Adoption Assistance by State

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

Alabama

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

A child who has certain documented physical, mental, or emotional issues
A child at risk of physical, mental or emotional difficulties in the future, due to high risk factors document in the background information
Children five years of age or older
Sibling group of two or more children being placed for adoption in the same home at the same time

To be eligible for adoption assistance, a child must first be in the care and custody of the Department of Human Resources or an Alabama licensed child-placing agency or be eligible to receive SSI at the time of placement.

Alaska

A child with special needs is defined as a “hard to place child” that has at least one of the following needs or circumstances that may be a barrier to placement or adoption without a subsidy:

Ethnic background, age, or membership in a minority or sibling group
Physical or mental disability
Emotional disturbance
A recognized high risk of physical or mental disease
Any combination of the above factors or conditions

Note: to see the Federal government requirements for eligibility for title IV-E adoption assistance refer to Adoption Assistance for Children Adopted From Foster Care on the Child Welfare Information Gateway, website: https://www.childwelfare.gov/pubs/f-subsid/.

Arizona

The State has determined that one of the following special needs exists because of which it is reasonable to conclude the child cannot be placed with adoptive parents without providing adoption assistance:

Physical, mental or developmental disability;
Emotional disturbance;
High risk of physical or mental disease that may result in a debilitating condition;
High risk of developmental disability that may result in a debilitating condition;
Age six or older at the time of application for adoption subsidy;
Sibling relationship when such factor impedes the child’s adoptive placement;
Racial or ethnic factors when such factor(s) impede the child’s adoptive placement;
High risk of severe emotional disturbance if removed from the care of the child’s foster parent or relative as diagnosed by a psychiatrist or psychologist.

Arkansas

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:

Two years of age or older and a child of color
Nine years of age or older and Caucasian
Member of any sibling group being placed together who share at least one biological parent and who have either lived together or otherwise developed a bond prior to adoptive placement
Severe medical or psychological needs that require ongoing rehabilitation or treatment
At high risk for the development of a serious physical, mental or emotional condition, if a medical professional specializing in the area provides documentation of the condition for which the child is considered at risk. Note: No adoption assistance payment can be made without documentation that the child has developed the actual condition.

Note: to see the federal government requirements for eligibility for title IV-E adoption assistance see Fact Sheets for Families
on the Child Welfare Information Gateway, link: https://www.childwelfare.gov/pubs/f-subsid/.

California

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:

Three years of age or older
Race, ethnicity, color, or language that is a barrier to adoption
Member of a sibling group that should remain together
Mental, physical, emotional, or medical disability certified by a licensed professional
Parental background of a medical or behavioral nature that can be determined to adversely affect the development of the child

Colorado

Physical disability (such as hearing, vision, or physical impairment; neurological conditions; disfiguring defects; and, heart defects).
Mental disability (such as developmental delay or mental retardation, perceptual or speech/language disability, or a metabolic disorder).
Developmental disability resulting in educational delays or significant learning processing difficulties.
Educational disability that qualifies for section 504 of the rehabilitation act of 1973 or special education services
Emotional disturbance (such as post-traumatic stress disorder, bi-polar disorder and other diagnoses).
Developmental disability resulting in educational delays or significant learning processing difficulties
Hereditary factors that have been documented by a physician or psychologist
High risk children (such as HIV-positive, drug-exposed, or alcohol-exposed in utero).
Other conditions that act as a serious barrier to the child’s adoption. Conditions may include, but are not limited to, a healthy child over the age of seven or a sibling group that should remain intact and medical conditions likely to require further treatment.
Ethnic background or membership in a minority group which may be difficult to place

Connecticut

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:

Eight years of age or older
Two years of age or older and a member of a minority
Member of a sibling group of two are more children to be placed together
Diagnosis of a physical, mental or emotional handicapping condition, or at high risk of developing such a condition

Delaware

The child must have “Special Needs” which are conditions or child characteristics that make it difficult to place a child for adoption without providing adoption assistance or Medical Assistance to prospective adoptive parents. There must be documentation that a child has at least one of the following, physical, mental, or emotional or handicapping characteristics:

Eight years of age or over
Member of a minority race or ethnic culture
Member of a sibling group to be adopted by the same family
A diagnosed physical handicap or chronic disease requiring medical attention
A mental or emotional condition requiring treatment

District of Columbia

The child is eligible for subsidy when the child is determined to have special needs based on one or more of the following conditions:

