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Title: Section 795.7 - Services for the care of patients

Effective Date

11/13/2019

Section 795.7 Services for the care of patients. All patients shall be assessed to determine availability of sufficient resources prior to and following delivery. The operator shall ensure that the midwifery birth center provides at least the following:

(a) admission screenings to ensure that only patients at low risk are admitted to the midwifery birth center;

(b) active participation by patients and families in their own plan of health care, which shall include but not be limited to:

(1) orientation to the midwifery birth center services and its philosophy and goals preceding registration; and

(2) access to prenatal education classes approved by the clinical staff which address, at a minimum, labor and delivery, infant care and feeding, parenting, nutrition, the effects of smoking, alcohol and other drugs on fetal development and on the newborn patient, signs of postpartum depression, what to expect if transferred, and the newborn screening program, including hearing screening, with the provision and distribution of newborn screening educational literature;

(c) prenatal and intrapartum care including:

(1) a plan of care developed according to accepted professional standards;

(2) selection of pediatric services by the patient for follow-up care of the infant;

(3) providing HIV counseling and recommending voluntary testing to pregnant patients during a prenatal visit. Counseling and/or testing, if accepted, shall be provided pursuant to Public Health Law Article 27-F. Information regarding the patient’s HIV counseling and HIV status must be transferred as part of the patient’s medical history to the labor and delivery site. Patients with positive test results shall be referred to the necessary health and social services within a clinically appropriate time;

(4) continuous risk assessment of all patients;

(5) labor support and professional attendance at birth for the patient and the patient’s family;

(6) consultation with perinatal qualified mental health professionals to determine the appropriate course of action for patients who screen positive during the prenatal screening for depression or perinatal mood disorder or who have other mental health conditions;

(7) a system for screening patients prior to admission for alcohol/substance use during pregnancy and for prior physical, sexual and emotional abuse, as part of routine obstetric care, and for referral of patients as appropriate to a higher-level facility; and

(8) a system for directing patients to appropriate health care providers for further diagnosis and treatment, including consultation by a radiologist or qualified provider who can interpret imaging results when results are inconclusive or an abnormality is detected that requires immediate care;

(d) postpartum care including:

(1) care in the midwifery birth center to be provided for a minimum of four hours and a maximum of 24 hours after the third stage of labor is complete;

(2) a physical assessment of the newborn with the required eye prophylaxis in accordance with sections 12.2 and 12.3 of this Title and newborn screening tests in accordance with Part 69 of this Title;

(3) birth registration in accordance with section 4130 of the Public Health Law;

(4) a physical assessment of the patient in accordance with established protocols including the evaluation of Rh status, need for Rh prophylaxis and the patient’s ability to feed the infant prior to discharge from the center; and

(5) the transfer to the newborn’s medical record of a patient’s HIV test result, if one exists; and

(e) discharge and follow-up including:

(1) a program for discharge and follow-up of the patient and infant in their home for the immediate postpartum period unless arrangements have been made for the infant to be seen by another health care provider. The home visits may be performed by licensed professional nursing staff from the midwifery birth center, if the facility is approved under article 36 of the Public Health Law, or through an agreement with a certified or licensed home health agency, to include an assessment of the parent-child relationship, an evaluation of the nutritional status of the infant and the physical and psychological status of the patient, performance of a hematocrit, rubella vaccination and Rh prophylaxis, if indicated, and newborn screening blood collection in accordance with Part 69 of this Title;

(2) assurance of immediate and ongoing pediatric care;

(3) provision of family planning counseling or arrangements for such services, if desired by the patient; and

(4) arrangements for follow-up visits at the midwifery birth center within a six-week period following the birth.

Statutory Authority

Public Health Law, Sections 2801 and 2803(11)

Volume

VOLUME E (Title 10)

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