5.10.1

Prenatal Enrollment

Prenatal women are prioritized and enrolled as soon as possible during their pregnancy, with the expectation the newborn infant will be enrolled in EHS following birth.

When a prenatal woman is enrolled, social service staff will complete a “Prenatal Risk Assessment Questionnaire” and scan it to the Health department/folder.  The Health Clerk will send the social service staff a set of “Partners for a Healthy Baby Handouts for Expectant Families” (tear off sheets) and “My Pregnancy Month by Month” booklet along with county specific prenatal resources.  These handouts are to be shared with the family throughout the pregnancy.

Once the expectant mother has delivered, social service staff will change the enrollment status from the prenatal woman to the newborn infant.  This involves terminating the record for the prenatal woman in Child Plus at the first postpartum visit, and enrolling the infant into an Early Head Start program.

Enrolling the expectant mother occurs during prenatal enrollment meetings.

Preparing for the Prenatal Enrollment Meeting

1. Prior to prenatal enrollment meeting with the mother, set up a file, similar to a child file, for the expectant mother. A prenatal mother’s file is specific to prenatal.Note: Once the child is born, you will need to create a Child File and enroll the child in Early Head Start.
2. Complete the Prenatal Enrollment Cover Sheet for the mother’s file, and attach it to the cover of the file.

Refer to the SOP Preparing for the Enrollment Meeting for additional instructions.

Prenatal Health Packet

When an expecting mother is going to be enrolled, the Home Visitor should visit Health Services and pick up a Prenatal Health Packet to take with them to the prenatal enrollment meeting.  The packet includes all the required forms which must be reviewed with the mother during the prenatal enrollment meeting. Individual forms are also available on the portal for download.

Prenatal health packets are assembled by the Health Department and are not available electronically.

The Prenatal Enrollment Meeting

At the prenatal enrollment meeting(s):

1. Complete the Prenatal Risk Assessment Questionnaire
2. Review the Prenatal Health Packet (forms signed, etc.)
3. Complete the Prenatal Enrollment Packet
4. Review Pedestrian Safety information
5. Review the Home Base Handbook

Prenatal Risk Assessment Questionnaire

During the first prenatal enrollment meeting with the expectant mother, the Home Visitor completes the Prenatal Risk Assessment Questionnaire. Completing the questionnaire kicks off the timeline for the expectant mother and determines the priorities for providing resources and education.

The questionnaire is completed interview-style with the expectant mother by following the interventions on the right-hand side of the form.

• Be prepared to refer the mother to the appropriate resources based on her responses to the questionnaire.
• If the mother is not on WIC (see question 4 in the Food Availability section of the questionnaire), refer her to WIC for services.
• The completed questionnaire is scanned to Health and the original is filed under the Health section of the mother’s file.
• The Health Clerk enters HDNA information into Child Plus

Reviewing the Prenatal Health Packet

The Prenatal Enrollment Cover Sheet is used as a guide when reviewing the Prenatal Health Packet with the expectant mother.

Forms and documents to be reviewed/completed during prenatal enrollment meeting(s):

1. Prenatal Health Cover Sheet – Complete this form and put it on top of the Health section in the mother’s file. As the mother receives health care, enter the relevant dates, providers, and any issues that arise.Note: Refer the mother to a Comprehensive Perinatal Service Provider (CPSP) if she is not receiving prenatal care (see question 2).
2. Prenatal Visit Verification – Complete the first section of this form. Then, fax it to the health care provider to complete the dates of any prenatal visits and list any concerns about the pregnancy. Once returned, place this form in the Health section of the mother’s file.
3. Prenatal Dental Examination form – Complete the first section of this form by entering the mother’s name and date of birth, as well as the dentist’s name, phone number, and address. Then, fax the form to the dental office to complete the details of any procedures that have been provided. When returned, place this form in the Health section of the mother’s file.
4. Prenatal Authorization to Release Health Information – This form authorizes health care providers to share medical and dental information with Head Start. Fax this form, along with the Prenatal Visit Verification and Prenatal Dental Examination forms to the appropriate provider.Note: Follow up with the providers as needed to obtain the medical and dental forms for the file.
5. Prenatal Permission to Share Information – This form authorizes SHS to share information about the family or child during the program year. Parents are informed when information is shared and SHS maintains their information in a confidential and secure manner. Complete the form and have the parent sign. Give the parent a copy and place the original in the Enrollment section of the file.
6. Family Demographics form – This form is used to gather information about both the child and parents. Complete this form with the mother and place it in the Enrollment section of the file. This information is entered into Child Plus by social services.
7. Admission Agreement – This document provides information about Shasta Head Start including basic services provided as well as other information. Review the admission agreement with the expecting mother. Then, both you and the parent sign and date it. Place the original in the Enrollment section of the mother’s file, and give her a copy.
8. Confidentiality Acknowledgement – Shasta Head Start parents, volunteers and staff are required to preserve the confidentiality of the children, families, staff and others who interact with them at all times. Review the agreement with the parent and have her sign. Place the original in the Enrollment section of the mother’s file, and give her a copy.
9. Attendance Policy – Review the attendance policy with the mother using the Attendance Flow Chart. Give her a copy of the attendance policy.
10. 20 Facts about Child Abuse – Give the mother a copy of this handout (available in English and Spanish)

Refer to the SOP Conducting the Enrollment Meeting for additional information.

After Enrolling the Mother

1. 1. Scan the completed Prenatal Risk Assessment Questionnaire to the Health department, then file the original in the Health section of the mother’s file.
   2. The Health Clerk sends the Home Visitor the following resources, to be provided to the mother during the prenatal home visits:
      • Partners for a Health Baby: Handouts for Expectant Families
      • The My Pregnancy Month-by-Month booklet
      • County-specific prenatal resources
   3. Within five days of the prenatal enrollment meeting being completed:
      • Enter the prenatal information in ChildPlus. [Link to CP: CP-Enter Prenatal Enrollment Information]
      • Enter the family demographic information in ChildPlus. [Link to CP: CP-Enter Family Demographics]

Resources

1. • Prenatal Risk Assessment Questionnaire – Formster | English | Spanish
   • Prenatal Health Cover Sheet – English | Spanish 
   • Prenatal Visit Verification
   • Prenatal Dental Examination form
   • Prenatal Authorization to Release Health Information – English | Spanish
   • Prenatal Permission to Share Information
   • Family Demographics form
   • Admission Agreement – English | Spanish
   • Confidentiality Acknowledgement – English | Spanish
   • Attendance Policy – see 5.3.10 Attendance Policy & Procedures
   • Attendance Flow Chart
   • 20 Facts about Child Abuse – English | Spanish