9. 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?
Alabama offers financial assistance for orthodontia services that have been documented as medically necessary at the time of adoptive placement and is in progress or set to begin within ninety (90) days of adoptive placement. Financial assistance is available for children receiving out-patient counseling services at the time of placement from a therapist who does not accept Medicaid to prevent the interruption of the therapeutic intervention. All financial assistance is subject to the availability of state funds. All financial assistance is subject to the availability of state funds.
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.
Alaska Office of Children's Services (OCS) makes all efforts to grant requests for additional services on a case-by-case basis when the need of the child or the circumstances of the family is well documented. Parents are directed to contact the OCS adoption program at 907.465.3209 for more information.
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.
Arizona provides additional adoption assistance though a Special Services Subsidy. Special Services Subsidy benefits may provide for extraordinary, infrequent or uncommon needs related to the preexisting special needs conditions noted in the original adoption assistance agreement which cannot be met by Medicaid coverage or other public or private resources.
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.
Arkansas offers a program known as a Special Subsidy. Funding is available to pay for services related to the special needs for which adoption assistance was granted. Funding is only available when no other resource or benefit, private or public, exists to meet the needs of the child. Services include the following examples: psychological services (testing, family/individual therapy), therapy (physical/speech), medical and surgical services, medications, and corrective physical devices.
California does not provide additional finances or services for medical or therapeutic needs not covered under their state medical plan to children receiving adoption assistance. California offers no subsidies or assistance over and above monthly maintenance payments, Medicaid, and reimbursement of nonrecurring adoption expenses.
Colorado offers what is known as a Medical Subsidy, a provision under Adoption Case Services. Funding is available to reimburse adoptive parents or to pay a medical provider for physical or psychological services. The need for such services must be identified in the initial adoption assistance agreement and the services received under the Medical Subsidy must relate to the special need for which adoption assistance was originally granted. Funding may be used to supplement private medical insurance and to cover services not offered under the state medical assistance plan. All other resources available to the adoptive family must be utilized before funding is available.
Colorado also offers Case Services. When the identified special needs of a child placed for adoption are not covered by the adoption assistance payment, the above Medical Subsidy program, or Medicaid, services can be provided through a Case Services. The need for such services must be identified in the initial adoption assistance agreement and the services received under the program must relate to the special need for which adoption assistance was originally granted. Services and items include the following examples: respite, medication, customized equipment, speech and physical therapy, and certain psychological services.
Adoptive parents can request additional payments for medically necessary services or items that were not part of the adoption assistance agreement. The only way to receive an adoption assistance increase is through a diagnosis of “medically complex” as all adoption assistance monetary payments are made at the maximum amount permitted at the of the child’s adoption finalization. If a child’s condition becomes what is referred to as “medically complex”, parents can request to increase to the rate available for children with this diagnosis. Payments can be on a one-time basis for a specific purpose or an on-going payment, depending on the nature of the need and request. Examples of need are van modifications for a handicapped child and specialized therapy not covered by Medicaid and therapeutic respite.
Delaware does not provide additional finances or services for medical needs. Families should contact their family insurance provider or Medicaid for additional services as needed.
Delaware offers an assistance known as a Psychological Subsidy. The program provides financial assistance for treatment of an identified psychological problem, either existing or potential. Assistance is limited to $3,000 per year for expenses not covered by the family medical insurance plan or by Medicaid.
Payments may be available on a special service basis to help a family meet a specific anticipated expense or expenses when no other resource appears to be available. These determinations are made on a case-by-case basis and are determined by the specific needs of the child and documentation that the service is available through no other means and the financial circumstances of the adoptive parents.
Note: Not all services may be available in all cases. Contact your adoption assistance workers for information regarding process, eligibility, availability, and duration of services.
Florida offers a program known as Medical Subsidy that can be requested at any time. The subsidy can be received for the length of time that the condition for which subsidy was sought exists, or until the child turns eighteen years of age, whichever occurs first. The need for medical subsidy must be supported by documentation of that need from appropriate professionals and established and authorized prior to the adoptive placemen. The need or potential need for the Medical Subsidy program must also be documented in the adoption assistance agreement. Medical and medically related service costs may be subsidized under this program for conditions which pre-existed the adoption and can not include costs that can be covered by the family's private insurance or other available medical coverage.
