Adoption and Guardianship Assistance - Kentucky

What specific factors or conditions does your State consider to determine that a child cannot be placed with an adoptive family without providing financial assistance? ("What is your State definition of special needs?")

A child with special needs is defined as a child that has at least one of the following needs or circumstances that may be a barrier to placement or adoption without financial assistance:

• A member of a racial and/or ethnic minority group two (2) years old or older
• Seven years of age or older with a significant emotional attachment or psychological tie to the foster family and the Department staff has determined that it would be in the child’s best interest to remain with the family
• A member of a sibling group of two or more children in which the siblings are placed together
• A physical or mental disability
• An emotional or behavioral disorder
• A recognized/documented risk of physical, mental or emotional disorder
• A previous adoption disruption or multiple placements

What is the maximum amount a family may receive in non-recurring adoption expenses from your State? (Adoptive parents can receive reimbursement of certain approved, "one-time" adoption expenses incurred in the process of finalizing a special needs adoption.)

Not to exceed $1,000 per child.

Does your State enter into deferred adoption assistance agreements? (In some States, adoptive parents can enter into an agreement in which they choose to defer the receipt of a Medicaid card, the monthly monetary payment, or both and can elect to receive the Medicaid card and/or monetary payment at another time.)

Kentucky does not offer deferred adoption assistance.

When can adoption assistance payments and benefits begin in your State?

Pre-adoptive assistance begins the day the adoption placement agreement form is signed, or on a later date if the family did not request adoption assistance at that time.

Post-adoptive assistance begins the day of adoption finalization.

How are changes made to the adoption assistance agreement in your State?

• When can a parent request a change in the adoption assistance agreement?
• How does a parent request a change in the adoption assistance agreement?
• What if a parent does not receive the change they request in the adoption assistance agreement?

Adoption assistance may be renegotiated before or after the adoption is finalized when the child’s special needs incur additional costs to the family to provide services to address those special needs. In rare instances, where a significant change in the family’s situation may negatively affect the stability of the placement, renegotiation may be warranted. A monthly subsidy does not automatically increase as the child becomes older or the foster care per diem rates change.

Requests are made via phone, e-mail, or written requests to the family’s social services caseworker. When the family requests an increase, the worker evaluates the situation, prepares an Adoption Assistance Renegotiation Form and forwards through supervisory and administrative channels for approval by the service region administrator or designee.

Increases and decreases in the adoption assistance payment and benefits are possible and requested changes take effect no earlier than the date of the request. Extraordinary medical expense requests which have caused a financial hardship on the family may be retroactive no earlier than July 1 of the current fiscal year.

If adoptive parents disagree with the agency’s answer to the requested change, they can file a service appeal request form, which initiates a fair hearing.

What types of postadoption services are available in your State, and how do you find out more about them?

Post adoption services in Kentucky are administered by the Cabinet for Health and Family Services (CHFS), Department for Community Based Services (DCBS), and largely contracted through outside agencies.

Kentucky has several resources related to postadoption. For more information, adoptive families may contact their CHFS regional Office or the Kentucky Foster and Adoptive Parent Training Support Network.

Parents may explore the Special Needs Adoption Program (SNAP): Supporting Services website.

Many private organizations offer a variety of respite options. See the ARCH National Respite Network Respite Locator Service, search by state to locate Kentucky's respite programs.

Note: Not all services may be available in all cases. Contact your adoption assistance worker or post adoption services contact for information regarding process, eligibility, availability, and duration of services.

What mental health services are provided by your State?

The Children’s Behavioral Health and Recovery Services Branch is responsible for the oversight of services and supports for children and youth who have or are at-risk of developing behavioral health concerns (including both mental health and substance use), and their families. This includes assisting providers and families in accessing training and coaching in a variety of evidence-based and promising approaches.

Branch staff work with Community Mental Health Centers and other agencies by providing oversight of and technical assistance regarding the delivery of a continuum of behavioral health care that includes promotion, prevention, early intervention, treatment, and recovery services and supports.

Additionally, staff work with specific state and regional initiatives, including but not limited to:

• Adolescent substance use prevention and treatment
• Crisis intervention
• Early childhood mental health
• High-fidelity wraparound
• Peer support
• School-based behavioral health
• Trauma-informed care

Finally, the branch has primary responsibility for oversight of several federal grants and initiatives whose funds are geared toward adolescent substance use, transition-age youth, early interventions for first episode psychosis, system-of-care expansion, bridging services from hospital to community, and others.

The branch adheres to and operates in accordance with the values and guiding principles of Systems of Care, as set forth by the federal Center for Mental Health Services within the Substance Abuse and Mental Health Services Administration.

