Adoption and Guardianship Assistance - Massachusetts

Date: September 2023

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 an ethnic or cultural minority for whom reasonable, but unsuccessful, efforts to place the child in an adoptive home were made and documented
  • A member of a sibling group of three or more to be adopted together
  • A member of a sibling group of two to be adopted together and one of the children is 8 years of age or older
  • One or more special needs as a result of a mental, emotional, or physical impairment, behavioral disorder, or medical condition that has been diagnosed by a licensed professional who is qualified to make the diagnosis
  • A birth and/or family history that places the child at risk of having special needs but, due to the child's age, a reasonable diagnosis cannot be made


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.)

$400 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.)

Massachusetts offers deferred adoption assistance.

The department may defer the financial assistance of a Tile IV-E or state adoption subsidy when a child meets the other adoption criteria, but she/he is at an age that makes it difficult to diagnose a special need impairment, disorder or condition or she/he is at risk of such an impairment, disorder or condition due to her/his birth history or family history prior to placement.


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

Adoption subsidy benefits shall begin no earlier than the finalization of the adoption unless the department determines that an earlier start date is in the best interests of the child.


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?

Adoptive parents may request a change in the adoption assistance agreement at any time. Requests must be made in writing to the subsidy manager and supported by documentation of a significant change in the child's special need. The significant change must be based on the current needs of the child and documented by a professional qualified to make the diagnosis. If the change in the special need would have resulted in a different rate if the child were in a home based foster care situation, the adoption assistance payment may be increased. The subsidy manager will review the request and the documentation provided to support it. The family will be provided with a written decision within a reasonable period of time. The Department of Children and Families must provide written notice prior to any proposed change in the adoption assistance agreement, unless there is reason to believe that the family is no longer providing any support for the child.

Adoptive parents can appeal if the department denies, reduces, suspends or terminates an adoption subsidy, except that there will be no right to appeal a decision to terminate a subsidy of a child if the child is 21 and has been receiving a IV-E subsidy or is age 22 and has been receiving a State subsidy.


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

A number of post-adoption support services are available to children and parents in Massachusetts through Child & Family Services’ Adoption Journeys program Adoption Journeys services guide, including:

  • Regional Response Team — A team leader, response worker, and parent liaison who can provide emergency support and advice to families
  • Support Groups — Groups for both parents and kids meet monthly around the state
  • Liaisons — Connections for families, parents, or children to someone else who’s shared their experience
  • Respite — Preplanned care and activities to help strengthen family bonds, give family members support or time off, or build friendships with others in their community

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


What mental health services are provided by your State?

The Massachusetts Department of Mental Health, as the State Mental Health Authority, assures and provides access to services and supports to meet the mental health needs of individuals of all ages, enabling them to live, work and participate in their communities. The Department establishes standards to ensure effective and culturally competent care to promote recovery. The Department sets policy, promotes self-determination, protects human rights and supports mental health training and research. This critical mission is accomplished by working in partnership with other state agencies, individuals, families, providers and communities.

The Children’s Behavioral Health Initiative (CBHI), as part of the MassHealth Office of Behavioral Health, focuses on strengthening, expanding, and integrating Massachusetts behavioral health services into a comprehensive, community-based system of care.

CBHI partners with child and family serving state agencies, providers, and payers to ensure that services:
- meet the individual needs of the child and family
- are easy for families to find and access
- make families feel welcomed and respected.

Information about CBHI services may be found in the CBHI Brochures and Companion Guide.


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?

Massachusetts offers what is known as Supplemental Reimbursements. If parents request payments for supplemental reimbursement in addition to the standard adoption assistance payment rate, the adoption social worker provides relevant documentation describing ongoing, additional expenses that are paid above the current foster care rate and which are not expected to be absorbed by other resources, services, or third party payments following the final decree of adoption. Need must be documented in the adoption assistance agreement. Massachusetts also offers a Clothing Allowance. Quarterly clothing allowances may be paid in addition to the standard adoption assistance rate. Parents are directed to contact their Adoption/Guardianship Subsidy Unit at 800.835.0838.


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.)

Pre-adoptive and adoptive parents have grounds to appeal decisions related to the adoption subsidy program, including:

  • the denial, reduction, suspension or termination of an adoption subsidy, except that there shall be no right to challenge a decision to terminate a subsidy if the child is 21 years of age and has been receiving a Title IV-E subsidy, or the child is 22 years of age and has been receiving a state adoption subsidy;
  • the decision to provide a deferred subsidy or to continue a deferred subsidy after a request for redetermination;
  • the existence of extenuating circumstances for an adoptive subsidy after finalization of the adoption of a child with special needs

To initiate an appeal, the family shall file a written request for a Fair Hearing with the Hearing Officer of the Department within 30 calendar days from the decision complained of or, if notice of such decision is required under the Department regulations, policy or procedures, then 30 days from such receipts of such written notice.

The family is encouraged to use the form provided by the Department’s Hearing Office to request a Fair Hearing, but a request which contains the following information is sufficient: the name, address and telephone number of the family, the date the alleged action occurred, the name and address of the office which made the decision being appealed, the decision being appealed, and a request for review of the decision. The family must provide a copy of the request to the Director of Ares of the office where the challenged decision was made.

To initiate the grievance procedure, the family must file a written complaint with the Area Office, Regional Office or Foster Care Review Unit whose decision was complained of or which employs the employee whose conduct is complained of, within 30 days of the action or inaction complained of. The Director of Areas, Regional Director or Director of Foster Care Review shall assign the complaint to a Regional Clinical Director, Area Clinical Manager, Area Program Manager or to the Assistant Director of Foster Care Review as the case may be.

Upon completion of the review, the assigned party will send a written notice of his/her decision to the family and to the employee(s) in question. The notice shall recite the grounds of the complaint, the facts of the case, and any action taken by the Department or Provider.

Specific policy details about the fair hearing process and grievances may be found in the Code of Massachusetts Regulations.

A request for a fair hearing may be sent to the following address:

Director of the Fair Hearing Unit
24 Farnsworth Street
Boston, Massachusetts 02110


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? Difference centers around eligibility of IV-E. When the program switches to State guardianship, children no longer meet IV-E criteria but qualify for State-funded guardianship subsidy instead.


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

To be eligible for a Title IV-E kinship guardianship subsidy, the following criteria must be met:

  • Child is in the department's care or custody and is in placement
  • Child was removed from her/his home pursuant to a Voluntary Placement Agreement or as a result of a judicial determination that continuation in the home would be contrary to the welfare of the child
  • Child was eligible for Title IV-E foster care maintenance payments for at least a 6 consecutive month; during this period, child resided in the home of the prospective kinship guardian who was licensed as a department's foster/pre-adoptive family
  • Child is a sibling of a Title IV-E eligible child and placed in the home of the same kinship guardian with the eligible child. The sibling’s guardianship need not be finalized at the same time as the eligible child’s guardianship. Sibling does not need to meet the agency requirements.

Additional information may be found in the Massachusetts Department of Children and Families Guardianship Subsidy Policy.


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

No but relative means a person(s) related by either blood, marriage or adoption (i.e., adult sibling, grandparent, aunt, uncle, first cousin) or a significant other adult to whom a child and/or the child’s parent(s) ascribe the role of family based on cultural and affectional ties or individual family values.


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