Hawaii State Subsidy Profile
Updated draft • October 2014
(state review pending)
State Subsidy Contact Person
Department of Human Services (DHS)
810 Richards St. Suite 400
Honolulu, HI 96813
NACAC Subsidy Representative (parent/volunteer)
It Takes An `Ohana, aprogram of Family Programs Hawai'i
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 Hawaii. 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 firstname.lastname@example.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.
Adoption resources on the web:
Hawaii Department of Human Resources has no general adoption information link.
Hawaii state-specific medical assistance:
Hawaii Revised Statutes 346-301 through 346-305.
Scroll down to sections 301 to 305.
Hawaii Administrative Rules Title 17 Chapter 944.1, Adoption Assistance for Children with Special Needs.
Scroll down and click on 17-944.1 for a PDF of the rules.
Who Is Eligible for Adoption Assistance?
1. How does Hawaii define special needs to determine eligibility?
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 adoption without financial assistance:
- Four years old or older at date of adoptive placement
- Race or ethic background
- Member of a sibling group of two or more children adopted by the same family or to join a sibling that has already been adopted
- Physical or mental disability
- Emotional disturbance
- High risk of developing a physical or mental disease
Children must be legally free for adoption and under 18 years of age to be eligible for assistance.
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 and be in the custody of the Hawaii Department of Human Services.
3. Are children adopted from private agencies in Hawaii eligible for adoption assistance?
Yes. Private agency workers must document the child's special needs and furnish an adoptive placement agreement. However, unless the child is an SSI recipient or received federal (IV-E) adoption assistance in a previous adoption or is the child of a minor parent in foster care who is receiving federal (IV-E) foster board payments that cover the minor parent and child, the child must have been placed in foster care by judicial determination to qualify for federal adoption assistance.
To be eligible for state-funded adoption assistance, children must be in the custody of the Department or a licensed child-placing organization at the time the adoption proceedings are initiated.
What Supports and Services Are Available?
4. What is the maximum basic monthly adoption assistance maintenance payment in Hawaii?
|0-5 years old
|6-11 years old
|12 years old and older
5. Does Hawaii provide specialized rates (based on the extraordinary needs of the child or the additional parenting skill needed to raise the child)?
Yes, the difficulty of care rate is up to $570 per month in addition to the basic rate. The rate is available if the child requires additional supervision and care because of physical or mental health conditions or emotional, psychological or behavioral problems.
6. When do adoption assistance payments begin?
Adoption assistance payments and benefits may begin at adoption placement.
7. When a child turns 18, which benefits, if any, continue?
Adoption assistance typically continues until the child reaches the age of 18. Assistance can extend to the child’s 21st birthday if the child has been determined by the Department to have a mental, emotional, or physical disability that warrants continued assistance. The child’s physical or mental disability must require ongoing medical supervision or treatment, or be a barrier to achieving and maintaining the goal of self-sufficiency according to documentation received from the child’s physician or other professional service provider.
For state adoption assistance, can continue until 20th birthday if youth is still in enrolled in high school.
8. Does Hawaii offer deferred adoption assistance agreements (agreements where initial monthly maintenance amount is $0 for children at risk of developing special needs later)?
9. What Medicaid services are available in Hawaii?
Hawaii’s Medicaid program is called Med-QUEST, and it is administered by a number of different managed care providers. For Medquest eligibility questions or for a referral to the child’s provider, parents can call 808-587-3540 or 808-587-3530
10. What medical benefits are available for state-funded children? (Children who have federally funded/Title IV-E adoption assistance are automatically eligible for Medicaid benefits.)
Medical coverage is identical for both groups of children. Children who are non-IV-E eligible (who receive state adoption assistance) may not qualify for Medicaid in another state. Hawaii Medicaid will continue, but its acceptance by providers may be limited in other states.
11. What mental health services are available?
Public mental health services for children in Hawaii are administered through Med-QUEST. For services and eligibility information, parents can contact MedQUEST at http://www.med-quest.us/ or phone 808-587-3540 or 3530. On the web site, a list of services is available at the Behavioral Health section on this page: http://www.state.hi.us/dhs/Q-Book.html
Parents may also contact the Department of Health, Child and Adolescent Division, (http://www.state.hi.us/doh/camh or phone 808-733-9333; bilingual access line: 808-526-9724).
