Tsev Cov Chaw Muab Kev Pabcuam & Cov Neeg Koom Tes Cov Lus Nug Feem Ntau Txog Kev Pabcuam Doula

Doula Cov Kev Pab Cuam Tshuam Cov Lus Nug

Doula Providers – Hospitals

Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) suav nrog cov kev pabcuam doula hauv ob qho tib si tswj kev saib xyuas thiab them nqi-rau-kev pabcuam kev pabcuam rau cov menyuam cev xeeb tub thiab tomqab yug menyuam. Cov kev pabcuam muaj xws li kev pabcuam tsis yog khomob rau kev mus ntsib ua ntej yug menyuam thiab tomqab yug menyuam, thiab thaum lub sijhawm ua haujlwm thiab yug menyuam, nchuav menyuam, thiab rho menyuam tawm. 

1. Cov neeg mob hauv tsev kho mob puas muaj cai rau tus qhua ntawm lawv xaiv, thiab puas muaj kev zam? (Ntxiv rau lub Cuaj Hlis 6, 2024)

  • Yog lawm. Hauv qab siv tau xeev thiab tsoom fwv kev taw qhia, tus neeg mob muaj cai tau txais cov qhua uas lawv xaiv. Yog xav paub ntxiv txog tsoom fwv cov cai, thov mus saib nqe lus nug #4 hauv qab no.
  • Txawm li cas los xij, lub tsev kho mob yuav tsum tsim kom muaj ib qho chaw kho mob uas tsim nyog lossis tsim nyog txwv lossis kev txwv ntawm cov cai no. Piv txwv li:
  • Lub tsev kho mob tsis tso cai rau txhua tus neeg tuaj saib, txawm hais tias qhov no tsis yog ib qho kev coj ua thiab tsuas yog tso cai rau qee qhov xwm txheej.
  • Lub tsev kho mob tsim nyog txiav txim siab, raws li qhov kev ntsuam xyuas los ntawm rooj plaub, tias qhov muaj ntawm a tshwj xeeb Tus neeg tuaj xyuas yuav ua rau muaj kev phom sij rau kev noj qab haus huv thiab / lossis kev nyab xeeb ntawm tus neeg mob, cov neeg ua haujlwm lossis lwm tus neeg tuaj xyuas lossis yuav cuam tshuam rau kev ua haujlwm ntawm lub chaw. Qee qhov piv txwv ntawm no yuav suav nrog yog tias tus qhua mob lossis mob (xws li, tswj kev kis kab mob), tus qhua tuaj yeem cuam tshuam rau kev ua haujlwm hauv tsev kho mob (xws li, chav ua haujlwm me), lossis tus neeg mob qhia tias lawv tsis xav kom tus qhua tuaj.
  • Txoj cai mus ntsib tsev kho mob tej zaum yuav txawv ntawm hom chav tsev, piv txwv li, cais cov cai rau cov tsev kho mob hnyav lossis rau cov chaw zov me nyuam yug tshiab.

2. What constitutes “patient visitation” under federal Centers for Medicare and Medicaid Services (CMS) regulations for hospitals? (Added September 6, 2024)

  • Cov neeg mob muaj cai tau txais cov qhua uas tus neeg mob xaiv.  Cov neeg tuaj xyuas no tuaj yeem suav nrog, tab sis tsis txwv rau, tus txij nkawm lossis tus khub hauv tsev (nrog rau tus txiv neej sib deev lossis tus khub hauv tsev), lwm tus neeg hauv tsev neeg, lossis phooj ywg.  Cov piv txwv ntxiv muaj xws li ib tug tswv cuab ntawm cov txiv plig, tus txiv plig, tus thawj coj, los yog tus thawj coj ntawm kev ntseeg.  Cov chaw ua haujlwm raws li CMS cov cai mus ntsib tus neeg mob yuav tsum xyuas kom lawv cov cai tsis muaj kev ntxub ntxaug raws li haiv neeg, xim, lub tebchaws tuaj, kev ntseeg, poj niam txiv neej, poj niam txiv neej, kev xav ntawm kev sib deev, lossis kev tsis taus. Tus neeg mob kuj muaj cai thim los yog tsis kam tso cai rau cov neeg tuaj xyuas no txhua lub sijhawm.  Cov cai no raug tiv thaiv raws li CMS cov cai ntawm Title 42 Code of Federal Regulations (CFR) Seem 482.13(h), uas tau hais nyob rau hauv cov lus nug #4 hauv qab no.
  • Tsoom Fwv Teb Chaws thiab lub xeev txoj cai tso cai rau tsev kho mob txwv kev mus ntsib ntau yam laj thawj. Piv txwv ntawm kev txwv kev tso cai thiab/lossis yog vim li cas muaj nyob rau hauv CMS Tsev Kho Mob Txhais Lus Qhia [Tags A-0215 to A-0217], thiab CMS Critical Access Hospital Interpretive Guidelines [Tags C-0154 to C-0158].

