922 KAR 1:050 - State funded adoption assistance
RELATES TO: KRS 199.555, 202B.010(12), Chapter 625
NECESSITY, FUNCTION, AND CONFORMITY: KRS 194A.050(1) requires the secretary of the Cabinet for Health and Family Services to promulgate, administer, and enforce those administrative regulations necessary to implement programs mandated by federal law or to qualify for the receipt of federal funds and necessary to cooperate with other state and federal agencies for the proper administration of the cabinet and its programs. KRS 199.555(10) requires the cabinet to establish and promulgate by administrative regulation criteria to be followed for the adoption of special needs children. This administrative regulation establishes guidelines for the implementation of the state-funded adoption assistance program for children who may otherwise grow up in foster care.
Section 1. Definitions.
(1) "Adoption subsidy" means a payment for a
special needs child placed for adoption when an adoption assistance agreement
is complete.
(2) "Extraordinary
medical expenses" is defined by
KRS 199.555(4).
(3) "Nonrecurring adoption expenses" is
defined by KRS 199.555(3).
(4) "Secretary" means the Secretary of the
Cabinet for Health and Family Services or designee.
(5) "Special needs child" is defined by
KRS 199.555(1).
(6) "State-funded adoption assistance" is
defined by KRS 199.555(2).
Section 2. Adoption Assistance Eligibility
Criteria.
(1) The secretary shall decide
whether to pay and provide adoption assistance in accordance with
KRS 199.555(5).
(2) A special needs child shall include a
child for whom adoptive placement without financial assistance is unlikely in
accordance with KRS 199.555(1), because the
child:
(a) Has a physical or mental
disability;
(b) Has an emotional or
behavioral disorder;
(c) Has a
recognized risk of physical, mental, or emotional disorder;
(d) Is a member of a sibling group in which
the siblings are placed together;
(e) Has had previous adoption disruption or
multiple placements;
(f) Is a
member of a racial or ethnic minority and two (2) years old or older;
or
(g)
1. Is age seven (7) or older;
2. Has a significant emotional attachment or
psychological tie to his or her foster family; and
3. The cabinet has determined should remain
with the family because it is in the best interest of the child.
(3) To qualify for
state-funded adoption assistance in accordance with
KRS 199.555, a special needs child shall:
(a) Be committed to the Cabinet for Health
and Family Services;
(b) Not have a
parent with custody or a legal claim to the child;
(c) Be under age eighteen (18); and
(d) Not be eligible for federal Title IV-E
adoption assistance in accordance with
922 KAR 1:060, with the exception
of extraordinary medical expenses pursuant to Sections 7(1), 8, and 10(2) of
this administrative regulation.
Section 3. Parental Standards. A parent
receiving a child eligible for adoption assistance payments shall meet the same
standards as those applied to other adoptive applicants in accordance with:
(1)
922 KAR 1:350; or
(2)
922 KAR 1:310.
Section 4. Adoptive Placement
Agreement.
(1) Prior to placing a child for
adoption, the prospective adoptive parent and the cabinet shall review and sign
an adoptive placement agreement to set forth the terms of a child's placement
with the prospective adoptive parent.
(2) The adoptive placement agreement shall
advise the prospective adoptive parent of the:
(a) Special needs of the child;
(b) Cabinet's expectations; and
(c) Services offered by the cabinet to assist
the prospective adoptive parent in the adoption process.
Section 5. Adoption Assistance
Agreement. Prior to finalization of the adoption, the prospective adoptive
parent and the cabinet shall discuss and sign an adoption assistance agreement
in accordance with KRS 199.555(6)
that shall:
(1) Determine the nature and
amount of the adoption subsidy; and
(2) Remain in effect until suspended,
reduced, or terminated in accordance with Section 6 of this administrative
regulation.
Section 6.
Adoption Assistance Suspension, Reduction, and Termination.
(1) Except as provided in subsection (2) of
this section, the cabinet shall temporarily suspend state-funded adoption
assistance payments during the period of time the adopted child reenters the
custody of the cabinet.
(2)
State-funded adoption assistance shall be reduced in accordance with
922 KAR 1:530, Section
3(2).
(3)
(a) If the adoptive parent fails to provide
documentation demonstrating financial responsibility and support after the
cabinet has requested the documentation in writing from the adoptive parent at
least three (3) times state-funded adoption assistance shall be
reduced.
