18 Miss. Code. R. 6-1-E-IV
The medical expenses of all children in the custody of DFCS are paid, and the primary sources of funding are Medicaid and local/state funds.
Foster children are Medicaid eligible when the child:
* Receives SSI. The Medicaid benefits are authorized by the Social Security Administration.
* Is eligible for and receiving Medicaid in the home of a parent or unlicensed relative. The eligibility determination and authorization are handled by the Division of Medicaid office in the county of residence.
* Meets the following eligibility requirements:
The child must be in the sole custody of the DFCS. Children placed in joint custody of DFCS and another person(s) will have their Medicaid eligibility determined by the local county Medicaid Office. Application must be made by the joint custodian or the COR Worker if the joint custodian is not a licensed resource home.
The child's own resources cannot exceed $10,000. MACWIS automatically re-evaluates the child's resource limits for Medicaid eligibility every month. The Worker will make every effort to maintain the child's resources below $10,000.
Children who receive SSI Medicaid will not be affected by the $10,000 resource limit. However, SSI has a resource limit of $2,000 which will terminate SSI Medicaid and monetary benefits.
The child's monthly unearned income will be tested against the 185% AFDC need rate for one child which is $403. If the child's monthly unearned income exceeds $403, the child will be ineligible for Title IV-E Medicaid. The child's own unearned monthly income will then be tested against the State Foster Care Need Standard. The State Foster Care Need Standard is the set amount of money established by the State for the foster care of this child. The amount may vary depending on the age and circumstances of the child and the type of home or institution in which s/he is placed. MACWIS will test, on a monthly basis; the child's income against the board rate the child is eligible for based on the age of the child and the placement.
If the child's unearned income is below this rate, the child is eligible for CWS Medicaid.
A child in a licensed relative placement will have his/her Medicaid eligibility determined by testing his monthly unearned income against the regular board payment rate based on age for CWS Medicaid.
If the child's unearned income exceeds the amount of the board rate, the child is ineligible for Medicaid through the foster care system. The Worker will refer the relative/child's assigned worker) providing care, who may be eligible for Medicaid, to the Division of Medicaid office.
Medicaid Card. Children who are eligible for Medicaid will be issued a one-time plastic Medicaid card. The card will be mailed to the County of Responsibility (COR). In the event the child is placed outside his own county, the COR Worker will be responsible for obtaining the card (or) placement and moving the card with the child. A duplicate Medicaid card can be requested from the Electronic Data System (EDS) by the Worker, should the card be misplaced. When the child leaves custody, the Worker should retrieve the card from the placement and give the card to the child's custodian or to the child, if the child is age eighteen (18) or older and file a copy of the card in the child's case file.
Title IV-E foster children receiving Title IV-E adoption assistance and ICPC children who are Title IV-E eligible in the state of origin are eligible for Medicaid in the state in which they reside provided a) the Worker has written verification that the child is Title IV-E eligible in the state of responsibility and b) the child is in a licensed Resource Home/facility in Mississippi.
The Worker will be responsible for initiating Medicaid for ICPC/COBRA children provided the children have entered the state through ICPC. If the children are not known to ICPC at State Office, the Worker will direct the Resource Home/Facility to the county Economic Assistance office for application of Medicaid benefits.
DFCS is required to take all reasonable measures to determine the legal liabilities of a "third party" to pay for medical services. The Worker will report all Third Party Liabilities (TPL) to Eligibility either by documentation to the Eligibility Unit or by entering the information in MACWIS. The Worker will make direct inquiry to the parent(s) or guardian regarding whether the child has any type of private insurance coverage.
The Worker will be alert to any children coming into care who may qualify for federal funds under the Refugee Act of 1980 (see 45 CFR 400 ). The funds are available for an eight (8) month period beginning with the first month of entry into the United States. For unaccompanied refugee minor cases, funds are available as long as the child is in care. There are two broad categories of children who may qualify for refugee funding:
* Those entering the United States with their families.
* Those designated as "unaccompanied minors" on the 1-94 cards.
Since the plan for these children does not include "returning the child to the home", these children must be certified for Child Welfare System (CWS) funds and not Title IV-E . The children will also be eligible for Medicaid benefits. To be eligible for foster care refugee funds, one of the following conditions must be met:
* The child must have been removed from the home of a family receiving refugee financial and medical assistance and the child must have been included in the grant, or
* The child has appropriate refugee or alien status as established by the National Immigration Service (NIS) and the child has been in the United States less than eight months, or
* The child entered this country without a family and has received appropriate unaccompanied minor status by the NIS.
Payments for Title IV-E foster care end one month following child's eighteenth (18 th) birthday. Children who are not eligible for Title IV-E foster care payments will have their needs tested to determine eligibility for foster care payments to be made from Title IV-B , CWS, funds. The criteria for CWS eligibility are that the child:
* Must be in the custody of the DFCS and under twenty (20) years of age if the court order is by the youth court or under twenty-one (21) years of age if the order is by the chancery court.
* Must be placed in an approved Resource Home or child caring facility.
* Own unearned income must not be over the amount of the board payment for his/her age group.
* Cannot have resources which exceed $10,000.
If all of the above criteria are met, the child will be eligible for foster care payment to be made from CWS funds.
Use of "Local" Funds:
The child's own monthly income, if any, is considered "local" funds. The child's own income up to the amount of that child's board payment will be used and applied toward his board payment each month.
Documentation of the receipt of income for a child will be made in MACWIS and MACWIS will evaluate that information in relationship to eligibility and the amount to be applied to the monthly board rate.
18 Miss. Code. R. 6-1-E-IV