3. Vim li cas cov doulas thiaj raug suav hais tias yog "cov qhua" ntawm tsev kho mob thaum lawv muab kev pabcuam rau cov neeg mob uas tsis yog kev kho mob rau kev mus ntsib ua ntej thiab tom qab yug menyuam, thiab thaum lub sijhawm yug menyuam, rho menyuam, thiab rho menyuam? (Ntxiv rau lub Cuaj Hlis 6, 2024)

  • DHCS nkag siab thiab lees paub tias muaj kev nkag siab txog cov doulas uas raug suav hais tias yog "tus qhua," tshwj xeeb tshaj yog thaum tus doula nrog tus neeg yug menyuam mus rau hauv tsev kho mob. Txawm hais li ntawd los, raws li lub xeev thiab tsoomfwv cov lus qhia muaj ntau pawg uas yuav tsum tau hais txog raws li cov cai thiab cov txheej txheem ntawm tsev kho mob (P&Ps) thiab pawg "tus qhua" yog pawg ze tshaj plaws. Txog qhov kawg no, DHCS thiab cov neeg koom tes hauv tsev kho mob tsuas yog siv cov lus no hauv cov ntsiab lus nqaim los piav qhia txog pawg hauv cov ntawv sau P&P hauv tsev kho mob uas doulas tuaj yeem xa mus rau kom nkag siab zoo dua txog kev coj ua ntawm tsev kho mob. 

4. Cov tsev kho mob puas yuav tsum tau sau ntawv P&Ps uas suav nrog cov ntaub ntawv hais txog txoj cai mus ntsib tus neeg mob, suav nrog rau cov neeg txhawb nqa? (Ntxiv rau lub Cuaj Hlis 6, 2024)

  • Yes. Under applicable state and federal requirements, all hospitals must have written P&Ps regarding patient visitation rights. Some hospitals may specifically reference “doulas” while others may refer to a “support person” generally. The P&Ps must address inpatient and outpatient settings and include any clinically necessary or reasonable restrictions on visitation and the reasons for those restrictions. Additionally, all hospitals must inform patients in writing of their right to have visitors of their choosing.
  • Cov kev cai no tau teev tseg hauv Title 42 CFR Tshooj 482.13(h), uas suav nrog cov tsev kho mob uas tau txais nyiaj Medicaid tseem ceeb hauv qab no:

    “(h) Lub tsev kho mob yuav tsum tau sau cov cai thiab cov txheej txheem hais txog txoj cai mus ntsib cov neeg mob, suav nrog cov kev teeb tsa kev kho mob tsim nyog lossis kev txwv tsim nyog lossis kev txwv tsis pub muaj kev txwv rau lub tsev kho mob li cas. txwv. Lub tsev kho mob yuav tsum ua raws li cov cai hauv qab no:

    (1) Qhia rau txhua tus neeg mob (lossis tus neeg txhawb nqa, yog qhov tsim nyog) ntawm nws txoj cai mus ntsib, suav nrog kev txwv kev kho mob lossis kev txwv ntawm cov cai li no, thaum nws raug ceeb toom txog nws txoj cai nyob rau hauv nqe lus no.

    (2) Qhia rau txhua tus neeg mob (lossis tus neeg txhawb nqa, qhov tsim nyog) ntawm txoj cai, raws li nws qhov kev pom zoo, kom tau txais cov qhua uas nws xaiv, suav nrog, tab sis tsis txwv rau, tus txij nkawm, tus khub hauv tsev (xws li poj niam txiv neej pw hauv tsev), lwm tus neeg hauv tsev neeg, lossis phooj ywg, thiab nws txoj cai thim lossis tsis lees txais qhov kev pom zoo no txhua lub sijhawm.

