123225-123255

HEALTH AND SAFETY CODE
SECTION 123225-123255




123225.  The department shall maintain a program of maternal and
child health.


123230.  The department may investigate, and disseminate educational
information relating to, conditions affecting the health of the
children of this state.


123232.  (a) The department shall develop or obtain a brochure to
educate pregnant women and new parents about the important role in
maintaining a healthy lifestyle and preventing chronic diseases of
both of the following:
   (1) Eating a diet rich in fruits and vegetables.
   (2) Staying active every day.
   (b) The brochure shall address how proper nutrition and exercise
help prevent the development of chronic disease in pregnant women,
new mothers, and young children. The brochure shall also include
information regarding the critical role of fruits and vegetables in a
person's diet, especially as an important source of vitamins and
nutrients to new mothers and their breast milk.
   (c) The department shall include the brochure on the department's
Web site.
   (d) The brochure shall be distributed as follows:
   (1) By the department to each individual who contacts the BabyCal
program and receives a package of information from the program.
   (2) By a provider to each participant in the Access for Infants
and Mothers (AIM) program one time during the participant's
pregnancy.
   (e) The brochure shall be available in both English and Spanish.
   (f) This section shall be implemented only if, and to the extent
that, federal or private funding, or both, are available for that
purpose.



123235.  The program may include the provision of educational,
preventative, diagnostic and treatment services, including medical
care, hospitalization and other institutional care and aftercare,
appliances and facilitating services directed toward reducing infant
mortality and improving the health of mothers and children. The
department may make grants or contracts or advance funds from any
funds that are made available for the purposes of the Maternal and
Child Health Program Act (Section 27).



123240.  (a) The Maternal and Child Health Branch of the department
shall conduct a pilot project to assess the effectiveness of daily
ambulatory uterine monitoring devices and services in reducing
preterm births in Medi-Cal eligible women.
   (b) The department shall implement the pilot program to assess the
incidence of preterm births in 1,000 women at high risk of preterm
birth, 500 of whom shall be provided daily ambulatory uterine
monitoring services between the 23rd and 36th weeks of gestation and
500 of whom shall be provided routine prenatal care augmented by
training in palpatation. Women participating in the pilot program
shall be Medi-Cal eligible women. To the maximum extent possible
these services shall be prescribed by providers participating in
other programs administered by the Maternal and Child Health Branch
of the department or the comprehensive perinatal program.
   (c) Women shall be deemed to be at high risk if they have multiple
gestation or any two of the following risk factors for preterm
labor; uterine malformation, a history of preterm labor or births,
cervical incompetence, cervical dilation or effacement, and those
patients who have been treated during the current pregnancy for
preterm labor.
   (d) The department shall select five counties to participate in
the project, at least one of which shall be a rural county, and shall
reimburse providers of ambulatory uterine monitoring services a fee
based on reasonable costs.
   (e) (1) The department shall also contract for an evaluation of
the pilot project to ascertain whether use of the ambulatory uterine
monitoring services significantly reduces the incidence of preterm
births. The evaluation shall compare the experimental and control
groups and identify the following for each group:
   (A) The number of preterm births.
   (B) The number of hospital days used by the mother prior to
delivery.
   (C) The number of hospital days used by the mother and child after
delivery, including neonatal intensive care.
   (D) The number of children born with developmental disabilities or
conditions that may lead to developmental disabilities.
   (E) The costs of providing prenatal services.
   (2) The evaluation shall also project the costs associated with
the health care provided to the mother and child during the course of
the pilot project and, if feasible, shall project the longer term
health care costs of children born prematurely, including costs of
services provided to the developmentally disabled.
   (3) The department may enter into the contract on a sole source
basis.
   (f) (1) The pilot project established pursuant to this section
shall be considered successful if it shows that the experimental
group, when compared to the control group, had all of the following:
   (A) A 20-percent reduction in the number of premature births.
   (B) A 20-percent reduction in the number of antepartum
hospitalization days.
   (C) A 20-percent reduction in the number of neonatal intensive
care unit days for premature births.
   (D) A 20-percent reduction in total patient costs.
   (2) The department shall submit the evaluation to the Legislature
by September 1, 1990.
   (g) (1) The department shall immediately seek any federal waivers
necessary to ensure full federal financial participation in the pilot
program established pursuant to this section.
   (2) The department shall not implement the pilot program under
this section until necessary federal waivers are received.



123245.  The Maternal and Child Health Program Act (Section 27) does
not give the power to force compulsory medical or physical
examination of children.


123250.  Upon request the department shall advise all public
officers, organizations, and agencies interested in the health and
welfare of mothers and children in the state.



123255.  (a) The department may maintain a maternal and child health
program in each county.
   (b) Notwithstanding any other provision of law, the department may
allocate, for the purposes of maintaining a maternal and child
health program, to a county an amount determined in a manner as the
director shall provide. The total of all county allocations shall not
exceed the annual appropriation for this purpose.
   (c) To be considered for an allocation, the county's governing
board shall submit a plan and budget for the county's program in
accordance with maternal and child health plans and priorities to be
approved by the department under Title V of the Public Health Service
Act (42 U.S.C. Sec. 701 et seq.). The department shall establish the
procedures and format for submission of the plan and budget. The
plan shall conform to the department's maternal and child health
priorities that are in accordance with the core public health
functions of needs assessment, policy development, and assurance.
   (d) The department shall establish minimum standards that govern
the basis for allocations to counties, including, but not limited to,
the services to be provided, administration, staffing, fiscal
accountability, and eligibility for services. The department may
recoup or withhold all or part of a county's allocation for failure
to comply with those standards.
   (e) Claims for reimbursement shall be made in a manner as provided
by the director for activities provided in accordance with the plan
and budget for the fiscal year in which the expenses upon which the
claim is based are incurred.
   (f) There shall be no reimbursement for any of the following:
   (1) Projects or programs identified unless previously approved by
the department as part of the maternal and child health plan.
   (2) Capital improvements.
   (3) The purchase or construction of buildings except for the
equipment items and remodeling expenses as may be allowed by the
department on a case-by-case basis.
   (g) The department and counties shall maximize the use of federal
funds available to implement this section, including using state or
county funds to match funds claimable under Title XIX of the federal
Social Security Act (42 U.S.C. Sec. 1396 et seq.).
   (h) (1) For purposes of this program, the department shall
reimburse a county pursuant to this section in lieu of renewing or
commencing a cooperative agreement with a county for the operation of
a maternal and child health program.
   (2) It is the intent of the Legislature that cooperative
agreements between the department and a county for the operation of a
maternal and child health program pursuant to this section be
replaced by the process described in this section beginning with the
1997-98 fiscal year.