Dear Lactnetters

About a week ago I posted a message asking for "managed care" guidelines for
breastfeeding that you might have developed and I only got one or two
responses. I thought that was a bit unusual so I did a lactnet search of
"managed care" and discovered that you and I define that term differently.

Someone in an archived message mentioned Marsha Walker so I e-mailed her and
she kindly set me straight on the American definition of managed care. This
is new to me so let me define what I'm looking for. I haven't started my
responsibilites writing the guidelines yet- I am doing some research first.

Our public health agency provides home visits to mothers who require
teaching after they give birth. Visits for short term minor problems are
paid for by the municipality. The provincial government will pay for visits
for problems which put the baby at risk of dehydration (due to many
different causes). Equipment like pumps and scales are also provided. What I
need to do is to write up care plans to help guide the nurse and the client
so they know what the treatment goals are and the approximate length of time
that it will take to meet those goals. The agency providing the government
funds seems quite reasonable in their expectations. For example some moms of
premature twins are receiving service even once the babies are home for a
couple of months or so. We need to write up what should be taught and what
should be accomplished each week for example.

I am wondering if anyone or any agency has already drawn up such care plans.
Some examples of problems (as you well know) might be:
latch problems due to prematurity, latch problems related to birth history,
low milk supply (due to whatever)etc.

If anyone has anything you think could be of help, please contact the list
or e-mail me privately. I am now back on lactnet.

Thanks

Maureen Kennedy PHN IBCLC
Ottawa ON