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Colorado State Subsidy Profile

Updated July 2011

State Subsidy Contact Person

Constance Vigil
Colorado Department of Human Services (CDHS)
1575 Sherman Street
Denver, CO 80203-1714
303-866-3209 • Fax: 303-866-5563
constance.vigil@state.co.us
www.changealifeforever.org

NACAC Volunteers

Deborah Cave
Colorado Coalition of Adoptive Families (COCAF)
P.O. Box 270398
Louisville, CO 80027-0398
Home: 303-665-9781
deborah.cave@cocaf.org
www.cocaf.org

Colleen Tarket
Colorado Coalition of Adoptive Families (COCAF)
5702 W. 114th Place
Westminster, CO 8002
720-937-4497
colleen@tarket.net
www.cocaf.org


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 Georgia. 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 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.

For more information on Title IV-E eligibility, view our fact sheet Eligibility and Benefits for Federal Adoption Assistance.

Colorado adoption resources on the web:
http://www.changealifeforever.org/ http://www.changealifeforever.org/adoption.asp

Colorado state-specific medical assistance:
http://www.chcpf.state.co.us/

Colorado adoption assistance:
http://www.changealifeforever.org/adopt_costs.htm

Colorado Revised Statutes 26-7-101 through 26-7-108:
http://www.michie.com/colorado/lpext.dll?f=templates&fn=
main-h.htm&cp=

Click on the folder Colorado Revised Statutes.
Click on Title 26–Human Services Code, then click on Article 7–Subsidization of Adoption

Colorado Regulations 12 CCR 2509-4 Vol.7.306.4 to 7.306.6:
http://www.colorado.gov/apps/cdhs/rral/rulesRegs.jsf
Click on 7.3 Child Welfare Services, then scroll to 7.306.4 Adoption Assistance Services


Who is Eligible for Adoption Assistance or Subsidy?

1. How does Colorado define special needs to determine eligibility?

A child must be legally free for adoption and have special needs to be eligible for assistance. Special needs are the specific factors or conditions that may prevent a child from being adopted without support. For a child to be considered as having special needs, the following three statements must be true:

  1. One or more of the following factors or conditions must exist:
    1. Seven years old or older
    2. Member of a sibling group of two or more children placed together in an adoptive placement
    3. Physical disability (such as hearing, vision, or physical impairment; neurological conditions; disfiguring defects; and, heart defects)
    4. Intellectual disability (such as developmental delay or disability, perceptual or speech/language disability, or a metabolic disorder)
    5. Emotional disturbance
    6. Developmental disability resulting in educational delays or significant learning processing difficulties
    7. Hereditary factors documented by a physician or psychologist
    8. High risk of developing a disability (such as HIV-positive, drug-exposed, or alcohol-exposed in utero)
    9. Ethnic background or membership in a minority group that may be difficult to place.
  1. The state has determined that the child cannot or should not be returned to the home of the birth parent; and
  1. The department or child-placing agency that placed the child for adoption must document that, except where it would be against the child’s best interests (due to such factors as the existence of significant emotional ties with the prospective adoptive parents while in their care as a foster child, or adoption by a relative), the department or child-placing agency had made a reasonable but unsuccessful effort to place the child for adoption without adoption support.

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 as defined above, be legally free for adoption, and be in the custody of a county Department of Child Welfare Services.

3. Are children adopted from private agencies in Colorado eligible for subsidies?

Yes, but only for federal IV-E assistance. Children who are in the custody of licensed non-profit, private agencies must meet federal IV-E eligibility requirements to receive adoption assistance.


What Supports and Services Are Available?

Children can be eligible for federally funded IV-E adoption assistance or state/county funded assistance. In either case, the child can be provided with one of the following level of assistance:

  • Medicaid only
  • Medicaid with a dormant assistance subsidy (deferred)
  • Medicaid with an assistance payment (which can also include Case and Medical Services)

Monthly Payments

4. What is the maximum basic monthly adoption assistance maintenance payment in Colorado?

Each Colorado county sets and negotiates its own adoption assistance rates. The amount shall be no more than the foster care rate that is currently being paid for the child’s out-of-home care or the rate that would have been paid if the child were in out-of-home care today. The foster care rate used to determine the maximum adoption subsidy payment does not include any additional rate paid for respite in foster care. Some counties cap the maximum adoption assistance subsidy rate at less than the foster care rate.

