To be designated as an APC, a hospital shall submit an
application to the Department for a grant to provide financial support to
assist the Department in the implementation and oversight of the Regionalized
Perinatal Health Care Program;and shall comply with all of the conditions
described for intensive (Level III) perinatal care in Section
640.43; and shall comply with
all of the conditions described in Subpart O of the Hospital Licensing
Requirements. The APC shall comply with the following:
a) Administrative Perinatal Center - General
Provisions
1) An APC shall be a university or
university-affiliated hospital, having Level III hospital designation. An APC
may be composed of one or more institutions. The APC shall be responsible for
the administration and implementation of the Department's regionalized
perinatal health care program, including but not limited to:
A) Continuing education for health care
professionals;
B) Leadership and
implementation of CQI projects, including morbidity and mortality reviews at
regional network hospitals;
C)
Maternal and neonatal transport services;
D) Consultation services for high-risk
perinatal patients;
E) Follow-up
developmental assessment programs; and
F) Laboratory facilities and services
available to regional network hospitals.
2) An APC shall be capable of providing the
highest level of care within a regional network appropriate to maternal and
neonatal high-risk patients. The following services shall be available:
A) Consultants in the various
medical-pediatric-surgical subspecialties including, but not limited to,
cardiac, neurosurgery, genetics, and other support services;
B) Follow-up developmental assessment
program;
C) Maternal and neonatal
transport services; and
D)
Laboratory facilities available to the hospitals within the regional perinatal
network.
b)
The Department will designate an APC within each regional perinatal network to
be responsible for the administration and implementation of the Department's
Regionalized Perinatal Health Care Program.
c) The APC will be responsible for providing
leadership in the design and implementation of the Department's CQI Program,
including the establishment and regularly scheduled meetings of a regional
quality improvement structure (Regional Quality Council).
d) The APC shall establish a Joint Mortality
and Morbidity Review Committee with the affiliated regional network hospitals.
The Committee shall review all perinatal deaths and selected morbidity,
including, but not limited to, transports of neonates born with handicapping
conditions, or developmental disabilities, or unique medical conditions. This
review shall also include a periodic comparison of total perinatal mortality
and the numbers attributable to categories of complications. Membership on the
Committee shall include, but not be limited to, pediatricians, obstetricians,
family practice physicians, nurses, quality assurance, pathology, and hospital
administration staff and representatives from the hospital's APC. The network
administrator shall prepare a yearly synopsis of the Regional Perinatal
Network's perinatal deaths. This synopsis shall include statistical
information, as well as an identification of the factors contributing to deaths
that are identified as potentially avoidable. The synopsis shall be shared with
the Regional Quality Council. The Council shall develop, for the Network, an
action plan to address issues of preventability. The Council's action plan
shall be forwarded to the Department. The membership of the Council shall
include representatives from all levels and disciplines of perinatal health
care providers.
e) Perinatal
Program Oversight
1) The Department shall
work in conjunction with the APCs to conduct site visits at network hospitals
to assure compliance with this Part on a periodic basis not to exceed three
years.
2) The requirements of this
Part do not apply to infants who, after having completed initial therapy, are
transferred back to the referring hospital for continuing care. The capability
of the hospital to provide necessary services for these infants shall be
determined by mutual consent with the APC and addressed in the letter of
agreement.
3) APCs shall provide
information to the Department no less frequently than quarterly. These reports
shall include, but not be limited to, network education activities; network
meetings; overview of CQI activities; schedule of mortality and morbidity
review meetings; and schedule of proposed and completed network hospital site
visits.