(b) The cabinet shall
resume payments pursuant to this section, including any needed adjustments to
the agreement, once the adoptive parent has provided the requested
documentation demonstrating financial responsibility and support of the
child.
(4) State-funded
adoption assistance payments shall be terminated in accordance with
KRS 199.555(8) if the:
(a) Adoptive parent:
1. Is no longer legally responsible for the
special needs child in accordance with KRS Chapter 625;
2. Becomes deceased; or
3. Requests discontinuation of the adoption
assistance payments; or
(b) Special needs child:
1. Becomes deceased;
2. Marries;
3. Is inducted into military
service;
4. Reaches age eighteen
(18); or
5. If the child is
enrolled in high school, reaches:
a. Age
nineteen (19); or
b. The month of
the child's high school graduation, if the child's graduation precedes the
child's 19th birthday.
Section 7. Adoption Assistance Payments.
(1) State-funded adoption assistance payments
may include:
(a) Extraordinary medical
expenses in accordance with
KRS 199.555;
(b) Nonrecurring adoption expenses not to
exceed $2,000 incurred in the adoption of a child who is considered a special
needs child; and
(c) An adoption
subsidy.
(2) An adoption
assistance payment shall begin on the date agreed to by the adoptive parent and
the cabinet representative, as documented on the adoption assistance
agreement.
(3) The amount of the
state-funded adoption assistance payment shall not exceed the amount paid for
foster care maintenance for the same child, in accordance with
KRS 199.555(7), including
medically complex, specialized medically complex, and care plus foster care per
diem reimbursements established by the Department for Community Based
Services.
(4) A child placed in
therapeutic foster care, as described in
922 KAR 1:310, shall not be
eligible to receive adoption assistance payments in excess of:
(a) A care plus foster care or medically
complex foster care per diem reimbursement established by the Department for
Community Based Services; or
(b)
The therapeutic foster care per diem reimbursed by the child-placing agency on
behalf of the child unless the:
1. Dollar
amount is necessary to meet the child's needs; and
2. Commissioner or designee
approves.
Section
8. Covered Extraordinary Medical Services.
(1)
(a)
Copayments for covered extraordinary medical expenses shall be required using
the adopted parent household's adjusted gross income in relation to Kentucky's
estimated median household income established by the United States Census
Bureau.
(b) To the extent state
resources allow, the cabinet shall annually adjust the estimated median income
used for copayment calculations concurrent with the United States Census
Bureau.
(c) Unless otherwise noted
in this section, copayments shall be as established in this paragraph.
1. A copayment for extraordinary medical
services shall not be required from an adoptive parent whose household's
adjusted gross income is at or below 100 percent of Kentucky's estimated median
household income.
2. A ten (10)
percent copayment for extraordinary medical services shall be required from an
adoptive parent whose household's adjusted gross income is over 100 percent,
but less than 150 percent, of Kentucky's estimated median household
income.
3. A fifteen (15) percent
copayment for extraordinary medical services shall be required from an adoptive
parent whose household's adjusted gross income is over 150 percent, but less
than 200 percent, of Kentucky's estimated median household income.
4. A twenty (20) percent copayment for
extraordinary medical services shall be required from an adoptive parent whose
household's adjusted gross income is over 200 percent of Kentucky's estimated
median household income.
(2) A verifiable receipt and service provider
contact information shall be submitted prior to reimbursement for services
listed in this section.
(3)
Copayments shall be deducted from each monthly receipt that is submitted for
payment of a covered extraordinary medical service.
