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High risk patients must fLrst be certified by the Departmmnt of Social Services in their county of residence. No services will be denied because of inability to pay. If lack of tramsportation is se~n as a de~_rrent fox out-of-county patientS receiv3_ng high risk maternity services frc~ Cabarru~ County Health Department, an amount of up to $8.00 per visit will be reimbursed. Patients within Cabarrus County with transportation probl~ns will be assisted by the Departn~t of Social Services. PatientS will be see~l by appointment, return patients receiving ~rning appoinh~_nts, and new patients receivir~ afternoon appointments. A contract (see Exhibit ~2) will be signed end witnessed by all maternity patients. , A standard series of educational ~opics will be presented weekly on a rotating basis. Patients will be re~,~red to attend each appropriats session. On their initial visits, all patients will be seen by the family nurse practitioner to ob~min a n~lical history and physical examination. On subsequent visitS, patientS my be examined by a public health nurse with advanced maternity training or the family nurse practitioner. In the eventuality of a proble~ arising which the family nurse practitioner cannot handle, the patient will be referred to the physician. Sc~e special ]mb tests that may be ordered will be performed in the physicians' offices, sc~ at the Cabarrus M~%Y)rial Hospital, sc~ at the Cabarrus County Health Department by lab personnel and by the consulting perinatologist. According to the criteria established by the nutritionist, patients will be referred by the family nurse practitioners and public health nurses for nutritional assessment and education. If the nutritionist believes the patient needs followup at home, the patient will be referred to the nutrition PatientS will be encouraged to make prior arrangements for payment of hospital delivery. The Cabarrus County Health Departmant can help patients in certain circ~nstances by paying portions of their hospital and physician bills using M~2H funds provided for this purpose. Patients with special complications will be sent by ambulance to Charlotte Memorial Hospital. Th~se patients ar~ thpi r infants will be referred back to ~he health department for follc~a~p hc~e visits and clinic care. Those who deliver at Cabarrus Memorial Hospital will be visited after delivery by the family nurse practitioner and by the public health nurse later at hom~ for a post-partum check. The newborn infant will be examined in the nursery by the family nurse practitioner and visited by the public health nurse at hc~ for a newborn assess~nt.