DPSS ePolicy

To convert existing policy to the new webpage - No content changes.

Revision of existing policy and/or form(s) 

What Changed?

1. Medi-Cal (MC) policy for youth in the Unaccompanied Refugee Minor (URM) Program.
2. Policy related to transition of Former Foster Youth (FFY) from managed care plan to fee for service MC.
3. Addition of reference to FFY notices.
4. Use of Social Security Number (SSN) for Pre-Adoptive and Post-Adoptive Records.
5. Addition of Medi-Cal Eligibility Determination System (MEDS) Alert 9068 information.
6. Addition of 5L aid code to list of aid codes eligible to FFY.

Effective January 1, 2014, the Affordable Care Act (ACA) extended MC coverage for the FFY program up to age 26 for youth who were in foster care under the responsibility of any State or tribe on their 18th birthday or at a later age.  Youth aging out of foster care are automatically eligible for the FFY MC Program and their income and/or resources are not counted to determine eligibility. 

Youth designated into the URM program by the Office of Refugee Resettlement (ORR) are also eligible to MC coverage under the FFY program up to age 26.  ORR regulations do not require that a URM youth be placed in the care and custody of the State.  Although URM youth do not receive assistance payments through the counties, such as Foster Care Maintenance Payments, they are to be treated like foster care children for MC eligibility purposes.

FFY who were missing from placement when they left foster care at age 18 or at a later age, as well as URM youth exiting placement or whose whereabouts are unknown, are eligible to receive MC under the FFY program.

Under Assembly Bill (AB) 12 provisions, some youth may be eligible to receive extended foster care up to age 21.  These youths are also known as Non-Minor Dependents (NMD).  At the end of their extended foster care eligibility, the Department of Children and Family Services (DCFS) will send an electronic referral to the MC Outreach District #16.  NMDs are automatically transitioned into the FFY program.  Under this provision, youth under age 21, who have transitioned to FFY status, may opt to return to the DCFS foster care program to receive additional foster care services.  URM youth are eligible for the URM version of extended foster care if they are between the ages of 18 and 21 and meet all eligibility requirements.

FFY Expansion in Coverage

The expansion in coverage created two FFY groups:

1. Mandatory Coverage Group
   
   
   1. Youth who were receiving MC or Medicaid in another State and were in foster  care under the responsibility of any State or tribe on their 18^th birthday or a later age and youth placed in Non-Related Legal Guardianship (NRLG).  NRLG is for youth placed with a nonrelated caregiver appointed by the court.  These youth are eligible for MC benefits in the FFY program until age 26.
      
      
   2. Youth designated into the URM program by the ORR who are exiting URM placement at age 18 or older are eligible to receive MC benefits in the FFY program until age 26.
       
2. Optional Coverage Group

Includes youth who were not receiving MC or Medicaid benefits in another State and were in foster care on their 18^th birthday and are between the ages of 18 and 21.

Currently, there is only one aid code for the FFY population.  Until further instructions are released by the State, FFY in the Optional Coverage Group must be aided under aid code 4M up to age 26.

FFY Self-Attestation

The FFY program provides a simplified eligibility determination and enrollment process through self-attestation.  Applicants/beneficiaries who were previously enrolled in aid codes 40, 42, 43, 45, 46, 49, 4C, 4H, 4L, 4N, 5K or 5L are eligible under the ACA FFY expansion with aid code 4M up to age 26 and must be identified early in the application process to avoid the request and collection of unnecessary information, such as income and tax filing information.  Eligibility staff are to immediately grant 4M eligibility based on self-attestation even if there is no foster care aid code in MEDS.  The Eligibility Worker (EW) shall verify former foster care status within 30 days.

Continued FFY Eligibility

FFY who receive MC under aid code 4M are no longer required to complete the annual renewal process.  MC eligibility under the FFY program will continue without interruption of benefits up to their 26^th birthday.  This includes circumstances where there is loss of contact or if the youth’s whereabouts is unknown.

