;

(2) Postpartum education including, but not limited to:

a. Family planning;

b. Breast care;

c. Hygiene;

d. Sexuality;

e. Perineal care for stitches and hemorrhoids;

f. Psychological adjustment and postpartum depression;

g. Exercising; and

h. Sleep safety measures;

(3) The provision of referrals to other community agencies as appropriate, including, but not limited to:

a. Supplemental nutrition program for women, infants and children (WIC);

b. Mental health services;

c. Domestic violence resources;

d Breastfeeding support;

e. Home visiting New Hampshire (HVNH) program for continued support;

f. Local Family Resource Center; and

g. Safe transportation programs to include car seat fitting; and

(4) The discussion of other health, social, or environmental concerns; and

(c) Parent or guardian education including:

(1) Nutrition, including:

a. Breastfeeding;

b. Preparation and storage of formula;

c. Feeding problems; and

d. Supplements;

(2) Behavioral issues, including:

a. Crying patterns;

b. Colic;

c. Consolability;

d. Sleep patterns;

e. Elimination; and

f. Individuality;

(3) Family relationships and interactions, including:

a. Parent/guardian-child;

b. Sibling rivalry;

c. Parent/guardian-to-parent/guardian; and

d. Relatives;

(4) Safety, and injury prevention, including:

a. Home environment including, but not limited to:

1.Fire safety;

2.Maintaining a smoke-free environment; and

3.Gun safety;

b. Use and placement of an appropriate infant car seat;

c. Poison control;

d. Safe water temperature;

e. Drowning;

f. Falling;

g. Crib safety, including safe sleeping environment;

h. Pets;

i. Sleep positioning and current safe sleep practices;

j. Choking;

k. Younger siblings;

l. Abusive head trauma, formally known as shaken baby syndrome; and

m. Sudden infant death syndrome (SIDS) risk prevention and sudden unexplained infant death safe sleep initiatives (SUID);

(5) Resources, including:

a. The supplemental nutrition program for women, infants and children (WIC);

b. Family planning programs;

c. Respite care;

d. Support from family and friends;

e. Mental health services;

f. Domestic violence programs;

g. Breastfeeding support services;

h. Home visiting programs for continued support;

i. Family Resource Centers, and

j. Programs that assist with car seat selection and fitting;

(6) Health promotion and related concerns, including:

a. Immunizations;

b. Rashes and jaundice;

c. When to call the newborn's primary health care provider for advice and concerns;

d. The importance of keeping appointments with the primary health care provider for the newborn's health check-ups, in accordance with the recommendations set forth in "Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents," 3rd edition, 2008, available as noted in Appendix A;

e. The medicaid program and the importance of maintaining continued medicaid coverage through the infant's first birthday;

f. Bathing and skin care;

g. Urinary tract infections;

h. Temperature taking;

i. The care of the umbilical cord and circumcision; and

j. Oral health care and the importance of bringing the child for his or her first dental visit with a dental provider no later than the child's first birthday, in accordance with the periodicity schedule contained in "Clinical Guideline on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance, and Oral Treatment for Children", of the American Academy of Pediatric Dentistry, 81 Reference Manual 2004-2005, Originating Committee- Clinical Affairs Committee, Review Council- Council on Clinical Affairs, adopted 1991, Revised, 1992, 1996, 2000, and 2003, available as noted in Appendix A;

(7) Identifying if the newborn is at risk for, or has, a nutritional problem or unstable housing;

(8) Ensuring follow-up appointments are scheduled with their primary health care providers; and

(9) Information regarding the child health assurance program, as described in He-W 546, Early and Periodic Screening, Diagnosis and Treatment Services.

N.H. Admin. Code § He-W 547.04

(See Revision Note at chapter heading He-W 500); ss by #6018, eff 4-1-95, EXPIRED: 4-1-03

New. #8446, eff 10-7-05; ss by #10428, eff 10-7-13