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Oklahoma State Subsidy Profile

Updated May 2011

State Subsidy Contact Person

Jacquelyn Hill-Anderson
Department of Human Services (DHS)
P.O. Box 25352
Oklahoma City, OK 73125
Phone: 405-522-4487
Fax: 405-522-2433
E-mail: Jacquelyn.Hill@okdhs.org

NACAC Subsidy Representative (parent/volunteer)

Currently, there is no Oklahoma Volunteer. If you or someone you know would like to volunteer to help families learn more about adoption assistance, please call Josh Kroll at NACAC, 800-470-6665 x15 or e-mail joshk@nacac.org.


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.okdhs.org/adopt,
http://www.okdhs.org/adopt/#What and
http://www.okdhs.org/adopt/#Question (FAQ)

Oklahoma’s state-specific medical assistance:
http://www.okdhs.org/medapp

Oklahoma’s adoption assistance:
http://www.okdhs.org/adopt/Adoptions/includes/content/adoptinfo.htm#facts
(See Adoption Services, Additional Facts)

Oklahoma Statute §10-7510-1.2 through §10-7510.1.6
http://oklegal.onenet.net/oklegal-cgi/get_statute?99/Title.10/10-7510-1.2.html

Oklahoma Administrative Code Section 340:75-15-128 through
340:75-15-128.7

http://www.okdhs.org/library/policy/oac340/075/15/

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. Eight years of age or older
  2. Racial or ethnic factors (Indian, Hispanic, Asian, and African-American children three years of age or older)
  3. Member of a sibling group of any age placed together
  4. Physical disability requiring regular treatment with a specific diagnosis given by the child's physician
  5. Mental disability meeting the eligibility criteria for educable multi-handicapped (EMH) or trainable multi-handicapped (TMH) classes and evaluated by a licensed psychologist, psychometrist, school, or recognized diagnostic center. Note: A child with a demonstrable need for intensive adult supervision beyond ordinary age needs also qualifies
  6. Emotional disturbance established by a physician, a psychologist, behavioral therapist, or social worker; corroborated by a Child Welfare worker's observations of the child's behavior; corroborated by one or more caregivers such as foster parent, Head Start or school personnel, church nursery, or child care provider; and documented with a specific diagnosis and prognosis, if applicable
  7. At high risk of physical or mental disease (Indicators of high risk physical or mental disease are social and medical history such as mental illness of biological parents and family; events or life experiences such as severe sexual abuse; and prenatal exposure to drugs or alcohol)

Note: The child who exhibits high risk of physical or mental disease for conditions that are not presently being treated may qualify. If no other special factors or conditions are met, no monthly payment is made until there are documented symptoms of physical or mental disease. See Question #13 for information regarding deferred 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, under the age eighteen, and previously in the court ordered custody of Oklahoma DHS or a federally recognized Indian tribe as defined by the federal Indian Child Welfare Act and the Oklahoma Indian Child Welfare Act.

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

Basic rates:
Age Rate
0-5 $310.50
6-12 $364.50
13-18 $418.50

 

Specialized rates:
Age Level I Level II Level III Level IV Level V
0-18 $50 $100 $150 $225 $400

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

There are five different difficulty-of-care payment rates:

DOC Rate I—A child approved at this level has one or more of the needs, conditions, or behaviors described in I through IV below. The child:

  1. requires ongoing scheduled medical or psychological appointments that routinely occur more than twice weekly;
  2. displays emotional difficulties that result in destruction of property;
  3. requires medical or educational supplies on a routine basis that are not compensable through Medicaid; or
  4. requires daily physical therapy performed by the adoptive parent(s).

DOC Rate II— A child approved at this level has one or more of the needs, conditions, or behaviors listed in DOC Rate I, and, in addition, this child:

  1. requires 24-hour intensive supervision due to severe medical or emotional needs;
  2. requires special food preparation and feeding due to a condition that restricts normal eating;
  3. requires special equipment for transportation that results in restricted mobility for the child and the adoptive parent(s);
  4. displays incontinence of the bladder and bowel that is not age appropriate;
  5. displays multiple disabilities, birth defects, or brain damage that prevents normal intellectual or physical functioning;
  6. requires strict monitoring of medication;
  7. requires assistance in movement which is very difficult due to the child's size;
  8. requires post-hospitalization care such as frequent changing of bandages, tubes, and special hygiene techniques; or
  9. displays emotional disturbances, developmental delay, or mental retardation that results in behavior such as constant difficulties in school, aggressive and delinquent activities, destructiveness, resistance to authority, and sexual disturbances.

