reglab/statecodes huggingface dataset:
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 4 - Obstetrical Levels of Care Requirements › Section 4-3 - Obstetric Level III facility requirements

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 3.
(a) An
				Obstetric Level III facility is an Obstetric Level II facility plus care of
				more complex maternal medical conditions, obstetric complications, and fetal
				conditions. In addition to the requirements of an Obstetric Level II facility,
				an Obstetric Level III facility shall meet the requirements set forth in this
				section.
(b) An Obstetric Level III
				facility shall demonstrate as follows its capability of providing uncomplicated
				and complicated obstetrical care through written standards, protocols,
				guidelines, and training, including (Obstetric Level II plus the following):
(1) Each Obstetric Level III facility shall
				have all of the following facility capabilities:
(A) Demonstrated experience and capability to
				provide comprehensive management of severe maternal complications.
(B) An onsite intensive care unit (ICU)
				should accept pregnant women and have critical care specialists, immediately
				available at all times.
(C) ICU
				collaborates actively with the maternal-fetal medicine (MFM) care team in the
				management of all pregnant women and women in the postpartum period who are in
				critical condition or have complex medical conditions.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 4 - Obstetrical Levels of Care Requirements › Section 4-4 - Obstetric Level IV facility requirements

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 4.
(a) An
				Obstetric Level IV facility is an Obstetric Level III facility plus onsite
				medical and surgical care of the most complex maternal conditions and
				critically ill pregnant women and fetuses throughout antepartum, intrapartum,
				and postpartum care. In addition to the requirements of an Obstetric Level III
				facility, an Obstetric Level IV facility shall meet the requirements set forth
				in this section.
(b) An Obstetric
				Level IV facility shall demonstrate as follows its capability of providing
				uncomplicated and complicated obstetrical care through written standards,
				protocols, guidelines, and training, including (Obstetric Level III plus the
				following):
(1) Each Obstetric Level IV
				facility shall have all of the following facility capabilities:
(A) Onsite medical and surgical care of
				complex maternal conditions (including congenital maternal cardiac lesions,
				vascular injuries, neurosurgical emergencies, and transplants) with the
				availability of critical care unit or intensive care unit (ICU) beds.
(B) Provide seamless communication between
				maternal-fetal medicine (MFM) specialists and other subspecialists in the
				planning and facilitation of care for women with the most high-risk
				complications of pregnancy.
(C)
				Institutional support for the routine involvement of a MFM care team with the
				critical care units and specialists.
(D) MFM care team with expertise to assume
				responsibility for pregnant women and women in the postpartum period who are in
				critical condition or have complex medical conditions. This includes
				co-management of ICU-admitted obstetric patients.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 5 - Neonatal Levels of Care Requirements › Section 5-1 - Neonatal Level I facility requirements

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 1.
(a) A
				Neonatal Level I facility is a facility that offers a basic level of newborn
				care to infants at low risk. These units have personnel and equipment available
				to perform neonatal resuscitation at every delivery and to evaluate and provide
				routine postnatal care for healthy term newborn infants. In addition, Level I
				neonatal units have personnel who can care for physiologically stable infants
				who are born at thirty-five (35) weeks of gestation or more and can stabilize
				ill newborn infants who are born at less than thirty-five (35) weeks of
				gestation until they can be transferred to a facility where the appropriate
				level of neonatal care is provided.
(b) A Neonatal Level I facility shall
				demonstrate its capability of providing neonatal care through written
				standards, protocols, guidelines, and training, including the following:
(1) Each Neonatal Level I facility shall have
				the following facility capabilities:
(A)
				Appropriately detect, stabilize, and initiate management of unanticipated
				neonatal problems that occur until the patient can be transferred to a facility
				at which specialty neonatal care is available.
(B) Ability to initiate education and quality
				improvement programs to maximize patient safety, collaborate with higher-level
				facilities to do so, or both.
(C)
				Provide resuscitation and stabilization of unexpected neonatal problems
				according to the most current Neonatal Resuscitation Program (NRP)
				training.
(D) Select and manage
				neonatal patients at a neonatal risk level appropriate to its
				capability.
(E) Access to
				laboratory testing and blood bank supplies at all times.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 5 - Neonatal Levels of Care Requirements › Section 5-2 - Neonatal Level II facility requirements

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 2.
(a) A
				Neonatal Level II facility is a Neonatal Level I facility plus the ability to
				provide specialty care for infants born at thirty-two (32) weeks gestation or
				more and weighing one thousand five hundred (1,500) grams or more at birth who
				have physiologic immaturity or who are moderately ill with problems that are
				expected to resolve rapidly and who would not be anticipated to need
				subspecialty-level services on an urgent basis. Level II facilities can
				stabilize ill newborn infants who are born at less than thirty-two (32) weeks
				gestation until they can be transferred to a facility where the appropriate
				level of neonatal care is provided. In addition to the requirements of a
				Neonatal Level I facility, a Neonatal Level II facility shall meet the
				requirements set forth in this section.
(b) A Neonatal Level II facility shall
				demonstrate as follows its capability of providing neonatal care through
				written standards, protocols, guidelines, and training, including (Neonatal
				Level I plus the following):
(1) Each Neonatal
				Level II facility shall have the following facility capabilities:
(A) Provide care for infants convalescing
				after intensive care.
(B) Accept
				risk-appropriate neonatal transports.
(C) Provide either:
(i) mechanical ventilation for brief duration
				(less than twenty-four (24) hours);
(ii) continuous positive airway pressure
				(CPAP); or
(iii) both.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 5 - Neonatal Levels of Care Requirements › Section 5-3 - Neonatal Level III facility requirements

