10A NCAC 43B .0302. APPLICATION FOR FUNDS

(a)  Local health departments in counties that are underserved with respect to obstetrical care may apply to the Division of Public Health for Rural Obstetrical Care Incentive Funds.  A physician or a nurse‑midwife may request a local health department to apply for the funds.

(b)  A county is considered underserved with respect to obstetrical care if the county meets one or more of the following criteria, listed in order of priority:

(1)           there are no public or private prenatal services available within the county;

(2)           there is no public prenatal clinic available within a health department, hospital or primary care center that serves low income pregnant women within the county;

(3)           there is a public prenatal clinic, but no physician or nurse‑midwife to staff the clinic or no physician back‑up for physician extenders;

(4)           the county has inadequate obstetrical coverage, demonstrated by such factors as: a waiting list of 28 calendar days or more for an appointment at the public prenatal clinic; 50 percent or more of resident live‑births occur outside the county; the five year infant mortality or premature birth rate is greater than the five year state rate; the percentage of resident live births to women who received no prenatal care or inadequate prenatal care exceeds the state rate; 50 percent or less of physicians who practice obstetrics in the county serve Medicaid recipients in their private practice; more than 15 percent of resident live births are to women who receive their prenatal care from public clinics; the percentage of resident live births to women who initiated prenatal care in the first trimester is lower than the state rate; or the percentage of resident live births to women who initiated prenatal care in the third trimester is greater than the state rate.

(c)  The Division of Public Health shall send a request for applications to local health departments that includes a deadline for receipt of applications.

(d)  Local health departments that apply for Rural Obstetrical Care Incentive Funds shall include in the application:

(1)           a coverage plan, developed in cooperation with eligible physicians, nurse‑midwives, and community, migrant, or rural health centers that addresses prenatal and delivery care for low income women in the county, and quality of care;

(2)           contracts with eligible physicians and contracts with eligible nurse‑midwives and their supervising physician who agree to participate in the local health department's coverage plan and provide the services required by Rule .0306; the contracts may be contingent upon the availability of Rural Obstetrical Care Incentive Funds; and

(3)           evidence that receipt of these funds will improve or rectify the problems with obstetrical coverage in the county.

 

History Note:        Authority S.L. 1989, c. 1066, s. 49;

Temporary Rule Eff. October 20, 1988, for a Period of 180 Days to Expire on April 18, 1989;

Eff. March 1, 1989;

Amended Eff. February 1, 1991; February 1, 1990.