FLORIDA DEPARTMENT OF JUVENILE JUSTICE PROCEDURE

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1 PROCEDURE Title: Medicaid Policy/Child in Care Procedures Related Policy: FDJJ 9325 I. DEFINITIONS Agency for Health Care Administration (AHCA)- State agency that administers the Medicaid program, grants licenses to health care providers and facilities, and regulates Florida s health care system. Behavioral Health and Overlay Services (BHOS) Mental health and substance abuse services designed to meet the behavioral health treatment needs of recipients placed in the care of Medicaid-enrolled, certified residential commitment programs under contract with the Department of Juvenile Justice. Child In Care (CIC) A Department of Children and Family assistance program that provides benefits for children that are removed from the care of their parents. Included are Title IV-E and non-title-iv-e Foster Care, Adoption Subsidy, Emergency Shelter; and non-title IV-E Delinquency and Independent Living Programs. (Only Medicaid benefits are provided through the FLORIDA system). Child In Care Medicaid Application Medicaid application submitted by Juvenile Probation Officers to the CIC Public Assistance Specialist within 5 days prior to the offender s placement (if known prior to placement) or at time of placement. DJJ/IS Form 36 (Attachment 1) Child in Care Specialist (CIC Specialist) An employee of the Department of Children and Family who works in the Economic Services section and determines client eligibility for Medicaid and/or other public assistance programs. Each DJJ circuit has a designated CIC Specialist to process applications for committed offenders placed into Medicaid Allowable facilities. Chief Probation Officer (Circuit Manager) The person responsible for supervising juvenile probation and community intervention efforts in each of the 20 circuits and serves as the key local contact person for the Department and community partners. Committed Offender An youth who has been adjudicated delinquent by the court, authorizing the Department to exercise active control over the youth, including, but not limited to custody, care, supervision, urine monitoring and treatment of the youth. Declaration of United States Citizenship/Lawful Alien Status Form A form that shows U. S. citizenship or lawful alien status. DJJ/IS Form 37 (Attachment 2) Department of Children and Family (DCF) The state agency that provides cash assistance, food stamps, Medicaid eligibility and other services to needy children and families. Juvenile Probation Officer (JPO) The authorized agent of the Department of Juvenile Justice who performs the intake, case management, probation and other community corrections functions for youth alleged to be delinquent and for delinquent offenders. This position follows a youth from entrance to exit from the juvenile justice system. Page 1 of 8

2 SECTION: Juvenile Probation Officer Supervisor The person responsible for supervising Juvenile Probation Officers by communicating, motivating, training, and evaluating employees, and planning and directing their work. Low-risk residential facility- A program for offenders who are assessed as low risk to public safety but require placement, services and 24-hour supervision. Medicaid A jointly funded state and federal program of medical assistance, administrated by the state, which is available to groups of specific individuals defined in policy. Federal matching funds for Medicaid are available to states under Title XIX of the Social Security Act, as amended. The purpose of this federal funding is to enable states to provide a more effective medical assistance program to individuals based on financial need. Medicaid Allowable Facility Low or moderate risk, privately operated residential commitment program contracted with the Department, which provides care, custody and control to committed offenders. Medicaid Child In Care Eligibility Review and Communication Worksheet JPO uses this form to communicate status changes to the CIC Specialist when a offender leaves a program, is transferred to another program or escapes. Status changes must be reported within 5 days. When an offender leaves a program, the JPO uses this form to request Medicaid dis-enrollment. Form CF-ES 2694A 10/2001 (Attachment 3). Medicaid Liaison DJJ staff designated within circuits for Probation and regions for Residential who receives and distributes updated lists of Medicaid allowable and BHOS programs. They also provide changes in a program s on-file information to the HQ Medicaid Liaison and resolves local Medicaid issues. Moderate-risk residential facility A program for offenders who are assessed as moderate risks to public safety and require close 24-hour awake supervision. Facilities are either environmentally secured, staff secured or hardware secured. Probation and Community Intervention The branch within DJJ responsible for administrative oversight and direction of probation and community intervention programs. Region A specific geographical area that encompasses several distinct circuits. Probation has 3 regions and Residential has 5 regions. Residential Services The branch within DJJ responsible for administrative oversight of the residential and correctional programs where offenders are placed due to their commitment and provide services through contracting with providers, training, placement and classification, technical assistance, etc. Residential Commitment Program Facility where offender is placed due to their adjudication and commitment as a juvenile offender. The facility s purpose is to provide for the care, custody, control, and treatment needs of offender within four different risk levels of security. Page 2 of 8

