NACAC | Adoption Subsidy

Susetta Schmelz, Policy Specialist
Department of Economic Security (DES)
Division of Children, Youth & Families
4433 E Broadway
Tucson, AZ 85711
Phone: 520-784-2569
E-mail: sschmelz@azdes.gov

Nancy Williams
Arizona Assocation for Foster and Adoptive Parents
3220 W. Folgers
Phoenix, AZ 85027
Phone: 623-582-4846
Fax: 623-582-4846
E-mail: nancywill2@centurylink.net

Adoption subsidies are available for children with special needs. Federal subsidies were created by Congress (through Public Law 96-272—the Adoption Assistance and Child Welfare Act of 1980) to encourage the adoption of special needs children and remove the financial disincentives to adoption for the families. Children may receive a federally funded subsidy under Title IV-E or a state-funded subsidy as per state guidelines. Below we have outlined information related to definitions of special needs, benefits available, and procedures in your state. 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 each state’s subsidy program are available on our web site at www.nacac.org. If you have additional questions, please call the North American Council on Adoptable Children (NACAC) at 651-644-3036 or our subsidy help line at 800-470-6665, or e-mail us at adoption.assistance@nacac.org. If you have state-specific questions, please call your State Subsidy Contact Person or the NACAC Subsidy Representative (listed above) for more information.

Arizona's adoption assistance link is through the Arizona Revised Statutes (law) found at Title 8, Chapter One, Adoption, Article 2, Adoption Subsidies. See the following links: Article 2 - Adoption Subsidies

8-141 - Definitions; exception
8-142 - Adoption subsidy program; funding; claims; limitation
8-142.01 - Adoption subsidy program; hospital reimbursement
8-143 - Eligibility; limitation
8-144 - Subsidy agreement; duration; amount; periodic review; confidentiality
8-145 – Appeals

1. What specific factors or conditions does your State consider to determine that a child cannot be placed with adoptive parents without providing financial assistance? ("What is your State definition of special needs?")

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 placement or adoption without financial assistance:

Note: Children must be legally free for adoption to be eligible for adoption assistance.

2. What are the eligibility criteria for the State-funded adoption assistance program?

In order to be eligible for state-funded adoption assistance a child must be in the custody of the Arizona Department of Economic Security or licensed private child placing agency, the State has determined that the child cannot or should not return to the home of his parents, the State has determined that there exists a specific factor or condition (as defined above) because of which it is reasonable to conclude that the child cannot be placed with adoptive parents without providing adoption assistance and a reasonable but unsuccessful effort has been made to place the child without adoption assistance except where it would be against the best interest of the child because of significant emotional ties with the prospective adoptive parents while in their care as foster parents or relatives.

3. The maximum basic monthly adoption assistance maintenance payment in Arizona is:

Existing adoption subsidy rates will continue at their current rates. For adoption subsidy agreements starting March 1st, 2009 these are the current rates.

Age	Rate	Monthly rate based on 30 days
0-11	$19.68/day	$590.40
12-20	$21.72/day	$651.60

Specialized rates:

AM 2*	$23.52/day	$705.60/month
AM 3	$29.94/day	$898.20/month
AM 4+	$35.75/day	$1072.50/month

*AM = adoption maintenance
AM 4+ is reserved for therapeutic or professional homes

4. Specialized rates are based on the extraordinary needs of the child, and/or the additional parenting skill needed to raise the child. If Arizona offers these rates, the criteria used to define them are as follows:

Specialized rates are based on the special needs of the child and the intensity of services and care s/he requires such as:

An evaluation of the severity of the child’s needs; the time, supervision and expense required to care for the child and the professional documentation are used to determine the rate for the child.

5. Parents can receive payment or reimbursement for certain nonrecurring adoption expenses directly related to the finalization of an adoption. Below are the allowed expenses and the limit per child.

Nonrecurring expenses include: reasonable and necessary adoption fees, court costs, attorney fees, and expenses that are directly related to the legal process of adopting a child with special needs (i.e., costs relating to the adoption study, health and psychological examinations, supervision of the placement before the adoption, and transportation and reasonable costs of lodging and food for the child or adoptive parents which are incurred to complete the adoption process). Nonrecurring expenses not subject to reimbursement include, but are not limited to, family counseling received prior to the final decree of adoption, one time costs associated with physical remodeling, renovation and alteration of the adoptive parents' home or property, and any other expenses not related to the legal process of adoption.
Note: Nonrecurring adoption expenses submitted more than nine months after the final decree of adoption are not eligible for reimbursement.

The reimbursement limit is $2,000 per child.

AHCCCS (Arizona Health Care Cost Containment System): is Arizona's version of Medicaid. For information and to enroll, call Karen Reynolds, 602-235-9358, ext. 13624.

Some covered services are as follows:

Acute Medical Services—

Behavioral Health Services—
These services are available to eligible members under the age of 18 through the Regional Behavioral Health Authorities.

7. Children who have federally funded (Title IV-E) subsidy are automatically eligible for Medicaid benefits. However, it is the state's decision whether state-funded (non-Title IV-E) children are eligible for Medicaid benefits inArizona. Below is information on the Medicaid benefits available for state-funded children.

