Missouri State Adoption Subsidy Profile
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?")
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, without any other characteristics listed below
- Minority racial or ethnic parentage
- Member of a sibling group of two or more children placed in the same adoptive home at the same time
- A handicapping mental, physical or emotional condition
- A “guarded prognosis” indicating possible future problems related to the child's condition or status at the time of adoptive placement
Note: Children must be legally free for adoption and have been either in the custody of the Missouri Children’s Division, The Missouri Division of Youth Services, The Missouri Department of Mental Health, or a Licensed Private Child Placing Agency to be eligible for adopiton assistance.
2. What are the eligibility criteria for your State-funded adoption assistance program?
In order to be eligible for state-funded adoption assistance a child must be a special needs child as defined above, legally free for adoption, and have been either in the custody of the Missouri Children’s Division, The Missouri Division of Youth Services, The Missouri Department of Mental Health, or a Licensed Private Child Placing Agency.
3. What is the maximum amount a family may receive in non-recurring adoption expenses from your State? (Adoptive parents can receive reimbursement of certain approved, "one-time" adoption expenses incurred in the process of finalizing a special needs adoption.)
$2,000.00 per child
4. Does your State enter into deferred adoption assistance agreements? (In some States, adoptive parents can enter into an agreement in which they choose to defer the receipt of a Medicaid card, the monthly monetary payment, or both and can elect to receive the Medicaid card and/or monetary payment at another time.)
Missouri offers deferred adoption assistance.
5. When may adoption assistance payments and benefits begin in your State?
Adoption assistance payments and benefits may begin in Missouri at the time the petition to adopt has been filed if the child is legally free for adoption. Until that time, foster care payments may be made to the placement resource.
6. How are changes made to the adoption assistance agreement in your State?
- When can a parent request a change in the adoption assistance agreement?
- How does a parent request a change in the adoption assistance agreement?
- What if a parent does not receive the change they request in the adoption assistance agreement?
Adoptive families can request a change in the adoption assistance agreement at any time, either in person or in writing. Requests for modification to the agreement are based on changes in the circumstances of the family or the needs of the child and are submitted to the child’s Children’s Division Adoption Specialist, who should be located within their local county office. Requests for assistance above the basic subsidy package must be accompanied with supporting documentation from appropriate sources. Adoption assistance agreements are reviewed on a yearly basis. DSS sends written notice of the need for such reviews at least sixty days prior to the effective date. If parents do not indicate a need for change in the agreement, agreements may be automatically renewed. Services within the agreement that are time specific do not automatically renew and must be must be reviewed and reauthorized.
If a family disagrees with a decision made by the Division regarding subsidy, they have a right to request a fair hearing regarding that issue within ten days after receiving written notification from the Division. If they wish to request a fair hearing, they must contact their social service worker to request the necessary paperwork. A hearing officer through the Division of Legal Services will arrange a hearing. Information regarding the request and documentation will be shared at this hearing. The family may hire an attorney if they wish, however, the Division will not cover this expense. The hearing officer will make a determination on the case once both sides have presented evidence. Once the hearing officer makes his or her determination, the matter is sent to the Division Director for final approval/disapproval and the determination will be sent to the family and the county for follow-through.
7. What types of post adoption services are available in your State and how do you find out more about them?
Post adoption services in Missouri are administered through the Department of Social Services, Children’s Division as well as adoptive family organizations and include the following examples:
- Information and referral
- Education programs
- Support groups program
- Therapeutic intervention
- Advocacy
- Respite
- Residential treatment
- State adoption registry
For post adoption services information, contact the Foster and Adoptive Care Coalition link: http://www.foster-adopt.org, or phone 314.340.7722 or 1.800.FOSTER3. Additional contacts include the Adoption Exchange at 800.554.2222, Midwest Foster Care and Adoption Association at 816.350.0215, and the Missouri Foster Care and Adoption Association at 417.538.4362.
Note: Not all services may be available in all cases. Contact your adoption assistance worker or post adoption services contact for information regarding process, eligibility, availability, and duration of services.
8. What mental health services are provided by your State?
Public mental health services for children in Missouri are administered through the DSS Division of Medical Services (DMS) and includes the following examples: inpatient and outpaitent hospital care, respite, prescription drugs, community pyschiatric rehabilitation, comprehensive substance treatment and rehabilitation (C-Star), physician services, psychological counseling, and case management. For childern in DSS Children’s Division custody in out of home placement, Children’s Treatment Services include the following examples: day treatment, evaluation and diagnosis, family residential treatment, family therapy, group counseling, individual counseling, respite care, and resource coordination.
Missouri Division of Medical Services Medicaid/mental health and Children’s Treatment Services link(s): http://www.dss.mo.gov/dfs/msmed.htm and http://www.dss.mo.gov/cd/cts.htm. Or phone DMS at 573.751.3425. The DSS Children’s Division operates a Parental Strees Helpline 24 hours a day, seven days a week at 1.800.367.2543. Medicaid coverage is secondary to any private insurance of the adoptive family.
Note: Not all services may be available in all cases. Contact your adoption assistance worker or medical assistance specialist for information regarding process, eligibility, availability, and duration of services.
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?
Missouri offers what is known as Special Services. Funding may be used for the family or child and only when no other resources are available to meet the identified need. Costs may be on a one-time or on-going basis and include: treatment or rehabilitative services (including day care and respite care), residential treatment services, and medical or dental services not covered under Medicaid. Prior authorization, professional documentation of need, and a listing of the need for Special Services in the adoption assistance agreement are required for eligibility.
Missouri also offers what is known as Time-Limited Services. Funding is intended to meet the short- or long-term diagnostic and treatment needs nature as secondary coverage. Parents must use private insurance as primary coverage whenever possible and Medicaid will serve as secondary coverage in these situations. The Division will not supplement payment made by private insurance.
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.
10. What is your State's process for applying for a fair hearing? (A fair hearing is a legal, administrative procedure that provides a forum to address disagreements with agency decisions.)
Adoptive parents can request a fair hearing whenever they disagree with any Children’s Division decision related to an adoption assistance agreement. Requests must be made in writing within ten days from the date of the contested Children’s Division action notification and sent to the local Children’s Division office. Requests are referred to fair hearing staff after a supervisory review process. A fair hearing request may be made when a child is determined to be ineligible for adoption assistance, when a request for assistance made by the family is denied, or when services have been removed, prior to then end date on the adoption assistance agreement. The request for a fair hearing is to be made to the family’s Adoption Specialist in writing. A fair hearing form (IM-87) may be requested through the Adoption Specialist, or the Specialist’s supervisor, and is to be completed either by the family’s Adoption Specialist or by the family.
11. What is your State Web address for general adoption information?
12. What is your State Web address for adoption assistance information?
Missouri’s adoption assistance link: http://www.dss.mo.gov/cd/adopt/masp.htm
13. What is your State Web address for State-specific medical assistance information for children?
Credits: Child Welfare Information Gateway (http://www.childwelfare.gov)
