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					Foster Care Handbook                                                           page 32-1
                                                                                Medi-Cal

32. Medi-Cal



32.1 Fee-For-Service
    Children receiving Foster Care, Adoption Assistance or Kin-GAP are eligible for
    fee-for service Medi-Cal. This means they can receive medical care from an
    individual doctor, dentist, pharmacy, etc. of choice who accepts the child as a
    Medi-Cal patient. Medi-Cal fee-for-service benefits do not restrict or require that
    clients receive their medical care from specified health care providers.
    Fee-for-service medical providers are individually reimbursed by Medi-Cal for
    specific services or procedures performed.

    At one time the state wanted to mandate managed care for foster care and
    adoptive children. Counties and other community groups advocated for the
    fee-for-service option for these children so that they would have immediate access
    to care. Many children experience multiple placements, placements in other
    counties, etc. and it can be difficult to disenroll a child in managed care. Only
    Medi-Cal recipients in one of the mandatory Aid Codes must select a Managed
    Care Plan, or they will be defaulted to one.

    Note:
        Health Care Options mails enrollment packets to ALL Medi-Cal applicants and
        beneficiaries.




32.2 Health Care Options for Foster Care, Adoptive
     and Kin-GAP Children

32.2.1      Policy

    Managed Care is OPTIIONAL for Foster Care, AAP and Kin-GAP recipients. The
    decision to enroll is the responsibility of the child’s guardian, Social
    Worker/Probation Officer, or, the adoptive parent, although the packet may be
    mailed to the Foster Parent.


                                     Update # 09-05                          Revised: 04/30/09
page 32-2                                                           Foster Care Handbook
Medi-Cal
       Managed Care may be a better option for the child’s medical care for various
       reasons, such as, when the child is in a stable placement with a relative or
       guardian, for easier access to medical care, other children in the home have
       managed care, to meet the child’s medical needs etc. Managed Care information is
       sent to non-mandated recipients at various times, as they have the option to enroll.
       EWs should try to clarify the available options if the child’s caretaker/provider has
       questions, as sometimes clients think they have to enroll.

32.2.2              Managed Care, Two-Plan Model

       The Department of Health Services (DHS) has contracted with two managed care
       plans to provide Santa Clara County’s Medi-Cal Services. One contract is with a
       local initiative - a publicly sponsored health plan cooperatively developed by local
       government, clinics, hospitals, physicians and other providers that historically have
       served the Medi-Cal population in the county. The other contract, awarded through
       competitive bidding, is with a commercial plan.

       Santa Clara County’s two managed care plans are:

       • Santa Clara Family Health Plan - Local Initiative
       • Blue Cross of California - Commercial Plan

32.2.3              Enrollment/Disenrollment from Two-Plan Model

       Due to privacy rules, foster parents may not be able to enroll or disenroll a child in
       managed care. Managed care may tell the foster parent that they cannot assist
       them because their name is not on the MEDS screen. When this occurs, have the
       MEDS Terminal Operator (MTO) enter the foster parents' name in the 2nd field
       below the child's name as C/O (foster parent's name). They will then have access
       to discuss enrollment, disenrollment and other issues with the managed care plan.

       All Two-Plan Model enrollment and disenrollment functions are handled by the
       Department of Health Services Health Care Options (HCO) contractor. The current
       HCO contractor is Maximus.

       When the child’s caretaker needs assistance selecting, enrolling or disenrolling
       from a plan, they may:

       • Contact the HCO contractor at 1-800-430-4263, weekdays from 8 a.m. - 5 p.m.
         Assistance is available in a variety of languages.

       • There are also HCO representatives at the AAC, VMC and South County Social
         Services District Offices who can help with enrollment and disenrollment.

Revised: 04/30/09                       Update # 09-05
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    • If difficulties arise when trying to disenroll a foster child from managed care,
      contact the Ombudsman’s office at (888) 452-8609.

32.2.4      Emergency Disenrollments

    When an emergency disenrollment from a managed care plan is needed, the EW:

    • Completes the “Disenrollment For Foster Care Children” form with the child’s
      information.

    • Fax’s it to: Health Care Options, Urgent Disenrollment Unit:
      Phone No. (916) 366-4823
      FAX (916) 364-0287, or (916) 491-2703, or (916) 364-0378

    • Files the Disenrollment form in the case folder until IDM scanning is available.

    • Documents the actions taken in the Maintain Case Comments window.

    [Refer to Medi-Cal Handbook, “Health Care Options/Managed Care,” page 15-1 for
    more information.]

32.2.5      Change of Address and Managed Care Disenrollment
            for Children in Foster Care and Adoption Assistance
            Program

    When a FC or AAP child is placed in a facility out of the county, the original county
    where the court has jurisdiction retains responsibility for the child. It is the
    RESIDENCE ADDRESSS and RESIDENCE COUNTY CODE on MEDS that
    determines which managed care plan is available to the child.

    Although Santa Clara is not a COHS county, the residence address and
    Residence-County code for a FC and AAP child, including those who also receive
    Supplemental Security Income (SSI) benefits, must be updated IMMEDIATELY in
    CalWIN and MEDS. This is to ensure the child can quickly obtain medical and
    mental health services in their new county of residence through fee-for-service
    providers or through a Medi-Cal managed care plan; especially if the county they
    move to is a COHS county.

    Additional information and process instructions is located in the User’s Guide to
    State Systems, “Change of Address for Foster Care Children Placed
    Out-of-County,” page 3-27].



                                     Update # 09-05                           Revised: 04/30/09
page 32-4                                                           Foster Care Handbook
Medi-Cal




32.3 Children Eligible Under Aid Code 45
     [MEM 50161, 50163]

32.3.1              Who Qualifies

       Medi-Cal Aid Code 45 is used when a child is not living with a parent or relative and
       a public agency is assuming financial responsibility for the child’s care, in whole or
       in part. Generally, children who are at our Childrens Shelter are eligible for
       Medi-Cal under Aid Code 45. The agency that is providing the financial support
       must have the responsibility for the child’s placement.

       The following children are eligible for Medi-Cal under Aid Code 45:

       • Children receiving Wraparound services and not in receipt of Foster Care or
         CalWORKs.

       • Children detained or placed under W & I Code 300 or 601, and 602’s pending
         placement. If they are incarcerated, they are NOT eligible.

       • Foster Care children who are on probation and are currently in placement.

       • Undocumented children are eligible for Medi-Cal under Aid Code 45 if
         “permanently residing under color of law” (PRUCOL) status is pending or
         approved, (e.g. the G-845 and the MC 845 Supplement has been completed and
         forwarded to USCIS.)

