Page 23

All County Welfare Directors Letter No.: 20-10 Page 23 April 30, 2020

Institutionalized Child Example: Institutionalized Child (age 14) not claimed as a tax dependent.

Institutionalized Child’s Household Composition: 1) Does Institutionalized Child expect to file a federal tax return? No. 2) Does Institutionalized Child expect be claimed as a tax dependent by another tax filer? No. 3) Institutionalized Child qualifies for Non-Filer Rules: household consists of the following people living with the individual: individual’s parents (natural, adopted, or step), the individual’s siblings (natural, adopted, half or step) that are under age 19, or if a full time student under age 21; individual’s spouse, and individual’s children (natural, adopted, or step). (Institutionalized Child, no other household members) 4) Is anyone in the household composition pregnant? No. 5) No additional changes, end household composition determination here.

Medi-Cal Household Parent 1 Parent 2 Child Family Size Institutionalized Child Not Included Not Included Included 1

3) Joint Custody and Determining the Custodial Parent Per 42 C.F.R. Section 435.603 (f)(2)(iii)(B) in scenarios where both parents share joint custody of a child(ren), regardless of whether a formal custody agreement exists, AND one or both parents request Medi-Cal coverage for the child(ren), the CEW must determine which parent is considered the custodial parent for determining Medi-Cal eligibility (see 25 C.F.R. Section 700.51 for the definition of a custodial parent). In order to determine the custodial parent, the CEW must determine the primary caregiver of the child(ren). The primary caregiver is typically the parent with whom the child(ren) spends the most nights.

When both parents are applying separately for health coverage for the same child(ren) in the same year, the child(ren) shall have Medi-Cal eligibility determined based on which parent has primary care of the child(ren). However, when both parents apply separately for health coverage for the same child(ren) and both parents claim to have shared custody with the child(ren) and the child spends equal nights with each parent, then the child(ren) are in the household of the parent who first applied for Medi-Cal, including Medi-Cal through CalWORKs (see ACWDL 86-60 for more information).