Indiana Pregnancy Promise Program

Frequently Asked Questions

• What is opioid use and opioid use disorder?

  Opioids are a class of drugs that include illegally obtained substances such as heroin or fentanyl as well as prescribed medications such as oxycodone (OxyContin^®), hydrocodone (Vicodin^®), codeine, morphine, and many others. (NIH, drugabuse.gov)

  Misuse occurs when someone is:

  • taking the medicine in a way or dose other than prescribed
  • taking someone else's prescription medicine
  • taking the medicine for the effect it causes-to get high
• Am I eligible for the Pregnancy Promise Program if I am pregnant and prescribed methadone or buprenorphine for my opioid use, or if I am taking prescribed opioids for chronic pain?

  Yes, pregnant women with current or past opioid use can participate in the Pregnancy Promise Program. This includes women with or without a diagnosis of opioid use disorder.

• How does the Pregnancy Promise Program work?

  The Indiana Pregnancy Promise Program provides each participant with a specially trained Pregnancy Promise Program case manager from the one of the state’s Medicaid managed care health plans. The Pregnancy Promise Program case manager provides care coordination and teamwork across all the professionals who care for a pregnant women with opioid use disorder, including health care, mental health care, treatment providers and social services.

  The Pregnancy Promise Program case manager will meet regularly with the pregnant women by phone or in person to provide resources and supports to the participant of the program from enrollment through 12 months postpartum.

  Participants of the Pregnancy Promise Program have the benefit of working with the same Pregnancy Promise Program case manager throughout the duration of enrollment. The Pregnancy Promise Program aims to ensure parents have resources (food, housing, clothing), medical care including physical and mental health care and OUD treatment services in place so that families can thrive together at home and in the community.

  By participating in the Pregnancy Promise Program, the goal is for parents and babies to be healthy and together .

  The Pregnancy Promise Program case managers work for Indiana’s manage care health plans: Anthem, CareSource, MDwise and MHS - https://www.in.gov/medicaid/members/170.htm

• What are the steps of the process for the Indiana Pregnancy Promise Program?
  1. Identify - Doctor, provider, family, friend or self- identify pregnant woman with OUD
  2. Check - for Medicaid eligibility or Medicaid coverage
  3. Refer – Referral to Indiana Pregnancy Promise Program (self-refer or provider referral)
  4. Consent - Participant signs consent to participate in Pregnancy Promise Program
  5. Enrollment - Pregnancy Promise Program enrollment begins after consent is given
  6. Initial assessments and screenings - completed with participant and case manager
  7. Care plan development- with participant, case manager and other important people
  8. Engagement – regular contact between participant and case manager during the prenatal and postpartum periods
  9. Review of care plan, coordination of medical and other appointments, reassessment of needed supports and resources and referrals to community resources
  10. Continued care coordination through 12 months postpartum for mother and infant, including postpartum follow-up care, pediatric care coordination
  11. Transition and program exit - after 12 months postpartum, celebrate health and well-being of the individual and baby
• Will my participation in the Indiana Pregnancy Promise Program affect my Medicaid coverage?

  No. Consent or denial to participate in the Pregnancy Promise Program will have no effect on Medicaid coverage. If you chose to decline participation, you will still be eligible for regular services through your managed care health plan.

• What questions will my Pregnancy Promise Program case manager be able to help me answer?

  The Pregnancy Promise Program case managers are knowledgeable about many topics and questions related to pregnancy, parenting, and substance use. The Pregnancy Promise Program case managers will help women navigate prenatal care and substance use disorder treatment including what to expect during prenatal visits and labor and delivery for both mother and infant. The Pregnancy Promise Program case manager can help parents identify beneficial family supports and community resources as well as programs and services available within the Department of Child Services.

• I don’t have Medicaid coverage, but I am pregnant and would like to participate in the Indiana Pregnancy Promise Program. Who should I contact?

  Pregnant women should submit the information above to be contacted by the Pregnancy Promise Program, then visit the FSSA Division of Family Resources website to begin the Medicaid application. https://fssabenefits.in.gov/bp/#/

  To find your local DFR office to complete a Medicaid application in person, visit: https://www.in.gov/fssa/dfr/ebt-hoosier-works-card/find-my-local-dfr-office

  Pregnant women may also call 800-403-0864 for help with DFR Medicaid application, but phone lines may require a wait time.

  Pregnant women may contact an insurance navigator to assist with the Medicaid application process.

  • Covering Kids and Families - https://www.ckfindiana.org/
  • Connecting Kids to Coverage - https://www.indianaruralhealth.org/services/connecting-kids-to-coverage-indiana/

  If  you need to visit a medical provider right away, you may receive short term coverage of health care services known as. To contact a PEPW enrollment broker please call 800-889-9949 or visit Indiana Medicaid Pregnant Women: https://www.in.gov/medicaid/members/219.htm

  Additional Presumptive Eligibility for Pregnant Women information may be found here:  https://www.in.gov/medicaid/members/apply-for-medicaid/presumptive-eligibility/PEPW-Flyer.pdf

• If I am not eligible for the Indiana Pregnancy Promise Program, where can I find help?

