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N.C. Department of Environment, Health, and Natural Resources <br />Division of General Services <br />CONTRACT ADDENDUM <br />Maternal Health Branch <br />Office, Section, or Branch - ` <br />Orange Corm tv Health tmeat <br />Contractor <br />Page 1 of 5 <br />WA <br />1991 -92 <br />5lbI <br />92- 5422 -068 <br />Contract Number <br />Maternal Health <br />Activity <br />1. An estimated 180 (m zber) new patients will be admitted to the Health <br />Department Maternity Program. HSIS Report: M&TERNAL HERLTH AC IVri[y <br />S (Item I.A.). <br />2. An estimated 1,620 (number) patient visits (i.e. ccoplete service) will <br />be made to the Health. Department maternity clinics. HSIS Report: <br />MMML EMAIM ACTIVI'T'Y S[lr!►PM (Item V.A.1. - 1110 'AL" column) . <br />3. An estimated 50 % of those persons served by the Health Department <br />Maternity Pmgram will initiate prenatal care in the first trimester (0 -14 <br />weeks) of pregnant'. HSIS Report: M7ERN ,L HEALM pROG7AM INEgC =W <br />(Item I.A. - "ALL FMS SERVED" column). <br />4. The health department has written policies in place for facilitating early <br />entry into prenatal care which include the following: <br />(a) Follow -up of positive pregnancy tests within two weeks to <br />assure patient has access to a health care provider. <br />(b) In the presence of a three weeks or greater waiting list, triage <br />of those warren who request prenatal services from the health <br />d )artsmeart for purposes of determining their scheduling priority <br />for their first clinic visit. <br />(c) Referral to WIC upon making contact with a pregnant women. <br />(d) Referral for medicaid eligibility determination and maternity <br />care coordination upon making contact with a pregnant women. <br />5. An estimated 85 $ of those pins served by the Health Department <br />Maternity Program will receive WIC Program services. HSIS Report: <br />MMUML HEM= CCOSM& S�iRy (Item X.A. "'TOTAL" column) or HSIS - WIC <br />MA'T(N Fit WcM. <br />6. An estimated 60 $ of those persons served by the Health Department <br />Maternity Program will receive care coordination services. HSIS Report: <br />M33R4AL HKkLTH PMGRAM IN IC AMWS (Item III.A. "OUNI'Y" column) . <br />Reviewed by <br />DEHNR 3300 (Revised 2/90) ,� ;5'- qr <br />General Services Division (Review 1/95) Initials Date <br />