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The HRIF Reporting System contains detailed information on all infants and children eligible for follow-up care. Eligibility for HRIF services begins at birth and lasts up until three years of age. Use the flow chart below to determine if a child is eligible for HRIF services and entry into the HRIF Reportign System. 

Did the child receive care that meets CCS medical care eligibility criteria within a CCS-approved NICU? ( Reference pg. 2 of Numbered Letter 05-0502 for medical care eligibility requirements)
Yes
No
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Did the child have a birth weight of less than or equal to 1500 grams or a gestational age at birth of less than 32 weeks?
Yes
No
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Did the child have a medical condition while admitted to a CCS-approved NICU that meets CCS medical condition eligibility criteria? (Reference California Code of Regulations, Article 2. Medical Eligibility for medical condition eligibility requirements).
Yes
No
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They are eligible for HRIF services and are required to be entered into the HRIF Reporting System.
Did the child have a birth weight of less than or equal to 1500 grams or a gestational age at birth of less than 32 weeks?
Yes
No
Start Again
Did the child have a birth weight of  greater than 1500 grams and a gestational age at birth of greater than or equal to 32 weeks and meet one of the following:
  • pH < 7.0 on an umbilical blood sample or a blood gas obtained within one hour of life, an Apgar score of ≤ 3 at five minutes, or an Apgar score of < 5 at 10 minutes.
  • Instability manifested by hypoxia, acidemia, hypoglycemia and/or hypotension requiring pressor support
  • Persistent apnea which required caffeine or other stimulant medication for treatment at discharge
  • Required oxygen for more than 28 days of hospital stay and had radiographic finding consistent with chronic lung disease (CLD)
  • Placed on extracorporeal membrane oxygenation (ECMO)
  • Received inhaled nitric oxide > 4 hours, and/or treatment during hospitalization with sildenafil or other pulmonary vasodilatory medications for pulmonary hypertension
  • Congenital heart disease requiring surgery or minimally invasive intervention
  • History of observed clinical or electroencephalographic (EEG) seizure activity or receiving antiepileptic medication(s) at time of discharge
  • Evidence of intracranial pathology, including but not limited to , intracranial hemorrhage (grade II or worse), white matter injury including periventricular leukomalacia (PVL), cerebral thrombosis, cerebral infarction or stroke, congenital structural central nervous system (CNS) abnormality or other CNS problems associated with adverse neurologic outcome
  • Clinical history and/or physical exam findings consistent with neonatal encephalopathy
  • Other documented problems that could result in neurologic abnormality, such as: history of CNS infection, documented sepsis, bilirubin at excessive levels concerning for brain injury as determined by NICU medical staff, history of cardiovascular instability as determined by NICU medical staff due to sepsis, congenital heart disease, patent ductus arteriosus (PDA), necrotizing enterocolitis, or other documented conditions.
Yes
No
Start Again
They are NOT eligible for HRIF services and should not be entered in the HRIF Reporting System.
They are NOT eligible for HRIF services and should not be entered in the HRIF Reporting System.
They are eligible for HRIF services and are required to be entered into the HRIF Reporting System.
They are eligible for HRIF services and are required to be entered into the HRIF Reporting System.
Did the child have a birth weight of  greater than 1500 grams and a gestational age at birth of greater than or equal to 32 weeks and meet one of the following:
  • pH < 7.0 on an umbilical blood sample or a blood gas obtained within one hour of life, an Apgar score of ≤ 3 at five minutes, or an Apgar score of < 5 at 10 minutes.
  • Instability manifested by hypoxia, acidemia, hypoglycemia and/or hypotension requiring pressor support
  • Persistent apnea which required caffeine or other stimulant medication for treatment at discharge
  • Required oxygen for more than 28 days of hospital stay and had radiographic finding consistent with chronic lung disease (CLD)
  • Placed on extracorporeal membrane oxygenation (ECMO)
  • Received inhaled nitric oxide > 4 hours, and/or treatment during hospitalization with sildenafil or other pulmonary vasodilatory medications for pulmonary hypertension
  • Congenital heart disease requiring surgery or minimally invasive intervention
  • History of observed clinical or electroencephalographic (EEG) seizure activity or receiving antiepileptic medication(s) at time of discharge
  • Evidence of intracranial pathology, including but not limited to , intracranial hemorrhage (grade II or worse), white matter injury including periventricular leukomalacia (PVL), cerebral thrombosis, cerebral infarction or stroke, congenital structural central nervous system (CNS) abnormality or other CNS problems associated with adverse neurologic outcome
  • Clinical history and/or physical exam findings consistent with neonatal encephalopathy
  • Other documented problems that could result in neurologic abnormality, such as: history of CNS infection, documented sepsis, bilirubin at excessive levels concerning for brain injury as determined by NICU medical staff, history of cardiovascular instability as determined by NICU medical staff due to sepsis, congenital heart disease, patent ductus arteriosus (PDA), necrotizing enterocolitis, or other documented conditions.
Yes
No
Start Again
They are NOT eligible for HRIF services and should not be entered in the HRIF Reporting System.
They are eligible for HRIF services and are required to be entered into the HRIF Reporting System.