2801 Assistance To Children In Placement Overview

Georgia State Seal

Georgia Division of Family and Children Services
Medicaid Policy Manual

Policy Title:

Assistance To Children In Placement Overview

Effective Date:

November 2020

Chapter:

2800

Policy Number:

2801

Previous Policy Number(s):

MT 45

Updated or Reviewed in MT:

MT-62

Requirements

The Assistance to Children in Placement Chapter contains policy on Medicaid Classes of Assistance (COA) and procedures associated with children who are under the legal care and supervision of the state Child Welfare Agency and children that are eligible for Adoption Assistance.

Basic Considerations

Funding for Georgia’s Foster Care and Adoption Assistance Programs is available from federal and state sources including Title IV-E, Title IV-B, state funds, Supplemental Security Income (SSI), and Medicaid.

All funding, reimbursability and Medicaid eligibility determinations for foster or adoption assistance children are the responsibility of Revenue Maximization Specialists (RMS) based on information provided by county Social Service Case Mangers (SSCM) through SHINES data entry and submitted to Revenue Maximization staff. Coordination between Social Services and Revenue Maximization is critical to the funding determination and Medicaid coverage for children in placement.

Children who are in an out-of-home placement may be eligible for Medicaid coverage under several Classes of Assistance. These include the following:

  • Foster Care under the age of 18

  • Foster Care ages 18-21

  • Adoption Assistance under age of 18

  • Adoption Assistance ages 18-21 DJJ commitment under age of 19

  • SSI

  • Medically Needy

  • Emergency Medical Assistance (EMA).

Children who are Title IV-E or SSI eligible are automatically eligible for Medicaid.

Youth and Young adults that were previously in foster care may be eligible for Chafee and Former Foster Care Medicaid if considered in foster care the month of their 18th birthday.

The state receives reimbursement for administrative costs based on the total number of children eligible for Title IV-E. In order for a state to receive federal reimbursement for the foster care maintenance costs of an individual child in care, the child must meet both eligibility and reimbursability criteria. Initial eligibility is determined once, while reimbursability may change on a monthly basis depending on the placement, the child’s income and other factors.

The Social Services Case Manager is responsible for the following:

  • Gathers and enters child and family data to the SHINES child welfare system and refers all children entering out-of-home care to Revenue Maximization for funding and Medicaid eligibility determinations regardless of length of stay;

  • Reviews court orders for the required judicial determinations and provides copies of the petition for custody, the initial order placing the child in foster care, the “contrary to the welfare” order, the “reasonable efforts” order, all custody extension orders, TPR orders, all permanency plan language orders, and any other documents of the court pertaining to the child to the Revenue Maximization RMS through SHINES External Documentation;

  • Provides notification of placement and other eligibility factors to the RMS;

  • Initiates action with the Social Security Administration for children receiving SSI;

  • Provides requested information and documentation to the RMS for redeterminations.

The Revenue Maximization Specialist is responsible for the following:

  • Determines initial eligibility Medicaid and reviews, corrects, verifies, documents and validates the SHINES derived funding determination;

  • Notifies the SSCM of child and family data clarification required for the initial determination;

  • Refers the absent parent(s) to the Division of Child Support Services when appropriate. Refer to 2851 Child Support Referrals for exception criteria;

  • Completes six-month IV-E funding reimbursability validation.

  • Completes annual Medicaid renewal process in Gateway system.

Children in Joint Custody with DJJ

Situations will occur when DFCS and DJJ share custody of a child. In situations of joint custody, the agency responsible for the placement of the child is responsible for the initial IV-E determination and any subsequent reviews. The Revenue Maximization DJJ Unit has responsibility for children and youth in joint DJJ and DFCS custody where DJJ has placement responsibility.