Inmates of Public Institutions 510-05-35-95

(Revised 10/01 ML #2716)

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(N.D.A.C. Section 75-02-02.1-19)

1. For purposes of this section:

1. "Individual on conditional release" means an individual who is away from the institution, for trial placement in another setting or for other approved leave, but who is not discharged. An individual on "definite leave" from the state hospital is an individual on conditional release.
2. "Inmate of a public institution" means a person who has been sentenced, placed, committed, admitted, or otherwise required or allowed to live in the institution, and who has not subsequently been unconditionally released or discharged from the institution.
3. "Unconditionally released" means released, discharged, or otherwise allowed or required to leave the institution under circumstances where a return to the institution cannot be required by the operator of the institution.

Examples of public institutions include but are not limited to: State Hospital, School for the Blind, School for the Deaf, State Developmental Center at Grafton, Veterans Administration Hospitals, North Dakota Veteran’s Home, North Dakota Youth Correctional Center, North Dakota State Penitentiary, and city, county, or tribal jails.

2. An inmate of a public institution is not eligible for Medicaid unless:

1. The individual is attending school at the North Dakota School for the Blind in Grand Forks, or North Dakota School for the Deaf in Devils Lake;
2. The eligible individual is residing in the ICF/MR at the State Developmental Center, or is in long term care in the North Dakota Veteran’s Home;
3. The individual is in a public institution for a temporary period pending other arrangements appropriate to his needs (i.e., Juvenile Detention Center, Fargo);
4. The individual is over age sixty-five and a patient in the state hospital; or
5. The individual is under age twenty-one, in the state hospital receiving inpatient psychiatric services, and who meets the certificate of need for admission. A person who attains age twenty-one while receiving treatment, and who continues to receive treatment as an inpatient, may continue to be eligible through the month the individual attains the age of twenty-two.

3. Individuals who are committed under the penal system to a public institution are not eligible for Medicaid even though they may be receiving care in a medical facility. Inmate status at a penal facility (correctional) begins at the time of confinement.

Residence in the institution is terminated by parole, discharge, release on bond, or whenever the individual is allowed to return and reside in their home. A transfer from a penal facility to the state hospital or another facility, for evaluation or treatment does not terminate inmate status.

4. An individual on conditional release from the state hospital is not considered to be a patient in that institution. However, such an individual who is under age twenty-two and has been receiving inpatient psychiatric services is considered to be a patient in the institution until unconditionally released or, if earlier, the last day of the month in which the patient reaches age twenty-two.

5. The period of ineligibility under this section begins the day after the day of entry and ends the day before the day of discharge of the individual from such an institution.