N.J. Admin. Code § 10:54-6.5

Current through Register Vol. 56, No. 19, October 7, 2024

Section 10:54-6.5 - Standards for a HealthStart comprehensive maternity care provider certificate

(a) HealthStart maternity care services shall be integrated and coordinated.

(b) HealthStart Maternity Care providers shall provide for comprehensive maternity care services, that is, maternity medical and health support services, as follows:

1. Providers shall provide directly or through approved agreements, at one contiguous site, the following services:

i. Ambulatory prenatal and postpartum care;

ii. Case coordination services;

iii. Nutrition assessment;

iv. Guidance and counseling services;

v. Health education assessment and instruction; and

vi. Social-psychological assessment, guidance and counseling.

2. Providers may provide just the Maternity Medical Care component as long as they have entered into a written agreement with a single HealthStart provider who shall provide the HealthStart Health Support services component. This agreement shall delineate which party shall take primary responsibility for the provision of all HealthStart services.

3. Independent clinics, hospital outpatient departments, home health agencies, and local health departments may provide just the HealthStart Health Support services component only when they have entered into a written agreement with a private practitioner(s) who shall provide the HealthStart Maternity Medical services component. This agreement shall delineate which party shall take primary responsibility for provision of all HealthStart services.

4. A separate certificate for each component will be issued by the New Jersey State Department of Health and Senior Services.

5. Two sites may be utilized only when one site for the provision of services is not feasible.

i. If two sites are utilized, a summary report, including pertinent findings, identification of problem(s), follow-up needs and amendments to the Plan of Care shall be communicated and documented between the case coordinator and obstetrical provider following each visit and postpartum.

ii. A case conference on each patient, including, but not limited to, the maternity medical care provider and case coordinator, shall occur whenever there is a change in the Plan of Care, but at least once a trimester.

(c) In addition to (a) and (b) above, the provider shall also:

1. Provide, or arrange for,the admission of patients to the hospital or birthing center which reflects the appropriate level for all obstetrical care delivery services;

2. Provide or arrange for all necessary laboratory services;

3. Coordinate and/or provide prenatal and postpartum home visits for each high risk patient when determined appropriate by the case coordinator, maternity medical care provider, and/or appropriate practitioner. These visits may be arranged through another provider under a purchase arrangement, or a letter of agreement but with no additional cost to the Division. The HealthStart Health Support services provider shall document the reports of the visits;

4. Adopt procedures and policies which assure the delivery of coordinated, integrated and comprehensive care;

5. Provide or arrange for the appropriate level of care for all obstetrical and medical services;

6. Provide and document referral and follow-up services, which shall include but not be limited to, referral for skilled nursing care services; specialized evaluation, counseling and treatment for extensive social, psychological, nutrition and medical needs; and

7. Be responsible for linking the mother and newborn infant to a pediatric care provider. If feasible, the linkage shall be with a HealthStart Pediatric Care provider.

N.J. Admin. Code § 10:54-6.5

Amended by R.2001 d.51, effective 2/5/2001.
See: 32 New Jersey Register 3929(a), 33 New Jersey Register 555(a).