For more information regarding additional supports, please contact your county DCFS Case Manager, the Adoption Assistance Case Manager or the Social Services Administration Unit (SSAU). Georgia DFCS county contact link: https://dfcs.georgia.gov/locations.
Hawaii does not provide additional finances or services for medical or therapeutic needs not covered under their state medical plan to children receiving adoption assistance. No specific program is available to meet a child’s extraordinary needs that are not covered by the adoption assistance payments or medical plan or other eligible services provided by the Department of Health. However, social services programs are available through what is referred to as Title XX (Social Security Act reference) to children receiving adoption assistance who meet the program’s eligibility criteria and have these program needs listed in their adoption assistance agreement. Adoptive parents are directed to contact their adoption assistance or adoption program social worker to apply for these services.
Idaho does not provide additional finances or services for medical or therapeutic needs not covered under the state medical plan to children receiving adoption assistance. Medical or therapeutic needs not covered under the state medical plan must be negotiated as part of the Adoption Assistance Agreement, or as an Amendment to the Agreement. Benefits must receive prior authorization from the State Adoption Assistance office before service delivery.
DHW local offices, link: http://healthandwelfare.idaho.gov/ContactUs/tabid/127/Default.aspx.
Illinois has a Needs Not Payable through Other Sources assistance. Payment may be made for physical, emotional and mental health needs not payable through insurance or public resource (e.g., other State or community funded programs) that are associated with, or result from, a condition whose onset has been established occurring prior to the entry of the final order of adoption. Payment shall not be made until the Department has been notified in writing that such services will begin and has approved the requested services, and a contract (when applicable has been executed. The Department’s reimbursement shall be limited to what are usual, customary, and reasonable based on Medicaid-eligible service rate in the community as determined by the Department. The Department will not pay for physical, emotional, medical, mental health or psychological services or treatment for a pre-existing condition or risk factors unless the pre-existing condition, service or risk factor is included in the adoption assistance agreement or can be documented as a pre-existing condition that was unknown at the time of the agreement by a medical provider.
Therapeutic Day Care is available only for children who are determined to have a disability that requires special educational services through an Individualized Education Plan (IEP), and Individual Family Service Plan (IFSP), or a 504 Education Special Needs Plan and is not fundable through another source. Specific therapeutic interventions must be provided as an integral part of the day care programming. Payment for therapeutic day care shall not made until the Department has been notified in writing that such services will begin, has approved the requested services, and a contract has been executed (when applicable).
Employment Related Day Care for children under the age of three years may be made if the adoptive parent is employed or in a training program that will lead to employment. Payment for day care services shall end on the child’s third birthday. This day care payment cannot be used in addition to therapeutic day care.
No, at this time Indiana does not offer any additional finances or services for medical or therapeutic needs not covered under the State medical plan.
Special services subsidy eligibility is based on the needs of the child and the availability of funds. The adoptive family and DHS adoption worker must negotiate the child’s needs for special services subsidy prior to adoption finalization. Special services may include: outpatient counseling and therapy services, the additional cost to add the child to the family’s health insurance, medical services not covered by the Medicaid program (limited to the additional cost to include the child in the family’s health insurance coverage plan), medical transportation not covered by Medicaid, supplies and equipment as required and unavailable through other resources along with other needs and reimbursements.
