North Dakota State Subsidy Profile
Updated draft • October 2014
(state review pending)
State Subsidy Contact Person
Department of Human Services
Children and Family Services
600 East Boulevard Avenue
Bismarck, ND 58505
NACAC Subsidy Representative (parent/volunteer)
7316 Ellis Lane
Horace, ND 58407
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 South Dakota. 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.
North Dakota’s adoption resources on the web:
North Dakota’s state-specific medical assistance information:
North Dakota’s adoption assistance information:
http://www.state.nd.us/humanservices/services/childfamily/adoption/types.html . See the paragraph titled Children with Special Needs under the heading Types of Adoption.
North Dakota Code 50-09-02.2, Assistance for adopted children with special needs:
North Dakota Code Chapter 50-28 Adoption Assistance:
Who Is Eligible for Adoption Assistance?
1. How does North Dakota define special needs to determine eligibility?
A child is defined as special needs if child that has at least one of the following needs or circumstances that may be a barrier to placement or adoption without financial assistance:
- Seven years of age or older and under 18 years of age
- Member of a minority race
- Member of a sibling group being placed together for adoption
- Has a physical, mental, or emotional disability
- Is at high risk of a physical, mental, or emotional disability as diagnosed by a licensed physician
To be eligible for adoption assistance, 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 must be in the custody of a public, private, or tribal agency prior to adoption.
2. Does the state-only funded adoption assistance program differ in any way from the Title IV-E program?
The state funded program is only available to children who are adopted from North Dakota’s foster care program.
3. Are children adopted from private agencies in North Dakota eligible for adoption assistance?
Yes, but only if they meet Title IV-E requirements.
What Supports and Services Are Available?
4. What is the maximum basic monthly adoption assistance maintenance payment in North Dakota?
Rates are negotiated based on the child’s needs. Frequently, the negotiated rate reflects the amount the child’s family received while 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 are listed below:
5. Does North Dakota provide specialized rates (based on the extraordinary needs of the child or the additional parenting skill needed to raise the child)?
Yes, with rates determined on a case-by-case basis based on the child’s needs. Adoption assistance rates may be negotiated up to the rate the child received, or would have received, in foster care, including any specialized rates. The following are the specialized rates in foster care:
Monthly increase over basic rate
Unspecified — must be negotiated based on child’s needs
6. When do adoption assistance payments begin?
In North Dakota, adoption assistance payments and benefits may begin at adoption placement.
7. When a child turns 18, which benefits, if any, continue?
Adoption assistance continues until a child reaches 18. However, state-funded adoption assistance benefits 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 and pursuing study leading to a diploma, degree, or gainful employment. Title IV-E adoption assistance may continue until the child’s 21st birthday if the adoptee has a mental or physical disability that warrants continuation of assistance.
8. Does North Dakota 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 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
Physical and occupational therapy
Nursing care services
Intermediate care for the developmentally disabled
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
For more information, parents can contact Marella Krein at 800-755-2604 or 800-472-2622.
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.)
Any child with special needs who has been found to be eligible for adoption assistance benefits is eligible for Medicaid in North Dakota
11. What mental health services are available?
Public mental health services for children in North Dakota are administered by the Department of Human Services through a 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 is also known as the Partnerships Program for Children's Mental Health. Services may include 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 mental illness or disorders.
More information is available at the following sites:
Services covered— http://www.state.nd.us/humanservices/services/medicalserv/medicaid/covered.html
Children’s mental health information— http://www.state.nd.us/humanservices/services/mentalhealth/children.html
Regional contacts— http://www.state.nd.us/humanservices/services/mentalhealth/partners.html
Not all services may be available in all cases. Parents should contact their adoption assistance worker or medical assistance specialist for information regarding process, eligibility, availability, and duration of services.
12. In North Dakota, what nonrecurring adoption expenses directly related to the finalization of an adoption may be reimbursed?
