The following services shall be covered when provided during a home visit:

1. (a) Newborn health assessment of the:

   1. (1) Skin, including color, condition, and birthmarks;
   2. (2) Head, including fontanelles;
   3. (3) Neck, including mobility;
   4. (4) Eyes, including appearance, movement, and evidence of sight;
   5. (5) Ears, including evidence of hearing;
   6. (6) Nose, including patency and septum;
   7. (7) Mouth, including lips, mucosa, palate, and gums;
   8. (8) Chest and lungs, including appearance, respiration, auscultation, and breasts;
   9. (9) Heart, including rate and rhythm;
   10. (10) Abdomen, including appearance, palpation, umbilicus, and femoral pulses;
   11. (11) Skeleton, including upper and lower structure, and range of upper and lower motion;
   12. (12) Genitourinary system, including genitalia, urine stream, and circumcision;
   13. (13) Back, including spine and anus;
   14. (14) Neurological and behavioral systems, including general appearance, cry, motor system, reflexes, and signs and symptoms of neonatal abstinence syndrome; and
   15. (15) Weight;

2. (b) Maternal postpartum assessment services including:

   1. (1) A determination of whether the following health characteristics and functions are within normal limits:

      1. a. Diet;
      2. b. Rest, activity, and exercise;
      3. c. Breast feeding;
      4. d. Abdominal cramping and tenderness;
      5. e. Urinating and bowels;
      6. f. Emotional response, including postpartum depression screening;
      7. g. Bonding;
      8. h. General appearance;
      9. i. Blood pressure;
      10. j. Temperature;
      11. k. Heart and lungs;
      12. l. Breasts and nipples;
      13. m. Abdomen and fundus;
      14. n. Perineum and episiotomy;
      15. o. Lochia;
      16. p. Wound care and healing; and

      17. q. Substance use, including:

          1. 1. Alcohol;
          2. 2. Tobacco; and
          3. 3. Illicit and illegal drug use;

   2. (2) Postpartum education including, but not limited to:

      1. a. Family planning;
      2. b. Breast care;
      3. c. Hygiene;
      4. d. Sexuality;
      5. e. Perineal care for stitches and hemorrhoids;
      6. f. Psychological adjustment and postpartum depression;
      7. g. Exercising;
      8. h. Sleep safety measures as recommended by the American Academy of Pediatrics; and
      9. i. Reactions to medications and vaccinations;

   3. (3) The provision of referrals to other community agencies as appropriate, including, but not limited to:

      1. a. The special supplemental nutrition program for women, infants, and children (WIC);
      2. b. Mental health services;

      3. c. Domestic violence resources;

         d Breastfeeding support;

      4. e. The department’s home visiting programs for continued support;
      5. f. Local family resource centers; and
      6. g. Safe transportation programs to include car seat fitting; and
   4. (4) The discussion of other health, social, or environmental concerns; and

3. (c) Parent or guardian education including:

   1. (1) Nutrition, including:

      1. a. Breastfeeding;
      2. b. Preparation and storage of formula;
      3. c. Feeding problems; and
      4. d. Supplements;

   2. (2) Behavioral issues, including:

      1. a. Crying patterns;
      2. b. Colic;
      3. c. Consolability;
      4. d. Sleep patterns;
      5. e. Elimination; and
      6. f. Individuality;

   3. (3) Family relationships and interactions, including:

      1. a. Parent or guardian to child;
      2. b. Sibling rivalry;
      3. c. Parent or guardian to parent or guardian; and
      4. d. Relatives;

   4. (4) Safety and injury prevention, including:

      1. a. Home environment;
      2. b. Use and placement of an appropriate infant car seat;
      3. c. Poison control;
      4. d. Safe water temperature;
      5. e. Drowning;
      6. f. Falling;
      7. g. Crib safety, including safe sleeping environment;
      8. h. Pets;
      9. i. Sleep positioning and current safe sleep practices;
      10. j. Choking;
      11. k. Younger siblings;
      12. l. Abusive head trauma, including shaken baby syndrome; and
      13. m. Sudden infant death syndrome (SIDS) risk prevention and sudden unexplained infant death (SUID) safe sleep initiatives;

   5. (5) Resources, including:

      1. a. The special supplemental nutrition program for women, infants, and children (WIC);
      2. b. Family planning programs;
      3. c. Respite care;
      4. d. Support from family and friends;
      5. e. Mental health services;
      6. f. Domestic violence programs;
      7. g. Breastfeeding support services;
      8. h. Home visiting programs for continued support;
      9. i. Family resource centers, and
      10. j. Programs that assist with car seat selection and fitting;

   6. (6) Health promotion and related concerns, including:

      1. a. Immunizations;
      2. b. Rashes and jaundice;
      3. c. When to call the child’s primary health care provider for advice and concerns;
      4. d. The importance of keeping appointments with the primary health care provider for the child’s health check-ups, in accordance with the recommendations set forth in the American Academy of Pediatrics’, “Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents,” (4th edition, February 2017), available as noted in Appendix A;
      5. e. The medicaid program and the importance of maintaining continued medicaid coverage through the child’s first birthday;
      6. f. Bathing and skin care;
      7. g. Urinary tract infections;
      8. h. Temperature taking;
      9. i. The care of the umbilical cord and circumcision; and
      10. j. Oral health care and the importance of bringing the child for their first dental visit with a dental provider no later than the child’s first birthday, in accordance with the periodicity schedule contained in the American Academy of Pediatric Dentistry’s, “Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance/Counseling, and Oral Treatment for Infants, Children, and Adolescents”, (2022 revision), available as noted in Appendix A;
   7. (7) Identifying if the newborn is at risk for, or has, a nutritional problem or unstable housing;
   8. (8) Ensuring follow-up appointments are scheduled with their primary health care providers; and
   9. (9) Information regarding early and periodic screening, diagnosis, and treatment services, as described in He-W 546.

Source. (See Revision Note at chapter heading He-W 500); ss by #6018, eff 4-1-95, EXPIRED: 4-1-03 New. #8446, eff 10-7-05; ss by #10428, eff 10-7-13; ss by #14334, eff 8-1-25, EXPIRES: 8-1-35