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North Dakota State Subsidy Profile

Updated June 2010

State Subsidy Contact Person

Julie Hoffman
Department of Human Services
Children and Family Services
600 East Boulevard Avenue
Bismarck, ND 58505
Phone: 701-328-4805
Fax: 701-328-3538

NACAC Subsidy Representative (parent/volunteer)

Keatha McLeod
7316 Ellis Lane
Horace, ND 58407
Home: 701-277-2741
Cell: 701-238-5737

Leanne Johnson
Catholic Charities North Dakota
5201 S. Bishops Blvd., Ste B
Fargo, ND 58104
Phone: 701-356-7986
Fax: 701-356-7993

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:

North Dakota’s state-specific medical assistance:

North Dakota’s adoption assistance:

See the paragraph entitled, Children with Special Needs.

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:

a.   Seven years of age or older and under eighteen years of age

b.   Member of a minority race

c.   Member of a sibling group of two or more children placed in the same adoptive home

d.   Physical, mental or emotional disability

e.   High Risk of a physical, mental or emotional disability as diagnosed by a licensed physician

Note: Children must be legally free for adoption, unless the child is being placed for adoption pursuant to a Tribal statute allowing for a “customary” adoption, and be in the custody of a public, private or tribal agency prior to adoption to be eligible for adoption assistance.

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, legally free for adoption, and in the custody of a public, private or tribal agency prior to adoption.

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

Rates are negotiated based on the needs of the child.  Frequently, the negotiated rate may reflect the rates allowed by the child and family team when the child was in foster care.  In no case may the negotiated rate exceed the rate that was paid while the child was, or would have been, in a foster care placement.

Foster care rates (effective July 1, 2009) are as follows:

Basic rates:









Specialized rates:

Level I $50/month increase
Level II $100/month increase
Level III $150/month increase
Level IV Unspecified

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

Specialized rates are provided based on the special needs of the child for a child in foster care.  Determinations are made on a case-by-case basis.  Adoption assistance rates may be negotiated up to the rate the child received, or would have received, in foster care, including any specialized rates.

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.

These expenses may include attorney fees, court costs, or any cost directly related to the finalization of the adoption of a special needs child.  Note: Home studies are not covered if completed through the special needs adoption program since the cost of these studies are underwritten by state contracts with the licensed child placement agency.

Families should apply for reimbursement for nonrecurring costs at the time they apply for subsidy.  Families must apply prior to finalization of an adoption. International adoptees are not eligible.

The reimbursement limit is $2,000 per child.

6. What Medicaid services are available in North Dakota?

  • Physician services, hospital services
  • Laboratory and x-ray services
  • Dental care (limits apply)
  • Eye care (limits apply)
  • Family planning services
  • Durable medical equipment and supplies
  • Home health care and hospice care
  • Chiropractic services
  • Physical and occupational therapy
  • Podiatric services
  • Nursing care services
  • Intermediate care for the mentally retarded
  • Home and community-based services for the developmentally disabled—Services include homemaker, personal care, adult day care, chore services and respite care.
  • Prescription drugs, including contraceptives provided in conjunction with family planning services and under physician services
  • Transportation (with limits)
  • Screening, diagnosis, and treatment for children under age 21.
  • Orthodontic services—Provided only through referral from the Health Tracks Program.
  • Emergency room—Non-emergency conditions must be treated during physician or clinic office hours        

The state contact person is Marella Krein, 800-755-2604 or 800-472-2622.

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

Any special needs child who has been found to be eligible for subsidized adoption is eligible for Medicaid.

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

Public mental health services for children in North Dakota are administered by the Department of Human Services through collaboration between the Division of Mental Health and Substance Abuse Services and the Children and Family Services Division. The Children’s Mental Health System of Care and is also known as the Partnerships Program for Children's Mental Health. Services include the following examples: psychiatric and psychological evaluations, inpatient hospitalization (psychiatric unit), individual-group-family psychotherapy, partial hospitalization services, and inpatient psychiatric and residential treatment centers services for individuals under 21 for the care and treatment of metal illness or disorders.

Services Covered:

Children’s mental health:

Regional contact:

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?

North Dakota does not provide additional finances or services for medical or therapeutic needs not covered under their sate medical plan to children receiving adoption assistance.  If a child needs services that are not funded by any other resource, adoptive parents may request the cost of these services be added to the monthly adoption assistance payments.  Examples of such services include specialized childcare and respite.

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 North Dakota are administered by the DHS Children and Family Services Division and contracted through private agencies. Post adoption services include the following examples:

  1. Information and referral
  2. Support groups
  3. Case management
  4. Family preservation (respite, parent aid, in-home family services)
  5. Educational programs (PRIDE)
  6. Search services

Services are not necessarily adoption specific. North Dakota does not have any services specifically designated as post adoption services for which only adoptive parents are eligible. Families apply for post adoption services at their local county social service or regional human service center offices. Families may also contact the Adults Adoption Special Kids Program (AASK) adoption specialist that assisted them in their adoption for referral to appropriate post adoption services. Statewide AASK, phone: 877-551-6054.

Many private organizations offer a variety of respite options. See the ARCH National Respite Network Respite Locator Service, search by state to locate North Dakota’s respite programs, link:

See also North Dakota’s Regional Human Services Centers:

Foster PRIDE/Adopt PRIDE training program:

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?

