(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 Mater
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(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.