West VirginiaMaternal Risk Screening

Anne Williams, RN, BSN, MS-HCA, DirectorOffice of Maternal, Child & Family HealthBureau for Public Health

Uniform Maternal Risk ScreeningWV Legislative Intent: SB 307

Develop a more comprehensive and uniform approachto screening methods conducted by physicians,midwives and other qualified health care practitionersto discover at-risk and high-risk pregnancies.

Simplify the process, standardize the procedure andbetter identify pregnancies that need more in-depthcare and monitoring.

Provide better and more measurable data regarding at-risk and high-risk pregnancies.

Allow public health officials to gain better understandingof conditions most frequently observed and to developa methodology to address those concerns.

Senate Bill 307 Uniform Maternal Screening Act

Purpose: To develop a more comprehensive and uniformapproach to maternal risk screening by developing astandardized tool to alert OB providers of the need for furtherevaluation and assessment of high-risk pregnant women

• Signed into law on May 28, 2009.

• Appears in the WV Code §16-4E-1 et seq.

• Bill granted legislative rule-making authority to the WV DHHR.

• Bill established an Advisory Council on maternalrisk assessment.

• Placed oversight responsibility with OMCFH.

Maternal Risk ScreeningAdvisory Committee

Dr. Luis BraceroCAMC Women & Children’s Hospital

Phyllis Bradley, RN, MS-HCACamden-Clark Memorial Hospital

Stephen Dexter, CEOThomas Memorial Hospital

Dr. Kimberly FarryAssociates for Women’s Health

Dr. Michael LassereSummersville Women’s Health

Dr. David JudeMarshall University

Dr. Victoria ShumanFamily Medicine of Clarksburg

Tina WilliamsUnited Hospital Center

VacantWVU – School of Medicine

VacantWV School of Osteopathic Medicine

Maternal Risk ScreeningAdvisory Committee – Con’t

Stephanie Nicodemus, CNM

Cristina Menking, CNM

Chris Curtis, Acting CommissionerWVDHHR – Bureau for Public Health

Kathy Cummons, DirectorDivision of Research, Evaluation & Planning/OMCFH

Jeannie Clark, DirectorPerinatal Programs/OMCFH

Denise Smith, DirectorDivision of Perinatal and Women’s Health/OMCFH

Anne Williams, DirectorOffice of Maternal, Child and Family Health

1st Meeting – January 2010

• Reviewed legislation.

• Discussed Committee’s role/expectation.

• Reviewed current Right From The Start Program’s Prenatal Risk Screening Instrument (PRSI).

• Reviewed other state’s screening instruments.

1st Meeting - Outcome

• Agreed to adapt current PRSI form, with modifications from members’ suggestions.

• Identified new form as WV Prenatal Risk Screening Instrument.

• Identified additional stakeholders.

• Discussed HIPAA compliance.

2nd Meeting – May 2010

•Reviewed draft of WV Prenatal Risk Screening Instrument that incorporated all member’s suggestions to date.

•Discussed data collection/flow process.

•Referral resource reports for clinicians.

•Strategies for implementation.

2nd Meeting - Outcome

•Additional edits to WV Prenatal Risk Screening Instrument.

•Data process - form will be faxed to designated # to OMCFH and entered into a data collection system.

•Potential HIPAA concerns were discussed regarding fax machine location & storage of confidential individual information.

• Informational mailing for provider notification.

WV Prenatal Risk Screening Instrument (PRSI)

• PRSI form finalized on June 16, 2010.

• Instructions located on back of form.

• Rule-making process posted for Public Comment.

• Public Comment period ended July 23, 2010(No Comments received).

• Rules passed in 2011 Legislative Session.

Implementation

Mass mailing to WV obstetrical/maternity providers to:

• Inform of legislative requirements.• Provide copies of the PRSI form.• Explain data submission procedures.

November 2010 – December 2010

PRSI Implementation: January 1, 2011

PRSI Data Collection Process

Provider completes

PRSI

RightFax

Review/Data Entry

PRSIDatabase

Fax Print

Planned Revisions/Upgrades:

Provider completes

PRSI

RightFax Teleform PRSI

DatabaseFax

Initial Implementation:

Planned: Electronic entry via web-based system

PRSI Implementation Update

January 1, 2011 thru March 31, 2011

# PRSI Forms Received: 2,638# Providers/Groups: 221

Provider Feedback

Good response overall.

Concerns:Release of Personally Identifiable Information.Time Consuming.Form completion difficult when some pregnancy risk factors are unknown at first visit.Lack of provider reimbursement.

Next Steps. . . . . . .Maternal Risk Screening Advisory Committee

April 12, 2011

• Implementation and Data Collection Progress• # Providers Participating• Provider Feedback, Concerns, Recommendations• Development of Data Matrix required by law

Once general report content and format meetCommittee approval, OMCFH will:

• Annually run report to measure incidence of high-risk pregnancies;• Evaluate long term provider utilization of risk screening tool; and• Develop format and content for legislative data reports.

Forms are available at:

• DHHR Materials Management• Website: www.wvdhhr.org/mcfh