3 SECTION: II. STANDARDS/PROCEDURES A. Procedure and Communication Development: 1. Each Chief Probation Officer shall appoint a Medicaid Liaison. Notification of the appointment shall be made to the local Department of Children and Families as well as Headquarters Office of Residential Services. 2. The Chief Probation Officer (or designee) shall develop a written circuit-specific operating procedure on how: a. The Medicaid application packet shall be submitted to the Department of Children and Families Economic Services unit upon notification of date for placement of an offender or immediately upon placement of an offender into a Medicaid Allowable facility. b. The residential commitment program shall be notified of the offender s Medicaid eligibility or changes to their coverage group and receive the Medicaid identification number. NOTE: If the offender is covered by their family Medicaid when placed in a Medicaid allowable facility, their coverage group will be changed but a new card will not be issued unless specifically requested. In general, Medicaid recipients retain their gold ID card regardless of changes in Medicaid coverage categories. c. If the Medicaid identification number is received by the JPO, it will be forwarded immediately upon receipt to the facility. d. The eligibility Reviews/ Annual Re-application shall be tracked and completed for the Department of Children and Families. e. The JPOs shall be trained on the use of the DJJ/IS Form 36, DJJ/IS Form 37 Attachments 1 and 2), and the Eligibility Review and Communication Worksheet, HRS-ES Form 2694 Attachment 3, (January 1992). f. Annual refresher training will be coordinated with the local DCF CIC specialist for all JPOs to review procedures, common problems and any local changes or issues. g. Residential commitment programs shall seek assistance from the circuit Medicaid liaison when problems are encountered with the Medicaid application/eligibility process. h. Medicaid Allowable Programs lists and BHOS Programs lists are distributed to all units and staff upon receipt and any changes, updates or modifications are routed to the Statewide Medicaid Liaison. 3. Juvenile Probation Office Supervisors shall ensure that all staff maintain a current list of BHOS and Medicaid Allowable facilities for reference. 4. The Residential Services Regional Director shall appoint a contact person as Medicaid Liaison. Notification of appointment shall be made to the Statewide Medicaid Liaison. Page 3 of 8