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 3.
(a) A
				Neonatal Level III facility is a Neonatal Level II facility plus the ability to
				provide acute and comprehensive neonatal intensive care for infants who are
				born at less than thirty-two (32) weeks gestation or less than one thousand
				five hundred (1,500) grams at birth or have medical or surgical conditions
				regardless of gestational age. In addition to the requirements of a Neonatal
				Level II facility, a Neonatal Level III facility shall meet the requirements
				set forth in this section.
(b) A
				Neonatal Level III facility shall demonstrate as follows its capability of
				providing neonatal care through written standards, protocols, guidelines, and
				training, including (Neonatal Level II plus the following):
(1) Each Neonatal Level III facility shall
				have the following facility capabilities:
(A)
				Provide sustained neonatal life support.
(B) Pediatric ophthalmology services for the
				monitoring of ROP. The facility shall have an organized program for or
				consultative agreement for the treatment and follow-up of ROP that incorporates
				neonatal risks and benefits with the provision of care.
(C) Pediatric surgical specialists (including
				anesthesiologists with pediatric experience) readily available at all times, or
				at another facility through prearranged consultative agreement, and shall
				perform all procedures in newborn infants within a time interval that
				incorporates neonatal risks and benefits with the provision of emergency
				care.
(D) Pediatric medical
				subspecialty services must be provided onsite or through prearranged
				consultative agreement, which allows for emergency transport between
				institutions within a time interval that incorporates neonatal risks and
				benefits with the provision of emergency care.
(E) Capability to perform major surgery
				onsite or through a prearranged consultative agreement with a risk appropriate
				institution.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 5 - Neonatal Levels of Care Requirements › Section 5-4 - Neonatal Level IV facility requirements

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 4.
(a) A
				Neonatal Level IV facility is a Neonatal Level III facility plus the ability to
				provide comprehensive subspecialty neonatal care services, including acute
				neonatal intensive care for infants of all birth weights and gestational ages,
				and neonatologists who assist in the management of fetuses who are extremely
				premature or have complex problems that render significant risk of preterm
				delivery and postnatal complications. In addition to the requirements of a
				Neonatal Level III facility, a Neonatal Level IV facility shall meet the
				requirements set forth in this section.
(b) A Neonatal Level IV facility shall
				demonstrate as follows its capability of providing neonatal care through
				written standards, protocols, guidelines, and training, including (Neonatal
				Level III plus the following):
(1) Each
				Neonatal Level IV facility shall have the following facility capabilities:
(A) Located within an institution with the
				capability to provide surgical repair of complex congenital or acquired
				conditions.
(B) Facilitate
				transport and provide outreach education.
(C) Managing all neonatal patients including
				those requiring advanced modes of neonatal ventilation and life
				support.
(D) Pediatric medical
				subspecialty services.
(E)
				Pediatric subspecialty surgical services such as pediatric cardio-thoracic
				open-heart surgery and pediatric neurosurgery within the institution.
(F) A neurodevelopmental follow-up clinic or
				practice.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 6 - Obstetrical and Neonatal Universal Standards › Section 6-1 - Laboratory requirements

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 1.
Each delivering facility shall meet the following
				  requirements for laboratory capacity:
(1) The programmatic leaders of the perinatal
				service, in conjunction with the hospital laboratory leaders, shall ensure
				appropriate processing and reporting times for samples drawn from obstetric and
				neonatal patients with specific consideration for the acuity of the patient and
				the integrity of the samples.
(2)
				The hospital laboratory shall demonstrate the capability to immediately
				receive, process, and report urgent and emergent obstetric and neonatal
				laboratory requests.
(3) The
				hospital laboratory shall have a process in place to report critical results to
				the obstetric and neonatal services.
(4) The hospital shall have available the
				equipment and trained personnel to perform newborn screening prior to discharge
				on all infants born at or transferred to the institution, as required by the
				department.
(5) The hospital shall
				have molecular, cytogenic, and biochemical genetic testing available or a
				written policy for consultation and referral in place.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 6 - Obstetrical and Neonatal Universal Standards › Section 6-2 - Education requirements