The Adoption and Safe Families Act requires health care coverage be provided for any special needs child for whom there is an adoption assistance agreement. It is important that the family understand the benefits and limitations of the Kansas Medicaid Program. Adoptive families shall be encouraged to add adoptive children to their health insurance policies to assure optimal coverage. They shall be informed their insurance will be considered primary if they choose to do so. A special service payment may be authorized on a time limited or one-time only basis if the child has a specific need which cannot be met through Medicaid, the monthly subsidy payment or another resource. Services are limited to a maximum of six (6) months. Plans totaling $1,000.00 or more, require prior approval from PPS Administration. Requests for approval are to be submitted in writing. The specific service payment must be identified on the adoption assistance agreement. Specify the length of service and the amount to be paid. The PPS Administration Medicaid liaison shall be consulted for information regarding Medicaid services. Kansas Department of Health and Environment, Division Health Care Services will assist in obtaining information regarding available medical services for specific children. Booklets and brochures are available through that Division for families. Additional information can be found in the Kansas Family Medical Assistance Manual (KFMAM).
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:
- Transportation for medical or treatment reasons related to the child’s special needs
- Day care services
- 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 which can be found at: http://manuals.sp.chfs.ky.gov/Resources/sopFormsLibrary/Kentucky%20Adoption%20Assistance%20Handbook%209%2019%202017.pdf.
Louisiana provides additional services to meet the special pre-existing need pay for a child’s heath related expenses when these are the result of a pre-existing chronic, severe medical or mental condition and such expenses are not covered through other sources. The amount of the Special Services Subsidy will be determined after consideration of the following factors:
- The special service is recommended by an appropriate specialist who estimates the length of time the service will be needed An estimate of the cost of service must be obtained and attached to the application
- The service needed in not available through Children’s Special Health Services, Medicaid, or some other community resource
- Payment on a reimbursement basis will be made following the submittal of receipts. Payment cannot be for more than would be paid by Foster Care
- The special service subsidy can be for an unspecified amount if based on the child’s age, or the complexity of the pre-existing condition, specialists have difficulty in projecting costs into the distant future
Maine offers the following additional services to children receiving adoption assistance. The services must be explicitly identified in the adoption assistance agreement if the needs are known at the time. It is possible to modify agreements with Central office approval to include specified services after the adoption assistance agreement is drafted.
Supplemental Services. Severely handicapped children are eligible for supplemental services, including therapeutic equipment not covered under state Medicaid, therapeutic summer camp (upon professional recommendation) and education beyond high school depending on annual funding allocations.
Limited Period Assistance. May be a monthly payment for a limited period of time, or a payment (on a recurring basis for a specified period of time) for medical or mental health costs, such as orthodontia, medical treatment, physical and mental health therapy, etc., or, if the child meets relevant criteria, educational benefits.
One-Payment Assistance. A one-time, nonrecurring payment can be made to meet a special need of a child. Examples include payment for an operation necessitated by a child's medical condition or payment for special orthopedic devices.
If a child develops a special need subsequent to finalization that was present at the time of the adoption but was not known at the time of adoption, the child may be eligible to receive post-adoption assistance. A post-adoption assistance is state-funded and the adoptive child must meet the following criteria:
- The child was in the guardianship of a Maryland public or private agency at the time of the adoption; and
- The child’s condition would have made the child eligible for adoption assistance had the condition been known prior to the finalization of the adoption
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.
The adoption medical subsidy is a reimbursement program that assists in paying for medical or treatment costs for children adopted from the public child welfare system who have an identified physical, mental or emotional condition which existed, or the cause of which existed, before the adoption petition was filed. Routine expenses for typical childhood illnesses and over-the-counter medical supplies are not covered. Eligibility may be determined before and/or after the adoption but must be made prior to the child’s 18th birthday. This subsidy is payment of last resort after all other medical coverage options are exhausted.
Adoption subsidy staff contacts can be found at: http://michigan.gov/documents/dhs/DHS-AdoptionSubsidy-Contacts_253834_7.pdf.
Reimbursement is available for special non-medical services, items, or equipment as provided in Minnesota Statutes, section 259A.20, subdivision 4, and section 256N.26, subdivision 10, that are periodically required to meet the special needs documented at the time the child was certified as eligible for adoption assistance. The adoptive parent(s) must obtain written authorization for the expense from the Adoption Assistance Program of the Department of Human Services at least thirty days before making the expenditure. The request for authorization must include documentation to support the request and three bids for the cost of items, services, or equipment. Failure to obtain prior authorization will result in denial of payment for the expense. Examples of such special non-medical services and items include: childcare, family counseling, post-adoption counseling, respite, specialized camps, specialized communication equipment, alterations to the family home or vehicle to accommodate a child’s special physical need(s), and burial expenses under certain circumstances up to a set maximum.
