County of San Diego Health and Human Services Agency HHSA MediCal Program Guide Juveniles in Public Institutions Number Page 060501 1 of 2 EffectiveRevision Date 312019 Background In determining the MediCal eligibility of a juvenile under the age of 18 in a facility staff must consider both the disposition status of the juvenile and the type of facility heshe is in A juvenile is not eligible to full scope MediCal if heshe is in a public institution for a criminal offense Inmates receiving inpatient or mental health services outside of the facility may be eligible to limited scope coverage that pays only for the inpatient or mental health services Policy A Disposition Disposition is the decision made by the court for the juveniles welfare A disposition order is the court decision that the minor will be placed in foster care sentenced placed on probation or released either temporarily or permanently When the juvenile is determined a Ward of the Court and is awaiting foster care placement and not awaiting sentencing for a criminal violation of law the juvenile is eligible for MediCal See MPG Article 5 Section 12 for information on Foster Care B Status Prior to Disposition If a juvenile is in a detention center due to criminal activity then they are considered an inmate of a public institution and not eligible to fullscope MediCal If they are in a detention center for care protection andor in the best interest of the child and there is a specific plan that makes the stay temporary 1 to 2 months then they are not considered an inmate of a public institution C Status After Disposition Juveniles on intensive probation with a plan of release which includes residence in a detention center are not eligible for MediCal benefits until released Juveniles placed or awaiting placement on intensive probation in a residential facility are eligible for MediCal benefits if the facility is not part of the criminal justice system D Facility Publicly operated community residences that serve no more than 16 residents are not considered institutions and juveniles in these facilities are entitled to MediCal if otherwise eligible These facilities may be psychiatric nursing facilities licensed by the Department of Mental Health or other community care facility Example A juvenile is detained for criminal activity and is placed on probation with specific conditions of release including a stay of 30 days or longer at a detention facility The facility is identified as a juvenile detention center not a treatment center Upon release from this detention center they would be placed on probation with their mother The juvenile is considered an inmate of a public institution and is not eligible for fullscope MediCal benefits during the period of incarceration After release from the detention center and while on probation the juvenile may be eligible for MediCal benefits County of San Diego Health and Human Services Agency HHSA MediCal Program Guide Juveniles in Public Institutions Number Page 060501 2 of 2 References ACWDL 1318 MEM Letter 241 Sunset Date This policy will be reviewed for continuance on or by 3312022 Approval for Release Rick Wanne Director Eligibility Operations County of San Diego Health and Human Services Agency HHSA MediCal Program Guide Suspension of Benefits for Incarcerated Juveniles Number Page 060502 1 of 1 EffectiveRevision Date 312019 Background Senate Bill 1147 requires that rather than being terminated MediCal eligibility must be suspended for up to one year for inmates of public institutions under the age 21 who were MediCal eligible at the time of incarceration Senate Bill 720 expanded suspension policy to adult inmates effective 1114 Suspension does not apply to adult inmates incarcerated prior to 1114 Policy Suspension of Benefits policy is the same for adults and juveniles and is located in MPG 060205 Procedure Suspension procedures are in the Inmate Eligibility Program Processing Guide section five References ACWDLs 1006 and 1426 Sunset Date This policy will be reviewed for continuance on or by 3312022 Approval for Release Rick Wanne Director Eligibility Operations County of San Diego Health and Human Services Agency HHSA MediCal Program Guide Juvenile PreRelease Application Process Number Page 060503 1 of 1 EffectiveRevision Date 312019 Background Senate Bill 1469 requires that juvenile wards held in county detention facilities Juvenile Hall a camp or ranch for more than 30 days may begin the MediCal application process while incarcerated so that they may have MediCal eligibility immediately upon release if possible This section was revised to move procedures to the processing guide Policy A Notification The County of San Diego Department of Probation will notify the wards parents 90 days prior to release that they intend to obtain MediCal for the ward If the parent requests an application or there is no response within 30 days the Department will send referral form 1488 to HHSA to evaluate B Evaluation If there is an active case suspense procedures apply If there is no active case it should be treated as a mailin application request with the referral date serving as the date of application and the release date as the beginning date of aid C Communication with Department of Probation Use form 1488 HHSA to communicate to The Department of Probation the outcome of the eligibility determination or If the determination cannot be completed prior to the release date at least ten days prior to the scheduled release D Release Date Changes When a release date changes The Department of Probation will send a modified referral form with the new date Change the beginning date of aid to the new release date NOTE Some wards may have shorter incarcerations and the referral form will reach the worker very close to the release date Make every effort to grant the case prior to release Procedure Suspension procedures are in the Inmate Eligibility Program Processing Guide section nine References ACWDL 0734 Sunset Date This policy will be reviewed for continuance on or by 3312022 Approval for Release Rick Wanne Director Eligibility Operations