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New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection and Permanency

Effective Date: 6-10-1980

Volume:

V

Health Services

Chapter:

A

Health Services

Revised

Date: 11-1-2018

Subchapter:

1

Health Services

Issuance:

600

Services to Pregnant Women

 

Purpose:

 

This issuance establishes policy and procedures related to services for pregnant women.

 

Authority:

 

·         N.J.S.A. 30:4C-11

 

Policy:

 

A)   Eligibility for Services

CP&P shall make services for a pregnant woman available to assure a high quality of care. CP&P may provide social services to a pregnant woman on behalf of the unborn child regardless of her eligibility for services from another source.

 

B) Social Services

CP&P may provide the following social services to a pregnant woman whether or not she is eligible for other services from CP&P or from another public or private source:

·         Counseling, including access to substance use disorder treatment services;

·         information and referral; and

·         advocacy.

 

CP&P shall provide services to assist the pregnant woman in making plans for herself and the unborn child, and to advocate for her in exploring what resources may be available.

 

CP&P shall encourage a pregnant woman to promptly apply to appropriate community, state, or federal programs.

 

C)   Maintenance Services

CP&P may provide maintenance services (medical, clothing, placement) to a pregnant woman only if she:

·         Is not eligible for any other financial or medical assistance program from NJ Family Care, the County Welfare Agency (CWA), the Municipal Welfare Agency (MWA), or other community resources;

·         Is registered on the CP&P services information system; and

·         Is a resident of New Jersey.

 

If a pregnant youth under the supervision or custody of CP&P is covered for maternity benefits through NJ FamilyCare, that coverage shall supersede medical services paid through CP&P.

 

D)   Group Homes for Pregnant Adolescents Involved with CP&P

CP&P shall contract with group homes for pregnant adolescents involved with CP&P to provide services. The services may include a structured living environment, recreational activities, educational programs, and psychiatric/psychological services. Generally, these programs also include parenting education and weekly medical examination by a registered nurse. CP&P shall retain responsibility for post-partum planning.

 

See CP&P-IV-E-5-100 for detailed procedures related to group home placements. Placements may be available through the County Welfare Agency (CWA), as well as CP&P, and are limited to those eligible women without a home, who are inappropriate for resource care or independent living.

 

E)   Medical Services

Medical services for a pregnant woman shall include prenatal, hospital, postnatal care, and treatment of health problems identified as necessary for improved parental functioning or protection of the unborn child.

 

CP&P may provide medical services to a pregnant youth under its supervision or custody after CP&P determines that she is not eligible for medical care through any other available county, State, or federal program.

 

F)   Other Medical Programs

The Department of Human Services, Division of Medical Assistance and Health Services (DMAHS) administers all of New Jersey’s Medicaid programs including NJ FamilyCare which provides health coverage to pregnant women. NJ FamilyCare’s comprehensive health coverage program provides a wide-range of services including: doctor visits, hospital services, prescriptions, tests, nursing home care and other healthcare services.

 

Pregnant women can determine their eligibility for NJ FamilyCare, Medicaid or other State or county benefits by contacting their local County Welfare Agency or calling NJ FamilyCare at 1-800-701-0710. Or they can apply online through www.njfamilycare.org or www.njhelps.org.

 

A child born to an eligible NJ FamilyCare mother is eligible for NJ FamilyCare for one year regardless of changes in the family's income or mother’s status. An application must be completed to take advantage of that eligibility. The first 60 days following birth are a “grace period” during which the mother’s NJ FamilyCare eligibility is extended to the newborn until the application is completed. An application must be submitted at www.NJFamilyCare.org or by calling the NJ FamilyCare Hotline at 1-800-701-0710 within those 60 days.

 

G)  CP&P Programs

The following programs are described in relation to the pregnant woman. They are available, however, to any person who meets the eligibility criteria.

 

·         Code 600 Medicaid

A woman in a CP&P placement usually receives Medicaid Code 600.  If she becomes pregnant, CP&P continues her Medicaid eligibility as long as she is in placement. This qualifies her for any medical services provided through the New Jersey Medicaid program, including but not limited to prenatal, hospital, and postpartum care even following her 18th birthday, should it occur during the term of the pregnancy.

