Other Institutions

The following facilities are not considered public institutions and its residents may be eligible for MC if other MC eligibility requirements are met.

Institution

An establishment that provides for four or more persons (unrelated to the proprietor) the following items:

  • Food, and
  • Shelter, and
  • Some treatment or services beyond basic needs.

Medical Institution

Medical institutions include acute care hospitals, state-licensed medical facilities, etc.

 

This includes:

  • An acute care hospital
  • An acute psychiatric hospital
  • A skilled nursing facility
  • A state licensed medical facility.

Non-medical Institution

An institution primarily engaged in providing:

  • Non-medical residential care
  • Custodial care
  • Custody or restraint (includes penal institution).

Tuberculosis Institution

An institution primarily engaged in providing diagnosis, treatment, and care of persons with tuberculosis, including:

  • Medical attention
  • Nursing Care
  • Related Services.

Individuals in a tuberculosis institution are eligible for MC if other MC eligibility requirements are met, UNLESS, they are sentenced for a criminal offense and the law enforcement agency retains responsibility for the individual.

Intermediate care facility

An intermediate care facility includes a convalescent hospital.

Child Care Institution

Child Care Institutions are for children who receive:

  • Foster Care payments under Title IV-E of the Social Security Act (SSA)
  • CalWORKs-Foster Care under Title IV-A of SSA.

Institution for the Mentally Retarded

An institution for the mentally retarded or persons with mental-related conditions is not considered a public institution. Mental-related conditions include:

  • Long-term disability due to cerebral palsy or epilepsy, or
  • Any other condition closely related to mental retardation.

Eligibility and placement in this type of institution is usually through a regional center administered by the Department of Developmental Services.

Exception: Any individual, regardless of age, who is serving a sentence for a criminal offense and residing in ANY mental institution, is not eligible for MC.

Community Care Facility

A community care facility refers to any facility, place or building which is maintained and operated to provide non-medical, 24-hour residential care. This includes day treatment, adult day care, or foster family agency services for children and adults including but not limited to: physically handicapped, mentally impaired, incompetent persons, and abused or neglected children. Examples of community care facilities are:

  • Residential Facility - A family home, or group care facility for 24-hour non-medical care of persons in need or personal services, supervision, or assistance essential for sustaining the activities of daily living or for protection of an individual
  • Adult Day Care Facility - Provides non-medical care to persons 18 years of age or older in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for protection of an individual on less than 24-hour basis
  • Therapeutic Day Services Facility - Provides non-medical care, counseling, educational or vocational support, or social rehabilitation services on less than 24-hour basis to persons 18 years or under who would otherwise be placed in foster care or are returning to a family from foster care.
  • Foster Family Home - A residential facility which provides 24-hour care for six or fewer foster children and is the residence of the foster parent or parents, including their family
  • Small Family Home - A residential facility which provides 24-hour care to six or fewer foster children who have mental disorders or developmental or physical disabilities and who require special care and supervision as a result of their disabilities. This home can also accept children without special health care needs
  • Social Rehabilitation Facility - A residential facility which provides social rehabilitation services for no longer than 18 months in a group setting to adults recovering from mental illness who temporarily need assistance, guidance, or counseling
  • Community Treatment Facility - A residential facility which provides mental health treatment services to children in a group setting
  • Group Homes - A residential facility which provides 24-hour care and supervision for juveniles under age 18 who have been declared wards of the court for violation of a state or federal law.
  • Temporary Shelter Care Facility - A 24-hour residential facility owned and operated by the county that provides short-term residential care and supervision for dependent children under 18 years of age who have been removed from their home because of abuse or neglect.

Publicly Operated Community Residence

A publicly operated community residence serving no more than 16 residents and is not considered a public institution.

Exception: The following facilities may be publicly operated community residences that serve no more than 16 residents, but are considered public institutions and MC is not available for its residents:

  • Residential facilities located on the grounds of or adjacent to any large public institution

  • Correctional or holding facilities for prisoners or individuals being held under court order as witnesses

  • Detention facilities, forestry camps, training schools, or any other facility for children determined to be delinquent

  • Educational or vocational training institutions that provide an accredited program for its residents.

Alternatively Sentenced

An individual may be sentenced by the court to serve a term in jail but with certain conditions. The sentenced individual may be eligible for MC:

  • If the sentence given by the court includes a periodic release of the individual, and
  • The individual is released from the care and control of the law enforcement agency for periods of not less than 24 consecutive hours, and
  • The law enforcement agency no longer maintains the custody and responsibility for the needs of the individual during the release period.

Eligibility for MC depends on the wording of the sentence given by the court as well as the legal responsibility of a law enforcement agency. Use the following examples as guidelines:

Situation # 1

An individual is sentenced by the court to serve a term in jail. The sentence provides that the individual is to be permitted to leave the jail daily to attend school or go to work. However, the individual must return to the jail after work or school each day and remain incarcerated on weekends, holidays, etc.
 
The individual is NOT eligible for MC while serving the sentence. The penal authority has the responsibility for the individual’s care and support.

Situation # 2

A married couple is sentenced to jail. However, because a minor resides in the home, the court orders that each parent be released on alternate months so that one parent is available to care for the child(ren).

Each parent is eligible for MC for the months spent in the home if other MC eligibility requirements are met, and ineligible for any month in which he/she is incarcerated.

Situation # 3

An individual is sentenced to be incarcerated for a given period with no provision for temporary release. The penal authority chooses to place the individual in a program without permission by the court, alteration of sentence, formal parole or probation.

The individual is NOT eligible for MC. The penal authority has not been released from responsibility for the individual’s care.

Situation # 4

An individual is sentenced to perform community service work in lieu of incarceration. The individual resides at home, performs his/her community service, and is (usually) loosely supervised to make sure he/she completes the sentence.

The individual is eligible for MC. The individual is not the financial responsibility of a penal authority until and unless the individual fails to comply with the sentence and is, as a result, incarcerated, then the individual becomes ineligible for MC.

Status Considerations

To determine eligibility for persons in an institution, the following must be considered in the order stated below:

  • Age
  • Inmate Status
  • Type of institution/facility
  • All other eligibility factors.
  • A person institutionalized before their 21st birthday is eligible until they reach their 22nd birthday as long as they remain continuously institutionalized and receive inpatient psychiatric care in an acute psychiatric hospital or a psychiatric health facility.
  • Individuals released on bail or on their own recognizance are eligible for MC.
  • Welfare and Institutions Code number explanations:
    • W&I 300    Person needs care due to mental or physical deprivation
    • W&I 601    Uncontrollable - ward of court
    • W&I 602    Violation of law
  • Under Penal Code Section 1367, if a person is incompetent to stand trial, he remains in a mental facility and is eligible for MC.
  • If a Murphy Conservatorship is established the sentence is terminated. (Refer to Penal Code 1370 on Section 43.4.3).
  • If a person is under sentence but transferred to a residential treatment center or board and care home before release, he/she is eligible for MC.
  • Fleeing Felons and violators of probation and parole are eligible for MC.
  • Individuals under an order of detention because of TB are eligible for MC unless they are booked and sentenced for a criminal offense.

Related Topics

Special Institutional Programs MEDS Functionality

Authorized Representative