Policy and Procedure Manual

The

Policies and Procedures

of

Maternity Care

 

Table of Contents

 

 

 

Health and Medical Division
Maternity Care/Circumcision Program

SUBJECT: Eligibility

PURPOSE: Determine eligibility for the CIRCUMCISION PROGRAM..

STAFF GOVERNED BY THIS POLICY: Health Board, Health & Medical staff

EFFECTIVE DATE: May 1, 2003

DATE REVIEWED OR REVISED: November 5, 2003

DISTRIBUTION: Health Board, Health & Medical Staff

POLICY:

To be served through the Circumcision Program:
1) Be an enrolled member of the Eastern Band of Cherokee Indians or an eligible pregnant female with a male fetus

Note: If you live outside the five (5) county contract service areas and are an enrolled member of the Eastern Band of Cherokee Indians, you are still eligible for service, however you must have delivered at Harris Regional Hospital.

 

 

 

Health and Medical Division
Maternity Care/Circumcision Program

SUBJECT: Patient Selection Process

PURPOSE: Determine how patients are selected for the CIRCUMCISION PROGRAM

STAFF GOVERNED BY THIS POLICY: HMD staff, Health Board

EFFECTIVE DATE: May 1, 2003

DATE REVIEWED OR REVISED: November 5, 2003


DISTRIBUTION: Health Board, Health & Medical staff

POLICY:

  1. The Maternity Care Coordinator will send the authorizations to RTC for initiation of the payment process.
  2. The names of patients requesting circumcision for their male child will be forwarded to RTC for authorization.
  3. Authorizations should be done 2-4 weeks prior to expected delivery date.

PROCEDURE:

  1. Maternity Care Coordinator will question clients about the sex of the unborn child if known.
  2. If the child is male, or if the sex is unknown, the MCC will ask if a circumcision is desired.
  3. If a circumcision is desired for the unborn child, a referral with the mother’s face sheet will be sent to RTC for authorization.
  4. Prospective pregnant women will be advised that Sylva Pediatrics will be performing the procedure.
  5. Prospective pregnant women will be advised that Medicaid does not cover this service.
  6. Prospective pregnant women who have private insurance will be advised that the program will pay the portion their insurance does not cover.

 

 

 


Health and Medical Division
Maternity Care/"Babylove"

SUBJECT: Legal Document Correction

PURPOSE: Meet legal requirements for error correction.

STAFF GOVENED BY THIS POLICY: Maternity Care Coordinator

EFFECTIVE DATE: 04-01-2000

DATE REVIEWED OR REVISED: 11-05-03

DISTRIBUTION: Maternity Care Coordinator, Health and Medial Division, Cherokee Indian Hospital.

POLICY:

Any error made in a Maternity Care Coordination record or medial record will be corrected without obliteration. Correction fluid, white out or complete obliteration of the error will not be allowed in the MCC chart or Medical record.

PROCEDURE:

  1. Draw a single line through the error assuring that the error is still legible.
  2. Write your initials and date of the correction by the error.
  3. Proceed with the entry.

Health and Medical Division
Maternity Care/"Babylove"

SUBJECT: Transportation of Clients by the Maternity Care Coordinator

PURPOSE: To maintain the safety of the client and Maternity Care Coordinator and decrease the liability of the Maternity Care Coordinator.

STAFF GOVENED BY THIS POLICY: Maternity Care Coordinator

EFFECTIVE DATE: April 01, 2000

DATE REVIEWED OR REVISED: November 5,2003

DISTRIBUTION: Maternity Care coordinator, Health and Medial Division, Cherokee Indian Hospital, Child Service Coordinator, WIC Director, MCC clients at enrollment.

POLICY:

Every attempt will be made to secure Maternity Care Coordination (MCC) client’s transportation to medical, WIC or Department of Social Service (DSS) appointments through sources such as DSS, EBCI Transit, County Transportation or family and friends of the client. If no other transportation is available and the MCC has time in her schedule, the MCC may transport the client to the client’s medical DSS or WIC appointment in a tribal vehicle.