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 2.
(a) Each
				delivering facility shall have identified minimum competencies for perinatal
				clinical staff, not otherwise credentialed, assessed prior to independent
				practice and on a regular basis thereafter.
(b) At a minimum annually, each delivering
				facility shall provide continuing education programs for physicians, nurses,
				and ancillary members of the perinatal team concerning the treatment and care
				of perinatal patients in the following areas:
(1) Conduct team training in perinatal areas
				to teach staff to work together and communicate effectively.
(2) Lactation and breastfeeding education for
				all members of the perinatal team.
(3) Conduct clinical drills to help staff
				prepare for high-risk, high complexity events with low rate of occurrence.
				Examples include, but are not limited to, shoulder dystocia, emergency cesarean
				delivery, maternal hemorrhage, and neonatal resuscitation.
(4) Conduct drill debriefings to evaluate
				team performance and identify areas for improvement for high-risk
				events.
(5) Educate nurses,
				residents, nurse midwives, and delivering physicians to use standardized
				terminology to communicate all categories of fetal heart rate monitor
				tracings.
(6) Identify specific
				triggers for responding to changes in the vital signs and clinical condition of
				the mother, fetus, and newborn, and develop and use protocols and drills for
				responding to changes such as preeclampsia, hemorrhage, or neonatal
				shock.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 6 - Obstetrical and Neonatal Universal Standards › Section 6-3 - Staffing requirements

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 3.
Each delivering facility shall have a written plan for
				  ensuring registered nurse-patient ratios as per Guidelines for Perinatal Care,
				  or Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN)
				  Guidelines for Professional Registered Nurse Staffing for Perinatal
				  Units.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 6 - Obstetrical and Neonatal Universal Standards › Section 6-4 - Performance improvement requirements

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 4.
Each delivering facility shall meet the following
				  requirements for performance improvement:
(1) Have a multidisciplinary continuous
				quality improvement program for improving maternal and neonatal health outcomes
				that has initiatives to promote patient safety including, but not limited to,
				the following:
(A) Safe medication
				practices.
(B) Universal protocol
				to prevent procedural errors.
(C)
				Educational programs to improve communication and team work.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 6 - Obstetrical and Neonatal Universal Standards › Section 6-5 - Written policy and procedural requirements

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 5.
Each delivering facility shall establish and maintain the
				  following written policies, protocols, or plans:
(1) Initial stabilization and continuing care
				of all obstetrical and neonatal patients appropriate to the level of care
				rendered at its facility.
(2)
				Obstetrical and neonatal resuscitation protocols.
(3) Medical staff credentialing process shall
				include documentation of competency to perform obstetrical and neonatal
				invasive procedures appropriate to its certified level of care.
(4) Plan for accepting or transferring
				mothers or neonates as "back transports" for ongoing convalescent care,
				including criteria for accepting the patient and necessary patient
				information.
(5) Policies that
				allow families, including siblings, to be together in the hospital following
				the birth of an infant and that promote parental involvement in the care of the
				neonate including care of the neonate in the neonatal intensive care unit
				(NICU).
(6) Appropriate newborn
				screening program in place according to federal and state law.
(7) Policies and protocols to address
				emergency preparedness for the obstetric and neonatal areas.
(8) Policies and procedures on local
				anesthesia.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 6 - Obstetrical and Neonatal Universal Standards › Section 6-6 - Reporting requirements

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 6.
Each delivering facility shall submit data to the department
				  or its designee as requested by the department.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 7 - Transport Requirements › Section 7-1 - Interhospital transfer requirements

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 1.
(a)
				Facilities who provide maternal-fetal or neonatal transport services must be
				certified as a Level III or Level IV facility for the patient population they
				wish to transfer.
(b) Facilities
				that own or contract for maternal-fetal transport services must comply with the
				Indiana emergency medical services commission rules on emergency medical
				services and the Indiana Perinatal Transport Standards issued by the Indiana
				Perinatal Quality Improvement Collaborative (IPQIC) dated October,
				2018.
(c) Facilities that own or
				contract for neonatal transport services must comply with the Indiana emergency
				medical services commission rules on emergency medical services and the Indiana
				Perinatal Transport Standards issued by the Indiana Perinatal Quality
				Improvement Collaborative (IPQIC) dated October, 2018.
(d) Facilities that own or contract for
				perinatal transfer services shall participate in data collection with the
				Ground and Air Medical Quality in Transport (GAMUT) national
				database.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 7 - Transport Requirements › Section 7-2 - Receiving hospital requirements

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 2.
A delivering facility that accepts maternal primary
				  transports, neonatal primary transports, or both, shall provide the following
				  to the referring hospital and providers:
(1) Guidance on indications for consultation
				and referral of patients at high risk.
(2) Information about alternative sources for
				specialized care not provided by the accepting hospital.
(3) Guidance on the pre-transport
				stabilization of patients.
(4)
				Feedback on the pre-transport care of patients.
(5) A process in place for communication
				between sending and receiving personnel, which may include updates on ongoing
				care, discharge planning, or the need for future referrals and
				follow-ups.
(6) Once the patient
				has reached the receiving hospital, information regarding the patient's
				condition, and care given during transport, shall be communicated to the
				referring provider and referring hospital staff.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 8 - Perinatal Centers › Section 8-1 - Qualifications for perinatal centers

