PSA 14-028/Former Foster Care Children Program-Medicaid Healthcare Coverage for Former Foster Youth Ages 18 through 25
November 18, 2013
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MEMORANDUM
TEXAS DEPARTMENT OF FAMILY AND PROTECTIVE SERVICESTO: CPS Regional Directors
CPS Program Administrators
CPS Program Directors
FROM: Audrey Deckinga
Assistant Commissioner for CPS
SUBJECT: Former Foster Care Children Program-Medicaid Healthcare Coverage for Former Foster Youth Ages 18 through 25
DATE: November 18, 2013 PSA 14-028 /
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PSA 14-028/Former Foster Care Children Program-Medicaid Healthcare Coverage for Former Foster Youth Ages 18 through 25
November 18, 2013
Page 2
The Patient Protection and Affordable Care Act (commonly called the Affordable Care Act) was enacted into law on March 23, 2010. Effective January 1, 2014, the Affordable Care Act requires states to provide Medicaid coverage to individuals under age 26 who were in foster care and receiving Medicaid when they aged out of foster care.
Currently, the Health and Human Services Commission (HHSC) provides Medicaid coverage under the Medicaid for Transitioning Foster Care Youth program to individuals who age out of foster care, who are under the age of 21, and who meet certain income/resource requirements. In addition, HHSC provides state medical coverage for young adults formerly in Texas foster care and enrolled in higher education through the Former Foster Care in Higher Education program up to their 23rd birthday.
Below is a detailed description of each program, how it will be administered and upcoming program changes beginning January 1, 2014.
Former Foster Care Children Program
Effective January 1, 2014, the Former Foster Care Children program will provide healthcare coverage through age 25 to young adults who age out of Texas foster care and who were receiving Medicaid when they aged out of care. This population will receive services in two separate programs based on age:
· Young adults aged 18 through 20 will be enrolled in STAR Health but can switch to STAR; and
· Young adults aged 21 through 25 will receive Medicaid through the STAR plan of their choice through the end of the month of their 26th birthday.
Detailed information about healthcare coverage for STAR Health and STAR member programs are available at:
STAR Health - http://www.hhs.state.tx.us/medicaid/STARHealthBenefits.pdf
STAR - http://www.hhsc.state.tx.us/medicaid/mc/ClientInformation.shtml#1
Former Foster Care Children Program Eligibility
To be eligible for this program, the young adult must:
· Be age 18 through 25;
· Have been in Texas foster care on his or her 18th birthday or older;
· Be receiving Medicaid when he or she aged out of Texas foster care; and
· Be a US citizen or have a qualified alien status, such as a green card.
There are no income, asset, or educational requirements to qualify for the Former Foster Care Children program.
Young adults who move out of Texas cannot receive healthcare coverage from the Former Foster Care Children program. These individuals will need to check with the state they move to for other types of healthcare coverage. Young adults who aged out of foster care from another state are also not eligible for the Former Foster Care Children in Texas.
Medicaid for Transitioning Foster Care Youth Program
Medicaid for Transitioning Foster Care Youth will continue to be available for former foster youth who are under the age of 21 and who are not eligible for the Former Foster Care Children program because they were not receiving Medicaid at the time they aged out of care. Those on Medicaid for Transitioning Foster Care Youth will receive STAR Health.
To be eligible for the Medicaid for Transitioning Foster Care Youth, the young adult must:
· Be age 18 through 20;
· Have been in Texas foster care on his or her 18th birthday or older;
· Not have other health coverage;
· Meet program rules for income; and
· Be a US citizen or have a qualified alien status, such as a green card.
With the implementation of the Affordable Care Act there are two policy changes to the Medicaid for Transitioning Foster Care Youth program.
· Young adults who age out of foster care from a state other than Texas are no longer eligible for Medicaid for Transitioning Foster Care Youth. Those currently receiving Medicaid for Transitioning Foster Care Youth who aged out of foster care from another state will continue to receive Medicaid for Transitioning Foster Care Youth until their 21st birthday or no longer meet the eligibility requirements, whichever occurs first.
· There no longer is an asset test when determining eligibility for Medicaid for Transitioning Foster Care Youth.
Former Foster Care In Higher Education Program
Effective January 1, 2014, no new individuals will be certified for Former Foster Care In Higher Education. Individuals receiving Former Foster Care Higher Education as of December 2013 who are eligible for the Former Foster Care Children program will automatically transition to the Former Foster Care Children program January 1, 2014. Individuals currently receiving Former Foster Care In Higher Education but not eligible for Former Foster Care Children will continue to receive Former Foster Care In Higher Education until their 23rd birthday or until they no longer meet the eligibility requirements, whichever comes first. Other health care options may be available at www.Healthcare.gov.