5. Does Colorado provide specialized rates (based on the extraordinary needs of the child or the additional parenting skill needed to raise the child)?

Specialized rates may be paid if the parent is providing extra services to meet a child’s extraordinary medical, physical, emotional, or behavioral problems.

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?

Adoption assistance benefits typically continue through the month of the child's 18th birthday. In some cases, assistance will continue until age 21, if the county department has determined that the child has a developmental or physical disability that warrants continued assistance. The county department will not provide adoption assistance funds for any youth over 18 who is attending college.

8. Does Colorado offer deferred adoption assistance agreements (agreements where initial monthly maintenance amount is $0 for children at risk of developing special needs later)?

Yes. It is called a “dormant adoption assistance” agreement in which no monetary assistance is immediately given but parents must choose to receive Medicaid for the child. To activate the adoption assistance in the future, documentation of the child’s potential special needs must be in the service record on file with the county department.


Medical Care

9. What Medicaid services are available in Colorado?

  • Inpatient hospital (limited basis)
  • Physician’s services
  • Health clinics
  • Prescribed drugs
  • Outpatient hospital
  • Home health care
  • Laboratory & x-ray
  • Medical equipment & supplies
  • Early and Periodic Screening, Diagnostic, and Treatment Services (EPSDT)
  • Eyeglasses (one pair/year)
  • Dental care
  • Community mental health services
  • Mental health institutional care
  • Transportation to health service

For more information on Medicaid services, call 303-866-2823.

10. What medical benefits are available for state-funded children? (Children who have federally funded/Title IV-E adoption assistance agreements are automatically eligible for Medicaid benefits.)

Medicaid is available for non-IV-E children as long as they reside in Colorado. If the child resides in a state that does not provide Medicaid for children who receive non-IV-E adoption assistance, the adoption assistance agreement may include Case Services to pay for medical insurance for the child in that state. The Case Services must be specifically written into the agreement.

11. What mental health services are available?

Public mental health services for children in Colorado are administered by the Department of Health Care Policy and Financing (HCPF) under the Medical Assistance Program and may include outpatient therapy, school-based therapy, in-home support, day treatment, hospitalization, residential care, crisis intervention support, prescription drugs, and medication management. Limited respite care and mentors may also be available.

There are 17 Community Mental Health Centers (MHCs) located across the state. The MHCs are overseen by one of five Behavioral Health Organizations (BHOs). The BHOs are responsible for providing necessary mental health services to Medicaid-eligible children. BHO Family Advocates and Consumer Representatives can help parents access needed services and resolve any problems with services received.

For more information, call 800-221-3943 (HealthColorado) or 303-866-7404 (Developmental Disability Services) or visit the following web sites:


Other Benefits

12. In Colorado, what nonrecurring adoption expenses directly related to the finalization of an adoption may be reimbursed?

Parents can be reimbursed for up to $800 of the following nonrecurring adoption costs: agency adoption fees (including health and psychological exams); transportation, food, and lodging for child and adoptive parents necessary to complete the adoptive placement or the legal adoption process; court costs; attorney’s fees; and replacement birth certificates.

Families should apply for reimbursement before finalization of the adoption, and no later than one year following finalization. International adoptees are not eligible for the program.

13. Is child care available? If yes, who is eligible and how do families access child care?

Case services may cover child care (see question 16 for more information).

14. Is respite care available? If yes, who is eligible and how do families access respite care?

Case Services may cover respite care (see question 16 for more information).

15. Is residential treatment available? If yes, who is eligible and how do families access residential treatment services?

The adoption assistance program does not specifically pay for residential placement. If a child needs residential treatment services, the family should contact the local county department of social services to request family preservation services. When a child is placed in residential treatment, adoption assistance and Medicaid continue. When a child is placed through the county department of social services, families may be charged a placement fee not greater than the adoption assistance payment. In these cases, the county agency pays the cost of residential treatment.

16. What other post-adoption services are available in Colorado and how do families find out more about them?

Case and Medical Services are available as part of the adoption assistance agreement. Case and Medical Services:

  • must be included in the initial subsidy agreement;
  • must relate directly to the barrier(s) or special needs identified at the time the initial subsidy agreement is approved; and
  • cannot be used for services covered by Medicaid or the adoption assistance agreements.

Case and Medical Services are not available for treatment of any physical or developmental disability or emotional disturbance identified after adoption finalization.