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 1.
(a) The
				purpose of perinatal centers is to coordinate perinatal care throughout the
				state by affiliating with delivering facilities. Perinatal centers will work
				with affiliate hospitals by providing the following:
(1) Training.
(2) Quality assurance review.
(3) Facilitation of transport of mother and
				newborn.
(4) Other support services
				as necessary.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 8 - Perinatal Centers › Section 8-2 - Perinatal collaboration

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 2.
(a) Each
				perinatal center shall annually engage in a minimum of two (2) efforts
				sponsored by the department supporting improved outcomes for pregnant women and
				newborns.
(b) At least annually,
				perinatal centers and their affiliates shall review quality metrics recommended
				by the department and review and revise programs and activities to improve
				outcomes for pregnant women and newborns.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 8 - Perinatal Centers › Section 8-3 - Training for affiliate hospitals

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 3.
Perinatal centers shall provide clinical training to address
				  affiliate needs that augment routine training as outlined by the department,
				  including the following:
(1) Obstetric
				training including fetal heart rate monitoring.
(2) Neonatal training including the
				following:
(A) Neonatal Resuscitation Program
				(NRP).
(B) Post-resuscitation and
				pre-transport stabilization care of sick infants.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 8 - Perinatal Centers › Section 8-4 - Quality assurance

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 4.
In addition to data collected on birth and death
				  certificates, perinatal centers will review and analyze quality metrics
				  recommended by the department with their affiliates for identification of
				  quality improvement initiatives.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 8 - Perinatal Centers › Section 8-5 - Support services

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 5.
Delivering facilities serving as perinatal centers shall
				  provide the following support to affiliate hospitals at all times:
(1) Maternal-fetal medicine (MFM) specialist
				consultation by phone or telemedicine.
(2) Maternal-fetal transport including a
				reliable and comprehensive communication system to initiate
				transport.
(3) Communication with
				the discharging obstetrician-gynecologist (OB-GYN) or MFM specialist, and the
				referring OB-GYN or family medicine physician regarding the outcome of
				pregnancy, recommendations for postdelivery care or continued interpregnancy
				care, and management of the next pregnancy including, when appropriate, birth
				spacing.
(4) Neonatal consultation
				by phone or telemedicine.
(5)
				Neonatal transport, including a reliable and comprehensive communication system
				to initiate transport.
(6)
				Developmental follow-up program for high-risk newborns.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 8 - Perinatal Centers › Section 8-6 - Back transport

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 6.
Perinatal centers shall make every effort to transfer
				  maternal-fetal or neonatal patients back to the affiliate hospital when risk
				  appropriate and by mutual agreement with the affiliate hospital and
				  family.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 8 - Perinatal Centers › Section 8-7 - Neonatal intensive care unit transition and developmental follow-up

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 7.
Perinatal centers shall support the following
				  services:
(1) Retinopathy of
				prematurity screening.
(2)
				Assistance to affiliate hospitals in accessing subspecialty care as
				needed.
(3) Work with affiliate
				hospitals and primary care providers to establish medical homes to coordinate
				ongoing well child care.
(4)
				Implementation of a developmental follow-up screening program, with the
				following requirements:
(A) Perinatal centers
				shall use a valid and reliable standardized screening tool.
(B) The tool shall be administered at
				recommended intervals.
(C) The
				developmental follow-up screening program shall serve high-risk infants
				including, but not limited to, those with the following conditions:
(i) Newborns weighing less than or equal to
				one thousand five hundred (1,500) grams at birth.
(ii) Hypoxic-ischemic encephalopathy
				(HIE).
(iii) Neonatal
				seizures.
(iv) Hypoxic
				cardiorespiratory failure.
(v)
				Complex, multiple congenital anomalies.
(vi) Neonatal abstinence syndrome
				(NAS).
(vii) All other high-risk
				infants with additional diagnoses at the discretion of the center.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 8 - Perinatal Centers › Section 8-8 - Memorandum of understanding between perinatal center and affiliate hospitals

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 8.
(a) Any
				facility not certified by the department as a perinatal center shall affiliate
				with a perinatal center. The department shall notify facilities when all
				initial perinatal centers have been certified. Facilities not certified by the
				department as perinatal centers will have twelve (12) months from notification
				to enter into a memorandum of understanding with a certified perinatal
				center.
(b) Nonperinatal centers
				may affiliate with only one (1) perinatal center.
(c) Every perinatal center shall affiliate
				with at least one (1) hospital outside of its own network, unless none are
				available.
(d) The department will
				assign unaffiliated hospitals to perinatal centers as needed.
(e) Each perinatal center and its affiliate
				hospitals shall enter into an agreement that defines the responsibilities of
				each partner as follows:
(1) Each perinatal
				center shall have the following responsibilities:
(A) Training to affiliates as specified in
				section 1 of this rule.
(B) Support
				services to affiliates as specified in section 1 of this rule.
(C) Sponsor and coordinate visits to
				affiliate hospitals related to outcomes and quality assurance at least
				annually.
(D) Support for
				transition of patients from perinatal specialty care to primary
				physician.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 39 - PERINATAL HOSPITAL SERVICES › Rule 9 - Matters Incorporated by Reference › Section 9-1 - Matters incorporated by reference

