Medicaid Eligibility for Detained Children

A reader asked follow-up questions to a post concerning the notice to the Division of Family Resources (DFR) about a child’s disposition or modification to the disposition order and any confidentiality issues.To review why DFR is notified about a juvenile delinquent’s disposition or modification, there are two relevant statutes.  Pursuant to IC 31-37-19-28, the juvenile court shall immediately forward a copy of the dispositional decree to DFR if a predispositional report indicates that a child receives Medicaid and the court places the child in a juvenile detention facility or a secure facility.  Pursuant to IC 31-37-22-9, the juvenile court shall immediately forward a copy of the modified dispositional decree to DFR whenever a disposition is modified, the child was receiving Medicaid before the original disposition as indicated by the predispositional report, and the child is being placed in a juvenile detention facility or a secure facility.The questions posed are:

1) Do you think a better policy would be for the court to simply inform IDFR of the child’s pending placement? That is, does the disposition order contain confidential information beyond the child’s name and disposition? Are there any rules or regulations as to what IDFR must do with the disposition order?

The recommended contents of the disposition order are outlined by the Indiana Judicial Center Juvenile Delinquency Benchbook Forms (See D-11.03 D-14.07 and D-14.08).  Pursuant to IC 31-37-18-9(a), any disposition decree must be accompanied by specified written findings and conclusions upon the record.  Whether any of those details are confidential will turn on whether the child is only alleged to have committed status offenses or misdemeanors, or whether there are allegations that would be a felony if committed by an adult.  In the situation of status offenses or misdemeanors alone, confidential information would be released to DFR.  There would need to be a change in the law to allow a notification of detention without more.

Pursuant to IC 12-15-1-20.4(a), if a Medicaid recipient is: (1) less than 18 years old, (2) adjudicated to be a delinquent child and placed in a community-based correctional facility for children, a juvenile detention facility, or a secure facility, and (3) ineligible to participate in the Medicaid program during placement because of federal Medicaid law, DFR shall suspend the child’s participation in Medicaid program for up to 6 months before terminating the child’s eligibility.

Pursuant to DFR Program Policy Manual Chapter 2237.05.00, “[w]hen a recipient becomes incarcerated…the individual’s health coverage is to be suspended and not discontinued….The suspension continues until the individual is released from the facility, but will not exceed 12 months.  There is no limit on the number of times a recipient can be suspended….The 12-month period begins on the first day of the month after the institutionalization (or the following month if required to meet adverse action rules) and ends on the last day of the 12th month, at which time health coverage is discontinued if the individual remains institutionalized…. Incarceration or psychiatric admission which will last for less than 30 days does not require an eligibility review.”

2) In Indiana, is there a policy to allow children to become eligible for Medicaid as soon as they re-enter their communities from facilities?

Pursuant to IC 12-15-1-20.4(b), if DFR receives a dispositional decree or a modified disposition order and the Indiana Department of Correction (DOC) gives DFR at least 40 days notice that a child will be released from DOC, DFR shall take the action necessary to ensure that a child is eligible to participate in the Medicaid program upon the child’s release, if the child is eligible to participate.  There is nothing that specifies the procedure for children detained in a community-based correctional facility or a juvenile detention facility.

Pursuant to DFR Program Policy Manual Chapter 2237.10.00, the requirements of IC 12-15-1-20.4(b), is also applicable to all suspended former recipients whose release date from any of the three types of facilities is established.  If the plan is release back to the community, and includes the release date, and is timely reported and documented in writing, the change must be processed in time so that the individual’s Medicaid coverage is active upon release from the facility.  In order for Medicaid to be reinstated timely, the report of release/discharge must include at minimum: the release date, community address, living arrangement, and household members, and should be provided to DFR within 40 days of release/discharge.  If all documentation is timely reported but the exact discharge date is not specified, benefits are not to be reinstated until the date is documented.  This may result in benefits not being available on the date of release/discharge.

3) Do you think juvenile defenders should be more aware of the relationship between Medicaid eligibility and juvenile records, or is the law straightforward enough that there is no role for them in this arena?

As this is a collateral consequence of the adjudication that can have a major impact on the child, it needs to be emphasized more explicitly through a variety of sources.  Some of the information contained in this post is also contained in the Indiana Public Defender Council (IPDC) Juvenile Delinquency Manual, which is only available to public defenders.  However, the mandatory suspension and information about eligibility upon release is not in that document, which was last updated in 2012.  The information is also not currently in the American Bar Association (ABA) collateral consequences (beforeyouplea.com).  The ABA website is currently being updated, and I will include it in the draft update.  At the IPDC juvenile delinquency seminar held on October 4, 2013, the notice to DFR and issue with Medicaid eligibility was mentioned very briefly during the probation revocation breakout session, but it probably should be emphasized more explicitly at future events.

Disclaimer — this blogger is not a Medicaid eligibility expert.  Information above comes from the cited resources.

This entry was posted in Detention, DOC, Medical Care, Mental Health and tagged , , , , . Bookmark the permalink.

One Response to Medicaid Eligibility for Detained Children

  1. David Shapiro says:

    Thanks! This is very interesting stuff.

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