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Designation of neonatal levels of care: a review of state regulatory and monitoring policies

Journal of Perinatology volume 40, pages 369–376 (2020)Cite this article

Subjects

Abstract

Objective

Summarize policies on levels of neonatal care designation among 50 states and District of Columbia (DC).

Study design

Systematic review of publicly available, web-based information on levels of neonatal care designation policies for each state/DC. Information on designating authorities, designation oversight, licensure requirement, and ongoing monitoring for designated levels of care abstracted from 2019 published rules, statutes, and regulations.

Result

Thirty-one (61%) of 50 states/DC had designated authority policies for neonatal levels of care. Fourteen (27%) incorporated oversight of neonatal levels of care into the licensure process. Among jurisdictions with designated authority, 25 (81%) used a state agency and 15 (48%) had direct oversight. Twenty-two (71%) of 31 states with a designating authority required ongoing monitoring, 14 (64%) used both hospital reporting and site visits for monitoring with only ten requiring site visits.

Conclusions

Limited direct oversight influences regulation of regionalized systems, potentially impacting facility service monitoring and consequent management of vulnerable infants.

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Acknowledgements

The authors would like to thank the data abstractors for contributing to the body of this work: Mary Charlotte Tate, Kim Tubbs Ramsay, Renyea M. Colvin, and Tracie Herold. The authors would like to thank Elizabeth Martin for facilitating management and coordination of the data abstractors and researchers. In addition, the authors would like to acknowledge Keriann Uesugi and graduate students from the University of Illinois at Chicago, as well as Ellen Pliska from the Association of State and Territorial Health Officials for supporting the policy updates for this work.

Author information

Authors and Affiliations

  1. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Charlan D. Kroelinger, Ekwutosi M. Okoroh, David A. Goodman & Wanda D. Barfield

  2. Independent Consultant, Mosiac Consulting Group, LLC, Atlanta, GA, USA

    Sarah M. Lasswell

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  1. Charlan D. Kroelinger
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Correspondence to Charlan D. Kroelinger.

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Kroelinger, C.D., Okoroh, E.M., Goodman, D.A. et al. Designation of neonatal levels of care: a review of state regulatory and monitoring policies. J Perinatol 40, 369–376 (2020). https://doi.org/10.1038/s41372-019-0500-0

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