32.3.2              Required Forms/Verifications

       The EW must complete the following forms and requirements for children receiving
       Medi-Cal under Aid Code 45:

       • The MC 250 is both the application and statement of facts form. It must be
         completed and signed by the EW, then reviewed and countersigned by another
         EW or the EW Supervisor. A SAWS 1 may be used as needed to clarify the
         application date and the beginning date of aid.

           There are exceptions. The EW does not complete the MC 250 in the following
           circumstances:


Revised: 04/30/09                       Update # 09-05
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                                                                               Medi-Cal
         • JPD must complete and sign the MC 250 for children who are in a juvenile
           detention center pending placement, and are not incarcerated, or are on
           probation and are currently in placement.

    Reminder:
       The MC 250 is valid for one year. For example, a JPD child is placed in a
       group home. The group home placement doesn’t work out, and the child
       returns to a juvenile center pending a new placement. Aid Code 45 may be
       established with the MC 250 on file if it is less than 12 months old.

    • A “Statement of Citizenship, Alienage and Immigration Status” (MC 13) is only
      required if the child is NOT a U. S. citizen (See “Forms/Verifications Not
      Required”, Section 29.3.3 below for citizenship status criteria.) The MC 13 is to
      be completed by the same person who completes the MC 250.

    • The child’s birth certificate or immigration documents must be requested if not on
      file.

    • A Social Security Number must be on file, or an application for an SSN must be
      completed when the child’s birth certificate is received.

32.3.3       Forms/Verifications Not Required

    The following forms and/or verifications are NOT required:

    • “Important Information for Persons Requesting Medi-Cal” (MC 219).

    • Child/medical support referral.

    • Verification of identity and residency (MC 212), however it is assumed that the
      county will have some type of documentation on file, and a birth certificate must
      be requested if not on file.

    • An MC 13 is NOT required for a child who is any of the following:

         •   U.S. born citizen
         •   Naturalized U.S. citizen
         •   U.S. Nationals
         •   Child with acquired or derived U.S. citizenship.

    An MC 13 must be completed when the child is not a U.S. citizen or was born
    outside of the United States.



                                     Update # 09-05                         Revised: 04/30/09
page 32-6                                                             Foster Care Handbook
Medi-Cal
       • The income and property of the child and his/her parents are not counted in the
         Medi-Cal determination.

32.3.4              Effective Date/Retroactive Medi-Cal

       Aid Code 45 is effective the first of the month of application. Three-month
       retroactive coverage can also be established, if otherwise eligible.

       • When a child is released from the agency to his/her parent’s or relative’s home,
         eligibility for Medi-Cal under Aid Code 45 continues until the end of the month of
         release. CEC then applies until the child is 19 or the RV is due, whichever is first.

       • Providers may bill for services rendered to a newborn on the birth mother’s Aid
         Code 45 Medi-Cal record for the month of birth and the following month, as with
         other Medi-Cal programs.

32.3.5              Month(s) Prior to Foster Care Approval

       Children often need to have Medi-Cal before their Foster Care is approved.
       Whenever the EW is approving Medi-Cal prior to Foster Care approval, the
       following requirements apply:

       • An MC 250 must be completed for Medi-Cal only (45) when Foster Care cash
         aid is not yet approved. If retroactive Medi-Cal is needed, an MC 210A must be
         completed for the retro month(s).

       • If only retroactive Medi-Cal is requested, an MC 250 must be completed for the
         first retro month and an MC 210A must be completed for the 2nd and 3rd
         month(s).

       The Medi-Cal Aid Code in CalWIN must match the Aid Code in MEDS, or a MEDS
       error will occur.

       • When foster care is approved, the cash Aid Code (42, 40 etc.) should override
         the 45 aid code on MEDS starting with the month of Foster Care approval.

               • If the information in CalWIN is incorrect, it must be correct.

               • If the information on MEDS is incorrect, and CalWIN has correct
                 information, complete an SC 1296 and request the MTO complete a
                 manual online transaction to correct the record.



Revised: 04/30/09                         Update # 09-05
Foster Care Handbook                                                               page 32-7
                                                                                    Medi-Cal




32.4 Medi-Cal for Children Entering California,
     Receiving Federal Foster Care from Another
     State

32.4.1      Background

    The California Department of Health Care Services (DHCS) added Aid Code 46
    effective October 1, 2008 to accommodate the Interstate Compact on the
    Placement of Children (ICPC) for out-of-state federal FC Medi-Cal only cases. Prior
    to this Aid Code the County had been using existing Aid Codes to establish
    Medi-Cal for out of state placements receiving federal FC. This did not allow for the
    state to accurately track these cases. DHCS implemented the new Aid Code for
    appropriate tracking of out-of-state Medi-Cal for these children.

32.4.2      Eligibility Requirements

    The following requirements are applicable to this program:

    Required Forms

    The ICPC SW completes the MC 250, MC 13 and the ICPC memo when an
    incoming ICPC is received.

    Income and Property

    This is a categorically eligible child. Medi-Cal eligibility is met by virtue of receiving
    Title IV-E benefits. No separate application, income, or asset test is required to
    establish Medi-Cal.

    Share-of-Cost

    There is NO Share-of Cost.




                                      Update # 09-05                             Revised: 04/30/09
page 32-8                                                           Foster Care Handbook
Medi-Cal
       Managed Care Plan Enrollment

       Children in this Aid Code will have voluntary enrollment status for Medi-Cal
       managed care plans.

       Residency

       California residency requirements apply.

       Redetermination:

       Annual redetermination of Medi-Cal must be conducted with the adoption state not
       the adoptive parents.




32.5 Medi-Cal for Children Entering California,
     Receiving Federal Adoption Assistance
     Payments (AAP) from Another State

32.5.1              Background

       The California Department of Health Care Services (DHCS) added Aid Code 06
       effective October 1, 2008 to accommodate the Interstate Compact on Adoption and
       Medical Assistance (ICAMA) for out-of-state federal AAP Medi-Cal cases. Prior to
       this Aid Code the County had been using existing Aid Codes to establish Medi-Cal
       for out of state placements receiving federal AAP. This did not allow for the state to
       accurately track these cases. DHCS implemented the new Aid Code for
       appropriate tracking of out-of-state Medi-Cal for these children.