4 SECTION: 5. The assigned Medicaid Liaison shall provide updates or changes in the BHOS programs or Medicaid Allowable programs lists to the Statewide Medicaid Liaison. 6. The assigned Medicaid Liaison shall assist as needed with Medicaid issues as they occur in programs within their region, such as timely submission of Medicaid application packets or receipt of Medicaid identification information. 7. The Medicaid Liaison will distribute the BHOS and Medicaid Allowable list to appropriate staff. 8. Contract Managers and Commitment Managers shall provide Medicaid Liaisons with information on new programs, changes in programs, program closures and any information as it relates to the BHOS or Medicaid Allowable 9. The Commitment Manager will notify the JPO via of placement made in Medicaid eligible facilities. 10. The Facilities Program Director or designee at Medicaid allowable residential and correctional facilities shall provide updates or changes to programs demographics, BHOS beds or Medicaid provider status to the Statewide Medicaid Liaison. B. Offender Eligibility Determination Process: 1. The Juvenile Probation Officer shall complete the Child In Care Medicaid Request form (DJJ/IS Form 36) Attachment 1 and Declaration of United States Citizenship/Lawful Alien Status form (DJJ/IS Form 37) Attachment 2 for every offender pending placement or transfer into a Medicaid allowable facility (even those offenders who were Medicaid eligible prior to placement through their family s eligibility). When approved for Medicaid as a CIC case, the offender will be eligible for a category of Medicaid that will preclude enrollment in an HMO and leave the offender in fee-for-service Medicaid. 2. Upon notification of planned placement or immediately upon placement into a Medicaid allowable facility, the Juvenile Probation Officer shall submit the original Medicaid application packet to the designated Child in Care Specialist as directed by the circuit specific procedures. 3. The Juvenile Probation Officer shall place a copy of the Medicaid application packet into the offender s original commitment packet and into the offender s official case file maintained by the JPO. If a copy is not included within the commitment packet prior to an offender s placement, a copy will be provided immediately to the residential commitment program where the offender is placed. 4. The Juvenile Probation Officer shall forward immediately upon receipt any Medicaid identification card or data to the residential commitment program where the offender is placed. 5. The Juvenile Probation Officer shall complete the Medicaid Child in Care Eligibility Review and Communication Form when there are any changes to the offender s income (assets), address, or commitment placement due release, escape or transfer. Changes must be reported to the Child in Care Specialist within 5 days. Page 4 of 8

5 SECTION: 6. At the time of release from a Medicaid allowable facility, Medicaid eligible parents/guardians are to be notified by the Juvenile Probation Officer that the offender will no longer be Medicaid eligible as a CIC case and the family must re-apply for Medicaid for the offender. 7. For offenders who remain in placement over a calendar year, the Juvenile Probation Officer shall complete and submit the updated Medicaid application packet two weeks or 10 working days prior to the annual date of eligibility determination. 8. The Juvenile Probation Officer shall assist the residential commitment program with any problems encountered with the Medicaid application/eligibility process. 9. The Juvenile Probation Officer shall follow-up immediately to inquiries made by Medicaid Liaisons based on problems encountered with the determination of eligibility of an offender. 10. Juvenile Probation Officer Supervisors shall review all Medicaid application packets for accuracy prior to their submission to the Department of Children and Families. 11. Juvenile Probation Officer Supervisors shall ensure timely submission of all Medicaid application packets, timely responses by JPO if problems arise with eligibility process, and timely communication with CIC Specialist of any changes that impact the Medicaid eligibility status of an offender. 12. The Facilities Program Director or designee at Medicaid allowable residential and correctional facilities shall communicate with the Juvenile Probation Officer and/or JPO Supervisor when problems with Medicaid application/eligibility process occur, to seek assistance or to relay planned changes in the offender s status. 13. If unable to make contact or obtain assistance from the Juvenile Probation Office in the Medicaid application /eligibility process, the Facilities Program Director or designee at Medicaid allowable residential and correctional facilities shall notify the Regional or Statewide Medicaid Liaison of the problem, confidentially provide identifying information regarding the offender and efforts to resolve. 14. The commitment program shall notify the JPO when an offender is transferred from the facility. III. RESPONSIBILITY AND DUTIES A. Assistant Secretary for Residential Services or Designee 1. Will maintain and distribute lists of all Medicaid Allowable facilities and specialized BHOS beds/facilities. 2. Will maintain communication with designated Medicaid Liaisons within the Residential Services and Probation and Community Intervention branches of the Department, Department of Children and Families and Agency for Health Care Administration. Page 5 of 8

