Referrals documented: RF01 100% F/U to documented: RF01 100% Demonstrates evidence of care coordination. 100% March of 100% Dimes “Becoming a Mom” Curriculum delivered Agency Name: Review Date: MCH Nurse Consultant: Agency Contact: Evaluation Not Evaluation Element Citation Met N/A Findings Mechanism Met The agency has an outreach BBO Contract Review of local policy and procedure in Exhibit C agency policy place that demonstrates and procedure outreach activities that will identify and recruit high-risk, hard-to-engage women during their 1st trimester of pregnancy. The agency has a written BBO Contract Review of local quality assurance process Exhibit B agency QA with internal policies and process practices specific to quality improvement. 3. Risk factor eligibility for BBO BBO Contract Case manager is determined by Exhibit B observation; administration of 707G chart review assessment prior to enrollment. 4. Agency is required to give BBO Contract Chart review; written notification to BBO Exhibit B local agency care policy and clients’ medical provider: name of BBO procedure agency; name and contact information of BBO case manager.
Referrals documented: RF01 100% F/U to documented: RF01 100% Demonstrates evidence of care coordination. 100% March of Dimes “Becoming a Mom” Curriculum delivered 100% Agency Name: Review Date: MCH Nurse Consultant: Agency Contact: Evaluation Element Citation Evaluation Mechanism Met Not Met N/A Findings The agency has an outreach policy and procedure in place that demonstrates outreach activities that will identify and recruit high-risk, hard-to-engage women during their 1st trimester of pregnancy. BBO Contract Exhibit C Review of local agency policy and procedure The agency has a written quality assurance process with internal policies and practices specific to quality improvement. BBO Contract Exhibit B Review of local agency QA process 3. Risk factor eligibility for BBO is determined by administration of 707G assessment prior to enrollment. BBO Contract Exhibit B Case manager observation; chart review 4. Agency is required to give written notification to BBO clients’ medical care provider: name of BBO agency; name and contact information of BBO case manager. BBO Contract Exhibit B Chart review; local agency policy and procedure
FY18BBOClinicalReview.docx