Description

Right From the Start (RFTS) is a statewide program that helps West Virginia mothers and their babies live healthier lives by offering home visitation services with a Designated Care Coordinator.

This project is a comprehensive statewide initiative for government sponsored pregnant women whose incomes are at or below 185% of the federal poverty level. RFTS provides case management services for Medicaid eligible at-risk infants up to the age of one year. A major component of RFTS is to provide in-home care coordination services whereby registered nurses and licensed social workers visit eligible prenatal clients in their homes throughout the pregnancy and eligible infants up to one year of age. The purpose of the home visits is to assess educational, social, nutritional and medical needs and to facilitate access to appropriate service providers. Coordination components include a personalized in-home assessment to identify barriers to health care, and individually designed care plan to meet the client’s needs, community referrals as necessary, follow-up and monitoring. All pregnant Medicaid and RFTS Maternity Services cardholders are eligible for educational activities designed to improve their health (i.e., childbirth education, smoking cessation counseling, parenting and nutrition.) These women and infants have access to transportation to medical appointments through the Access to Rural Transportation (ART) Project under RFTS.

Eligibility for Women

A. Criteria for RFTS Services Eligibility

To be eligible for RFTS Care Coordination and/or Enhanced Prenatal Care Services throughout her pregnancy and through the end of the second month after the pregnancy ends, a woman must:

  1. Be a West Virginia resident.
  2. Have verification of pregnancy and an estimated date of delivery from a licensed clinician.
  3. Have either a valid Medicaid card or a valid RFTS Maternity Services care from the Office of Maternal Child and Family Health (OMCFH).
  4. Have had a Prenatal Risk Screening Instrument (PRSI) completed. The PRSI is the assessment tool chosen by RFTS to identify risk factors.

NOTE: Pregnant teens ages 19 and under are eligible for RFTS services regardless of family income, if uninsured. The pregnant teen must first make an application for Medicaid coverage at the local Department of Health and Human Resources (DHHR) office and be denied coverage. DHHR forwards the Medicaid denial information to OMCFH for eligibility coverage assessment for pregnancy service.

Since WV Children’s Health Insurance Program (CHIP) does not cover pregnancy/labor or delivery charges, pregnant CHIP participants will be referred to OMCFH for care coordination including securing financial support t pay for their pregnancy care.

Eligibility for Infants

A. Criteria for RFTS Services Eligibility

To be eligible to receive Care Coordination until the age of one year an infant must:

  1. Be a West Virginia resident, and
  2. Be less than one year of age, and
  3. Have a valid DHHR Medicaid card.

Medicaid eligible infants may be referred to the RFTS Project by a physician, nurse practitioner, nurse, social worker, other individual or parent/guardian because of medical, social and/or environmental factors. Infants are not eligible for enhanced services.

 

Related Links

More info from wvha.org