The child has a chronic medically diagnosed disability that substantially limits one or more major life activities, or requires professional treatment, or assistance in self-care
The child has been diagnosed by a qualified mental health professional to have a psychiatric condition which impairs the child’s mental, intellectual, or social functioning, and for which the child requires professional services
The child has been determined to be mentally disabled by a qualified medical professional
The child has been diagnosed by a qualified mental health professional to have a behavioral or emotional disorder characterized by situationally inappropriate behavior which deviates substantially from behavior appropriate to the child’s age and interferes significantly with the child’s intellectual, social, and personal adjustment
The child meets all medical or disability requirements of title XVI of the Social Security Act with respect to eligibility for supplemental security income benefits
The child is a member of a sibling group, in which the siblings should be placed together and the adoptions must be finalized at the same time
The child is of an age or has an ethnic or racial background which presents a barrier to adoption
The child has been legally free for adoption for six (6) months or more and an adoptive placement has not been found

Florida

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:

Eight years of age or older
African American or racially mixed parentage
Member of a sibling group of any age, provided two or more members remain together for purposes of adoption
Mentally handicapped
Physically handicapped
Emotionally handicapped
Significant emotional ties with their foster parent(s)

Georgia

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 child who has been in the care of a public or private agency or individual other than the legal or biological parent for more than 24 consecutive months
A child with physical, mental, or emotional disability, as validated by a licensed physician or psychologist
A child who is a member of a sibling group of 2 or more placed in the same home
The child meets the medical or disability requirements for Supplemental Security Income (SSI)

Guam

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:

Eight years of age or older
African American and two years of age or older
Member of a sibling group of three or more children placed at the same time with the same family
Documented mental or physical disability
Documented emotional disturbance/problem
Documented high risk of developing a mental or physical disability

Hawaii

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:

Age 4 or older by the date of placement with prospective adopted parent(s)
Race or ethnic background
Member of a sibling group of two or more children adopted together; or a sibling of a child previously adopted by adoptive parents
Presence of a severe or chronic medical, physical, mental, or emotional condition, behavioral disorder or other clinically diagnosed disability established and documented by a professional, other than the child’s placement worker
High risk of developing a severe or chronic medical, physical, mental, or emotional condition, behavioral disorder or other clinically diagnosed disability established and in writing by a professional, other than the child’s placement worker

Idaho

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:

The child has a physical, mental, emotional or medical disability, or is at risk of developing such disability based upon the child’s experience of documented physical, emotional, or sexual abuse, or neglect; or
The child’s age makes it difficult to find an adoptive home; or
The child is being placed for adoption with at least one (1) sibling
The child has not been able to be placed without adoption assistance (attempts at placement for adoption were made, but were unsuccessful), except where it would be against the best interest of the child.

Illinois

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:

One year of age or older
Irreversible or non-correctable physical mental or emotional disability
Physical, mental, or emotional disability correctable through surgery, treatment, or other specialized services
Member of a sibling group being adopted together where at least one child meets one of the other criteria listed here
Being adopted by adoptive parents who have previously adopted, with adoption assistance, another child born of the same mother or father

Indiana

There must exist a specific factor or condition which makes it reasonable to conclude that the child cannot be adopted without providing financial assistance or Title XIX Medicaid, and one of the following criteria exists:

A child two years of age or older
A child who is a member of a sibling group of two or more children, of which at least one is two years of age or older and who will be placed with the sibling group in the same home
A child with a qualifying medical condition or a physical, mental or emotional disability as determined by a physician or psychiatrist licensed to practice in Indiana or another state or territory.

Iowa

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:

Eight years of age or older and Caucasian
Two years of age or older and a member of a minority race or ethnic group or of mixed parentage
Member of a sibling group of three or more children placed in the same adoptive home
Medically diagnosed disability which substantially limits one or more major life activities or requires professional treatment, assistance in self-care, or the purchase of special equipment
Diagnosed with a psychiatric disorder that impairs the child’s mental, intellectual, or social functioning, and for which the child requires professional services
Diagnosed by a qualified mental health professional to have a behavioral or emotional disorder characterized by behavior that is inappropriate to the situation which deviates substantially from behavior appropriate to the child’s age or significantly interferes with child’s intellectual, social, and personal adjustment
Determined to be mentally retarded by a qualified mental retardation professional
Determined by a qualified professional to be at high risk of developing a qualifying medical, mental or emotional condition, in which case, a future agreement may be negotiatied

Kansas

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:

Twelve years of age or older
Member of a sibling group of two or more children placed for adoption together. For a sibling group of two, one of the siblings shall have one of the special needs factors or conditions. Sibling groups of three or more placed together do not need to meet any other special needs criteria
Medically diagnosed physical disability, which requires professional treatment, impairs normal functioning, or requires assistance in self-care or the purchase of special equipment. The disability is to be diagnosed by a physician, hospital, clinic or other qualified licensed medical practitioner qualified to make disability determinations
Significant developmental disabilities and/or delays with demonstrated need for intensive adult supervision beyond chronological age, determined through an evaluation by a licensed psychologist, diagnostic center, special education services, or other qualified professional individual
Diagnosed as having a psychiatric condition, which impairs the child’s intellectual, behavioral or social functioning. Diagnosis and prognosis shall be established by a licensed physician, psychologist or clinical social worker
With a guarded prognosis and not currently being treated for a specific disability or condition but presenting factors in his/her genetic, health, and/or social background, which indicate that child may develop physical, emotional or developmental problems at a later date