DOC Rate III—A child approved at this level has one or more of the needs, conditions, or behaviors listed in each of DOC Rates I and II, and, in addition, this child:

  1. requires medical supplies, special equipment or educational supplies on a routine basis which are not compensable through Medicaid; or
  2. requires specialized substitute care.

DOC Rate IV —The child approved at this level has one or more of the needs, conditions, or behaviors described in each of DOC Rates I, II, and III and required such specialized care that normally the child would be in institutional or inpatient psychiatric care. The child:

  1. requires special equipment, such as apnea monitor, suction machine, gastronomy tube, oxygen, tracheotomy tube, and shunt;
  2. requires special feeding or nursing care around the clock;
  3. requires frequent nighttime supervision and care that is not age appropriate;
  4. displays such frequent seizures or other abnormal physical reactions that 24-hour monitoring is required;
  5. displays bizarre, socially unacceptable behavior, violent tendencies, potentially harmful behavior to self or others, or sexually predatory behavior to others or animals;
  6. required previous inpatient mental health treatment or has recently been discharged from an inpatient facility;
  7. requires such intensive care that the adoptive parent(s) is severely restricted in normal daily activities and is frequently homebound;
  8. requires frequent 24-hour awake supervision; or
  9. requires post-hospitalization care for sever burns.

DOC Rate V —The child approved at this level has one or more of the needs, conditions, or behaviors described in each of DOC Rates I, II, III and IV and has a significant number of high severity needs. The child’s level of need is not moderate, is likely to become more severe over time, and is likely at some time to require personal attendant care or specialized care outside of the home, when prescribed by a professional. A current medical or psychological report within the last six months is required from a qualified physician. Medical or psychological conditions considered in determination of DOC Rate V include a child who has:

  1. been diagnosed by a qualified physician as having severe mental illness, such as child schizophrenia, severe developmental disabilities, brain damage, or autism;
  2. severe physical disabilities or mental conditions that are not expected to improve over time and adversely impact life expectancy when compared with others who have similar physical disabilities or mental conditions;
  3. severely inhibiting diagnosed mental health conditions, defined by the Diagnostic and Statistical Manual of Mental Health (DSM), diagnosed within the past year, that severely limit normal social and emotional development and require ongoing outpatient behavioral health services;
  4. severe mental retardation as determined by the Social Security Administration and defined by DSM;
  5. been waiting for an organ transplant or is up to one year post transplant; or
  6. a physical condition uncontrolled by medication or treatment such as Tourette’s syndrome or epilepsy.

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 expenses include adoption fees, attorney fees, court costs, adoptive home study fees, health and psychological information on family members, supervision of the adoptive placement, transportation, food and lodging during the placement process, and the cost of fingerprinting paid by the adoptive family.

International adoptees may be eligible for reimbursement if they meet all eligibility requirements.

As of December 2002, the reimbursement limit is $1,200 per child on finalized adoptions. There are two exceptions in which Oklahoma will consider payment of up to the maximum of $2,000 per child. Either of the following events had to be obtained in the adoption case:

  • An order terminating parental rights; or
  • An order determining the child eligible for adoption without the consent of a biological parent

6. What Medicaid services are available in Oklahoma?

  • Long-Term Care—nursing facility, intermediate care facility for the mentally retarded, etc.
  • Case Management for High-Risk Pregnant Women
  • Hospice Services
  • Inpatient Hospital Services (with some limitations)
  • Renal Dialysis
  • Physician's Services (with some limitations)
  • Outpatient Surgery in Approved Facilities
  • Home Health Care Services
  • Prescription Drugs (with some limitations)
  • Transportation to Obtain Medical Services
  • Lodging and Subsistence While Receiving Medical Services
  • Certain Prosthetic Devices
  • Organized Outpatient Clinic Services
  • Outpatient Hospital Services
  • Limited Maternity Clinic Services
  • Case Management Services for the Chronically Mentally Ill
  • Blood and Blood Products
  • Limited X-Ray and Laboratory Services
  • Outpatient Mental Health Services
  • Family Planning Services
  • Primary Health Care for Children Under 21
  • Limited Podiatry Services for Children
  • Nurse Midwife and Birthing Services
  • Certified Nurse Practitioner services

The state contact person is Karen Hylton, 405-521-3679.

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

Payment for Medical Services Prior to Consummation of Adoption—When a child is in an adoptive home and has unusual medical needs which cannot be met by the family and the child is not included in the family's medical insurance coverage, DHS can be a resource for payment of medical expenses.

Payment for Medical Services Following Consummation of Adoption—Payment for medical services following legal adoption can be made in two ways: (1) the child may be eligible for adoption subsidy with automatic Medicaid coverage; (2) a family may be eligible on the basis of need and income and may apply for Medicaid (Title XIX) in their local DHS office.

