Health Education (1) (d) (4) Nutrition (1) §51348(c) (5) Perinatal dietary assessment (1) §51348(c) (5) Individualized Care Plan Yes No Source Comments Includes identification of risks; prioritization of needs; proposed interventions, including methods, timeframes Includes patient strengths T 22 §51348 Includes patient goals T 22 §51348 Referrals and Care Coordination Yes No Source Comments The system prompts required referrals: Women, Infant and Children (WIC) §51348(j) Genetic Screening §51348(j) Dental Care §51348(j) Family Planning §51348(j) Well Child Care (CHDP) §51348(j) Documentation Requirements Yes No Source Comments Shows coordination of obstetric and support services including (1) Personal §51179.5 Supervision the personal supervision by a licensed physician, of services performed by others through direct communication, either in (2) p 2 Policies and person or through electronic means. Each provider’s protocols must define how personal supervision by a physician occurs and is documented. Includes a CPSP Progress Note for documenting and billing with (1) date, staff signature and CPSP practitioner title and number of minutes. Each CPSP support service includes the date, signature of (1) §51179.7 (7) p 1 Documentation the staff providing the service, CPSP practitioner title and of CPSP time in minutes. If the person is a comprehensive perinatal health worker, §51179.7(a)(10)(B) his/her physician supervisor's signature should appear on the patient record. CPHWs must work under the direct supervision of a physician. Record documents attendance at group classes including the (7) p 2 Documentation of CPSP name of class, date and length of the class in minutes and the name and title of the CPSP practitioner conducting the class. The provider keeps separate records of group classes with class lists and signatures of attendees and instructors. Section 2: Optional but Recommended Features
Health Education (1) (d) (4) Nutrition (1) §51348(c) (5) Perinatal dietary assessment (1) §51348(c) (5) Individualized Care Plan Yes No Source Comments Includes identification of risks; prioritization of needs; proposed interventions, including methods, timeframes Includes patient strengths T 22 §51348 Includes patient goals T 22 §51348 Referrals and Care Coordination Yes No Source Comments The system prompts required referrals: Women, Infant and Children (WIC) §51348(j) Genetic Screening §51348(j) Dental Care §51348(j) Family Planning §51348(j) Well Child Care (CHDP) §51348(j) Documentation Requirements Yes No Source Comments Shows coordination of obstetric and support services including the personal supervision by a licensed physician, of services performed by others through direct communication, either in person or through electronic means. Each provider’s protocols must define how personal supervision by a physician occurs and is documented. (1) §51179.5 Personal Supervision (2) p 2 Policies and Includes a CPSP Progress Note for documenting and billing with date, staff signature and CPSP practitioner title and number of minutes. (1) Each CPSP support service includes the date, signature of the staff providing the service, CPSP practitioner title and time in minutes. (1) §51179.7 (7) p 1 Documentation of CPSP If the person is a comprehensive perinatal health worker, his/her physician supervisor's signature should appear on the patient record. CPHWs must work under the direct supervision of a physician. §51179.7(a)(10)(B) Record documents attendance at group classes including the name of class, date and length of the class in minutes and the name and title of the CPSP practitioner conducting the class. The provider keeps separate records of group classes with class lists and signatures of attendees and instructors. (7) p 2 Documentation of CPSP Section 2: Optional but Recommended Features
CPSP-EHRReviewTool.docx