Guidelines for Midwives drawing Newborn Screens on Kaiser infants

Update July 17, 2014

Here is updated information for the two new East Bay Kaiser Hospitals. Â Please use these addresses when completing Kaiser NBS forms.

Kaiser PermanenteÂ
275 W. MacArthur BoulevardÂ
Oakland, CA 94611Â

Dr Roberta Cunningham will have the new address as well. Â The phone numbers are not changing for Oakland.Â

Here is the San Leandro information;Â

Kaiser Foundation Hospital, San LeandroÂ
2500 Merced StreetÂ
San Leandro, CA Â 94577Â
Main Number510-454-1000Â

Smita Mohan MD, PhD
27303 Sleepy Hollow Ave
Hayward CA 94545
510-784-6289

Update April, 2014:

Collect Newborn screen within 4 days of birth

Check expiration date and order new forms before July 1.

Kaiser Newborn Screen Collection Information

Before collecting the specimen ask parents with Kaiser insurance to call Kaiser member services and get a medical record number for the baby (they may also be able to select a pediatrician at that time)

When filling out the Newborn Screening form, please complete the information with the specific Kaiser MD and Facility Code for the Kaiser location you are submitting to, see attachments.

Write your name and phone number in the side margin, see example.

Drop off the test form at the hospital lab. Â If they ask for an order number call Kaiser North Area Service Center -Â 510-752-6192

Call Kaiser Newborn Screening if you need help scheduling a newborn screen collection at Kaiser - North Area Service Center -Â 510-752-6192.

If not collected due to refusal, complete BOTH Newborn Screening Test Refusal (NBS-TR) and Hospital Report of Newborn Screening Not Obtained (NBS-NO)Â

The result for SCID is available after two to three weeks.

. . . from Pat at Kaiser newborn screening.

Update 6/30/09:
 

Guidelines for Midwives drawing Newborn Screens on Kaiser infants
 
The family can call Kaiser Member Services to obtain a medical record number for the baby.  Please fill in the “medical record #” field at the bottom of the TRF with this information. The screen can be clearly linked to the correct infant.
The State requests that the midwife providers legibly print their name, type of license, and best contact number in the blank space on the left side of the TRF.
Please be sure the mother’s information, especially her telephone number, is correct.
Under “newborn physician information” put the pediatrician, if known, or the pediatrician responsible for newborn screens at the particular Kaiser facility the Mom utilizes (there is one designated at each).  At the bottom of this document is a list of the pediatrician TRF contacts at each facility, including license numbers and contact information, for your use.  That way the results will be mailed to Kaiser for inclusion in the medical record.
Under “facility/submitter drawing specimen” put the Kaiser facility where the specimen will be dropped off.  It’s best to drop it off at a hospital rather than a medical office building.  .
Under “hospital/submitter code” put the code corresponding to the Kaiser facility where you dropped the specimen off.  The codes for each hospital are included at the end of this document--they must match the hospital.
The State website (http://www.cdph.ca.gov/programs/nbs) can provide additional information about the program.
Most importantly, please know that the NBS staff are available to you at (510) 752-6192, Monday through Friday from 8:30am-5pm.  A coordinator is on call weekends and holidays from 9am-4pm and will respond to a message left at that number within a few hours. We welcome your questions and comments.
 
Newborn Screening TRF contacts and hospital codes:
 
Hospital
Code
Abbrev
MD TRF contact
License #
Address
Phone number
Antioch
K785
AMC
Ricardo Navarette, MD
G052425
4501 Sandcreek Rd
Antioch 94531
(925) 813-6500
 
Fresno
K772
FRS
Lola Chan, MD
A044029
4785 1st St.
Fresno 93726
(559) 448-4500
Hayward
K014
HAY
Smita Mohan, MD
G261257
27400 Hesperian Blvd
Hayward 94545
(510) 784-6289
Modesto
K787
MOD
Rabia Formoli, MD
C049408
P.O. Box 577680
Modesto 95357
(209) 735-5000
Oakland
K015
OAK
Roberta Cunningham, MD
G064538
280 W. MacArthur Blvd
Oakland 94611
(510) 752-2000
Redwood City
K549
RWC
Thomas Sipes, MD
A74828
1150 Veterans Blvd
Redwood City
94063
(650) 299-2000
Roseville
K788
RMC
Steve H. Chou, MD
A737811
1840 Sierra Gardens Dr
Roseville 95661
(916) 787-6433
South Sacramento
K763
SSC
Weldon Jordan, MD
A38832
6600 Bruceville Rd
Sacramento 95823
(916) 688-6340.
San Francisco
K515
SFO
Carlos Botas, MD
G10366
2425 Geary Blvd
San Francisco 94115
(415) 833-2000
San Jose
K578
SJO
Alexander Gelber, MD
A039903
250 Hospital Parkway
San Jose 95119
(408) 972-6186
Santa Clara
K571
SCL
Chandrika Kapadia, MD
A35992
700 Lawrence Expressway
Santa Clara 95051
(408) 851-7116
Santa Rosa
K751
SRO
Mario Solano, MD
G062081
401 Bicentennial Way
Santa Rosa 94503
(707) 566-5314
Vallejo
K600
VAL
Edward Martin, MD
G45995
972 Sereno Dr
Vallejo 94589
(707) 258-6296
 
