Section 123240 Of Article 1. Maternal, Child, And Adolescent Health From California Health And Safety Code >> Division 106. >> Part 2. >> Chapter 1. >> Article 1.
123240
. (a) The Maternal and Child Health Branch of the department
shall conduct a pilot project to assess the effectiveness of daily
ambulatory uterine monitoring devices and services in reducing
preterm births in Medi-Cal eligible women.
(b) The department shall implement the pilot program to assess the
incidence of preterm births in 1,000 women at high risk of preterm
birth, 500 of whom shall be provided daily ambulatory uterine
monitoring services between the 23rd and 36th weeks of gestation and
500 of whom shall be provided routine prenatal care augmented by
training in palpatation. Women participating in the pilot program
shall be Medi-Cal eligible women. To the maximum extent possible
these services shall be prescribed by providers participating in
other programs administered by the Maternal and Child Health Branch
of the department or the comprehensive perinatal program.
(c) Women shall be deemed to be at high risk if they have multiple
gestation or any two of the following risk factors for preterm
labor; uterine malformation, a history of preterm labor or births,
cervical incompetence, cervical dilation or effacement, and those
patients who have been treated during the current pregnancy for
preterm labor.
(d) The department shall select five counties to participate in
the project, at least one of which shall be a rural county, and shall
reimburse providers of ambulatory uterine monitoring services a fee
based on reasonable costs.
(e) (1) The department shall also contract for an evaluation of
the pilot project to ascertain whether use of the ambulatory uterine
monitoring services significantly reduces the incidence of preterm
births. The evaluation shall compare the experimental and control
groups and identify the following for each group:
(A) The number of preterm births.
(B) The number of hospital days used by the mother prior to
delivery.
(C) The number of hospital days used by the mother and child after
delivery, including neonatal intensive care.
(D) The number of children born with developmental disabilities or
conditions that may lead to developmental disabilities.
(E) The costs of providing prenatal services.
(2) The evaluation shall also project the costs associated with
the health care provided to the mother and child during the course of
the pilot project and, if feasible, shall project the longer term
health care costs of children born prematurely, including costs of
services provided to the developmentally disabled.
(3) The department may enter into the contract on a sole source
basis.
(f) (1) The pilot project established pursuant to this section
shall be considered successful if it shows that the experimental
group, when compared to the control group, had all of the following:
(A) A 20-percent reduction in the number of premature births.
(B) A 20-percent reduction in the number of antepartum
hospitalization days.
(C) A 20-percent reduction in the number of neonatal intensive
care unit days for premature births.
(D) A 20-percent reduction in total patient costs.
(2) The department shall submit the evaluation to the Legislature
by September 1, 1990.
(g) (1) The department shall immediately seek any federal waivers
necessary to ensure full federal financial participation in the pilot
program established pursuant to this section.
(2) The department shall not implement the pilot program under
this section until necessary federal waivers are received.