Categorically Needy Foster Care / Adoption Support / Juvenile Rehabilitation Medical (D01/D02/D26)

Created on: 
Jul 12 2017

See ACES Screens and Online Pages for an example of pages or screens used in this chapter.

Who is eligible to receive FC/AS/JRA/SSI CN (D01) medical?

A child in foster care, foster care relative placement, adoption support, or juvenile rehabilitation, who is an SSI recipient and age 0 - 21.  

See Apple Health eligibility manual - Foster Care Relative Placement Adoption Support Juvenile Rehabilitation Unaccompanied Minor Program and EAZ Manual - Foster Care/Relative Placement/Adoption Support/Juvenile Rehabilitation/Unaccompanied Minor Program.

Who is eligible to receive FC/AS/JR Medical (D02)?

A child in foster care, foster care relative placement, adoption support, or juvenile rehabilitation, who doesn't receive SSI and is age 0 - 18.

See Apple Health eligibility manual - Foster Care Relative Placement Adoption Support Juvenile Rehabilitation Unaccompanied Minor Program and EAZ Manual - Foster Care/Relative Placement/Adoption Support/Juvenile Rehabilitation/Unaccompanied Minor Program.

Can a client receive FC/AS/JRA/SSI CN (D01), FC/AS/JR Medical (D02), or Washington Apple Health Post-Foster Care Coverage (D26) medical coverage while incarcerated?

When a client is active or approved under some medical coverage groups while incarcerated, they can still be eligible to receive medical assistance in a suspended status. For more information, see Suspended Medical – State Bill (SB 6430).

Who is eligible to receive Washington Apple Health Post-Foster Care Coverage (D26) medical? 

Adults who were in foster care on their 18th birthday (on or after July 22, 2007) that aren't receiving SSI and are age 18 - 26.

See Apple Health eligibility manual - Foster Care Relative Placement Adoption Support Juvenile Rehabilitation Unaccompanied Minor Program and EAZ Manual - Foster Care/Relative Placement/Adoption Support/Juvenile Rehabilitation/Unaccompanied Minor Program.

Who can open and close a FC/AS/JRA/SSI CN (D01); FC/AS/JR Medical (D02) or Washington Apple Health Post-Foster Care Coverage (D26) Medical AU?

Only users on the Health Care Authority (HCA) Foster Care Medical Team (FCMT) and the Juvenile Rehabilitation Administration (JRA) Case manager who belong to the Office of Medicare, Medicaid, Eligibility and Policy (OMMEP) section can open or update a D01, D02 and D26 Assistance Units(AUs). Workers assigned to this unit are designated as unit type 17 in CSO 076.

Other users have read-only access to D01, D02 and D26 AUs.

NOTE:  For read-only users, the address for any Authorized Representative or child(ren) active on D01 and D02 appears as asterisks.

What happens before opening a FC/AS/JRA CN SSI (D01) or FC/AS/JR Medical (D02) AU?

The Children’s Administration Case Management System (FAMLINK) sends notifications to the Foster Care Medical Team (FCMT) for every child placed in foster care or adoption support.

Juvenile Rehabilitation Administration (JRA) Group Homes notify the JRA case manager when a child is placed in a juvenile rehabilitation group home.

If a child who is placed in foster care is active on an ACES Assistance Unit (AU), an interface between ACES and FAMLINK generates Alert 190 - ACES CHILD IN FOSTER CARE - CONTACT FOSTER CARE UNIT to the Community Services Office (CSO) user of record for the active AU.

As soon as possible, before month end, the CSO user contacts the FCMT to determine the child’s status. If appropriate, the child is closed off all other active medical AUs so the FCMT can open the child on D01 or D02 medical.

The CSO user also processes all benefit changes for the active ACES AUs from which the child was removed. See Change of Circumstances and EAZ Manual - Change of Circumstances - TOC.

For instructions about removing a child from an active ACES AUs, see Close an Assistance Unit/Client.

What do I do when a child leaves foster care, adoption support, or juvenile rehabilitation?

Foster Care Medical Team (FCMT) receives a tickle from the Children's Administration Case Management System (FAMLINK) that the child has left the placement.

FCMT users redetermine the child’s medical eligibility for any medical program and closes D01 or D02 Assistance Unit (AU).  