  1. The MCC will only transport the client, her child/children and one other adult.
  2. Each person must be in a seat belt and/or meet NC State law for car seat compliance.
  3. If no Tribal vehicle is available of the MCC is unavailable the client will need to reschedule her appointment.
  4. The transport must be within a seventy-mile radius of the Qualla Boundary.
  5. The transport must be within the eight hour work day and five day work week of the MCC
  6. The client’s own car seats will be used.
  7. Client’s car seats should be properly installed in the Tribal vehicle by the client.
  8. Absolutely no transportation will occur if car seats ( when necessary) and seat belts are not used.
  9. Transportation from a situation of domestic abuse will not be done.
  10. Transportation will not occur when there is inclement weather, such as ice and snow covered roads.
  11. The MCC can transport the client to other facilities if the primary need for the transport has been a Medical, WIC, or DSS appointment.
  12. No transportation of clients will occur unless the client is enrolled in Maternity Care Coordination.

PROCEDURE:

  1. The client will call the MCC requesting transportation.
  2. The MCC will ask the client if other transportation options have been exhausted.
  3. If other options have not been exhausted, then the MCC will instruct the client to seek other sources first.
  4. If no other means of transportation is available, and the MCC has time available and a proper tribal vehicle can be secured with the needed amount of seat belts and/or car seats, the MCC will provide transportation to the client to the defined appointment.

 

 

 


Health and Medical Division
Maternity Care Coordination

SUBJECT: Eligibility

PURPOSE: Define eligibility for MCC services

STAFF GOVENED BY THIS POLICY: Maternity Care Coordinator

EFFECTIVE DATE: November 7, 2002

DATE REVIEWED OR REVISED: November 5, 2003

POLICY:

Pregnant women and women who are less than 60 days post partum, regardless of financial status, are eligible for MCC services as long as they are eligible to receive services at CIHA.

 

 

 


Health and Medical Division
Maternity Care Coordination

JOB TITLE: Maternity Care Coordinator/RN

DEPARTMENT: Community Health

DIVISION: Health/Medical Division

SECTION: Community Health Nursing

REPORTS TO: Community Health Nursing Supervisor

Specialized Skill

PRIMARY FUNCTION:

Provides comprehensive health care services to pregnant women enrolled in the Baby Love Program. Coordinates and administers program guidelines targeted at women at risk for poor pregnancy, parenting, and/or child birth outcomes through a team approach.
________________________________________________________________________
JOB DESCRIPTION:

Plans, directs, and coordinates the Maternity Care Coordination (Baby Love) program. Provides prenatal, postnatal, and neonatal education to clients as required.

Maintains various records, files, and logs of program participants and prepares summary reports and recaps as required, including MCC, HMD, and CIHA.

Assures activities are in compliance with local and state guidelines of the Baby Love Program, and applicable OSHA, CIHA, and HMD policies.

Provides assistance to clients and other staff as needed through problem solving and consultation on specific issues, questions, and policy interpretations.

Coordinates the quality assurance activities of the program and prepares reports as required.
Participates in QA and Performance Improvement projects as assigned.

Collaborates with prenatal and high risk OB/GYN staff on specified clients.

Monitors Medicaid billing process to ensure accurate accounting practices.

Assists clients in sign up procedures (Medicaid) and makes home visits to assess specific needs as required.

Develops an individual health care plan for clients to meet various identified needs including medical, financial, psychological, educational, and nutritional.

Makes client referrals and facilitates the process of assistance to clients as required by setting up appointments and follow up for such needs as housing, behavioral health, skilled nursing, etc.

Maintains regular contacts with clients and monitors progress through office visits, home visits, and phone calls.

Participates in various teams, committees, and meetings such as Child Protection, Adolescent Parenting Policy Advisory Council, and Cherokee Children’s Coalition.

Develops and implements a plan of care with involvement of client, and others as needed.
Makes written referrals to other disciplines and programs as needed to care for patients.

Determines eligibility for payment of circumcisions for eligible neonates.

Attends educational workshops, seminars, classes, and other meetings to represent the interests of the program. Attends all mandatory in-service/educational programs as required. Attends at least 16 hours/year of work-related educational programs.

