Pregnancy Care Management program offered locally

By Annie Fennell, RN - Sampson County Health Department

The Sampson County Health Department offers a prenatal program, Pregnancy Care Management Services — OBCM. The Program was developed by the North Carolina Division of Public Health and the North Carolina Division of Medical Assistance and is designed to assist pregnant women with Medicaid who have priority risk factors to achieve a healthier pregnancy. Pregnancy Care Management (OBCM) serves Pregnant Women with Medicaid who have a priority Maternal Infant Impact Score (MIIS) associated with low birth weight or other risk factors.

Pregnancy Care Management services are provided by nurses and social workers with a focus on patient need and risk status. The type and frequency of patient contacts are determined by the patient’s individual needs and plan of care in order to effectively meet desired outcomes.

Prenatal care providers may refer patients for OBCM services by completing the Pregnancy Home Risk Screening form at the initial prenatal visit, in order to identify risk factors. If the pregnancies risk screening form is not utilized when making the referral, the Pregnancy Care Manager will contact the patient to assess for the presence of priority risk factors. Some priority risk factors include but are not limited to:

• Hypertension

• A history of spontaneous preterm labor

• A history of low birth weight

• Unsafe living environment (homelessness, inadequate housing, domestic violence or abuse)

• Substance Use

• Tobacco Use

• Antenatal hospital utilization

Services are available to any woman with Medicaid who lives in Sampson County, regardless of where she goes for prenatal care. Pregnancy Care Management staff receives a referral and contacts the person for follow-up care. Any medical provider or agency that works with pregnant women can refer clients. Clients that have any of the above risk factors and are interested in the program can also contact the Pregnancy Care Management staff.

The Pregnancy Care Management staff provides the following services:

• Follow-ups on prenatal care issues and other clinical needs

• Work with OB Providers and others who provide services to the pregnant woman to make sure everyone is aware of her concerns and needs.

• Provide education regarding: the need to keep all prenatal-related appointments; understanding and following the OB provider’s instructions; and the importance of getting postpartum care.

• Arrange/assist with the transition from the OB Provider to a primary care medical home as needed for the woman after delivery if she remains or becomes eligible for Medicaid after the postpartum period.

The Pregnancy Care Management staff also offers assistance with 17P treatment program. 17P is a series of weekly injections offered to women who have had previous preterm labor and/or deliveries. The purpose of the injections is to help prevent preterm labor with the current pregnancy. Services provided are:

• Educating the client/family on 17P and its purpose

• Assisting the patient in arranging to receive 17P injections and follow up when an injection is missed

Effective and ongoing communication and collaboration between the Pregnancy Care Manager and the 17P patient’s prenatal care provider is a key component of the program. The overall goal of the 17P program seeks to improve birth outcomes by reducing the rate of preterm birth, which is measured by rates of low birth weight and very low birth weight, in addition to other indicators.

If you are: a Medical Provider and would like to refer a client; a pregnant woman; know someone that may qualify for the program; or you would like more information on the Pregnancy Care Management Program, please call the Sampson County Health Department at 910-592-1131, ext. 4973, 4230, 4241, 4238 or 4237.

By Annie Fennell, RN

Sampson County Health Department