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District of Columbia Subsidy Profile

Updated January 2013

State Subsidy Contact Person

Patricia Johnson
Child and Family Services Agency
Adoption Resources Program
400 6th St. SW, 3rd floor
Washington, DC 20024
202-727-5424 • fax: 202-727-7236
patricia.johnson2@dc.gov

NACAC Subsidy Representative (parent/volunteer)

Currently, there is no District Volunteer. If you or someone you know would like to volunteer to help families learn more about adoption assistance, please call Josh Kroll at NACAC, 800-470-6665 x15 or e-mail joshk@nacac.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 District of Columbia. 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.

Washington, D.C.’s specific medical assistance links:
http://dchealth.dc.gov/doh/site/default.asp

District of Columbia Code 4-301
http://government.westlaw.com/linkedslice/default.asp?SP=DCC-1000
Click on Title 4, Public Care Systems
Click on Chapter 3, Adoption programs
Click on Subchapter I, General
Click on s4-301, Adoption subsidy payments

Washington, D.C.'s Adoption Subsidy Policy
http://cfsa.dc.gov/DC/CFSA/About+CFSA/Policy/CFSA+Policy+Manual+
Table+of+Contents/Program+Policies/Program+-+Adoption+Subsidy


Who is Eligible for Adoption Assistance or Subsidy?

1. How does the District of Columbia define special needs to determine eligibility?

In determining eligibility for adoption assistance, 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:

  1. The child has a chronic medically diagnosed disability that substantially limits one or more major life activities, or requires professional treatment, or assistance in self-care.
  2. The child has been diagnosed by a qualified mental health professional to have a psychiatric condition that impairs the child’s mental, intellectual, or social functioning, and for which the child requires professional services.
  3. The child has been determined to be mentally disabled by a qualified medical professional.
  4. The child has been diagnosed by a qualified mental health professional to have a behavioral or emotional disorder characterized by situationally inappropriate behavior that deviates substantially from behavior appropriate to the child’s age and interferes significantly with the child’s intellectual, social, and personal adjustment.
  5. The child meets all medical or disability requirements of Title XVI of the Social Security Act with respect to eligibility for supplemental security income benefits.
  6. The child is a member of a sibling group, in which the siblings will be adopted together at the same time.
  7. The child is of an age or has an ethnic or racial background that presents a barrier to adoption.
  8. The child has been legally free for adoption for six months or more and an adoptive placement has not been found.

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

2. Does the state-only funded adoption assistance program differ in any way from the Title IV-E program?

Children receiving D.C.-funded adoption assistance receive the same benefits as children who receive Title IV-E adoption assistance. However, Medicaid provisions may differ when families move outside the District of Columbia. To be eligible for D.C.-funded adoption assistance, a child must be a child with special needs as defined above and be in the custody of a public or private child-placing agency.

3. Are children adopted from private agencies in the District of Columbia eligible for adoption assistance?

Children adopted from private agencies in D.C. are eligible for adoption assistance if the child meets all eligibility criteria.


What Supports and Services Are Available?

Monthly Payments

4. What is the maximum basic daily adoption assistance maintenance payment in District of Columbia?

  Age 11 and Under Age 12 and Over
Normal
$32.23
$36.33
Special
$32.87
$37.62
Handicapped
$34.94
$40.22
Multi-handicapped
$41.00
$47.39

The above rates went into effect on January 1, 2013, and are consistent with CFSA foster care rates.

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

These rates must be established prior to adoption finalization, and are based upon the child’s rate in foster care, which are described below:

Normal Board Rate: The Normal Board Rate is paid for the basic and routine care required by a child who comes from a neglecting or abusing family.

Special Board Rate: The Special Board Rate is paid for a child who has a regular, re-occurring, or ongoing professionally diagnosed special need that requires extraordinary time or expense on the part of a foster parent.

Handicapped Board Rate: The Handicapped Board Rate is paid for a child who needs foster parent intervention because he cannot accomplish normal age-appropriate life processes, (such as eating, bathing, toileting, dressing, walking, or maintaining emotional and/or social control without adult intervention).