32.5.2              Eligibility Requirements

       The following requirements are applicable to this program:

       Required Forms

       • A copy of the Adoption Assistance Agreement; or, verification of receipt of
         state-only AAP benefits from the state the child is coming from.
       • SAWS 1
Revised: 04/30/09                       Update # 09-05
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                                                                                    Medi-Cal
    •   SC 41
    •   MC 250
    •   ICAMA 6.01
    •   Verification that child is a resident of California
    •   Social Security Number (or an application for an SSN).

    Income and Property

    This is a categorically eligible child. Medi-Cal eligibility is met by virtue of receiving
    Title IV-E benefits. No separate application, income, or asset test is required to
    establish Medi-Cal.

    Share-of-Cost

    There is NO Share-of Cost.

    Managed Care Plan Enrollment

    Children in this Aid Code will have voluntary enrollment status for Medi-Cal
    managed care plans.

    Residency

    California residency requirements apply.

    Redetermination:

    Annual redetermination of Medi-Cal must be conducted with the adoption state not
    the adoptive parents.




                                      Update # 09-05                             Revised: 04/30/09
page 32-10                                                          Foster Care Handbook
Medi-Cal




32.6 Medi-Cal for Children Entering California,
     Receiving State-Only Adoption Assistance
     Payments (AAP) from Another State

32.6.1              Background

       Effective January 1, 2000, Senate Bill 1270 allows Medi-Cal benefits for children
       entering California, who are in receipt of state-only AAP and do not qualify for
       Medi-Cal, because the state-only AAP is from another state.

       Any child entering California, who applies for Medi-Cal and is receiving state-only
       AAP from another state qualifies. Aid Code 4A is used for this program.

32.6.2              Eligibility Requirements

       The following requirements are applicable to this program:

       Income and Property

       There are NO Income or Resource tests. The income and resources of the parents
       and sibling(s) are NOT considered in the child’s eligibility determination.

       Share-of-Cost

       There is NO Share-of Cost.

       Managed Care Plan Enrollment

       These children are eligible for fee-for-service Medi-Cal, however they may choose
       to enroll in a Managed Care plan.

       Residency

       California residency requirements apply.



Revised: 04/30/09                      Update # 09-05
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                                                                               Medi-Cal

32.6.3      Required Forms/Verifications

    The following forms/verifications are required:

    • A copy of the Adoption Assistance Agreement; or, verification of receipt of
      state-only AAP benefits from the state the child is coming from.
    • SAWS 1
    • SC 41
    • MC 250
    • ICAMA 6.01
    • Verification that child is a resident of California
    • Social Security Number (or an application for an SSN).

32.6.4      Forms/Verifications NOT Required

    The following forms/verifications are NOT required:

    • MC 210
    • The “Important Information for Persons Requesting Medi-Cal (MC 219)”
    • A Child/Medical Support referral.

32.6.5      Effective Date

    The effective date is the first of month of the application. Three-month retroactive
    coverage can be approved if requested; however, an MC 210A must be completed
    for the retro months.




32.7 Miscellaneous Medi-Cal Only Determinations for
     Foster Care and Adoptive Children

32.7.1      General

    This section contains clarifications regarding the determination of Medi-Cal only for
    children who are in various types of placements. Special emphasis is given to those
    situations for which Aid Code 45 is NOT appropriate.




                                    Update # 09-05                           Revised: 04/30/09
page 32-12                                                         Foster Care Handbook
Medi-Cal

32.7.2              FC Child’s Income Exceeds Cost of Care

       Occasionally a child is under the care and control of an agency yet has enough
       income or property to meet his/her needs (placement costs, personal needs, etc.)
       without financial assistance. Do NOT use Aid Code 45 when the agency is not
       assuming any financial responsibility. Determine eligibility for regular Medi-Cal.

       • The SW/PO must complete all regular Medi-Cal forms (SAWS 1, MC 210,
         MC 219, etc., on behalf of the child).

       Note:
           The MC 219 does not need to be signed or returned. Just document it was
           given to the client and when.

       • An MC 13 if the child does not have citizenship status (An MC 13 is NOT
         required for U.S. born citizens, naturalized U.S. citizens, U.S. Nationals and
         persons who have acquired or derived U.S. citizenship).

       • A child/medical support referral is required, unless a referral exemption applies.

       • MI Aid Code (82, 83) is appropriate unless the child is living with a caretaker
         relative (AFDC-MN Aid Code 34, 37).

       Note:
           The caretaker relative can be linked to Medi-Cal, if otherwise eligible.

       • The child’s income and property must be verified and counted. The portion of the
         child’s income which represents the difference between the maintenance need
         and the foster care rate is considered “unavailable.”

       Example:
          A 16-year-old child resides in a specialized adolescent care home; rate, $741.
          The child receives $680 per month Social Security and $200 Veteran’s
          benefits; total, $880. This income must be applied to the Medi-Cal budget as
          follows:

              Enter in CalWIN, or in the space at the bottom of the MC 176M, determine the
              amount of “unavailable” income.

              $741 Foster Care Rate
              - 600 Medi-Cal Maintenance Need (one person)
              _____
              $141 Unavailable Income

Revised: 04/30/09                       Update # 09-05
Foster Care Handbook                                                         page 32-13
                                                                               Medi-Cal
         Subtract the unavailable income ($141) from the child’s total countable income
         before determining the share of cost.

         $880 Total Income (unearned, no deductions apply)
         - 141 Unavailable Income
         ____
         $739 Net Nonexempt Income
         - 600 Medi-Cal Maintenance Need (1 person)
         ____
         $139 Share of Cost

32.7.3      Child Not Receiving Foster Care at Age 18

    If the child was NOT receiving Foster Care when he/she turned 18, and he/she is
    no longer eligible for CEC, the following rules apply:

    Persons age 18 - 21 who are not living with a parent or a caretaker relative are
    “adults” by Medi-Cal definition, even though a public agency (i.e. California Youth
    Authority) is assuming financial responsibility for their care.

    • A regular Medi-Cal determination is required. The individual must complete all
      Medi-Cal forms (SAWS 1, MC 210, MC 219, MC 13 (if not a citizen), etc.)

    Note:
        The MC 219 does not need to be signed or returned. Just document it was
        given to the client and when.

    • His/her income and property must be verified and counted, unless it is otherwise
      exempt.

32.7.4      Adoptive Placement

    When a child is residing with adoptive parents who have waived financial support,
    Medi-Cal is issued through AAP (Aid Code 03, 04).

    • The income and property of the prospective adoptive parents are not used in
      determining eligibility until the adoption is final.

    • The SW/PO shall complete the MC 210 and other required forms.




