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WELCOME!
Healthy Start Prenatal
Screening Training
Direct Services
Program Components
• Universal prenatal and infant risk screening
• Healthy Start Care Coordination and
Wr...
Risk Screening
Florida Statute 383.14 - requires the screen
(questionnaire) to be offered to all pregnant
women at their f...
Monitoring
The Healthy Start Coalition
monitors screening rates of the county
and individual providers
and offers technica...
Benefits of Screening
Identifies risk factors which could increase a
woman’s risk of having a poor pregnancy
outcome
Ass...
More on
Screening
• The Prenatal Risk Screen is initiated at the first
prenatal visit
• The staff member completing the sc...
The Healthy Start
Program IS
A statewide, voluntary program available at
no cost to participants
Designed for prenatal w...
Healthy Start is NOT
It is Risk-Based
• Income-based
• A Medicaid program
• Based on immigration status
• Department of Ch...
Healthy Start
Care
Coordination
Three methods of referral to Healthy Start
1. Prenatal risk screen score of 6 or more
2. R...
Other Risk Factors for
Eligibility and Referral
• Prior fetal or infant loss
• Complicated medical conditions impacting
pr...
Self Referral
If the patient does not score a six or more or the
patient does not have any of the other risk
factors for e...
After a Referral
is Made
• Assignment to a Care Coordinator
• Initial Contact within 5 working days to
determine risk leve...
Healthy Start Care
Coordination
• Make contacts on a regular schedule based
on risk level (P, E, I, II, III)
• Provide edu...
Wraparound
Services
• Breastfeeding Education and Support
• Psychosocial Counseling
• Tobacco Education and Cessation
• Ch...
Length of Services
• Prenatal – up to 6-8 weeks post-partum
A client can be closed whenever services are
declined, transit...
Why Screen?
Screening benefits your patients!
• Helps identify women who are at risk for
having poor birth outcomes
• Prov...
Why Screen?
Florida Statute 383.14 - requires the screen to be
offered to all pregnant women at their first
prenatal visit...
Filling Out the Screen
The Prenatal Screen: Patient Sections
Not Married
Felt down or
depressed
Not Graduated
High School
The Prenatal Screen: Patient Sections
Black Race
Alcohol Use
Tobacco Use
Not wanting to be
Pregnant
First
pregnancy
Previo...
DEMOGRAPHIC INFO*
The Prenatal Screen: Patient Sections
Age less than
18
*Demographic information needs to be filled out r...
The Prenatal Screen: Patient Sections
CONSENT STATEMENT
SPECIFIC INFORMATION RELEASE
DECLINE STATEMENT
IF PATIENT DECLINES PARTICIPATION
IN SCREENING:
DECLINE STATEMENT
Provider Information Additional Screening Questions
The Prenatal Screen: Provider Section
The Prenatal Screen: Provider Section
BMI <19.8 or >35:
Chart located on back
of page 2
Interpregnancy Interval less than
...
The Prenatal Screen: Provider Section
2nd trimester entry
into prenatal care
Patient has an illness requiring
ongoing medi...
Scoring the Screen
A Positive Score is 6 or More
Scoring the Screen
Scoring the Screen cont’d.
Screening Score
Goes Here
Referral Options
Check “referred” if score
≥ 6 or referred based on
reasons other than score
If score 5 or less and
no oth...
“Yes” Required Fields
“Yes” Required Fields
“No” Required Fields
“No” Required Fields cont’d.
• Consent to the Healthy Start screen - This is done by
signing and dating the first statement
• Consent to release of inf...
Your Role Is Critical
• Ensure every pregnant women is offered the Prenatal Screen
at her first prenatal visit
• Encourage...
Reimbursement Tips
Reimbursement for the Healthy Start Prenatal Risk
Screen requires that the screening form is
consented ...
Reimbursement Tips
When the screen is consented and complete, the
recipient’s trimester of care should be referenced
and m...
How can we increase
consent?
Explain why the screen is important and how it is used.
• Help identify infants and moms that...
How can we increase
consent for the third
consent item?
Explain why consenting to releasing information
is important.
• We...
When she says yes, you can add:
“You are making a good decision to screen your new
baby. Even if you or your baby may not ...
If the patient is reluctant
to sign:
• Reinforce that this information is absolutely
confidential.
• Healthy Start follows...
If the patient doesn’t want the screen because she
doesn’t think she is at risk, let her know that our
Healthy Start Progr...
Discussing the results if the
prenatal score is 6 or more:
• Nurse, midwife, or doctor shares the score with the
mother an...
According to Florida State Statute, 383.14 (FAC
64-C), the health care provider shall assure that
the patient is informed ...
If at any time during pregnancy someone feels they may
need Healthy Start services, they can call 861-2905 to
talk to a Ca...
For more information…
Contact: Jamee Thumm
Education Coordinator
941.373.7070 ext. 307
jamee.thumm@healthystartsarasota.or...
