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Hawaii State Subsidy Profile

Updated Septebmber 2008

State Subsidy Contact Person

Bernadette Lane
Department of Human Services (DHS)
810 Richards St. Suite 400
Honolulu, HI 96813
Phone: 808-586-5794
Fax: 808-586-4806

NACAC Subsidy Representative (parent/volunteer)

Judith Wilhoite
It Takes An `Ohana, aprogram of Family Programs Hawai'i
Phone 808-540-2543

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 ( Profiles for each state’s subsidy program are available on our web site at 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 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:

Hawaii Department of Human Resources has no general adoption information link. 

See the Hawaii Revised Statutes (HRS) for Hawaii law on adoption at HRS 578:

Hawaii’s state-specific medical assistance links:

Hawaii Revised Statutes 346-301 through 346-305.
Scroll down in this directory to sections 301 to 305.

Hawaii Administrative Rules
Title 17 Chapter 944.1, Adoption Assistance for Children with Special Needs.
Scroll down to 17-944.1, click it for a PDF of the rules.

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 has at least one of the following needs or circumstances that may be a barrier to placement or adoption without financial assistance:

  1. Age
  2. Race or ethic background
  3. Member of a sibling group of two or more children adopted by the same family (need not be adopted at the same time)
  4. Physical or mental disability
  5. Emotional disturbance
  6. High risk of developing a physical or mental disease

Note: Children must be legally free for adoption, under 18 years of age

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 and in the custody of the State of Hawaii Department of Human Services.

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

Basic rate:                          

0-5 years old
6-11 years old
12 years old and older

Difficulty of care rate: Additional $570

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

The child requires additional supervision and care because of physical or mental health conditions or emotional, psychological 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.

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 special needs child).

International adoptees who are adopted in Hawaii may be eligible for non-recurring adoption expense reimbursement upon documentation of 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.

The reimbursement limit is $2,000 per child.

6. What Medicaid services are available in Hawaii? Who is the Medicaid contact person in Hawaii?

Medquest is Hawaii's Medicaid program, but it is administered by managed care organizations.  No brochure is available because it is handled by many different providers.  For Medquest eligibility questions, call 808-587-3540 or 808-587-3530.  These numbers may also be able to help with some service-related questions, or refer family to appropriate managed care phone numbers.

The Medquest Administrator is Aileen Hiramatsu, 808-692-8050.

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

Yes, coverage is identical for both groups of children. It should be noted that non-IV-E (state adoption assistance) children may possibly not qualify for Medicaid in another state. Hawaii State Medicaid will continue, but its acceptance by providers may be limited in other states.

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

Public mental health services for children in Hawaii are administered through MedQUEST.  MedQUEST is comprised of managed care organizations delivering services through many different providers.  No listing of mental health services offered to children is available. 

For services and eligibility information, contact MedQUEST, or phone 808-587-3540 or 3530.

See QUEST’s listing of services, scroll down to Behavioral Health,

Parents may also contact the Department of Health, Child and Adolescent Division, or phone 808-733-9333. Bilingual Access Line, phone: 808-526-9724.

Note: Not all services may be available in all cases. Contact your 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.

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?

Hawaii does not provide additional finances or services for medical or therapeutic needs not covered under their state medical plan to children receiving adoption assistance.  No specific program is available to meet a child’s extraordinary needs that are not covered by the adoption assistance payments or medical plan or other eligible services provided by the Department of Health. However, social services programs are available through what is referred to as Title XX (Social Security Act reference) 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.

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 Hawaii are administered by the Department of Human Services and contracted through outside agencies. DHS’s post-adoption services include the following examples:

1.   Resource and referral
2.   Newsletter
3.   Support groups
4.   Trainings
5.   Crisis intervention
6.   Counseling/therapy
7.   Advocacy
8.   Parenting education

Parents can access post adoption services on their own or through the Department of Human Services.

Contact the Hawaii Foster Parent Association

Hawaii Foster Parent Association
PMB #261
111 Hekili St., Suite A
Kailua, HI 96734
Phone 808-263-0920 or toll free at 877-775-4400
Fax: 808-263-0921

Link to the Association’s publication, Resource Sites for Foster-Adoptive Parents at:

Respite is not provided through the subsidy program; families apply through the Department of Health, Division of Developmental Disabilities, 808-733-9174, for developmentally disabled children.  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)—regardless of adoption status—and respite service is indicated in the Department of Education’s (DOE) Individualized Education Plan (IEP) and Comprehensive Service Plan (CSP), DOH-CAMHD will authorize respite care services.  However, Many private organizations offer a variety of respite options. See the ARCH National Respite Network Respite Locator Service, search by state to locate Hawaii’s respite programs,

Parents may also contact the following individuals/organizations in the listed cities for post adoption service information:

Tammie Vesperas
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

Regina Purinton
99 Au Puni Street, Room 212
Hilo, Hawaii 96720

Personal Parenting and Assessment Services
74-5620 Palani Rd., Suite 101
Kailua-Kona, Hawaii 96740

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?


