The CCYA/JPO has several placement options when a child is taken into custody. For example, the child may be placed in a shelter or juvenile detention center until final disposition and then later placed in a foster home, group home or residential placement.
The CCYA/JPO placing the child will contact the CAO in the county where the CCYA/JPO is located no later than the end of the next work day after the placement date. The contact may be by phone, FAX, e-mail, or submission of the CY 60 form.
The CCYA/JPO will give the CAO the following information about the child:
The child’s full name (last, first, middle initial)
Date of birth
Gender
Race
Access Card and Issue #
Child's Personal Income
Non-Minor Resumption (age 18-21 and meets defintion of child)
The CCYA/JPO will also give the CAO the following information:
Name of the reporting CCYA/JPO staff person
Address and telephone number of the reporting CCYA/JPO
CCYA or JPO case number
Date of initial placement
Type of placement, using placement/facility code
Where the child is placed, using county/district code
The CAO will authorize MA benefits for the child after the telephone, FAX, e-mail, or CY 60 contact with the CCYA/JPO as follows:
STEP 1: Do a file clearance to find out if the child is currently receiving benefits.
If the child is not currently receiving MA, the CAO will authorize MA benefits no later than the end of the next work day after the telephone, FAX, e-mail contact or receipt of the CY 60.
NOTE: In a medical emergency, once MA is authorized, the CAO will immediately give the CCYA/JPO the child's recipient number, card issue number and managed care information, if appropriate.
If the child is currently receiving MA or SSI, the contact by telephone, FAX, e-mail or CY 60 notifies the CCYA/JPO that the child is no longer in the home. The CAO worker in the county where the CCYA/JPO is located must:
If the child is currently receiving SSI, the CAO will immediately notify the CCYA/JPO. The CCYA/JPO will notify the Social Security Administration of the child's address change. The SSI MA budget stays open until SSA notifies the CAO that SSI benefits are discontinued.
STEP 2: Enter the appropriate information into eCIS. If the child is or was getting MA and the eCIS information differs from the CCYA/JPO information, authorize MA using the eCIS information until the CCYA/JPO verifies that their information is correct.
STEP 3: Authorize MA in a PC 33 category.
For the budget open date, use the placement date.
For the payment name, use the child’s name in care of the CCYA/JPO at the CCYA/JPO address.
STEP 4: Enter the correct county/district code and placement/facility code into eCIS. This ensures the correct MA services program (managed care or fee-for-service).
The CCYA/JPO will determine the placement/facility code and county code.
Contact the CCYA/JPO for the code if it is not provided.
It is important to use the correct code. The code directly affects the child’s ability to get medical services.
See Chapter 850, Appendix D for a list of facility codes.
STEP 5: Complete and return the CY 60 to the CCYA/JPO.
STEP 6: Set a case alert for 60 days from the budget open date to review the case record.
STEP 7: Contact the CCYA/JPO if the CY 61 has not arrived..
If the CCYA has custody of a baby born to a mother who is in CCYA placement, the newborn has the same MA status as the mother. The newborn is automatically eligible for the same type of MA coverage, with the same program status code, as the mother.
A newborn not in CCYA custody is automatically eligible, but not in CCYA MA category.
The CCYA will send a CY 842 when a child is born to a mother in placement. The form can be sent with a CY 61 or later as a supplement.
When the CAO receives a Newborn Eligibility Form (MA 112) or CY 842, MA is authorized immediately for the child based on the information on the form.
The CAO will issue a notice of MA eligibility for the newborn shown on the form.
A child born to a mother who receives placement maintenance may not receive TANF. The newborn is eligible for placement maintenance benefits.
An ongoing MA eligibility determination is made when the CAO receives the completed CY 61 from the CCYA/JPO.
A child in placement will be enrolled and remain in the MA Program without interruption of coverage unless the child's income is above the MA eligibility limits.
If the child’s income is over the limits, the CAO will contact the CCYA/JPO to explore spend-down eligibility. The CAO must make sure MA benefits continue for these children while spend-down eligibility is being determined.
The CCYA/JPO in the county placing the child will send the CY 61 to the CAO within sixty days of the child's placement. The CAO will not require an application. The CAO will use the CY 61 to determine MA for the child.
MA eligibility is based on Modified Adjusted Gross Income (MAGI) methodology. The child is considered a household of one. MAGI income limits are applicable in the determination. See MAEH Chapter 312, Appendix A for applicable MAGI income limits.
Based only on the information on the CY 61 from the CCYA/JPO, the CAO will determine eligibility and:
If the child is eligible, continue MA in category J or PC/program status code 33 until the CCYA/JPO notifies the CAO that the child is IV-E eligible.
If the child is not eligible for MA, close category PC with program status code 33 effective the day before the first day of the next benefit eligibility period for which the deadline can be met. The CAO will review the child for the Children’s Health Insurance Program (CHIP) using the CY 61.
The CAO must notify the CCYA/JPO of the eligibility determination within 10 working days by sending the appropriate notice and the original copy of the CY 61 with the appropriate sections completed.
When a child is discharged from placement, and does not enter an eligible facility, the CAO will close the foster care case.
NOTE: If a child enters an ineligible facility, do not close the foster care case. See Section 850.26, Placement in Ineligible Facilities.
If the child is returning to the household of removal with an open case and they received MA in that household, the child is to be added to that case and MA reopened with no gap in coverage. An application is NOT required to reopen the child’s MA. See MAEH 304.16, Where to Find a Form, and Who Does or Does Not Need One.
Example: Child received MG00 on case with parents before removal. Child is subsequently opened PC33 and then discharged back to parents. PC33 set to close 5/15. Child should be reopened MG00 in parents’ case effective 5/16 without requiring an application.
If the child is not returning to the household of removal or there is no open case, send an Advanced Notice to the parents or persons to whom the child is released, advising them to apply for MA benefits for the child.
To ensure that MA coverage and appeal rights are uninterrupted, the CAO will:
1. Begin case action timely based on receipt of the earliest available information
2. Change the case record payment name and address to the name and address of the parents or person to whom the child is released
3. End date the placement/facility code
4. If the child is eligible for MA, close the Foster Care case and open MA for the child in the case record of the parents or person to whom the child is released.
Send a notice to the parents explaining that the child remains eligible for MA.
NOTE: A new MA application is not necessary to add a child who is moving back into the household if the child is under 21, not emancipated, and under the care and control of a parent or legal guardian. MA may be authorized while waiting for proof of citizenship and identity. Check for any income changes.
5. If the child is not eligible for MA, close the Foster Care case by sending an Advance Notice to the parents (or person to whom the child is released). The Advance Notice must show that MA is ending because the child is no longer in placement and does not meet eligibility requirements.
6. If the parents ask for an application after the Foster Care case is closed, process the application according to Medical Assistance Eligibility Handbook Chapter 304, Application.
850.26 Placement in Ineligible Facilities
If the CAO is notified that a child is placed in an ineligible facility while in substitute care, MA must continue under the foster care category.
Ineligible facilities include:
These facilities are indicated using facility code ‘73’ on the CY 60.
The following process should be followed when a CY60 is received indicating the individual has been placed in a YDC (facility code “73”):
Entry of facility code 73 disenrolls the individual from Managed Care and prevents payments via fee-for-service. This will fulfill the requirements of the public institution exclusion by maintaining the individual’s MA eligibility while disenrolling them from Managed Care and fee-for-service.
Revised July 8, 2024, Replacing August 30, 2018