                                    Update # 09-05                          Revised: 04/30/09
page 32-14                                                                        Foster Care Handbook
Medi-Cal

32.7.5              Child Residing with a Relative

       If a child is residing with a caretaker relative other than a parent, use AFDC-MN Aid
       Code 34 or 37.

       • The relative shall complete the MC 210 and other required forms.

       • The relative may be linked if otherwise eligible.

32.7.6              Child Residing in a Home for the Developmentally
                    Disabled

       If a child is residing in a board and care home for the developmentally disabled
       (i.e. San Andreas Regional Center), and SSI is pending:

       • Although the regional center may be providing financial assistance, Aid Code 45
         may not be used unless the court has appointed the regional center as the
         child’s conservator, guardian or executor.

       • The parent(s) should complete the MC 210 if they are still financially responsible
         for the child; however, the regional center may complete the MC 210 if the parent
         is not available.

32.7.7              Children Under a Penal Hold (including Section 602)

       When a child is residing under a penal hold, including Section 602 (has been
       arrested and needs medical attention), follow these rules:

           If:                                                   Then:

           Medical care is needed prior to booking               Establish eligibility for regular Medi-Cal,
                                                                 as Aid Code 45 is not appropriate.

           The child is in juvenile hall awaiting disposition    The child is ineligible for Medi-Cal.

           The dispositional hearing has been held and           The child may be eligible for Medi-Cal
           there are placement orders for the child              under Aid Code 45.




Revised: 04/30/09                               Update # 09-05
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                                                                                   Medi-Cal

32.7.8      Children in the Uplift or SED Program

    Children who are placed at home through the Uplift program and children who are
    participating in the Severely Emotionally Disabled (SED) Program must have their
    Medi-Cal determined as part of a family. They are considered to be “living in the
    home”. Regular Medi-Cal rules apply.




32.8 Medi-Cal Eligibility for Former Foster Care
     Children (FFCC) 18 to 21 Years of Age

32.8.1      Background

    The federal Foster Care Independence Act of 1999 authorized continued Medi-Cal
    coverage for all youth who are in Foster Care under the responsibility of the state
    on their 18th birthday. Eligibility for this program continues until their 21st birthday.

    The statute under Welfare and Institutions Code Section 14005.28 was part of the
    Governor’s Mental Health Initiative for fiscal year 2000/2001. It provides medical,
    dental, and counseling services for these youth as they transition from Foster Care
    to independent adult life. The effective date is October 1, 2000.

    The law permits waiving income and asset tests for this population. Youth eligible
    for this program are entitled to full scope zero share-of-cost Medi-Cal benefits,
    including Early and Periodic Screening, Diagnosis, and Treatment services until
    age 21.

32.8.2      Who is Eligible for FFCC

    Children receiving Foster Care

    Foster Care children in the following Aid Codes at the time of their 18th birthday are
    entitled to FFCC.

                  Aid Code    Description

                      40      Non-Federal, Children in Foster Care

                      42      Federal, Children in Foster Care


                                      Update # 09-05                            Revised: 04/30/09
page 32-16                                                              Foster Care Handbook
Medi-Cal

                       Aid Code   Description

                          4C      Voluntary Placement Children in Foster Care

                          45      AFDC-Foster Care Children, supported in whole or in
                                  part by public funds

                          5K      Emergency Assistance, Child in Foster Care

       Former Foster Care Children (FFCC) who are currently under age 21, and were
       receiving Foster Care in any of the above Aid Codes on their 18th birthday, are
       entitled to the FFCC program.

       [Refer to “Who is Eligible,” page 22-35] of the Medi-Cal Handbook for additional
       details.

       Children Receiving CalWORKs

       Relatives who do not want Foster Care payments for a dependent child may
       choose to apply for CalWORKs instead. If the child is discontinued from
       CalWORKs and court dependency at age 18, the child is eligible for FFCC.
       Collateral contact with the SW is all that is required to determine if dependency
       applies.

32.8.3              Children Ineligible for FFCC

       • Children age 18-21 who are institutionalized or incarcerated.

       Note:
           Children who are on probation are eligible for FFCC if they were receiving
           Foster Care on their 18th birthday and they are under 21 yrs. old. Upon
           release, they must apply (or re-apply) for the FFCC Medi-Cal program. Only a
           SAWS 1 is required to establish eligibility.

       • Emancipated Minors

       • Undocumented former foster care children

       • Children exiting the AAP program on their 18th birthday

       • Children exiting the Kin-GAP program on their 18th birthday.




Revised: 04/30/09                        Update # 09-05
Foster Care Handbook                                                        page 32-17
                                                                              Medi-Cal

    Note:
        Children under age 19, who are discontinued from Foster Care, AAP or
        Kin-GAP are potentially eligible for CEC.

32.8.4      General Eligibility Rules

         • There are NO income or resource tests, regardless of the child’s living
           arrangements or with whom they reside.

         • There is NO share-of-cost.

         • There are NO additional forms required.

         • The child is set up in his/her own case.

         • Children who are discontinued from Foster Care because of age, must be
           transferred to FFCC and shall remain in this program until their 21st
           birthday, regardless of any change in circumstances as long as he/she
           continues to meet the criteria and wishes to retain Medi-Cal coverage.

    Example:
       If an FFCC returns to live with his/her parents who are receiving Medi-Cal or
       CalWORKs, the child’s FFCC is not affected. Eligibility for other family
       member(s) is determined based on existing program rules. The FFCC child
       has his/her own case, and is an excluded member of his/her parent’s case:

         • Other health coverage must be reported, if applicable.

         • If the FFCC has a child, his/her child will be in his/her own case and
           Medi-Cal eligibility is based upon program rules applicable to the child.

         • If a former foster child provides verification that he/she was receiving
           Foster Care on his/her 18th birthday in another state, he/she is eligible for
           FFCC Medi-Cal.

         • Enrollment in a Managed Care Plan is optional, unless the individual lives
           in a county that has a County Organized Health System (COHS) where
           enrollment is mandatory.

32.8.5      ICT Requirements for FFCC Child

    If the FFCC moves to another county, this program follows the child. Regular ICT
    rules apply. California residency regulations apply.
                                    Update # 09-05                          Revised: 04/30/09
page 32-18                                                            Foster Care Handbook
Medi-Cal
       The following forms are to be sent when initiating and ICT for an FFCC:

       • “CalWIN Notification of Intercounty Transfer” (CalWIN initiates ICT)

       • Documentation that the child was receiving Foster Care until their 18th birthday.
         (Copy of FC discontinuance NOA or MEDS screen with month the child went
         from Foster Care to FFCC. (It also shows the month the last RD was completed.)