Multiple Handicapped Board Rate: The Multiple Handicapped Board Rate is paid for children who require adult intervention in more than one age-appropriate daily living process. The Multiple Handicapped Rate is reserved for the most severely disabled children.

6. When do adoption assistance payments begin?

Adoption assistance payments and benefits begin at adoption finalization.

7. When a child turns 18, which benefits, if any, continue?

For children whose adoptions finalized on or after May 7, 2010, adoption assistance is available for the child until 21 years of age. For adoptions finalized before May 7, 2010, if circumstances warrant an extension, adoption assistance can continue for an appropriate period of time, up to the child’s 21st birthday. The adoptive parent must remain legally and financially responsible for the child.

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

Yes, Washington, D.C. offers deferred adoption assistance. Deferred agreements are available to children who are at high risk of developing a special need but do not otherwise qualify as special needs. “High risk” means that a child does not currently exhibit a special need but, due to factors in their biological, social, or familial background, are at risk of developing a special need in the future.


Medical Care

9. What Medicaid services are available in District of Columbia?

The program covers the following services to eligible recipients when furnished by eligible providers:

  • Inpatient hospital
  • Outpatient hospital
  • Hospital emergency room
  • Laboratory and x-Ray
  • Skilled nursing facility
  • Intermediate care facility
  • Physician
  • Optometrist
  • Doctors of osteopathy
  • Medical transportation
  • Dental
  • Medical equipment, supplies, prosthetics, orthosis, and appliances
  • Early and Periodic Screening, Diagnosis and Treatment (EPSDT)
  • Pharmacy
  • Podiatrist
  • Optician
  • Home health agency care
  • Personal care
  • Health maintenance organizations
  • Out-of district services

For more information, visit http://www.dchealth.dc.gov/doh.

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

Children who are eligible for D.C.-funded adoption assistance are eligible for Medicaid benefits from the District of Columbia. However, coverage for specific medical services may be limited.

11. What mental health services are available?

Public mental health services for children in the District of Columbia are administered by the Department of Health, Medical Assistance Administration and may include mental health, physician, clinic, inpatient or outpatient hospital care, residential treatment, and pharmacy or prescription drugs. Generally, the District does not pay for therapeutic services. Contact Information: http://dchealth.dc.gov/doh or 202-698-2000.

In addition, the Post Permanency Family Center (see question 16) offers short-term counseling focused on adjustment difficulties, grief and loss, abandonment, identity development, and family identity formation. For more information, call 202-526-4802.

Not all services may be available in all cases. Parents should contact their adoption assistance worker or post-adoption services contact for information regarding process, eligibility, availability, and duration of services.


Other Benefits

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

Parents may be reimbursed, up to $2,000 per child, for nonrecurring adoption expenses. Nonrecurring expenses can include attorney’s fees directly related to the finalization of the adoption, court costs, travel costs for placement, and other costs reasonably related to the placement. Families should submit their receipts for these nonrecurring adoption expenses after adoption finalization. International adoptees, children in private agency custody, and private adoption adoptees are not eligible for the program.

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

Child care assistance is not a service available through the adoption assistance program.

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

Respite care assistance is available to children qualified for the Handicapped or Multi-handicapped level of adoption assistance payment. Determinations are made on a case-by-case basis. A special services agreement would be included in the adoption assistance agreement.

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

Residential treatment costs are not covered by the adoption assistance program; however, the District has access to more than 20 residential treatment providers who accept D.C. Medicaid. To access residential treatment for D.C. residents, the family may contact the D.C. adoption subsidy unit, and provide a doctor's recommendation for residential treatment. The family should first look for a facility that accepts Medicaid or private insurance. The Medicaid Residential Placement Unit must review the child’s case for medical suitability.

On a limited, case-by-case basis, D.C. may pay for unique treatment needs that can only be treated at certain specialized non-Medicaid facilities.

