Below is the HillCo client report from the October 7 Perinatal Advisory Council meeting.

The Perinatal Advisory Council (PAC) held their 7th meeting today to review the 2nd draft of the perinate designation rule and to receive further public comment on the rule. Please see attached for the newest draft of the rule and the presentation from the meeting.
 
 
General Discussion

  • Dr. Toy explained how this new draft was just released to them last night
  • The previous draft of the rule was released by DSHS to stakeholders without PAC review
    • The PAC submitted their guidelines to the state to craft the rule, so the first draft didn’t reflect all of the PAC’s intentions
    • Initial concern from stakeholders was that CMS was going to force transfers
    • The second draft of the rules made significant changes to alleviate rural concerns
  • Discussion of the site survey teams
    • Dr. Hankin, American Academy of Pediatrics
      • 32 states currently have NICU designations but do not have survey requirements
      • Believes this will be a national effort
      • Wants to cross breed individuals on the site survey teams; teams could include professionals from out of state
      • Work in progress trying to figure out how this will all be organized
      • Tenet – will there be nurses on the survey teams? Yes
  • Background on 2012 Perinatal Standards
    • Dr. Hankin, American Academy of Pediatrics
      • The majority of doctors on the committee that created the 2012 standards were academically based
      • The standards were presented at their annual meeting where private providers vetted the standards
      • Supported by ACOG and March of Dimes
        • The March of Dimes really represents the parent’s voices, many with a NICU experience
  • Baylor – What work is being done to finance back transfer of a baby, either home or to a lower level NICU?
    • Dr. Toy – we are not allowed to put that into the rule
    • The PAC will be making strong recommendations to HHSC to provide this funding
    • Believes that it will be a cost savings to the state
      • Being able to transfer a baby to a facility when it needs a lower level of NICU care will decrease the cost of care than if the baby remained at a NICU with a higher level of cost and care
      • HHSC is having internal meetings looking into the possibility of making this change
  • THA – The transferring agreement in the NICU rules absolutely needs to be the same as what is in statute under Hospital Licensure; requested that the PAC include a reference to that statute in the final rule under the definition
  • Jaime Capelo – Very concerned that this rule places the NICU Designation Unit under the Office of EMS/Trauma Systems of Care
    • HHSC tried to explain how the office will have no purview over the Unit – it will be placed there for logistical reasons
    • Concern was still voiced so Dr. Toy and HHSC will create an organizational chart to clarify
  • Discussion on outliers to the rule, for example a baby that is a certain age but doesn’t fit weight criteria
    • Use common sense
    • Put the situation through the facility’s PI process
    • Concern was voiced that the rule would pigeon hole them (discussion of “and versus or” in the rule language)
  • Dr. Toy said that they would continue to work on this rule language and they will be sure to send out to stake holders as they continue to craft a rule that everyone can agree on

 
 

Attachments