Current through July 10, 2024
Authority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 1.
(a) When
				used in this article, references to the following publications shall mean the
				version of that publication listed and are hereby incorporated by reference:
(1) Indiana Perinatal Quality Improvement
				Collaborative (IPQIC), Indiana Perinatal Transport Standards (October 2018
				Edition) available at:
https://www.in.gov/laboroflove/files/perinatal-transport-guidelines-12-18.pdf
.
(2) Association of Women's Health, Obstetric
				and Neonatal Nurses (AWHONN), Guidelines for Professional Registered Nurse
				Staffing for Perinatal Units (2010 Edition) available at:
https://www.awhonn.org/
.
(3) United States Lactation Consultant
				Association, International Board Certified Lactation Consultant Staffing
				Recommendations for the Inpatient Setting (July 2010) available at:
				https://uscla.org/.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 40 - CERTIFICATE OF NEED PROGRAM › Rule 1 - Definitions › Section 1-1 - Applicability

Current through July 10, 2024
Authority: IC 16-29-7-19
Affected: IC 16-29-7
Sec. 1.
(a) The
				definitions in this rule apply throughout this article.
(b) The definitions in IC 16-29-7 apply
				throughout this article.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 40 - CERTIFICATE OF NEED PROGRAM › Rule 1 - Definitions › Section 1-2 - "Commissioner" defined

Current through July 10, 2024
Authority: IC 16-29-7-19
Affected: IC 16-29-7
Sec. 2.
"Commissioner" means the state health commissioner or
				  commissioner's designee.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 40 - CERTIFICATE OF NEED PROGRAM › Rule 1 - Definitions › Section 1-3 - "Department" defined

Current through July 10, 2024
Authority: IC 16-29-7-19
Affected: IC 16-29-7
Sec. 3.
"Department" means the Indiana department of
				  health.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 40 - CERTIFICATE OF NEED PROGRAM › Rule 1 - Definitions › Section 1-4 - "Review period" defined

Current through July 10, 2024
Authority: IC 16-29-7-19
Affected: IC 16-29-7
Sec. 4.
"Review period" means the period for review of certificate
				  of need applications beginning July 1 of each year and lasting until the
				  following June 30.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 40 - CERTIFICATE OF NEED PROGRAM › Rule 2 - Applicability › Section 2-1 - Applicability

Current through July 10, 2024
Authority: IC 16-29-7-19
Affected: IC 16-29-7
Sec. 1.
(a) Except
				as permitted in IC 16-29-7 and this article:
(1) comprehensive care beds may not be:
(A) added;
(B) transferred; or
(C) constructed;
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 40 - CERTIFICATE OF NEED PROGRAM › Rule 3 - Application; Public Comment › Section 3-1 - Application

Current through July 10, 2024
Authority: IC 16-29-7-19
Affected: IC 16-29-7
Sec. 1.
(a)
				Certificate of need applications must be submitted in accordance with IC
				16-29-7-11.
(b) Certificate of need
				applications shall be submitted on a form created by the department along with
				any required supporting documentation.
(c) The certificate of need applicant shall
				provide sufficient information to enable the commissioner to perform a thorough
				review of each of the criteria established by IC 16-29-7-12.
(d) Certificate of need applications may be
				submitted each year between July 1 and July 31.
(e) The department will publish any
				certificate of need application accepted for review on the department's
				Internet website before August 15 of the review period.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 40 - CERTIFICATE OF NEED PROGRAM › Rule 3 - Application; Public Comment › Section 3-2 - Public comment

Current through July 10, 2024
Authority: IC 16-29-7-19
Affected: IC 16-29-7
Sec. 2.
(a) The
				department shall accept public comment on any certificate of need application
				before October 15 of the review period.
(b) Public comment may be submitted by either
				of the following:
(1) United States Postal
				Service or equivalent delivery sent to the department at: Indiana department of
				health 2 North Meridian St. Indianapolis, IN 46204
(2) Electronic mail submitted to
				providers@isdh.in.gov.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 40 - CERTIFICATE OF NEED PROGRAM › Rule 4 - Review › Section 4-1 - Applications

Current through July 10, 2024
Authority: IC 16-29-7-19
Affected: IC 16-29-7
Sec. 1.
(a) The
				department will review applications submitted in accordance with this article
				based on the criteria established in IC 16-29-7-12.
(b) The commissioner shall approve a
				certificate of need application for:
(1) the
				transfer of comprehensive care beds; or
(2) the construction of a comprehensive care
				health facility consisting of transferred beds; only after finding that the
				transfer of construction is necessary as provided in IC 16-29-7-12.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 40 - CERTIFICATE OF NEED PROGRAM › Rule 5 - Fees › Section 5-1 - Fees

