Adoption
Subsidy

Colorado State Subsidy Profile

Updated March 2006

State Subsidy Contact Person

Sharen Ford
Department of Human Services (DHS)
1575 Sherman Street
Denver, CO 80203-1714
Phone: 303-866-3197
Fax: 303-866-5563
E-mail: sharen.ford@state.co.us
Web: www.changealifeforever.org

NACAC Subsidy Representative (parent/volunteer)

Deborah Cave
Colorado Coalition of Adoptive Families
P.O. Box 270398
Louisville, CO 80027-0398
Home: 303-665-9781
Office: 303-664-4638
E-mail: cocafcave@yahoo.com

Colleen Tarket
Colorado Coalition of Adoptive Families
5702 W. 114th Place
Westminster, CO 80020
Phone: 720-937-4497
E-mail: colleen@tarket.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.

Adoption Resources on the Web:

http://www.changealifeforever.org/ http://www.changealifeforever.org/adoption.asp

Colorado’s state-specific medical assistance:

http://www.chcpf.state.co.us/

Colorado’s adoption assistance:

html://www.changealifeforever.org/adopt_costs.htm

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?")

"Special needs" means the specific factors or conditions that apply to the child and that may prevent the child from being adopted unless the department provides adoption support services.

To be considered a child with special needs the following three statements must be true:

1. One or more of the following factors or conditions must exist:

a.   Seven years of age or older

b.   Member of a sibling group of two or more children placed intact in an adoptive placement

c.   Physical disability (such as hearing, vision, or physical impairment; neurological conditions; disfiguring defects; and, heart defects)

d.   Mental retardation (such as developmental delay or disability, perceptual or speech/language disability, or a metabolic disorder)

e.   Emotional disturbance

f.    Developmental disability resulting in educational delays or significant learning processing difficulties

g.   Hereditary factors that have been documented by a physician or psychologist

h.   Children at high-risk of developing a disability (such as HIV-positive, drug-exposed, or alcohol-exposed in utero)

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

2. The state has determined that the child cannot or should not be returned to the home of the biological parent; and
   
   
3. The department or child-placing agency that placed the child for adoption must document that, except where it would be against the best interests of the child, the department or child-placing agency had made a reasonable but unsuccessful effort to place the child for adoption without adoption support.

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

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

Colorado counties negotiate rates based on the counties' policy on adoption assistance rate negotiation.

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

The establishment of specialized rates is based on whether or not the provider is giving extra services for extraordinary medical, physical, emotional, or behavioral problems.

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.

The following nonrecurring costs are reimbursable: 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 fees; and replacement birth certificates.    

Families should apply for this reimbursement prior to finalization of the adoption. International adoptees are not eligible for the program.  The reimbursement limit is $800 per child.

6. What Medicaid services are available in Colorado?

• Inpatient Hospital (limited basis)
• Physician's Services
• Health Clinics
• Prescribed Drugs
• Outpatient Hospital
• Home Health Care
• Laboratory and X-Ray
• Medical Equipment/Supplies
• Early and Periodic Screening, Diagnostic, and Treatment Services (EPSDT)
• Eyeglasses (one pair per year)
• Dental Care
• Community Mental Health Services
• Mental Health Institutional Care
• Transportation to health services

The state contact number is 303-866-2823.

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 inColorado.  Below is information on the Medicaid benefits available for state-funded children.

Medicaid is available following finalization for non-IV-E children effective 7-1-98.

8. What mental health services are provided by your State?

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 include the following examples: out patient 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.

Each area of the state has a Community Mental Health Center (CMHC) and a Mental Health Assessment and Service Agency (MHASA). The MHASA is responsible for providing necessary mental health services to Medicaid eligible children. Family Advocates and Consumer Representatives can assist parents in accessing needed services and resolving any dissatisfaction with services received.

Select Frequently Asked Questions for Colorado’s Medicaid Program, link: http://www.chcpf.state.co.us/, or phone 800-221-3943. Link to the Mental Health Program of the Colorado Department of Health Care Policy and Financing at: http://www.chcpf.state.co.us/HCPF/mntlhlth/MHIndex.asp.

See also DHS Division of Mental Health: http://www.cdhs.state.co.us/ohr/mhs/index.htm,

Colorado's Publicly Funded Mental Health System: http://www.cdhs.state.co.us/ohr/mhs/SB1265_1-05_Brochure.pdf

and the Colorado Behavioral Healthcare Council: http://www.cbhc.org.