The range of benefits/services is the same as for Title IV-E eligible children.

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

Public mental health services for children in Oklahoma are administered by the Department of Human Services, Health Care Authority and include the following examples: mental health services (psychological/psychiatric services, emotional/psychological/ behavioral counseling), outpatient and inpatient hospitalization, substance abuse services and prescription drugs. Oklahoma offers all medical services compensable through the state’s fee for service Title XIX (Medicaid) program. Some services require prior authorization by the Oklahoma Health Care Authority (OHCA).

Oklahoma’s Medicaid: http://www.okdhs.org/medapp and http://www.okdhs.org/medapp/servicescovered.htm

See also the Disabled Children’s Program available to children receiving Supplemental Security Insurance disability payments for possible additional services: http://www.okdhs.org/medapp/ssidcp.htm

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?

Oklahoma offers what is known as Special Service Subsidies. Funding is available for services not met by the family’s private insurance or Medicaid. Adoptive parents must first seek and exhaust all resources, both pubic and private, before Special Service Subsidies are available.

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 Oklahoma are administered by the Department of Human Services (DHS), Children and Family Services Division through DHS and private and parent groups. Post adoption services include the following examples:

  1. Information and referral
  2. Educational/training programs
  3. Educational materials/library
  4. Support groups
  5. Advocacy
  6. Respite Care
  7. Residential treatment
  8. Home-based services
  9. Mediation/search/reunion services

The Spaulding Curriculum on Adoption Support and Preservation was implemented throughout Oklahoma in January of 2000 and Casey Family Services hosts an adoption conference in November of each year. Weekend retreats are held four times a year in the metro areas of Oklahoma City and Tulsa to provide information and develop sustained support groups.

Swift Adoptions has developed several training videos, including Swift Adoptions: A Guide to Adoption Through the Oklahoma Department of Human Services; The Sibling Connection: Keeping Brothers and Sisters Together Through Adoption. For information contact Oklahoma Swift, phone: 877-OKSWIFT (877-657-9438) or the designated Swift adoption specialist in their county of residence or state Adoption Assistance Contact Karen Poteet, phone: 405-522-0331. DHS county offices locator: http://www.okdhs.org/icounties/default.asp.

One Church, One Child of Oklahoma, Inc. is an adoptive parent support group located in Oklahoma City providing roundtable discussions, panels, lectures and audio-video presentations, phone: 405-424-0225 or e-mail: 1church1child@sbcglobal.net.

Reunion services are available through the DHS Confidential Intermediary Search Program: http://www.okdhs.org/adopt/Adoptions/includes/content/reunion.htm (Also known as the Adoption Reunion Registry).

Many private organizations offer a variety of respite options. Call Karen Poteet, Programs Field Representative at 405-521-2475, for referral information. Also see the ARCH National Respite Network Respite Locator Service, search by state to locate Oklahoma’s respite programs, link: 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.

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 services are not covered for adoptive families. Limited hospital-based residential care may be provided under the scope of Oklahoma Medicaid if proper prior authorization is obtained.

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

Yes, Oklahoma offers deferred adoption assistance. The application process is the same for deferred adoption assistance as for adoption assistance except that the family indicates on the application that they are requesting an “Agreement Only” agreement—to receive no benefits now but to receive benefits in the future if needed. Adoptive parents are asked to identify possible future needs in the deferred adoption assistance agreement.

14. Does Oklahoma operate a subsidized guardianship program?

There is no IV-E subsidized guardianship program in the state. However, a limited program identified as Supported Permanency with Relatives is available. Key guidelines are that the child has to be age 12 or older and living in a paid kinship placement with a relative who resides in Oklahoma and meets the specified degree of relationship as defined by the TANF program. It is not intended for children in adoptive placements. A monthly stipend is based on the standard foster care rate. Financial assistance for obtaining legal guardianship is provided. Further information about the program may be obtained from Amy White, Program Manager, at 918-599-8894. Interested persons may also view the policy on-line at www.okdhs.org (340:75-6-31.4).


Programmatic Procedures

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

Adoption workers assist families in making applications and negotiating monthly payments. A Subsidized Adoption Review Committee determines eligibility.

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

No means test is used.

17. When do subsidy payments begin?

Adoption assistance payments and benefits may begin at adoption finalization or at adoption placement, depending on circumstances. If Oklahoma foster parents who receive foster care maintenance payments for a child adopt, agreements are set up to begin the day after finalization and foster care payments continue until finalization. In other situations, families may request payment at placement.