If the Foster Care Placement has ended, the D-track medical closes with Reason Code 166 - No Longer in Foster Care

If the child returns to a household that has an active ACES AU, the head of household reports this change. See EAZ Manual - WAC 388-418-0005 How will I know what changes to report?

When notified that the child has returned to the household, the Community Services Office (CSO) user adds the child back to the active AU(s) according to the eligibility requirements for the program(s). See EAZ Manual - WAC 388-418-0020 How does the department determine the date a change affects my cash and Basic Food benefits?

For instructions on adding a child to an active AU, see Add a Person.

Online Processing

NOTE:  Only FCMT staff can screen D01, D02 and D26 cases.

How do I screen FC/AS/JRA/SSI CN (D01)/FC/AS/JR Medical (D02)/Washington Apple Health Post-Foster Care Coverage (D26) medical?

To screen a D01, D02 or D26 AU, take the following steps:

  1. From the Welcome Back page in aces.online, click the Screen New Application link at the top of the page. The Applicant page displays in a new window.
  2. On the Applicant page, using the child as the Head-of-Household (HOH), enter the HOH's [Name], [Residential], and [Mailing Addresses].
  3. If the child is in a Child Placing Agency foster or adoptive home, click the checkbox next to AREP/Payee so the Child Placing Agency and the foster parent(s) can both be entered as authorized representatives.
  • Child Placing Agencies are licensed organizations allowed to recruit, train, and license foster homes; recruit and train adoptive parents; place children, including children referred by the department, for foster care or adoption. Both the Agency and the foster parents may need to obtain medical services for the same child during the same month.
  1. To add the authorized representatives, see How do I add an authorized representative (AREP) during screening?
  • Use AREP type Foster Care Agency (FC)  for the Child Placing Agency and type Other-Receives Letters, ER, Warrants/EFT, and Medical Services Card (NA) for the foster parents.
  1. Continue with the screening process until you reach the Programs page.
  1. On the Programs page, click the checkbox next to Foster Care/Adoption Support.
NOTE:  If you are not in the Foster Care Medical Team (FCMT), this option is grayed-out and cannot be checked.
  1. Complete the screening process. See Screening an Application.
  1. On the Finalize page, aces.online defaults to the D01 coverage group. If the child does not receive SSI benefits, the program trickles to D02 when the AU is processed and finalized.
  • For D26 coverage, click the Specify Program button.
  • The Medical Coverage Group: field defaults to Washington Apple Health Post-Foster Care Coverage (D26).
  • Click Next to select this program and return to the Finalize page.

How do I process a pending FC/AS/JRA CN SSI (D01)/FC/AS/JR Medical (D02)/Washington Apple Health Post-Foster Care Coverage (D26) AU?

To process a D01, D02 or D26 AU, take the following steps:

  1. From the Commit Status page when screening has been completed, click on Interview
  2. On the Pending Application page, check the Begin Intake Box
  3. On the Client page, update the following fields:
  • Living arrangement code using the drop down list.​
    • Foster Care Non-Title IV-E (FC)
    • Foster Care Title IV-E (FE)
    • Adoption Support Non IV-E (AD)
    • Adoption Support IV-E (AE)
    • Juvenile Rehabilitation (JR)
  • Placement code using the drop down list
    • Only placement code Foster Care Expansion (E) is valid for D26 medical. 
  • Temporary Placement End date (if appropriate)
  • Placement Begin date 
  1. On the Programs page, click the checkbox next to Foster Care/Adoption Support.
NOTE:  If you are not in the Foster Care Medical Team (FCMT), this option will be grayed-out and cannot be checked.
  1. If the child receives SSI benefits, add unearned income type SI – SSI Benefits.  
NOTE: Only FCMT staff and Juvenile Rehabilitation Administration (JRA) case managers should use Foster Care related living arrangement codes.
 
  1. Complete the interview following the instructions in the Interview chapter.  
  2. From the Case Actions Page, Process the current/historical months if the client's data is different in those month.  
  3. From the Case Actions Page, click on Finalize to finalize the application. 

When does a D-Track medical AU trickle/spawn/close?