Most families who live outside the District will have their home state’s Medicaid program available to them. Families must follow the Medicaid procedures in their state of residence. The family must also explore local funding through their state of residence, such as from a community services board.

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

Post-adoption services in Washington, D.C. are offered through Post Permanency Family Center (PPFC), Child and Family Services Agency (CFSA) Post Permanency Services Unit, and the adoption assistance program.

The PPFC can help D.C. families find supportive community resources in such areas as mental health, parenting, emergency services, public health, academic support, and adoption assistance.

Post-adoption services may include:

  • Information and referral
  • Short-term individual, family and group counseling
  • Support groups for adults, teens and children
  • Crisis intervention services 24 hours a day/7 days a week
  • Parent trainings and workshops
  • Resource library
  • Case management and advocacy
  • Professional training

For more information, contact PPFC at 202-526-4802. The PPFC’s crisis hotline at 202-526-4802 is available 7 days a week, 24 hours a day.

The CFSA Post Permanency Services Unit connects adoptive and guardianship parents with post-permanency services. Families can access CFSA Post Permanency Services by calling Mary Hembry at 202-727-4817.

Not all services may be available in all cases. Parents 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?

Yes. A special services clause must be included in the adoption assistance agreement identifying any specific services being provided for the child.


What Should Families Know About Applying for Subsidy?

18. Who initiates the adoption assistance agreement?

Your subsidy social worker will initiate the adoption assistance agreement.

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

In accordance with state regulations and CFSA policy, the subsidy social worker, subsidy supervisor, and program manager (in certain cases) make the final determination.

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

In limited circumstances, a child adopted without adoption assistance may be eligible for assistance after finalization. For review, families should submit a request in writing to the adoption assistance program. The family must provide medical documentation (such as psychological, psychiatric or medical evaluations) that establishes that the child’s special needs existed, but were not known, before the adoption, and that the special needs would have made the child eligible for adoption assistance. Adoption assistance program staff will assist those interested in applying for adoption assistance post finalization.

To initiate the process, should contact the Adoption Subsidy Unit at 202-727-5424 or submit a written request to:

Child and Family Services Agency
Adoption and Guardianship Subsidy Unit
Attn: Patricia Johnson
400 6th St., SW
Washington, DC 20024


How Can a Family Adjust an Adoption Assistance Agreement?

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

Adoptive parents who have an adoption assistance agreement can request a change in the agreement any time there is a change in the child’s condition that was part of the special needs determination or an at-risk designation at the time of adoption. Parents must send a written request specifying the reason for change to the adoption assistance unit. Requests for modification of the adoption assistance agreement are reviewed within 30 days of receipt by CFSA.

With the change request, parents will need to submit a copy of a current evaluation administered either by a physician (M.D.), a psychiatrist (M.D.), or a psychologist (Ph.D.). The following elements must be in the evaluation:

The child’s evaluation must include the child’s diagnosis/diagnoses as categorized by DSM-IV format. The evaluation should describe the child’s current behavioral or health management needs with a history and description of the special needs that the parent must address. Doctors should be specific about the child’s need, describing behaviors, frequency and severity of the problems, intervention requirements, testing, results, diagnosis/diagnoses, date of diagnosis, treatment recommendations and prognosis. This evaluation must be no older that one year old. If conditions are unchanged or stable from the time of adoption, CFSA will not approve a request for an increase.

Parents must submit the request and documentation to:

Child and Family Services Agency
Adoption Subsidy Unit
400 6th Street, SW
Washington, DC 20024

Each year, CFSA reviews adoption assistance agreements for continued need. Adoptive families must verify the child’s residence by providing a copy of the child’s school registration and provide proof of medical coverage for the child.

22. What steps does a family go through to appeal an adoption assistance decision in the District of Columbia?

An adoptive parent can appeal CFSA’s denial, reduction, or termination of their adoption assistance benefits through the Office of Fair Hearings and Appeals. With each decision, CFSA sends Notice of Action and a Fair Hearing request form to parents instructing them on how to formally request a hearing. Parents must submit the fair hearing request form or a written request for fair hearing by mail.