Yes. Most children who are eligible for state funded (non-IV-E) adoptive assistance may receive Title XIX Medicaid. These children receive a full array of Medicaid coverage similar to IV-E eligible children.

Public mental health services for children in Arizona are administered by the Arizona Department of Health Services (ADHS), Division of Behavioral Health Services (DBHS). Public funding is through Arizona’s Medicaid program, known as the Arizona Health Care Cost Containment System (AHCCCS). Mental health services include the following examples: evaluation and screening, inpatient psychiatric facility care, outpatient clinic care, behavioral health residential treatment, individual, group and family therapy, counseling, crisis intervention, behavior management, psychotropic medication, and respite.

ADHS is responsible for the provision of all publicly funded behavioral health services to citizens in Arizona (Title XIX, XXI and State-only populations). AHCCCS maintains a contractual relationship with ADHS/DBHS for provision of behavioral health services to Title XIX and Title XXI members. Behavioral health services for Title XIX (Medicaid) and KidsCare (TitleXXI) eligible persons are administered through ADHS Division of Behavioral Health Services (DBHS) through subcontracts with five Regional behavioral Health Authorities (RBHA). RBHA contracts with a network of service providers to deliver a range of behavioral health services, including prevention programs, services for substance abuse, general mental health disorders, and services for children with serious emotional disturbance.

Note: Not all services may be available in all cases. Contact your adoption assistance worker or medical assistance specialist for information regarding process, eligibility, availability, and duration of services.

9. Does your State provide additional finances or services for medical or therapeutic needs not covered under your State medical plan to children receiving adoption assistance?

Arizona provides additional adoption assistance though a Special Services Subsidy. Special Services Subsidy benefits may provide for extraordinary, infrequent or uncommon needs related to the pre-existing special needs conditions noted in the original adoption assistance agreement which cannot be met or can only be met at reduced levels by Medicaid coverage or other public or private resources. Special services subsidy must have prior authorization.

Note: Not all services may be available in all cases. Contact your adoption assistance worker for information regarding process, eligibility, availability, and duration of services.

10. What types of post adoption services are available in your State and how do you find out more about them?

Post adoption services in Arizona are administered by the Department of Economic Security and through private agencies. Post adoption services include the following examples:

The Family Connection is a collaboration of family and child service agencies providing family support before and after adoption finalization, ask your adoption assistance worker for information. Parents can contact

Respite care is available up to 288 hours if the need for this service is related to a condition on the Adoption Subsidy agreement. Public resources that offer respite must be exhausted first and respite must be authorized by the Adoption Subsidy case manager prior to using the service.

Many private organizations offer a variety of respite options. See the ARCH National Respite Network Respite Locator Service, search by state to locate Arizona's respite programs: http://www.respitelocator.org/

Note: Not all services may be available in all cases. Contact your adoption assistance worker or post adoption services contact for information regarding process, eligibility, availability, and duration of services.

11. If the additional assistance (listed above in questions #8 -10) is to cover specific services (e.g., counseling/mental health services, respite care, etc.), must these services be explicitly identified in the adoption assistance agreement?

The medical, dental, and/or mental health conditions, which may necessitate the provision of special service subsidies, must be explicitly identified in the adoption assistance agreement.

12. How are residential treatment costs covered (if at all) for adoptive families? What procedures must a family follow to receive these services?

Medicaid covers residential treatment costs. Beyond Medicaid coverage, families should contact the adoption subsidy case manager to request payment for special services. The request would be referred to the Adoption Subsidy Review Committee for authorization.

13. A deferred adoption assistance agreement is one in which the initial monthly maintenance amount is $0. Does Arizona offer such agreements?

Yes. Arizona legislation established a subsidized guardianship program for children in the care, custody, and control of the Department of Economic Security. Guardianships finalized on or after August 6, 1999 for foster children in the custody of Child Protective Services are eligible for monthly cash assistance.

Specific eligibility factors are: 1) permanent guardianship finalized through Juvenile Division of Arizona Superior Court in accordance with state statute A.R.S. §8-872; 2) child is in the custody of Child Protective Services; and 3) guardian must apply for other state and federal program benefits on behalf of the child.

The rates are as follows and do not exceed those of adoption assistance and are off set by any benefits received on behalf of the child:

AMG 2*                      $12.95 per day
AMG 3                        $15.73 per day
AMG 4                        $22.06 per day
AMG 5 (DDD)           $17.77 per day
AMG 6 (DDD)           $24.03 per day
AMG 7                        $27.81 per day

15. Who makes the final determination of a child's subsidy eligibility in Arizona? What roles, if any, do workers and administrators at the county, district, or regional level play in eligibility determination and/or assistance negotiation?

Local case managers are responsible for informing the family of the availability of Adoption Subsidy. The application and all necessary documentation are reviewed by the local office supervisor, who then submits the packet for approval to the Adoption Subsidy Unit. A three-member adoption subsidy review committee reviews all applications and makes the final decision about eligibility for all cases. The Adoption Subsidy staff then negotiate the agreement with the adoptive parent(s).

