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The Comprehensive Perinatal Services Program

The Comprehensive Perinatal Services Program. Insert name of PSC Insert date. CPSP. What is the CPSP?. The CPSP provides enhanced perinatal services for Medi -Cal eligible women from the date of conception through the end of the second month after delivery

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The Comprehensive Perinatal Services Program

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  1. The Comprehensive Perinatal Services Program Insert name of PSC Insert date CPSP

  2. What is the CPSP? • The CPSP provides enhanced perinatal services for Medi-Cal eligible women from the date of conception through the end of the second month after delivery • The CPSP has been shown to improve birth outcomes • Medi-Cal Managed Care plans are required to provide access to CPSP services for all Medi-Cal eligible enrollees

  3. Goals of the CPSP • Decreaseand maintain the decreased level of perinatal, maternal and infant mortality and morbidity • Support methods of providing comprehensive prenatal care that prevent prematurity and the incidence of low birth weight infants http://www.cdph.ca.gov/services/funding/mcah/Documents/MO-MCAH-MCAHPP-2012-13.pdf

  4. Why be a CPSP Provider? • Better patient outcomes • CPSP offers higher reimbursement • More staffing flexibility

  5. Basic OB vs. CPSP Reimbursement * Not available to FQHCs

  6. CPSP Flow Sheet and Billing Summary

  7. CPSP Documentation Requirements and Forms • Client Orientation • Initial Assessments • Individualized Care Plans • Reassessments (second, third trimester and postpartum) • Referrals All recommended forms are located here: http://www.cdph.ca.gov/programs/CPSP/Pages/LHJPerinatalServicesCoordinatorInformation.aspx

  8. CPSP Services • Orientation • Case Coordination • OB • Psychosocial • Health Education • Nutrition • Perinatal Education individual groups • Vitamin/mineral supplements • Initial assessments • Trimester reassessments • Postpartum assessments • Intervention/follow-up

  9. CPSP Model of Care • Client centered • Strength-based • Multi-disciplinary • Site specific protocols • Culturally sensitive • Community referrals • Voluntary participation

  10. Who can Become a CPSP Provider? Any of the following can become a CPSP provider, if they have an active National Provider Identifier (NPI) number and are an active Medi-Cal provider in good standing with Medi-Cal and their licensing board: • Physicians, including general practitioners, family practice physicians, pediatricians, or obstetrician-gynecologists • Certified Nurse Midwives (CNMs) • Medical Groups • Clinics • PPOs http://files.medi-cal.ca.gov/pubsdoco/publications/masters-mtp/part2/pregcom_m00o03.doc

  11. Who can Deliver CPSP Services? All CPSP Providers and the following CPSP Practitioners may deliver CPSP services under the supervision of a physician and as permitted by their Scope of Practice, if licensed. • Registered Nurses • Nurse Practitioners • Physician Assistants • Social Workers • Health Educators • Childbirth Educators • Registered Dieticians • Comprehensive Perinatal Health Workers (CPHW) who are at least 18 years old, have a High School Diploma, and have a minimum one year paid perinatal experience. http://files.medi-cal.ca.gov/pubsdoco/publications/masters-mtp/part2/pregcom_m00o03.doc

  12. Models of CPSP Service Delivery • Approved CPSP providers can be found in solo practice, group practice, health departments, hospitals, community clinics, managed care plans, Federally Qualified Health Center (FQHCs), Indian Health Services (IHS), Rural Health Clinics (RHCs), and residency programs • Insome cases, obstetrical services are provided in the provider’s office with other services provided elsewhere, under subcontract, or by a second CPSP provider • Flexibility of program design and implementation allows for the use of a wide range of professional and paraprofessional personnel

  13. Protocols for CPSP Services & Supervision 22 CCR 51179.9 defines “Protocol” as "written procedures for providing psychosocial, nutrition, and health education services and related case coordination.” 22 CCR 51179.5 defines “Personal supervision” as "evaluation, in accordance with protocols, by a licensed physician, of services performed by others through direct communication, either in person or through electronic means.” http://www.cdph.ca.gov/services/funding/mcah/Documents/MO-MCAH-MCAHPP-2012-13.pdf http://files.medi-cal.ca.gov/pubsdoco/publications/masters-mtp/part2/pregcom_m00o03.doc

  14. The CPSP Application Process • Your CPSP Perinatal Services Coordinator (PSC) can assist you with your application • The PSC will review the completed application and submit it to the California Department of Public Health (CDPH/MCAH) for final approval • The application approval process may take up to 60 days from the date that CDPH/MCAH receives a completed application • http://www.cdph.ca.gov/programs/CPSP/Pages/ApplicationforCertificationasaCPSPProvider.aspx

  15. How does the CPSP work in FQHCs & RHCs? • TARs (Treatment Authorization Request) are not used in FQHCs or RHCs however, chart documentation for additional CPSP services must demonstrate the same justification necessary to obtain a TAR. • FQHCs and RHCs should bill the MCMC plan first for services to MCMC clients and should contact the FI for information regarding any additional payments for which they may be eligible • CPSP visits in these health care delivery settings are paid at a flat fee per visit, for on-site and off-site services, as defined in their prospective payment system

  16. Electronic Health Record (EHR) • EHRs should facilitate the CPSP work flow in each provider office • Each PSC and Provider should evaluate the content and functionality of the EHR system • The PSC will review the EHR content using an approved set of CPSP forms as a guide to assure that required elements of State recommended prenatal and postpartum assessment, reassessment, and intervention are included http://www.cdph.ca.gov/services/funding/mcah/Documents/MO-MCAH-MCAHPP-2012-13.pdf

  17. Resources: • CPSP Website http://www.cdph.ca.gov/programs/CPSP/Pages/default.aspx • Provider Handbook http://www.cdph.ca.gov/programs/CPSP/Documents/MO-CPSP-ProviderHandbook.pdf • Steps To Take http://www.cdph.ca.gov/programs/CPSP/Documents/MO-CPSP-StepsToTake.pdf • Medi-Cal Website http://www.dhcs.ca.gov/Pages/default.aspx • PSCs Directory CPSP Perinatal Services Coordinators

  18. Honorable Edmund G. Brown Jr. Governor State of California 2014 California Department of Public Health Maternal and Child Adolescent Health Program 1615 Capitol Avenue, MS 8306 Sacramento, California 95899-7420 Diana Dooley Secretary California Health & Human Services Agency Ron Chapman, MD, MPH Director California Department Of Public Health

  19. Thank you! Questions??

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