Adoption
Subsidy

Florida State Subsidy Profile

Updated January 2009

State Subsidy Contact Person

Kathleen Waters
Adoption/ICAMA Program Manager
Office of Family Safety
1317 Winewood Blvd.
Bldg. 6, Room 301P
Tallahassee, FL 32399-0700
Phone: 850-717-4686
Fax: 850-414-8691
E-mail: Kathleen_Waters@dcf.state.fl.us

NACAC Subsidy Representatives (parent/volunteer)

Bob Rooks
Florida's Adoption Information Center
4203 Southpoint Blvd.
Jacksonville, FL 32216
Phone: 800-96-ADOPT (in Florida); 904-353-0679 (outside Florida)
Fax: 904-353-3472
E-mail: brooks@danielkids.org

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.adoptflorida.com (DCF’s Florida Adoption Information Center)

Florida’s state-specific medical assistance:
http://ahca.myflorida.com/Medicaid/index.shtml

Florida’s adoption assistance:
Florida’s DCF Website includes a Benefits page that covers some adoption assistance information issues.www.adoptflorida.org

For a description of specific special needs: http://www.myflorida.com/cf_web/myflorida2/healthhuman/
adoption/specialneeds.shtml and
http://www.adoptflorida.com/assistance-program.htm

Florida Statutes 409.166
http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute
&Search_String=&URL=Ch0409/SEC166.HTM&Title=-%3E2007-%3E
Ch0409-%3ESection%20166#0409.166

Florida Administrative Codes 65C-16.001 through 65C-16.017
https://www.flrules.org/gateway/ChapterHome.asp?Chapter=65C-16

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:

1. Was permanently committed to the Department or licensed child placing agency, and
2. Has at least one of the following needs or circumstances that may be a barrier to placement or adoption without financial assistance:

a. Eight years of age or older
b. African American or racially mixed parentage
c. Member of a sibling group being placed for adoption as a unit
d. Mentally handicapped.
e. Physically handicapped.
f. Emotionally handicapped.
g. Significant emotional ties with his foster parents or relative caregiver

AND

3. Except for children adopted by their foster parent or relative caregiver, there was reasonable but unsuccessful efforts to place without subsidy.

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.

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

For adoptions finalized after July 1, 2007, the annual maintenance adoption subsidy is usually negotiated at $5000 or $417 monthly. There were no appropriations to increase previously approved subsidies.

Prior to July 1, 2007, the monthly maintenance payment is based on the age of the child and the statewide standard foster care board rates. These negotiations were based on 80 percent of the statewide standard foster care board rate for the child’s age group at the time the negotiation occurs.

The following chart shows the basic payment by age of the special needs child being adopted (prior to July 1, 2007):

Children may also qualify for supplemental benefits.

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

The supplemental rate was taken out of the current administrative rule. The answer to #3 applies here in that if a child is receiving a therapeutic or medical foster care rate, the adoptive family can negotiate up to the actual foster care board rate the child received in foster care.

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 are one-time expenses such as attorney fees, court costs, birth certificate fees, travel expenses (including food and lodging), agency fees, and physical and psychological examination fees. All adoptive parents of special needs children will be advised of the availability of nonrecurring expense reimbursement, regardless of the child's IV-E eligibility status. There can be no income eligibility requirements for adoptive parents in determining whether payments for nonrecurring expenses will be made. As with maintenance and medical subsidy, parents of children in the custody of private agencies may also qualify for nonrecurring expense reimbursement. Payments can be made up to two years following the finalization of the adoption. However, every effort should be made to complete these transactions within three months after the adoption is finalized.
           
The reimbursement limit is $1000 per child.