  There are several resources and services available across Indiana for pregnant individuals with substance use disorder

  • Contact Indiana 211 for immediate needs such as food assistance, shelter, transportation assistance, and for residential substance use treatment ask about Open Beds https://in211.communityos.org/
  • Find a Treatment Program. Indiana Division of Mental Health and Addiction Treatment Locator: https://www.in.gov/fssa/addiction/
    • If you an uninsured, treatment is still possible. If you need assistance, call the DMHA main phone number 317-232-7800
  • Connect with others in recovery.
    • Indiana Recovery Network https://www.indianarecoverynetwork.org/
    • Regional Recovery Hubs- https://www.indianarecoverynetwork.org/regional-recovery-hubs/
  • Support for alcohol use in pregnancy. Indiana Organization on Fetal Alcohol Syndrome - https://indiananofas.org/drinking-pregnancy/
• I have Medicaid coverage and would like to learn more about the Pregnancy Promise Program, who do I contact?

  Please submit Pregnancy Promise Program referral form by clicking here .

  For pregnant women who have Medicaid coverage, contact and the Division of Family Resources to provide notification of your pregnancy. Pregnant women receive a special Medicaid package while pregnant and during the postpartum period to support prenatal and postpartum care. https://www.in.gov/fssa/dfr/about-dfr/contact-dfr/

  If a woman is pregnant, enrolled in a Medicaid pregnancy category, and has been assigned to a health plan, the Pregnancy Promise Program case manager from the health plan will contact the individual to discuss the Pregnancy Promise Program and begin enrollment.

  Contact information for the Medicaid health plans (Anthem, CareSource, MDwise, MHS)

  https://www.in.gov/medicaid/members/170.htm

• What is Neonatal Abstinence Syndrome/ Neonatal Opioid Withdrawal Symptoms?

  The Indiana Perinatal Quality Improvement Collaborative definition of newborn withdrawal refers to a group of symptoms that are sometimes seen in a baby whose mother has taken certain drugs or medications during pregnancy. Newborn withdrawal may be referred to as NAS/NOWS. A range of symptoms may include irritability, high-pitched cry, poor sleep and uncoordinated sucking reflexes that can lead to poor feeding. Symptoms may begin anytime in the first two weeks of life and may last several days or weeks. (ACOG, 2017)

  The Pregnancy Promise Program will assure best practices are used to treat and reduce NAS/NOWS.

• What is medication-assisted treatment?

  Medication-assisted treatment is the use of medications, in combination with counseling and behavioral therapies, to provide a whole patient approach to substance use disorders. Medications used in MAT are approved by the Food and Drug Administration, and MAT programs are clinically driven and tailored to meet each patient’s needs.

  • Methadone
  • Buprenorphine
  • Naltrexone  (typically not recommended during pregnancy, consult physician)

  MAT and patient rights

  • SAMHSA produced a brochure designed to assist MAT patients and to educate and inform others. Under the Confidentiality Regulation, 42 Code of Regulations 2, personally identifiable health information relating to substance use and alcohol treatment must be handled with a higher degree of confidentiality than other medical information.
    • https://www.samhsa.gov/sites/default/files/programs_campaigns/medication_assisted/Know-Your-Rights-Brochure.pdf
    • https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&sid=b7e8d29be4a2b815c404988e29c06a3e&rgn=div5&view=text&node=42:1.0.1.1.2&idno=42
• Will my Pregnancy Promise Program case manager help me find prenatal care?

  Yes, Pregnancy Promise Program case managers will connect members with prenatal and postpartum care, MAT, mental and behavioral health supports, and other health related needs.

  If  you need to visit a medical provider right away, you may receive short term coverage of health care services known as Presumptive Eligibility for Pregnant Women. To contact a PEPW enrollment broker please call 800-889-9949 or visit the Indiana Medicaid Pregnant Women website here: https://www.in.gov/medicaid/members/219.htm

  Additional PEPW enrollment broker information may be found here:  https://www.in.gov/medicaid/members/apply-for-medicaid/presumptive-eligibility/PEPW-Flyer.pdf

  To learn more about specialized care for pregnant women with opioid use visit these links.

  • Indiana Medicaid provider directory
  • IHCP Provider Locator
  • IDOH MAT webpage
  • OB/MAT – CHOICE, Community Hospital Indianapolis, Anderson, Howard Co.
  • Eskenazi Health
  • Volunteer of America Fresh Start Recovery Center for mothers recovering from opioid and other drug addictions and their children 
  • Learn more about Indiana Opioid Treatment Programs
  • Map of Indiana OTPs
  • Find a Community Mental Health Center near you
  • Find Indiana Recovery Network and Recovery Hubs, or be connected with a Peer Recovery Specialists 
  • Find a local Syringe Exchange Program
• Will my Pregnancy Promise Program case manager help me and my family find community resources?

  Yes, your Pregnancy Promise Program case manager will ask about any health-related social needs including your living situation, food, transportation, utilities, and safety needs. Based on individual responses, Pregnancy Promise Program case managers will connect families with appropriate resources.