       • Copy of DHS 6155 if there is other health coverage.

       • Other documentation on file that is relevant (birth certificate, identity, etc.)

       • If not a citizen, MC 13 and copy of an immigration document if available.

       Note:
           Other counties may want an MC 250A for the last RD, however it is not a
           required form. An FFCC child should not have to complete any forms, however
           the address is needed to ensure the child is receiving Medi-Cal from the
           county where he/she is living in order to have easier access to medical care.‘

32.8.6              Retroactive Eligibility for FFCC

       Former Foster Care Children (FFCC) entitled to this program may request
       retroactive Medi-Cal coverage.

32.8.7              FFCC and CalWORKs

       If the FFCC becomes eligible for CalWORKs, they have the option to choose
       CalWORKs over the FFCC Medi-Cal program. If CalWORKs is discontinued, and
       he/she is under 21, the child must be automatically transferred back to the FFCC
       program.

32.8.8              FFCC and SSI

       An FFCC may be placed in this program if they are no longer eligible for SSI
       benefits. If, however, they are receiving disability-based SSI benefits, they must
       remain in the appropriate SSI Aid Code.

32.8.9              Current Residence Address

       A current California address is necessary, if the child is to continue to receive FFCC
       Medi-Cal benefits without any interruption in benefits.
Revised: 04/30/09                        Update # 09-05
Foster Care Handbook                                                            page 32-19
                                                                                  Medi-Cal




32.9 District Office FFCC Procedures

32.9.1        Application Process

    CSTs/EWs in Intake District Offices must screen all Medi-Cal applicants from 18
    through 20 years of age, whether applying in person, or through the mail-in
    application process, to determine if they are entitled to the FFCC Medi-Cal
    program.

    In order to identify this population, screening may include but is not limited to the
    following questions:

         • Were they in Foster Care on their 18th birthday?

         • Were they terminated from Foster Care because they reached age 18?

32.9.2        Forms/Verifications

    The primary method of establishing entitlement to the FFCC Medi-Cal program is
    through the CalWIN and MEDS query completed during the applicant ID process. If
    it is determined that the applicant was in one of the appropriate Aid Codes on their
    18th birthday, they are entitled to this program. Information related to eligibility may
    be obtained from the closed foster care case record if necessary.

32.9.3        Statement of Facts

    DHS developed a one-page Statement Of Facts for individuals between the ages of
    18 and 21 who were in Foster Care placement on their 18th birthday. The form is
    entitled “Application and Statement of Facts For An Individual Who Is Over 18 and
    Under 21 And Who Was In Foster Placement On His Or Her 18th Birthday”
    (MC 250A).

    Although an application is not required for FFCC children, the MC 250A may be
    used to request the necessary identifying information about the child. The child is
    NOT required to complete any additional forms.




                                      Update # 09-05                           Revised: 04/30/09
page 32-20                                                          Foster Care Handbook
Medi-Cal

32.9.4              Retroactive Request for Medi-Cal

       An MC 210A must be completed if retroactive Medi-Cal coverage is requested. The
       following applies if retroactive Medi-Cal coverage is requested:

               • EWs must not require any income or resource verifications.
               • EWs must not require any information/verifications other than that
                 necessary to determine eligibility for the FFCC Medi-Cal program.

       Example:
          California Residency

       EWs must determine eligibility for FFCC Medi-Cal for applicants using the mail-in
       process without delay.

       Medi-Cal regulations require that individuals with a medical emergency are given
       priority appointments. Applicants who meet the criteria and are not using the mail-in
       process must be scheduled ahead of regular Medi-Cal applicants, if appointments
       are available.

32.9.5              Independent Living Program (ILP)

       Many former foster care youth are in receipt of services through the Independent
       Living Program (ILP). ILP makes referrals to Intake offices for youth who were in
       foster care on their 18th birthday, and have exited the foster care system due to
       age. Due to the nature of this program, ILP recommends a mail-in or telephone
       application process.

       If the applicant prefers a face-to-face interview, his/her request shall be honored.




32.10 Redeterminations
       An annual redetermination is required for the FFCC program, however, since all
       income and resource tests are waived, it is limited to confirming the client’s current
       address to verify California residency.

       EWs may make contact with the client either by phone or by mail to complete the
       redetermination process.


Revised: 04/30/09                        Update # 09-05
Foster Care Handbook                                                         page 32-21
                                                                               Medi-Cal
    Documentation of the method of contact, the client’s current address, and his/her
    desire to continue Medi-Cal coverage must be entered in CalWIN and noted in the
    Maintain Case Comments window. The client is required to report information on
    change of residency if applicable.

    The Medi-Cal case must remain active until the beneficiary reaches age 21, or is
    discontinued from the program due to moving out of state or notifying the EW of the
    desire not to continue in the program.




32.11 SB 87 - Medi-Cal Eligibility Determination
      Process for Cases Discontinued From Foster
      Care
    Children who are 18 or older when they exit the Foster Care system are eligible for
    FFCC until they reach age 21. Therefore, SB 87, which requires Edwards Aid Code
    38 and an ex - parte review to establish Medi-Cal, is no longer applicable to Foster
    Care children when they reach age 18.

    Children who are under age 18 when they exit the Foster Care system are
    automatically eligible for CEC. CEC continues until the child reaches age 19 or the
    redetermination is due, whichever is earlier.

32.11.1      Other Exceptions

    SB 87 (Edwards, Aid Code 38, etc.) does not apply to children discontinued from
    Foster Care for any of the following reasons:

    •   Death
    •   Recipient requests to discontinue Medi-Cal benefits
    •   Incarceration
    •   Loss of California residency
    •   The individual is transferring into another PA program that provides no share-of-
        cost Medi-Cal benefits.




                                     Update # 09-05                          Revised: 04/30/09
page 32-22                                                                          Foster Care Handbook
Medi-Cal

32.11.2              SB 87 Exparte Procedures For Cases Discontinued
                     From Foster Care

                    If...                         Then the FC EW must...

                    Foster Care cash aid is       1. Attempt to contact the Foster Parent provider and/or Social
                    terminated for any reason,       Worker by phone for current whereabouts or address
                                                     information.

                                                  2. Advise the Foster Parent provider or Social Worker to contact
                                                     the Foster Care EW to update the child(ren)’s current living
                                                     situation.

                                                  3. Transition the child to CEC or FFCC, whichever is applicable.




32.12 Continuous Eligibility For Children (CEC)
      [Section 50189 of Title 22]
       Assembly Bill (AB) 2900 (Chapter 945, Statutes of 2000), established a new
       Medi-Cal provision; Continuous Eligibility For Children (CEC) effective
       January 1, 2001. CEC ensures that children under age 19 who are determined
       eligible for zero share-of-cost Medi-Cal maintain their eligibility until the next
       redetermination.