 

·         Code 650 Medicaid

Pregnant youth in their own homes under the supervision of CP&P may be eligible for Code 650 Medicaid.

 

The DCF Office of Clinical Services may provide medical services to a woman on behalf of her unborn child through the Code 650 Medicaid program. Such approval must be based upon confirmation of pregnancy and documented evidence that the woman is not able to obtain needed medical services through any available family or community resources.  The Local Office Worker shall confirm the denial of the woman's eligibility for medical services from available community resources (including NJ FamilyCare, Medicaid, or TANF) verbally or in writing.  See CP&P-V-A-4-100.

 

If a woman requesting medical services on behalf of her unborn child cannot afford to pay for a doctor's examination to confirm her pregnancy, and such an exam is not available through the CWA or any other community resource, CP&P may pay for the exam. CP&P shall pay the doctor at Medicaid rates through use of the CP&P Form K-100. Consult the Office of Clinical Services regarding Medicaid rates.

 

All services included under the Medicaid program are available to the pregnant woman who has Code 650 Medicaid. It is essential that she receive prenatal, hospital, and postpartum care (including the six-week checkup and any additional postnatal medical services confirmed by a physician). She may also receive, both before and after the infant's birth, treatment of health problems identified as necessary for improved parental functioning or protection of the infant.

 

The Worker shall inform the pregnant woman who intends to retain custody of the infant to file an application for NJ FamilyCare before the  birth, so that if eligible she and the newborn will be covered immediately after the  birth. If she is not eligible for any NJ FamilyCare program after the birth, the Worker shall reevaluate the woman's continued need and eligibility for Code 650 Medicaid. If the need for Code 650 Medicaid no longer exists for the mother, CP&P terminates her from Code 650 Medicaid upon completion of her six-week postpartum checkup.

 

H)   Services After the Birth

Social services may continue as long as necessary to achieve the service goals established with the mother for herself and for the infant. The Worker shall reevaluate the mother's need and eligibility for medical services after the birth. 

 

If an infant is born a substance-affected infant and will remain with his or her mother, CP&P shall develop a Plan of Safe Care with the family for the infant.  See CP&P-II-C-2-800.

 

 

Procedures:

 

1)    Procedures Related to Services for Pregnant Women

 

RESPONSIBILITY

ACTION REQUIRED

CP&P Worker

 

1.    Provide social services for the pregnant woman to:

·         make plans for herself and the unborn child, and

·         explore eligibility for needed services through family or community resources.

2.    Continue Code 600 for a Medicaid-eligible woman already in CP&P placement. Provide necessary social services relevant to her pregnancy.

3.    Determine eligibility for Code 600 Medicaid for new referrals. Refer a pregnant woman to NJ FamilyCare or other appropriate resources if not eligible for Code 600.

4.    If not eligible for CP&P Code 600 Medicaid and in need of payment for medical services:

·         obtain documentation confirming pregnancy, and

·         obtain documentation that the woman is not eligible for financial or medical assistance through any public or private agency.

5.    Complete an Interoffice Memo requesting Code 650 to the Office of Clinical Services. Obtain approvals.

Office of Clinical Services

6.    Approve request for Code 650 Medicaid and forward for processing or consult with the Local Office regarding other services that may be available.

Medicaid Liaison

7.    Enroll pregnant woman in Code 650 Medicaid.

8.    Clarify placement plans for newborn.

9.    Enroll the newborn in Code 600 Medicaid effective his or her date of birth if the newborn will enter CP&P placement home after discharge from the hospital.

10. Refer the newborn for Code 650 Medicaid if eligibility for Code 650 services exists.

11. Reevaluate continued need and eligibility for Code 650 medical coverage for mother and infant prior to discharge.

 

 

Forms and Attachments:

 

·         CP&P Form K-100, Client Service Invoice

 

Policy History:

 

·         2-13-2012

·         11-21-2011

·         8-17-2009

·         2-23-2004

·         11-10-1997

·         10-1-1996

·         9-5-1991

·         9-29-1989

·         8-24-1989

·         9-22-1988

·         2-5-1988

·         9-26-1986

·         2-22-1985

·         9-14-1984

·         6-5-1981

·         6-10-1980