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N.C. Department of Environment, Health, and Natural Resources page 2 of 5 <br />Division of General Services <br />CONTRACT ADDENDUM gy 1991 -92 <br />a real Health Branch 92- s*23-06$ <br />Office, Section, or Branch <br />Contract Number <br />Orange Conn tv Health De Went <br />Contractor <br />i✓ K1r <br />;aternal Health <br />Activity <br />L <br />7. An estimated AY % of those persons served the Health <br />Maternity Program will receive a �' g examtrreit <br />8 weeks after deliv or family planning exam within <br />cry. HSIS Report: Imo, Hgu= CLOSM S�1rI�RY <br />(•item XI.A. '"DOTAL" column) - <br />8. Public Health Nurses who are the hictX?st level of medical provider for <br />subsequent prenatal visits will have cmPleted the Maternal Health <br />"'W-1—sment TrainiM Program at Gulford County or an equivalent maternal <br />assessment course. <br />9. The health dot has written policies in place that appropriately <br />address the following: <br />(a) Follow -up of missed prenatal. appointments. <br />(b) Postpartum follow -up of wcren who received no prenatal care based <br />upon information received fram. birth certificates or other <br />appropriate sources. <br />(c) Follow -up of pregriant umven who express interest in pernianent <br />sterilization or contraception. <br />(d) Hick risk conditions indicating referral to a high risk maternity <br />clinic or obstetrician. <br />lo. Persons enrolled in the Health Department Maternity <br />following services as o will be provide_ �`:e <br />in their medical records: <br />(a) An estimated loo $ will receive an initial maternal health histo <br />consists of at least 7 of the following ' wt`l "� <br />surgical; 1 � n,?' zatian (TD, Rubella); � � � kcal ; family. <br />ive; obstetrical; and m � /medication; menstrual; <br />social. <br />(b) An estimated 100 % will receive an initial icy <br />consists of at least 6 of the following 8 thyroid; ilu which <br />breast; heart; <br />:thyroid; lungs; <br />and blood and extremities; pelvic (uterine size or ft dal height) <br />Fes• <br />Reviewed by <br />DEHNR 3300 (Revised 2/90) <br />General Services Division (Review 1/95) <br />Initials Dare <br />