12 Va. Admin. Code § 5-191-230

Current through Register Vol. 41, No. 6, November 4, 2024

Section 12VAC5-191-230 - Scope and Content of the Virginia Bleeding Disorders Program

A. Mission. Virginia Bleeding Disorders Program improves the availability and accessibility of comprehensive care for clients with inherited bleeding disorders and their families.

B. Scope of services. In collaboration with a network of comprehensive bleeding disorders clinics in the Commonwealth, services are provided by a multidisciplinary team that focuses on the physical, emotional, social, educational, financial and workplace impact of inherited bleeding disorders. The comprehensive care team collaborates closely with the client's primary care provider within their community.

The Virginia Bleeding Disorders Program provides the following enabling services:

1. Assistance in accessing comprehensive specialty health care services for clients with inherited bleeding disorders and a medical home.

2. Care coordination.

3. Insurance case management that may include a comprehensive resource assessment, consultation, and referral of eligible individuals to third party payers; education and assistance to individuals regarding health care choices relevant to insurance options; procurement of grants for the funding of third party medical coverage; and assistance to eligible individuals in the health insurance application and enrollment process and procurement of the least costly and beneficial medical coverage.

4. Information and referral.

5. Collaboration with the Virginia Department of Education and its Education in Hospitals Program to provide consultation for families, educators, and school administrators.

6. Transition from child to adult oriented health care system.

7. Family-to-family support.

8. Training and technical assistance for community providers.

9. Promotion of quality assurance and policy development through the Hemophilia Advisory Board.

C. Criteria to receive services of Virginia Bleeding Disorders Program. Individuals are eligible to receive services from the Virginia Bleeding Disorder Program if they are:

1. Residents of the Commonwealth.

2. Any age.

3. Diagnosed as having an inherited bleeding disorder.

4. Clients of a comprehensive bleeding disorder clinic.

No financial eligibility criteria are required for clients to receive the enabling services. However, clients who meet the above criteria must also meet the financial requirements for eligibility for access to a pool of funds for payment of their direct health care services.

D. Goals. The Title V national performance measures, as required by the federal Government Performance and Results Act (GPRA- Pub. L. 103-62 ), are used to establish the program goals. The following goals shall change as needed to be consistent with the Title V national performance measures:

1. Clients with inherited bleeding disorders will partner in decision making at all levels and will be satisfied with the services they receive.

2. Clients with inherited bleeding disorders will receive coordinated, ongoing, comprehensive specialized care in partnership with their community-based primary care provider.

3. Clients with inherited bleeding disorders will have adequate private or public insurance or both to pay for the services they need.

4. All youth with inherited bleeding disorders will participate in preparing for transition to adult life, including adult health care, work and independence.

12 Va. Admin. Code § 5-191-230

Derived from Virginia Register Volume 23, Issue 21, eff. July 25, 2007.

Statutory Authority

§§ 32.1-12 and 32.1-77 of the Code of Virginia.