Iowa Administrative Code › Agency 641 - Public Health Department › Chapter 76 - Maternal and Child Health Program › Rule 641-76.4 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
"Applicant"
means a private nonprofit or
				public agency that seeks a contract with the department to provide MCH
				services.
"BFH"
means the bureau of family
				health.
"Care/service coordination"
or
"care
				coordination"
means a comprehensive, family-centered approach that
				proactively engages and links clients and families to needed health care
				services, including medical, dental, emotional, behavioral, and health
				education services. Care coordination encompasses a specific set of activities
				that promote a client's potential for optimal health and facilitate quality
				outcomes. By working with the client, family, and other involved disciplines, a
				care coordinator can promote seamless access and a holistic approach to service
				provision. Care coordination incorporates the following:
1. Meaningful assessment of needs and
			 concerns.
2. Shared development of
			 care plans.
3. Mobilization of
			 agency and community resources.
4.
			 Continued monitoring and follow-up.
5. Clear and transparent
			 communication.
6. Complete
			 documentation.
"Chairperson "
means the chairperson of the
				MCH advisory council, who has been elected by the majority of the council's
				members.
"Children and youth with special health care needs
				"
or
"CYSHCN"
means children and youth with chronic
				physical, developmental, behavioral, or emotional conditions that require
				health and related services of a type or amount beyond that required by
				children and youth generally.
"CHSC"
means Child Health Specialty Clinics, a
				statewide program for children and youth with special health care needs
				authorized under Title V of the Social Security Act.
"Client"
means an individual who receives MCH
				services through a contract agency.
"CMS"
means the DHHS Centers for Medicare and
				Medicaid Services.
"Contract agency "
means a private nonprofit
				or public agency that has a contract with the department to provide MCH
				services and receives funds from the department for that purpose.
"Core public health functions"
means the
				functions of community health assessment, policy development, and
				assurance.
1. Assessment: regular
			 collection, analysis, interpretation, and communication of information about
			 health conditions, risks, and assets in a community.
2. Policy development: development,
			 implementation, and evaluation of plans and policies, for public health in
			 general and priority health needs in particular, in a manner that incorporates
			 scientific information and community values and is in accordance with state
			 public health policy.
3. Assurance:
			 ensuring, by encouragement, regulation, or direct action, that programs and
			 interventions that maintain and improve health are carried out.
"Council"
or
"MCH advisory
				council"
means the maternal and child health advisory council.
"Dental home "
means a network of
				individualized care based on risk assessment, which includes oral health
				education, dental screenings, preventive services, diagnostic services,
				treatment services, and emergency services.
"Department"
means the Iowa department of
				public health.
"DHHS"
means the United States Department of
				Health and Human Services.
"DIA "
means the Iowa department of
				inspections and appeals.
"Direct health services"
means those services
				generally delivered one-on-one between a health professional and a client in an
				office or clinic.
"Director "
means the director of the Iowa
				department of public health.
"Enabling services "
means services that are
				designed to help families gain access to health care. Enabling services include
				but are not limited to outreach, informing/reinforming, and care coordination
				services to link women, children, and families to needed health care
				services.
"EPSDT"
means the Early and Periodic
				Screening, Diagnosis, and Treatment program which provides for regular
				preventive health care services for children aged 0 to 21 as authorized by
				Title XIX of the Social Security Act.
"Essential public health services "
means
				those activities carried out by public health entities and their contractors
				that fulfill the core public health functions in the promotion of maternal and
				child health.
"Family, "
for the purpose of establishing
				eligibility, means a group of two or more persons related by birth, marriage or
				adoption or residing together and functioning as one socioeconomic unit. For
				the purpose of these rules, a pregnant woman is considered as two individuals
				when calculating the number of individuals in the family. If a pregnant woman
				is expecting multiple births, the family size is thereby increased by the
				number expected in the multiple birth.
"Family planning "
means the promotion of
				reproductive and family health by the prevention of and planning for pregnancy,
				and reproductive health education.