Note: Not all services may be available in all cases. Several services are only available for children receiving pre-Northstar Adoption Assistance. Contact your adoption assistance worker for process, eligibility, availability, and duration of services.
Mississippi does not offer additional finances or services for medical or therapeutic needs not covered under their state medical plan to children receiving adoption assistance.
Missouri offers CTS which are services that should be helpful in reducing risk and improving family functioning. CTS provide services across the Division’s continuum of care. All children and families served through CTS must have active involvement with the Division, such as an open child abuse/neglect investigation, family assessment, family centered service case, family-centered out-of-home case or adoption. CTS are purchased by the Division on behalf of the family and CTS should be used, as a payer of last resort, with children and families to prevent child maltreatment and to treat its negative consequences. These services are administered by third party providers, which may include the provision of counseling and therapy; parent aide and education services; and/or, intensive in-home services (family preservation). Services are provided in order to keep children from entering Family Centered Out-of-Home Care (FCOOHC) as well as to return children safely to their homes or other permanency plan.
Children and families may present a multitude of problems, which may require a variety of services. Contracted services to an individual or family should be provided based on the goals developed by the Children’s Service Worker, family or individual, and the provider.
CTS are established through contracts with vendors statewide to provide the following:
- Therapeutic services
- Therapeutic services are primarily intended to provide mental health assessments, psychological testing and treatment to children and family’s not otherwise eligible, covered, or receiving the specific mental health services by another entity.
- Non-Therapeutic services
- Non-therapeutic Services are intended to provide a way for the Division to offer a variety of services as needed based on the identified needs of children and families. The client or group of clients served through non-therapeutic services must have active/open CA/N, case management or adoption involvement with the Division. Services intended to prevent further incidents of child abuse and neglect, to meet the case specific needs of children, and families with open/active involvement with the Division.
- Intensive In-Home Services
- Intensive Family Reunification
- Crisis Funds Dispersement
- Language Translation and Interpretive Services for People with Hearing Loss
- Interpretive and Counseling Services for the Deaf
- Drug Testing
- Paternity Testing
- Medical Examinations (SAFE Network and Other Medical Examinations) Needed during a CA/N Investigation
- Legal Feeds
- Paying for Medical Records
- Emergency medical examination services (related to CA/N investigations
More information regarding CTS may be found in the Child Welfare Manual.
Nebraska offers what is known as Payment for Pre-Existing Medical Conditions. Funding is available to adoptive parents for medical or mental health services which were identified and document on the subsidy agreement before the decree and are not available through any other program or benefit. This care may include psychiatric, psychological, and mental health services, inpatient hospitalization, and care needed to teach basic life skills, sustain life, or maintain a physical/medical condition, as well as medication and prostheses. It does not include vocational training. The care or treatment must be medically necessary and provided by a medical practitioner or qualified mental health professional and/or prescribed by a physician and in the least restrictive, most family-like setting appropriate to meet the child’s needs. Payment for care is paid from non-Medicaid funds only if the care is not covered under the Medicaid program or no Medicaid provider is available in the community. Payment for services is made directly to providers. The need for services must be listed in the adoption assistance agreement and conditions cannot be added after adoption finalization.
Nebraska also offers what is known as a Special Service Subsidy. Funds are allocated on a one-time basis for a specific service or item for a specified period of time. Services or items must relate to the child’s special needs as indicated in the original adoption assistance agreement and are only available if no other program or resource exists to meet the child’s need. These services must be connected to the special need indicated on the original subsidy agreement. Examples of such services and items include:legal fees for the adoption, costs of integrating the child into the adoptive family, including items such as furniture for three or more siblings placed together or where specially designed furniture is required because of a child’s disability, or training for adoptive parents in parenting a special-needs child, expenses related to modifying a home to accommodate a special-needs child, such as a ramp or widening of doors, expenses for transportation, lodging and meals for the child and one parent for the the child to received medical care/treatment for a pre-existing condition.