For more information, parents may contact Developmental Disability Services, phone: 303-866-7404.

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?

Colorado offers what is known as a Medical Subsidy, a provision under Adoption Case Services. Funding is available to reimburse adoptive parents or to pay a medical provider for physical or psychological services. The need for such services must be identified in the initial adoption assistance agreement and the services received under the Medical Subsidy must relate to the special need for which adoption assistance was originally granted. Funding may be used to supplement private medical insurance and to cover services not offered under the state medical assistance plan. All other resources available to the adoptive family must be utilized before funding is available.

Colorado also offers Case Services Subsidy for Non-Medical Cases. When the identified special needs of a child placed for adoption are not covered by the adoption assistance payment, the above Medical Subsidy program, or Medicaid, services can be provided through a Case Services Subsidy for non-medical cases. The need for such services must be identified in the initial adoption assistance agreement and the services received under the program must relate to the special need for which adoption assistance was originally granted. Services and items include the following examples: respite, medication, customized equipment, speech and physical therapy, and certain psychological services.

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 Colorado are administered by the Department of Human Services, Division of Child Welfare Services and offered through the state, parent groups, and contracted organizations. Post-adoption services include the following examples:

• Information and referral
• Educational material
• Support groups
• Support programs
• Therapeutic intervention
• Respite
• Diagnostic evaluations
• Mental health supports
• Developmental Disabilities Services
• Financial assistance on a very limited basis ($500/family/year). Contact the Adoption Exchange (see below) for the requirements.

Colorado DHS post adoption services:
http://www.changealifeforever.org/adopt_adoptive.htm

Colorado has several non-profit organizations dedicated to adoption.

1. Contact the Colorado Coalition for Adoptive Families (COCAF): http://www.cocaf.org
COCAF Post-Adoption Support Programs: http://www.cocaf.org/cr_pas_main.asp

2. See the Adoption Exchange: http://www.adoptex.org/about.htm
Or phone the Adoption Exchange at 303-755-4756 or
800-451-5246

Respite care is available on a limited basis through the county department that placed the child for adoption.  Additionally, many private organizations offer a variety of respite options. See the ARCH National Respite Network Respite Locator Service, search by state to locate Colorado’s respite programs at: http://www.respitelocator.org/ or phone them at: 303-866-3003.

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?

Any service which is to be purchased on behalf of an eligible child would need to be detailed by item and fiscal limit 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?

Should a child need residential treatment services, the family should contact their local county department of social services to seek family preservation services. The adoption assistance program will not specifically pay for residential placement. When a child is placed in residential treatment, adoption subsidy continues. Medicaid is kept active. A placement fee is charged which is not greater than the subsidy payment when the child is placed through the county department of social services.

If the county department obtains custody of the child, the custodial county agency will pay the cost of residential care after assessing a fee not to exceed the adoption subsidy payment.

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

Yes, Colorado offers deferred adoption assistance.  It is known as a “dormant subsidy” agreement in which no monetary assistance is immediately given but Medicaid can be received if the parents choose.  Documentation of the child’s special needs must be in the service record on file with the county department in order to activate the adoption assistance in the future.

14. Does Colorado operate a subsidized guardianship program?

No.

Programmatic Procedures

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

The county department shall determine the child's eligibility for subsidized adoption.  County workers, supervisors, administrators, and/or county directors participate in the assistance agreement negotiations.

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

The county department shall not use an income eligibility requirement (means test) for prospective adoptive parents in determining eligibility for subsidized adoption. Subsidy amounts shall be based on the child's need and the family’s circumstances.  However, the county will use the family’s financial information in determining the initial subsidy, and in requests for increases post-finalization.

17. When do subsidy payments begin?

Adoption assistance payments and benefits may begin in Colorado at adoption placement.

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

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

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

Subsidy benefits may continue through the month of the child's 18th birthday or until age 21, when the county department has determined that the child has a developmental disability or physical disability, which warrants continuation of assistance. The county department shall not use state subsidy funds for any child over 18 attending college.

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

There is a redetermination of eligibility done every three years for all ongoing subsidies.  The county department shall provide written notice of the redetermination requirement to the adoptive parent(s) no later than 60 days prior to the anniversary of the subsidy agreement.  Families are asked to share changes in their circumstances.  Requests for information vary since subsidies are based on the specific special needs of the child.        

