Juveniles in Public Institutions

In determining the MC eligibility of juveniles (under age 18,) the nature of the detention, pre- and post-disposition situations, and types of facilities must be considered.

Disposition

Disposition in a juvenile case is the decision made by the court for the juvenile’s welfare. A disposition order is the court decision as to whether the minor will be placed in foster care, sentenced, placed on probation, or released either temporarily or permanently. When the juvenile is ordered a "Ward of the Court" and is awaiting foster care placement and not awaiting sentencing for a criminal violation of law, the juvenile may be eligible for MC.

Before Disposition

A juvenile who is in a detention center due to criminal activity is a resident of a public institution and not eligible for MC.

If a juvenile resides in a detention center for the sole purpose of receiving physical/mental care and protection, or getting services that are for the best interest of the child, the juvenile is not considered an “inmate of a public institution.” If there is a specific plan for him/her that makes the stay temporary (one or two months), he/she may be eligible for MC.

After Disposition

Juveniles placed on intensive probation that are residents of a detention center (which is part of the criminal justice system) are not eligible for MC benefits until the individual is released by the court.The juvenile may be eligible for MC if the facility is not part of the criminal justice system.

Nature of the Facility

The nature of the facility and status of the juvenile is important in determining MC eligibility because Title 42, Code of Federal Regulations (CFR) prohibits MC benefits to "inmates of public institutions." Refer to Section 43.4 for a definition and list of those considered inmates of public institutions. A juvenile is not eligible for MC if he/she is a resident of a public institution for a criminal offense.

Sample Disposition Orders

The decision or dispositional order must be reviewed by the EW to determine both the status of the minor and nature of the facility where the minor will be placed.

Juvenile Court Order Status	MC Benefits
Minor is in Foster Care in Licensed Residential Treatment Facility	Eligible
Minor is on Probation Awaiting Placement in Foster Care	Eligible
Minor is on Probation with residence in Licensed Residential Facility pending permanent placement	Eligible
Minor placed in a psychiatric facility - awaiting order of detention under Section 602	Not Eligible
Minor is placed in a Residential Treatment Center and then a Psychiatric Hospital	Eligible
Minor is placed with parents with permission to place the minor in a hospital. This would be viewed as Foster Care/Probation Placement with parents.	Eligible
Minor is released on probation to parents with a hospital stay, then placement to a 24-hour school upon release from hospital. Exception: If the 24-hour school is part of the criminal justice system and is a correctional facility, then the minor would not be eligible for MC.	Eligible
Minor is declared a Ward of the Court and is placed in a non-profit, residential facility which is a boy’s camp to receive mentoring and counseling services. The facility is a 24-hour, non-medical facility which is not part of the criminal justice system.	Eligible

SB 1469 Pre-Release Application Process for Wards in County Juvenile Facilities

A juvenile loses MC eligibility if he/she is:

In a detention center due to criminal activity and a resident of a public institution, or
On intensive probation with a plan of release which includes residence in a detention center.

SB 1469 allows the MC application process to begin before the ward is released from custody allowing eligibility to begin immediately upon release from the juvenile detention facility.

A ward who previously would have had to re-apply for MC benefits after release from incarceration can, under SB 1469, apply for MC before release.

SB 1469 requires County juvenile detention facilities, in Santa Clara County this is the Probation Department, provide specific information to the Social Services Agency (SSA), to allow SSA to expedite MC eligibility determination for juvenile wards being released.

SB 1469 Application Process

The provisions of SB 1469 require:

Juvenile Ward Application Process

Juvenile Court
1. Issues an order pertaining to the disposition of the ward of the county, committing that ward to a juvenile hall, camp, or ranch for 30 days or more.
County Probation Department
1. Provides SSA with:
  1. The ward’s name
  2. The scheduled or actual release date, or if applicable, notify the SSA about placement into a medical/mental health facility
  3. Any known information regarding the ward’s MC status prior to disposition and/or any other health coverage available.
  4. Sufficient information when available, to begin the process of determining MC eligibility
  5. Contact information for the ward’s parent or guardian, if available, and
  6. Any changes in the ward’s release date.
EW
1. Processes the MC application.
  1. NOTE: The EW will generally need to request additional information in order to complete the eligibility determination. However, there is NO change to existing eligibility policies and procedures, including citizenship/identity verification requirements and Performance Standards.

Eligibility Requirements

Applications submitted for juvenile inmates are processed like any other MC applications. The application may be signed by the person/agency responsible for the ward in accordance with current MC policy.

SB 1469 applications submitted by the Probation Department are processed by specific units within the Application Assistance Center (AAC) office. SB 1469 applications must be processed as URGENT.

The following rules apply:

When the release date is scheduled for the ward, the Probation Department immediately notifies the ward’s parent/guardian of the referral for MC benefits for the ward and allows 30 days for a response.

Note: If the parent/guardian informs the Probation Department that they do not want an application to be submitted on behalf of their child, no application will be initiated and the process ends. If the parent/guardian does not respond, the process continues.

Within 45-90 days before the scheduled release date, the Probation Department sends a Transmittal form with the ward’s information to BAC via E-mail along with supporting documentation, if applicable. BAC will acknowledge receipt of the referral via E-mail within 10 days of receiving the information.

Note: If a disability is claimed for the ward, the Probation Department will also provide all known medical information for the EW to request a disability evaluation.

The assigned EW works with Probation Department staff, and with the ward’s parent/guardian as necessary to complete the MC application process.
When the Probation Department is contacted for additional information, all MC application requirements apply. Eligibility cannot be established upon the ward’s release unless all necessary information is provided.
The application can be denied if the responsible individual does not cooperate with the request for information/verification needed.

