OAR 413-100-0435: Title XIX Medicaid Eligibility for a Child or Young Adult Receiving Adoption Assistance or Guardianship Assistance

(1) The Child Welfare Post Adoption Program will determine and maintain Child Welfare Title XIX Medicaid eligibility for the following children and young adults: (a) A child or young adult who has exited Department custody as the result of a finalized adoption, and the child or young adult is the subject of an effective adoption assistance agreement administered by the Department. Prior to the adoption finalization the child or young adult receives medical coverage as described in OAR 413-100-0430. (b) A child or young adult who is determined eligible for guardianship assistance and is the subject of an effective guardianship assistance agreement administered by the Department. (c) A child or young adult who is the subject of an adoption that does not require the Department’s consent and is the subject of an effective adoption assistance agreement administered by the Department. (2) Before a child or young adult described in section (1) of this rule may receive a medical card providing Child Welfare Title XIX Medicaid services, the Child Welfare Post Adoption Program must determine the eligibility of the child or young adult for Child Welfare Title XIX Medicaid. (3) The requirements listed in OAR 413-100-0430(3) also apply to children and young adults described in section (1) of this rule. (4) A child or young adult described in section (1) of this rule who is the subject of a guardianship assistance agreement where Title IV-E funded payments are being made to the guardian is eligible for Child Welfare Title XIX Medicaid. (5) A child or young adult described in section (1) of this rule who is the subject of an adoption assistance agreement where the pre-adoptive parent or adoptive parent is eligible to receive a Title IV-E funded payment is eligible for Child Welfare Title XIX Medicaid. (6) A child or young adult described in section (1) of this rule who is the subject of an adoption assistance agreement or guardianship assistance agreement, where the child or young adult was eligible for Child Welfare Title XIX Medicaid while in substitute care but ineligible for Title IV-E foster care, will be determined eligible and provided Child Welfare Title XIX Medicaid. (7) A child or young adult described in section (1) of this rule determined ineligible to receive Child Welfare Title XIX Medicaid will be provided General Assistance medical when: (a) The child or young adult resides in Oregon; or (b) The child or young adult resides outside of Oregon but in the United States or a territory or possession thereof and is not able to receive medical assistance through the state of residence. (8) Annual redeterminations are not required for children and young adults under a finalized adoption assistance agreement or guardianship assistance agreement.