Communication to Foster Care Eligibility with a Medi-Cal Packet

JPD will communicate information to the Foster Care SSBS with an 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 form (MC 250). This communication intends to inform the SSBS that the minor in custody must be activated for Medi-Cal only.

Medi-Cal Packet

A Medi-Cal packet is received when a minor is under JPD’s responsibility and needs Medi-Cal only.

Forms and Documents

  • MC 250
  • SAWS 2 Plus
  • Statement of Citizenship, Alienage, and Immigration Status form (MC 13)
  • Birth Certificate
  • Social Security Card
  • PRUCOL Documents (for cases with undocumented children)
  • RH/FH/PIP Dispo Minute Order

Reopen Medi-Cal

A Reopen Medi-Cal packet is received from JPD when a minor is to receive Medi-Cal only (this occurs when a runaway returns or after "Home on Trial").

Forms

  • MC 250 (if one's not on file within a year)
  • SAWS 2 Plus
  • MC 13
  • PRUCOL Documents (for cases with undocumented children)
  • RH/FH/PIP Dispo Minute Order.

Note: A Post-It is attached to advise that the minor is now back in custody.

Related Topics

Juvenile Probation Department (JPD)

Communication to Foster Care Eligibility with SOC