A D02 medical trickles to D26 the month following the child’s 18th birthday when the placement code is auto-changed to Foster Care Expansion (E) or when the placement code is one following:

  • Foster Care Placement (F)
  • Relative Placement (R)
  • Tribal Foster Care Placement (T)
  • Interstate Compact on Placement of Children (ICPC) (P)

When D02 trickles to D26:

  • During the automated batch process, any Authorized Representatives (AREP) is removed.  
  • As a result of worker actions, the worker determines if the AREP should be retained or deleted.
  • The Address Confidentiality security function is removed making the client address viewable for users with read-only access.

A D02 medical spawns to D01 medical if  SSI is approved for Foster Care clients under age 18 who are eligible for SSI.

A D26 medical spawns to D02 in the ongoing month, through the month a client turns age 21, when the Placement Code Foster Care Expansion - E is changed to one of the following codes:

  • Adoption Support Client in Relative Placement (A)
  • DDD Client in Relative Placement (D)
  • Foster Care Higher Education (H)
  • Juvenile Rehabilitation Placement (J)
  • Interstate Compact on Placement of Adoption & Medical Assistance (ICAMA) Placement (M)
  • Special Immigration Juvenile Status in Foster Care (S)
  • Unaccompanied Minor Program (U)
  • Voluntary Placement Program (V)

ACES automatically terminates D26 Assistance Units (AUs) at the end of the month the child turns age 26 with Reason Code 220 – Failed Age Requirement.

When Foster Care Placement has ended, the D-track medical is closed with Reason Code 166 - No Longer in Foster Care

Mainframe Processing

How do I process a pending FC/AS/JRA CN SSI (D01)/FC/AS/JR Medical (D02)/Washington Apple Health Post-Foster Care Coverage (D26) AU? 

To process a D01, D02 or D26 AU, take the following steps:

NOTE:  Only Foster Care Medical Team (FCMT) staff can screen D01, D02 and D26 cases.
  1. From AMEN, access the pending Assistance Unit (AU) via Option O – Interview.
  2. On the STAT screen, enter [PN] - Applicant in the Finl Resp field for the applicant.
  3. On the DEM1 screen:
  • Living Arrangement field, enter the appropriate code:
    • [FC] - Foster Care Non-Title IV-E
    • [FE] - Foster Care Title IV-E
    • [AD] - Adoption Support Non IV-E
    • [AE] - Adoption Support IV-E
    • [JR] - Juvenile Rehabilitation
NOTE: Only FCMT staff and Juvenile Rehabilitation Administration (JRA) case managers should use Foster Care related living arrangement codes.
  1. If the child receives SSI benefits, code income type [SI] – SSI Payment, the claim number, and the monthly income amount on the UNER screen.
  2. Complete the interview following the instructions in the Interview chapter.
  3. After committing the interview data, follow the instructions in the Process Application Month chapter for all pending months.
  4. Finalize the pending AU following the instructions in the Finalize Application chapter.

When does a D-Track medical AU trickle/spawn/close?

A D02 medical trickles to D26 the month following the child’s 18th birthday when the placement code is auto-changed to E - Foster Care Expansion or when the placement code is one following:

  • F – Foster Care Placement
  • R – Relative Placement
  • T – Tribal Foster Care Placement
  • P – Interstate Compact on Placement of Children (ICPC)

When D02 trickles to D26:

  • During the automated batch process, any Authorized Representatives (AREP) is removed.  
  • As a result of worker actions, the worker determines if the AREP should be retained or deleted.
  • The Address Confidentiality security function is removed making the client address viewable for users with read-only access.

A D02 medical spawns to D01 if  SSI is approved for Foster Care clients under age 18 who are eligible for SSI.

A D26 medical spawns to D02 in the ongoing month, through the month a client turns age 21, when the Placement Code E - Foster Care Expansion is changed in ACES 3G to one of the following codes:

  • A- Adoption Support Client in Relative Placement
  • D - DDD Client in Relative Placement
  • H - Foster Care Higher Education
  • J- Juvenile Rehabilitation Placement
  • M - Interstate Compact on Placement of Adoption & Medical Assistance (ICAMA) Placement
  • S - Special Immigration Juvenile Status in Foster Care
  • U - Unaccompanied Minor Program
  • V - Voluntary Placement Program

ACES automatically terminates D26 Assistance Units (AUs) at the end of the month the child turns age 26 with Reason Code 220 – Failed Age Requirement.

When Foster Care Placement has ended, the D-track medical is closed with Reason Code 166 - No Longer in Foster Care

 

See ACES Screens and Online Pages for an example of pages or screens used in this chapter.