In addition, Kentucky developed the IMPACT program which was designed to increase the variety and availability of community-based service options and to decrease the need for out of home and non-community based care. Kentucky IMPACT was established as a coordinated, interagency approach to service delivery for children/youth with serious emotional disabilities (SED) and their families. The model provides services not traditionally available, such as mentoring, school-based services, and intensive in-home therapy, as well as flexible funding for informal supports such as community activities, family support, and after-school and summer activities.

Does your State provide additional finances or services for medical or therapeutic needs not covered under your State medical plan to children receiving adoption assistance?

The state offers Extraordinary Medical Expenses for Kentucky Adoption Assistance children. Extraordinary Medical Expenses are expenses related to a child’s special needs, which existed prior to the adoption which are not reimbursable by private insurance, the medical card, or any other resource.

The services are utilized as the last resort when ALL other services have been exhausted and are contingent upon Department of Community Based Services (DCBS) approval. A co-pay may be required based on the family’s income. The family’s worker can assist with co-pays, eligibility requirements, and identifying the services available. A verifiable receipt and service provider contact information is required to be submitted for reimbursement of these services.

Approval may be requested for:

• Orthodontia
• Transportation for medical or treatment reasons related to the child’s special needs
• Day care services
• Tutoring
• Nutritional supplement, diapers, attends
• Respite care
• Mental health counseling and Expressive, Behavioral, Physical, Occupational and Speech therapies
• Medication/doctor visits related to child’s special needs including psychiatric hospitalization and special equipment needs

For more specific information related to the approval and reimbursement for Extraordinary Medical Expenses, please refer to The Kentucky Adoption Assistance Handbook.

Note: Not all services may be available in all cases. Contact your adoption assistance worker for information regarding process, eligibility, availability, and duration of services.

What is your State's process for applying for a fair hearing? (A fair hearing is a legal, administrative procedure that provides a forum to address disagreements with agency decisions.)

At any point after adoption finalization, adoptive parents may request a fair hearing. The request for adoption assistance may be approved if one of the following situations has occurred:

• The State agency failed to notify or advise adoptive parents of the availability of adoption assistance for children with special needs; or
• Assistance was denied based upon an erroneous determination by the state that a child did not meet Special Needs Criteria; or
• Relevant facts, which may have affected a child’s special needs determination, regarding the child, the biological family, or the child’s background were known but not presented to the adoptive parents prior to finalization.

The adoptive parents shall submit a request for a fair hearing in writing of file the DCBS 154 with:

The Quality Assurance Section
Cabinet for Families and Children
275 East Main Street, 1E-B
Frankfort, Kentucky 40621

A request for a hearing shall be made by the adoptive parents within 30 days of Cabinet action.

The adoptive parents bear the burden of proving extenuating circumstances and adoption assistance eligibility in a fair hearing.

For resolution of a matter not subject to review through an administrative hearing, you may contact the Office of the Ombudsman at 1-800-372-2973. If you do not wish to speak with the Office of the Ombudsman, you may submit your grievance in writing to a Service Region Administrator or designee no later than 30 days from the date of a cabinet action to which you object.

Does your state, territory, or tribe offer a guardianship subsidy or assistance (monthly payments and medical coverage) program?

Yes. Assistance is available regardless of the child’s title IV-E eligibility.

• Does the guardianship assistance program differ from the adoption assistance program? Yes
• If so, how does it differ? The fictive kin program provides the option of pursuing permanent custody of a child; at that point financial support stops but medical benefits continue. If the guardian is a relative, he/she can apply for Supplemental Nutrition Assistance Program benefits. Benefits would continue if a guardian chooses the foster parent path and adopts. Then the subsidy would continue like any other adoption case.

What are the eligibility criteria for a child to receive guardianship assistance?

The child must currently be in Kentucky’s Cabinet of Health and Family Services (CHFS) custody or must have been previously in the custody of CHFS for the current removal episode prior to the relative or fictive kin receiving temporary custody. In addition, the relative or fictive kin must not have yet obtained permanent custody through a permanent custody order. This includes cases that are currently closed.

Do families have to meet a kinship definition to receive guardianship assistance? If yes, how is kinship defined?

Kentucky has a Fictive Kin Placement program to allow non-relatives to take custody of a child and receive benefits to help support the placement. Providers also have the option of taking the foster care path and receive a higher rate subsidy and more services with the understanding that if adoption is a permanency option, that will be their goal. Specific details may be found in the Chapter 4-Out of Home Care Services (OOHC) Section:4.5.5 Relative and Fictive Kin Placement Consideration of the Standards of Practice Online Manual.

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