       Any adverse changes in the family’s circumstances including income, property, are
       disregarded until the end of the CEC period. The statute establishes CEC for
       children for up to a 12-month period, which ends with the date of the next annual
       eligibility determination or the child’s 19th birthday, whichever occurs first.

       Children, under age 19, who are discontinued from the Foster Care, Adoption
       Assistance, and or the Kin-GAP Programs meet the qualified population for CEC.

32.12.1              Transfer to CEC Program

       In order to meet the state mandate, children under age 19 who are discontinued
       from Foster Care, Adoption Assistance, or Kin-GAP must be transitioned to CEC.




Revised: 04/30/09                                Update # 09-05
Foster Care Handbook                                                          page 32-23
                                                                                Medi-Cal

    Exception:
        For AAP, redeterminations are completed every two years; however, a
        redetermination for AAP Medi-Cal must be completed annually. Therefore,
        children under 19 who are discontinued from AAP are eligible for CEC until
        age19, or when the next AAP or “AAP Medi-Cal” RD is due, whichever is
        earlier.

32.12.2      CEC Eligibility Rules

    The following eligibility rules apply to the CEC program:

    • The CEC period begins with the first month of zero SOC Medi-Cal Eligibility.

    • The CEC period continues for up to a 12-month period, and ends the last day of
      the month in which the annual redetermination (RD) is due, or the end of the
      month in which the child turns age19, whichever occurs first.

    • Financial eligibility changes, such as income, which would otherwise move a
      child under age 19 from no share-of-cost to a SOC category or ineligibility are
      disregarded.

    • Any changes in financial eligibility, such as income reported by the family during
      the CEC period, which would cause the child to have a SOC or financial
      ineligibility in the succeeding month are NOT to be considered until the annual
      RV.

32.12.3      Exceptions

    CEC does Not apply in the following circumstances:

    •   Child turns age 19
    •   In the event of death
    •   In the event of incarceration
    •   Child(ren) moved out-of-state.

    Note:
        If the child’s parent(s) later request the child’s Medi-Cal to be discontinued,
        then CEC must be discontinued on their request.




                                     Update # 09-05                          Revised: 04/30/09
page 32-24                                                                      Foster Care Handbook
Medi-Cal

32.12.4              Aid Codes for CEC

       Aid Codes for the CEC program.:

                Aid Code       Description

                      7J       Full Scope Medi-Cal benefits without a SOC to qualified children under
                               19.

                      7K       Restricted (emergency and pregnancy related services only) Medi-Cal
                               benefits without a SOC to qualified children under 19 who do not have
                               satisfactory immigration status.




32.12.5              CEC Period

       The CEC period is always twelve months, which begins with the initial month of
       zero share-of-cost eligibility determination or the first month impacted by an annual
       redetermination, and ends with the last month covered by that redetermination, or
       the child’s 19th birthday, whichever occurs first.

       Note:
           For continuing cases this means the 12-month CEC period begins with the
           month following the annual redetermination (see example below).

        11/03       12/03   1/04   2/04   3/04    4/04     5/04   6/04   7/04   8/04   9/04   10/04     11/04

        FC          CEC     CEC    CEC    CEC     CEC      CEC    CEC    CEC    CEC    CEC    CEC       RV
        RV
                    FC is                                                                               CEC
                    Disc                                                                                Ends,
                                                                                                        Disc
                                                                                                        CEC



32.12.6              Guaranteed CEC Period

       The CEC guaranteed period is within the CEC period, but must begin with a zero
       SOC month. The months from the time of the zero SOC determination until the next
       RV is referred to as the CEC guaranteed period.

       Guaranteed CEC Period Rules

       The following rules apply to the CEC guaranteed period:

Revised: 04/30/09                                Update # 09-05
Foster Care Handbook                                                                           page 32-25
                                                                                                 Medi-Cal
    • The CEC guaranteed period always starts from the month a child is determined
      eligible for any one of the categories of zero SOC Medi-Cal, including
      cash-based categories.

    • The CEC period and the CEC guaranteed period always end at the time of the
      following annual RV.

    This guarantees that the child, under age 19, will received zero SOC Medi-Cal for
    the remainder of the 12-month CEC eligibility period.

32.12.7      CEC Procedures

    When a Foster Care, Adoption Assistance, and/or Kin-GAP child is determined
    eligible for CEC, the child must be transferred to CEC using the appropriate Aid
    Type.

    The FC EW staff must take the following action for all children, under age 19, who
    are discontinued from the Foster Care, Kin-GAP or Adoption Assistance programs:

     If...                        And...                    Then...

     A child is on the Kin-GAP    The child is under        The child must be set up on the CEC
     program,                     19 and                    program (Aid Code 7J or 7K) through either
                                  discontinued,             the end of the next RV, or until the child turns
                                                            19, whichever occurs first.

     A child is on the Foster     The child is under        The child must be set up for CEC, (Aid Code
     Care Program,                18 and is                 7J or 7K), through either the end of the next
                                  discontinued,             RV, or until the child turns 18, whichever
                                                            occurs first.
                                  Note:
                                  A FC child who is         FFCC takes precedence over CEC.
                                  discontinued at 18
                                  is eligible for
                                  FFCC.

     A child is on the Adoption   The child is under        The child must be set up on CEC (Aid Type
     Assistance Program,          19 and is                 7J or 7K), through either the end of the next
                                  discontinued,             AAP or annual Medi-Cal RV, or until the child
                                                            turns 19, whichever occurs first.




    Cases transferred to the CEC program will be kept at the Foster Care Bureau until
    CEC has ended.


                                           Update # 09-05                                     Revised: 04/30/09
page 32-26                                                         Foster Care Handbook
Medi-Cal

32.12.8             Non-Citizen/Undocumented Children

       Any Undocumented Foster Care child terminated from Foster Care must be
       transitioned into CEC. Aid Code 7K is designated to qualified children under age 19
       who do not have satisfactory immigration status.

32.12.9             Documentation

       Foster Care Eligibility Workers must document on the Maintain Case Comments
       window when the CEC period begins and ends.

32.12.10 Intercounty Transfer

       CEC cases shall be treated the same way and current Inter-County Transfer
       procedures followed. The EW must:

       • Review information contained in the case file prior to transfer,

       • Ensure the child’s zero SOC Medi-Cal continues during the CEC period, and

       • Do NOT discontinue the child(ren)’s zero SOC Medi-Cal until the receiving
         county has placed the child in zero SOC Medi-Cal.