Current through July 10, 2024
Authority: IC 16-29-7-19
Affected: IC 16-29-7
Sec. 1.
(a) The fee
				for a certificate of need application is five thousand dollars
				($5,000).
(b) Fees imposed in this
				section are payable to the department for use in the administration of the
				certificate of need program.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 41 - ABORTION COMPLICATIONS REPORTING › Rule 1 - Definitions › Section 1-1 - Applicability

Current through July 10, 2024
Authority: IC 16-34-2-4.7
Affected: IC 16-34-2-4.7
Sec. 1.
The definitions in this rule apply throughout this
				  article.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 41 - ABORTION COMPLICATIONS REPORTING › Rule 1 - Definitions › Section 1-2 - "Abortion complication" defined

Current through July 10, 2024
Authority: IC 16-34-2-4.7
Affected: IC 16-34-2-4.7
Sec. 2.
"Abortion complication" means a condition listed in IC
				  16-34-2-4.7 that, in the reasonable medical judgment of the treating provider,
				  arises from the induction or performance of an abortion.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 41 - ABORTION COMPLICATIONS REPORTING › Rule 1 - Definitions › Section 1-3 - "Department" defined

Current through July 10, 2024
Authority: IC 16-34-2-4.7
Affected: IC 16-34-2-4.7
Sec. 3.
"Department" means the Indiana department of
				  health.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 41 - ABORTION COMPLICATIONS REPORTING › Rule 1 - Definitions › Section 1-4 - "Facility" defined

Current through July 10, 2024
Authority: IC 16-34-2-4.7
Affected: IC 16-21-2-2.5; IC 16-34-2-4.7
Sec. 4.
"Facility" means an entity, other than a physician, that is
				  required to report abortion complications under IC 16-34-2
				  4.7.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 41 - ABORTION COMPLICATIONS REPORTING › Rule 2 - Abortion Complications Reporting › Section 2-1 - Reporting complications

Current through July 10, 2024
Authority: IC 16-34-2-4.7
Affected: IC 25-22.5; IC 16-34-2-4.7
Sec. 1.
(a) The
				following persons shall report to the department each case in which the person
				treated a patient suffering from an abortion complication:
(1) A physician licensed under IC
				25-22.5.
(2) A facility.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 41 - ABORTION COMPLICATIONS REPORTING › Rule 2 - Abortion Complications Reporting › Section 2-2 - Submission and contents of report

Current through July 10, 2024
Authority: IC 16-34-2-4.7
Affected: IC 16-34-2-4.7
Sec. 2.
(a) A report
				of an abortion complication shall be submitted to the department within thirty
				(30) calendar days of the date of the onset of treatment for the reported
				complication.
(b) The report shall:
(1) include the information required by IC
				16-34-2-4.7; and
(2) be made on the
				form prescribed by the department.
Indiana Administrative Code › Title 412 - INDIANA HEALTH FACILITIES COUNCIL › Article 2 - QUALIFIED MEDICATION AIDES › Rule 1 - General Provisions › Section 1-1 - "Qualified medication aide" or "QMA" defined

Current through July 10, 2024
Authority: IC
				  16-28-1-11
Affected: IC 16-28
Sec. 1.
As used in this rule, "qualified medication aide" or "QMA"
				  means an individual who has satisfactorily completed the state-approved
				  qualified medication aide course, passed the state-approved competency
				  evaluation test, and received state certification.
Indiana Administrative Code › Title 412 - INDIANA HEALTH FACILITIES COUNCIL › Article 2 - QUALIFIED MEDICATION AIDES › Rule 1 - General Provisions › Section 1-2 - "Supervised practicum" defined

Current through July 10, 2024
Authority: IC
				  16-28-1-7;
				  IC
				  16-28-1-11
Affected: IC 16-28-1
Sec. 2.
As used in this rule, "supervised practicum" means training
				  in a long term care setting in which the QMA student demonstrates competency
				  while dispensing and passing medications and/or applying/administering
				  treatments under the direct supervision of a registered nurse or a licensed
				  practical nurse.
Indiana Administrative Code › Title 412 - INDIANA HEALTH FACILITIES COUNCIL › Article 2 - QUALIFIED MEDICATION AIDES › Rule 1 - General Provisions › Section 1-2.1 - Employment of QMA and registry verification

Current through July 10, 2024
Authority: IC
				  16-28-1-11
Affected: IC 16-28
Sec. 2.1.
(a) An
				individual shall not work as a QMA unless that individual:
(1) has satisfactorily completed a
				state-approved QMA training and competency evaluation program; and
(2) is certified by the Indiana state
				department of health.
An individual shall maintain QMA certification as required by
				  subsection 10(c)
[section 10(c)]
of this rule in order to
				  continue working as a QMA.
Indiana Administrative Code › Title 412 - INDIANA HEALTH FACILITIES COUNCIL › Article 2 - QUALIFIED MEDICATION AIDES › Rule 1 - General Provisions › Section 1-2.2 - Program applicants

