Title IV-E Eligibility & Benefits

Federal and state adoption assistance (subsidy) programs were designed to ensure that families who adopt special needs children have the necessary services and financial resources to meet their children's varied (and often costly) needs.

If you have adopted or are thinking about adopting a special needs child, your child may be eligible for a federally or state-funded subsidy. A State is required to enter into an adoption assistance agreement with the adoptive parents of a child with special needs (as defined in section 473(c) of the Act) and provide adoption assistance if the child meets specific requirements. Children must be special needs to receive a subsidy. In addition, there are four doors through which a child can walk to be eligible for Title IV-E adoption assistance:

1. Aid to Families with Dependent Children (AFDC)[1]

Adoption assistance eligibility that is based on a child's AFDC eligibility is predicated on a child meeting the criteria for such both at the time of removal[2] and in the month the adoption petition is initiated. In addition, the State must determine that the child meets the definition of a child with special needs prior to finalization of the adoption.

The method of removal has the following implications for the AFDC-eligible child's eligibility for Title IV-E adoption assistance:

If the child is removed from the home pursuant to a judicial determination, such determination must indicate that it was contrary to the child's welfare to remain in the home; or

If the child is removed from the home pursuant to a voluntary placement agreement, that child must actually receive Title IV-E foster care payments to be eligible for Title IV-E adoption assistance.

2. Supplemental Security Income

A child is eligible for adoption assistance if, at the time the adoption petition is filed, the child meets the requirements for Title XVI Supplemental Security Income (SSI) benefits, and prior to the finalization of the adoption is determined by the State to be a child with special needs.

There are no additional criteria that an SSI-eligible child must meet to be eligible for Title IV-E adoption assistance. Specifically, how a child is removed from his or her home or whether the State has responsibility for the child's placement and care is irrelevant in this situation.

Unlike AFDC eligibility that is determined by the State child welfare agency, only a designated Social Security Administration claims representative can determine SSI eligibility and provide the appropriate eligibility documentation to the State. The child's eligibility for SSI benefits must be established no later than at the time the adoption petition is filed.

3. Child of a Minor Parent

A child is eligible for Title IV-E adoption assistance in this circumstance if:

*the child's parent is in foster care and receiving Title IV-E foster care maintenance payments that cover both the minor parent and the child at the time the adoption petition is initiated; and
*prior to the finalization of the adoption, the child of the minor parent is determined by the State to meet the definition of a child with special needs.

There are no additional criteria that must be met in order for a child to be eligible for Title IV-E adoption assistance if the child's eligibility is based on his or her minor parent's receipt of foster care while placed with the minor parent in foster care. As with SSI, there is no requirement that a child must have been removed from home pursuant to a voluntary placement agreement or as a result of a judicial determination. However, if the child and minor parent have been separated in foster care prior to the time of the adoption petition, the child's eligibility for Title IV-E adoption assistance must be determined based on the child's current and individual circumstances, consistent with section 473 of the Act.

4. Dissolution of a Prior Adoption

In the situation where a child is adopted and receives Title IV-E adoption assistance, but the adoption later dissolves or the adoptive parents die, a child may continue to be eligible for Title IV-E adoption assistance in a subsequent adoption. The only determination that must be made by the State prior to the finalization of the subsequent adoption is whether the child is a child with special needs, consistent with the requirements in section 473(c) of the Act. Need and eligibility factors in sections 473(a)(2)(A) and (B) of the Act must not be redetermined when such a child is subsequently adopted because the child is to be treated as though his or her circumstances are the same as those prior to his or her previous adoption. Since Title IV-E adoption assistance eligibility need not be reestablished in such subsequent adoptions, the manner of a child's removal from the adoptive home, including whether the child is voluntarily relinquished to an individual or private agency, is irrelevant.

