64F-2.002. Coalition Responsibilities

(1) Perform an assessment of the prenatal and infant health care needs of the services delivery catchment area or areas represented by the coalition, as described in Section 383.216(2)(a), F.S. This assessment shall include, at a minimum, the following:

(a) A demographic and economic profile of the coalition's service area which describes the population in terms of age, race, ethnicity, sex, income level, educational level, type of occupation and any other locally relevant characteristics.

(b) An estimate of the number of women who will get pregnant each year in the coalition's service area and an estimate of the number of these women who will have insufficient financial means to cover prenatal, labor and delivery, postpartum, and infant care.

(c) A determination of priority target groups by geographic location by use of census tracts or zip codes of groups which may be at risk of adverse pregnancy outcomes due to medical, socioeconomic conditions, or past experience. In identifying priority target groups, the coalition should consider barriers to services such as:

1. Transportation difficulties.

2. Inconvenient days and hours of care available from providers and excessive waiting periods.

3. Inability to pay for services or lack of third-party coverage.

4. Difficulties in obtaining eligibility for Medicaid.

5. Problems with child care.

6. Poor motivation due to impaired psychosocial functioning.

7. Illegal or alien status.

8. Lack of knowledge of where to seek, and the importance of seeking, prenatal care.

9. Past negative experiences with providers.

10. Language barriers.

11. Cultural barriers.

12. Insufficient health care providers.

13. Negative perceptions of provider quality.

(d) An evaluation of outcomes by provider within the coalition's service area.

(2) Establish service area outcome objectives with guidance from the department, using the Agency Functional Plan, the State Health Plan, Healthy People 2000, Healthy Communities 2000: Model Standards, Guidelines for Attainment of Year 2000 Objectives for the Nation, and any local health plans or education plans (such as those relating to teenage pregnancies).

(3) Develop a comprehensive resource inventory of services available for residents of the coalition's service area which includes identifying actual and potential local providers of services. The resource inventory should include an analysis of each actual and potential provider's ability and willingness to serve the target population identified in paragraph 64F-2.002(1)(c), F.A.C. Information supplied by the resource inventory should include the following service characteristics:

(a) Location.

(b) Catchment area.

(c) Hours and days of operation.

(d) Type and extent of core services being provided.

(e) Willingness to accept Medicaid clients and the conditions under which clients are accepted.

(f) Willingness to accept medically indigent clients and the conditions under which clients are accepted.

(g) Arrangements for making referrals and obtaining specialty services for clients.

(h) Capability of provider to deliver one or more of the core services to the priority target population.

(i) Funds available to provide services.

(j) Other information deemed appropriate by the coalition.

(4) Determine the services required to provide care to the identified priority target groups and the unmet needs for services by soliciting information from various community sources within the coalition’s service area.

(5) Develop a prenatal and infant health care services delivery plan. The purpose of this plan is to focus all the prenatal, labor and delivery, postpartum, and infant care resources available in the service area on developing and maintaining a system to ensure adequate and appropriate prenatal and infant care. It shall include action steps or strategies for both the coalition and the member agencies and organizations. These action steps shall include the responsible entity or entities, time frames and evaluation measures. The initial plan shall be due to the department within six months of official designation of the coalition. Changes and updates to the plan may be done at the discretion of the coalition. Subsequent reviews and updates of the plan shall be done, at a minimum, on an annual basis. A copy of all initial, annual and revised plans shall be submitted to the State Surgeon General within 30 days of final approval by the coalition.

(6) Organize a local provider network or networks to implement the services delivery plan.

(7) Upon completion of the service delivery plan, develop an allocation methodology using identified resources which are appropriated for the coalition’s service area and over which the coalition has been given authority by the responsible federal, state or local agency.

(8) Develop and implement a methodology to evaluate the effectiveness of the service or services delivered by the provider. Each coalition will compile baseline data and update this data at least on a yearly basis and review the results with the department. The evaluation should address the performance of the delivery system compared to established outcome standards.

(9) Build a supportive community network within the coalition’s service area to ensure the needs of the priority target group are being met.

(10) Assure that a quality assurance system is in operation within each provider’s organization in the network.

Rulemaking Authority 383.216(10) FS. Law Implemented 383.216 FS. History–New 11-11-91, Amended 4-21-96, Formerly 10D-113.003.