HF4217

1. Purpose and Goals
2. The bill aims to strengthen support for youths aging out of foster care by extending health coverage and foster care support into early adulthood, clarifying who is covered and under what conditions, and expanding planning and transition services.

3. Key aims include extended medical assistance (MA) eligibility for former foster youth, extended foster care placement and supports up to age 21 (with options to reenter up to age 21), improved transition planning, and enhanced definitions to cover more scenarios for custody and guardianship.

4. Main Provisions (What the bill changes or adds)

5. Health care for former foster youth (MA/Medicaid)

   • Medical assistance may be paid for a person under 26 who was in foster care and under the state system during the age-18/19/20 period or who received foster care benefits past age 18.
   • Coverage also extends to youths who were in foster care and enrolled in another state’s Medicaid program under federal law.
   • The commissioner must seek federal waiver approval to include youths who aged out of foster care before January 1, 2023, even if they wouldn’t be eligible under the usual Medicaid rules.

6. Notice and eligibility to continue in foster care

   • Six months before a child’s 18th birthday, agencies must notify about the option to continue foster care up to age 21 when eligible under certain criteria.

7. Definitions

   • Adds a precise definition for “child in foster care,” including cases where permanent custody is transferred to a relative after age 10.

8. Independent Living Plan (ILP) and ongoing services

   • For youth aged 14 and older, agencies must develop and update an ILP with the youth and other parties.
   • For youths near or at 18, ILPs must address employment, education, and maturational needs and be submitted as part of court reviews; agencies must continue services to implement the ILP.

9. Eligibility to stay past age 18

   • A youth who was in foster care immediately before turning 18 may stay past 18 unless: they can safely return home; they are in certain disability-related placements; or they can be adopted or have permanent custody transferred to a relative before 18.

10. Expanded eligibility criteria to stay until age 21

    • To remain in or return to foster care through age 21, a youth must meet at least one of: completing secondary education or a credential program; enrollment in higher education or vocational training; participation in programs to promote employment; employment of at least 80 hours per month; or medical conditions that prevent the other activities.

11. Reentry and ongoing services after age 18

    • If a young adult who was under guardianship left foster care without adoption, agencies must develop a plan to increase safety and independence and can offer foster care if the plan includes it.
    • If a youth who was not under guardianship before 18 asks to reenter, the agency that planned before discharge must assess and provide foster care or related services to help meet eligibility criteria.
    • A formal voluntary placement agreement can be used when the plan includes foster care.
    • A youth who left foster care while under guardianship may reenter placement at any time before age 21.

12. Termination of foster care and appeals

    • If a youth ceases to meet 3a eligibility criteria (for staying in foster care), the agency must give a 30-day written notice of termination and inform about court review options.
    • The youth, guardian ad litem, or the court can review the agency’s decision; transition planning must accompany the termination notice; the agency is not responsible for payments after the youth leaves.

13. Scope and purpose for youth supports (new subsection)

    • Defines “youth” as someone 14 to 23 years old.
    • Outlines a broad set of supports in areas like education, employment, daily living skills (finance, driving), preventive health, connections with caring adults, age-appropriate activities, and financial/housing counseling.
    • Allows for case management and supportive services up to age 23, even though foster care placement generally ends at age 21.

14. Significant Changes to Existing Law

15. Extends medical assistance coverage for former foster youth up to age 26, including those who aged out or were in foster care under the state program.

16. Extends foster care eligibility and supports up to age 21, with a pathway to continue or reenter through age 21, and a framework for reentry.

17. Introduces systematic, mandatory independent living planning starting at age 14, with ongoing court-involved reviews and transition planning.

18. Establishes a broad, flexible “youth” support framework (age 14–23) to provide education, employment, life skills, and other services beyond traditional foster care placement.

19. Adds explicit reentry pathways, voluntary placement arrangements, and guardian/guardianship considerations to facilitate ongoing supports into early adulthood.

20. Creates the potential for federal waivers (42 U.S.C. 1315) to extend Medicaid eligibility historically beyond typical limits for those who aged out before 2023.

21. Implementation and Oversight Considerations

22. Requires federal waiver applications to include the targeted population (former foster youth who aged out before 2023) for continued health coverage.

23. Adds formal notice requirements (six months before 18th birthday) and court-involved reviews for termination decisions.

24. Introduces formal transition plans and “transition out of foster care” plans linked to eligibility criteria and future supports.

25. Sets up ongoing agency responsibilities for independent living planning and case management up to age 23, with the possibility of extended supports even after placement ends.

Relevant Terms - foster care, medical assistance (MA), extended foster care, adults who were in foster care at age 18/19/20, 26 years old, 21 years old, 18th birthday, six months notice, guardian ad litem, permanent custody, transfer of permanent legal and physical custody, relative, adoption, independent living plan (ILP), 260C.451, 260C.452, 260C.212, 42 U.S.C. 1315, waiver, Affordable Care Act (ACA) section 2004, Public Law 115-271, voluntary placement agreement, reentry into foster care, transition plan, vouchers for education and training, employment requirements, age-appropriate activities, case management, guardianship, termination notice.