    (3) Tsis txwv, txwv, lossis txwv tsis pub muaj cai tuaj xyuas vim yog haiv neeg, xim, keeb kwm ntawm lub tebchaws, kev ntseeg, poj niam txiv neej, poj niam txiv neej, kev nyiam poj niam txiv neej, lossis kev tsis taus.

(4) Ensure that all visitors enjoy full and equal visitation privileges consistent with patient preferences.”

5. Vim tias cov neeg mob muaj cai mus ntsib cov tib neeg uas lawv xaiv, lub tsev kho mob puas tuaj yeem tiv thaiv Medi-Cal cov tswv cuab kom tsis txhob nkag mus rau lawv cov doulas hauv tsev kho mob? (Ntxiv rau lub Cuaj Hlis 6, 2024)

  • No. If the patient designates their doula as their support person, then a hospital generally must allow a doula to accompany Medi-Cal members into the hospital, including triage and assessment, labor and delivery, and post-delivery/recovery, if the hospital’s written P&Ps allows a support person (visitor, doula, etc.) to accompany birthing individuals. The P&Ps must address inpatient and outpatient settings and include any clinically necessary, reasonable restrictions on visitation rights and the reasons for those restrictions. If there is a specific hospital that is denying Medi-Cal members access to their doulas, please refer to question #6 below for instructions about reporting that information to DHCS.
  • Txawm li cas los xij, raws li tau hais hauv #1 saum toj no, kev nkag mus rau doula lossis kev nkag mus rau txhua tus qhua yuav raug txwv lossis txwv raws li tau piav qhia hauv tsev kho mob P&Ps, uas tuaj yeem suav nrog kev ntsuam xyuas ib rooj plaub los ntawm tsev kho mob ntawm cov yam xws li, tab sis tsis txwv rau, mob, ua rau muaj kev cuam tshuam lossis kev hem thawj, tsis kam ua raws li cov lus qhia tsim nyog txog kev noj qab haus huv lossis kev nyab xeeb tseem ceeb, lossis cuam tshuam rau kev kho mob ntawm tus neeg yug menyuam lossis lwm tus neeg mob.

6. Yuav ua li cas yog tias tus doula ntsib teeb meem nrog, los yog raug tsis pom zoo, muab kev txhawb nqa rau lawv cov neeg siv khoom / tus neeg mob? (Ntxiv rau lub Cuaj Hlis 6, 2024)

  • DHCS can and does work closely with the California Hospital Association (CHA), other hospital associations, and individual hospitals, to address these types of concerns, and work to resolve the individual’s circumstance. Additionally, DHCS can provide technical assistance directly to hospitals to clarify that doula services are a covered Medi-Cal benefit and that Medi-Cal members have a right to visitors/support persons of their choosing, which includes doulas.
  • Yog tias koj muaj teeb meem nrog lub tsev kho mob tshwj xeeb, thov hu rau DHCS ntawm email ntawm DoulaBenefit@dhcs.ca.gov thiab muab cov ntaub ntawv hauv qab no:
  • Lub npe tsev kho mob;
  • Lub npe ntawm ib tus neeg sawv cev hauv tsev kho mob uas koj tau hais txog qhov teeb meem;
  • Cov lus piav qhia luv luv ntawm qhov teeb meem;
  • Hnub tim (s) txuam nrog qhov teeb meem; thiab
  • Tiv tauj cov ntaub ntawv rau kev taug qab (email thiab xov tooj nyiam).
  • DHCS tau tsim ib pawg neeg ua haujlwm hauv tsev kho mob-doula rov ua haujlwm los koom nrog kev sib tham qhib los daws qhov kev txhawj xeeb no thiab txheeb xyuas cov hauv kev los txo cov kev cuam tshuam rau kev nkag mus.

7. Where can I learn more about a hospital’s P&Ps? (Added September 6, 2024)

  • Every hospital has its own P&Ps, and no two are the same. Therefore, it is best to inquire about a particular hospital’s P&Ps by visiting the hospital’s website or by contacting the hospital directly. 

8. Kuv tuaj yeem tau txais cov ntaub ntawv ntxiv los yog muab cov lus qhia txog cov teeb meem kev nkag mus rau hauv tsev kho mob qhov twg? (Ntxiv rau lub Cuaj Hlis 6, 2024)