850.3 Applications for Juveniles Placed in Detention Centers

A juvenile placed in a Juvenile Detention Center (JDC) may receive MA benefits until the court's final disposition is implemented.

850.31 Enrollment Process

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:

850.32 CAO Duties

When contacted by the JPO or the JDC, the CAO will:

1. Do a file clearance immediately to determine if the juvenile currently receives MA or SSI.

2. If the juvenile currently gets MA, SSI or cash assistance:

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.

3. If the juvenile is not receiving MA or SSI on the date of placement:

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.

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.

850.33 JPO Responsibilities

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.

 

850.34 Discharge from JDC

If the juvenile was receiving MA or SSI on the placement date, once the court's final disposition is implemented or the juvenile is released from the JDC, the CAO will take action based on what is indicated by the JPO:

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.

1. Discontinue MA benefits for the juvenile.

2. 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.

  1. 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.

  1. Begin a separate case record for the juvenile if separate case record not already created.

NOTE: If juvenile not already on separate case record, benefits on current record should be closed. Notify the CAO worker responsible for the child's active benefits. The worker will send a Notice to confirm the child’s removal from the family's benefits effective the first date possible.

  1. Determine ongoing MA eligibility for the juvenile based on the information provided on the CY 61:

    1. 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.

    1. Enter another placement/facility code, as indicated by the CCYA/JPO on the CY60.

If Placed in Ineligible Facility (Facility Code 73)

Do not terminate MA for the juvenile.

On the “Facility Placement” screen, enter “73 – Youth Development Ctr/Yth Forestry Camp” as the “Facility Type.”  Enter the “County of Placement” and “Admission Date” indicated on the CY60.

Use this template to issue a manual notice regarding the individual’s MA:  PA 162 YDC

                                                                               

1. 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.

2. Discontinue MA for the juvenile upon receipt of the CY 60 showing "Date of Return Home" or "Date of Placement in Ineligible Secure Facility."

3. Send an Advance Notice.

4. 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.,

55 Pa. Code § 105.1(c)(3)

55 Pa. Code § 133.4(b)

850.35 MA for Juveniles Released from a Youth Development Center (YDC) or Youth Forestry Camp System (YFC)

In order to facility transition to the community, juveniles released from a Youth Development Center (YDC) or Youth Forestry Camp (YFC) can be authorized automatically for MA if:

MA will be authorized in a PC 30 category beginning on the date of release from the YDC/YFC and will extend to the end of the third month after the calendar month of release for a total period of eligibility of up to 122 days.

This process will be a series of communications between the YDC/YFC and the CAO of the county in which the youth will reside upon discharge. The process will begin 30 to 60 days prior to a youth’s release from the YDC/YFC and will conclude with the authorization or denial (as appropriate) of MA benefits.

Notes:

Step 1:

Within 30-60 days of the release date, the YDC/YFC contact person, using the Notification/Confirmation of Release form Part A, will provide the following information to the appropriate CAO:

If the youth is NOT a former MA recipient, the standard application process must be used to obtain MA.  This process applies ONLY to former MA recipients.  Youth who are not former recipients must submit a standard application if they wish to receive MA benefits.

The policy and procedures in this memorandum should not be confused with those in Supplemental Handbook 850.34, which pertain only to youths discharged from Juvenile Detention Centers.

Step 2:

Upon receipt of the Notification/Confirmation of Release form with Part A completed, the CAO will review and verify information in the eCIS to establish whether the youth is eligible for MA.

 An eligible individual is defined as one who has been in a YDC/YFC for three years or less, and who had been an MA recipient at the time of placement in the YDC/YFC.

Youths who formerly had been Supplemental Security Income (SSI) recipients and who are released from a state YDC/YFC should be coded as PC 30 upon release.  The CAO is to make a referral to the Social Security Administration to reinstate SSI benefits.  The category is to be changed to a “J “upon reinstatement of SSI benefits.

 Step 3:

Within 10 days of receipt of the Notification/Confirmation of Release form, the CAO will notify the YDC/YFC as to whether the youth will be eligible for MA upon release; this information will be provided via the Eligibility/Ineligibility form.  

Step 4:

The YDC/YCF will complete Part B of the Notification/Confirmation of Release form and send to the CAO approximately one week prior to the anticipated release date.  Part B provides confirmation of or a delay in the anticipated release date.

Step 5:

     The release date should be used as the eligibility begin date.  The reapplication due date should be the last day of the calendar month that occurs three months after the month in which the release date occurred.  

Example:  On July 20th, the CAO receives from the YDC the Notification/Confirmation of Release form, Part A completed.  The anticipated release date is September 2nd.  The CAO contact person then reviews eCIS, determines that the youth will be eligible upon release, and furnishes this information to the YDC/YFC on the Eligibility/Ineligibility form.  On August 28th, the CAO receives the Notification/Confirmation of Release form, Part B completed.  This confirms the release date, and the CAO will then authorize Medicaid.  The youth is eligible for Medicaid from September 2nd through December 31st, at which time continued MA eligibility must be redetermined.  

2.   A new case number is to be created for these children if the child is not returning to the previous case record household.  If the child is returning to the previous case record, these youths are treated as a separate budget group.  

3.   The child should be made the case payment name only when a new case record is created.   

4.   A new ACCESS card should be issued if the youth does not have possession of the current ACCESS card. 

5.     The manual PA162 notice must contain the exact begin date and end date for MA.  It should be sent to the address at which the child will reside and should be addressed to the responsible adult(s) with whom the youth will be living.

The following wording is to be used for the PA 162 that is sent to provide notification of the individual’s eligibility for MA:

“The County Assistance Office has been notified that ________ has been discharged from __________ and returned to your care. The child is authorized for Medical Assistance (MA)  benefits and will continue to automatically receive these benefits until ______. An ACCESS card will be mailed. It is important that you contact this County Assistance Office within 30 days prior to the above termination date, so that a caseworker can make a determination of continued MA benefits for this child.”

6.      If there is a change in circumstances (e.g. child obtains a job, changes address, is included in family’s application for assistance, etc.) during the period of PC 30 eligibility, a review of the youth’s continued MA eligibility must be completed.  The child is entitled to an advance 162 notice for termination of PC 30 benefits if the review indicates that eligibility requirements are not being met.

Step 6:

The YDC/YFC will send the Notification/Confirmation of Release form, Part C completed, to the CAO approximately two days after the date of release.  If Part C indicates that the child was not released on the anticipated release date, the CAO will close the case.  If Part C indicates that release did occur, no further CAO action is necessary.

This step is necessary to address the rare instance when a youth may not be released on the anticipated date.  Unforeseen events (such as problems at the prerelease hearing) sometimes result in a child return to the YDC/YFC.

NOTE: The Notification/Confirmation of Release is to be filed in the case record as documentation that the individual has been released from the YDC/YFC.

 

 

Revised July 8, 2024, replacing July 30, 2013