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TITLE 16 HEALTH AND SAFETY DELAWARE ADMINISTRATIVE CODE 8 e) For any other institutionalized individual, the State of residence is the state where the individual is living and intends to reside. 17 DE Reg. 503 (11/01/13) 23 DE Reg. 303 (10/01/19) 14110.10 Specific Prohibitions for Denial or Termination of Eligibility 42 CFR 435.403(j); 42 CFR 435.956(c)(2) Per 42 CFR 435.956(c)(2), Evidence of immigration status may not be used to determine that an individual is not a State resident. A State cannot deny Medicaid eligibility to otherwise qualified resident of the State because: a) The individual's residence is not maintained permanently or at a fixed address. b) The individual has not resided in the State for a specific period of time; or c) An institutionalized individual did not establish residence in the community prior to admission to an institution. A State cannot terminate Medicaid eligibility for an otherwise qualified resident of the State due to temporary absence from the State if the person intends to return when the purpose of the absence has been accomplished, unless another State has determined that the person is a resident there for purposes of Medicaid. A State cannot wait to approve Medicaid eligibility in situations where the individual has moved to Delaware from another State and the Medicaid case is still open in the former State. The individual is no longer a resident of the former State and is ineligible in that State. The case may not be closed yet due to administrative processes. 17 DE Reg. 503 (11/01/13) 23 DE Reg. 303 (10/01/19) 14110.11 Exceptions to General Residency Rules When the following exists, it supersedes the general residency rules: a) When two or more States cannot resolve which State is the State of residence, the State in which the individual is physically located is the State of residence. 17 DE Reg. 503 (11/01/13) 23 DE Reg. 303 (10/01/19) 14120 Inmate of a Public Institution Statutory Authority Patient Protection and Affordable Care Act (ACA, P.L.111-148, as amended) Inmates of a public institution who are held involuntarily may be enrolled in Medicaid if otherwise eligible, but Medicaid may not provide coverage for most services while the individual is detained. The inmate may be eligible for Medicaid coverage of services as an inpatient in a medical institution if admitted to the medical institution for more than 24 hours. An inmate of a public institution is a person who is living in a public institution. A public institution is a facility that is under the responsibility of a governmental unit or over which a governmental unit exercises administrative control. This control can exist when a facility is actually an organizational part of a governmental unit or when a governmental unit exercises final administrative control, including ownership and control of the physical facilities and grounds used to house inmates. Administrative control can also exist when a governmental unit is responsible for the ongoing daily activities of a facility; for example, when facility staff members are government employees or when a government unit, board, or officer has final authority to hire and fire employees. Privately supported institutions that are not under the control of a governmental unit do not meet the definition of a public institution. An individual is an inmate and is not eligible when he or she is serving time for a criminal offense or is confined involuntarily awaiting trial, criminal proceedings, penal dispositions, or other involuntary detainment determinations and is living in: a. State or Federal prison b. jail