12. How are residential treatment costs covered (if at all) for adoptive families? What procedures must a family follow to receive these 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 individualized 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/youth to be in need of 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.

The other way that adoptive families access residential care is through their Healthcare provider/Insurer.  All insurance companies in Hawaii cover the cost of residential care if medically necessary.

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

Yes, Hawaii offers deferred adoption assistance agreements.

14. Does Hawaii operate a subsidized guardianship program?

Yes.  Relatives and nonrelatives may receive the same amount as foster parents. Contact Mr. Lee Dean at 808-586-5704 for more information.

Programmatic Procedures

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

Workers secure special needs documentation. An eligibility worker clears categorical eligibility. The section administrator then gives final approval. The worker, with his/her supervisor, sets payment levels.

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

There is no income eligibility requirement or means test for prospective parents in determining eligibility for either federally or state-funded adoption assistance. Subsidy amounts are based upon the needs of the child and the stated ability of the adoptive family in meeting those needs.

17. When do subsidy payments begin?

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

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

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 in order to qualify for federal adoption assistance.

NOTE: In order to be eligible for state-funded adoption assistance subsidy, children must be in the custody of the Department or a licensed child-placing organization at the time the adoption proceedings are initiated.

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

Adoption assistance may continue until the child reaches either the age of 18, or the age of 21 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 the child’s disability is 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.  The adoptive parents must indicate their inability to meet the child’s needs without adoption assistance.

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

Biennial review of the child's and adoptive family's status shall be conducted to determine if there are any significant changes which may affect the terms of the adoption assistance agreement.

The biennial review will determine if the child is still in the home and under their legal custody; if the child receives previously unreported benefits, (VA, SSI, etc.) or if there has been an increase in reported benefits; if previous medical insurance is still available or if new insurance is now in force.  

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

Adoptive parents may request a change in the adoption assistance agreement when a child exhibits a change in their needs requiring an increased level of care and resulting in their eligibility for a Difficulty of Care payment or when the circumstances of the family change. To request a change, parents are directed to 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. DHS departmental contact,

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

Adoptive parents can request a fair hearing when there is disagreement with a DHS decision which affects their child’s adoption assistance.  Requests should be in writing to the adoption assistance worker or the department’s administrative appeals office within ninety days from the receipt of a notice of a denial/ reduction/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 fifteen days of the request, and will contact the adoptive parents to schedule a hearing not less than fifteen days prior to the hearing. Adoptive parents will receive a written decision in the mail, issued by the administrative appeals office, within ninety days of the hearing request.

Send written requests for fair hearing to the adoption assistance worker or the following address (administrative appeals office):

Administrative Appeals Office
1390 Miller Street, Room 106
Honolulu, Hawaii  96813

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.

  1. Request an application and file it.
  2. 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.
  3. The hearing will be scheduled and may be conducted by telephone for out-of-state families.
  4. The decision will be sent, in writing, to the family within 90 days.
  5. If successful, the family will be contacted by the CWS Section Adoption Unit/Worker to complete paperwork, negotiate subsidy, etc.     
In order to start the process, families should contact Child Welfare Services Intake Unit at 808-832-5300 or the case management unit that serviced the child.

System Operation and Program Funding

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

The program is state supervised/state administered. This means that both policy and eligibility decisions are made by personnel within the responsible state department at the state office.

The current federal reimbursement for contribution to Title IV-E-eligible
children is 51.85% in Hawaii. This is known as the Federal Financial
Participation (FFP) rate. The remaining cost of the program is funded
entirely with state general funds.

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

The Hawaii ETV Program—You may be eligible for funding of up to $5,000 per year while you are in college or a vocational or technical training program!

You may qualify if:

  1. You are 18, 19 or 20 years old.
  2. You are in foster care or you were in foster care as a teenager and you are a US citizen or qualified non-citizen
  3. You aged out of the foster care system at age 18 or were adopted from foster care with adoption finalization after your 16th birthday.
  4. You have been accepted into or are enrolled in a degree, certificate or other program at a college, university, technical or vocational school and you show progress towards that degree or certificate.

To find out more about the specific eligibility requirements for your state, contact your caseworker or:

Lee Dean
Social Services Division
Hawaii Department of Human Services
810 Richards Street Suite 400
Honolulu, HI 96813
Phone: 808-586-5704


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