470-1 INELIGIBLE INSTITUTIONS

470-1 INELIGIBLE INSTITUTIONS

470-1 A. INELIGIBLE INSTITUTIONS

Recipients must live outside of certain institutional settings to qualify for APA benefits. An individual is not eligible for APA during any full calendar month during which he or she lives throughout the month in:

An Alaska Pioneers' Home;

A prison or jail;

A public or private institution for mental disease, such as the Alaska Psychiatric Institute ( API ); or

Any other public institution, except a long term nursing care facility or a hospital.

Note: Alcohol and substance abuse treatment centers are not ineligible institutions for APA and IA purposes. Residents may receive regular APA or IA benefits while undergoing treatment.

Exception: Incarcerated adults who have been admitted to a hospital for more than 24 hours may be eligible for Medicaid for only the hospital stay. The hospital will assist the incarcerated individual with completing an application if they are not already receiving Medicaid. All of the eligibility requirements for Medicaid must still be met to receive this coverage. If an incarcerated individual no longer falls into an eligible Medicaid category, his or her case will be closed or denied. Adverse action is not needed to close Medicaid for an incarcerated individual. When it has been reported that an applicant or recipient is incarcerated, the Medicaid Subtype must be changed to 'incarcerated.' The Medicaid case will close at the end of the certification period unless it has been reported that the individual is no longer incarcerated.

470-1 B. COMMUNITY RESIDENTIAL CENTERS (HALFWAY HOUSES)

APA eligibility may be available to an individual who is living in a Community Residential Center (aka halfway house) ( CRC ) if they have the freedom of movement at the CRC . Community Residential Centers reserve a small number of beds for individuals on probation or parole that may be ordered to live in a structured environment as a condition of their supervision.

Individuals are considered to have freedom of movement if all three of the following criteria are met:

The individual can work outside the CRC in employment available to individuals who are not under justice system supervision; and

The individual can use community resources such as libraries, grocery stores, recreation, education, etc. at will; and

The individual can seek health care treatment in the broader community to the same or similar extent as other Medicaid recipients.

An incarcerated individual living at a CRC may or may not have freedom of movement. Do not attempt to verify freedom of movement by calling the CRC directly. The CRC 's are not staffed by Department of Corrections ( DOC ) employees and only DOC can verify if the inmate is confined or has freedom of movement (furlough placement).

If an individual applies for APA benefits and the application shows a CRC address, the Eligibility Technician must send an email to doc.idodocs@alaska.gov in order to verify if the individual is confined or on a furlough placement. When sending the email to DOC , the subject line should state CRC Verification for APA /Medicaid and the body of the email must include the individual's name and date of birth. See ADLTC Addendum 6 for CRC 's addresses.