SECTION 317:35-7-16. Special application procedures for children in OKDHS custody

   The rules in this section apply when determining eligibility for health benefits for children who are reported by OKDHS as being in custody.

(1)   When a child placed in custody as reported by OKDHS remains in the parent's home and there is not an active medical case:

(A)   The OKDHS child welfare specialist advises the family that an application for medical services may be made at the local OKDHS office.

(B)   The OKDHS Family Support Services (FSS) worker is responsible for processing the SC-1, SoonerCare Health Benefits application or FSS-1, Comprehensive Application and Review, whichever is appropriate.

(2)   When a child placed in custody as reported by OKDHS has an active case and a change in placement is made to a home or facility outside the parent's home:

(A)   The OKDHS child welfare specialist completes Form CWS-KIDS-4, Eligibility Determination, and forwards it to the OKDHS custody specialist advising of this change, including the date the child was placed outside the home. This referral is made within five working days of the placement.

(B)   The OKDHS custody specialist makes the appropriate change to remove the child from the family case and opens a child only case the next effective date.

(3)   When a child in custody as reported by OKDHS is placed outside the home and there is not an active case, the OKDHS child welfare specialist is responsible for completing and forwarding the CWS-KIDS-4, Eligibility Determination, to the OKDHS custody specialist. The CWS-KIDS-4 must be sent within five working days of removal from the home. The date of application is the date the child is placed in custody. The OKDHS custody specialist is responsible for processing the application.

(4)   When a child in custody as reported by OKDHS placed outside the home is later returned to the home but remains in custody:

(A)   The OKDHS child welfare specialist forwards Form K-13 to the OKDHS custody specialist advising of the change in placement. The OKDHS child welfare specialist advises the family that a Medicaid application may be made at the local OKDHS office for medical benefits to continue, if the family meets eligibility criteria.

(B)   The OKDHS custody specialist is responsible for sending a SC-1 to the family so the child's Medicaid eligibility can be redetermined. If the family does not return the completed SC-1, the OKDHS custody specialist closes the child's Medicaid case.

(5)   When a child in custody as reported by OKDHS and living in an out of home placement attains age 18, he/she may still be eligible for medical benefits until the age of 21 under the Foster Care Independence Act if his/her income is below the standard on OKDHS Appendix C-1, Schedule 1.A. The individual must complete a new application and have eligibility redetermined in accordance with OAC 317:35-6.

[Source: Added at 12 Ok Reg 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff 7-27-95; Amended at 23 Ok Reg 275, eff 9-1-05 (emergency); Amended at 23 Ok Reg 1387, eff 5-25-06]