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Hs prenatal screening training 2013 8 5-13

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Education on Healthy Start Prenatal Services, including screening and referral instructions.

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Hs prenatal screening training 2013 8 5-13

  1. 1. WELCOME! Healthy Start Prenatal Screening Training
  2. 2. Direct Services Program Components • Universal prenatal and infant risk screening • Healthy Start Care Coordination and Wraparound Services
  3. 3. Risk Screening Florida Statute 383.14 - requires the screen (questionnaire) to be offered to all pregnant women at their first prenatal visit (and all infants before leaving the delivering facility*) Training program for the Infant Risk Screening Process is also available from the Healthy Start Coalition of Sarasota County.
  4. 4. Monitoring The Healthy Start Coalition monitors screening rates of the county and individual providers and offers technical assistance as needed. Prenatal Screening Rate for Fiscal Year 2011-12 Sarasota County 96% Florida 81%
  5. 5. Benefits of Screening Identifies risk factors which could increase a woman’s risk of having a poor pregnancy outcome Assures early referral to Healthy Start for services Helps health care providers care for the “whole patient” Increases Healthy Start funding in the county
  6. 6. More on Screening • The Prenatal Risk Screen is initiated at the first prenatal visit • The staff member completing the screen must “offer” the screen and receive consent to conduct the screen • The staff member must review the screen results with the patient • Consent must be obtained to send the screen answers to Healthy Start
  7. 7. The Healthy Start Program IS A statewide, voluntary program available at no cost to participants Designed for prenatal women and infants Tailored to meet each individual’s needs and circumstances by providing referrals, information, and supportive services Confidential
  8. 8. Healthy Start is NOT It is Risk-Based • Income-based • A Medicaid program • Based on immigration status • Department of Children and Families
  9. 9. Healthy Start Care Coordination Three methods of referral to Healthy Start 1. Prenatal risk screen score of 6 or more 2. Referrals based on other factors 3. Self-referrals
  10. 10. Other Risk Factors for Eligibility and Referral • Prior fetal or infant loss • Complicated medical conditions impacting pregnancy, including HIV+, Hepatitis B+, thyroid or cardiac diseases, hypertension, diabetes, etc. • Current substance misuse or abuse – tobacco, drugs, or alcohol • Mother has severe depression or active mental illness • Current abuse or neglect in the home • Homelessness • Need breastfeeding classes or education
  11. 11. Self Referral If the patient does not score a six or more or the patient does not have any of the other risk factors for eligibility: The mother can call Healthy Start at 861-2905 to discuss her needs.
  12. 12. After a Referral is Made • Assignment to a Care Coordinator • Initial Contact within 5 working days to determine risk level and assets • A more in-depth assessment is scheduled if necessary. • Ongoing coordination of care commences as needed.
  13. 13. Healthy Start Care Coordination • Make contacts on a regular schedule based on risk level (P, E, I, II, III) • Provide education, support, and monitoring • Make linkages in the community • Make referrals for wraparound services if needed We have 9 Care Coordinators
  14. 14. Wraparound Services • Breastfeeding Education and Support • Psychosocial Counseling • Tobacco Education and Cessation • Childbirth Education • Nutrition Counseling • Parenting Education and Support • Interconception Education We have 8 Wraparound Service Providers
  15. 15. Length of Services • Prenatal – up to 6-8 weeks post-partum A client can be closed whenever services are declined, transitioned elsewhere, or when risks are resolved. A prenatal client remains in care coordination as long as services are necessary and the client is actively participating.
  16. 16. Why Screen? Screening benefits your patients! • Helps identify women who are at risk for having poor birth outcomes • Provides access to FREE services Good for your office! • A tool to learn about your patient’s history • Medicaid reimburses at a higher rate when the prenatal screen has been completed, especially in the first trimester
  17. 17. Why Screen? Florida Statute 383.14 - requires the screen to be offered to all pregnant women at their first prenatal visit by their prenatal care provider. It is the prenatal care provider’s responsibility to: • Administer the screen to the patient • Complete and score the screen correctly • Send the screen to the Health Department within 5 business days It’s the law!
  18. 18. Filling Out the Screen
  19. 19. The Prenatal Screen: Patient Sections Not Married Felt down or depressed Not Graduated High School
  20. 20. The Prenatal Screen: Patient Sections Black Race Alcohol Use Tobacco Use Not wanting to be Pregnant First pregnancy Previous Poor Outcome
  21. 21. DEMOGRAPHIC INFO* The Prenatal Screen: Patient Sections Age less than 18 *Demographic information needs to be filled out regardless of whether the patient consents or declines participation.
