Adoption
Subsidy

Montana State Subsidy Profile

Updated June 2006

State Subsidy Contact Person

Laura Taffs
Department of Public Health & Human Services
Division of Child and Family Services
P.O. Box 8005, 1400 Broadway
Helena, MT 59604
Phone: 406-444-5975
Fax: 406-444-5956
E-mail: ltaffs@mt.gov

NACAC Subsidy Representative (parent/volunteer)

Pat Llewellyn
MT State Foster Adoptive Parent Assn
8540 Mourning Dove Drive
Missoula MT 59808
Phone: 406-327-1519; 877-728-7173
Fax: 406-728-7173 (call first)
E-mail: Twelvellewellyns@aol.com

April Horvath
7049 Fox Lane
Darby, MT 59829
Home: 406-349-2872
Fax: 406-349-2488 (call first)
E-mail: runingfox@yahoo.com

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.dphhs.mt.gov/index.shtml

Montana’s state-specific medical assistance links:

http://www.dphhs.mt.gov/hpsd/index.htm

Montana’s adoption assistance links:

Montana’s adoption assistance information is found in the Montana Code Annotated 2003, Title 42 Adoption, Chapter 10 Subsidized Adoption: http://data.opi.state.mt.us/bills/mca_toc/42_10_1.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?")

A child with special needs is one who is under the placement and care responsibility of the State agency (DPHHS) or that of a Tribe with whom the State has a Title IV-E agreement, and:

1. The child has been defined as a “child with special needs” because he or she meets at least one of the following criteria that serve as a barrier to placement or adoption without financial assistance:

   a.   Diagnosed as having a physical, mental, or emotional disability;

   b.   Recognized to be at high risk of developing a physical, mental or emotional disability;

   c.   A member of a minority group;

   d.   Six years of age or older;

   e.   A member of a sibling group to be placed together for adoption; and

2. The child is under 18 years of age at the time the subsidized adoption agreement is signed; and
3. The child is legally free for adoption and cannot or should not be returned to the home of his or his parent(s); and
4. Adoptive placement is in the child’s best interest; and
5. The State of Montana has determined that reasonable, but unsuccessful, efforts have been made to place the child with appropriate adoptive parents without a subsidy, except where it would be against the best interests of the child because of such factors as the existence of significant emotional ties with prospective adoptive parents while in the care of such parents as a foster child.

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, under the placement and care responsibility of the state of Montana (DPHHS), a Tribe with whom the state has a Title IV-E agreement, or a licensed private adoption agency, under eighteen years of age at the time the adoption assistance agreement is signed, and legally free for adoption. (Only IV-E- eligible special needs children are eligible for adoption assistance if they are under the placement and care responsibility of a tribe or a licensed private adoption agency.)

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

Current adoption subsidy rates:          

Current foster care rates are:

Subsidy rates are negotiated on an individual basis. There is no guarantee that a child will receive the maximum rate of $10 less per month than the rate the child received in foster care.  The rate is negotiated with families and takes into consideration the needs of the child and the parents’ ability to meet those needs.

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

The family is providing care to children with problems that cannot be adequately addressed through regular foster care.  Specialized foster care may be used during transition of a child with high needs from a higher level of care back into the community or to prevent placement into a higher level of care.

Specialized Foster Care Daily Rates (current June 2006):

The amount of the subsidy is negotiated with the parents, considering the child’s needs and the ability of the parents to meet those needs.  Specialized rates include respite, transportation, and clothing allowances.

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 adoption expenses mean reasonable and necessary adoption fees, court costs, attorney fees, and other expenses (i.e., costs of the adoption study, including health and psychological examinations, supervision of the placement prior to the adoption, and reasonable costs of transportation, food, and lodging for the child and/or adoptive parents when necessary to complete the adoption process) directly related to the legal adoption of a child with special needs.           

Requests for reimbursement for nonrecurring expenses may be submitted in conjunction with requests for financial and medical assistance or may be submitted separately.       

The reimbursement limit is $2,000 per child as negotiated prior to signing the subsidy agreement.

6. What Medicaid services are available in Montana?

Please refer to the web site www.medicaid.mt.gov for a current list of covered services.  Or, call the Medicaid Recipient Hot Line at 1-800-362-8312.

• Ambulance
• Birth control (family planning)
• Chiropractor services
• Clinics (routine care), clinics (county health department)
• Dental services
• Diagnostic clinic (for disabled children)
• Dialysis
• Drug/alcohol treatment, drugs
• Emergency room
• Eye exams, eyeglasses
• Hearing aids
• Home care
• Hospice
• Hospital (inpatient), hospital (outpatient)
• Lab and x-ray
• Mental health (outpatient—community mental health centers)
• Mental health (outpatient—psychologists, licensed clinical social workers, and licensed professional counselors)
• Nursing homes, nursing services (including private duty nursing)
• Nutrition services
• Occupational therapy
• Outpatient surgery
• Physical therapy
• Physician services, physician assistant services
• Podiatry
• Residential psychiatric treatment
• Respiratory therapy
• School-based services
• Speech therapy
• Supplies and equipment
• Targeted case management
• Transpiration (non-emergency)
• Well child check-ups                                         

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

The medical needs of a child approved for an adoption subsidy are met through the Medicaid program.  Non-IV-E eligible children are eligible for Montana Medicaid if the following conditions are met:

(a) a subsidized adoption agreement is in effect between the department and the adoptive parents;

(b) the state agency has determined that the child has special needs for medical or rehabilitative care that make the child difficult to place for adoption without medical assistance; and

(c) the child was eligible for Medicaid prior to entry of the subsidy agreement (or would have been if IV-E methodologies and standards had been applied).