Nevada does not have a separate program or funding source to provide additional finances or services for medical or therapeutic needs not covered under the state medical plan (Medicaid) to children receiving adoption assistance. Children with exceptional medical or behavioral needs may qualify for special payment rates, as determined by the agency, to help cover the cost of a child’s exceptional care. Parents are directed to contact the adoption assistance worker to determine if their child is eligible for exceptional care rates.
New Hampshire does not offer additional finances or services for medical or therapeutic needs not covered under their state medical plan to children receiving adoption assistance. New Hampshire adoption assistance staff will assist families in obtaining other available resources.
New Jersey offers what is known as a Special Service Subsidy. The Division of Youth and Family Services (DYFS) is responsible for the cost of services and items necessary to meet the special needs of the child.
Special services expenses resulting from a condition which qualified the child for the adoption subsidy and which are not covered by the adoptive parent's health insurance or Medicaid may be covered for reimbursement by the Division if specified in the approved adoption agreement, CP&P Form 14-184, Initial Agreement Between the New Jersey Division of Child Protection and Permanency and Adoptive Parents Regarding Subsidy Payments.
In order for CP&P to pay for a special service, determine if:
- The child has documented exceptional needs that require support services that cannot reasonably be expected to be met from the subsidy board payments; and
- No other source or program is available or able to pay for the service, including New Jersey Medicaid and the adoptive parent's privately held health insurance. It is the responsibility of the special services provider to consult with the local Medical Assistance Customer Center to determine whether the service is one which the New Jersey Medicaid program reimburses
Covered expenses include, but are not limited to:
- Speech therapy,
- Physical therapy,
- Special training, and
- Home or van renovation (not purchases) to meet the needs of a child
Adoptive parents may request payment for other medical or psychological expenses related to the child’s needs. The family requests the payment in writing with justification for the payment. The family first requests payment through either Medicaid or private insurance before requesting payment from Children, Youth and Families Department (CYFD). The family submits verification of the denial of benefits with the request for payment by CYFD. CYFD considers payment for the following:
- A pre-existing medical cost not covered by Medicaid or insurance that is necessary to meet the needs of the child as verified by a physician
- Out-patient therapy for behavioral, emotional, or psychological needs that are necessary to meet the needs of the child as verified by a physician or therapist
- Residential Treatment Center (RTC) or group home placements, with the following conditions:
- The statewide entity has approved this level of treatment; and
- The family is participating in the therapy; and
- The child’s plan is reunification with the family; and
- The child remains in the family’s legal custody; and
- The family is providing for the child (clothing, school expenses, allowances, daily living needs, etc.)
If approved, the subsidy specialist sends written verification of the payment change in the subsidy and prepares a new annual agreement form for the family’s signature. Upon receipt of the signed agreement, the subsidy specialist enters the changes in FACTS effective on the date of the signature. There is no retroactive payment for increases in subsidy maintenance. If the increase is not approved, the subsidy specialist notifies the adoption manager and notifies the family of the right to an administrative hearing of the decision. The adoption manager makes arrangements with the regional manager to assign a placement worker for the purpose of meeting with the family to assess the child’s needs and identify any resources in the community necessary to assist the family and child.
Note: Not all services may be available in all cases. Contact the local placement services social worker for information regarding process, eligibility, availability, and duration of services.
New York does not provide additional finances or services for medical or therapeutic needs not covered under its state medical assistance state plan to children receiving adoption assistance.
Special needs children with chronic mental or physical conditions or illness may receive services in addition to those covered under North Carolina’s Medicaid plan if services are medically necessary and receive pre-certification under Early and Periodic Screening, Diagnostic and Treatment (EPSDT). Contact your Medicaid caseworker for more details on EPSDT.
