Decision-Making Under the Interstate Compact On Adoption and Medical Assistance

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This Issue Brief describes responsibility for administering the Interstate Compact on Adoption and Medical Assistance (ICAMA). In particular, it deals with interpretation of the Compact and with remedies available in the event that there are differences of opinion as to the meaning of ICAMA or its application in a particular case. The two principal questions answered are:

1) Who interprets ICAMA? and

2) What is the role of the Secretariat in interpretation?

Need for Consistency

ICAMA is an interstate compact. This means that it has the force of law in each party state. Also, ICAMA is a legally binding contract between and among the party states. Thus, the rule of Contract Law that the agreement must be performed by all the parties in compatible ways and its terms must have the same meaning for all the parties is applicable.

The need for consistency is also a practical matter. In the administration of the Compact from state to state, each of the cases under it is interstate in character, i.e., it involves rights created by an adoption assistance state and administered in whole or in part by another state. Therefore, proper discharge of the responsibilities of both states and the delivery of benefits and services to the child and the adoptive family require that the actions of the two states involved in each case be compatible.

The fact that ICAMA is adopted in each party state in identical words makes certain that in most cases, all the states and their personnel will understand the same things by the Compact's provisions. However, there can be misunderstandings or differences of opinion among different agencies and between or among states.

Interpretation of ICAMA

Each party state administers its own responsibilities under ICAMA. Because of its subject matter, the children's services agency (particularly its adoption services unit of units) and the Medicaid agency are each to perform their respective functions. Each agency or unit will be doing its part to serve the same child in an individual case and the population or special needs children to which ICAMA applies. However, cooperation between the affected agencies or units within the state is essential if the client(s) is to be served efficiently and effectively. The means for bringing this about are the same as for other matters of an interagency character. The administrative executives within state government who hold positions in the department(s) concerned, will provide the informal and formal mechanisms for accomplishing proper administration. ICAMA does not affect organizational structure or procedure.

If adoptive parents or other private persons or agencies have grievances arising under ICAMA, they can resort to whatever hearing procedures and other administrative and judicial remedies the laws of the particular state provide.

ICAMA does not deal with intrastate administration and has no provisions relating to that subject. The only exception is that a state can designate one or more Deputy Compact Administrators in addition to its Compact Administrator. For example, if the Compact Administrator comes from the Adoption Services Program Agency, it would be well for there also to be designated a Deputy Compact Administrator from the Medicaid Agency. If both units are in the same department of the state government and the department head is the Compact Administrator, there could well be a Deputy Compact Administrator from the Adoption Services and Medicaid Unit. Article VI of ICAMA expressly allows such an arrangement. It provides for an institutional avenue of intrastate, interagency cooperation, in addition to the other means that may be available under regular state practice. Further, this Deputy Compact Administrator approach encourages the state to have representation in the ICAMA Compact Administrators Association from both the Adoption Services and the Medicaid Programs.

The Secretariat

Article VI(b) of ICAMA provides for the Compact Administrators of the party states, acting jointly, to develop forms and procedures to be used under the Compact. They have begun to do so (e.g., standardized forms to be used in transmitting information between adoption assistance and residence states). From time to time, as need arises, they will undoubtedly add to their forms and procedures. The Compact Administrators Association (AAICAMA) has established a Secretariat to assist it in this work and in other administrative and technical matters which are difficult or impracticable to be handled on an individual state basis. This Compact Administrators Association is similar to the Compact Administrators for the Interstate Compact on the Placement of Children (ICPC). The ICAMA Secretariat is largely patterned after the Secretariat for ICPC. It has a similar legal basis and similar functions, with differences primarily due to the differing subject matters of the two compacts and the greater length of time that ICPC has been in existence.

Fifty states and the District of Columbia are familiar with and make(s) use of the ICPC Secretariat.

When requested by a Compact administrator, the ICPC Secretariat will answer questions of an informational or legal character concerning the meaning of particular compact provisions or the proper application of ICPC to a particular case or problem. The ICAMA Secretariat has not yet engaged in any extensive way in the provision of "Secretariat Opinions", but it could do so, if presented with appropriate requests or if interstate disputes are referred to it for advice. ICPC Secretariat Opinions are strictly advisory and any issued under ICAMA would also be advisory. The provisions of ICAMA do not confer upon its Secretariat the power to write opinions which the party states, their agencies or any other persons are legally bound to accept. Nevertheless, the ICPC Compact Administrators and others have found the ICPC Secretariat Opinions helpful.

The ICPC Secretariat has helped to resolve conflicts resulting from differing interpretations of ICPC provisions, when it has been requested to do so. However, it does so by giving advice. If a dispute cannot be resolved in this way, the parties have the legal remedies that state agencies normally have when they believe a contract to which they are party has been breached. The Secretariat is neither a court nor an administrative tribunal.

The existence of ICAMA and of its Secretariat services are useful in helping state and (where appropriate) local government personnel to know more about the peculiarities of interstate administration in the fields of their responsibility under Title IV-E, state adoption programs, COBRA, other federal laws and ICAMA. Further, in cases where there are interstate disputes, where private parties may seek to assert interstate rights against a state agency, or where preventive measures can be taken to forestall affected governmental agencies from exposing themselves to liability or unnecessary litigation, ICAMA and its Secretariat activities are assets to each state and its agencies.

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