(4) Services covered by the extraordinary
medical program may include:
(a) Orthodontia
with a:
1. Copayment of fifty (50) percent of
the cost; and
2. Dentist or
physician's verification that the child's medical or dental need exists, is
medically necessary, and verification was obtained prior to the adoption
finalization;
(b)
Transportation if mileage for health treatment needs exceed the yearly mileage
for foster care rates;
(c) Child
care services:
1. For a full-time or part-time
working parent who works a minimum of twenty (20) hours per week;
2. For a non-working parent with
documentation from a qualified professional, as defined by
KRS 202B.010(12), of the
therapeutic need for the service;
3. With fees paid to the child care provider
by the adoptive parent and reimbursed by the cabinet only after the cabinet
receives a paid receipt as verified from the child care provider;
4. With annual employment verification
provided to the cabinet by a working adoptive parent;
5. Reimbursed at a rate based on the age of
the child and certification of the provider in accordance with
922 KAR 2:160; and
6. Ending upon the child reaching age
thirteen (13), unless documentation from a medical or mental health
professional stating the diagnosed need for continuance of the child care is:
a. Provided upon the child reaching age
thirteen (13); and
b. Submitted
every six (6) months to the cabinet's social service worker;
(d) Tutoring:
1. Not to exceed twenty-five (25) dollars per
hour for no more than two (2) hours per week;
2. Provided by personnel other than immediate
family, for which qualifications are verified by a social services
worker;
3. For a child:
a. With an individual education plan (IEP);
or
b. Two (2) or more grade level
years behind chronological age; and
4. With need and unavailability of services
as documented by the child's school;
(e) Respite care:
1. Offered to a child approved for the
medically complex or care plus rates prior to adoption finalization, at two (2)
respite days per child per month;
2. Offered to a child approved for the
specialized medically fragile rate prior to adoption finalization, at three (3)
respite days per month per child;
3. That shall not be cumulative;
and
4. Submitted monthly for
reimbursement; and
(f)
Evidence-based or evidence-informed health services after Medicaid and private
health insurance have been exhausted, such as:
1. Counseling;
2. Expressive or art therapy;
3. Behavioral therapy;
4. Physical therapy;
5. Occupational therapy;
6. Speech therapy;
7. Prescribed medication, excluding over the
counter medication; or
8. Special
equipment.
(5)
The extraordinary medical program shall include the reimbursement of funeral
and burial expenses for a medically complex child who had a terminal medical
diagnosis documented by a treating physician prior to an adoption being
finalized, not to exceed $4,500 for the cost of the funeral and
burial.
Section 9. Annual
Family Contact.
(1) Annual contact with the
adoptive family shall be made by mail, email, phone, home visit, or other
cabinet method of contact to determine that the:
(a) Child remains in the adoptive
home;
(b) Parent continues to
provide care and support for the child; and
(c) Adoption assistance payments continue to
meet the special needs of the child.
(2) The cabinet may conduct a home visit
after an adoption assistance annual contact is made by mail, email, phone, or
other cabinet method of contact:
(a) If:
1. The adoptive parent requests a home
visit;
2. The special needs of the
child change, as indicated by the adoptive parent;
3. Attempts to update information by mail,
email phone, or other cabinet method of contact have failed; or
4. The cabinet receives information that is
contrary to the information verified by the adoptive parent during the annual
contact; or
(b) In
accordance with
922 KAR 1:330.
Section 10. Adoption Assistance
Renegotiation.
(1) Renegotiation of an
adoption assistance agreement:
(a) May be
requested by the cabinet or the adoptive parent before or after the adoption is
finalized; and
(b) Is contingent on
compliance with Sections 2(2), 6, 9, and 12 of this administrative
regulation.
(2) If
conditions in KRS 199.555(6) are met, the
cabinet shall reimburse extraordinary medical expenses requested by an adoptive
parent of a special needs child to prevent disruption of the adoption:
(a) After the adoption is final;
and
(b) Through state funded
adoption assistance.
(3)
A move of the special needs child or the adoptive parent of the special needs
child out of the state or country shall have no effect on the child's
eligibility for state funded adoption assistance payments.
(4) If an adoption assistance payment is
changed through renegotiation, the cabinet and adoptive parent shall sign a new
adoption assistance agreement.
Section
11. Service Appeal. An applicant for adoption assistance payments
or an adoptive family aggrieved by a cabinet action shall be granted an
administrative hearing in accordance with
922 KAR 1:320.
Section 12. Notice of Change.
(1) Cabinet staff shall provide notice of a
reduction, suspension, or termination of adoption assistance payments:
(a) Ten (10) calendar days in advance;
and
(b) In accordance with
922 KAR 1:320, Section
6.
(2) An adoptive parent
shall notify the cabinet of any changes in circumstances that would make the
adoptive parent ineligible for adoption assistance payments or change the
amount of the adoption assistance payment as described in
KRS 199.555(9) and Section 6 of
this administrative regulation.
Section 13. State-funded Adoption Assistance
Limitation. The number of state-funded adoption assistance cases and the amount
of state-funded adoption assistance payments paid per case shall be limited by
available funds for the state-funded adoption assistance program.
Notes
STATUTORY AUTHORITY: KRS 194A.050(1), 199.555(10)
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