Medical Services
Medical Services are paid to a vendor or reimbursed to adoptive parents for treatment of physical or developmental disabilities or emotional disturbances. Medical Services may supplement private insurance. They are most often used for medically fragile children.

Case Services
Case Services are reimbursable expenses to the family or provider for the following:

  1. Medical
    1. Orthodontia—May be reimbursed for special needs designation (such as cleft palate), but not for cosmetic reasons.
    2. Eyeglasses—Medicaid covers one pair per year. Additional eyeglasses or contacts are reimbursable only if necessary because of the child’s special needs.
    3. Medication—Only medications related to special needs are reimbursable, and must be prescribed by licensed physician.
    4. Special therapies (speech, occupational, and physical)—Only reimbursable if no other community resources available. Families should first look to school system or Medicaid for these services.
    5. Special equipment—Special medical needs or equipment prescribed by a physician may be reimbursable. Equipment costs should not exceed $2,000 without a supervisor's written authorization.
  1. Psychological Services: Time-limited outpatient therapy may be reimbursable if it is not covered by Medicaid. The service provider must provide a written plan.
  2. Respite and Child Care
    1. Respite care—Reimbursable.
    2. Child care—Reimbursable. In addition, if the need for child care is part of the child's special needs because of the child’s and family's situation (for example, the child in pre-school and parents are working), the county can include costs for child care as part of the subsidy. Frequently, child care coverage is time-limited.
  1. Other Services—Additional services may be provided for a specified time to provide needed services. These time-limited services are provided on a case-by-case basis, and must be clearly documented in the agreement. For example, these services may include modifying a family’s home for a child with special needs if the family cannot afford the modification.

For services not included in the adoption assistance agreement, Colorado's County Departments of Human Services or Social Services offer several post-adoptive services. These services vary in each county, but can include:

  • Visits from your adoption caseworker
  • Social activities for adoptive families
  • "Buddy" families or mentors
  • Support groups
  • Individual or family counseling
  • Respite care

For more information on Colorado’s post-adoption services, visit http://www.changealifeforever.org/adopt_adoptive.htm
Colorado has several nonprofit organizations dedicated to adoption that provide advocacy, information, and pre- and post-adoption services:

  • Colorado Coalition for Adoptive Families (COCAF) — http://www.cocaf.org; 303-562-9864 (provides advocacy and information for pre- and post-adoptive and kinship families)
  • The Adoption Exchange — http://www.adoptex.org (then click on Adoption and select Post Adoption Services); 303-755-4756 or 800-451-5246

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?

Any service that is to be paid for on behalf of an eligible child would need to be detailed by item and fiscal limit in the adoption assistance agreement.


What Should Families Know About Applying for Subsidy?

18. Who initiates the adoption assistance agreement?

Families applying for adoption of a child with special needs must be informed of the adoption assistance program. The particular agreement shall be negotiated based on the child’s need and the family’s circumstances.

19. Who makes the final determination on an adoption assistance agreement?

The county department determines a child's eligibility. County workers, supervisors, administrators, and county directors participate in assistance agreement negotiations.

Adoption assistance agreements are reviewed every three years from the date of the initial agreement.

20. How do families request adoption assistance after finalization of an adoption?

If a family applied for and was denied adoption assistance, they must go through the fair hearing process described in question 22. If a family never applied for assistance, they should make a request for assistance to the county from which they adopted.


How Can a Family Adjust an Adoption Assistance Agreement?

21. Can adoptive parents ask to change an adoption assistance agreement?

Adoptive parents may request changes to the adoption assistance agreement. Requests must be based on the child’s needs, the family’s circumstances, and the availability of services in the community. Changes in the agreement must be related to the child’s original barriers to adoption on which the decision to grant assistance was made.

Parents must submit the request in writing to the adoption supervisor in the county that provides the child’s adoption assistance. Once a request letter is received, the county will ask the adoptive family to send documentation from a medical, psychological, health, or school professional (such as an M.D., Ph.D., Psy.D., school, therapist, mental health, probation professional) to substantiate the request for change in the agreement.

If parents disagree with a decision regarding a change request, they may request an administrative fair hearing. The process for requesting a fair hearing is detailed on the adoption assistance agreement forms. See question 22 for complete information regarding fair hearings.

To find county departments of social services, go to http://www.colorado.gov/cs/Satellite/CDHS-Main/CBON/1251590215770.