Kentucky

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

Louisiana

A child with special needs is defined as a child with a preexisting condition(s) such that it is reasonable to conclude that the child may be difficult to place in an adoptive home without the aid of subsidy. Recruitment and placement barriers are also considered. The child must have at least one of the following needs or circumstances that may be a barrier to placement or adoption without financial assistance:

All children, age 5 or older
Ethnic background
Membership in a sibling group of two or more children who should not be separated
Physical, mental or emotional disability
Severe chronic medical condition
Significant, chronic, or genetically predisposed medical or mental health risk factors in child’s birth family history

Maine

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:

Physical, mental or emotional handicap that makes placement difficult
Medical condition that makes placement difficult
Member of a sibling group to be placed together includes at least one member who is difficult to place and meets one or more of criteria
Age 5 or older
Difficult to place because of race
Victim of physical, emotional or sexual abuse or neglect that places the child at risk for future emotional difficulties OR
Has a family background that includes severe mental illness, substance abuse, prostitution, genetic or medical conditions or illnesses that place the child at risk for future problems. For purposes of this definition “at risk” is meant to have some significance in a statistical or medical sense, i.e., some probability of occurrence that is not merely speculative or statistically insignificant

Maryland

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:

Six years to 17 years old
Race or ethnicity if combined with any of these factors
Membership in a sibling group
Physical, mental, or emotional disability or disease
Recognized high risk of physical or mental disability or disease
Emotional disturbance
Physical or mental disease or disability

Massachusetts

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 eight 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 which places the child at risk of having special needs but, due to the child's age, a reasonable diagnosis cannot be made

Michigan

Michigan has specific requirements to meet both the federal definition and the state’s special needs eligibility criteria. At the time of eligibility determination, the child must be a child with special needs. A child is considered a child with special needs if the Michigan Department of Health and Human Services (MDHHS) has determined all of the following:

The child is under age 18
The parental rights to the child have been terminated
- If an American Indian child can be adopted in accordance with tribal law without a termination of parental rights and the tribe has documented a valid reason why the child cannot or should not be returned to the home of the parents, termination is not required
- State funded eligibility requirement: Termination of parental rights must be under Michigan Complied Laws (MCL) 712A.19b (abuse and neglect) or MCL 710.29 (release) while the child was involved in an abuse or neglect proceeding
The child has one of the following specific factors or conditions:
- Eligibility for Supplemental Security Income (SSI), based solely on the medical and disability requirements without regard to the SSI income requirements, as determined by the Social Security Administration (SSA)
- A MDHHS foster care level II or above Determination of Care (DOC) rate that meets all of the following:
  - Documented by the DHS-470, 470A or 1945
  - Supported by the current foster care updated service plan - Permanent Ward Service Plan (PWSP or Updated Service Plan(USP)
  - Approved in accordance with DHS foster care policy
- The child is at least age 3
- The child is being adopted by a relative (within the 5th degree of consanguinity);
- The child is being adopted by the parent(s) of his/her previously adopted sibling
- The child is a member of a sibling group being adopted together and at least one sibling group member has been determined eligible for adoption support subsidy as an individual.
- An effort to place the child without providing adoption support subsidy is demonstrated by the adoptive parent(s) signature(s) in Section 1 of the DHS-4081, Adoption Assistance Intent Statement

Minnesota

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

A documented physical, mental, emotional, or behavioral disability, including Supplemental Security Income-eligible disabilities
A member of a sibling group being adopted at the same time by the same parent
Being adopted by a parent who previously adopted a sibling for whom the parent receives adoption assistance
At risk of developing one or more physical, mental, emotional, or behavioral disabilities

Note: When a child’s eligibility for adoption assistance is based on being at risk of developing physical, mental, emotional, or behavioral disabilities, it is known as “at-risk adoption assistance.” A child eligible for at-risk adoption assistance does not receive a payment unless and until the potential disability manifests itself, as documented by an appropriate health care professional.