Current through July 10, 2024
Authority: IC
				  16-28-1-11
Affected: IC 16-28
Sec. 2.2.
All applicants wishing to enroll in a training program to
				  become a QMA shall meet all of the following preenrollment criteria:
(1) Proof of a high school diploma or
				GED.
(2) Proof of being at least
				eighteen (18) years of age.
(3)
				Proof of completion of an Indiana nurse aide training course, including
				certification and on the Indiana state CNA registry.
(4) At least one thousand (1,000) hours of
				documented work experience as a CNA within the last twenty-four (24)
				months.
(5) Demonstrated ability to
				read and write in English and the ability to perform the four (4) basic
				mathematical functions:
(A)
				addition;
(B)
				subtraction;
(C) multiplication;
				and
(D) division;
as determined per training entity enrollment
				  pre-test.
Indiana Administrative Code › Title 412 - INDIANA HEALTH FACILITIES COUNCIL › Article 2 - QUALIFIED MEDICATION AIDES › Rule 1 - General Provisions › Section 1-3 - QMA training

Current through July 10, 2024
Authority: IC
				  16-28-1-11
Affected: IC 16-28-1
Sec. 3.
A QMA program shall include, at a minimum, the
				  following:
(1) One hundred (100) hours
				of training to include sixty (60) hours of classroom instruction and forty (40)
				hours of supervised practicum.
(2)
				Classroom training performed by a registered nurse who possesses a minimum of
				two (2) years of licensed nursing experience, of which at least one (1) year
				shall be in the provision of long term care facility services. Instructors
				shall have documentation of completion of an Indiana state department of health
				instructor QMA course.
(3) A
				curriculum that includes a review of the following areas:
(A) Communication and interpersonal skills,
				including communication with a cognitively impaired or combative resident as
				follows:
(i) Techniques for addressing the
				unique needs and behaviors of individuals with dementia (Alzheimer's and
				others).
(ii) Communicating with
				cognitively impaired residents.
(iii) Understanding the behavior of
				cognitively impaired residents.
(iv) Appropriate responses to behavior of
				cognitively impaired residents.
(v)
				Methods of reducing the effects of cognitive impairments.
Indiana Administrative Code › Title 412 - INDIANA HEALTH FACILITIES COUNCIL › Article 2 - QUALIFIED MEDICATION AIDES › Rule 1 - General Provisions › Section 1-4 - Means to assess progress

Current through July 10, 2024
Authority: IC
				  16-28-1-7;
				  IC
				  16-28-1-11
Affected: IC 16-28-1
Sec. 4.
The training program shall use an evaluation system that
				  appropriately assesses the student's ongoing progress. Documentation of the
				  student's ongoing progress and competency during the training program must be
				  available for review by the Indiana state department of health.
Indiana Administrative Code › Title 412 - INDIANA HEALTH FACILITIES COUNCIL › Article 2 - QUALIFIED MEDICATION AIDES › Rule 1 - General Provisions › Section 1-5 - Practicum

Current through July 10, 2024
Authority: IC
				  16-28-1-7;
				  IC
				  16-28-1-11
Affected: IC 16-28-1
Sec. 5.
(a) The
				supervisor of the forty (40) hour practicum shall be a:
(1) registered nurse licensed in Indiana;
				or
(2) licensed practical nurse
				licensed in Indiana who has a minimum of one (1) year of licensed nursing
				experience.
Indiana Administrative Code › Title 412 - INDIANA HEALTH FACILITIES COUNCIL › Article 2 - QUALIFIED MEDICATION AIDES › Rule 1 - General Provisions › Section 1-6 - Location for supervised practicum

Current through July 10, 2024
Authority: IC
				  16-28-1-11
Affected: IC 16-28-1
Sec. 6.
(a) The site
				for the supervised practicum shall be a facility or unit operating under 410
				IAC 16.2. The practicum training site shall have written approval from the
				Indiana state department of health every two (2) years.
(b) If the supervised practicum site is
				conducted at a location other than the site of the classroom training, a
				written agreement shall be in place stating the practicum is being conducted
				under appropriate supervision.
(c)
				The Indiana state department of health may remove approval to train QMAs from
				any training entity that:
(1) fails to meet
				the requirements of 410 IAC 16.2;
(2) refuses unannounced visits by the Indiana
				state department of health;
(3)
				refuses to submit an acceptable plan of correction to an Indiana state
				department of health survey;
(4)
				falsifies any documents pertaining to the QMA training;
(5) has a pattern of excessive failure rates
				on the competency evaluation test; and
(6) has validated training
				improprieties.
Indiana Administrative Code › Title 412 - INDIANA HEALTH FACILITIES COUNCIL › Article 2 - QUALIFIED MEDICATION AIDES › Rule 1 - General Provisions › Section 1-7 - Classroom requirements