32.12.11 CEC and FFCC

       The FFCC program takes priority over CEC. Individuals who were in Foster Care
       on their 18th birthday are eligible to receive zero SOC Medi-Cal until their 21st
       birthday. A Foster Care child who ages out of Foster Care at 18 must be transferred
       to the FFCC program.

32.12.12 Request for CEC Discontinuance

       The parent(s) and/or Adoptive parent(s) of an eligible CEC child(ren) may request
       discontinuance of his/her child(ren)’s Medi-Cal benefits. If a request is made for
       discontinuance, the EW must discontinue benefits as requested.




Revised: 04/30/09                      Update # 09-05
Foster Care Handbook                                                                      page 32-27
                                                                                            Medi-Cal

32.12.13 CEC Case Examples

    Case Example #1

    A 17 year-old child is receiving Foster Care until 3/04 when she is returned to the
    home of her parent(s). The parent(s) are not requesting Medi-Cal. The last Foster
    Care reinvestigation was completed in 11/03. This child is entitled to CEC from 4/04
    through 11/04.

     11/03   12/03   1/04   2/04   3/04    4/04     5/04   6/04   7/04     8/04   9/04   10/04    11/04

     FC      FC      FC     FC     FC      CEC      CEC    CEC    CEC      CEC    CEC    CEC      RV
     RV
                                   FC      Starts                                                 CEC
                                   Disc                                                           ends,
                                                                                                  Disc
                                                                                                  CEC


    Note:
        4/04 begins the first month of CEC and this continues until the month of the
        next annual redetermination, unless the parent(s) request discontinuance.

    Case Example #2

    A 17 year-old child is receiving Foster Care until 3/04 when he/she is discontinued
    because he/she returned home. The parents are receiving Medi-Cal with a SOC
    and they have a redetermination scheduled for 7/04. The last Foster Care
    redetermination was completed in 11/03. This child is entitled to CEC from 4/04
    through 11/04. When CEC ends for the child in November 2004, the child’s
    eligibility will be based on the parent’s existing Medi-Cal case information.

     11/03   12/03   1/04   2/04   3/04    4/04     5/04   6/04   7/04     8/04   9/04   10/04    11/04

     FC      FC      FC     FC     FC      CEC      CEC    CEC    CEC      CEC    CEC    CEC      RV
     RV
                                           Starts                 Parent                          CEC
                                                                  RV
                                                                                                  ends,
                                                                                                  Disc
                                                                                                  CEC
                                                                                                  SOC in
                                                                                                  Parent
                                                                                                  Case




                                          Update # 09-05                                 Revised: 04/30/09
page 32-28                                                        Foster Care Handbook
Medi-Cal

       Note:
           4/04 begins the first month of CEC and this continues until the end of the
           12-month period established in the Foster Care case, which is 11/04. The
           12-month CEC period begins the month following the last Foster Care
           redetermination.

32.12.14 Annual Redetermination

       For purposes of the CEC program, the eligibility redetermination refers to the
       annual redetermination pursuant to Section 50189 of Title 22. This states that the
       annual redetermination is completed within 12 months. The annual redetermination
       date is based on case status not the individual status.

       The CEC period ends the last month covered by that annual redetermination period
       or the last day of the month that the child reaches age 19, whichever occurs first.

       The annual redetermination date follows the case not the child.

       Note:
           This does not preclude the child from receiving CEC for the remainder of the
           child’s CEC period.

32.12.15 Parent(s) Option to Accept or Reject CEC for a Child

       The parent(s) have the option of whether or not they want Medi-Cal for their
       child(ren). If the parent(s) wants Medi-Cal to continue, the FC EW must set up CEC
       for the child. If the parent(s) do NOT wish to pursue Medi-Cal for their child, then
       CEC does not apply.




32.13 Expedited Medi-Cal For Children Entering The
      Foster Care Program
       All children entering the Foster Care Program are considered an immediate need
       applicant. Expedited case processing is required. Children removed from their
       homes and placed in Foster Care must have immediate proof of eligibility for
       Medi-Cal thereby ensuring immediate access to health care services.



Revised: 04/30/09                      Update # 09-05
Foster Care Handbook                                                                page 32-29
                                                                                      Medi-Cal




32.14 Medi-Cal and California Children Who Are Placed
      Out-of-State
    Medi-Cal covers children who are placed out of state under the following
    circumstances:

    • Child is receiving non-federal (state-only) cash aid payments

    • Child is receiving Adoption Assistance payments and the receiving state does
      not have the Cobra option/reciprocity

    • Child is receiving CalWORKs payments.

    In many instances families choose to leave California and move to another state.
    When California is responsible to provide Medi-Cal to children, the families must be
    informed on how to use California Medi-Cal when they reside out of state. Form
    3609 is used to assist families with information about this process.

    Foster Care Eligibility Workers (EWs) must provide the form “Procedures for Using
    Medi-Cal With California Children Who Are Placed Out-of-State” (Form 3609) when
    a non Title IV-E Foster Care or Adoptive family moves out of state and the
    child(ren) will maintain California Medi-Cal. Form 3609 has specific information on
    how families are to utilize California Medi-Cal when the child is living out of state.

      Form #              Description

      Form 3609 (05/04)   “Procedures for Using Medi-Cal With California Children Who Are
                          Placed Out-of-State”




                                        Update # 09-05                              Revised: 04/30/09
page 32-30                                                        Foster Care Handbook
Medi-Cal




32.15 Safely Surrendered Baby Law Program

32.15.1             Background

       The Safely Surrendered Baby Law (Senate Bill 1368, Chapter 824, Statutes of
       2000) (formerly known as Safe Arms for Newborns) was signed into law by
       Governor Davis on September 2000 and went into effect on January 1, 2001. The
       purpose of the law is to allow a mother or any adult to bring an unwanted baby
       three days (72 hours) or younger to a public or private hospital or other location
       designated by the county Board of Supervisors. The law protects the person
       surrendering the baby from prosecution for child abandonment.

       Applications received under “Safely Surrendered Baby Law” must be processed as
       an immediate need. This is to ensure that the infant has immediate proof of
       eligibility for Medi-Cal thereby ensuring immediate access to health care services
       and payment to medical providers.Thereafter, if the parent(s) don’t change their
       minds, a regular application for Foster Care will be initiated by the Social Worker.