Note: to see the federal government requirements for eligibility for title IV-E adoption assistance see Fact Sheets for Families (on the Child Welfare Information Gateway), link: http://www.childwelfare.gov/pubs/f_subsid.cfm#federal or the Child Welfare Policy Manual (on the Children’s Bureau website), link: https://www.acf.hhs.gov/cwpm/public_html/programs/cb/laws_policies/laws/cwpm/index.jsp

Mississippi

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:

Six years of age or older
Membership in a sibling group (or fictive sibling group) of two (2) or more children being placed together – fictive sibling is defined as unrelated children who have resided in the same home for at least 6 months and who have developed significant emotional ties to each other
Physical disability
Mental disability (I.Q. of 70 or less)
Developmental disability
Emotional disturbance
Medical conditions
Factors in a child’s or biological family’s medical history or background that place the child at risk to acquire a medical condition, a physical, mental or developmental disability or an emotional disorder

Children who are determined to have special needs will be further assessed for their level of special needs. There are 6 levels:

Deferred – Includes children under the age of 6 who have documented risk factors for special needs in their background, but currently have no known special needs. This would include documented mental or medical health issues in the family, unknown background history of abuse or neglect, or risk factors documented by the child’s birth records.
Basic Special Needs – Includes age, sibling group membership, a single developmental, mental health or medical diagnosis not serious in nature, i.e. Eczema, speech delays, allergies, etc.
Special Needs I – When a child has ongoing medical conditions requiring frequent medical attention or daily medications or interventions and the SSO application is either pending or been denied
Special Needs II – When a child is receiving SSI benefits at the time of adoption
Therapeutic Rate – When a child has multiple diagnoses (either mental health or medical conditions or a combination) for which he/she continues to receive therapeutic interventions or the adoptee has a single diagnosis which is causing significant impairment in multiple settings
Medically Fragile Rate – When an adoptee has a medical condition or multiple medical diagnoses which are life threatening in nature or require specialized medical care in the home or will require corrective major surgery/recurrent surgeries or the prognosis for full recovery is negligible and the child is not expected to ever live independently

Missouri

Children in the care and custody of the Children’s Division are considered special needs.

A child not in the care and custody of the Children's Division is defined as having special needs if s/he has at least one of the following needs or circumstances that may be a barrier to placement or adoption without financial assistance:

Under the age of 18
In the care and custody of the Missouri Department of Social Services (DSS)
In the care and custody of a licensed child-placing agency
A child who cannot or should not be returned to the home of his/her parents
A child with a specific factor or condition (such as his/.her ethnic background, age, membership in a minority or sibling group, or the presence of factors such as medical condition or physical, mental, or emotional handicaps) that may be a barrier to placement for adoption without financial assistance.
A child who has a condition (i.e., a state of health or behavior) which results in a guarded prognosis (although the child may appear normal) due to mental illness or retardation, drug usage by, or venereal disease of the parents
A child who has a history, which includes circumstances such as long-term out-of-home care, incest, or social or genetic complication in the family background

Montana

In order to be eligible for State-funded adoption assistance a child must be a special needs as defined below and under the placement and care responsibility of the State of Montana Department of Public Health and Human Services (DPHHS). The State must determine that reasonable efforts have been made to place the child adoptively without subsidy.

Six years of age or older
A member of a minority group
A member of a sibling group of two or more children placed together for adoption
Diagnosed as having a physical, mental or emotional disability
Recognized to be at high risk of developing a physical, mental or emotional disability
If he is an applicable child, meeting requirements for Supplemental Security Income

AND

Under 18 years of age at the time the subsidized adoption agreement is signed and the time the adoption is finalized
Legally free for adoption (cannot or should not be returned to the home of his or her parents)
Adoptive placement is in the child's best interest and the division has determined that reasonable, but unsuccessful, efforts have been made to place the child with appropriate pre-adoptive parents without a subsidy, except where it would be against his/her best interests due to the existence of significant emotional ties with pre-adoptive parent(s) while in the care of such parent(s) as a child in foster care.

Nebraska

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:

Over the age of 8 years
Member of a sibling group of three or more children to be placed together
Behavioral, emotional, physical, or mental disability, as documented by a recent report (less than six months old) from an appropriate, qualified professional (which could include but is not limited to a physician, psychiatrist, psychologist, or Licensed Mental Health Practitioner (LMHP). This report must include diagnosis, severity of condition, and present and future care or treatment required or likely to be required. A child who has been determined SSI eligible in his or her own right (as opposed to receiving SSI due to a parent's disability) meets this criteria
Membership in a minority race (race by itself is not sufficient to make a child eligible for subsidy);
The child must meet all of the following:
- Cannot be adopted without subsidy (see 479 NAC 8-001.02B2);
- Cannot or should not be returned to the home of the legal/biological parents;
- Is a ward of the Nebraska Department of Health and Human Services at the time the adoption petition is filed; and
- Is age 18 or younger

Nevada

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:

Five years of age or older
Member of a minority ethnic group
Member of a sibling group of two or more children to be placed together and at least one of the children is three years of age or older,
Diagnosis of a medical, physical, emotional, or mental disability or documented history of abuse/neglect requiring treatment intervention
Documented factors in his/her background that places child at high risk for developing a condition requiring future treatment. Children meeting this criteria include those genetically related to persons having heritable physical, mental, emotional, or behavioral conditions; prenatal substance abuse exposure; and other factors identified/determined by a treatment professional which will result in a child’s need for treatment or special services

New Hampshire

For the child to be eligible for an adoption subsidy all of the following conditions shall apply:

Under 18 years of age
Legally free for adoption or in the process of being legally freed for adoption
Deemed "hard-to-place" because of physical or other reasons including, but not limited to:
- At least 6 years old, if age is the only criteria;
- Member of a minority group;
- Part of a sibling group, or joining a sibling;
- Documented physical, mental, or emotional handicapping condition; or
- At risk of physical, mental, or emotional disability, based on birth family history, prenatal factors, or more than two adverse childhood experiences.