  22. 22. The Prenatal Screen: Patient Sections CONSENT STATEMENT SPECIFIC INFORMATION RELEASE DECLINE STATEMENT
  23. 23. IF PATIENT DECLINES PARTICIPATION IN SCREENING: DECLINE STATEMENT
  24. 24. Provider Information Additional Screening Questions The Prenatal Screen: Provider Section
  25. 25. The Prenatal Screen: Provider Section BMI <19.8 or >35: Chart located on back of page 2 Interpregnancy Interval less than 18 months: See question 15 for date last pregnancy ended
  26. 26. The Prenatal Screen: Provider Section 2nd trimester entry into prenatal care Patient has an illness requiring ongoing medical care
  27. 27. Scoring the Screen A Positive Score is 6 or More
  28. 28. Scoring the Screen
  29. 29. Scoring the Screen cont’d. Screening Score Goes Here
  30. 30. Referral Options Check “referred” if score ≥ 6 or referred based on reasons other than score If score 5 or less and no other risk factors exist, check not referred Enter reason referred if score <6; must meet eligibility guidelines!
  31. 31. “Yes” Required Fields
  32. 32. “Yes” Required Fields
  33. 33. “No” Required Fields
  34. 34. “No” Required Fields cont’d.
  35. 35. • Consent to the Healthy Start screen - This is done by signing and dating the first statement • Consent to release of information - This is done by stating initialing “yes” to the second statement* * If the patient states “no” to either of the above statements, she will not be able to access Healthy Start services. Recap: How can a patient begin to access services?
  36. 36. Your Role Is Critical • Ensure every pregnant women is offered the Prenatal Screen at her first prenatal visit • Encourage every pregnant woman to consent to be screened • Encourage every pregnant woman or new mother to participate in Healthy Start when:  Her answers indicate that either she or her baby may be high risk (score of 6 or above)  You, as the professional, think she or her baby would benefit from Healthy Start services Remember:
  37. 37. Reimbursement Tips Reimbursement for the Healthy Start Prenatal Risk Screen requires that the screening form is consented and complete. This means:  the patient has not declined the screen  the screening questions are answered  the form is signed, scored and referral status is indicated by the provider
  38. 38. Reimbursement Tips When the screen is consented and complete, the recipient’s trimester of care should be referenced and must correspond with the reimbursement code filed by the provider. If reimbursement is filed and received for a prenatal risk screen that is not consented or the recipient’s trimester of care and reimbursement code do not agree, then the provider will be expected to refund overpayment amount to Medicaid as well as other applicable fees
  39. 39. How can we increase consent? Explain why the screen is important and how it is used. • Help identify infants and moms that might need help. • It is so important that we are required by Florida Law to offer this screen to all new moms. • If you need help this allows Healthy Start to contact you. • Sometimes mom’s needs change, saying “yes” means Healthy Start can contact you if you need help later.
  40. 40. How can we increase consent for the third consent item? Explain why consenting to releasing information is important. • We need permission to share this screening info with Healthy Start. • All information is kept private and confidential. • Healthy Start only shares information that is needed for your or your baby’s care.
  41. 41. When she says yes, you can add: “You are making a good decision to screen your new baby. Even if you or your baby may not need services now, if you do in the future this helps getting you in Healthy Start more quickly.”
  42. 42. If the patient is reluctant to sign: • Reinforce that this information is absolutely confidential. • Healthy Start follows state laws and HIPAA guidelines. • The mother’s social security number is entered into the state data system regardless of consent to share the Healthy Start Screening Information.
  43. 43. If the patient doesn’t want the screen because she doesn’t think she is at risk, let her know that our Healthy Start Program gets additional funding from the state the greater the number of screens that are completed and consents to participate in Healthy Start. Altruism sometimes enhances consent. If the patient still refuses any aspect of screening, the demographic information, patient signature declining screen, and provider’s signature must be entered and the form is sent to the county health department.
  44. 44. Discussing the results if the prenatal score is 6 or more: • Nurse, midwife, or doctor shares the score with the mother and explains what the risks mean. • Tell about Healthy Start and the free services offered. • Let the patient know that a Care Coordinator will be contacting her soon to learn more about what services are needed. • Make sure the patient has authorized consent to contact and share information! • Please make sure the patient has brochures about the Healthy Start and the Infant Screen.
  45. 45. According to Florida State Statute, 383.14 (FAC 64-C), the health care provider shall assure that the patient is informed of her risk status as determined by the risk screening instrument. Remember!
  46. 46. If at any time during pregnancy someone feels they may need Healthy Start services, they can call 861-2905 to talk to a Care Coordinator. Patients can always call Healthy Start for more information about any of the services offered. If the patient wants more information:
  47. 47. For more information… Contact: Jamee Thumm Education Coordinator 941.373.7070 ext. 307 jamee.thumm@healthystartsarasota.org Visit the local Healthy Start Coalition website: healthystartsarasota.org Visit the Florida Dept. of Health info. website: www.healthystartbaby.com

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