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Effective: December 1, 2006 |
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14.10.05 - Children in Facilities |
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Children may or may not be eligible for Minnesota Health Care Program (MHCP) coverage while residing in a facility or institution.
Children on MinnesotaCare who are placed in correctional facilities, single foster homes, group homes, Institutions for Mental Diseases (IMDs), residential treatment or other institutional settings follow the same policy as Medical Assistance (MA) for continuing eligibility based on the particular setting they are in.
Exception: If children are in a setting where they are no longer eligible for continued coverage under MA, close MA immediately. If children are on MinnesotaCare, continue coverage until the next renewal.
Children in Correctional Facilities.
Title IV-E Certified Facilities.
Children in Institutions for Mental Diseases (IMDs)
Depending on where they are placed, children may or may not be eligible for MHCP coverage while residing in an IMD.
l A child may be eligible for MHCP when placed in a public or private licensed and certified psychiatric inpatient hospital for mental illness (MI) (system codes 50 or 53) or chemical dependency (CD) treatment (system code 58).
l A child who is enrolled in MA must be changed to program IM for payment of services received from outside providers when placed in either of the following:
n An IMD facility for MI or CD treatment (system codes 51 or 52) that is not a licensed and certified psychiatric hospital.
n An out-of-state residential treatment facility for severe emotional disturbance (SED) that is an IMD (i.e., has more than 16 beds) (system code 59).
Children in Correctional Facilities
Depending on where they are placed, children may or may not be eligible for MHCP coverage when placed in a correctional facility. Some juvenile correctional facilities have both a secure unit and a non-secure unit; contact these facilities to find out which unit the child is in.
A child may be eligible for MHCP when placed in:
l A non-secure publicly owned and operated juvenile residential facility or group foster home with no more than 25 beds (system code 72).
l A privately operated juvenile residential facility or group foster home of any size (system code 74).
l A Department of Corrections (DOC) licensed juvenile private foster home (system code 75).
l A publicly or privately operated non-secure temporary holdover facility (system code 77).
A child will not be eligible for MHCP when placed in:
l A secure unit of a correctional facility, public or private (system code 71).
l A state owned and operated correctional facility (such as Thistledew Camp in Itasca County) (system code 70).
l A publicly owned and operated juvenile residential facility or group foster home with over 25 beds (system code 73).
l A publicly or privately operated secure juvenile temporary holdover facility (system code 76).
Title IV-E Certified Facilities
There are numerous facilities that meet the treatment needs of children. Many of these have Title IV-E certification. As a rule, children in IV-E certified facilities may be eligible for health care program coverage if they meet eligibility requirements.
The DHS Financial and Management Operations Division issues a quarterly per diem rate bulletin that lists all of the Title IV-E certified children’s facilities.
l This bulletin is usually published in the months of March, June, September and December each year.
l At the time of publication, the last issue was numbered 08-32-07 (dated June 17, 2008) and can be found on the DHS public website.
The bulletin includes residential treatment facilities, foster homes licensed by DHS and DOC, group foster homes and out-of-state facilities. Also included is a list of juvenile correctional placement facilities that may or may not be IV-E certified. If IV-E certified, they will appear on one of the other attached lists.
For more information, see: