Effective Date: June 1, 2025

Previous Policy

A. Definition

Non-medical institutions include jails, prisons, and community residence facilities. Other institutions may also be non-medical. CHIP policy differs for residents of public or private non-medical institutions.

B. Residents of Private Non-Medical Institutions

Residents of private non-medical institutions can receive CHIP if they meet all other factors of eligibility.

C. Residents of Public Non-Medical Institutions

A public non-medical institution is an institution that is the responsibility of a governmental unit or that is under the administrative control of a governmental unit. Residents of some public, non-medical institutions are not eligible for CHIP. Individuals living in the following institutions may be eligible for CHIP if all other factors or eligibility are met. See 604 for suspending benefits for incarcerated individuals. Residents of a public non-medical institution who are within 30 days of release may be eligible for pre-release services.

1. A community residence facility. An eligible community residence facility must meet the following requirements:

a. Designed for and actually serving 16 or fewer individuals;

b. Cannot be located on the grounds of or adjacent to an ineligible institution; and

c. Must operate primarily as a facility that provides other services the residents need. Such as:

o social services;

o help with personal living activities;

o training in socialization and life skills; or

o occasional or incidental medical or remedial care.

2. A halfway house. An eligible halfway house must meet following the requirements:

a. Residents of the facility must have freedom of movement and association as outlined according to the following tenets:

o Residents are not precluded from working outside the facility;

o Residents can use community facilities ‘at will’, such as libraries, grocery stores, recreation areas, or schools; and

o Residents can seek health care treatment in the community to the same extent as other CHIP enrollees in the state.

b. ‘At will’ includes Facility operational rules or “house rules”. For example, the facility may be locked or closed during certain hours of the day, residents may be required to report in during certain times, or sign in and out, etc.

3. Home Confinement, also known as “house arrest,” “ankle monitor,” or “electronic monitoring.” If the conditions of home confinement fit the definition of freedom of movement described in 2.a. and b., the individual is eligible for Medicaid.

4. A child already on CHIP and in jail, prison or in secure care with Juvenile Justice and Youth Services (JJYS)

a. If a child is in jail, prison or in secure care with JJYS and is within 30 days of release.