Library: Policy

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

Revised 3-1-24

        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:

the OKDHS child welfare specialist advises the family of available medical resources and refers the parent(s) to SoonerCare to apply for medical assistance. Application for children receiving Supplemental Security Income must be made in the local OKDHS office.

(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 enters the child's removal information into the Child Abuse and Neglect Information System (KIDS) Removal screen, which generates an assignment to the custody specialist for Title XIX medical benefits.  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 enters the child's removal information into the Child Abuse and Neglect Information System (KIDS) Removal screen, which generates an assignment to the OKDHS custody specialist.  This referral is made 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 advises the OKDHS custody specialist the change izn placement.  The OKDHS child welfare specialist advises the family of available medical resources and refers the parent(s) to SoonerCare to apply for medical assistance. Application for children receiving Supplemental Security Income must be made in the local OKDHS office.

(B) The child remains continuously eligible for the remainder of the certification period, as defined at OAC 317:35-1-2, pursuant to 42 U.S.C. 1396a(e)(12).

(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.

• (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 (.pdf, 5 pp, 689 KB), 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 (.pdf, 5 pp, 689 KB) to the family so the child's Medicaid eligibility can be redetermined.  If the family does not return the completed SC-1 (.pdf, 5 pp, 689 KB), 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.