FAQ’s - Enrolment of Babies & Children under 18 years Is a birth certificate required to establish eligibility to enrol in General Practice? Where the parent, legal guardian or person applying to be their guardian or adoptive parent is eligible then the child will also automatically be eligible up to 18 years of age. If the practice uses that person’s evidence of eligibility as proof of the child's eligibility, the child’s birth certificate is NOT required. Establishing Identity of the child / Relationship to the parent, legal guardian etc? Evidence of parental relationship: NIR birth nomination, child’s NHI record, correspondence relating to the birth from the hospital or mid-wife showing a link between the parents and baby. The practice may also know from other sources, i.e. the mum has been seen by the practice during the pregnancy. Evidence legal guardian etc: Birth certificate, adoption papers, guardianship papers or for adoption; CYF social worker confirmation or NZ Family Court confirmation Recommendation: The practice write a small audit file note in the PMS or better still, on the enrolment form, noting the reason they believe the baby to be eligible. i.e. "Eligibility tested: Mum seen throughout pregnancy, mum and dad are confirmed as eligible (confirmed as NZ citizen), therefore baby is also eligible" (then initial and date the file note). References:
Health and Disability Services Eligibility Direction 2011 PHO Enrolment Checklist October 2015 / Table One: Children on page 7
Required selection on Enrolment Form “My declaration for entitlement and eligibility”? Parent or legal guardian etc, needs to tick the following criteria on the enrolment form "I am under 18 years and in the care and control of a parent/legal guardian/adopting parent who meets one criterion in clauses a–f above OR in the control of the Chief Executive of the Ministry of Social Development " What evidence is recommended to be retained in the PMS? A copy of the evidence of eligibility held for the parents or legal guardian should be retained in the child’s PMS patient folder/inbox. What if the parent or legal guardian etc, ceases to be eligible or entitled to be enrolled? If the practice has used this eligibility criteria for an under 18-year-old they will also cease to be eligible unless the child’s eligibility can be proven under another criteria. E.g. Foreign nationals who are eligible because they hold a work visa which then expires What happens when the child turns 18 years of age? The child will have to prove eligibility under other criteria, or they will cease to be eligible.
WBOP PHO Dec 2019
Advisor: Justin McCulloch Senior Auditor / Audit and Compliance MOH