SECTION 353.702. Member Participation

(a) Children and young adults in the following categories are eligible to participate in the STAR Health program:

(1) a child in the conservatorship of DFPS, if the state as conservator elects to place the child in the STAR Health program;

(2) a young adult, from 18 years of age through the month of his or her 22nd birthday, who voluntarily agrees to continue in foster care placement, if the state as conservator elects to place the child in the STAR Health program;

(3) a young adult, from 18 years of age through the month of his or her 21st birthday, who is an FFCC member or participating in the MTFCY Program; and

(4) a child or young adult, from birth through the month of his or her 21st birthday, who is enrolled in the Adoption Assistance Program or the Permanency Care Assistance Program and who:

(A) receives Supplemental Security Income (SSI);

(B) received SSI before becoming eligible for the Adoption Assistance Program or the Permanency Care Assistance Program;

(C) is enrolled in a Medicaid 1915(c) waiver; or

(D) is enrolled in Medicare.

(b) A young adult described in subsection (a)(2) or (3) of this section may choose to transfer from the STAR Health program to the STAR program or STAR Kids program, if the young adult meets the member participation requirements in §353.802 of this chapter (relating to Member Participation) or §353.1203 of this chapter (relating to Member Participation).

(c) The following Medicaid recipients cannot participate in the STAR Health program:

(1) Children and youth who have been adjudicated and placed with the Texas Juvenile Justice Department (TJJD);

(2) Children and youth from other states who are placed in Texas through the Interstate Compact Placement Commission (ICPC) as defined by DFPS in 40 TAC Chapter 700, Subchapter S (relating to Interstate Placement of Children);

(3) Children and youth in Medicaid-paid facilities such as nursing facilities or state supported living centers;

(4) Children and youth who are in the conservatorship of DFPS who are placed outside of Texas; and

(5) Children who are declared manifestly dangerous as defined by the Texas Department of Health Services in accordance with 25 TAC Chapter 415, Subchapter G (relating to Determination of Manifest Dangerousness).

Source Note: The provisions of this §353.702 adopted to be effective March 1, 2012, 37 TexReg 1283; amended to be effective September 1, 2014, 39 TexReg 5873; amended to be effective November 1, 2016, 41 TexReg 8265; amended to be effective September 1, 2017, 42 TexReg 4273; amended to be effective August 12, 2021, 46 TexReg 4843