6 SECTION: 3. Shall designate a Statewide Medicaid Liaison and make notification to all Residential Services regional offices, Probation and Community Intervention, Department of Children and Families (DCF) and Agency for Health Care Administration (AHCA). B. Regional Residential Services Director 1. Will designate a contact person to serve as a Medicaid Liaison. C. Headquarters Statewide Medicaid Liaison: 1. Shall maintain current lists of all Behavioral Health Overlay Services (BHOS) programs and all Medicaid Allowable programs. Distribute quarterly or as significant changes occur to all Medicaid Liaisons, DCF and AHCA contacts. 2. Shall maintain current lists of all Medicaid Liaisons for Probation and Community Intervention and Residential Services, designated DCF Child in Care Specialist by circuit, liaisons with Department of Children and Families and Agency for Health Care Administration and distribute as needed 3. Shall maintain communication with Department of Children and Families, Child in Care (CIC) staff and Agency for Health Care Administration to remain current on issues relevant to Medicaid services and eligibility as it relates to Medicaid Allowable facilities, BHOS programs and offender CIC eligibility. 4. Shall serve as Medicaid Consultant/Liaison to work cooperatively with Agency for Health Care Administration and Department of Children and Families to facilitate compliance with standard operating procedures listed below as they impact offender Medicaid Child in Care eligibility determination: a. Agency for Health Care Administration (1.) Administer the Medicaid program by maintaining the offender s Medicaid eligibility file, enrolling/dis-enrolling the offender from Medicaid managed care and reimbursing Medicaid providers for covered services. (2.) Provide assistance on an as-needed basis when requested by DJJ Medicaid Liaison. (3.) Provider updates or changes in Medicaid policies as they relate to the BHOS programs or the Medicaid Allowable programs to the Statewide Medicaid Liaison for distribution or dissemination to providers or other liaisons. b. Department of Children and Families (1.) Determine the offender s eligibility for Medicaid and send appropriate information to AHCA allowing the offender to be placed on Medicaid. (2.) Send the Medicaid Identification Card to the facility in which the offender is placed or to the JPO if so designated by the Chief Probation Officer s circuit specific operating procedure. Page 6 of 8

7 SECTION: (3.) Provide updates and changes to the designated Child in Care Specialist list to the Statewide Medicaid Liaison. (4.) Distribute BHOS and Medicaid Allowable programs lists to all Child in Care Specialist and route any changes or updates known by the Child in Care Specialist to the Statewide Medicaid Liaison. (5.) Provide assistance on an as-needed basis when requested by DJJ Medicaid Liaison. (6.) Coordinate with Chief Probation Officers to provide annual training or refresher training to Probation and Community Intervention staff. D. Chief Probation Officer (Office of Probation & Community Corrections) 1. Shall appoint a Medicaid liaison. Notification of the appointment shall be made to the local Department of Children and Families as well as Headquarters Offices of Residential Services. E. Juvenile Probation Officer 1. Shall complete the Medicaid application packet for all offenders placed into Medicaid allowable facilities. 2. Shall update DCF Child In Care staff of any changes in an offender s placement or status as it relates to their Medicaid eligibility and shall assist the CIC with their 6-month s eligibility reviews by confirming offenders placement or status upon request. F. Circuit Liaisons 1. Medicaid Liaisons will communicate with the Statewide Medicaid Liaison as needed to maintain current program lists of Behavioral Overlay Services (BHOS) programs and Medicaid Allowable programs. 2. Distribute updated lists of Behavioral Health Overlay Services (BHOS) programs and Medicaid allowable programs to all appropriate staff. 3. Work with facility s Medicaid staff and other liaisons to resolve problems in the event an offender is placed in a Medicaid allowable program without a completed application packet (Child in Care Medicaid Application, DJJ/IS Form 36 Attachment 1 and Declaration of United States Citizenship/Lawful Alien Status, DJJ/IS Form 37 Attachment 2, Copy of offender s Green card or other INS documentation) to ensure timely submission and eligibility determination. 4. Provide assistance when an offender has been placed into a Medicaid Allowable facility and all necessary forms have been submitted but an identification number or eligibility is not determined within a timely manner. Contact will be made with the designated DCF CIC Specialist to determine status of the application, determine time frame for completed processing and relay eligibility data to the facility. Page 7 of 8

8 SECTION: IV. ATTACHMENTS Attachment 1 - Child in Care Request for Medicaid (DJJ/IT Form 36) Attachment 2 - Eligibility Review and Communications Form Page 8 of 8