Xxxx Management for High-Risk Pregnancy Sample Clauses

Xxxx Management for High-Risk Pregnancy. Population Identification and Engagement i. LHD shall review and enter all pregnancy risk screenings received from Pregnancy Management Program providers covered by the pregnancy care managers into the designated Care Management documentation system within five (5) Calendar Days of receipt of risk screening forms. ii. LHD shall utilize risk screening data, patient self-report information and provider referrals to develop strategies to meet the needs of those patients at highest risk for poor pregnancy outcomes. iii. LHD shall accept pregnancy Care Management referrals from non-Pregnancy Management Program prenatal care providers, community referral sources (such as Division of Social Services or WIC programs) and patient self-referral and provide appropriate assessment and follow-up to those patients based on the level of need. iv. LHD shall review available CFSP data reports identifying additional pregnancy risk status data, including regular, routine use of the Obstetric Admission, Discharge and Transfer (OB ADT) report, to the extent the OB ADT report remains available to LHD. v. LHD shall collaborate with out-of-county Pregnancy Management Program providers and CMHRP teams to facilitate cross-county partnerships to ensure coordination of care and appropriate Care Management assessment and services for all patients in the target population.
Sample 1
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Xxxx Management for High-Risk Pregnancy. Interventions i. LHD shall provide Care Management services in accordance with program guidelines, including condition-specific pathways, utilizing those interventions that are most effective in engaging patients and meeting their needs. This includes in-person Encounters (practice visits, home visits, hospital visits, community Encounters), telephone outreach, professional Encounters and/or other interventions needed to achieve Care Plan goals. ii. LHD shall provide Care Management services based upon level of patient need as determined through ongoing assessment. iii. LHD shall develop person-centered Care Plans, including appropriate goals, interventions and tasks. iv. LHD shall utilize NCCARE360 to identify and connect Members with additional community resources. v. LHD shall refer the identified population to childbirth education, oral health, BH or other needed services included in the Member’s CFSP Network. vi. LHD shall document all Care Management activity in the Care Management documentation system.
Sample 1
Xxxx Management for High-Risk Pregnancy. Integration with the CFSP and Health Care Providers i. LHD shall assign a specific care manager to cover each Pregnancy Management Program provider within the county or serving residents of the county. LHD shall ensure that an embedded or otherwise designated care manager has an assigned schedule indicating their presence within the Pregnancy Management Program. ii. LHD shall establish a cooperative working relationship and mutually agreeable methods of patient-specific and other ongoing communication with the Pregnancy Management Program providers. iii. LHD shall establish and maintain effective communication strategies with Pregnancy Management Program providers and other key contacts within the practice in the county or serving residents of the county. iv. LHD shall ensure the assigned care manager participates in relevant Pregnancy Management Program meetings addressing care of patients in the target population. v. LHD shall ensure awareness of CFSP Members’ “in network” status with providers when organizing referrals. vi. LHD shall ensure understanding of the CFSP’s prior authorization processes relevant to referrals.
Sample 1
Xxxx Management for High-Risk Pregnancy. Collaboration with CFSP i. LHD shall work with the CFSP to ensure program goals are met.
Sample 1
Xxxx Management for High-Risk Pregnancy. Staffing i. LHD shall employ care managers meeting pregnancy Care Management competencies, defined as having at least one of the following qualifications: a) Registered nurses b) Social workers with a bachelor’s degree in social work (BSW, BA in SW, or BS in SW) or master’s degree in social work (MSW, MA in SW, or MS in SW) from a Council on Social Work Education-accredited social work degree program. c) Care managers for High-Risk Pregnancy hired prior to September 1, 2011, without a bachelor’s or master’s degree in social work may retain their existing position; however, this grandfathered status does not transfer to any other position. ii. LHD shall ensure that Community Health workers for CMHRP services work under the supervision and direction of a trained care manager. iii. LHD shall include both registered nurses and social workers on their team in order to best meet the needs of the target population with medical and psychosocial risk factors. iv. If the LHD has only a single care manager for High-Risk Pregnancy, the LHD shall ensure access to individual(s) to provide needed resources, consultation and guidance from the non- represented professional discipline. v. LHD shall engage care managers who operate with a high level of professionalism and possess an appropriate mix of skills needed to work effectively with a pregnant population at high risk for poor birth outcomes. This skill mix should reflect the capacity to address the needs of patients with both medically and socially complex conditions. vi. LHD shall ensure that pregnancy care managers demonstrate: a) A high level of professionalism and possess appropriate skills needed to work effectively with a pregnant population at high risk for poor birth outcomes b) Proficiency with the technologies required to perform Care Management functions c) Motivational interviewing skills and knowledge of adult teaching and learning principles d) Ability to effectively communicate with families and providers e) Critical thinking skills, clinical judgment and problem-solving abilities vii. LHD shall provide qualified supervision and support for pregnancy care managers to ensure that all activities are designed to meet performance measures, with supervision to include: a) Provision of program updates to care managers b) Daily availability for case consultation and caseload oversight c) Regular meetings with direct service Care Management staff d) Utilization of reports to actively assess individual care mana...
Sample 1

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