MEMORANDUM
TEXAS DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES
TO:
CPS Regional Directors
CPS Program Administrators
CPS Program Directors
FROM:
Audrey Deckinga
Assistant Commissioner for CPS
SUBJECT: Former Foster Care Children ProgramMedicaid Healthcare Coverage for Former
Foster Youth Ages 18 through 25
DATE:
November 18, 2013
PSA 14-028
The Patient Protection and Affordable Care Act (commonly called the Affordable
Care Act) was enacted into law on March 23, 2010. Effective January 1, 2014, the
Affordable Care Act requires states to provide Medicaid coverage to individuals
under age 26 who were in foster care and receiving Medicaid when they aged out
of foster care.
Currently, the Health and Human Services Commission (HHSC) provides Medicaid
coverage under the Medicaid for Transitioning Foster Care Youth program to
individuals who age out of foster care, who are under the age of 21, and who meet
certain income/resource requirements. In addition, HHSC provides state medical
coverage for young adults formerly in Texas foster care and enrolled in higher
education through the Former Foster Care in Higher Education program up to their
23rd birthday.
Below is a detailed description of each program, how it will be administered and
upcoming program changes beginning January 1, 2014.
Former Foster Care Children Program
Effective January 1, 2014, the Former Foster Care Children program will provide
healthcare coverage through age 25 to young adults who age out of Texas foster
care and who were receiving Medicaid when they aged out of care. This
population will receive services in two separate programs based on age:
 Young adults aged 18 through 20 will be enrolled in STAR Health but can
switch to STAR; and
 Young adults aged 21 through 25 will receive Medicaid through the STAR
plan of their choice through the end of the month of their 26th birthday.
AN EQUAL OPPORTUNITY EMPLOYER
PSA 14-028/Former Foster Care Children Program-Medicaid Healthcare Coverage
for Former Foster Youth Ages 18 through 25
November 18, 2013
Page 2
Detailed information about healthcare coverage for STAR Health and STAR
member programs are available at:
STAR Health - http://www.hhs.state.tx.us/medicaid/STARHealthBenefits.pdf
STAR - http://www.hhsc.state.tx.us/medicaid/mc/ClientInformation.shtml#1
Former Foster Care Children Program Eligibility
To be eligible for this program, the young adult must:
 Be age 18 through 25;
 Have been in Texas foster care on his or her 18th birthday or older;
 Be receiving Medicaid when he or she aged out of Texas foster care; and
 Be a US citizen or have a qualified alien status, such as a green card.
There are no income, asset, or educational requirements to qualify for the Former
Foster Care Children program.
Young adults who move out of Texas cannot receive healthcare coverage from the
Former Foster Care Children program. These individuals will need to check with
the state they move to for other types of healthcare coverage. Young adults who
aged out of foster care from another state are also not eligible for the Former
Foster Care Children in Texas.
Medicaid for Transitioning Foster Care Youth Program
Medicaid for Transitioning Foster Care Youth will continue to be available for
former foster youth who are under the age of 21 and who are not eligible for the
Former Foster Care Children program because they were not receiving Medicaid
at the time they aged out of care. Those on Medicaid for Transitioning Foster Care
Youth will receive STAR Health.
To be eligible for the Medicaid for Transitioning Foster Care Youth, the young adult
must:
 Be age 18 through 20;
 Have been in Texas foster care on his or her 18th birthday or older;
 Not have other health coverage;
 Meet program rules for income; and
 Be a US citizen or have a qualified alien status, such as a green card.
With the implementation of the Affordable Care Act there are two policy changes to
the Medicaid for Transitioning Foster Care Youth program.
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PSA 14-028/Former Foster Care Children Program-Medicaid Healthcare Coverage
for Former Foster Youth Ages 18 through 25
November 18, 2013
Page 3


Young adults who age out of foster care from a state other than Texas are
no longer eligible for Medicaid for Transitioning Foster Care Youth. Those
currently receiving Medicaid for Transitioning Foster Care Youth who aged
out of foster care from another state will continue to receive Medicaid for
Transitioning Foster Care Youth until their 21st birthday or no longer meet
the eligibility requirements, whichever occurs first.
There no longer is an asset test when determining eligibility for Medicaid
for Transitioning Foster Care Youth.
Former Foster Care In Higher Education Program
Effective January 1, 2014, no new individuals will be certified for Former Foster
Care In Higher Education. Individuals receiving Former Foster Care Higher
Education as of December 2013 who are eligible for the Former Foster Care
Children program will automatically transition to the Former Foster Care Children
program January 1, 2014. Individuals currently receiving Former Foster Care In
Higher Education but not eligible for Former Foster Care Children will continue to
receive Former Foster Care In Higher Education until their 23rd birthday or until
they no longer meet the eligibility requirements, whichever comes first. Other
health care options may be available at www.Healthcare.gov.
In October 2013, HHSC started mailing enrollment packets for STAR Health and
STAR Member services to individuals eligible for the Former Foster Care Children
program and Medicaid for Transitioning Foster Care Youth explaining the
upcoming changes from the Affordable Care Act.
