Ohio Admin. Code 5101:2-44-12 - State adoption maintenance subsidy records
(A) The public children services agency
(PCSA) shall
is
to establish a state adoption maintenance subsidy record for each child's
application for a state adoption maintenance subsidy (SAMS).
(B) The state adoption maintenance subsidy
record shall
is
to contain all information applicable to the adoption maintenance subsidy
including, but not limited to the following:
(1) JFS 01654 "Adoptive Placement
Agreement." (rev.
2/2017).
(2) JFS 01613
"Application for State Adoption Maintenance Subsidy." (rev.
4/2019).
(3) Copy of the
Title IV-E adoption assistance denial to include the JFS 01451 "Title IV-E
Adoption Assistance Application,"
(rev. 12/2015), JFS 01451-B "Title IV-E
Adoption Assistance Annual Assurance of Legal Responsibility, School Attendance
and Eligibility for Continued Medicaid Coverage" (rev. 12/2015) and the JFS 07334 "Notice of Denial
of Your Application for Assistance."
(rev. 9/2011).
(4) Documentation of the adoptive child's
special needs.
(5) Verification of
family's annual gross income at initial application and
redeterminations.
(6) JFS 01615
"Approval for State Adoption Maintenance Subsidy Agreement." (rev.
4/2019).
(7) JFS 01614
"Redetermination or Amendment of a State Adoption Maintenance Subsidy." (
4/2019).
(8) Any JFS 04065
"Prior Notice of the Right to a State Hearing" (rev.
5/2001) or JFS 07334, if applicable.
(9) JFS 01449 "Determination of Special Needs
for Medical, Mental Health or Rehabilitative Care" (rev. 7/2016) to determine whether the child has or
does not have special needs for medical, mental health, or rehabilitative
care.
(10) Copy of the final decree
of adoption.
(11) Case notes and
dictations concerning the activities of the state adoption maintenance subsidy
case.
(12) Requests for and
findings of any state hearings or administrative appeals conducted pursuant to
section 5101.35 of the Revised Code and
division 5101:6 of the Administrative Code.
(13) Child study inventory.
(14) JFS 01616 "Social and Medical
History." (rev.
6/2009).
(15) JFS 01673
"Assessment for Child Placement (Homestudy)"(rev.
12/2014) or JFS 01692 "Application for Adoption of a Foster Child or
Sibling Group." (rev.
12/2014).
Notes
Promulgated Under: 119.03
Statutory Authority: 5153.163
Rule Amplifies: 5153.163, 5153.16
Prior Effective Dates: 10/02/1980, 07/01/1990, 05/01/2003, 07/01/2004, 05/01/2009, 05/29/2014, 08/01/2019
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