Current through July 10, 2024
Authority: IC
				  16-28-1-7;
				  IC
				  16-28-1-11
Affected: IC 16-28-1
Sec. 7.
(a) The
				classroom training may be provided by one (1) of the following:
(1) A licensed long term care
				facility.
(2) A program of an
				Indiana vocational school governed by the department of education or North
				Central Accreditation.
(3) A
				program conducted by an accredited school of nursing.
(4) A nonfacility based program.
Indiana Administrative Code › Title 412 - INDIANA HEALTH FACILITIES COUNCIL › Article 2 - QUALIFIED MEDICATION AIDES › Rule 1 - General Provisions › Section 1-8 - QMA competency evaluation

Current through July 10, 2024
Authority: IC
				  16-28-1-11
Affected: IC 16-28-1
Sec. 8.
(a) A QMA
				competency evaluation test shall be administered consisting of multiple choice
				questions requiring a passing score of eighty percent (80%) by the
				state-approved testing entity. Ongoing revision of test questions may be
				necessary in an effort to maintain a valid exam that includes new medications
				and updated materials for various medication classifications. The application
				for competency exam shall be submitted within thirty (30) days of practicum
				completion.
(b) The competency
				evaluation test may be taken three (3) times within one (1) year of the
				completion date of classroom training. Prior to the student applying to take
				the second or third test, the student shall provide documentation to the
				testing entity of additional training that is based on the QMA training program
				and conducted by a registered nurse. However, if the student is unsuccessful
				after three (3) attempts, he or she shall repeat the training program in its
				entirety. Testing will be administered and scored by an entity approved by the
				Indiana state department of health.
(c) The student must complete the forty (40)
				hour practicum and apply to take the competency evaluation test within six (6)
				months of the completion date of the sixty (60) hour classroom portion of the
				program. Applications to take the second or third test must be submitted, along
				with documentation of additional training, within one (1) year of the
				completion date of the classroom training.
(d) Graduate nursing students that do not
				pass the state nursing boards may function as a QMA after successfully
				completing the competency evaluation test with a passing score of eighty
				percent (80%).
(e) Nursing students
				who have completed a pharmacology class with a grade of "C" or above would be
				exempt from the classroom training; however, the student is required to
				complete the practicum and successfully complete the competency evaluation
				test.
(f) The competency evaluation
				program must be approved by the Indiana state department of health every two
				(2) years.
Indiana Administrative Code › Title 412 - INDIANA HEALTH FACILITIES COUNCIL › Article 2 - QUALIFIED MEDICATION AIDES › Rule 1 - General Provisions › Section 1-10 - Certification, recertification, reinstatement, and in-service education requirements

Current through July 10, 2024
Authority: IC
				  16-28-1-11
Affected: IC 16-28
Sec. 10.
(a) A QMA
				shall be certified by the Indiana state department of health.
(b) For initial certification as a QMA, the
				individual must do the following:
(1) Complete
				the requirements of this rule.
(2)
				Submit to the testing entity an application approved by the Indiana state
				department of health.
(3) Pass the
				written competency test in three (3) or fewer attempts with a passing score of
				at least eighty percent (80%).
Indiana Administrative Code › Title 412 - INDIANA HEALTH FACILITIES COUNCIL › Article 2 - QUALIFIED MEDICATION AIDES › Rule 1 - General Provisions › Section 1-11 - Disciplinary action

Current through July 10, 2024
Authority: IC
				  16-28-1-11
Affected: IC 16-28
Sec. 11.
(a) All
				incidents in a health facility of alleged abuse, neglect, misappropriation of
				resident property, or conduct outside the QMA scope of practice shall be
				reported to the Indiana state department of health. The Indiana state
				department of health will investigate the incident.
(b) The Indiana state department of health
				may revoke the certification of a QMA following appropriate
				investigation.
(c) Acts that may
				result in the revocation of QMA certification include, but are not limited to,
				the following:
(1) Stealing, diverting, or
				otherwise misusing medications.
(2)
				Fraudulently procuring or attempting to procure a certification.
(3) Neglecting to administer appropriate
				medications as prescribed.
(4)
				Performing duties outside the QMA scope of practice.
Indiana Administrative Code › Title 412 - INDIANA HEALTH FACILITIES COUNCIL › Article 2 - QUALIFIED MEDICATION AIDES › Rule 1 - General Provisions › Section 1-12 - Reciprocity

Current through July 10, 2024
Authority: IC
				  16-28-1-11
Affected: IC 16-28
Sec. 12.
An individual who is a certified QMA in another state may
				  petition the Indiana state department of health to be exempt from the Indiana
				  QMA training course and supervised practicum. The petition for exemption shall
				  be in writing and shall include proof that the applicant is a QMA in good
				  standing in another state. If a petition for exemption is granted, the
				  individual will be required to take and pass the competency evaluation test
				  with a score of eighty percent (80%) or higher before that individual can be
				  certified as a QMA in Indiana.