(1) A person is eligible for case management as a high risk pregnant woman if:

(a) the person is receiving Medicaid or is presumptively eligible for Medicaid; and

(b) the person's pregnancy outcome is considered to be at high risk as determined by the case manager.

(2) A pregnancy is of high risk if the person:

(a) is age 17 or younger;

(b) has medical factors which indicate the potential for a poor pregnancy outcome;

(c) or someone in the person's immediate environment abuses alcohol or drugs;

(d) is currently in an abusive relationship;

(e) is homeless; or

(f) demonstrates an inability to obtain necessary resources and services and the person meets three of the following criteria. The person:

(i) has a history of physical or sexual abuse;

(ii) has no support system or involvement of a spouse or other supporting person;

(iii) has two or more children under age five;

(iv) is not educated beyond the 12th grade level;

(v) has a physical disability or mental impairment;

(vi) has had no prenatal care before or during the first 20 weeks of gestation;

(vii) is a refugee;

(viii) is age 18 or 19; or

(ix) has limited English proficiency.

(3) Case management services may be delivered to the client, if Medicaid eligibility continues, until the last day of the month in which occurs the 60th day following the end of the pregnancy.