The Federal Foster Care Independence Act of 1999 authorized States to provide continuing MC eligibility for all children who were in foster care under the responsibility of any State on their 18^th birthday up to age 21.

Implementation of the ACA on January 1, 2014, extended the continued MC coverage for FFY up to age 26.

Terms and Definitions

Former Foster Youth (FFY)

Youth who exited foster care on their 18^th birthday or at a later age.

Mandatory Coverage Group

Youth who were receiving MC or Medicaid benefits and were in foster care under the responsibility of any State or tribe on their 18^th birthday or a later age.  These FFY are eligible for MC benefits in the FFY program up to age 26.

Optional Coverage Group

Youth who were not receiving MC or Medicaid benefits in another State and were in foster care and are between the ages of 18 and 21.  These youths may be covered under the FFY program up to age 21.

Note:  Pending additional State instructions, FFY in the Optional Coverage Group must be aided under aid code 4M up to age 26.

MC 250A-LA, Application for Medi-Cal for Former Foster Care Youth

The application used to collect information for youth who declare former foster care status.

4M Aid Code

This aid code covers FFY who were in foster care on their 18^th birthday, from age 18 and up to age 26.  This is a fee-for-service aid code.

Note:  Managed care plan enrollment is voluntary under 4M for FFY in Los Angeles County.

Assembly Bill (AB) 12 California Fostering Connections to Success Act

Category of non-minor dependents eligible to receive extended Foster Care, Kin-GAP, Adoption Assistance Program, and CalWORKs benefits up to age 21.

Non-Minor Dependent (NMD)

Current dependent child or ward of the Juvenile Court who is 18, but under 21  years of age; is in foster care under the responsibility of the county welfare  department, county probation department, or Indian Tribe, and is participating in a transitional independent living case plan.

Office of Refugee Resettlement (ORR)

ORR is a federal agency that provides individuals in need with critical resources to assist them in becoming integrated members of American Society.

Unaccompanied Refugee Minor (URM) Program

The URM program provides child welfare, foster care, and independent living services to URMs.

Unaccompanied Refugee Minor (URM)

Minors who enter the United States unaccompanied by a parent, an immediate adult relative, or an adult having documentable legal evidence of custody of the minor.

Two-Contact Process

The process of contacting the applicant (verbally or in writing) two times to request additional information and/or verification prior to taking negative action (denial).  The process must include:

1. First contact – Request information and/or verification from the applicant and allow at least a ten-calendar due date to submit the information and/or verification.
   
   
2. Second contact – If the applicant fails to provide or provides incomplete information and/or verification by the due date, then a second request must be given to the applicant with an additional ten-calendar due date to submit the information and/or verification.

Eligibility to the FFY Medi-Cal Program

Individuals between the ages of 18-26 that were in foster care on their 18^th birthday are eligible to the FFY MC Program.

Electronic referrals for youth exiting foster care, including youth exiting URM placement, at age 18 or at a later age, are sent to the FFY Unit at MC Outreach District (MOD) #16.  DCFS provides these referrals to MOD on a monthly basis.  These referrals are used to automatically establish FFY eligibility without the need for additional information from the FFY.

Applications for FFY can be submitted via paper applications or online.  FFY paper applications may be submitted in person, by mail, or fax.

• The MC 250A LA - Application for Medi-Cal for Former Foster Care Youth form has been revised to include the fax number and mailing address for MOD #16.  Additionally, the form was revised to ask the following questions:
  • Were you in foster care on your 18^th birthday or later?  Yes, No, Not Sure.
  • Which State were you in foster care (for example, California?)
     
• Applications submitted by FFY using the Single Streamline Application (SSApp) or SAWS 2 PLUS.
  
  
• FFY may also apply online via Your Benefits Now (YBN) or Covered California (CoCA).

Applicants Not Meeting FFY Requirements

Individuals that self-attest FFY status are granted 4M eligibility pending verification.  If upon verification, it is determined that the criteria for FFY eligibility was not met, the beneficiary must be evaluated for eligibility under other MC programs.

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