No—but the services must be requested in writing and approved by the county social service agency.  The services must be necessary for the family based on the child's needs.

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 costs may be considered for payment under Medical Assistance.  However, the treatment facility must be a provider and agree to the Medical Assistance rate.  It also must be verified that residential treatment is required for the child.

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

Yes, North Dakota offers deferred adoption assistance.

14. Does North Dakota operate a subsidized guardianship program?

Yes. The subsidized guardianship program became effective in North Dakota on March 1, 2000.  A guardianship subsidy is available for youth age 12-18 who have been in foster care for a minimum of six months and for whom the state has responsibility for foster care maintenance payments.  Guardians do not have to be relatives. An assessment is required as well as a state, local and FBI (unless exempted by state law) criminal history record investigation.

A monthly grant of $490 (less amounts received by the child from other sources) is available. Assistance can also be obtained for one-time legal expenses.

For more information, contact:

Deb Petry
Children and Family Services
North Dakota Department of Human Services
600 E. Boulevard Avenue
Bismark, ND  58505

Programmatic Procedures

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

An eligibility review is conducted by county agency eligibility staff.  Negotiation of the subsidy amount is between the adoptive parents and the county social service office.  Agreements are signed at the local level by the County Director and then forwarded to the state office for final approval.

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

Adoption assistance must be provided without regard to the income or resources of the adopting parents. As such, means tests may not be used to determine adoptive parents' eligibility for subsidy payments nor can they be used to determine the amount of subsidy payments. Negotiations are based on the child's needs and conducted in the context of all resources available to the child.

17. When do subsidy payments begin?

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

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

Yes, but subject to the provisions in ACYF-CB-PA-01-01 (effective January 23, 2001).

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

Adoption assistance continues until a child reaches 18.  However, state-funded subsidies may continue until the child reaches 21 if the agency determines that the adopted child is a student regularly attending a secondary, post-secondary, or vocational school in pursuance of a course of study leading to a diploma, degree, or gainful employment.  Title IV-E subsidy may continue until the child’s 21st birthday if services are required for a mental and/or physical disability.

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

Adoptive parents are required to sign an annual Adoption Subsidy Review form and an adoptive family information form (giving current information and medical insurance coverage).

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

Adoptive families can request a change in the adoption assistance agreement any time there is a documented change in the needs of the child or the circumstances of the family.  Parents can make a request for modification of the agreement at an annual review or whenever there is a change that requires a change in payment level.  The request for modification must be made in writing to the county social service office administering the adoption assistance grant and must detail the specific reasons for the requested change in adoption assistance amount, including rational for the specific amount requested.  Negotiation regarding requested changes may be initiated by the county social service office administering the adoption assistance grant.  Additional documentation may be requested during the negotiation process.

County social services offices/locations:

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

Adoptive families have the right to request a fair hearing any time they wish to appeal county or state decisions affecting the receipt of benefits under the adoption assistance agreement.  Parents must make a written request to the county social service office administering the adoption assistance or the North Dakota Department of Human Services to initiate the process.  North Dakota’s county social services locator:

The NDDHS or county social service agency must receive the hearing request within thirty days of the mailing date of the notice of contested DHS action.  If someone else makes a written request for the adoptive parent, it must include a written statement, signed by the parent, informing DHS that person is the family’s representative.  After a timely request for a hearing is received, and if the issue is an appealable one, the office of administrative hearings will send a notice giving the date, time, and place of the hearing.  This notice will be sent to the family at least ten days before the hearing.  The notice also will inform parents what to do if they cannot come to the hearing as scheduled.  The family may bring witnesses, friends, relatives, or a lawyer to assist in presenting the case.

The hearing officer will listen to both sides but will not make a decision at the hearing. Instead, the hearing officer will issue a recommended decision to the NDDHS after the hearing.  Then, the NDDHS will either accept or reject the hearing officer’s recommended decision.  Families will receive the NDDHAS written decision in the mail a few weeks later.  Parents should receive a decision within ninety days of the hearing request. The hearing officer will record the hearing so that the facts are taken down correctly.  After the NDDHS decision is issued, parents can obtain a copy, for a fee, of the tape by contacting the NDDHS.  If parents disagree with the decision, they may appeal to the district court.

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.

Initial designation as a child with special needs is determined by the State Office and an application taken when the following requirements are met:

a.  Application is taken on behalf of an adopted child whose adoption has been finalized.

b.  The child's congenital, genetic, or predisposed condition is diagnosed by qualified diagnosticians appropriate to the child's condition.

c.  Eligibility for other financial resources must be ruled out (i.e., SSI and the family's medical insurance coverage) and the cost of care for the child must exceed the family income and ability to pay.

Families should contact Julie Hoffman at 701-328-4805.

System Operation and Program Funding

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

The program is state supervised/county administered.  This means that personnel at the state office are responsible for making policy decisions regarding the adoption assistance program, and provide guidance to county offices.  The counties make decisions related to children’s eligibility.

The federal contribution to Title IV-E-eligible children is 50.00% in North Dakota. This is known as the Federal Financial Participation (FFP) rate.  The remaining cost of the program is funded by county and state funds.

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




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