Special Needs Determinations

An integral part of establishing adoption assistance eligibility requires the State to determine that the child is a child with special needs in accordance with all three criteria defined in section 473(c) of the Act:

*First, the State must determine that the child cannot or should not be returned to the home of his or her parents (section 473(c)(1) of the Act); and
*Second, the State must determine that there exists a specific factor or condition because of which it is reasonable to conclude that the child cannot be placed with adoptive parents without providing Title IV-E adoption assistance or Title XIX medical assistance. Such a factor or condition may include (but is not limited to) ethnic background, age or membership in a minority or sibling group, the presence of a medical condition, or physical, mental or emotional disabilities. For example, in some States ethnic background alone may inhibit the ability of a child to be adopted, while in other States a combination of factors, such as minority status and age, may be factors. In each case the State must conclude that, because of a specified factor or factors, the particular child cannot be placed with adoptive parents without providing assistance; and
*Third, the State must determine that in each case a reasonable, but unsuccessful, effort to place the child with appropriate parents without providing adoption assistance has been made. Such an effort might include the use of adoption exchanges, referral to appropriate specialized adoption agencies, or other such activities. The only exception to this requirement is when it would not be in the best interests of the child because of such factors as the existence of significant emotional ties with prospective adoptive parents while in the care of those parents as a foster child. The exception also extends to other circumstances that are not in the child's best interest, as well as adoption by a relative, in keeping with the statutory emphasis on the placement of children with relatives.

The State must document in each child's case record the specific factor(s) that make the child difficult to place and describe the efforts to place the child for adoption without providing assistance. In an effort to find an appropriate adoptive home for a child, and meet the requirement that a reasonable, but unsuccessful, effort be made to place the child without adoption assistance, it is not necessary for the agency to "shop" for a family while the child remains in foster care. Once the agency has determined that placement with a certain family is in the child's best interest, the agency should make full disclosure about the child's background, as well as known or potential problems. If the agency has determined that the child cannot or should not return home and the child meets the statutory definition of special needs with regard to specific factors or conditions, then the agency can pose the question of whether the prospective adoptive parents are willing to adopt without assistance. If they say they cannot adopt the child without adoption assistance, the requirement in section 473(c)(2)(B) for a reasonable, but unsuccessful, effort to place the child without providing adoption assistance will be met.

Benefits

Benefits available through adoption subsidy programs vary between states, but may include:

*Monthly Maintenance Payments

*Monthly maintenance payments may be in any amount up to the foster care payment that the State would have made during the same period if the child remained in family foster care, including special costs. The amount of the payment "ceiling" may vary between children, and may change for an individual child over time. For example, some states provide a higher foster care rate for children who require special care (often called specialized rates). If the adopted child would have been eligible for a specialized rated in family foster care, the specialized rate should be the ceiling for the child's adoption assistance payment.

Medical Assistance

Children who are eligible for the federal and state adoption assistance programs are automatically eligible for Medicaid benefits (states may choose to provide another type of coverage for state-funded children as long as the coverage is identical to Medicaid). Medicaid benefits transfer across state lines if families move. The need for medical coverage is clear in the case of a child whose special needs are based on a medical condition. In other cases, however, the need may not be apparent at the time of the adoption, but undiscovered conditions, medical problems that have not been fully recognized or disclosed by the child welfare agency, and problems created by prolonged or multiple foster care placements may make the need for medical coverage equally great. It is important that the adopting parents recognize and secure the child's rights to the full amount of Medicaid assistance available.

Social Services

Under Title XX of the Social Security Act, special needs adopted children may be eligible for social services benefits if there is an adoption assistance agreement in effect with respect to the child. Title XX provides an opportunity for the worker and family to identify a set of post-adoption services that may be helpful in keeping the new family intact. Services vary between states, and are dependent upon the State's Plan for Title XX services. Services might include: day care, specialized day care, respite care services, in-house supportive services such as housekeeping and personal care, counseling, referral and assistance in obtaining help in the community, and other child welfare services. Services may or may not be available.

Nonrecurring Adoption Expenses

Adoptive parents are eligible for a onetime, reimbursement (up to $2,000) to help with the cost of adopting a special needs child. Reimburseable costs may include: adoption fees, court costs, attorney fees, transportation expenses (including travel, food, and lodging), physical and psychological examinations, and other expenses directly related to the legal adoption of a special needs child.

Families should check with their case worker to determine which expenses are covered, and how to process claims for reimbursement. Some states require the paperwork to be filed prior to adoption finalization, while others accept it up to two years after the fact. In some cases, states may pay certain expenses up-front for families (i.e., agency fees), if allowed by the state.