Public Institutions

An institution that is under government control and responsibility is considered a public institution. The following are public institutions:

  • State or federal prisons
  • Correctional facilities
  • County, city or tribal jails
  • Detention centers
  • California Youth Authority (CYA) Camps
  • Custody to Community Transitional Reentry Program/ Enhanced Alternative Custody Program (CCTRO/EACP) facilities
  • Female Offender Treatment and Employment Program (FOTEP) facilities
  • Male Community Reentry Program (MCRP) facilities

 

Any individual, regardless of age, who meets any of the following situation is NOT eligible for Medi-Cal (MC).

  • Incarcerated in any of the above public institutions

An individual who is incarcerated but with specific conditions of release (e.g., can leave prison or jail to attend school or go to work but must return at specific times) is NOT eligible for MC.

  • Resident of any facility that is part of the criminal justice system
  • Serving a sentence for a criminal offense, and residing or placed in ANY institution, and the law enforcement agency retains responsibility for the individual.

Reentry Facilities

Included in the category of public institutions are reentry facilities which include Custody to Community Transitional Reentry Program/ Enhanced Alternative Custody Program (CCTRO/EACP), Female Offender Treatment and Employment Program (FOTEP) and Male Community Reentry Program (MCRP).

If an individual lists their address as one of the above mentioned facilities on their application for MC, the EW must verify the institutional status of the applicant (i.e., bail, parole, court probation) and follow current MC eligibility guidelines. If the individual does not meet the status requirement for MC eligibility they are considered an inmate and their MC must be approved and immediately suspended.
 
The new facility types and address are as follows:

  • Custody to Community Transitional Reentry Program/Enhanced Alternative Custody Program
    1. Casa Aurora, C/O Mental Health Services, Inc. Kern County, 1932 Jessie Street, Bakersfield, CA 93305
    2. WestCare, San Diego County, 3050 Armstrong Street, San Diego, CA 92111
    3. L.A. CADA, LA County, 11121 Bloomfield Avenue, Santa Fe Springs, CA 90670
    4. WestCare, San Joaquin County, 1609 N. Wilson Way, Stockton, CA 95205
    5. St Johns, Sacramento County, 4410 Power Inn Road, Sacramento, CA 95821
    6. Mental Health Systems, Kern County, 1932 Jessie Street, Bakersfield CA 93305
  • Male Community Reentry Program
  1. Butte County  Probation, Butte County, 2740 Oro Dam Blvd., Oroville, CA 95966
  2. Geo Reentry, Inc., Los Angeles County, 2233 East 69th Street, Long Beach, CA 90805
  3. Turning Point of Central California, Inc., Kern County, 1100 Union Avenue, Bakersfield, CA 93307
  4. Health Right 360, Inc., LA County, 2307 West 6th Street, Los Angeles, CA 90057
  5. Amity Foundation, LA County, 3745 South Gand Ave, Los Angeles, CA 90007
  6. Core Civic DBA Correctional Alternatives, San Diego County, 2727 Boston Avenue, San Diego, CA 92113
  • Female Offender Treatment and Employment Program
  1. Center Point, Sacramento County, 11228 Fair Oaks Blvd., Fair Oaks, CA 95628
  2. Health Right 360, San Francisco County, 1563 Mission Street, San Francisco, CA 94103
  3. Community Social Model Associates, Merced County, 508 Mendocino Court, Atwater, CA 95301
  4. Inland Valley Recovery Services, San Bernardino County, 1260 E. Arrow HWY. Upland, CA 91786
  5. Health Right 360, Los Angeles County, 12423 Dahlia Avenue, El Monte, CA 91732

Note: There are currently no new facilities considered a public institution in Santa Clara County, however, staff must be aware in the event that a courtesy application is required.

Inmates of a Public Institution

The EW must consider both the facility and the person’s circumstances when making a MC determination of eligibility for either a juvenile or an adult who is incarcerated or placed in any type of public institution.

Individuals who are released from prison or jail based on any of the following situations are eligible for MC, if other MC eligibility requirements are met.

  • Bail
  • Parole
  • Permanent release
  • Their own recognizance
  • Court probation order.

These individuals are potentially eligible for MC because they are no longer under the custody and care of the law enforcement agency.