6. What Medicaid services are available in Florida?  Who is the state’s Medicaid contact person?

• Adult Health Screening Services
• Advanced Registered Nurse Practitioner (ARNP)
• Ambulatory Surgical Centers
• Birth Centers
• Durable Medical Equipment/Supplies
• Project AIDS Care
• Rural Health Clinic
• Transportation
• Podiatry
• Outpatient Hospital
• Nursing Home or Hospice Care
• Optometry
• Physician Assistant (PA)
• Portable X-Ray
• Prescribed Drugs
• Inpatient Hospital
• Independent Laboratory
• Licensed Midwife
• Visual and Hearing Services
• Family Planning
• Health Maintenance Organizations (HMOs)
• Chiropractic
  
• Community Mental Health—include rehabilitative services which are either psychiatric in nature, rendered or recommended by a psychiatrist; or medical in nature, rendered or recommended by a psychiatrist or other physician.
  
• Dental (Children)—includes the provision of diagnostic examinations, radiographs necessary to make a diagnosis, preventive treatment, restorations, endodontics, periodontal treatment, dentures, oral surgery and orthodontic treatment. For orthodontics, services are limited to treatment of severely handicapping malocclusions or correction of a dental condition deterring physical development. Exceptions to service limitations are considered on a case-by-case basis.
  
• EPSDT—Early and Periodic Screening, Diagnostic and Treatment Services (EPSDT) recipients are screened according to the following schedule: Birth, two months, four months, six months, nine months, one year, 15 months, 18 months, and once per year from age two through six and once every two years from age seven through age 20.
  
• Early Intervention—Medical and remedial services designed to enhance the capacity of children with conditions causing a delay in normal development. The services include screenings, evaluations and medically related early intervention services, such as nutritional, psychological, audiological, nursing, developmental, social work, speech language pathology and parent training.
  
• Home and Community-Based Waiver Service—Examples of home and community-based services include: case management, respite care, personal care, home management/homemaker services, health support, escort services, developmental training, diagnosis and evaluation, training and therapies, transportation and caregiver training and education.
  
• Home Health Care—A Medicaid recipient under age 21, who is eligible for the EPSDT program, may receive respiratory, occupational, speech and physical therapies
  
• Intermediate Care Facility Services for the Mentally Retarded or Developmentally Disabled—Provided to individuals who, because of their mental or physical condition, require care and services which can be made available to them only through institutional facilities.
  
• Routine immunizations are covered for children under 21. Prescribed Pediatric Extended Care (PPEC)—Non-residential health care service that provides the needed continuum of care for children who are medically complex.
  
• Targeted Case Management—Case management is defined as activities associated with ensuring access to necessary medical, social, educational, and other services as required by a given client.
  
• Occupational, Physical, and Speech Therapies—Available on an in-home basis, but the recipient need not be homebound.

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

Some children who are not eligible for Title IV-E benefits may still be eligible for Medicaid. In order to be eligible, two requirements must be met: (1) an adoption assistance agreement must be in effect; and (2) the child must have been eligible for Medicaid before the agreement was signed.

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

Public mental health services for children in Florida are administered by the Department of Children and Families, Substance Abuse and Mental Health. The Children’s Mental Health system of care is public-funded and serves eligible children with serious emotional disturbance, children with emotional disturbance, and children at risk of emotional disturbance, within the amount of funds appropriated for these services. Mental health services in Florida are received through various programs including:

Community Mental Health: Includes rehabilitative services which are either psychiatric in nature, rendered or recommended by a psychiatrist; or medical in nature, rendered or recommended by a psychiatrist or other physician.

Early Intervention: Includes medical and remedial services designed to enhance the capacity of children with conditions causing a delay in normal development. The services include screenings, evaluations and medically related early intervention services, such as nutritional, psychological, audiological, nursing, developmental, social work, speech language pathology and parent training.

Intermediate Care Facility Services for the Mentally Retarded or Developmentally Disabled: Provided to individuals who, because of their mental or physical condition, require care and services which can be made available to them only through institutional facilities.

The Florida Mental Health and Children’s Mental Health: http://www.dcf.state.fl.us/mentalhealth/ and http://www.dcf.state.fl.us/mentalhealth/cmh.shtml
Or phone Medicaid help line: 888-367-6554.