In October 2013, HHSC started mailing enrollment packets for STAR Health and STAR Member services to individuals eligible for the Former Foster Care Children program and Medicaid for Transitioning Foster Care Youth explaining the upcoming changes from the Affordable Care Act.
Staff Responsibilities
CPS Caseworkers, Preparation for Adult Living (PAL) staff and Youth Specialists must review information outlined in Attachment A: Form 1014 and provide the form to the youth or young adult during Circles of Support or Transition Plan Meetings before leaving foster care, at the PAL Life Skills Training classes and Aging-Out Seminars, and upon request. The form will be posted on the Texas Youth Connection website, the DFPS Public website, and in SMILEY.
Questions about STAR Health or STAR Member Healthplans
If questions arise that are not covered in this PSA, CPS staff will inform the youth or young adult to follow one of the steps outlined on Form 1014, such as:
· Calling one of the Helpful numbers;
· Calling 2-1-1; or
· Using the www.YourTexasBenefits.com website.
Note: 2-1-1 is only used to re-apply, update or report changes for the Medicaid for Transitioning Foster Care Youth and Former Foster Care Children Programs, not to re-enroll in STAR Health.
Contact HHSC State Support for Assistance with 2-1-1
If a young adult uses the 2-1-1 system but is not able to resolve Medicaid for Transitioning Foster Care Youth or Former Foster Care Children program issues or speak to a HHSC State Support staff, CPS staff (not the young adult) may use the HHSC State Support staff e-mail address at to seek further assistance for the young adult.
Consent for 2-1-1 Help from a Third Party
If a young adult requests assistance from a third party (staff or other individual) to discuss their case with a 2-1-1 operator, Form 1826 http://www.dads.state.tx.us/forms/H1826/H1826.pdf must be signed. This form gives consent to the 2-1-1 operator to discuss an individual’s case with another party. The 2-1-1 operator will direct individuals on where to send this form.
Address Changes
Staff must emphasize to youth and young adults the importance of updating his or her mailing address to avoid a loss of healthcare coverage. If there is a loss of healthcare coverage the young adult must re-apply for one of the programs (see below).
Exiting and Returning to Foster Care
If a youth or young adult exits paid foster care, returns to extended foster care, and then leaves paid foster care again, the young adult must re-apply for one of the programs (see below).
A young adult who leaves paid foster care at any time at 18 or older will be automatically referred to HHSC to determine if he or she qualifies for either the Medicaid for Transitioning Foster Care Youth or the Former Foster Care Children program.
Assistance in Re-Enrolling in STAR Health
For young adults who are having difficulty re-enrolling in STAR Health, CPS staff (not the young adult) send a secure email to the MAXIMUS Special Services Unit. Staff email the MAXIMUS contact person Antoinette Sanders, and copy Peggy Gulledge . The email must contain the client’s name, Medicaid number and a telephone number for MAXIMUS to use when contacting the young adult.
To Apply or Re-Apply for Medicaid for Transitioning Foster Care Youth and Former Foster Care Children Programs:
Effective January 1, 2014, young adults may apply or re-apply for either Medicaid for Transitioning Foster Care Youth or Former Foster Care Children programs by:
· Faxing or mailing (information on application):
o Form H1010, Texas Works Application for Assistance, or
o Form H1205, Texas Streamlined Application;
· Using the www.YourTexasBenefits.com; or
· Accessing www.HealthCare.gov (Marketplace); or
· Calling 2-1-1.
Note: Form H1010 and Form H1205 can be printed from the www.YourTexasBenefits.com website.
On either the H1010 or the H1205, to be considered for the Former Foster Care Children or Medicaid for Transitioning Foster Care Youth programs, the individual must mark either of the following questions as “Yes:”
· Were you in foster care at age 18 or older?
· Were you in an approved Unaccompanied Refugee Minor’s Resettlement program at age 18 or older?
If the applicant is not eligible for the Former Foster Care Children or Medicaid for Transitioning Foster Care Youth programs he or she will be evaluated for other Medicaid programs.
Attachment: Form 1014-Medicaid coverage and help with benefits for Texans ages 18 through 25 who were in foster care.
Actions:
CPS Caseworkers, PAL Staff and Youth Specialists must review information outlined in Form 1014 and provide the form to youth and young adults during Circles of Support or Transition Plan Meetings (before leaving care), PAL Life Skills classes, in Aging out Seminars, and upon request.
CPS Caseworkers, PAL Staff and Youth Specialists should share information from this PSA and Form 1014 with youth and young adults, Transition Centers, PAL Contractors, caregivers, and community partners.
State Office Contacts:
Shannon Ramsey, Transitional Living Services, Team Lead at (512)-438-2350.
Gaye Vopat, Statewide PAL Program Specialist at (512) 438-5442.
Tym Belseth, State Education and Training Voucher/Youth Program Specialist at
(512) 438-3769.
Regional Well Being Specialists
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