Welcome

What is MCAH?

The Maternal, Child, and Adolescent Health (MCAH) programs aim to improve the maternal, infant, child, and adolescent health of residents of Tulare County. In addition, it aims to increase access to health care for childbearing-age women, pregnant/postpartum women, infants, children, and youth with special health care needs.

Home Visiting Programs

Perinatal Wellness Program

The Perinatal Wellness Program (PWP) will assign a case manager to a woman who is demonstrating signs/symptoms of perinatal mood and anxiety disorders (PMAD) based on her score on any of the 3 screening tools named below. To qualify for PWP services, a woman must meet the following criteria:

• Be a resident of Tulare County.
• Pregnant or less than one year post delivery.
• Receive a score of 12 or greater or (+) on question #10 of the Edinburgh Postnatal Depression Scale (EPDS).

OR

• Receive a score of 10 or higher of the Patient Health Questionnaire-9 (PHQ-9).

OR

• Receive a score of 10 or higher on Generalized Anxiety Disorder scale-7 (GAD-7).

Prenatal Substance Exposure Program

Any pregnant woman with any of the following factors will be identified as having a baby at risk for alcohol or other drug exposure and will be eligible for referral to the Prenatal Substance Exposure Program (PSEP) if she meets the following criteria:

• Is a resident of Tulare County
• Has had any positive urine drug screen during current pregnancy
• And/or client admits substance use or abuse, including prescription drugs and/or alcohol, during current pregnancy.

High-Risk Infant Program

The High-Risk Infant Program (HRIP) aids with accessing community early intervention services as well as assistance with accessing medical care through coordination and referrals to deliver desired services to infants and their families. Any child from birth to one year of age is eligible for referral if they meet the following criteria:

• Is a resident of Tulare County
• Diagnosed failure to thrive
• And/or developmental delays not identified in the first six months of age and not receiving other case-management.

Case management and Disease Investigation for Pregnant Women of Childbearing Age

In Tulare County, gonorrhea infection increased in women of childbearing age from an average of 264 cases per year in 2014-2016 to 305 cases in 2022.  In addition, rates of early syphilis among women of childbearing age have increased from 10.7 per 100,000 in 2016 to 51.4 per 100,000 in 2022.  Unfortunately, with the increase of early syphilis rates, there has been a corresponding increase in congenital syphilis.  Tulare County reported 16 cases of congenital syphilis in 2022 while in 2016 the number was less than 7.

A nurse case manager provides education to women of childbearing age and pregnant women diagnosed with gonorrhea and syphilis. In conjunction with primary care providers, the nurse case manager will ensure women receive appropriate treatment to prevent complication during pregnancy.

Nurse-Family Partnership

The Nurse-Family Partnership provides first-time expectant mothers with a Public Health Nurse to improve pregnancy outcomes, improve infant health and development, and promote economic self-efficacy of families. Nurses provide support and education to first-time mothers from pregnancy until their child’s 2^nd birthday. To qualify for NFP services a woman must meet the following criteria:

• Is pregnant with their first child
• Is less than 28 weeks pregnant
• Meets the income requirements
• Is a resident of Tulare County

Drug-Exposed Infant Program

Any infant or child, from birth to one year of age, having any of the following risk factors is eligible for referral:

• Positive urine drug screen during prenatal care or at delivery
• Any maternal admission of substance use or abuse, including prescription drugs or alcohol, during the pregnancy

Safe Asleep Program: 
https://tchhsa.org/eng/public-health/safe-asleep-program/

Car Seat Safety Program: 
https://tchhsa.org/eng/public-health/car-seat-safety-program/

Related Documents & Links