Alabama State Subsidy Profile
Updated May 2012
State Subsidy Contact Person
Department of Human Resources (DHR)
50 N. Ripley Street
Montgomery, AL 36130
NACAC Subsidy Representative (parent/volunteer)
AL Foster/Adoptive Parent Assn.
1091 County Rd 1659
Cullman, AL 35058
AL Foster/Adoptive Parent Assn.
PO Box 16
Titus, AL 36080
Phone: 334-567-4143 or 334-303-1426
What Is Adoption Subsidy?
Parents who are thinking about or are in the process of adopting a child with special needs from foster care should know about adoption assistance (also known as adoption subsidy). Federal (Title IV-E) and state (often called non-IV-E) adoption assistance programs are designed to help parents meet their adopted children’s varied, and often costly, needs. Children can qualify for federal adoption assistance or state assistance, depending on the child’s history. Adoption subsidy policies and practices are, for the most part, dependent on the state in which the child was in foster care before the adoption.
Below is information related to definitions of special needs, benefits available, and procedures in Alabama. Answers to select questions were made available by the Association of Administrators of the Interstate Compact on Adoption and Medical Assistance (AAICAMA) through the Child Welfare Information Gateway (www.childwelfare.gov). Profiles for other states’ subsidy programs are available. If you have additional questions, please contact NACAC at 651-644-3036, 800-470-6665, or firstname.lastname@example.org. If you have state-specific questions, please call your State Subsidy Contact Person or the NACAC Subsidy Representative (listed above) for more information.
For more information on Title IV-E eligibility, view our fact sheet Eligibility and Benefits for Federal Adoption Assistance.
Adoption resources on the web:
Alabama state-specific medical assistance:
Alabama Statutes: 26-10-20 through 26-10-30
Click on the far left tab Code of Alabama,
then click on View,
then click on Title 26, Infants and Incompetents,
then click on Chapter 10, Adoption of Children
Alabama Administrative Code: 660-5-22-.06 Subsidized Adoption
Scroll down to Chapter 660-5-22 Adoption
Who is Eligible for Adoption Assistance or Subsidy?
1. How does Alabama define special needs to determine eligibility?
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 adoption without financial assistance:
- Eight years of age or older
- Member of a sibling group of three or more children placed together at the same time
- A child who has certain documented physical, mental, or emotional issues
- A child at risk of physical, mental or emotional difficulties in the future, due to high risk factors document in the background information
To be eligible for adoption assistance a child must first be in the custody of the Department of Human Resources or an Alabama licensed child-placing agency or be eligible to receive SSI at the time of placement.
2. Does the state-only funded adoption assistance program differ in any way from the Title IV-E program?
To be eligible for state-funded adoption assistance, a child must have special needs child as defined above and be in the permanent custody of the Alabama Department of Human Resources.
3. Are children adopted from private agencies in Alabama eligible for adoption assistance?
Only federal (title IV-E) adoption assistance is available to children who were adopted from the custody of private agencies.
What Supports and Services Are Available?
4. What is the maximum basic monthly adoption assistance maintenance payment in Alabama?
5. Does Alabama provide specialized rates (based on the extraordinary needs of the child or the additional parenting skill needed to raise the child)?
Therapeutic rate (negotiated):
not to exceed $1,055
not to exceed $1,068
not to exceed $1,079
not to exceed $1,091
Difficulty of Care Rates
Specialized services $50 /month in addition the base rate
Medically fragile rate $1,080 / month
Difficulty of care may be provided to:
- Children who have exceptional physical, mental, emotional, or behavioral needs
- Children with extreme illness or disabilities requiring nursing care (excluding children in residential treatment facilities)
- Emotionally disturbed children requiring more restrictive therapeutic care
- Medically fragile children
6. When do adoption assistance payments begin?
Adoption assistance benefits may begin at adoption placement.
7. When a child turns 18, which benefits, if any, continue?
State-funded adoption assistance typically terminates when a child reaches age 19, but may continue until 21, provided she is in high school or in a specialized training program for the intellectually impaired, which is designed to aid her in becoming self-supporting.
Federally funded (IV-E) adoption assistance can be extended to the age of 21 if the child has a documented disability that warrants continuation of assistance.
8. Does Alabama offer deferred adoption assistance agreements (agreements where initial monthly maintenance amount is $0 for children at risk of developing special needs later)?