A A prospective adoptive family shall meet the following conditions to qualify for an adoption subsidy:

The adoptive couple or individual shall have an approved adoptive home
he adoptive home shall be under consideration for a specific child before acceptance of the adoptive parents’ application for a subsidy

New Jersey

A child with special needs is defined as a child who the State of New Jersey has the legal right to place for adoption, or any child who is legally free and is being placed by a private adoption agency with a certificate of approval to provide adoption services in New Jersey, but who is reasonably expected not to be placed for adoption due to the lack of a prospective adoptive home or any of the following reasons:

10 years old or older
A serious medical or dental condition that will require repeated or frequent hospitalization or treatment
Any physical handicap which makes the child totally or partially incapacitated for education or the potential to earn income
Any substantial disfigurement
Diagnosed emotional, mental health, or behavioral problem, psychiatric disorder, serious intellectual incapacity, or brain damage that seriously affects the child’s ability to relate to his or her peers or authority figures, including but not limited to a diagnosed developmental disability
Member of a group of three or more siblings (including half siblings) placed together or third or additional sibling placed in the same home, even though the first and second sibling receive no subsidy
One of two siblings (including half siblings), one of whom meets the special needs criteria, and the resource home is considered the most appropriate setting for the siblings or the child is being placed in the home with a sibling receiving subsidy
Member of an ethnic or minority group from whom adoptive homes are not readily available to Child Protection and Permanency (CP&P). Information regarding adoption home availability may be obtained from CP&P
Abuse or neglect that resulted in an out-of-home placement by CP&P
Meeting the medical or disability requirements for Supplemental Securitys
Any other condition which may be approved by the CP&P Director or designee that is not contrary to Federal or State statute and regulations which may include, but is not limited to:
- high risk of developmental, educational, or emotional problems secondary to prenatal drug exposure
- high risk of genetic predisposition to mental illness due to parental mental health history
- placed with relative or kin who will not adopt without subsidy

New Mexico

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:

Over the age of five years
From a minority ethnic background
Part of a sibling group of three or more brothers and sisters
Diagnosed with moderate to severe developmental, psychological or physical disabilities

New York

Adoption subsidies are available for handicapped and hard-to-place children who are in the custody and guardianship of the local commissioner of social services, or an authorized voluntary agency in New York State, or a certified or approved foster parent. (Not every child in the guardianship and custody of a commissioner or a voluntary agency in New York State is eligible for a subsidy).

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:

New York divides special needs into two categories “hard-to-place” and “handicapped”.

A handicapped child is a child with a specific physical, mental or emotional condition or disability of such severity or kind, which, in the opinion of the Office of Children and Family Services (OCFS) would constitute a significant obstacle to the child’s adoption. Such conditions include, but are not limited to:

Any medical or dental condition which will require repeated or frequent hospitalization, treatment or follow-up care;
Any physical handicap, by reason of physical defect or deformity, whether congenital or acquired by accident injury or disease, which makes or may be expected to make a child totally or partially incapacitated for education or for remunerative occupation or makes or may be expected to make a child handicapped
Any substantial disfigurement, such as the loss or deformation of facial features, torso or extremities; or
A diagnosed personality or behavioral problem, psychiatric disorder, serious intellectual incapacity or brain damage which seriously affects the child’s ability to relate to his peers and/or authority figures, including mental retardation or developmental disability.

A hard-to-place child is a child, other than a handicapped child:

(State Definition) Who has not been placed for adoption within six months from the date his or her guardianship and custody were committed to the social services official or the voluntary authorized agency; or
(State Definition) Who has not been placed for adoption within six months from the date a previous placement terminated and the child was returned to the care of the social services official or voluntary authorized agency; or
Who meets any of the following conditions, which the OCFS has identified as constituting a significant obstacle to a child’s adoption, notwithstanding that the child has been in the guardianship and custody of the social services official or the voluntary authorized agency for less than six months:

The child is one of a group of two siblings (including half-siblings) for whom it is considered necessary that the group be placed together and

at least one of the children is five years of age or older; or
at least one of the children is a member of a minority group which is substantially over represented in New York State foster care in relation to the percentage of that group to the State’s total population; or
at least one of the children is otherwise eligible for adoption assistance in accordance with the provisions of this subdivision:

The child is the sibling or half-sibling of a child already adopted and it is considered necessary that such children be placed together and

