Or. Admin. Code § 413-130-0110 - Administration of Approved Adoption Assistance
(1) Except as provided in OAR
413-130-0130, in order for the
Department to provide adoption assistance on behalf of an eligible child:
(a) An adoption assistance agreement must be
signed by each individual who is a party to the agreement and a Department
representative; and
(b) The
adoption assistance agreement must be in effect before the judgment of
adoption.
(2) An adoption
assistance agreement must include each of the following:
(a) A statement indicating that an adoption
assistance agreement remains in effect regardless of the state or residency of
the pre-adoptive family or the adoptive family and the child.
(b) An effective date which, except as
provided in OAR 413-130-0130, must be before the
date of the judgment of adoption.
(c) Information identifying the eligibility
of the child or young adult to receive medical assistance and specifying the
eligibility of the child or young adult for Title XIX and XX.
(d) Information that ORS
192.558 allows the Oregon Health
Plan (OHP) and OHP managed care plans to exchange the following protected
health information without authorization from the pre-adoptive family or
adoptive family for the purpose of treatment activities related to behavioral
or physical health of the child or young adult when the child or young adult is
the recipient of OHP services:
(A) The name
and Medicaid recipient number for the child or young adult;
(B) The hospital or medical provider for the
child or young adult;
(C) The
hospital or medical provider's Medicaid number;
(D) Each diagnosis for the child or young
adult;
(E) Each treatment
activity's date of service;
(F)
Each treatment activity's procedure or revenue code;
(G) The quantity of units or services
provided; and
(H) Information about
medication prescription and monitoring.
(e) Specification of the amount and nature of
all adoption assistance to be provided.
(f) A statement informing the pre-adoptive
family or adoptive family of the right to a contested case hearing under OAR
413-010-0500 to
413-010-0535.
(3) The Department remains financially
responsible for providing the services specified in the adoption assistance
agreement if the needed service is not available in the new state or service
area of residence, except as described in OAR
413-130-0100(4).
(4) The foster care base rate payment, level
of care payment, any level of personal care payment, and medical coverage end
when adoption assistance begins. Medical assistance, as determined by the
child's eligibility, may continue when requested by the pre-adoptive family or
adoptive family.
(5) The Department
may require documentation from the pre-adoptive family or adoptive family
verifying that the child:
(a) Is enrolled in
an elementary or secondary school as determined by the law of the state of
residence;
(b) Is home schooled in
accordance with the law of the state of residence;
(c) Is enrolled in an independent study
program in accordance with the law of the state of residence;
(d) Has completed secondary school;
or
(e) Is incapable of attending
school due to a documented medical condition, mental disability, or physical
disability.
(6) A
pre-adoptive family or adoptive family must immediately inform the Adoption
Assistance and Guardianship Assistance Unit of a change in circumstances that
may make them ineligible for adoption assistance or eligible for an adoption
assistance payment in a different amount.
(7) An individual who is a party to an
adoption assistance agreement may request a change of payee due to a divorce,
legal separation, or other judicially recognized modification of custody.
(a) The requesting individual must provide
the Department with the current address and telephone number of the current
payee.
(b) The Department must
notify the current payee that there has been a request to change the payee
within 30 calendar days of receipt of a request for a change of
payee.
(c) Unless the current payee
submits a challenge to the request to change payee within 30 calendar days of
the date the Department sends the notice in subsection (b) of this section, the
request to change payee will be approved.
(d) If the change of payee is challenged, the
Department requires legal documentation describing physical custody of the
child to make a change in payee.
(e) The new payee must be one of the parties
to the adoption assistance agreement.
(8) Overpayment.
(a) If the Department issues an adoption
assistance payment on behalf of a child or young adult after the date the
adoption assistance agreement automatically expires, the Department may seek
reimbursement of the overpayment and the pre-adoptive family or the adoptive
family must repay the Department.
(b) If the pre-adoptive family or adoptive
family fails to comply with any provisions of the adoption assistance
agreement, including failing to notify the Department of any of the events or
circumstances described in section (6) of this rule and OAR
413-130-0112, the Department may
collect any adoption assistance payment or medical assistance which the
Department would not have provided had the pre-adoptive family or adoptive
family complied with the provisions of the adoption assistance
agreement.
Notes
Statutory/Other Authority: ORS 418.005 & ORS 418.340
Statutes/Other Implemented: ORS 418.005, ORS 418.340, ORS 418.330 & ORS 418.335
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