A juvenile placed temporarily in a Juvenile Detention Center (JDC) is entitled to receive MA benefits until the court's final disposition is implemented.
The JPO or JDC may contact the CAO outreach liaison in the county where the juvenile was living before placement to find out if the juvenile currently receives MA and/or to request MA for the juvenile.
The JPO/JDC will give the following information to the CAO outreach liaison:
Juvenile’s full first name (last, first, middle initial
Date of birth
Sex
Race
Social Security number
Name of the JPO/JDC staff person, agency address and telephone number
Date of placement
When contacted by the JPO or the JDC, the CAO will:
1. Do a file clearance immediately to determine if the juvenile currently gets MA, SSI or cash assistance.
2. If the juvenile currently gets MA, SSI or cash assistance:
Immediately give the juvenile's recipient number, card issue number and managed care information, if appropriate, to the JPO or the JDC.
Continue the juvenile's MA, SSI or cash assistance benefits in the active case record.
NOTE: Lack of an ACCESS card should not prevent or delay medical services for the juvenile. The JPO and the JDC will try to get the juvenile's ACCESS card. If they cannot get the card, the CAO will issue a replacement card for the juvenile.
Enter facility code 74 and begin date (detention center placement date).
3. If the juvenile is not receiving MA, SSI or cash assistance on the date of placement:
Authorize MA benefits for the juvenile by the end of the next work day following the day of contact with the JPO or the JDC.
Use the appropriate MA category with a budget open date effective the JDC placement date.
Enter facility code 74, the appropriate county code to ensure correct medical coverage, and the begin date (detention center placement date).
4. Mail or FAX the completed CY 60 to the JPO or JDC within five working days after it is received. This is written notification that MA has been authorized for the juvenile and that he or she is not a TANF or SSI recipient.
5. If the juvenile has previously received MA and the CIS information differs from the JPO or JDC information, authorize MA using the CIS information until verified by the JPO or JDC. Use the child as the payment name in care of the JPO using the JPO address.
6. All juveniles placed in JDC are enrolled in EPSDT. Enter a “Y” in the EPSDT field. Enter the physician's name, if known.
Each CAO must have local office procedures that ensure a review of the juvenile's case record no later than 120 days after JDC placement. It may be necessary to contact the JPO or the JDC to verify that the juvenile is still residing in the JDC.
MA benefits continue for the juvenile if the court’s final disposition has not been implemented and the juvenile is still a resident of the JDC.
When a CAO eligibility determination is required, the JPO is responsible for verifying the demographic information, income, and third party resources available to the juvenile. The JPO will keep the verification and put on the CY 61 all information that the CAO needs to determine eligibility. The CAO will not contact the juvenile or the family.
The JPO is not required to fill in the household income and resource information on the CY 61 for a juvenile if the CAO has certified on the CY 60 that the juvenile is receiving TANF or SSI on the placement date.
OPS050408-Medicaid Authorization for Youths Released From the State Youth Development Center/Youth Forestry System (Linked September 21, 2016)
If the juvenile was receiving MA, SSI or cash assistance on the placement date, once the court's final disposition is implemented or the juvenile is released from the JDC, the CAO will:
1. Continue benefits in the active case record if the CY 60 shows that the juvenile has returned home.
2. End date facility code 74 showing the date discharged from the detention center. Use discharge code 01.
3. Discontinue the juvenile's benefits in the active case record on receiving the CY 889 or CY 60 showing "Date of Placement in Ineligible Secure Facility" or "Juvenile Placed in a Non-Secure Eligible Facility." The CAO worker responsible for the active case record sends a Confirming Notice showing that the juvenile has been removed from the home and benefits are discontinued.
4. Enter the end date for facility code 74, and discharge code 12.
5. Enter facility code 73 and the appropriate county code.
6. If form CY 60 shows that the juvenile has been placed in an eligible facility, complete the CY 60 and mail or FAX it to the JPO within five working days to tell the JPO the recipient’s status. Based on this information, the CCYA/JPO will complete the CY 61 and send it to the CAO within five working days for a determination of MA eligibility.
7. Determine eligibility for the juvenile based on the information provided on the CY 61 and begin a separate case record for the eligible juvenile.
If MA benefits were authorized for the juvenile on the JDC placement date, once the court's final disposition is implemented or the juvenile is released from the JDC, the CAO will:
1. Determine MA eligibility upon receipt of the CY 61 sent by the CCYA/JPO showing that the juvenile has been placed in an eligible facility.
2. Continue MA for the juvenile in the appropriate CCYA/JPO MA category. Enter the end date for facility code 74, showing the JDC discharge date. Use discharge code 01. Enter another placement/facility code, if appropriate.
If the juvenile is determined ineligible for MA the CAO will:
1. Send an Advance Notice.
2. Close the CCYA/JPO MA category effective the day before the first day of the next benefit eligibility period for which the deadline can be met.
3. Enter the end date for facility code 74 showing the JDC discharge date, using discharge code 01.
NOTE: The CAO will notify the CCYA/JPO of the eligibility determination within ten working days by sending the appropriate notice along with the original copy of the CY 61, with the appropriate sections completed.
4. Discontinue MA for the juvenile upon receipt of the CY 60 showing "Date of Return Home" or "Date of Placement in Ineligible Secure Facility." Enter the end date for facility code 74 showing the JDC discharge date.
5. If the CY 60 shows "Date of Return Home," see Section 850.27, Discharge From Placement, for closing the juvenile's case record. Form CY 61 must be attached to the CY 60.
6.Based on the information on the CY 61, an eligibility determination must be completed for the period the juvenile received MA while a resident of the JDC.
The CAO will notify the JPO of the eligibility determination by sending the appropriate notice giving the eligibility dates and the reason MA benefits were discontinued for the juvenile.
Reviewed July 30, 2013