Hearing requests must be received within 30 days from receipt of the Notice of Action. The parent may request a hearing with an examiner or choose to have the case mediated by an impartial third party. A trained mediator will work to bring the parties together to help resolve disputes quickly and to the satisfaction of both CFSA and parents. The Office of Fair Hearings and Appeals must submit a notification of the hearing within 45 days of receiving the family’s request for a hearing.

To initiate the process or request a hearing, parents should contact the Office of Fair Hearing at 202-724-7100 or submit a hearing request form to:

Tamara Rutland, Fair Hearings Coordinator
Child and Family Services Agency
Office of Fair Hearings and Appeals
955 L’Enfant Plaza – North Building, S.W.
Suite P101
Washington, DC 20024
Fax (202) 727-5619

Before seeking a formal fair hearing, the adoptive parent may request an administrative program review, which will be conducted by CFSA program staff.


What Else do Families Need to Know?

23. How is the adoption assistance program operated and funded in the District of Columbia?

The program is city-supervised/city-administered, which means both policy and eligibility decisions are made by personnel at the city level. The federal contribution to Title IV-E-eligible children (known as the Federal Financial Participation or FFP rate) is 70% in D.C. The remaining cost of the program is funded entirely with D.C. government funds.

24. Does District of Columbia operate a subsidized guardianship program?

In 2002, D.C. started a guardianship assistance program for kinship caregivers, which has since been expanded to included non-kinship caregivers. Permanent guardianship enables children to retain ties to their families of origin and community through placement with kin and non-kinship caregivers.

An applicant may be eligible to receive a permanent guardianship subsidy until the child reaches the age of 21 when all of the following criteria are met:

  1. The court has awarded the applicant permanent guardianship over a child.
  2. The applicant must be licensed in the state where they reside.
  3. All of the following criteria are met at the time of the application and continue to be met until the court awards permanent guardianship:
    1. The court has adjudicated the child to be a neglected child;
    2. Following the disposition hearing, the court placed the child in CFSA’S legal custody;
    3. The child has been determined to meet one or more of the following special needs criteria:
      1. Difficult to place for adoption because of age, race, ethnic background, physical or mental condition
      2. The child is a member of a sibling group that should be placed together
      3. The child in all likelihood would go without another permanent placement except for her or his acceptance as a member of the permanent guardian’s family.
    1. CFSA has determined that the child’s best interest is not met by the permanency plan of either reunification or adoption.
    2. CFSA has determined that the permanency plan of legal guardianship with the applicant is in the child’s best interest.
    3. The applicant is qualified in every other way but has a current and ongoing financial need for a permanent guardianship subsidy

25. Does the District of Columbia offer a tuition waiver program?

No.

26. Does the District of Columbia offer a local adoption tax credit?

No.

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

When his or her adoptive parent(s) dies, a child shall remain eligible for adoption assistance if the child received title IV-E Adoption Assistance and if the child continues to meet special needs criteria. CFSA’s Post Permanency Unit shall help the child’s new custodian/caretaker to identify alternative financial resources for which the child may be eligible (i.e. SSI, survivor benefits, TANF, Medicaid, etc.). The child’s new caretaker may receive payments from CFSA for the child’s care for three months to help stabilize the household.

Caretakers who are residents of the District of Columbia, they may continue receiving adoption assistance payments beyond the three-month period as long as the caretaker files a petition to adopt the child. The caretaker must file an adoption petition within six months after assuming care for the child.

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

On May 7, 2010, the District of Columbia passed the Adoption Reform Amendment Act (ARA) of 2010. The law extends a child or youth’s eligibility for an adoption or guardianship subsidy until he or she turns 21 years of age. The law also expanded guardianship to include non-relatives. The law only extends subsidies until 21 years of age for adoptions and guardianships that finalized after May 7, 2010


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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