Alabama offers deferred adoption assistance. Evidence of disability is not necessary at the time of placement, but professional documentation of a high risk of developing a physical, emotional or psychological disability is necessary. The high-risk background is based on the documented emotional or psychological history of the child's biological family.
9. What Medicaid services are available in Alabama?
- EPSDT (MediKids)—MediKids screenings may be done up to nine times before the child reaches two years old and once a year after that.
- Hospital care: In certain hospitals, children under 6 years of age receive unlimited inpatient days.
- Dental Care: Medicaid will pay for routine dental care for children under 21.
- Eye care: Children under 21 may be examined every year.
- Hearing: children under 21 years of age may be examined every year.
- Psychiatric Care: unlimited medically necessary inpatient psychiatric services are provided to children under 21 years of age in certain psychiatric hospitals
- Prescription Drugs (most have a co-pay)
- Laboratory & X-ray
- Doctor—14 doctor's visits per year
- Ambulatory Surgical Centers
- Prenatal Services
- Family Planning
- Home & Community-Based Services
- Nursing Home Care
- Renal Dialysis Program
- Hospital—Inpatient: 16 days per year; for a semi-private hospital room; Outpatient: 3 non-emergency outpatient hospital visits each year. Health Care Clinics and Centers—Medicaid pays for medical services available at rural health clinics, and community health centers.
- Community Services for Substance Abusers and the Mentally Ill • Home Health Care (services for persons of all ages who are SSI eligible and who have been diagnosed by a doctor to be mentally retarded or developmentally disabled)
- Case Management (to help eligible mentally ill, developmentally delayed, or disabled persons and others receive needed services in their community.
10. What medical benefits are available for state-funded children? (Children who have federally funded/Title IV-E adoption assistance are automatically eligible for Medicaid benefits.)
Non-IV-E eligible children for whom there is in effect a signed, approved state adoption assistance agreement may be eligible for Medicaid. To be eligible, it must be determined that the child cannot be placed for adoption without medical assistance because of the child’s special needs for medical or rehabilitative care. Before the execution of the adoption assistance agreement, the child must have been eligible for Medicaid under the state’s approved Medicaid plan.
11. What mental health services are available?
Public mental health services for children in Alabama are administered by the Alabama Medicaid Agency and may include psychiatric hospital services, physician services, and prescription drugs. Medicaid pays for medically necessary services in a psychiatric hospital for children under 21 as long as the treatment is approved in advance by Medicaid. The services received from a mental health center do not count against regular doctor's office visits or other Medicaid covered services. For more information about Medicaid, visit http://www.medicaid.alabama.gov/
Additional information may be available from the local DHS office (listed at http://dhr.alabama.gov/counties/county_select.aspx).
12. In Alabama, what nonrecurring adoption expenses directly related to the finalization of an adoption may be reimbursed?
Parents may be reimbursed for up to $1,000 per child for eligible expenses including attorney fees, court costs, criminal records clearance, medical and psychological evaluations, supervision of the placement prior to finalization, transportation costs for placement and pre-placement, and the reasonable costs of lodging and food for the child and/or adoptive parents necessary to complete the adoption process.
All families adopting children with special needs (including private agency adoptions, independent adoptions, and intercountry adoptions) are potentially eligible for reimbursement of nonrecurring expenses. Adoptive parents are required to pay for expenses incurred and provide the Office of Adoption with original receipts to claim reimbursement. Alabama now provides direct payment to attorneys upon adoption finalization, with the agreement of the adoptive parent. All claims must be made within 12 months of the final adoption decree.
13. Is child care available? If yes, who is eligible and how do families access child care?
Parents may be able to access child care assistance from their local county department of human services based on income eligibility or protective services needs.
14. Is respite care available? If yes, who is eligible and how do families access respite care?
Respite care is not currently provided. See question 16 for more about available post-adoption services.
15. Is residential treatment available? If yes, who is eligible and how do families access residential treatment services?
Adoption assistance may cover outpatient counseling, but not residential treatment. A family may contact the local county office of human services (http://dhr.alabama.gov/counties/county_select.aspx) to determine if residential services are available outside of the adoption assistance program. The county will assess each case individually to determine if it will provide residential services.