Walnut Creek
K045
WCR
Randy Bergen, MD
G52916
1425 S. Main St
Walnut Creek 94596
(925) 779-5000
 

We at the Newborn Screening Program (NBS) at Kaiser are aware that many issues have arisen around midwives drawing screens on Kaiser infants. We are working with the California State Department of Public Health around clarification and Heidi Lerner, the nurse consultant for the newborn screening program, plans to develop and distribute formal guidelines.  In the meantime, the following directions for completing the test request form (TRF) will hopefully provide a framework to facilitate the process:
Because we will need to contact you if there’s a problem with the screen resulting in the need to have it redrawn (i.e. not enough blood), missing information, etc. the State requests that the midwife providers legibly print their name, type of license, and best contact numbers in the blank white space on the left side of the TRF.  The forms are scanned into the State database so we can see all this information.

Please be sure the mother’s information, especially her telephone number, is correct.  It is essential that we have a current, working number in case we need to contact the family about repeating the screen or obtaining confirmatory testing.  Completing the “primary language” field below helps us to know whether we need an interpreter to assist us in discussing issues with the family.

Under “newborn physician information” put the pediatrician, if known, or the pediatrician responsible for newborn screens at the particular Kaiser facility the Mom utilizes (there is one designated at each).  At the bottom of this document is a list of the pediatrician TRF contacts at each facility, including license numbers and contact information, for your use.  That way the results will be mailed to Kaiser for inclusion in the medical record.

“Race” and “ethnicity” are important, especially if the screen is hemoglobin positive, since this information will need to be shared with the lab where hemoglobin electrophoresis specimens are processed.

Under “facility/submitter drawing specimen” put the Kaiser facility where the specimen will be dropped off.  It’s best to drop it off at a hospital rather than a medical office building as there is more frequent lab courier service at the hospitals.  The specimens are run at a Kaiser regional lab in Berkeley.
Under “hospital/submitter code” put the code corresponding to the Kaiser facility where you dropped the specimen off.  The codes for each hospital are included at the end of this document--they must match the hospital.

Of course the birth date/time and date of collection/time are critical pieces of data as the newborn screen cannot be accepted and accurately interpreted without them. Our data shows that the date of collection is sometimes entered incorrectly entered in the” date of blood transfusion completed” field, which delays processing of the screen.
The family can call Kaiser Member Services to obtain a medical record number for the baby.  Please fill in the “medical record #” field at the bottom of the TRF with this information. That way the screen can be clearly linked to the correct infant.

The State website (http://www.cdph.ca.gov/programs/nbs) can provide additional information about the program.

Most importantly, please know that the NBS staff are available to you at (510) 752-6192, Monday through Friday from 8:30am-5pm.  In addition, a coordinator is on call weekends and holidays from 9am-4pm and will respond to a message left at that number within a few hours.  We always welcome your questions and comments.
 

Newborn Screening TRF contacts and hospital codes:
Hospital Code Abbreviation MD TRF contact License # Address
Antioch K785 AMC Ricardo Navarette, MD G052425 4501 Sandcreek Rd

Antioch 94531
Fresno K772 FRS Lola Chan, MD A044029 4785 1st St.

Fresno 93726
Hayward K014 HAY Smita Mohan, MD G261257 27400 Hesperian Blvd

Hayward 94545
Modesto K787 MOD Rabia Formoli, MD C049408 P.O. Box 577680

Modesto 95357
Oakland K015 OAK Roberta Cunningham, MD G064538 280 W. MacArthur Blvd

Oakland 94611
Redwood City K549 RWC Thomas Sipes, MD A74828 1150 Veterans Blvd

Redwood City

94063
Roseville K788 RMC Steve H. Chou, MD A737811 1840 Sierra Gardens Dr

Roseville 95661
South Sacramento K763 SSC Weldon Jordan, MD A38832 6600 Bruceville Rd

Sacramento 95823
San Francisco K515 SFO Carlos Botas, MD G10366 2425 Geary Blvd

San Francisco 94115
San Jose K578 SJO Alexander Gelber, MD A039903 250 Hospital Parkway

San Jose 95119
Santa Clara K571 SCL Chandrika Kapadia, MD A35992 700 Lawrence Expressway

Santa Clara 95051
Hospital Code Abbreviation MD contact License # Address
Santa Rosa K751 SRO Mario Solano, MD G062081 401 Bicentennial Way

Santa Rosa 94503
Vallejo K600 VAL Edward Martin, MD G45995 972 Sereno Dr

Vallejo 94589
Walnut Creek K045 WCR Randy Bergen, MD G52916 1425 S. Main St

Walnut Creek 94596