DHS 107.32(3)(a)9.9. Any other professional service which is a covered service under this chapter and which is provided by an MA certified or certifiable provider, including time spent in a staffing or case conference for the purpose of case management; or DHS 107.32(3)(b)(b) Involve information and referral services which are not based on a plan of care. DHS 107.32 HistoryHistory: Cr. Register, February, 1988, No. 386, eff. 3-1-88; corrections in (1) (a) 1. and (d) (intro.) made under s. 13.92 (4) (b) 7., Stats., Register December 2008 No. 636. DHS 107.33DHS 107.33 Ambulatory prenatal services for recipients with presumptive eligibility. DHS 107.33(1)(1) Covered services. Ambulatory prenatal care services are covered services. These services include treatment of conditions or complications that are caused by, exist or are exacerbated by a pregnant woman’s pregnant condition. DHS 107.33(2)(2) Prior authorization. An ambulatory prenatal service may be subject to a prior authorization requirement, when appropriate, as described in this chapter. DHS 107.33(3)(a)(a) Ambulatory prenatal services shall be reimbursed only if the recipient has been determined to have presumptive MA eligibility under s. 49.465, Stats., by a qualified provider under s. DHS 103.11. DHS 107.33 HistoryHistory: Cr. Register, February, 1988, No. 386, eff. 3-1-88; correction in (3) made under s. 13.92 (4) (b) 7., Stats., Register December 2008 No. 636. DHS 107.34DHS 107.34 Prenatal care coordination services. DHS 107.34(1)(a)1.1. Prenatal care coordination services covered by MA are services described in this section that are provided by an agency certified under s. DHS 105.52 or by a qualified person under contract with an agency certified under s. DHS 105.52 to help a recipient and, when appropriate, the recipient’s family gain access to medical, social, educational and other services needed for a successful pregnancy outcome. Nutrition counseling and health education are covered services when medically necessary to ameliorate identified high-risk factors for the pregnancy. In this subdivision,“successful pregnancy outcome” means the birth of a healthy infant to a healthy mother. DHS 107.34(1)(a)2.2. Prenatal care coordination services are available as an MA benefit to recipients who are pregnant, from the beginning of the pregnancy up to the sixty-first day after delivery, and who are at high risk for adverse pregnancy outcomes. In this subdivision, “high risk for adverse pregnancy outcome” means that a pregnant woman requires additional prenatal care services and follow-up because of medical or nonmedical factors, such as psychosocial, behavioral, environmental, educational or nutritional factors that significantly increase her probability of having a low birth weight baby, a preterm birth or other negative birth outcome. “Low birth weight” means a birth weight less than 2500 grams or 5.5 pounds and “preterm birth” means a birth before the gestational age of 37 weeks. The determination of high risk for adverse pregnancy outcome shall be made by use of the risk assessment tool under par. (c). DHS 107.34(1)(b)(b) Outreach. Outreach is a covered prenatal care coordination service. Outreach is activity which involves implementing strategies for identifying and informing low-income pregnant women who otherwise might not be aware of or have access to prenatal care and other pregnancy-related services. DHS 107.34(1)(c)(c) Risk assessment. A risk assessment of a recipient’s pregnancy-related needs is a covered prenatal care coordination service. The assessment shall be performed by an employee of the certified prenatal care coordination agency or by an employee of an agency under contract with the prenatal care coordination agency. The assessment shall be completed in writing and shall be reviewed and finalized in a face-to-face contact with the recipient. All assessments performed shall be reviewed by a qualified professional under s. DHS 105.52 (2) (a). The risk assessment shall be performed with the risk assessment tool developed and approved by the department. DHS 107.34(1)(d)(d) Care planning. Development of an individualized plan of care for a recipient is a covered prenatal care coordination service when performed by a qualified professional as defined in s. DHS 105.52 (2) (a), whether that person is an employee of the agency or under contract with the agency under s. DHS 105.52 (2). The recipient’s individualized written plan of care shall be developed with the recipient. The plan shall identify the recipient’s needs and problems and possible services which will reduce the probability of the recipient having a preterm birth, low birth weight baby or other negative birth outcome. The plan of care shall include all possible needed services regardless of funding source. Services in the plan shall be related to the risk factors identified in the assessment. To the maximum extent possible, the development of a plan of care shall be done in collaboration with the family or other supportive persons. The plan shall be signed by the recipient and the employee responsible for the development of the plan and shall be reviewed and, if necessary, updated by the employee in consultation with the recipient at least every 60 days. Any updating of the plan of care shall be in writing and shall be signed by the recipient. The plan of care shall include: DHS 107.34(1)(d)1.1. Identification and prioritization of all risks found during the assessment, with an attached copy of the risk assessment under par. (c); DHS 107.34(1)(d)2.2. Identification and prioritization of all services to be arranged for the recipient by the care coordinator under par. (e) 2. and the names of the service providers including medical providers; DHS 107.34(1)(d)3.3. Description of the recipient’s informal support system, including collaterals as defined in par. (e) 1., and any activities to strengthen it; DHS 107.34(1)(d)4.4. Identification of individuals who participated in the development of the plan of care; DHS 107.34(1)(d)5.5. Arrangements made for and frequency of the various services to be made available to the recipient and the expected outcome for each service;