Introduction

It appears that some of the states party to the Interstate Compact on Adoption and Medical Assistance (ICAMA) are not using the approved forms for transferring and ascertaining the status of interstate cases. This failure to use the forms is a serious matter for several reasons:

1. It is a breach of the state's legal obligation when the forms are not used.

2. It results in inconvenience, increased costs for other party states, and delays in processing eligibility documents.

3. It delays or denies to adoptive parents and their children rights and benefits assured them under state contracts.

4. It could be viewed as a violation of federal law that could result in disallowance of federal payments to the State pursuant to Titles IV-E and XIX of the Social Security Act.

This Issue Brief addresses the legal and administrative significance of ICAMA forms and procedures. While clearly a convenience, use of ICAMA forms is also a requirement for party states.

Meaning of ICAMA Provisions

ICAMA has the force of statutory law in the party states. It is also a contract in effect between each party state and all of the other party states. Consequently, all officers and employees of the party states have both a legal and a moral obligation to act in accordance with the provision and intent of ICAMA.

Four provisions of ICAMA are especially relevant in determining whether use of the forms developed jointly by the ICAMA Administrators is optional or required. These are Article I (d), Article II (b), Article VI (b) and Article VIII.

Article I includes a declaration of the importance to the states of the cooperation provided by ICAMA to the financial well-being of the states as well as to the interests of adoptive parents and children. Article I (d) goes on to expressly provide:

"The necessary assurances of adoption assistance for children with special needs in those instances where children and adoptive parents living in states other than the one undertaking to provide the assistance include the establishment and maintenance of suitable substantive guarantees and workable procedures for interstate cooperation..." (emphasis added).

Under Article II the purposes of the Compact includes: "(b) Provide substantive assurances and operating procedures which will promote the delivery of medical and other services to children on an interstate basis..." (emphasis added).

To carry-out the express provisions in Articles I and II, Article VI (b) states: "Acting jointly, the Compact Administrators shall develop uniform forms and administrative procedures for the interstate monitoring and delivery of adoption and medical assistance benefits and services..." Moreover, the first sentence of Article VIII provides: "The provisions of this Compact shall be liberally construed to effectuate the purposes thereof."

Article VI (b) does not merely empower the Compact Administrators, acting jointly, to make forms and procedures. It says that they shall develop uniform forms and procedures. Thus, there is a requirement that there be uniform forms and procedures. It would be ridiculous to argue that this provision says only "develop" and that each party state then has an option as to whether to use forms or procedures developed pursuant to the Compact. The language of Articles I (d) and II (b) quoted above expressly find and set forth the intent and purpose of the party states, acting through ICAMA, to establish and maintain a system of interstate cooperation for interstate adoption assistance and medical assistance cases.

Uniformity of forms and procedures for handling interstate cases is clearly the essence of such a cooperative system. There is no uniformity as between a state and the other party states unless they all use the same forms and procedures which have been developed by the joint action of the Compact administrators pursuant to Article VI (b) of ICAMA. In regard to these points, the commentary to the Compact concerning the Article VI (b) reads as follows:

The performance of many functions, especially those involving individuals cases and the basic methods for handling certain types of cases requires uniformity or consistency among the Compact states. Continuity in administrative processes is necessary because agencies of two or more states rather than only one are involved. Forms and procedures adopted by joint action pursuant to this provision are to be used by the state agencies and, where appropriate by other affected persons and entities, in processing matters to which the Compact applies. Their use is an important part of the contractual obligations undertaken by Compact member states. (Emphasis added).

Finally, the requirement of Article VIII that the provisions of ICAMA be liberally construed to effectuate its purposes merits attention. This section lays down the rule that in case of any doubt, or ambiguity, the interpretation of the wording should be such as to further implementation of the Compact -- in this case uniformity.

State and Federal Law

Upon entering the ICAMA, each state made a contractual commitment to the other party states. This is done pursuant to specific statutory authority for that purpose and at the direction of the state legislature. By law, therefore, party states are mandated to create and maintain a cooperative system for the handling of interstate cases.

Federal law is to the same effect as the state statutes. With the passage of Public Law 96-272, the Adoption Assistance and Child Welfare Act of 1980, states are required to protect the interstate interests of adoption assistance children in order to receive Title IV-E and Title XIX funds. An interstate compact (i.e., ICAMA) is expressly specified in the federal law as a means of affording the protection envisioned. This means that failure to follow the provisions of ICAMA and its implementation measures could provide the ground for adverse federal audit action that would lead to the withholding or withdrawal of federal contributions to the state's medicaid program, its adoption assistance program, or both.

Administrative Convenience and Efficiency

ICAMA's uniform forms and their accompanying procedures have a very real place in achieving the convenience and efficiency which is the purpose of the Compact and its underlying state and federal legislation. It is true that initially there is some effort in making any change. However, those states which have adopted the ICAMA forms have made this change with minimal disruption.

Where the ICAMA forms are used, there are savings in time, work and cost for the state personnel involved and for the adoptive parents. Failure to use approved ICAMA forms seriously impairs the ability of Compact administrators to fulfill the state law and the promise of uniformity and consistency under the Compact. Since the forms and process are the same from state-to-state, regular use at both ends of the individual account transactions cuts down the time and effort required to handle interstate cases. Further, it serves to avoid confusion about the source and availability of benefits and services for children during the interim period surrounding a transfer from one residence state to another.

ICAMA forms 5.01 and 5.02 (dealing with interstate establishment or transfer of Medicaid eligibility and records in interstate cases) reduce the amount of paperwork required to set up new Medicaid accounts. They make it unnecessary to reproduce or reassemble documentation and information previously provided by at least one other state and by the adoptive parents. They also establish an easy and consistent system for transferring the Medicaid eligibility of a child from one state to another in accordance with federal and state law. ICAMA form 4.01, Report on Child's Status, is a simple way to keep track of the circumstances of an interstate case.

ISSUE BRIEF XII

© May 1990