16. What other post-adoption services are available in Alabama and how do families find out more about them?
Post-adoption services in Alabama are administered by the Department of Human Resources through contracts with outside agencies. Known as the Alabama Post Adoption Connections (APAC) program, services are provided through three offices located throughout the state. Post-adoption services may include:
- Information and referral
- Educational programs
- Educational materials
- Support groups
- Adoptive family crisis counseling
- Resource libraries
- Scholarships/camp funding
For more information, contact the Alabama Post Adoption Connection at http://www.casapac.org or 866-803-2722. See also the Alabama Foster and Adoptive Parent Association (AFAPA) at http://www.afapa.org or 888-545-2372. Additional resources can be found at http://www.dhr.state.al.us.
Counseling and orthodontia services, which may be covered under adoption assistance, must be approved by the state office.
Not all services may be available in all cases. Parent should contact their adoption assistance worker or post adoption services contact for information regarding process, eligibility, availability, and duration of services.
17. If the assistance listed above in questions 13 to 16 are for specific services, must these services be explicitly identified in the adoption assistance agreement?
What Should Families Know About Applying for Subsidy?
18. Who initiates the adoption assistance agreement?
The caseworker involved in placement should initiate discussions about adoption assistance. In most cases that social worker initiates the adoption agreement. however, in cases of private agency adoptions sometimes families have initiated agreements.
19. Who makes the final determination on an adoption assistance agreement?
The county determines the regular rate of adoption assistance eligibility based on the special needs criteria with the concurrence of the State Office of Permanency. Therapuetic and medically fragile rates and counseling and orthodontia services, which may be covered under adoption assistance, are determined at the state level.
20. How do families request adoption assistance after finalization of an adoption?
Parents must submit a written request along with any supporting documentation to:
Office of Permanency
Alabama State Department of Human Resources
50 North Ripley Street
Montgomery, AL 36130-4000
How Can a Family Adjust an Adoption Assistance Agreement?
21. Can adoptive parents ask to change an adoption assistance agreement?
Adoptive parents can make a request for a change in the adoption assistance agreement at any time when there is a change in the family’s circumstances or the child’s needs. Professional documentation supporting the requested change is required, if appropriate. Requests for change must be in writing to the Program Manager, Office of Permanency (see question 20 for contact information).
22. What steps does a family go through to appeal an adoption assistance decision in Alabama?
Adoptive parents have the right to request a fair hearing to review any DHR decision affecting the receipt of their child's adoption assistance benefits. Parents request a fair hearing by writing to:
Alabama Department of Human Resources
50 Ripley Street
Montgomery, AL 36130-4000
After a request for a fair hearing is received, it is forwarded to the state administrative hearings office. The hearings office will then send a notice giving the date, time, and place of the hearing. This notice will be sent at least 10 days before the hearing. The notice also will explain what to do if parents cannot come to the hearing as scheduled. Parents may bring witnesses, friends, relatives, or a lawyer to help present their case. The hearing officer will record the hearing so that the facts are taken down correctly. The hearing officer will listen to both sides but will not make a decision at the hearing. Parents will receive a written decision in the mail, from the hearing authority, within 90 days of the hearing. The written decision will explain to parents how to ask for an administrative appeal if they do not agree with the decision.
What Else do Families Need to Know?
23. How is the adoption assistance program operated and funded in Alabama?
The program is state supervised and state administered, meaning that policy and eligibility decisions are made by personnel at the state office.
In Alabama, the federal contribution to Title IV-E-eligible children is 68.54 percent (the Federal Financial Participation/FFP rate). The remaining cost of the program is funded entirely by state funds.
24. Does Alabama operate a subsidized guardianship program?
It will soon. The 2010 legislature created a kinship guardianship program, which will be implemented by October 2010.
25. Does Alabama offer a tuition waiver program?
No. However, children adopted from foster care after their 16th birthday may qualify for up to $5,000 a year for four years of college or other post-secondary training through the Alabama Education and Training Voucher Program. The program offers funds to foster youth and former foster youth to enable them to attend colleges, universities, and vocational training institutions. Funds may be used for tuition, books, or qualified living expenses. These funds are available on a first-come, first-served basis, and some restrictions apply. For more information, contact the Office of Foster Care (334-242-9500) or visit https://www.statevoucher.org/state.shtml?state=AL.
26. Does Alabama offer a state adoption tax credit?
No, but families who receive adoption assistance are typically eligible for the federal adoption tax credit. For more information, parents should contact NACAC at http://www.nacac.org/taxcredit/taxcredit.html or 651-644-3036.
27. Does Alabama have any program to support an adoptee whose adoptive parents die until the child is adopted again?
28. What else differentiates Alabama’s adoption assistance program from others around the country?