641—76.4 (135) Definitions.
“Applicant” means a private nonprofit or public agency that seeks a contract with the department to provide MCH services.
“Care/service coordination” means a process of linking the service system to the recipient and organizing the various elements in order to achieve a successful outcome. The terms “care coordination” and “service coordination” may be used interchangeably.
“Children with Special Health Care Needs (CSHCN)” means children with chronic physical, developmental, behavioral, or emotional conditions that require health and related services of a type or amount beyond that required by children generally.
“CHSC” means Child Health Specialty Clinics, a statewide program for children with special health care needs authorized under Title V of the Social Security Act.
“Client” means an individual who receives MCH services through a contract agency.
“CMS” means the United States Department of Health and Human Services Centers for Medicare and Medicaid Services (formerly Health Care Financing Administration).
“Contract agency” means a private nonprofit or public agency that has a contract with the department to provide MCH services and receives funds from the department for that purpose.
“Core public health functions” means the functions of community health assessment, policy development, and assurance.
	  1. 	 Assessment: regular collection, analysis, interpretation, and communication of information about health conditions, risks, and assets in a community.
	  2. 	 Policy development: development, implementation, and evaluation of plans and policies, for public health in general and priority health needs in particular, in a manner that incorporates scientific information and community values and is in accordance with state public health policy.
	  3. 	 Assurance: ensuring, by encouragement, regulation, or direct action, that programs and interventions that maintain and improve health are carried out.
“Dental home” means a usual source of dental care where dental care services are provided in a primary care setting where care is accessible, family-centered, continuous, comprehensive, coordinated, compassionate, and culturally competent. In addition, the dental care provider and parents partner to identify and access all the dental and nondental services needed to help children and their families achieve maximum oral health.
“Department” means the Iowa department of public health.
“DHHS” means the United States Department of Health and Human Services.
“DIA” means the Iowa department of inspections and appeals.
“Direct health services” means those services generally delivered one-on-one between a health professional and a client in an office or clinic.
“Director” means the director of the Iowa department of public health.
“Enabling services” means services that allow or provide for access to and the derivation of benefits from, the array of basic health care services and include activities such as outreach, case management, health education, transportation, translation, home visiting, smoking cessation, nutrition, support services, and others.
“EPSDT” means the Early and Periodic Screening, Diagnosis, and Treatment program which provides for regular preventive health care services for children aged 0 to 21 as authorized by Title XIX of the Social Security Act.
“Essential public health services” means those activities carried out by public health entities and their contractors that fulfill the core public health functions in the promotion of maternal and child health.
“Family,” for the purpose of establishing eligibility, means a group of two or more persons related by birth, marriage or adoption or residing together and functioning as one socioeconomic unit. For the purpose of these rules, a pregnant woman is considered as two individuals when calculating the number of individuals in the family. If a pregnant woman is expecting multiple births, the family size is thereby increased by the number expected in the multiple birth.
“Family planning” means the promotion of reproductive and family health by the prevention of and planning for pregnancy, and reproductive health education.
“Gap filling” means direct health services supported by Title V staff or resources that are needed by children with special health care needs but are not otherwise accessible in the community.
“HAWK-I” means healthy and well kids in Iowa and is the child health insurance program in Iowa as authorized in Title XXI of the Social Security Act.
“HCFA” means the DHHS, Health Care Finance Administration.
“Health education” means services provided by a health professional to include instruction about normal anatomy and physiology, growth and development, safety and injury prevention, signs or symptoms indicating need for medical care, and other anticipatory guidance topics.
“Health professional” means an individual who possesses specialized knowledge in a health or social science field or is licensed to provide health care.
“Health services” means services provided through MCH contract agencies.
“Informing” means the act of advising families of the services available through the EPSDT/Care for Kids program, explaining what to expect at screening, and providing information about health resources in the community.
“Infrastructure building” means activities directed at improving and maintaining the health status of all clients by providing support for the development and maintenance of comprehensive health services systems including development and maintenance of health services standards or guidelines, training, data, and planning systems.
“MCH services” means essential public health services provided by MCH contract agencies.
“Medicaid” means the Medicaid program authorized by Title XIX of the Social Security Act and funded through the Iowa department of human services from the DHHS.
“Medical home” means a usual source of health care where the physician/health care provider is available to coordinate preventive, primary and follow-up care at all times (24 hours per day, seven days per week) for the patient while maintaining the client’s health records. In addition, the physician/health care provider and parents partner to identify and access the medical and nonmedical services needed to help children and their families achieve their maximum potential.
“Nutrition screening” means nutrition education appropriate to the needs of the client, and referral to a licensed dietitian if indicated.
“OMB” means the United States Department of the Treasury, Office of Management and Budget.
“Oral health counseling” means services to assess oral health status and to provide education appropriate to the needs of the client and referral to a dentist if indicated.
“Oral health education” means information provided by a health professional about dental disease, prevention, and oral hygiene and other anticipatory guidance.
“Parenting education” means educational services for parents or expectant parents provided by health professionals to include care of infants and children, normal development, discipline, and other topics as appropriate.
“Performance measures” means a narrative statement that describes a specific maternal and child health need or requirement that, when addressed, will lead to a specific health outcome within a community and generally within a specified time frame.
“Performance standards” means criteria or indicators of the quality of service provided or the capability of a contract agency to provide public health services in a cost-effective or efficient manner as identified in the quality assurance section (501) of the MCH Administrative Manual. Copies of the performance standards are available from the Chief, Family Services Bureau, Department of Public Health, Lucas State Office Building, Des Moines, Iowa 50319-0075, or on the Iowa department of public health Web site (www.idph.state.ia.us).
“Pharmacist” means a person currently licensed to practice pharmacy under Iowa Code chapter 155.
“Physician” means a person currently licensed to practice medicine and surgery, osteopathic medicine and surgery, or osteopathy under Iowa Code chapters 148 and 150A.
“Population-based services” means preventive interventions and personal health services, developed for and available to the entire MCH population of the state rather than for individuals in a one-on-one situation. Disease prevention, health promotion, and statewide outreach are major components.
“Prenatal and postpartum care” means those types of services as recognized by the American College of Obstetricians and Gynecologists.
“Program income” means gross income earned by the contract agency from activities in which part or all of the cost is either borne as a direct cost by the funds received from the department or counted as a direct cost toward meeting cost-sharing or matching requirements of the contract agency. “Program income” includes but is not limited to such income in the form of fees for services, third-party reimbursements, and proceeds from sales of tangible, personal or real property.
“Psychosocial services” means screening activities that include social assessment and assisting with a family’s additional needs for support and referral.
“Title V” means Title V of the Social Security Act and the federal requirements contained in the Omnibus Reconciliation Act of 1989 (Public Law 101-239) which address the Maternal and Child Health and Children with Special Health Care Needs programs.
“Title X” means the program authorized in the federal regulations found in 42 CFR Subpart A, Part 59, published in the Federal Register on June 3, 1980, and the Program Guidelines for Project Grants for Family Planning Services.
“Title XIX” means the Medicaid program authorized in the Social Security Act and funded through the Iowa department of human services from the DHHS.
“Title XXI” means the child health insurance program authorized in the Social Security Act and implemented in Iowa as the HAWK-I program as administered by the Iowa department of human services.
“Well-child health care” means those types of services as recognized by the latest edition of the American Academy of Pediatrics, Guidelines for Health Supervision.
“WIC” means the Special Supplemental Nutrition Program for Women, Infants and Children, funded through the department from the United States Department of Agriculture.