Brad Barron

No specific tirnelina right now, | believe Deb Brinson has reached out ta me te discuss this request further.

Hi Bracl~ thanks for getting back tous and asking for the information. We wil put some info together far you and get hack to you. Do you have a timeline in which you need a response from us? Nancy

Hi Nancy — | hope all is well. | would like to re-open this discussion of nursing assessment visits. In 2012 we spoke about the need to increase these in-home visits and | wanted to see if you or someone from your section could provide me with additional information or justification for why the limit of 2 visits is an unrealistic expectation and should be increased? Thanks in advance,

Thanks, Brad, good to know where to find this information. Yes. | think we can think about justification for changing what is currently offered, and how best to move forward in the future. Sent from my iPhone

| found this today within the Practitioner chapter of the Medicaid Provider manual: Nursing Assessment/ Investigation Visits MDCH covers up to two nursing assessment/investigation visits per episode of blood lead poisoning. If more than one child in the home has blood lead poisoning, the nursing assessment/investigation visits are covered for each child. Blood lead nursing visits must be provided in the child's home. For FFS beneficiaries, 1 xxxEND_PAGE:dhhs03_b0524_1845_1846_1 001846 an enrolled home health agency, a LHD or other medical clinic, or a physician may conduct the visits. This procedure is not covered for Maternal Infant Health Program (MIHP) providers. Blood lead nursing visits provided through a MHP are covered by the individual MHP. The first nursing assessment/investigation visit focuses on: - Assessment of the growth and developmental status of the child, including any symptomatology that may be present in the child. - Behavioral assessment of the child, including any aggressiveness and/or hyperactivity. - Nutritional assessment of the child. - Assessment of typical family practices that may produce lead risk (e.g., hobbies, occupation, cultural practices). - Limited physical identification of lead hazards within the dwelling. - Identification and planning for testing for any other family member at risk for sequelae of lead hazard exposure. - Education and information regarding lead hazards and ways to minimize those risks in the future. - Development of a family plan of care to increase the safety of the child from lead hazards. The second blood lead nursing visit focuses on: - Reinforcement of the educational information presented to the family during the first visit. - Validation of the family’s ability to carry out activities to minimize risks of continued lead exposure. - Modifications of the plan to minimize lead risks, as needed. So, it is correct that a limit of 2 visits has been established. Would you be able to provide additional information or justification for why the limit of 2 visits is an unrealistic expectation? | know | have heard these complaints from Health Departments before. | have not looked in to the federal regulations related to this yet. -Brad Brad J. Barron, MPA Medicaid Program Policy Division Department of Community Health (517)241-1286 barronb@imichigan soy This message, including any attachments is intended solely for the use of the named recipient(s) and may contain confidential and/or privileged information. Any unauthorized review, use, disclosure, or distribution of any confidential and/or privileged information contained in this e-mail is expressly prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy any and all copies of the original message. xxxEND_PAGE:dhhs03_b0524_1845_1846_2