"Gap filling"
means direct health care
				services supported by Title V staff or resources that are not otherwise
				accessible in the community.
"HA WK-F'
means healthy and well kids in Iowa
				and is the child health insurance program in Iowa as authorized in Title XXI of
				the Social Security Act.
"Health care services"
means services provided
				through MCH contract agencies.
"Health professional"
means an individual who
				possesses specialized knowledge in a health or social science field or is
				licensed to provide health care.
"HRSA"
means the Health Resources and Services
				Administration with the United States Department of Health and Human
				Services.
"Infrastructure building "
means activities
				that support developing and maintaining comprehensive health care service
				systems. These activities include but are not limited to needs assessment, data
				collection, strategic planning, working with community partners, developing
				protocols, quality assurance, and training.
"I-Smile" program "
means the department
				program implemented through public and private nonprofit agencies and private
				health care providers to increase access to dental care for children and to
				ensure a dental home.
"Maternal and child health services"
means
				services provided through local contract agencies to meet the needs of the
				client. The types of services provided include infrastructure building,
				population-based services, enabling services, and direct health care
				services.
"Medicaid"
means the Medicaid program
				authorized by Title XIX of the Social Security Act and funded through the Iowa
				department of human services from the DHHS.
"Medical home "
means a team approach to
				providing health care that originates in a primary care setting; fosters a
				partnership among the client, the personal provider, and other health care
				professionals, and where appropriate, the client's family; utilizes the
				partnership to access all medical and nonmedical health-related services needed
				by the client and the client's family to achieve maximum health potential;
				maintains a centralized, comprehensive record of all health-related services to
				promote continuity of care; and has all of the characteristics specified in
				Iowa Code section
				135.158.
"MIECHV"
means the Maternal, Infant and Early
				Childhood Home Visiting program.
"OHDS"
means the bureau of oral and health
				delivery systems.
"OMB "
means the United States Department of
				the Treasury, Office of Management and Budget.
"Performance measures"
means National
				Performance Measures (NPM) and State Performance Measures (SPM) required
				through the HRSA, Maternal and Child Health Bureau (MCHB), Title V MCH Block
				Grant.
"Physician "
means a person currently licensed
				to practice under Iowa Code chapter 148.
"Population-based services "
means services
				that include preventive personal health care services for groups of individuals
				(rather than one-on-one). Payer status of the individuals is not assessed, and
				services are not billed. Population-based services may be provided to an entire
				community, county, or region. Examples include but are not limited to mass
				immunizations, classroom oral health education, and the use of media for health
				promotion and education.
"Prenatal and postpartum care"
means those
				types of services as recognized by the American College of Obstetricians and
				Gynecologists.
"Presumptive eligibility determination "
means
				temporary Medicaid eligibility that pays for medical services while a formal
				Medicaid decision is being made by the Iowa department of human services.
				Presumptive eligibility is available for children, youth, and pregnant
				women.
"Program income "
means gross income earned by
				the MCH contract agency resulting from activities related to fulfilling the
				terms of the contract. "Program income" includes but is not limited to such
				income as fees for services, third-party reimbursements, and proceeds from
				sales of tangible, personal or real property.
"Title V"
means Title V of the Social Security
				Act and the federal requirements contained in the Omnibus Reconciliation Act of
				1989 ( Public Law
				101-239) which address the MCH and CYSHCN
				programs.
"Title X"
means the program authorized in the
				federal regulations found in 42 CFR Subpart A, Part 59, published in the
				Federal Register on June 3,1980, and the Program Guidelines for Project Grants
				for Family Planning Services.
"Title XIX"
means the Medicaid program
				authorized in the Social Security Act and funded through the Iowa department of
				human services from the DHHS.
"Title XXI"
means the child health insurance
				program authorized in the Social Security Act and implemented in Iowa as the
				HAWK-I program as administered by the Iowa department of human services.
"WIC"
means the Special Supplemental Nutrition
				Program for Women, Infants and Children, funded through the department from the
				United States Department of Agriculture.