22. What steps does a family go through to appeal an adoption assistance decision in Colorado?

When the county department denies, reduces, or terminates an application for adoption assistance or the assistance maintenance amount, the applicant or recipient has a right to appeal through the Office of Administrative Courts. Families may appeal an adverse action through the following fair hearing process:

  1. Within 10 days of the adverse action, the family must send a letter to Office of Administrative Courts’ fair hearing office at:

    Department of Personnel and Administration
    Office of Administrative Courts
    633 – 17th Street, Suite 1300
    Denver, CO 80202
    http://www.colorado.gov/cs/Satellite/DPA-OAC/OAC/1245071787063

    Parents will then receive written notice of a fair hearing date, and can choose to attend in person or to participate by phone. A fair hearing is conducted like a legal hearing. The family may choose, at the family’s own expense, to be represented by legal counsel or an advocate.
  1. The hearing office will ask the county department of social services to attend the hearing and provide information regarding the adverse action that has been taken. The county may be represented by a lawyer.
  1. At the hearing, the administrative law judge hears the testimony and reviews all submitted documents. Parents (or their counsel) can choose to call witnesses and cross-examine any county witnesses. At the end of the hearing, the judge will announce a timeline for a decision.
  1. The Office of Administrative Courts submits an intial written decision to the CDHS Office of Appeals (http://www.colorado.gov/cs/Satellite/
    CDHS-Emp/CBON/1251586557621
    ), which distributes the intial decision to all parties and to the adoption program staff of Child Welfare Services.
  1. If the parents or the child welfare staff disagree with the judge's decision, they must submit a written response (called an exception) to the CDHS Office of Appeals. Exceptions must be based on testimony and evidence presented at the hearing. The CDHS Office of Appeals will review all exceptions, and issues a final agency decision.
  1. If parents or the child welfare agency still disagree with the decision, they must appeal the decision in state appellate court.

What Else do Families Need to Know?

23. How is the adoption assistance program operated and funded in Colorado?

Colorado's adoption system is a state-supervised, county-administered program. This means that personnel at the state office are responsible for making policy decisions regarding the adoption assistance program, and provide guidance to county offices. The counties make decisions related to children’s adoption assistance agreement.

In Colorado, the federal contribution for Title IV-E-eligible children is 50 percent (known as the Federal Financial Participation or FFP rate). The remaining cost of the program is funded 30 percent by the state and 20 percent by the county.

24. Does Colorado operate a subsidized guardianship program?

Yes, contact Mary Griffin for more detail at 303-866-3546 or mary.griffin@state.co.us.

25. Does Colorado offer a tuition waiver program?

The Colorado Education and Training Voucher (ETV) Program offers funds to the state’s foster youth and former foster youth to attend colleges, universities, and vocational training institutions. Students may receive up to $5,000 a year up to the youth’s 23rd birthday as long as they receive ETV funds before their 21st birthday. The funds may be used for tuition, books, computers, school supplies, qualified living expenses, housing, child care, health insurance, groceries, and transportation. These funds are available on a first-come, first-served basis.

To be eligible for ETV funds, youth must meet all of the following criteria:

  1. Fall into one of these categories:
    • Be in foster care on their 18th birthday and age out at that time,
    • Have their foster care case closed between the ages of 18 and 21, or
    • Been adopted from foster care with finalization after the 16th birthday. +
  2. Have a high school diploma or GED
  3. Be a U.S. citizen or qualified non-citizen (legally present in the U.S.)
  4. Have personal assets (bank account, car, home, etc.) of $10,000 or less
  5. Be age 18, 19 or 20 at the time of the first application to the ETV Program
  6. Have been accepted into or be enrolled in a degree, certificate, or other accredited program at a college, university, technical or vocational school. To remain eligible for ETV funding, youth must show progress toward a degree or certificate.

For more information, youth can e-mail colorado@statevoucher.org.

26. Does Colorado offer a state adoption tax credit?

No.

27. Does Colorado have any program to support an adoptee whose adoptive parents die until the child is adopted again?

No.

28. What else differentiates Colorado’s adoption assistance program from others around the country?

n/a



North American Council on Adoptable Children (NACAC)
970 Raymond Avenue, Suite 106
St. Paul, MN 55114
phone: 651-644-3036
fax: 651-644-9848
e-mail: info@nacac.org
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