Article 5 Section 06 Institutional Status Table of Contents TITLE PG CITE Institutions 050601 General 050601A Public Institutions 050601B NonPublic Institutions 050601C Institutional Status for Inmates and NonInmates 050602 CMS Ineligible 050602A CMS Eligible 050602B Penal Code Sections 050602C Institution for Mental Diseases IMD 050603 General 050603A Definition 050603B Fleeting and Drug Abuse Felons 050604 General 050604A Fleeing Felons 050604B Drug Abuse Felons 050604C Identifying Inmates and NonInmates Appendix A 050601 Institutions 050601 General This section provides staff with instructions regarding the determination of CMS eligibility for persons in public institutions Eligibility staff must consider both the facility and the individuals circumstances when making a CMS determination of eligibility for an adult who is incarcerated or placed in any type of public institution 050601A Public Institutions The following are identified as public institutions and inmatesresidents are NOT entitled to CMS benefits State or Federal prisons Correctional facilities or County city or tribal jails Detention Centers 050601B NonPublic Institutions Residential facilities located on the grounds of or adjacent to any large public institution Correctional or holding facilities for prisoners or individuals being held under court order as witnesses Education or vocational training institutions that provide an accredited program for its resident The following facilities are not public institutions and residents of these facilities are entitled to CMS coverage if otherwise eligible A medical institution An intermediate care facility A publicly operated residence that serves no more than 16 residents A community care facility which is maintained and operated to provide 24hour nonmedical care for adults including but not limited to the physically handicapped mentally impaired incompetent persons and neglected or abused adults 050602 Institutional Status for Inmates and NonInmates 050602A Ineligible to CMS The following individuals are NOT entitled to CMS benefits An inmate in a prison or a county city or tribal jail Note This includes inmates being held prior to arraignment conviction or sentencing It does not include individuals who are out on bail or their own recognizance An individual who is incarcerated but can leave prison or jail on work release or work furlough and must return at specific intervals Individuals released from prison or jail due to a medical emergency who would otherwise be incarcerated but for the medical emergency 050602B The following individuals are entitled to receive CMS benefits if CMS Eligible otherwise eligible An individual who after arrest but before booking is escorted by police to a hospital for medical treatment and held under guard An individual in prison or jail who transfers temporarily one to two months to a halfway house or residential treatment facility prior to a formal probation release order An individual who is released from prison or jail but who is on probation parole or release order with one of the following conditions o Home arrest 050602C Penal Code Sections o Work release o Community service o Outpatient treatment or o Inpatient treatment An individual released from prison or jail under a court probation order due to a medical emergency Individuals with tuberculosis who are under an order of detention in one of the following facilities to protect public health o A residential treatment center o A skilled nursing facility or o A county city or tribal jail awaiting placement for treatment Penal Code 1367 This penal code applies to individuals charged with a misdemeanor but who are incompetent to stand trial Penal Code 1367 provides that A person cannot be tried or adjudged to punishment while that person is mentally incompetent If a judge finds reason to believe that a defendant may be incompetent to stand trial heshe may order that the defendant be referred for 72hour treatment and evaluation During this time the defendant is entitled to CMS benefits if otherwise eligible If the result of the evaluation is that the individual is to be placed in a mental health facility for treatment heshe may be entitled to receive CMS benefits if otherwise eligible Penal Code 1370 This code applies to individuals charged with a serious felony who are placed in a mental health facility because they were determined incompetent to stand trial If an individual is still determined to be incompetent after the placement period a Murphy Conservatorship may be established An individual under a Murphy Conservatorship may be entitled to receive CMS benefits if otherwise eligible Penal Code 1372 This code applies to defendants who have regained competency When a defendant returns to court with a certification that competence has been regained the court shall determine whether the person is to be released on bail An individual who is released on bail is not a resident of a public institution and therefore entitled to receive CMS benefits if otherwise eligible If not released on bail the individual is likely to be held in a prison or jail prior to conviction or sentencing In this situation the individual would be a resident of a public institution and would not be eligible for CMS benefits 050603 Institution for Mental Disease IMD 050603 Applicants in an IMD can receive CMS benefits if otherwise eligible General 050603A An IMD is defined as a hospital nursing facility or other institution of Definition more that 16 beds that is primarily engaged in providing diagnosis treatment or care of persons with mental diseases Whether an institution is an IMD is determined by whether it functions primarily as a facility established and maintained for the care and treatment of individuals with mental diseases and it does not have to be licensed as such An institution for the mentally retarded is not an IMD 050604 Fleeing and Drug Abuse Felons 050604A Fleeing felons and drug abuse felons are entitled to CMS benefits if General otherwise eligible Under federal regulations a fleeing felon is defined as an individual who is fleeing to avoid prosecution or custody or confinement after conviction for a crime which is a felony under the laws of the place from which the individual flees or who is violating a condition of probation or parole imposed under Federal or State law 050604B In order to receive CMS fleeing felons are subject to all the eligibility Fleeing requirements of the program If otherwise eligible fleeing felons can Felons continue to receive CMS benefits until they have been booked sentenced or incarcerated When any of the three occur eligibility to CMS ends 050604C Drug abuse felons if otherwise eligible are entitled to CMS As long Drug Abuse as they remain otherwise eligible they can continue to receive benefits Felons until they have been booked sentenced or incarcerated Appendix A Identifying Inmates and NonInmates Inmates and Noninmates THE FOLLOWING ARE CONSIDERED AN INMATE OF A PUBLIC INSTITUTION AND ARE NOT ELIGIBLE FOR CMS THE FOLLOWING ARE NOT AN INMATE OF A PUBLIC INSTITUTION AND ARE ELIGIBLE FOR CMS An inmate in a prison An individual who after arrest but before booking is escorted by police to a hospital for medical treatment and held under guard An inmate of a county city or tribal jail An individual in prison or jail who transfers temporarily to a halfway house or residential treatment facility prior to a formal probation release order An inmate in a prison or jail An individual released from Prior to arraignment prisoner jail on probation parole Prior to conviction or release order Prior to sentencing With a condition of home arrest Work release Community service Outpatient treatment Inpatient treatment Individuals released from prison or jail due to a medical emergency WHO WOULD OTHERWISE BE INCARCERATED BUT FOR THE MEDICAL EMERGENCY Individuals released from prison or jail under a court probation order due to a medical emergency An individual who is incarcerated Individuals with tuberculosis who but CAN LEAVE prison or jail on are under an order of detention work release or work furlough and in one of the following facilities to MUST return at specific intervals protect public health A residential treatment center A skilled nursing facility or A county city or tribal jail awaiting placement for treatment