New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 3 - Hospital Operation › Part 721 - Perinatal Regionalization System › Section 721.2 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Level I
					 perinatal care service means a comprehensive maternal and newborn service
					 provided by a hospital designated as such by the department for normal low-risk
					 newborns and for women who have been assessed as having a normal, low-risk
					 pregnancy and having a fetus which has been assessed as developing normally and
					 without apparent complications.
(b)
					 Level II perinatal care means a comprehensive maternal and newborn service
					 provided by a hospital designated as such by the department which includes
					 services for moderately high-risk newborns and for women who have been assessed
					 as having the potential or likelihood for a moderately complicated or high-risk
					 delivery and/or bearing a fetus exhibiting the potential for unusual or
					 high-risk development. Such services may also provide services to women
					 requiring care normally provided at Level I perinatal care services.
(c) Level III perinatal care means a
					 comprehensive maternal and newborn service provided by a hospital designated as
					 such by the department and which includes services for women and newborns who
					 have been assessed as high-risk patients and/or are bearing high-risk fetuses,
					 who will require a high level of specialized care. Such programs may also
					 provide services to women and newborns requiring care normally provided at
					 Level I and II perinatal care services.
(d) Regional perinatal center (RPC) means a
					 hospital or hospitals housing a perinatal care service which meets the
					 standards for a Level III perinatal care service but which also, includes
					 highly specialized services that may not be available at all Level III
					 hospitals, and designated as such by the department. An RPC serves a geographic
					 area or a group of perinatal affiliates. It provides all aspects of
					 comprehensive maternal and neonatal care, and its functions and
					 responsibilities also include efforts to coordinate and improve quality of
					 perinatal care among its affiliates, attending level consultation regarding
					 patient transfer and clinical management, transport of high-risk patients,
					 outreach to affiliates to determine educational needs, education and training
					 of affiliate hospitals, data collection, evaluation and analysis within that
					 region. If two or more hospitals jointly sponsor an RPC, they must define in a
					 written agreement between or among the hospitals comprising the RPC how the
					 aforementioned functions and responsibilities will be carried out.
(e) Perinatal affiliation agreement shall
					 mean a written fully executed agreement between a Level I, II or III perinatal
					 care hospital, and that hospital's designated RPC. A perinatal affiliation
					 agreement shall include provisions for, at a minimum:
(1) criteria, policies and procedures for
					 transfer of patients, with appropriate consent, to the RPC and from the RPC
					 back to the sending hospital;
(2)
					 criteria and process for attending level subspecialty consultation on a 24-
					 hour basis, including types of consultation processes (i.e., via telephone,
					 telemedicine or in-house consults) acceptable for each subspecialty;
(3) participation in the statewide perinatal
					 data system (SPDS) including the provision of the confidentiality and
					 protection of all data obtained through the SPDS;
(4) cooperation in outreach, education,
					 training and data collection activities;
(5) authority for one geographically
					 accessible RPC representative or representatives to participate in the
					 affiliate hospital's quality assurance committee and other reviews of the
					 quality of perinatal care provided by the affiliate and to provide
					 recommendations for quality improvement of perinatal services. Each RPC and
					 each affiliate hospital shall take actions necessary, including but not limited
					 to, entering into a perinatal affiliation agreement, to authorize such
					 participation by the RPC's representatives in the affiliate hospital's quality
					 assurance committee and for purposes of such participation, the RPC
					 representative or representatives shall be deemed member(s) of the affiliate's
					 quality assurance committee, shall maintain the confidentiality of all
					 information obtained in such capacity and are subject to the confidentiality
					 restrictions of Public Health Law section 2805-m;
(6) RPC involvement in the development of
					 written agreements among perinatal affiliates including criteria regarding
					 transport of women and newborns;
(7) timely consultation on treatment plans
					 for women and neonates who develop or exhibit unanticipated conditions which
					 may require transfer to a higher level of care; and
(8) resolution of disputes or disagreements
					 between the RPC and the perinatal affiliate, including disagreements regarding
					 interpretation of affiliation agreement criteria for consultation and/or
					 transfer. In cases of disputes or disagreement between an affiliate and its
					 RPC, the affiliate and the RPC shall follow the dispute resolution process
					 outlined in their perinatal affiliation agreement. If the dispute is not
					 resolved within 60 days, the parties must request review by the department. The
					 department shall initiate compliance reviews at both sites, advise each
					 facility of its findings, and require corrective action, as indicated, to
					 resolve the dispute. This process shall not interfere with the timely and
					 proper transfer of mothers and newborns.