The child to be adopted is five years of age or older; or
The children is a member of a minority group which is substantially over represented in New York State foster care in relation to the percentage of that group to the State’s total population; or
The sibling or half sibling already adopted is eligible for adoption assistance or would have been eligible for adoption assistance if application had been made at the time of or prior to the adoption;

The child is one of a group of three or more siblings (including half-siblings) for whom it is considered necessary that the group be placed together; or
The child is eight years of age or older and is a member of a minority group which is substantially over represented in foster care in relation to the percentage of that group to the State’s total population; or
The child is ten years of age or older; or
The child is hard to place with parents other than his/her foster parent(s) because he/she has been in care with the same foster parent(s) for 12 months or more prior to the signing of the adoption placement agreement by such foster parents and has developed a strong attachment to his/her foster parent(s) while in such care and separation from the foster parent(s) would adversely affect the child’s development.

A child, for adoption assistance purposes in New York, is defined as:

A person under the age of 21 whose guardianship and custody have been committed to a social services official or a voluntary authorized agency or whose guardianship or custody have been committed to a certified or approved foster parent prior to the child's 18th birthday.
A person under the age of 21, who prior to their 18th birthday, had a petition filed to free them, and guardianship and custody was granted to a social services official or voluntary authorized agency after the person’s 18th birthday, and the person consented to the transfer of guardianship and custody to the social services official or voluntary authorized agency or certified or approved foster parent.
A person under the age of 21 whose care and custody have been transferred prior to such person’s eighteenth birthday to a social services official or a voluntary authorized agency either as an adjudicated abused or neglected child or a voluntarily placed child, whose parents are deceased or where one parent is deceased and the other parent is not a person entitled to notice to the adoption proceeding and where such official or agency consents to the adoption of such person in accordance with law.

North Carolina

A child with special needs is defined as a child for whom one of the following factors or conditions must exist and be documented in order for the child to be eligible for adoption assistance:

Six years of age or older
Two years of age or older and a member of a minority race or ethnic group
Member of a sibling group of three or more children to be placed in the same adoptive home
Member of a sibling group of two children to be placed in the same adoptive home, in which one or more of the siblings meet at least one of the other criteria for special needs
Has a medically diagnosed disability which substantially limits one or more major life activity, requires professional treatment, assistance in self-care, or the purchase of special equipment
Diagnosed by a qualified professional to have a psychiatric condition which impairs the child’s mental, intellectual, or social functioning, and for which the child requires professional services
Diagnosed by a qualified professional to have a behavioral or emotional disorder characterized by inappropriate behavior which deviates substantially from behavior appropriate to the child’s age or significantly interferes with child’s intellectual, social and personal functioning
Diagnosed to be mentally retarded by a qualified professional
At risk for a diagnosis described above in items above, due to prenatal exposure to toxins, a history of abuse or serious neglect, or genetic history.
Note: if the child qualifies only under this criterion, the child must be placed in the potential category where they shall receive Medicaid but will receive a zero amount monthly payment until a diagnosis is made. When the diagnosis is made and documented appropriately, a change will be made to the DSS-5095 to reflect payment beginning the month following diagnosis.
Meets all of the medical and disability requirements for Supplemental Security Income (SSI)

North Dakota

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:

Seven years of age or older
Member of a minority race
Member of a sibling group being placed together for adoption
0-18 years of age with a physical, emotional, or mental disability or diagnosed by a licensed physician to be a high risk for such a disability

Ohio

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:

Six years of age or older
Member of a minority or ethnic group
Member of a sibling group which should be placed together
A medical condition, physical impairment, or developmental disability
In the permanent custody of a public children services agency (PCSA) or private child-placing agency (PCPA) for more than one year
Previous adoption disruption or multiple placements while in the care of a PCSA or PCPA
At risk of acquiring a medical condition, physical impairment, or mental or developmental disability based on his/her family's social or medical history
In the home of his/her prospective adoptive parents as a foster child for at least six months and would experience severe separation and loss if placed in another setting due to his or her significant emotional ties with these foster parents (as determined and documented by a qualified mental health professional)

Oklahoma

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:

