N.J. Admin. Code § 10:69-3.27 - Release from a State institution
(a) A parent or
parent-person who is about to be released from an institutional facility
(medical, mental, or correctional) may apply for AFDC -C related
Medicaid .
(b) When eligibility has
been established, benefits can begin upon release from the institution,
providing the parent and child will be living together within 30 days of the
date of issuance except in circumstances identified in (b)1 below. This
application may be registered and processed up to two months before anticipated
date of release.
1. When an applicant parent
is being released from an institution for the mentally ill or intellectually
disabled, or a correctional facility, no Health Benefits Identification (HBID)
Card or HBID Emergency Services Letter shall be issued until the actual
release, discharge, or parole is a matter of record and verified by the CWA,
and the applicant is not adjudged or alleged to be mentally
incompetent.
(c) A
parent or parent-person separated from a dependent child for a period no more
than 30 days prior to application, who wishes to maintain an already
established home for that child with whom such parent or parent-person
customarily resides, may apply for and receive a Health Benefits Identification
(HBID) Card or HBID Emergency Services Letter for the child(ren) temporarily
absent from the home. In this case, such parent or parent-person must indicate
plans to return to the home within two months from the month in which the HBID
Card or HBID Emergency Services Letter is initially issued (see
N.J.A.C.
10:69-3.28 through 3.30).
(d) In the case of the return to the home of
a beneficiary family by a parent, parent-person , or spouse in AFDC -C or child
of eligible age in any segment, no application for Medicaid is involved.
1. If the individual will return to a home or
plans to establish a home with a dependent child in the county receiving the
inquiry and appears eligible for Medicaid , the CWA of that county shall
register the application, assist in completion of the plan as necessary,
complete the determination of eligibility and be responsible for issuance of
the Health Benefits Identification (HBID) Card or HBID Emergency Services
Letter (see
N.J.A.C.
10:69-3.24).
2. If the individual is to return to a home
or desires to establish a home with a dependent child in another county, the
CWA receiving the inquiry shall complete an application interview and assist
the individual to complete an application form. All information that the
applicant can supply shall be obtained and recorded on appropriate case record
forms, which shall be forwarded to the county where the family currently
resides or is planning to establish a home. The county receiving the
application shall process and register the application without delay.
(e) Responsibility for initial
planning for the return of a patient to the community rests with the
institutional authorities. When AFDC-related Medicaid is necessary and the
person appears eligible, the Division of Mental Health and Addiction Services
shall coordinate the application with the appropriate CWA. The Division of
Mental Health and Addiction Services shall be responsible for reviewing such
referrals to assure that all essential information is assembled, and for
expediting the processing of an application by the appropriate CWA for final
determination of eligibility.
1. The
institution shall routinely complete the following forms without change, a
stock supply of which shall be provided to them by the DMAHS , and shall forward
copies to the CWA along with copies of staff notes pertinent to each case:
i. Form PA-12, Referral by State Mental
Institution to AFDC-related Medicaid Agency; and
ii. Form DRS-8, Report of Findings by
Psychiatric Diagnostic Group, where appropriate.
2. Persons under the jurisdiction of Division
of Developmental Disabilities, Bureau of Field Services, shall be referred
directly to the appropriate CWA.
(f) When a parent is about to be released
from a veteran's hospital, the hospital shall make referral in writing, with
the knowledge and consent of the veteran, to include the following minimum
information: identifying data, the anticipated date of discharge, and a
description of any known or tentative living arrangement following discharge.
1. In addition, the hospital shall complete,
without charge, the following forms as appropriate;
i. DRS-8, Report of Findings by Diagnostic
Group;
ii. Abstract of patient's
hospital record, or in absence of abstract;
iii. DRS-1, Examining Physician's Report;
and
iv. DRS-1A, Report of Eye
Examination.
2.
Thereafter, the CWA shall arrange for an application interview and shall
process the application as any other.
(g) The social service staff of the
institution shall assist in completing the application in accordance with
N.J.A.C. 10:69-2.
1. The social service worker
is responsible for prompt investigation to determine initial eligibility,
including inquiry regarding any funds held by the institution or other party in
a personal account for the applicant . The social service worker shall discuss
available services including assistance in locating a suitable living
arrangement with the applicant . The social service worker shall not send the
completed referral forms to the designated CWA.
(h) The CWA shall register cases transferred
from Division of Mental Health and Addiction Services within one working day.
The CWA shall determine initial eligibility within 30 days and so inform in
writing the social service worker that will coordinate discharge of the
client .
(i) A child of eligible age
or a spouse of an AFDC -C beneficiary parent who is at home on extended visit or
convalescent leave from a State institution is eligible for inclusion in the
AFDC -C or-F eligible unit , as appropriate.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.