Parents can also contact their adoption assistance worker, medical assistance specialist, or the Department of Health, Child and Adolescent Mental Health Division for information regarding process, eligibility, availability, and duration of services.
12. In Hawaii, what nonrecurring adoption expenses directly related to the finalization of an adoption may be reimbursed?
Parents may be reimbursed up to $2,000 for reasonable and necessary adoption fees, court costs, attorney fees, and other expenses (i.e., adoption home study, health and psychological examinations, costs of placement supervision prior to adoption, and costs of transportation and food/lodging) directly related to the adoption of a child with special needs.
The amount of reimbursement for non-recurring expenses is based upon a bill or receipt for the allowable expense, submitted no later than two years after the final decree of adoption.
13. Is respite care available? If yes, who is eligible and how do families access respite care?
Respite is not provided through the adoption assistance program. For developmentally disabled children, families can apply for support through the Department of Health, Division of Developmental Disabilities (808-733-9174). Representatives from the Department of Health state that as long as the child is registered with the department’s Child and Adult Mental Health Division (DOH-CAMHD) and respite service is indicated in the child’s Department of Education’s (DOE) Individualized Education Plan (IEP) and Comprehensive Service Plan (CSP), DOH-CAMHD will authorize respite care services.
Many private organizations also offer a variety of respite options. Parents can search for Hawaii resources in the ARCH National Respite Network Respite Locator Service: http://www.respitelocator.org/
14. Is residential treatment available? If yes, who is eligible and how do families access residential treatment services?
Children and youth (and their families) who are Medicaid eligible and who have serious emotional and behavioral challenges can request mental health services from the Department of Health, Children and Adolescent Division Behavioral Health Division (DOH-CAMHD).
Children in this category receive services from a range of home-based and residential care. Services must be based on least restrictive setting guidelines and are determined based upon an individual planning process. The costs for residential care are covered by Medicaid and DOH-CAMHD.
Children and youth with serious emotional and behavioral challenges who are IDEA eligible and whose Department of Education's (DOE) Individualized Educational Program determines the child or youth needs intensive mental health care can receive focused services with the goal of improving school performance. Services are individualized and may involve in-home and out–of-home care. Costs are covered by DOE, Medicaid (if eligible) and DOH-CAMHD.
Families can also access residential care through their healthcare provider. All insurance companies in Hawaii cover the cost of residential care if the care is medically necessary.
15. What other post-adoption services are available in Hawaii and how do families find out more about them?
Post-adoption services in Hawaii are administered by the Department of Human Services and contracted through outside agencies. DHS’s post-adoption services include the following:
- Resource and referral
- Support groups
- Crisis intervention
- Parenting education
Parents can access post-adoption services on their own or through the Department of Human Services.
Parents may also contact the following individuals/organizations in the listed cities for post-adoption service information:
200 N. Vineyard Blvd, Building B
Honolulu, Hawaii 96817
Child and Family Services
333 Dairy Rd., Room 201
Kahului, Hawaii 96732
Child and Family Services
2970 Kele Street, Suite 203
Lihue, Hawaii 96766
99 Au Puni Street, Room 212
Hilo, Hawaii 96720
Personal Parenting and Assessment Services
74-5620 Palani Rd., Suite 101
Kailua-Kona, Hawaii 96740
In addition to specific post-adoption services, social services programs are available through Title XX to children receiving adoption assistance who meet the program’s eligibility criteria and have these program needs listed in their adoption assistance agreement. Adoptive parents are directed to contact their adoption assistance or adoption program social worker to apply for these services.
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.
16. If the assistance listed above in questions 13 to 15 are for specific services, must these services be explicitly identified in the adoption assistance agreement?
Yes. Post-adoptoin services do not need to be listed in the agreement.
WHAT SHOULD FAMILIES KNOW ABOUT APPLYING FOR ADOPTION ASSISTANCE?