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

Adoptive parents may contact their county adoption assistance worker to make changes to the adoption assistance agreement at any time.  Requests for change must be in writing and based on the needs of the child, the circumstances of the family, 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.  Requests are made to the county department that placed the child for adoption or entered into the adoption assistance agreement on behalf of the child and directed to the adoption supervisor in the county that provides the child’s adoption assistance.  Once a request letter is received, the adoptive family is asked to send in documentation from a medical/psychological/health/school professional (such as MD, PhD, Psy D, school, therapist, mental health, probation professional) to substantiate their request for change in the agreement.  Adoption assistance agreements are reviewed every three years from the date of the initial 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 also Question number 22 for complete information regarding fair hearings.

County departments of social services locator: http://www.cdhs.state.co.us/edo/org/hs_counties.html

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

Adoptive families may request an administrative fair hearing whenever there is a disagreement with an agency decision affecting their child’s adoption assistance benefits, adverse action to the child’s current assistance, or a request made by the family is denied.  Adoptive families are asked to submit a written letter requesting a fair hearing to the Division of Administrative Hearings within fifteen days of the contested agency action.  Written requests made to the adoption assistance worker will prompt the county staff to send a written notice to the family informing parents of their right to appeal and provide the Division of Administrative Hearings address.

Fair hearings are conducted like a legal hearing.  Parents have a right to bring legal counsel to assist in representing them.  The county department will usually have legal counsel present to represent the Department.  The Division of Administrative Hearings will send information to the adoptive family informing them of their right to have legal counsel present at the family’s own cost.  If parents come to the hearing without legal counsel, they are informed that they can call witnesses and cross-examine any witnesses the county provides for the hearing.  Parents are informed that they can present written documents and receive instructions on how to label them as exhibits for the hearing.  Parents are able to have an advocate of their own choosing and at their own expense in the room during the hearing.  Once the family is granted a hearing they will receive written notice. Families may choose to request a hearing conducted over the phone or an in-person hearing. Both parties to the hearing, the parents and the Department, are present and the court case proceeds.  At the end of the hearing the Administrative Law Judge (ALJ) informs the parties of the timeframe for an initial decision to be reached and released.  Parties have the option of filing exceptions (disagreements with the elements of the decision) once the initial decision is released.  However, exceptions must be based on testimony and evidence that was presented at the hearing.  An external party reviews the exceptions and a final agency decision is issued.  Parties wishing to appeal the final agency decision must do so in the state Appellate Court.

Send written requests for fair hearing to the following address:

Division of Administrative Hearings
633 – 17th Street, Suite 1300
Denver, Colorado 80202

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.

When the county department denies, reduces, or terminates an application for adoption subsidy or the subsidy grant, the applicant or recipient shall have a right to appeal.  The adoptive family is given at the time of the adoption the address of the Office of Appeals.  At any time when the family receives an adverse action notice they may appeal through the fair hearing process.

1. The family must send a letter to the fair hearing office and a fair hearing date is set. The family may or may not be represented by counsel. If they choose to be represented by counsel the court, county, and state are not responsible for these expenditures.
   
2. The county department of social services is contacted by the hearing office to attend the hearing and provide information regarding the adverse action that has been taken.
   
3. The administrative law judge hears the testimony, reviews all submitted documents, and, then, drafts a response.
   
4. The response is submitted to all parties and to the adoption program staff of Child Welfare Services for review.
   
5. Should the parties and the adoption Child Welfare staff take exception to the judge's decision, a response must be prepared and submitted to the Office of Appeals. Otherwise, the decision stands.
   

System Operation and Program Funding

24. How is the subsidy program operated and funded in Colorado?

Colorado's adoption system is operated as 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 subsidy.

Each county department of social services (county director) has the discretion to provide on behalf of a child with special needs a State/County Only Subsidy (non-IV-E eligible):

• Medicaid only
• Medicaid with a dormant assistance subsidy (deferred)
• Medicaid with assistance payment
• Assistance payments with case services (when the child resides in a state that does not have reciprocity for the state option Medicaid for non-IV-E eligible children.)
  

OR for IV-E eligible children:

• Medicaid only
• Medicaid with a dormant assistance subsidy (deferred)
• Medicaid with assistance payment

The federal contribution to Title IV-E-eligible children is 50% in Colorado. This is known as the Federal Financial Participation (FFP) rate.  The remaining cost of the program is funded with 30% state funds and 20% county funds.

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

None.