DAR File No. 39165

Health, Health Care Financing, Coverage and Reimbursement Policy

Section R414-303-8

Foster Care, Former Foster Care Youth and Independent Foster Care Adolescents

Notice of Proposed Rule

(Amendment)

DAR File No.: 39165
Filed: 03/04/2015 07:52:55 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this change is to clarify coverage under the Former Foster Care Youth coverage group and the Independent Foster Care Adolescents program.

Summary of the rule or change:

This amendment clarifies when individuals may become eligible for Former Foster Care Youth and the Independent Foster Care Adolescent program. It also makes other technical changes.

State statutory or constitutional authorization for this rule:

• Pub. L. No. 111-148
• Section 26-1-5
• Section 26-18-3

This rule or change incorporates by reference the following material:

• Adds Subsection 1902(a)(10)(A)(ii)(XVII) of the Compilation of Social Security Laws, published by Social Security Administration, 01/01/2015
• Updates Subsection 1902(a)(10)(A)(i)(IX) of the Compilation of Social Security Laws, published by Social Security Administration, 01/01/2015
• Updates 42 CFR 435.115(e)(2), published by Government Printing Office, 10/01/2014

Anticipated cost or savings to:

the state budget:

There is no impact to the state budget because this amendment only clarifies when individuals may become eligible for Former Foster Care Youth and the Independent Foster Care Adolescent program.

local governments:

There is no impact to local governments because they do not fund or provide Medicaid services to Medicaid recipients.

small businesses:

There is no impact to small businesses because this amendment only clarifies when individuals may become eligible for Former Foster Care Youth and the Independent Foster Care Adolescent program.

persons other than small businesses, businesses, or local governmental entities:

There is no impact to Medicaid providers and to Medicaid recipients because this amendment only clarifies when individuals may become eligible for Former Foster Care Youth and the Independent Foster Care Adolescent program.

Compliance costs for affected persons:

There are no compliance costs to a single Medicaid provider or to a Medicaid recipient because this amendment only clarifies when individuals may become eligible for Former Foster Care Youth and the Independent Foster Care Adolescent program.

Comments by the department head on the fiscal impact the rule may have on businesses:

There is no impact on business because the amendment neither expands nor reduces eligibility requirements for medical assistance recipients or Medicaid providers.

David Patton, PhD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Health Care Financing, Coverage and Reimbursement Policy
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Craig Devashrayee at the above address, by phone at 801-538-6641, by FAX at 801-538-6099, or by Internet E-mail at [email protected]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

05/01/2015

This rule may become effective on:

05/08/2015

Authorized by:

David Patton, Executive Director

R414. Health, Health Care Financing, Coverage and Reimbursement Policy.

R414-303. Coverage Groups.

R414-303-8. Foster Care, Former Foster Care Youth and Independent Foster Care Adolescents.

(1) The Department adopts and incorporates by reference 42 CFR 435.115(e)(2), October 1, 201[2]4 ed.[, and] The Department also adopts and incorporates by reference Subsection 1902(a)(10)(A)(i)(IX) and Subsection 1902(a)(10)(A)(ii)(XVII) of the Social Security Act, effective January 1, 201[3]5.

(2) Eligibility for foster children who meet the definition of a dependent child under the State Plan for Aid to Families with Dependent Children in effect on July 16, 1996, is not governed by this rule. The Department of Human Services determines eligibility for foster care Medicaid.

(3) The Department covers individuals who [age out of foster care]are under the responsibility of the State and meet the criteria of Subsection 1902(a)(10)(A)(i)(IX) of the Social Security Act. Former Foster Care Youth is the name of this coverage group.[This coverage is called the Former Foster Care Youth. These individuals must be enrolled in Utah Medicaid at the time they age out of foster care.]

(a) Coverage is available through the month in which the individual turns 26 years of age.

(b) There is no income or asset test for eligibility under this group.

(4) The Department elects to cover individuals who [age out of]are in foster care under the responsibility of the State at the time the individual turns 18 years of age, are not eligible under the Former Foster Care Youth coverage group, and who are 18 years old but not yet 21 years old as described in Subsection 1902(a)(10)(A)(ii)(XVII) of the Social Security Act. This coverage is under the Independent Foster Care Adolescents program. The Department determines eligibility according to the following requirements.

(a) At the time the individual turns 18 years of age, the individual must be in the custody of the Division of Child and Family Services, or the Department of Human Services if the Division of Child and Family Services is the primary case manager, or a federally recognized Indian tribe, but not in the custody of the Division of Youth Corrections.

(b) Income and assets of the child are not counted to determine eligibility under the Independent Foster Care Adolescents program.

(c) When funds are available, an eligible independent foster care adolescent may receive Medicaid under this coverage group until he or she reaches 21 years of age, and through the end of that month.

 

KEY: MAGI-based, coverage groups, former foster care youth, presumptive eligibility

Date of Enactment or Last Substantive Amendment: [December 1, 2014]2015

Notice of Continuation: January 23, 2013

Authorizing, and Implemented or Interpreted Law: 26-18-3; 26-1-5