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?

Florida offers a program under post adoption services known as Medical Subsidy that can be requested at any time, however, the budget is limited and can only be requested when adopting family’s medical insurance, Children’s Medical Services, Children’s Mental Health Services, Medicaid, Agency for Persons with Disabilities or local school districts will not provide the needed service. The cost of medical, surgical, hospital, and related services needed as a result of a physical or mental condition that existed prior to the adoption may qualify for medical subsidy. However, a service to be paid with medical subsidy funding must be pre-approved before the service is provided. Medical subsidy can be received for the length of time that the condition exists, or until the child turns eighteen years of age, whichever occurs first. The need for medical subsidy must be supported by documentation of that need from appropriate professionals (i.e., licensed physician, dentist, or mental health professional) and established prior to the adoptive placement. The need or potential need for the Medical Subsidy program must also be documented in the adoption assistance agreement. Medical and medically related service costs may be subsidized under this program for conditions that pre-existed the adoption and cannot include costs that can be covered by the family's private insurance or other available medical coverage. A request for medical subsidy may be initiated at any time but must be terminated when the condition for which it was granted no longer exists, or on the child's 18th birthday, whichever occurs first.

Note: Not all services may be available in all cases. Contact your adoption assistance worker or post adoption counselor 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 Florida are administered by the Department of Children’s Services, Family Safety Program Office and the Community Based Care Agencies or their sub-contracted agencies. The DCF and contracted agencies provide various services, depending on location. Post-adoption services include the following examples:

1. Information and referral
2. Support groups
3. Adoption related libraries
4. Case management
5. Training
6. Florida Adoption Reunion Registry (FARR)

A collaboration of community-based agencies, Adoption Support Network, is a parent support group serving adoptive families in the Sarasota area. Network link: http://www.sarasota-ymca.org or phone: 941-721-7670 x205. Statewide, adoptive families are directed to contact 800-96ADOPT or their adoption assistance worker, or the unit through which they finalized the adoption. DCFS office contact locator: http://www.dcf.state.fl.us/admin/dcfcontacts.shtml

Many private organizations offer a variety of respite options. See the ARCH National Respite Network Respite Locator Service, search by state to locate Florida’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?

Yes.

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

Note: When a child goes into residential treatment and is expected to remain there for more than 60 days, continuation of his/her monthly maintenance subsidy will be decided on a case-by-case basis.

The state Children's Mental Health budget pays for residential treatment, and pays for treatment before and after 60 days, if necessary.  Also, the family may contribute to the costs of residential treatment via their insurance or through their monthly adoption assistance payment.  However, the state would bear the primary burden.  To be eligible, a child must be proved dependent or delinquent.  The child’s adoption counselor can provide program information and referrals.

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

Yes, Florida offers deferred adoption assistance. If at the time the child is placed for adoption, the adoptive parents choose not to receive adoption assistance for the child, they are encouraged to sign the initial assistance agreement with a payment amount of zero ($0) listed in the agreement. Establishing a deferred adoption assistance agreement preserves future active adoption assistance eligibility for the child in the event that the family needs assistance in meeting the needs of the child. Although the agreement documents a $0 amount, the child is eligible for Adoption Assistance Medicaid.

14. Does Florida operate a subsidized guardianship program?

No. Although Florida does not have a program called subsidized guardianship, Florida does have a Relative Caregiver Benefit Program that provides a monthly subsidy and Florida Medicaid until the child reaches age 18. To be eligible for this program, the child must have been adjudicated dependent by the dependency court and the relative must have obtained permanent guardianship, long term custody or custody by a fit and willing relative and remain in Florida.

Programmatic Procedures

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

The final determination of eligibility is made by the Community Based Care adoption specialist. A denial of a subsidy must be approved and signed by the district administrator or his/her designee. The denial letter sent to the adoptive family must provide legal sufficiency for the denial and an explanation of the timeframes and process to request a fair hearing.