Demonstrates safe practices by using proper body mechanics, following policies for sharp/dangerous material handling and disposal, and reporting and/or acting to correct unsafe or costly conditions.

May be necessary to work when Administrative leave is granted if patient care would be compromised.

Performs other duties assigned by supervisor to promote efficient operation of the agency.

EDUCATION & EXPERIENCE:


Current license as a Registered Nurse in North Carolina required. BS in Nursing required. Minimum one year of work experience in community health nursing as an RN with pregnant women required. Must maintain certification in Basic Life Support/CPR.

JOB KNOWLEDGE:


Must have a thorough knowledge of the policies, procedures, and guidelines of the Maternity Care Program, EBCI Health and Medical Division and Community Health systems, standard nursing practices, applicable OSHA mandates, and related regulatory controls. Must be familiar with various aspects of the MCC, CSC, and Baby Love Programs. Requires the ability to perform various nursing skills, such as measurement of vital signs and health education. Must be skilled in the use of all assigned clinical equipment and knowledgeable of sterile and aseptic techniques. Requires the ability to assess clients, develop, and coordinate a total plan of care to meet medical, financial, psychological, educational, and motivational needs. Must have basic clerical and computer skills, and knowledge of specified software applications. Requires the ability to maintain records, files, and logs; collate and compile data; and prepare reports, recaps, and summaries. Must know various reporting systems, forms, and requirements of HMD, MCC, and CIHA. Requires the ability to legibly document and maintain clinical records, files, reports, and logs. Must maintain specified certifications and a North Carolina driver’s license. Must have good communication skills, both written and verbal. Must have an understanding of the EBCI culture, life styles, and risk factors. Requires knowledge of the geography of the assigned area. Six to nine months would be necessary to become proficient in most phases of this position.

COMPLEXITY OF DUTIES:


Requires the ability to plan, coordinate activities, solve problems, assess situations, and develop appropriate patient case management. Must use judgement and initiative to maintain accuracy or work. Must be resourceful when responding to changing circumstances. .

SUPERVISION RECEIVED:


Performs nursing assessments, procedures and interventions in the community independently, notifying the Supervisor only if further information or assistance is needed. Reports directly to the Community Health Nursing Supervisor.

RESPONSIBILITY FOR ACCURACY:


Most administrative errors would be detected through proofing and review procedures. Undetected errors could have minimal or life threatening results. Requires a high degree of accuracy of the documentation of nursing assessments, to be used in establishing an appropriate plan of care and minimize the risk of negative outcomes for the client. Federal and State Government regulations require the submitting of accurate patient information to allow for appropriate reimbursement for patient visits. The submission of false or inaccurate information would place the program at risk for fraudulent claims, resulting in loss of program certification, and the nurse’s license would be in jeopardy.

CONTACT WITH OTHERS:


Has frequent contacts with patients, families, coworkers, and other health professionals where tact, courtesy, and diplomacy are required to maintain positive relationships. Requires sensitivity to others while dealing with patients and their families who may be under stress while dealing with issues of potential poor neonatal outcomes. Purpose of contacts is to exchange information, offer instruction, and work together to meet the patient’s goals.

CONFIDENTIAL DATA:


Must adhere to all tribal guidelines, EBCI policies and procedures for working with confidential data. An above average degree of discretion is required while handling patient and related medical information.

MENTAL/VISUAL/PHYSICAL EFFORT:


Job duties can be mentally/emotionally stressful at times. Close mental concentration and attention to detail are required for most nursing procedures, record keeping, and reporting duties, that can be for short or extended periods of time. Physical activities require the ability to walk, sit, reach, bend,and occasional lifting of up to 25 pounds. Must have visual acuity, manual dexterity, and the ability to speak and hear.

ENVIRONMENT:


Works in community and office environment and is exposed to biohazards, disease, etc., which require strict adherence to OSHA guidelines and protocol for aseptic technique. While traveling in the field, there could be exposure to inclement weather and a wide range of temperatures.

Revised Apr 03.