16. Will Arizona consider my family income to determine my child's eligibility for an adoption subsidy?

No, family income and resources are not considered when determining adoption subsidy eligibility.

Adoption assistance payments may begin after the petition to adopt has been filed and the Adoption Subsidy agreement has been signed by the Adoption Subsidy supervisor.

18. Do children adopted from private agencies in Arizona receive the same subsidies as those children adopted from public agencies?

Yes—The adoption subsidy supervisor is to provide instructional materials, forms, and technical assistance to private child placing agencies that want to apply for adoption subsidies on behalf of children in their custody. There may be an exception as to the medical coverage in states that are non-participating states.

19. When my child turns 18, which benefits, if any, are available to our family?

All subsidy benefits may continue through the age of 21 if the individual is enrolled in and regularly attending school, unless the person has received a high school diploma or certificate of equivalency. However, the Title XIX coverage will end at age 21.

20. A child's adoption assistance agreement may be periodically reviewed by the state. What is the typical process used in Arizona?

All subsidy agreements shall contain provisions for periodic review. The department shall conduct periodic reviews of subsidy agreements at least once a year (in cooperation with the adoptive parents) to determine the appropriateness and reasonableness of all subsidies and to ascertain the need for continuing or adjusting them.

21. Can adoption assistance agreements be modified if requested by adoptive parents?

Parents can request a change in the adoption assistance agreement at any time. Parents are directed to contact their adoption assistance case manager to request a change and to provide documentation from appropriate professionals in support of the request for change. Requests for changes should be in writing but can be made over the phone. There is a form that can be obtained from and returned to the adoption assistance case manager. The Adoption Subsidy Review Committee must approve all changes. Parents have the right to appeal any agency decision they disagree with by requesting a fair hearing in writing within fifteen calendar days of the decision. Adoption assistance agreements are reviewed annually. Contact the Arizona Foster and Adoption Offices: www.de.state.az.us/dcyf/adoption/information.asp.

Send written requests to one of the following addresses, depending on the family’s location:

Adoption Subsidy Program
Phoenix Unit
4620 N. 16th Street, Suite E219
Phoenix, AZ 85012

Adoption Subsidy Program
Tucson Unit
432 S. Williams Blvd, Suite 200
Tucson, AZ 85711

22. What are the exact steps a family must go through to access the fair hearing/appeal process in Arizona?

Adoptive parents have the right to request a fair hearing any time DCYF denies, reduces, or terminates adoption assistance benefits. Parents are directed to contact their adoption assistance caseworker to request a fair hearing. Requests must be made in writing within fifteen calendar days after the mailing of an agency decision informing parents of an action affecting their child’s adoption assistance benefits. A pre-hearing summary of the facts and grounds shall be prepared and submitted to the hearing officer not less than four days prior to the hearing. Benefits will not be reduced or terminated prior to a hearing decision, unless there is a substantial change in household eligibility. The hearing will be held at the local office or any other place mutually agreed upon by the hearing officer and the appellant. The hearing shall be scheduled not less than twenty days or more than thirty days from the date of filing for the appeal. Appellant, in lieu of appearance, may submit a written statement or be available by telephone to testify. Hearings are conducted in accordance with Arizona Administrative Code R6-5-2405. The hearing officer shall listen to both sides and a full and complete record shall be kept. All hearing decisions are final unless reconsideration is requested. An appellant may request a reconsideration of the hearing decision in writing within ten calendar days of the mailing of the decision.

23. Families may request a subsidy after the finalization of an adoption under certain circumstances. Below is the process by which families access a subsidy after finalization.

Along with the application, parents should submit documentation showing the child's special needs condition(s) was undiagnosed but pre-existing at the time the adoption was finalized.

Families should contact:

Susetta Schmelz
Department of Economic Security (DES)
Division of Children, Youth & Families
4433 E Broadway
Tucson, AZ 85711
Phone: 520-784-2569
sschmelz@azdes.gov

The program is state supervised/state administered. This means that both policy and eligibility decisions are made by personnel at the state office.

The federal contribution to Title IV-E-eligible children is 66.47% in Arizona. This is known as the Federal Financial Participation (FFP) rate. The remaining cost of the program is funded entirely with state general funds. Counties have no responsibilities for these costs.

25. Below are other programs that may differentiate Arizona's adoption assistance program from others around the country.

Each family is assigned a case manager to assist them locate and utilize supportive and preventive services in their communities. The case manager is available to support and assist the family when assistance is requested by the adoptive family.

Although Arizona does not currently sponsor a state tuition waiver, we do have access to the federal Education and Training Voucher (ETV) Program.

The Arizona Education and Training Program provides funds for post-secondary (after high school) education and training to young adults who are currently or were formerly in foster care.

Any person who was in foster care when age 16, 17 or 18 or who was adopted from the state foster care system at age 16 or older, and who has not yet reached 21 years of age may apply for these funds.

Applications are available via contact with the state Independent Living Coordinator (480-545-1901) or online at www.azdes.gov.