North Carolina also has adoption assistance vendor payment for medical and therapeutic services, HIV Supplemental Payments, and Supplemental Special Children Adoption Incentive Fund for child with severe medical and rehabilitative needs. Supplemental Special Children Adoption Incentive Fund is limited to county participation and is therefore not available to all children.
North Dakota does not provide additional services for medical or therapeutic needs not covered under their sate medical plan to children receiving adoption assistance.
Post Adoption Special Services Subsidy (PASSS) program limitations include eligibility criteria and state funding ability. Funding is only available when the assistance sought exceeds the adoptive family’s private resources and assistance is capped at $10, 000 per fiscal year. The limit of $10,000 may be increased up to five thousand dollars a total of fifteen thousand dollars per child per state fiscal year if Medical and surgical services, including respite care is required, if:
- The family’s income and resources substantial decrease due to involuntary loss of employment and
- A qualified professional recommends residential treatment, in-patient hospitalization, or therapeutic foster care to prevent disruption of adoption
To receive additional PASSS funding, the family must complete the Application for Additional Post Adoption Special Services Subsidy (PASSS) Funding for Extraordinary Circumstances. The benefit application must be made at the county department of job and family services, local Benefit Bank Site or https://benefits.ohio.gov/.
State Adoption Maintenance Subsidy (SAMS) program provides financial assistance to families based on children’s special needs at the time of the adoptive placement. Application for SAMS must be made prior to the final decree of adoption. Once an adoption has been finalized, a child will not be eligible for SAMS but may be eligible for Post Adoption Special Services Subsidy (PASSS).
The benefits of the SAMS program are a monthly adoption assistance payment and/or a Medicaid card. Medicaid cards are available to children with mental, physical or rehabilitative needs. The benefit application must be made at the county department of job and family services, local Benefit Bank Site or https://benefits.ohio.gov/.
Oklahoma offers what is known as Special Services. A special service is usually a one-time payment and is used to meet a child’s needs that cannot be met by the adoptive parents and are not covered under any other program for which the child would qualify. These services may include corrective medical equipment, such as leg braces, prostheses and walkers. Adoptive parents must first seek and exhaust all resources, both public and private, before Special Services are available.
Oregon may provide one-time payments for services approved in exceptional cases as negotiated between Oregon Department of Human Services (ODHS) and the adoptive family. ODHS may authorize these expenses for a limited duration, subject to the agency’s discretion and availability of resources. If necessary, the family will be requested to provide documentation substantiating the need for assistance to ODHS. Payment is made to the adoptive family who is then responsible for reimbursing the provider for services.
Pennsylvania does not offer additional finances or services for medical or therapeutic needs not covered under its state medical plan to children receiving adoption assistance. However, uncovered costs may prompt an adoptive family to request a renegotiation of their adoption assistance agreement, particularly if the child’s medical or therapeutic needs have increased since the agreement was originally signed. In no case may the adoption assistance payments exceed the amount the county agency would expend to maintain the child in foster care.
Rhode Island offers Other Services. Services include the following examples: day care, respite, and psychological/emotional/behavioral counseling if included in the adoption assistance agreement.
Supplemental Benefits for Medical Assistance (SBMA)is available for conditions that preexisted adoption finalization. Adoptive families must determine the amount of the supplement and request this benefit at the time the adoption assistance agreement is drafted and signed. SBMA is available to meet children’s physical, emotional, and psychological needs unable to be met under any other resource, public or private. Availability is limited to children placed through the South Carolina Department of Social Services.
South Dakota offers what is known as Special Non-medical Subsidies. Funding is available for expenses incurred for services in care of the adopted child. Services include the following examples: expenses incurred in transporting the child to medical care, special education, and psychological treatment; psychological/psychiatric testing and treatment, special education necessary to meet psychological or emotional needs preexisting adoption finalization; and family training or education needed to address the child’s special needs or to provide for their care.
South Dakota also offers what is known as Medical and Surgical Subsidies. Funding is available for physical conditions that existed prior to adoption finalization and is only available once the adoptive family has exhausted all insurance resources. Services include the following examples: prescription medication, physician service, hospitalization/hospital services. If necessary services are not covered under South Dakota’s state medical plan, need for such services must be listed in the adoption assistance agreement to be eligible for funding.