32.15.2             Eligibility Criteria

       The following rules apply to the Safely Surrendered Baby Law Program:

       • Medi-Cal Aid Code 2A is designated for this program. Aid Type 2A provides
         full-scope, no SOC Medi-Cal to infants 72 hours or younger, surrendered under
         the “Safely Surrendered Baby Law”.

       • “Mother Doe” is the designated Case Name (if no name reported).

       • “Baby Doe 43” is the designated name for the child(ren) and MEDS (if the child
         is not named).

       • There are NO income or resource limits.

       • Medi-Cal under Aid Code 2A is NOT to exceed 3 months.

       • Cases set up under the “Safely Surrendered Baby Law” must be kept
         CONFIDENTIAL. (Due to the confidential nature of these cases, cases must be
         noted as “CAGED” and the normal cage procedures must be followed.)


Revised: 04/30/09                          Update # 09-05
Foster Care Handbook                                                      page 32-31
                                                                            Medi-Cal
    Required Forms

    The following forms are required for this program:

    • “Application for Cash Aid, Food Stamps and/or Medi-Cal/State CMSP” (SAWS 1)

    • “Application and Statement of Facts for Child Not Living With A Parent or
      Relative and For Whom A Public Agency is Assuming Some Financial
      Responsibility” (MC 250)

    • “Safe Arms for Newborns Medical Questionnaire” (MC 356), if provided.

    Forms NOT Required

    The following forms are NOT required for this program:

    • “Statement of Immigration Status” (MC 13)
    • “Child Support Questionnaire” (CW 2.1)
    • “Referral to Local Child Support Agency” (CA 371)

32.15.3     14-Day Cooling Off Period

    The Safely Surrendered Baby Law provides a 14-day cooling off period. This
    means that the person who surrendered the newborn can reclaim the child. The
    14-day period begins on the day the child is voluntarily surrendered.

32.15.4     Public or Hospital Responsibility

    Upon accepting a child who has been voluntarily surrendered, the hospital
    designated person is required to:

    • Place a coded, confidential ankle bracelet on the child and furnish the person
      surrendering the child with a copy of the bracelet and a “Safe Arms for Newborns
      Medical Questionnaire” (MC 356).

    • Notify the Child Welfare Services Agency no later than 48 hours after taking
      custody of the newborn.




                                    Update # 09-05                        Revised: 04/30/09
page 32-32                                                                     Foster Care Handbook
Medi-Cal

32.15.5             Department of Family and Childrens Services (DFCS)
                    Responsibility

       Upon receiving notification that a newborn child has been voluntarily surrendered,
       DFCS’s responsibility includes the following:

       • Taking temporary custody of the child.
       • Immediately investigating the details of the case and filing a petition with the
         juvenile court.
       • Initiating a Foster Care and/or Medi-Cal application.

32.15.6             Immediate Need Processing

       Infants covered under the Safely Surrendered Baby Law will be processed through
       the Childrens Shelter as a Paper Admit. The process is as follows

          STEP         WHO                           ACTION

          1.           Emergency Response Social     • Completes SAWS 1 and Shelter Intake Sheet.
                       Worker
                                                     • FAXes SAWS 1 and Shelter Intake Sheet to PAC Unit
                                                       at the Foster Care Eligibility Bureau.

          2.           PAC CST                       • Completes Application Registration.

                                                     • If the child is not named, the case name must be
                                                       assigned as “Mother Doe” and child’s name as
                                                       “Baby Doe 43”.
                                                     • Assigns to Foster Care Intake Worker for immediate
                                                       processing.

          3.           FC Intake EW                  • Obtains Medi-Cal Application form MC 250 and
                                                       “Safe Arms for Newborns Medical
                                                       Questionnaire” (MC 356), if provided, for the
                                                       Medi-Cal case file.

                                                     • Approves Medi-Cal under Aid Code 2A and
                                                       issues immediate need Medi-Cal card.

                                                     • Document the case in the Maintain Case
                                                       Comments window.

                                                     • Set a User to User alert in CalWIN for
                                                       discontinuance at 3 months. (Medi-Cal eligibility
                                                       under Aid Code 2A must NOT exceed 3 months;
                                                       therefore, the case is to remain with the FC
                                                       Intake EW.)
                                                     • If Foster Care is not initiated, once the Medi-Cal case
                                                       is discontinued, the FC EW will close the case and
                                                       send it to retention, following the CAGE procedures.

Revised: 04/30/09                           Update # 09-05
Foster Care Handbook                                                              page 32-33
                                                                                    Medi-Cal

32.15.7      Transition to the Foster Care Program

    Once the determination is made that the child(ren) will be placed into Foster Care,
    the Foster Care EW must transition the child(ren) from the “Safely Surrendered
    Baby Law” program to the Foster Care program. The process is as follows:

      Step      Who                Action

      1.        FC Intake EW       • Closes the “Safely Surrendered Baby Law” case.

                                   • Follows the CAGE procedures and send case file to
                                     Retention.

                                   • Obtains SAWS 1 and gives it to PAC CST.

      2.        PAC CST            • Receives SAWS 1 and Registers Applicant for Foster
                                     Care.

      3.        CST Control        • Assigns case to a FC Intake EW

      4.        FC Intake EW       Approves FC benefits as appropriate, following regular
                                   intake procedures.




32.16 Craig v. Bonta Beneficiaries
    The Superior Court in the Craig v. Bonta lawsuit prohibited the Department of
    Health Care Services (DHCS) from terminating the Medi-Cal benefits of
    beneficiaries discontinued from Supplemental Security Income State
    Supplementary Payment (SSI/SSP) . The Superior Court ruled that SB 87
    Redetermination Process must be implemented for these beneficiaries. These
    beneficiaries may be children placed Foster Care (FC) who need an SB 87
    Redetermination Process completed.

32.16.1      Craig v. Bonta and Foster Care Procedures

    • The Craig v. Bonta will be forwarded to the assigned EW. The child may be in a
      pending case in the Foster Care Bureau.

    • Complete an Ex parte Review for the child at the time the Medi-Cal/Foster Care
      eligibility is reviewed.


                                    Update # 09-05                               Revised: 04/30/09
page 32-34                                                         Foster Care Handbook
Medi-Cal
       • Complete an SC 1296 to activate MEDS in the FC aid code effective the future
         month.

       • If the child returns home before the FC case is set up, the Craig application will
         be forwarded to the non-FC intake office for processing.

       For further details on how to process a Craig v. Bonta, refer to the Medi-Cal
       Handbook “Craig v Bontá,” page 67-5.




Revised: 04/30/09                      Update # 09-05

				
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