Physical disability. The child has a physical condition that adversely affects his or her day-to-day motor functioning
Intellectual disability. The child has a significantly sub-average, general cognitive capacity and/or motor-functioning existing concurrently with deficits in adaptive behavior, manifested during the developmental period adversely affecting socialization and learning
Age and type of placement. Eligibility based on the child's age and type of placement is determined according to:
- Kinship placement. There is no age requirement when the child is placed with a relative who meets the specified degree of relationship
- Non-related placement. When no other special needs are determined, the child must be 8 years of age and older
Sibling relationship
- A child of any age and at least one sibling are placed in trial adoption status in the same home
- A child younger than 3 years of age, not determined eligible to receive an adoption assistance payment at the time of the adoption assistance application, becomes eligible when there is a sibling relationship
- When an adoptive child was not adoption-assistance eligible at the time of adoption and the adoptive parent adopts an adoption-assistance eligible sibling within one year of the original child's adoption finalization, the original child becomes eligible for an adoption assistance payment
- The effective date the adoption assistance payment begins for the child is also the effective date the adoption assistance payment begins for the sibling
Emotional disorder. A child with an emotional disorder exhibits one or more of the following characteristics over an extended period of time and to a marked degree, which are:
- an inability to build or maintain satisfactory interpersonal relationships
- inappropriate types of behavior or feelings under normal circumstances
- a general pervasive mood of unhappiness or depression or
- a tendency to develop physical symptoms or fears associated with personal problems
Racial or ethnic factor. The child is American Indian, Hispanic or Latino, Asian, or African American and 3 years of age and older
High risk of emotional disorder or physical or intellectual disability. The child who has a high risk of emotional disorder or physical or intellectual disability for conditions not currently being treated may qualify for adoption assistance. When no other special factors or conditions exist, a monthly payment is not approved until there are documented symptoms of emotional disorder or physical or intellectual disability. Indicators of high risk for emotional disorder or physical or intellectual disability are:
- social and medical histories, such as the biological parents' or family member's emotional disorder
- events or life experiences, such as severe sexual abuse; or
- prenatal exposure to drugs or alcohol

Oregon

A child with special needs has at least one of the following factors or conditions that make adoptive placement difficult to achieve:

A documented medical, physical, mental, or emotional condition or other clinically diagnosed disability, or a documented history of abuse or neglect or other identified predisposing factor that places the child at significant risk for future problems that need treatment
Member of a sibling group that will be placed together and is difficult to place because there are three or more children, or if in a sibling group of two, at least one of the children is six years of age or older
Member of an ethnic, racial, or cultural minority (such as African American, Hispanic, Asian, Indian, or Pacific Islander)
Eight years of age or older

Pennsylvania

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:

The child is free for adoption
The child has a qualifying factor or condition (see list below)
Reasonable efforts were made to place the child without adoption assistance unless it is not in the child’s best interest; for example, if there is the existence of significant emotional bond between the adoptee and the adoptive parents

For a child to be determined to have a qualifying factor or condition, he or she must meet at least one of the following circumstances:

Be five years of age or older and under the age of 18 or 21
Be a member of a racial or ethnic minority group
Be a member of sibling group of two or more placed together in the same adoptive home
Have a physical, mental, emotional condition or disability
Have a genetic condition that indicates a high risk of developing a disease or disability

Rhode Island

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:

Nine years of age or older
Member of an ethnic or racial minority
Member of a sibling group of two or more children being adopted into the same home
Documented medical condition or a physical, emotional, or mental disability
At high risk of developing a medical condition or a physical, emotional or mental disability, based upon family background or history
Prior adoption disruption or dissolution

Note: If a child is at high risk of developing a medical condition or a physical, emotional or mental disability, based upon family background or history, they may be eligible for deferred adoption assistance. See Question #4 for information on deferred adoption assistance.

South Carolina

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:

African American or of blended racial heritage and six years of age or older
Caucasian and ten years of age or older
African American or of blended racial heritage and a member of a sibling group of two or more children placed together, one of whom is at least six years of age
African American or of blended racial heritage and a member of a sibling group of three or more children of any age placed together
Caucasian and a member of a sibling group or three or more children placed together, one of whom is at least six years of age
Caucasian and a member of a sibling group of four or more children of any age placed together
Member of a sibling group of two or more children placed together, one of whom is a special needs child

South Dakota

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 child’s age, race or religion
A child with a physical, emotional, neurological, or intellectual disability
A sibling group that needs to be placed together
A child needing extensive ongoing or anticipated medical care or therapy
Need of a prosthesis, extensive, on-going, or anticipated medical care, or therapy for speech, physical, or psychological problems
When adoption by the foster parents with whom the child is living is the only appropriate plan

Tennessee

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:

Nine years of age or older and Caucasian
Two years of age or over and of minority heritage
Member of a sibling group of two or more children placed together at the same time, with the same family for the purpose of adoption at the same time
Moderate to severe medical, physical or psychological condition, as diagnosed by a licensed by a physician, psychologist or licensed mental health professional and the identified condition requires treatment
Life experiences include neglect, physical abuse and/or sexual abuse as indicated by Tennessee Department of Children’s Services (DCS) or adjudicated by a court and as defined by T.C.A. 37-1-102 (23) (A-(D) 'Severe Abuse'
Three or more consecutive years in Tennessee DCS custody
Has a medically diagnosed disability which substantially limits one or more major life activities, requires professional treatment, and assistance in self-care
Is diagnosed to be mentally retarded by a qualified professional
Is diagnosed by a qualified professional to have a behavioral or emotional disorder characterized by inappropriate behavior, which deviates substantially from behavior appropriate to the child’s age or significantly interferes with child’s intellectual, social, and personal functioning
Meets all of the medical and disability requirements for SSI (Supplemental Security Income)