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

Children placed by private agencies must meet Title IV-E criteria. State funded adoption assistance is not available. Private agencies involved must demonstrate that they made an effort to place the child without subsidy. In Oklahoma, state funded adoption assistance is also available to children in the legal custody of OKDHS or a federally recognized tribe.

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

Adoption Assistance ends at age 18 unless:

  • the child continues to attend high school or a vocational education program full time; or
  • meets the criteria for an adoption assistance difficulty of care rate as determined by the Department

Adoption Assistance will be terminated at age 19 unless the child is receiving a Difficulty of Care Rate IV or V, and

The parent must submit documentation of a pending or denied
SSI application

Adoption Assistance will be terminated once SSI is approved.

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

When subsidies are for more than one year, adoptive parents shall present an annual certification that the adopted child remains under their care and that the conditions that caused the child to be certified continue to exist. Statements from verifying professionals need not be submitted each year for review. Many children have needs that will obviously not change within a year or even a number of years. Children over the age of 18 require yearly documentation of a continued physical or mental handicap.

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

Adoption assistance agreements may be changed and the adoption assistance payment amount adjusted periodically when warranted by a change in the circumstances of the family or the needs of the child. Any change to the adoption assistance agreement must be with the concurrence of the adoptive parent(s). An increase in monthly payments is sometimes requested when a child has specialized care needs (known as difficulty of care payments). Agreements are usually renegotiated if a child temporarily enters placement outside the family home. Adoptive parents are asked to send a written request and, if applicable, attach professional reports to support the requested change in payment or services in the adoption assistance agreement. DHS county offices locator link: http://www.okdhs.org/icounties/default.asp.

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

Adoptive parents can request a fair hearing whenever a DHS/CFSD decision affects their child’s adoption assistance benefits. Parents are first given an opportunity for an administrative review of the adverse decision. If parents choose to decline this review or the agency decision is unchanged following the review, they may complete and submit what is known as a Form H-4, Resource Family Request for a Fair Hearing. Parents are directed to contact their adoption assistance worker for Request for Fair Hearing form and information on seeking a fair hearing.

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 State Office Adoption Assistance Program at 405-521-2475 to request an application packet. The Oklahoma program includes the state funded Post-Legal Adoption Assistance and Title IV-E Post-Legal Adoption Assistance. The state funded program has been in place since 1987 for those adoptions in which a pre-existing condition that was unknown at the time of the adoption has later resulted in a severe medical or psychological condition requiring treatment. Retroactive payments are limited to two months prior to the application. This program does not require a fair hearing. Title IV-E Post-Legal Adoption Assistance may be approved if the child is eligible for Title IV-E, the adoptive parents were denied benefits, and there is an extenuating circumstance which meets the eligibility requirements. This process requires a fair hearing. Families should contact Karen Poteet, Programs Manager, Oklahoma Department of Human Services, at 405-522-2467.


System Operation and Program Funding

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

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

The federal contribution to Title IV-E-eligible children is 64.02% in Oklahoma. This is known as the Federal Financial Participation (FFP) rate. The remaining cost of the program is funded entirely by state funds.

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

Oklahoma offers a tax deduction for adoption.
Qualified Adoption Expense—An Oklahoma resident may deduct "Nonrecurring adoption expenses" not to exceed $20,000 per calendar year (Title 68 O.S. Section 2358). Expenses are to be deducted in the year incurred. "Nonrecurring adoption expenses" means adoption fees, court costs, medical expenses, attorney fees and expenses which are directly related to the legal process of adoption of a child. Enclose a schedule describing the expenses claimed.

College Tuition Waivers are available for children placed for adoption from Oklahoma Department of Human Services (OKDHS) or Oklahoma Tribal custody who were in foster care for 9 months between the ages of 16 and 18. Eligible schools include any Oklahoma public college or university, or any public vocational program that has courses that can transfer to the colleges and universities. Waivers are valid until the youth reaches age 26 or completes their degree, whichever comes first.

In addition, we offer the Oklahoma Higher Education Access Program (OHLAP). If students are enrolled in OHLAP during the 8th, 9th or 10th grade year of their education, maintain a 2.5 GPA, and meet behavioral requirements (i.e., drug free and violence free at school), tuition expenses are handled at any public Oklahoma State College or University. OHLAP has a family income component, but this is waived for foster youth. Once the youth is enrolled in the program, they are eligible even if they are adopted and the adoptive family has a higher income. We are diligent in trying to enroll our foster youth the minute they reach the 8th grade.

For more information on the college tuition waivers or the OHLAP, contact Cathy Connelly, OKDHS, 605-521-6671 or Cathy.Connelly@okdhs.org.

 

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