Families can be reimbursed for up to $2,000 per child in nonrecurring adoption expenses. These expenses may include attorney fees, court costs, or any cost directly related to the finalization of the adoption of a child with special needs. 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 adoption assistance. Families must apply before adoption finalization. International adoptions are eligible only if they meet specific Title IV-E criteria.
13. Is respite care available? If yes, who is eligible and how do families access respite care?
Many private organizations offer respite services. Parents should search for North Dakota options using the ARCH National Respite Network Respite Locator Service at http://www.respitelocator.org/.
14. Is residential treatment available? If yes, who is eligible and how do families access residential treatment services?
Residential treatment costs may be considered for payment under Medical Assistance. However, the treatment facility must be an approved provider and agree to the Medical Assistance rate. It also must be verified that residential treatment is required for the child.
15. What other post-adoption services are available in North Dakota and how do families find out more about them?
Post-adoption services in North Dakota are administered by the DHS Children and Family Services Division and provided through contracted private agencies. Post-adoption services may include:
- Information and referral
- Support groups
- Case management
Family preservation (respite, parent aid, in-home family services)
- Educational programs (PRIDE)
- Search services
Families may also access support services that are not specific to adoptive families from their local county social service or regional human service center offices. North Dakota’s Regional Human Services Centers are listed at http://www.state.nd.us/humanservices/locations/regionalhsc/.
Families should contact the Adults Adoption Special Kids Program (AASK) adoption specialist who assisted them in their adoption for referral to appropriate post-adoption services. The statewide AASK phone number is 877-551-6054.
Parents should contact their adoption assistance worker 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?
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.
What Should Families Know about Applying for Adoption assistance?
17. Who makes the final determination on an adoption assistance agreement?
County agency staff conduct an eligibility review, and then parents and the county social service office negotiate the adoption assistance amount. Agreements are signed at the local level by the county director, and the state office makes final approval.
18. How do families request adoption assistance after finalization of an adoption?
The family must request assistance the licensed child placement agency that facilitated the adoption. The state office can make the special needs determination and accept the application for assistance if the following requirements are met:
- The child's congenital, genetic, or predisposed condition is diagnosed by qualified diagnosticians appropriate to the child's condition.
- Eligibility for other financial resources (such as Social Security Income and the family’s medical insurance coverage) must be ruled out and the cost of care for the child must exceed the family’s income and ability to pay.
Families should contact Julie Hoffman at 701-328-4805 for more information.
How Can a Family Adjust an Adoption Assistance Agreement?
19. Can adoptive parents ask to change an adoption assistance agreement?
Adoptive families can request a change in the adoption assistance agreement any time there is a documented change in the child’s needs or the family’s circumstances. Parents must make the request for modification in writing to the county social service office that administers the adoption assistance. The request must detail the specific reasons for the requested change, including the rational for the specific amount requested. The county social service will negotiate any revision to the agreement and may request additional documentation.
Parents can find their county social services offices at http://www.state.nd.us/humanservices/locations/countysocialserv/.
20. What steps does a family go through to appeal an adoption assistance decision in North Dakota?
Adoptive families have the right to request a fair hearing any time they wish to appeal county or state decisions affecting adoption assistance benefits. 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. See question 19 for a link to the state’s county social services offices.
What Else Do Families Need to Know?
21. How is the adoption assistance program operated and funded in North Dakota?
The program is state supervised/county administered, which means that personnel at the state office are responsible for making policy decisions 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% 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.
22. Does North Dakota operate a subsidized guardianship program?
23. Does North Dakota offer a tuition waiver program?
Youth in foster care may be eligible for funding of up to $5,000 per year while they are in college or a vocational or technical training program. Adoptees may qualify if:
- They are 18, 19 or 20 years old.
- They were in foster care as a teenager and are a U.S. citizen or qualified non-citizen.
- They 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 show progress toward that degree or certificate.
Parents or youth can learn more from their caseworker or from Dean Sturn at 701-328-1018 or email@example.com.