Texas

A child with special needs is one who meets all of the criteria in this section:

At the time the adoptive placement agreement is signed, the child is less than 18 years old and meets at least one of the following conditions:
- On the day immediately preceding the date of adoption, the child was in the managing conservatorship of Department of Family and Protective Services (DFPS) or an authorized entity, and:
  - the child is at least six years old;
  - the child is at least two years old and a member of a racial or ethnic group that exits foster care at a slower pace than other racial or ethnic groups;
  - the child is being adopted with a sibling or to join a sibling who has been adopted by the parents or for whom the parents already have permanent managing conservatorship or an equivalent arrangement in another state; or
  - the child has a verifiable physical, mental, or emotional handicapping condition, as established by an appropriately qualified professional through a diagnosis that addresses:
    - what the condition is; and
    - that the condition is handicapping; or
The child has been determined by the Social Security Administration to meet all the medical or disability requirements with respect to eligibility for Supplemental Security Income (SSI) benefits

Utah

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:

Five years of age or older
Member of a sibling group placed together for adoption
Under the age of eighteen with a physical, emotional, or mental disability

Vermont

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:

Four years of age or older
Race or ethnic background and over the age of three years of age
Member of a sibling group of two or more children being adopted by the same family
Medical condition/disability
Physical, mental, emotional or psychological disability
Certain high risk factors such as documented prenatal exposure to drugs/alcohol or diagnosis of genetic or mental illness of birth mother or father

Virginia

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:

Six years of age or older and has been in foster care for 18 months or longer
Member of a minority or mixed racial heritage
Member of a sibling group that is ready for placement at the same time and should not be separated
A physical, mental, or emotional disability
Hereditary tendency, congenital problem or birth injury resulting in a substantial risk of future disability
A child with a hereditary, congenital problem or birth injury that could lead to a future disability
Emotional ties with foster parents with whom the child has been living for longer than 12 months

Washington

A child with special needs is defined as a child that has one or more of the following factors or conditions:

Six years of age or older at the time of application for adoption assistance
Minority ethnic background.
Member of a sibling group of three or more
Member of a sibling group in which one or more siblings meet the definition of special needs
Diagnosed with a physical, mental, developmental, cognitive or emotional disability.
At risk for a diagnosis of a physical, mental, developmental, cognitive or emotional disability due to prenatal exposure to toxins, a history of serious abuse or neglect, or genetic history

West Virginia

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:

Eight years of age and older and under the age of eighteen
Member of minority group/heritage and three years of age and older
Member of a sibling group of two or more children to be adopted together
An emotional, physical, mental or medical disability

Wisconsin

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:

Ten years of age or older (if age is the only factor in determining eligibility)
Member of a minority race and children of that minority race cannot be readily placed due to a lack of appropriate placement resources
Member of a sibling group of three or more children
For an adoption assistance agreement entered into before July 1, 2011, child exhibits special need characteristics judged to be moderate or intensive under the schedule of difficulty-of-care levels specified in s.DCF 50.12(3)
For an adoption assistance agreement entered into on or after July 1, 2011, child exhibits five or more needs identified as moderate or intensive in the areas listed in s.DCF 56.23(2)(a)1.a. to e., in the rate schedule under s.DCF 56.23(2) (a). Link: http://docs.legis.wisconsin.gov/code/admin_code/dcf/021_099/56/23/2
At high risk of developing a moderate or intensive level of special needs as outlined above and based on any of the following:
- Either or both of the child's birth parents have a documented medical diagnosis or medical history that could result in a condition for the child described in subd. 3. at a later time
- The child's birth mother received inappropriate prenatal care that could later result in the child developing special needs described in subd. 3., and the inappropriate care is documented in medical or hospital records
- The child's birth mother used harmful drugs or alcohol during pregnancy that could later result in the child developing special needs described in subd. 3., and the birth mother's use of the harmful drugs or alcohol during pregnancy is documented in medical, hospital, law enforcement, or court records; the records of a county department or the department; or the records of an agency under contract with a county department or the department to provide child welfare services
- The child has experienced 4 or more placements with extended family or in foster homes that could affect the normal attachment process
- The child experienced neglect in the first 3 years of life or sustained physical injury or physical disease that could have a long-term effect on physical, emotional, or intellectual development

Wyoming

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:

Six years of age or older
Member of a racial minority
Member of a sibling group that needs to be placed in the same home
Irreversible or non-correctable physical or mental disabilities
Physical, mental or emotional disabilities correctable through surgery, treatment or other specialized services
Residing in the same foster family home for a lengthy period of time where emotional ties have been developed with the foster family and adoption assistance is necessary to facilitate an adoption