Foster Care Relative Placement Adoption Support Juvenile Rehabilitation Unaccompanied Minor Program

Revised December 17, 2014

Purpose: To give instructions and contact information when working with children enrolled in Foster Care, Adoption Support, Juvenile Rehabilitation, and Unaccompanied Refugee Minor programs. Children in these programs will be active on D01/D02 medical coverage groups.

WAC 182-505-0211 Washington apple health -– Foster Care.

Effective July 1, 2017.

  1. A person under the age of nineteen is eligible for Washington apple health when they:
    1. Are in foster care under the legal responsibility of the state, or a federally recognized tribe located within the state; and
    2. Meet Washington residency requirements as described in WAC 182-503-0520 or 182-503-0525.
  2. A person age twenty or younger is eligible for coverage when the person meets:
    1. Washington residency requirements as described in WAC 182-503-0520 or 182-503-0525;
    2. Citizenship or immigration status requirements as described in WAC 182-503-0535;
    3. Social Security number requirements as described in WAC 182-503-0515; and
    4. One of the following requirements:
      1. Is in foster care, or is eligible for continued foster care services as determined by the children's administration, under the legal responsibility of the state, or a federally recognized tribe located within the state; or
      2. Receives subsidized adoption services through the children's administration; or
      3. Is enrolled in the unaccompanied refugee minor (URM) program as authorized by the office of refugee and immigrant assistance (ORIA); or
      4. Is living in a group home operated or contracted by the juvenile rehabilitation administration; or
      5. Is placed in a foster home or group home through the voluntary placement waiver program managed by the division of developmental disabilities.
  3. A person age nineteen or older but under age twenty-six is eligible for coverage when the person:
    1. Was both in foster care under the legal responsibility of the state or a federally recognized tribe located within the state and enrolled in medicaid:
      1. On the person's eighteenth birthday; or
      2. At such higher age at which foster care assistance ended; and
    2. Meets residency, Social Security number, and citizenship requirements as described in subsection (2) of this section.
  4. A person described in subsections (1) through (3) of this section is not eligible for full-scope coverage if the person is confined to a public institution as defined in WAC 182-500-0050, except:
    1. If the person is under age twenty-one;
    2. Resides in an institution for mental disease (IMD); and
    3. Meets the institutional status requirements in WAC 182-505-0240.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

Note: Children in foster care, adoption support, and juvenile rehabilitation have special confidentiality concerns. Please be sure that your narrative and remark references contain only information regarding financial eligibility. Limit any comments that have to do with the child’s placement, name change or biological parents.

Clarifying Information

The Foster Care Medical Team (FCMT) is responsible for the following cases:

  1. Foster Care (D01/D02): These are children who are placed in a licensed foster care or relative's home by the Children's Administration (CA) or a federally recognized Tribe. The foster care parent receives a monthly payment from CA and the child is eligible for Apple Health.
    1. CA sends an alert to the FCMT to inform them a child has entered foster care. FCMT works the alert and opens a D01 (foster care child receiving SSI) or D02 (foster care) case for the child.
    2. D01/D02 foster care cases:
      1. Are assigned to CSO 076
      2. Display in ACES with asterisks in the address field and AREP screen. The asterisks have been added to insure address confidentiality for the foster care family and child.
      3. Require special coding in the DEM1 living arrangement and DEM1 REL code fields.
    3. When the CSO/CSC and FCMT have a shared D01/D02 case, only the FCMT can finalize or update the case. The CSO can "add a program" to a D01/D02 case, but will not be able to finalize the case. CSO/CSC staff will need to coordinate with the FCMT @ 800-562-3022 ext. 15480 to have them complete case actions. FAX number is 360-725-1158.

      Note: CSO staff should not change the living arrangement or REL code on the foster care child's DEM1 screen or close out a foster care assistance unit. To make any change to a D01/D02 case contact the FCMT @ 800-562-3022 ext. 15480.
       

  2. Former Foster Care Medical Program (D26): The Affordable Care Act expanded Medicaid eligibility for individuals who were in foster care and receiving Medicaid on their 18th birthday to age 26. These individuals have their D02 medical coverage automatically spout to D26 the first of the month following their 18th birthday. They remain eligible for health care coverage under the D26 program until their 26th birthday regardless of changes in income, household composition, or marital status, as long as they remain a Washington resident.
  3. Adoption Support (D01/D02): Is a payment received by an adoptive parent who cares for children who have been placed by Washington State or another state. These children are categorically eligible for Apple Health as long as they are receiving an adoption support payment. Children in adoption support may be eligible up to age 21.
    1. Adoption Support cases are approved by the Children's Administration (DSHS). CA communicates adoption support enrollment to the FCMT. The FCMT opens D01 or D02 medical program.
    2. D01/D02 adoption support cases are:
      1. Assigned to CSO 076
      2. Display in ACES with asterisks in the address field and AREP screen.
      3. Require special coding in the DEM1 living arrangement and the REL code fields.
    3. Changes to adoption support case and any case associated with adoption support can only be made by FCMT.

      Note: A child placed with adoptive parents will often be assigned a new Client Identification (CL ID) number. The assignment of a new CL ID number will help ensure confidentiality.
       

  4. Juvenile Rehabilitation (D01/D02): Children who reside in a Juvenile Rehabilitation Administration (JRA) group home are eligible for Apple Health through the month in which they are paroled.
    1. JRA notifies the FCMT that a child has been placed in a group home. The FCMT opens a D01 or D02 medical case for the child.
    2. JRA cases are:
      1. Assigned to CSO 076
      2. Display in ACES with asterisks in the address field and AREP screen.
      3. Require special coding in the DEM1 living arrangement and REL code fields.
    3. CSO/CSC may see JRA cases in ACES when the child has recently been released from the group home. To add a child back to their family assistance unit or to open new coverage for the child the CSO/CSC must contact FCMT @ 360-725-1519.
  5. Unaccompanied Refugee Minor (URM) Program: The Department of State and the Office of Refugee Immigration Assistance (ORIA) work together to identify minor children who need foster care placement and approve them for resettlement in this country. Children are placed in culturally sensitive foster homes and are eligible for Apple Health. When a child has been placed in the URM Program, the ORIA program manager notifies the FCMT to open Apple Health coverage under D02 program. Children in the URM program remain eligible for Apple Health coverage up to age 21 as long as URM payments are being made.

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