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

The monthly basic maintenance payment will be based on the needs of the child and the circumstances of the adoptive family to meet those needs. Generally, the subsidy is negotiated at 80 percent of the statewide standard foster care board rate at the time the payment determination is being made. Income scales were not used as of March 24, 1999, following changes made to Florida’s Administrative Rules chapter 65C-16, Adoptions.

17. When do subsidy payments begin?

Adoption assistance payments and benefits may begin at adoption placement.

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

Yes, but they must meet the same eligibility requirements for special needs. No special measures are required.

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

Subsidy payments will be terminated when the child reaches 18 years of age, however, if the child was adopted at age 16 or 17 and participates in the Road to Independence, the child will be eligible for Florida Medicaid until age 21.

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

Florida deleted the requirement for annual renewals beginning 7/1/2008, however, subsidies that are funded with TANF, continue to require annual renewals. The only questions for the renewals are if the child is receiving an income and if the family continues to reside in Florida. Every 12 months, the eligibility for Adoption Assistance Medicaid is required by federal law, however, the family does not have to complete any paperwork because the Child in Care Worker only needs to verify that the family continues to receive a subsidy and therefore Adoption Assistance Medicaid is renewed.

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

Adoptive parents may request modifications to adoption assistance agreements at any time, but the request must be in writing. The amount of the subsidy may be readjusted periodically up to the maximum allowable payment for the child, or reduced, with the concurrence of the adoptive parents, to fit the changing needs of the child and the circumstances of the adoptive parents. To start this process, families are directed to contact the adoption unit or private adoption agency through which they adopted the child. Families are directed to contact (1) the social worker or department through which they receive their adoption assistance check, (2) the unit through which they finalization the adoption, or (3) the district administrator at their local Children and Family Services office.

Adoptive parents have a right to appeal a decision to deny their request for a change in the subsidy because this is a denial of a service. They may seek redress through levels of the departmental administration up to and including the district administrator. If an issue is not resolved to a family’s satisfaction, they may request a fair hearing pursuant to Florida statute.

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

A notification of the adoptive family’s right to a fair hearing is sent from the circuit administrator with each denial of a service, including a request for a change to the subsidy amount. Fair hearings must be requested in writing as directed in the notification sent by the circuit administrator. Families are directed to contact (1) the social worker or department through which they receive their adoption assistance payment (2) the unit through which they finalization the adoption or (3) the circuit administrator at their local DCFS office. DCFS office contact locator: http://www.dcf.state.fl.us/admin/dcfcontacts.shtml

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.

To start this process, families are directed to contact the adoption unit or private adoption agency through which they adopted the child. There are only certain circumstances when a subsidy agreement can be signed after finalization and usually the valid reasons are that the family was not told of the availability of subsidy or was provided misinformation.

System Operation and Program Funding

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

Our system is state supervised/state administered. Florida is divided into 20 circuits located throughout the state.

The federal contribution to Title IV-E-eligible children is 55.40% in Florida. This is known as the Federal Financial Participation (FFP) rate. The remaining cost of the program is funded entirely by general revenue (state) funds. Local/county governmental units are not responsible for any portion of the state share of IV-E adoption assistance payments. For those children who are determined to be eligible for subsidy but are determined to be non-IVE, subsidies are available and can be funded through TANF funding or 100% general revenue.

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

All adoption fees shall be waived for adoptive parents who adopt children in the care and custody of the Department.

A family who adopts a child without subsidy will be asked to sign the Adoption Subsidy Disclaimer form, indicating that the subsidy program has been explained to them and they can provide for the child without financial assistance.

College Tuition Waiver Program—Children who, at age 18, are in foster care, receiving independent living services, in the custody or guardianship of a relative or who are adopted from the Department of Children and Families after May 5, 1997 are exempt from all undergraduate fees, including registration, matriculation, and laboratory fees. The college tuition waiver program is only for the State Community College System, the State University System, and other adult general education programs in Florida.