*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
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Effective: June 1, 2011 |
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14.15 - Correctional Facilities |
Archived: June 1, 2016 (Previous Versions) |
In general, people who are incarcerated in detention or correctional facilities are not eligible for Minnesota Health Care Program (MHCP) coverage. Children who are placed by a juvenile court in certain juvenile programs may be eligible depending on the type of facility.
Exception: People who meet all other eligibility requirements for Refugee Medical Assistance (RMA) are eligible for RMA regardless of their living arrangement.
Applicants in Correctional Facility.
Enrollees in Correctional Facility.
Medical Assistance Eligibility for Children in Correctional Facilities.
Coverage Upon Release from Correctional Facility.
Types of Correctional Facilities and MMIS Codes.
Applicants Residing in Correctional Facility
Applicants for MHCP, regardless of age, are ineligible for coverage while they reside in the following correctional facilities:
l City, county, state and federal correctional and detention facilities for adults.
This includes inmates who are:
n in a work release program that requires they return to the facility during non-work hours.
n admitted to an acute care medical hospital for medical treatment or to give birth, but required to return to the facility when treatment or convalescence is completed.
n sent by the court or penal institution to a chemical dependency residential treatment program while serving a sentence and are required to return to the correctional facility after completing treatment.
l Secure juvenile facilities licensed by the Department of Corrections (DOC) that are for holding, evaluation, and detention purposes.
l State-owned and operated juvenile correctional facility.
l Publicly-owned and operated juvenile residential treatment and group foster care facilities licensed by the DOC with more than 25 non-secure beds.
People who reside in a correctional facility may apply for MHCP 45 days prior to their release. See Applications for Inmates for more information.
Enrollees Residing in Correctional Facility
A MinnesotaCare enrollee who is incarcerated and residing in a correctional facility remains eligible for coverage until the next renewal.
n If a MinnesotaCare enrollee is eligible under major program LL or FF for a MinnesotaCare major program that is federally funded, change the enrollee to state-funded MinnesotaCare (KK or JJ) starting the month after admission (unless that is the renewal month).
Note: Do not change the living arrangement code. The living arrangement code must remain "80” for these MinnesotaCare enrollees.
n Continue to count incarcerated adults or children in the MinnesotaCare household size if they continue to have MinnesotaCare coverage.
n Close MinnesotaCare coverage at the time of renewal if the enrollee still resides in a correctional facility.
Note: MinnesotaCare enrollees who remain eligible while residing in a correctional facility must continue to receive care through their health plans. They must obtain authorization from the health plan to use an out-of-network provider.
An MA enrollee who resides in a correctional facility is ineligible unless the enrollee is a child under age 21 who resides in a certain correctional setting. See MA Eligibility for Children in Correctional Facilities.
Close MA eligibility immediately when an MA enrollee begins residing in a correctional facility. Ten-day notice is not required.
Note: MA enrollees who reside in a correctional facility for no more than 12 consecutive calendar months may request to have coverage reopened upon release from the correctional facility through a shortened process. MA closing notices notify enrollees who are closed due to incarceration of the shortened process. See MHCP and Incarcerated Individuals and the MMIS User Manual (Incarceration) for more information.
MA Eligibility for Children in Correctional Facilities
A child who resides in a non-secure correctional setting may be eligible for MA. Some correctional facilities have both secure and non-secure units. Confirm which unit the child resides in.
Refer to the DHS Financial and Management Operations Division quarterly bulletin entitled “Title IV-E Per Diem Rates for Children’s Residential Foster Care Facilities and MA Percents for Residential Facilities with Mental Health Certification” issued every March, June, September, and December to determine if a child residing in a correctional facility is eligible for MA. The child is eligible if he or she resides in a correctional facility that is listed on both of the following attachments: “Juvenile Correctional Facilities” and “Title IV-E Facility Reimbursements Lists.”
Coverage Upon Release from a Correctional Facility
People are not considered to be residing in a correctional facility and may be eligible for MHCP when they are:
l Released on their own recognizance.
l On bail.
l Given a pardon.
l Released upon completing sentence.
l Under home surveillance, required to wear a monitoring bracelet or cuff.
l Determined not guilty.
l On probation.
l Released to a privately-owned and operated halfway house (currently all halfway houses in Minnesota are privately owned and operated).
Note: Contact DHS if informed that a halfway house is government owned and operated before denying coverage.
l Released on a conditional medical leave. This occurs when an individual is suffering from a grave or terminal illness; can be a juvenile or an adult. This is not a furlough.
l Under civil court hold orders.
l On parole or supervised release, or, in the case of a juvenile, on extended furlough (usually 90 days).
l Placed in facilities licensed by the Department of Corrections (DOC) as privately owned and operated, non-secure residential treatment program, or a group or foster home.
l Placed in a publicly owned and operated DOC licensed juvenile residential treatment facility or group foster home that is IV-E certified and licensed for no more than 25 non-secure beds.
l Committed by court order to an Institution for Mental Diseases (IMD).
l Transferred from a prison to a nursing home.
l On supervised release and residing temporarily in a county jail until a community residence is found. A person’s status in this situation can be verified by the Report on Status of Person Living in a County Correctional Facility (DHS-5994).
Types of Correctional Facilities and MMIS Codes
The MMIS/RLVA codes for correctional facilities and penal institutions are:
l 68 County correctional or detention facility.
l 69 Adult - Other Correctional Facility.
l 70 Juvenile - State Correctional Facility (includes Thistledew Camp in Itasca County).
l 71 Publicly or Privately Operated Secure Juvenile Detention Facility (Residential Facility or Group Home) or Bed.
l 72 Publicly Owned and Operated Juvenile Residential Facility or Group Foster Home. IV-E certified; no more than 25 non-secure beds.
l 73 Publicly Owned and Operated Juvenile Residential Facility or Group Foster Home. More than 25 beds.
l 74 Privately Operated Juvenile Residential Facility or Group Home. Non-secure facility.
l 75 Juvenile Foster Home.
l 76 Publicly or Privately Operated Juvenile Temporary Holdover Facility. Secure facility.
l 77 Publicly or Privately Operated Juvenile Temporary Holdover Facility. Non-secure facility.
l 80 (community) Correctional halfway house.