Staff Responsibilities
CPS Caseworkers, Preparation for Adult Living (PAL) staff and Youth Specialists
must review information outlined in Attachment A: Form 1014 and provide the
form to the youth or young adult during Circles of Support or Transition Plan
Meetings before leaving foster care, at the PAL Life Skills Training classes and
Aging-Out Seminars, and upon request. The form will be posted on the Texas
Youth Connection website, the DFPS Public website, and in SMILEY.
Questions about STAR Health or STAR Member Healthplans
If questions arise that are not covered in this PSA, CPS staff will inform the youth
or young adult to follow one of the steps outlined on Form 1014, such as:
 Calling one of the Helpful numbers;
 Calling 2-1-1; or
 Using the www.YourTexasBenefits.com website.
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PSA 14-028/Former Foster Care Children Program-Medicaid Healthcare Coverage
for Former Foster Youth Ages 18 through 25
November 18, 2013
Page 4
Note: 2-1-1 is only used to re-apply, update or report changes for the Medicaid for
Transitioning Foster Care Youth and Former Foster Care Children Programs, not
to re-enroll in STAR Health.
Contact HHSC State Support for Assistance with 2-1-1
If a young adult uses the 2-1-1 system but is not able to resolve Medicaid for
Transitioning Foster Care Youth or Former Foster Care Children program issues or
speak to a HHSC State Support staff, CPS staff (not the young adult) may use the
HHSC State Support staff e-mail address at cbs_ffche-mtfcy@hhsc.state.tx.us to
seek further assistance for the young adult.
Consent for 2-1-1 Help from a Third Party
If a young adult requests assistance from a third party (staff or other individual) to
discuss
their
case
with
a
2-1-1
operator,
Form
1826
http://www.dads.state.tx.us/forms/H1826/H1826.pdf must be signed. This form
gives consent to the 2-1-1 operator to discuss an individual’s case with another
party. The 2-1-1 operator will direct individuals on where to send this form.
Address Changes
Staff must emphasize to youth and young adults the importance of updating his or
her mailing address to avoid a loss of healthcare coverage. If there is a loss of
healthcare coverage the young adult must re-apply for one of the programs (see
below).
Exiting and Returning to Foster Care
If a youth or young adult exits paid foster care, returns to extended foster care, and
then leaves paid foster care again, the young adult must re-apply for one of the
programs (see below).
A young adult who leaves paid foster care at any time at 18 or older will be
automatically referred to HHSC to determine if he or she qualifies for either the
Medicaid for Transitioning Foster Care Youth or the Former Foster Care Children
program.
Assistance in Re-Enrolling in STAR Health
For young adults who are having difficulty re-enrolling in STAR Health, CPS staff
(not the young adult) send a secure email to the MAXIMUS Special Services Unit.
Staff
email
the
MAXIMUS
contact
person
Antoinette
Sanders,
antoinettesanders@maximus.com
and
copy
Peggy
Gulledge
peggygulledge@maximus.com.
The email must contain the client’s name,
Medicaid number and a telephone number for MAXIMUS to use when contacting
the young adult.
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PSA 14-028/Former Foster Care Children Program-Medicaid Healthcare Coverage
for Former Foster Youth Ages 18 through 25
November 18, 2013
Page 5
To Apply or Re-Apply for Medicaid for Transitioning Foster Care Youth and
Former Foster Care Children Programs:
Effective January 1, 2014, young adults may apply or re-apply for either Medicaid
for Transitioning Foster Care Youth or Former Foster Care Children programs by:
 Faxing or mailing (information on application):
o
Form H1010, Texas Works Application for Assistance, or
o
Form H1205, Texas Streamlined Application;
 Using the www.YourTexasBenefits.com; or
 Accessing www.HealthCare.gov (Marketplace); or
 Calling 2-1-1.
Note:
Form H1010 and Form
www.YourTexasBenefits.com website.
H1205
can
be
printed
from
the
On either the H1010 or the H1205, to be considered for the Former Foster Care
Children or Medicaid for Transitioning Foster Care Youth programs, the individual
must mark either of the following questions as “Yes:”
 Were you in foster care at age 18 or older?
 Were you in an approved Unaccompanied Refugee Minor’s
Resettlement program at age 18 or older?
If the applicant is not eligible for the Former Foster Care Children or Medicaid for
Transitioning Foster Care Youth programs he or she will be evaluated for other
Medicaid programs.
Attachment: Form 1014-Medicaid coverage and help with benefits for Texans ages
18 through 25 who were in foster care.
Actions:
CPS Caseworkers, PAL Staff and Youth
Specialists must review information outlined in
Form 1014 and provide the form to youth and
young adults during Circles of Support or
Transition Plan Meetings (before leaving care),
PAL Life Skills classes, in Aging out Seminars,
and upon request.
CPS Caseworkers, PAL Staff and Youth
Specialists should share information from this
PSA and Form 1014 with youth and young
adults, Transition Centers, PAL Contractors,
caregivers, and community partners.
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PSA 14-028/Former Foster Care Children Program-Medicaid Healthcare Coverage
for Former Foster Youth Ages 18 through 25
November 18, 2013
Page 6
State Office Contacts:
Shannon Ramsey, Transitional Living Services,
Team Lead at (512)-438-2350.
Gaye Vopat, Statewide PAL Program Specialist
at (512) 438-5442.
Tym Belseth, State Education and Training
Voucher/Youth Program Specialist at
(512) 438-3769.
Regional Well Being Specialists
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