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Aged, Blind and Disabled Manual Policy Manual Number: 125.005 Section: Institutional Medicaid Chapter: Institutional Status

November 3, 2025 Division of TennCare 6

b. Tennessee IMD

An individual may qualify for TennCare Medicaid benefits as an institutionalized individual when his patient or inmate status in one of the following public institutions is interrupted:

i. Memphis Mental Health Institute, Memphis; ii. Middle Tennessee Mental Health Institute, Nashville; iii. Western Mental Health Institute, Bolivar; or iv. Moccasin Bend Mental Health Institute, Chattanooga

These individuals must follow all procedures for filing an application for assistance and must meet all non-financial and financial requirements for TennCare Medicaid. As applications are processed for this group, refer to any individuals who might qualify for Supplemental Security Income (SSI) cash assistance to Social Security. Eligibility for SSI cash assistance includes TennCare Medicaid benefits.

The IMD representative will arrange for placement in a medical institution and will develop a plan with either the individual’s family or the medical facility to apply for TennCare Medicaid. Because of the individual’s former patient or inmate status, TennCare should be able to secure all necessary information from an IMD representative. If the IMD representative applies on behalf of the patient, she will act as the responsible person for the patient.

9. Children in Residential Treatment Centers

Children in residential treatment centers are not considered to be continuously confined for the purpose of determining institutional status.

When a child is ordered by Juvenile Court or by a treating physician to undergo a psychiatric evaluation or treatment for a sex offense, alcohol and drug abuse or some other type of residential treatment, the cost of care is the responsibility of the child’s family if the child remains in the custody of his parents or other caretaker relative.

a. Children not Currently Receiving TennCare Medicaid

If a child is placed in a residential treatment center and the family cannot afford to pay the cost of care, the family may apply for medical assistance. The child will be considered a member of the household whose absence from the home is temporary. This policy is applied to children who are in approved treatment centers, whether in state or out of state facilities.

Note: Residential treatment when medically necessary is a TennCare covered service for children.