Inmates Who May be Eligible for MC Benefits

The following individuals may be eligible for MC benefits if they meet other MC eligibility requirements:

  • An individual who, after arrest but before booking or sentencing, is escorted by police to a hospital for medical treatment and held under guard
  • An individual released from prison or jail, probation, parole, or release order; with a condition of:
    • Home arrest
    • Work release
    • Community service
    • Outpatient treatment
    • Inpatient treatment.
  • A minor placed in a juvenile detention center prior to disposition (judgement). 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. This could include those juveniles awaiting placement but still physically present in a juvenile hall
  • A minor placed on probation by a juvenile court on juvenile intensive probation with home arrest restrictions
  • A minor placed on probation by a juvenile court on juvenile intensive probation to a secure treatment facility contracted with the juvenile detention center if the secure treatment facility is not part of the criminal justice system. This would include juveniles who become wards of the court and placed in a 24-hour non-medical residential facility which provides counseling and other rehabilitative services
  • A minor placed on probation by a juvenile court or on juvenile intensive probation with treatment as a condition of probation:
    • In a psychiatric hospital
    • In a residential treatment center, or
    • As an outpatient.
  • An individual with tuberculosis who is under an order of detention to protect public health in a:
    • Residential treatment center
    • Skilled nursing facility
    • County, city, or tribal jail awaiting placement for treatment.

Inmates Ineligible for MC Benefits

The following individuals are not eligible for MC benefits because they are residents of a public institution:

  • An inmate in a prison
  • An inmate of a county, city, or tribal jail
  • An inmate in a prison or jail: prior to arraignment, conviction, or sentencing
  • An individual who is incarcerated, but can leave prison or jail on work release and must return at specific intervals.

ExampleExample

An individual is sentenced by the court to serve a term in jail. The sentence provides that the individual is to be permitted by the proper authority to leave the jail daily to attend school or go to work. However, the individual must return to jail after work or school each day and remain incarcerated on weekends, holidays, etc.

  • An individual temporarily released from prison or jail due to a medical emergency. The individual must go back to jail after the medical emergency. The law enforcement agency maintains the custody and responsibility for the needs of the individual.
  • A minor in a juvenile detention center prior to disposition (judgment) due to criminal activity of the minor
  • A minor, after disposition, placed in a detention or correctional facility, including a youth ranch, forestry camp, or home which is part of the criminal justice system
  • A minor placed on regular or intensive probation by a juvenile court to a secure treatment facility contracted with the juvenile detention center if the secure treatment facility is part of the criminal justice system
  • A minor placed on regular or intensive probation by a juvenile court with specific conditions of release, including residence in a juvenile detention center
  • A minor sentenced to a term of incarceration but due to inadequate space in the juvenile detention center, is temporarily placed in a foster home pending available space in the detention center. The penal authority retains full responsibility for the minor and anyone serving a sentence and not formally released is ineligible for MC
  • Pregnant women serving sentences in jail or prison. However, the newborn child is eligible even if living with the mother in the jail or prison as the child has not committed criminal offense and is not sentenced to the jail/prison regardless of the living arrangement.

Inmates Under Penal Code

Anyone of age who is arrested AND incarcerated is ineligible for MC regardless of the Penal code section used. However, any individual who is released from incarceration on bail or meets any of the following penal code provisions may be eligible for MC:

  • Penal Code 1367

Penal Code Section 1367 provides that a person cannot be tried or sentenced while that person is mentally incompetent. If the judge finds reason to believe that the defendant may be incompetent to stand trial, the judge may order that the defendant be referred for a 72-hour treatment and evaluation. If evaluation results in placement of the individual in a mental health facility for treatment, then the individual may be eligible for MC benefits if other MC eligibility requirements are met.

  • Penal Code 1370

Penal Code 1370 provides that a Murphy Conservatorship be established if a state hospital patient charged with a serious felony is not restored to competence. A Murphy Conservatorship requires a determination that the patient is gravely disabled in accordance with Welfare and Institutions Code Section 5008(h)(1). The state hospital patient may be eligible for MC benefits, if other MC eligibility requirements are met.

  • Penal Code 1372

Penal Code 1372 includes felons who were initially determined incompetent to stand trial, but after treatment at the state hospital, has regained competency and are returned to stand trial. When a defendant is returned to court with a certification that competence has been regained, the court will determine whether the person is entitled to be admitted to bail or not.

An individual who is released from incarceration on bail is not a resident of a public institution and may be eligible for MC benefits, if other MC eligibility requirements are met. If not released on bail, the individual is likely to be held in a prison or jail prior to conviction or sentencing. Hence, the individual would then be a resident of a public institution and is ineligible for MC benefits.

Fleeing Felon

A fleeing felon is defined as an individual (either an adult or juvenile) who is fleeing to avoid prosecution, custody or confinement after a:

  • Conviction of a crime that is considered a felony under the law from where the individual is fleeing, or
  • Violation of a condition of probation or parole.

The existence of a warrant of arrest is presumed to be evidence of fleeing, unless proven otherwise by other evidences.

Fleeing felons are eligible for MC benefits until they are incarcerated, if other MC eligibility requirements are met.

Inmate

A person living or being cared for in an institution. See Section 43.2, 43.3 and 43.8 for a list of institutions.

 

Related Topics

Special Institutional Programs MEDS Functionality

Other Institutions