Tennessee does not provide additional finances or services for medical or therapeutic needs not covered under their state medical plan to children receiving adoption assistance. No additional financial assistance or services are available outside of the adoption assistance agreement. Adoption assistance agreements initiated on or after October 1, 1997 require that medically necessary services be funded by either TennCare or private insurance (family coverage).
Texas does not have a specific program to provide additional finances or services for medical or therapeutic needs not covered under the state medical plan. Additional services may be available through their Post Adoption Service Program- see Question #7 for information on post adoption services in Texas.
Note: Not all services may be available in all cases. Contact your adoption assistance worker or post adoption services contact for process, eligibility, availability, and duration of services.
Utah may provide payment through what are known as Supplemental Adoption Assistance Agreements. These agreements are time limited for 6-12 months based on annual funding appropriated by the Utah State legislature. Requests for up to $3, 000 can be approved within an agency, up to $10, 000 by a Regional Adoption Assistance Committee, and requests over $10, 000 are sent to a state-wide Supplemental Adoption Assistance Committee.
Vermont does not provide additional finances or services for medical or therapeutic needs not covered under its state medical plan to children receiving adoption assistance.
Any medical service needed by the child as a result of the child’s physical, mental or emotional disabilities are available. Medicaid is used and any additional health needs are covered through Special Service Payments funded by the state. Funds are available for special services which are unavailable through the family’s private insurance or through an alternate resource. Services include the following examples: medical care, physical equipment, remedial educational services, psychological and psychiatric evaluations and treatment, and residential treatment. Receipts for services must be submitted for payment to Virginia DSS within six months of the end of the month services were received.
No, Washington does not provide additional finances or services for medical or therapeutic needs not covered under its state medical plan to children receiving adoption assistance.
West Virginia has a program known as Adoption Assistance Conditional Services. Funding is available for time-specified, short-term assistance to meet medical expenses not covered by Medicaid (except for therapeutic hospitalization). Need for such services must be based on conditions preexisting adoption finalization and should be included in the adoption assistance agreement. Assistance is granted on a case-by-case basis and is subject to the availability of funds. Financial support for extraordinary needs or services is subject to the approval of the administrative management team. Contact the adoption assistance program specialist for program specifics.
Note: Not all services may be available in all cases. Contact your adoption assistance program specialist for information regarding process, eligibility, availability, and duration of services.
The adoption assistance rate is negotiated to cover costs not covered by Medicaid. After the adoption is finalized, the family can request minor adjustments to the supplemental rate on an annual basis, but there is no funding to cover major costs not included in the adoption assistance rate. If a monthly monetary adoption assistance amount was awarded, it consists of a basic rate that is determined by age, a supplemental rate based on the needs of the child, and exceptional rate when applicable
A supplemental rate is based on an assessment of a child’s emotional, behavioral, and physical and personal care characteristics. An exceptional rate is established, if applicable, at the time the adoption assistance agreement is signed and is designed to allow the child to live in a less restrictive environment. For a complete listing of these characteristics and their corresponding levels of care for a child whose adoption assistance agreement was signed prior to July 1, 2011, see Schedule of difficulty-of-care levels at: http://docs.legis.wisconsin.gov/code/admin_code/dcf/021_099/50/12/3.
For a listing of these characteristics and their corresponding levels of care for a child whose adoption assistance agreement was signed on or after July 1, 2011, see DCF 56.23 Supplemental payments, exceptional payments, initial clothing allowance, and retainer fee – 56.23(2) at: http://docs.legis.wisconsin.gov/code/admin_code/dcf/021_099/56/23.
Note: Not all services may be available in all cases. Contact your adoption assistance worker or the Department’s Adoption Services Section at 866-666-5532 for information regarding process, eligibility, availability, and duration of services.
Wyoming does not provide additional finances or services for medical or therapeutic needs not covered under their state medical plan to children receiving adoption assistance.