If an approved subsidy agreement is in place, Medicaid may begin at the time of adoptive placement or upon finalization.  Coverage is the same as it is for IV-E children.

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

Public mental health for children in Montana is administered through the Children’s Mental Health Bureau, Health Policy and Services Division (HPSD), DPHHS, and includes the following examples: inpatient and outpatient hospital care, outpatient community mental health centers, outpatient psychologists, licensed clinical social workers, licensed professional counselors, physician services, residential treatment, and prescription drugs. HPSD’s Medicaid client information:

http://www.dphhs.mt.gov/programsservices/medicaid.shtml

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?

Montana offers what is known as State Medical Subsidy.  Funding is allocated for children requiring medical expenses not covered by Medicaid and is limited to $2,600 per state fiscal year.  The State Medical Subsidy benefit is negotiated as part of adoption assistance agreement and is available as funding is available.

10. What types of post adoption services are available in your State and how do you find out more about them?

Each region of the state has a permanency planning specialist who provides or arranges for post adoption services. Families can request services by contacting their adoption assistance worker or the adoption program officers. Some organizations privately provide some support services. CFSD workers provide information and referral to adoptive families upon request.  Ask your adoption assistance worker for contact information for support groups and any available post adoption services.

Contact the Montana Foster/Adoptive Parent Association at http://www.msf-apa.org or the local CFSD office: http://www.dphhs.mt.gov/contactus/index.shtml.  Some private organizations offer a variety of respite options.  See the ARCH National Respite Network Respite Locator Service, search by state to locate Montana’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, if they are not covered by Medicaid.

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

Residential treatment is covered through Medicaid.  Covered services are limited to licensed inpatient treatment centers for those under age 21.  The child must be screened and approved for admission prior to treatment. Duration is limited to what is medically necessary.

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

Yes, Montana offers deferred adoption assistance.

14. Does Montana operate a subsidized guardianship program?

Yes. For more information, contact Betsy Stimatz at 406-444-1675.

Programmatic Procedures

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

Requests for adoption subsidy are sent to an adoption program officer by the child's social worker, who completes an eligibility determination form.  The adoption program officer seeks additional information from the IV-E unit, the child’s worker, supervisor, or Regional Administrator when needed, negotiates the subsidy agreement with the family, and approves the subsidy agreement.           

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

Subsidy amounts are negotiated on a case-by-case basis, taking into consideration the needs of the child and the parents’ ability to meet those needs.

17. When do subsidy payments begin?

Adoption assistance payments and benefits may begin at adoptive placement or upon adoption finalization once an approved adoption subsidy agreement is in place.

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

Yes, if they are either Title IV-E or SSI (Supplemental Security Income) eligible.

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

Subsidy payments and Medicaid will terminate when a child reaches age 18.  However, adoptive parents may request approval of a continued Medicaid and financial subsidy until the child is 21 (at the latest), if the child has a mental or physical disability that warrants continuation. Contact the adoption program officer for more information.

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

It is the responsibility of the adoptive parents to notify the MT DPHHS of any change that might affect the subsidy.

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

Adoptive parents or CFSD can request a change in the adoption assistance agreement any time there is a change in the needs of the child/family circumstance or an increase in the foster care rate the child would have received if they were in foster care. Requests for modification of the subsidy agreement should be made in writing to the adoption program officer.  Contact link: ltaffs@mt.gov or (406) 444-5975.

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

Adoptive parents who have applied for or been granted adoption assistance for their child can appeal a denial or other negative or adverse determination pertaining to the amount, duration or continuation of adoption assistance benefits.  This includes any decision that denies, reduces, changes or terminates benefits that affect the adoption assistance agreement.  Adoptive parents who wish to contest any negative or adverse decision must send a written request for hearing received by the Office of Fair Hearings within ninety days of the mailing date of the notice of the contested action.

After the request for a hearing is received, the Office of Fair Hearings will assign a hearing examiner and send a notice giving the date, time and place of the hearing.  The hearing may be held by telephone or in person.  The notice will also provide additional information on what is needed to prepare for the hearing and who to contact if the family needs to change the date or time of the hearing.  Parents can represent themselves or have a lawyer or another individual assist them in presenting their case and are permitted to bring witnesses.  The hearing examiner will record the hearing so that the facts are taken down correctly.  Parents can request a free copy of the tape by contacting the Office of Fair Hearing after the hearing decision is issued.  The written decision will explain how to appeal the decision if the family disagrees with the decision.

Send your request in writing to:

DPHHS, Office of Fair Hearings
Division of Quality Assurance
2401 Colonial Drive, 3rd floor
Helena, MT  59620-2953

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.

Contact the adoption program officer or send your request in writing to:

DPHHS, Office of Fair Hearings
Division of Quality Assurance
2401 Colonial Drive, 3rd floor
Helena, MT  59620-2953

System Operation and Program Funding

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

The adoption system is a combination of state/regional supervision and administration.  Policies are developed and adoption subsidies are negotiated at the state level, but social workers for the child and adoptive family are under the supervisory jurisdiction of regional administrators.  Funding is provided to the department and then allocated to the regions.  There are currently five regions.

The federal contribution to Title IV-E-eligible children is 70.54% in Montana.  This is known as the Federal Financial Participation (FFP) rate.  The remaining cost of the program is funded entirely with state funds.

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

Scholarships—Information about scholarships for foster children can be found on the National Foster Parent Association website: http://www.nfpainc.org (Click on "scholarships and awards”).
 
For information on family camps, sibling camps, and parent to parent mentoring programs, parents should contact their local CFSD Family Resource Specialist or the Montana Foster and Adoptive Parent Association: http://www.msf-apa.org/about_us.html