17. Who initiates the adoption assistance agreement?
The child’s worker will document the child’s eligibility and initiate an agreement.
18. Who makes the final determination on an adoption assistance agreement?
The worker, with a supervisor’s approval, sets payment levels. The section administrator gives final approval.
19. How do families request adoption assistance after finalization of an adoption?
- Request an application for adoption assistance and file it.
- Upon denial of the application, notify the Child Welfare Service Section of intent to appeal the decision, or send appeal directly to the Administrative Appeals Office.
- The hearing will be scheduled. (Out-of-state families may participate by phone.)
- The decision will be sent, in writing, to the family within 90 days.
- If successful, the family will be contacted by the CWS Section Adoption Unit/Worker to complete paperwork, negotiate adoption assistance, and finalize an agreement.
To start the process, families should contact Child Welfare Services Intake Unit at 808-832-5300 or the case management unit that was responsible for the child.
HOW CAN A FAMILY ADJUST AN ADOPTION ASSISTANCE AGREEMENT?
20. Can adoptive parents ask to change an adoption assistance agreement?
Adoptive parents may request a change when a child’s needs change so they require an increased level of care, which would result in eligibility for a Difficulty of Care payment . Parents may also apply for a change if the family’s circumstances. To request a change, parents should contact the unit administrating the adoption assistance payments or the unit that finalized the adoption. Modifications in adoption assistance agreements are often made in response to changes relayed at the biennial review of the adoption assistance agreement. A list of DHS contacts is available at http://www.state.hi.us/dhs/ph_dhs.html.
21. What steps does a family go through to appeal an adoption assistance decision in Hawaii?
Adoptive parents can request a fair hearing when there is disagreement with a DHS decision that affects their child’s adoption assistance. Requests should be in writing to the adoption assistance worker or the department’s administrative appeals office within 90 days of the receipt of a the department’s notice of denial, reduction, or termination of adoption assistance. If someone makes a written request on behalf of the adoptive parents, there must be a written statement, signed by the adoptive parent(s) authorizing this person to be their representative.
An administrative appeals officer will acknowledge the request for the hearing within 15 days of the request, and will contact the adoptive parents to schedule a hearing. Adoptive parents will receive a written decision in the mail within 90 days of the hearing request.
Parents should send written requests for fair hearing to the adoption assistance worker or to the administrative appeals office:
Administrative Appeals Office
1390 Miller Street, Room 106
Honolulu, Hawaii 96813
WHAT ELSE DO FAMILIES NEED TO KNOW?
22. How is the adoption assistance program operated and funded in Hawaii?
The program is state supervised/state administered, which means policy and eligibility decisions are made by personnel at the state Department of Human Services.
The current federal reimbursement on behalf of Title IV-E-eligible children (the the Federal Financial Participation or FFP rate) is 51.85% in Hawaii. The remaining cost of the program is funded with state general funds.
23. Does Hawaii operate a subsidized guardianship program?
Yes. Relatives and nonrelatives may receive the same amount as foster parents. Parents can contact Mr. Lee Dean (808-586-5704) for more information. For information about the differences between subsidized guardianship and adoption assistance, visit http://humanservices.hawaii.gov/ssd/files/2014/02/Permanency-Options-0207.pdf
24. Does Hawaii offer a tuition waiver program?
No, but the Hawaii Education and Training Vouchedr (ETC) program may provide education assistance. Through the ETV program, youth may be eligible for funding of up to $5,000 per year while they are in college or a vocational or technical training program!
Youth may qualify if:
- They are 18, 19 or 20 years old.
- They are in foster care or were in foster care as a teenager and are a US citizen or qualified non-citizen
- They aged out of the foster care system at age 18 or were adopted from foster care with adoption finalization after their 16th birthday.
- They have been accepted into or are enrolled in a degree, certificate or other program at a college, university, technical or vocational school and they show progress towards that degree or certificate.
To find out more about the specific eligibility requirements for Hawaii, parents or youth can contact their caseworker or:
Social Services Division
Hawaii Department of Human Services
810 Richards Street Suite 400
Honolulu, HI 96813