Note: Only the minimum information needed to determine or restore eligibility in accordance with current MC policy may be requested.

MC eligibility begins on the date of release.
The Probation Department must be notified whether the ward is eligible for benefits.

Note: The application must be forwarded to the Healthy Kids program if the ward is not eligible for MC/OTLIC as long as consent is given.

The Probation Department must be notified at least 10 days prior to the expected release date if the MC determination is not completed.
If the ward is scheduled for release in less than 45 days, the pre-release application process must be expedited.
An immediate need paper BIC must be issued for the juvenile as soon as eligibility is established to allow the ward to access services immediately upon release. The temporary card must be sent to the facility before the release date.
All MC Notice of Action requirements apply.

SB 1469 Juvenile Intake Procedures

The following chart provides instructions for processing SB 1469 applications. The shaded column section of the chart refers to the columns that are completed in the SB1469 Minor Probation Medi-Cal Ins. Log (JPD Log). The unshaded column section of the chart refers to the columns that are completed in the JPD SB 1469 Application Log (MBA Log).

Step	Who	Action		Column in the BAC Log
1.	JPD	Makes at least 2 attempts to contact the parent/guardian by mail/phone to inquire if they want to apply for MC or ask if they have Other Health Coverage (OHC). Documents the date the parent/guardian was contacted and if they want to apply for MC or have OHC. Within 30-60 days of the release date, sends the referral transmittal via e-mail for wards who have or want to apply for MC to the e-mail box (BACAppRegSB1469@ssa.sccgov.org) and documents the date the transmittal was sent. The email should provide the release date, and the e-mail subject line should include SB 1469 and the ward’s last name. On the first Monday (or the next working day when Monday is a holiday) of every month, sends the excel version of the JPD Log of wards via e-mail to BAC e-mail box with information on wards who have OHC and are not interested in applying for MC. The e-mail subject line should include SB 1469.		J,K,M,N,O
2.	BAC Clerical	Retrieves the referral transmittal from the e-mail box. IDs the child in CalSAWS, CalHEERS and MEDS to determine if the child is currently enrolled in MC. Records the referral transmittal on the BAC Log for tracking purposes. Records the Medi-Cal status on columns A thru J.		A-J
	BAC Clerical	If the child...	Then BAC clerical...
		Is currently active on CalWORKs or MC,	Documents in the Journal page “Urgent: Ward (fill in name) will be released on (fill in release date) ensure MC is active upon release.” Scans a copy of the referral transmittal into case Imaging. Issues Immediate Need BIC and e-mails it to JPD at: Michelle.Warzek@pro.sccgov.org and PRO-SB1469@pro.sccgov.org Creates a Task for follow-up action and includes the Journal page entry in the long description.
		Is currently pending or active at Foster Care (FC),	Notifies FC by e-mailing Info Sup of the day, and fostercareprocessing@ssa.sccgov.org. Include the release date, name, and DOB.
		Is not currently active, but the family has an open CalWORKs or MC case (i.e. in suspended status or not on aid),	Notifies District Office (DO) SSPMs by email and copies the DO MC Liaison. Include in the subject line “JPD SB 1469 Urgent Processing” and the case number. The body of the e-mail should include the name of the ward, DOB, and release date. DO assigns for Urgent Processing. EW will make contact with the child’s family to add the child to the case. Issues Immediate Need BIC and e-mails it to JPD at: Michelle.Warzek@pro.sccgov.org and PRO-SB1469@pro.sccgov.org.
		Has no open case record,	Notifies JPD that MC is not active by marking an N in column K of the BAC log.	K
		Returns the completed BAC Log on the 2nd Monday (or the next working day when Monday is a holiday) of each month as a password-protected document via secure e-mail to: Michelle.Warzek@pro.sccgov.org, PRO-SB1469@pro.sccgov.org, and copy the JPD manager.
3.	JPD	Receives and reviews the completed BAC Log. Adds MC status and outcome into the JPD Log. Provides the family with an application if MC is not active.		N
4.	BAC Clerical	If a MC application is returned by JPD, sends an email to the BAC Assignment team to request a Task be created and assigned to the next available Intake EW. Records the date the application was received on the BAC Log.		P
5.	AAC EW	Receives the completed application and follows the normal intake process. Contacts the parent/guardian for additional information as necessary. Enters pertinent information into CalSAWS to process the application, as appropriate. Sends the appropriate Notice of Action.
		Completes SCD 1296 for Clerical to issue an Immediate Need BIC. Provides a screen print of the Person Search section, to clerical staff, (if APTC eligible make a note), in order to indicate the outcome of the MC application.
6.	BAC Clerical	Clerical will issue Immediate Need (IN) BIC at EW request Clerical will them e-mail Immediate Need BIC to JPD at: Michelle.Warzek@pro.sccgov.org and PRO-SB1469@pro.sccgov.org. Indicates the disposition of the MC application by logging the outcome on the BAC Log.		R, S

Foster Care

Foster Care children are automatically eligible for MC after utilizing whatever other health coverage is available. Foster Care children are excluded from being classified as an inmate of a public institution when such children are temporarily in an institution pending more suitable arrangements such as Foster Care placement in a foster family or group home. This include those juveniles awaiting placement but still physically present in juvenile hall.

Foster Care placement may be in a relative’s or non-relative’s home as well as ranch, group home, or a facility which offers 24-hour non-medical care and is not under the criminal justice system.