Kan. Admin. Regs. § 129-6-60 - Public institutions
(a)
Definitions. For purposes of this regulation, each of the following terms shall
have the meaning specified in this subsection:
(1) "Institution" means an establishment that
furnishes food, shelter, and some form of treatment or services to four or more
persons who are unrelated to the proprietor.
(2) "Public institution" means any
institution that is the responsibility of a governmental unit or over which a
governmental unit exercises administrative control.
(b) Living arrangement. Each applicant or
recipient who lives in a public institution shall be ineligible for medical
assistance, unless the applicant or recipient meets one of the following
conditions:
(1) Lives in a state institution
and is under the age of 21 or at least aged 65;
(2) is blind or disabled, as defined by the
social security administration, and is living in a state institution that has
been approved as a medicaid intermediate care facility;
(3) is under the age of 21, under the age of
22 if receiving inpatient psychiatric care on the person's 21st birthday, or at
least aged 65 and is receiving inpatient care in either of the following:
(A) A state institution that has been
approved as a medicaid-accredited psychiatric hospital; or
(B) a nursing facility for mental health that
has been approved for medicaid coverage of inpatient services;
(4) is receiving inpatient care in
a psychiatric residential treatment facility, as defined in K.A.R. 28-4-1200,
and is under the age of 21 or, if receiving inpatient treatment on the person's
21st birthday, under the age of 22; or
(5) meets the provisions of subsection (c)
regarding persons who are residing in a jail or prison or under the care,
custody, and control of the criminal justice system.
(c) Residing in a correctional facility.
(1) For purposes of this subsection, an
inmate shall mean a person serving time for a criminal offense or confined
involuntarily in a state correctional facility. Inmates in other correctional
facilities, including county or city correctional facilities, shall not be
eligible under this paragraph. The following requirements shall apply:
(A) The inmate shall otherwise qualify for
medicaid and meet all general and financial eligibility criteria for the
appropriate medical program. No inmate shall be eligible for medical assistance
under K.A.R. 129-6-86.
(B) Each
inmate shall be covered for inpatient services received outside of the
correctional facility. No coverage shall be provided for outpatient care
outside of the correctional facility or for medical services provided on the
premises of the facility.
(C) For
budgeting purposes, each inmate shall be treated as a household of one, except
for pregnant women. Each pregnant woman shall be treated as a household of two
or more, based on the number of children the woman is expected to deliver.
Neither the income nor resources of the parent or the spouse of the inmate
shall be included in the eligibility determination.
(2) The following provisions shall apply to
each individual in a correctional facility:
(A) Except as noted in paragraph (c)(2)(B),
there shall be no eligibility for medicaid for each person who meets any of the
following conditions:
(i) Is physically
residing in a correctional facility;
(ii) is an accused person or convicted
criminal under the custody of the juvenile or adult criminal justice system. A
person may receive medical assistance if there is no indication of custody or
if the person has been pardoned or released on the person's own recognizance,
is on probation, parole, bail, or bond, or is participating in a prison
diversion program operated by a privately supported facility; or
(iii) is placed in a detention
facility.
(B) Any inmate
of a correctional facility administered by the department of corrections may be
eligible for medical assistance to cover inpatient hospital services.
Notes
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