The Comprehensive Perinatal Services Program (CPSP) CPSP Insert name of PSC Insert date

What is CPSP? CPSP provides enhanced perinatal services, nutrition, psychosocial and health education, for Medi-Cal eligible women from pregnancy through the end of the second month after delivery CPSP has been shown to improve birth outcomes

What is CPSP? Medi-Cal managed care plans (Plans) must inform members of childbearing age of the availability of comprehensive perinatal services Plans are required to implement a comprehensive risk assessment tool for all pregnant members, comparable to the American Congress of Obstetricians and Gynecologists (ACOG) and CPSP standards

Goals of CPSP  Decrease and 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 13.pdf

Why be a CPSP Provider? Better patient outcomes CPSP receives reimbursement for enhanced services, in addition to basic obstetrical services More staffing flexibility

Basic OB vs. CPSP Reimbursement

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:

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

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

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

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.

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 In some 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

Protocols for CPSP Services & Supervision 22 CCR defines “Protocol” as "written procedures for providing psychosocial, nutrition, and health education services and related case coordination.” 22 CCR 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.” MCAHPP pdf mtp/part2/pregcom_m00o03.doc

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 aCPSPProvider.aspx

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 Plan first for services rendered to Medi-Cal Managed Care clients. 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

Electronic Health Record (EHR) EHRs should facilitate the CPSP work flow in each provider office The Provider is responsible for evaluating the content and functionality of the EHR system The PSC will review the EHR content using an approved set of CPSP forms or CPSP CCR Title 22, section as a guide to assure that the required elements of prenatal and postpartum assessment, reassessment, and interventions are included MCAHPP pdf

Resources: CPSP Website Provider Handbook c67e1ab4d8dac1fe0d5d3847bb3.aspx Steps To Take c67e1ab4d8dac1fe0d5d3847bb3.aspx Medi-Cal Website CPSP Perinatal Services Coordinators

Thank you! Questions??