64C-6.002. Standards - General

(1) The CMS RPICC Program represents the basic unit required for all other Children’s Medical Services authorized regional programs which include spina bifida, craniofacial anomalies, hematology and oncology, complex surgery, cardiac, and transplantation.

(2) The Regional Perinatal Intensive Care Centers (RPICC) Program provides services in designated hospitals through two interrelated components:

(a) Neonatal including Level II and Level III neonatal intensive care;

(b) Obstetrical.

The standards set forth in this section pertain to the RPICC Program in general.

(3) Facilities and Location.

(a) Upon review of available information or upon the request of an individual or institution the CMS Program office shall make a determination of the need for the establishment of a center within a geographic area. This determination shall be based upon the following factors:

1. The number of live births per year, as required in Section 383.19, F.S.

2. The access of patients (infants and pregnant women) in the area to established RPICC services.

(b) Upon the determination of the need for a center within a geographic area, the CMS Program office shall review the hospitals within the geographic area to determine which facility should be considered for designation as a RPICC.

(c) CMS Program office staff and RPICC Program consultants shall conduct an on-site review of the hospital to ascertain the extent to which the hospital’s facilities, personnel, and services comply with the standards set forth herein. Based on this review a recommendation shall be made for appropriate designation as a center.

(d) In order to be designated a center, a hospital must be approved by the Assistant Secretary for Children’s Medical Services, based on the recommendation from the on-site review.

(e) In order to be designated as a center, the maternal and neonatal intensive care services must be present in the same complex and must be located in close proximity.

(f) Institutions designated as centers shall meet all standards for facilities, personnel, and services, as set forth herein, within 3 years of designation as a center.

(g) If all standards for facilities, staffing, and services, as set forth herein, are not met without appropriate waiver, then designation as a center shall be removed unless the Assistant Secretary for CMS determines that removal will reduce essential services.

(4) Personnel.

(a) Each center shall designate one or more RPICC liaisons to provide coordination between the center, the CMS Program office and local CMS offices. This person shall keep all records, interview patients for CMS eligibility, and maintain statistical records for review.

(b) Each center shall provide one registered nurse who will be responsible for coordinating staff development and continuing education programs for perinatal nursing staff at that center, and for coordinating educational outreach activities of the RPICC to other hospitals and health care professionals.

(5) Patient Eligibility.

(a) Patients who have been determined medically eligible, as defined in paragraph 64C-6.003(1)(c) or 64C-6.003(3)(c), F.A.C., for the RPICC Program shall have their financial eligibility for the RPICC Program determined. A patient shall be considered financially eligible for the RPICC Program if the applicant meets the Medicaid requirement for pregnant women and newborns in Section 409.903(5), F.S.

(6) Waivers.

(a) In the event that compliance with any facility or personnel standard is not attained, a provider may request a waiver of that standard.

(b) All requests for waiver of a specific standard shall be made in writing to the Children’s Medical Services Program office and shall include documentation of the need of the waiver.

(c) A waiver of a specific standard shall be granted only for a specific period of time.

(d) Final approval or disapproval of all requests for waiver shall be made by the Assistant Secretary for Children’s Medical Services. The Assistant Secretary for CMS shall base the decision to grant or deny a specific request for waiver of a standard upon the documentation submitted with the request.

Rulemaking Authority 120, 383.19 FS. Law Implemented 120, 383.171, 383.19 FS. History–New 9-1-81, Amended 4-25-83, Formerly 10J-7.02, Amended 6-13-87, 5-15-96, Formerly 10J-7.002.