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Oklahoma State Subsidy Profile

Updated draft • October 2014
(state review pending)

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

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

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 Oklahoma. 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 other states’ subsidy programs are available. If you have additional questions, please contact NACAC at 651-644-3036, 800-470-6665, or 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.

Adoption resources on the web: , and (FAQ)

Oklahoma state-specific medical assistance information:

Oklahoma adoption assistance information: (See Adoption Services, Additional Facts)

Oklahoma Statute §10-7510-1.2 through §10-7510.1.6:

Office of Administrative Rules Section 340:75-15-128 through 340:75-15-128.7:

Who Is Eligible for Adoption Assistance?

1. How does Oklahoma define special needs to determine eligibility?

A child is defined as having special needs if he or she has at least one of the following needs or circumstances that may be a barrier to placement or adoption without financial assistance:

  • The child is eight years old or older.
  • The child is American Indian, Hispanic, Asian, or African American and is three years of age or older.
  • The child is part of a sibling group placed together for adoption.
  • A child younger than three years of age becomes eligible if the adoptive parent finalizes the adoption of the child's sibling within one year of the first child’s adoption finalization. In this case, the effective date the adoption assistance payment for the first child placed is the same as the effective date for the newly adopted sibling.
  • The child has a physical disability requiring regular treatment with a specific diagnosis given by the child's physician.
  • The child has a mental disability meeting the eligibility criteria for educable multi-handicapped (EMH) or trainable multi-handicapped (TMH) classes and evaluated by a licensed psychologist, psychometrist, or recognized diagnostic center. A child with a demonstrable need for intensive adult supervision beyond ordinary age needs also qualifies.
  • The child has an emotional disturbance that is: (1) established by a physician, a psychologist, behavioral therapist, or social worker; (2) corroborated by a child welfare worker's observations of the child's behavior; (3) corroborated by one or more caregivers such as foster parent, Head Start, or church nursery, or child care provider; and (4) if applicable, documented with a specific diagnosis and prognosis.
  • The child is at high risk of developing a physical or mental disease. Indicators of high risk for developing a physical or mental disease include elements of the child’s 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.) 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 #8 for information regarding deferred adoption assistance.

2. Does the state-only funded adoption assistance program differ in any way from the Title IV-E program?

To be eligible for state-funded adoption assistance, a child must meet the definition of special needs above, be under the age of 18, and have previously been 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. Are children adopted from private agencies in Oklahoma eligible for adoption assistance?

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 adoption assistance. In Oklahoma, state funded adoption assistance is also available to children in the legal custody of OKDHS or a federally recognized tribe.


What Supports and Services Are Available?

Monthly Payments

4. What is the maximum basic monthly adoption assistance maintenance payment in Oklahoma?









5. Does Oklahoma provide specialized rates (based on the extraordinary needs of the child or the additional parenting skill needed to raise the child)?

Yes, children may receive the following monthly addition to the basic payment, based on the five levels described below.













DOC Rate I — The child has one or more of the following needs, conditions, or behaviors:

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

DOC Rate II— The child has one or more of the needs, conditions, or behaviors listed in DOC Rate I, and has at least one of the following needs:

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

DOC Rate III — The child has one or more of the needs, conditions, or behaviors listed in each of DOC Rates I and II, and also requires specialized substitute care.

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

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

  • severe mental illness, such as child schizophrenia, severe developmental disabilities, brain damage, or autism, diagnosed by a physician
  • 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
  • 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
  • severe mental retardation as determined by the Social Security Administration and defined by DSM;
  • been waiting for an organ transplant or is up to one year post transplant
  • a physical condition uncontrolled by medication or treatment such as Tourette’s syndrome or epilepsy

6. When do adoption assistance payments begin?

If Oklahoma foster parents who are receiving foster care maintenance payments for a child adopt that child, agreements are set up to begin the day after finalization. The foster care payments continue until finalization.
In all other situations, families may request payment at placement.

7. When a child turns 18, which benefits, if any, continue?

Adoption assistance ends at age 18 unless:
the child continues to attend high school or a GED program full time or
the child meets the criteria for an adoption assistance DOC rate as determined by DHS
Adoption assistance will then be terminated at age 19.

8. Does Oklahoma offer deferred adoption assistance agreements (agreements where initial monthly maintenance amount is $0 for children at risk of developing special needs later)?

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. They receive no benefits now but can receive benefits in the future if needed. Adoptive parents are asked to identify possible future needs in the deferred adoption assistance agreement. 

Medical Care

9. 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 s-ray and laboratory services
  • Outpatient mental health services
  • Family planning services
  • Primary health care
  • Limited podiatry services for children
  • Nurse midwife and birthing services
  • Certified nurse practitioner services

For more information about Medicaid, parent scan contact Karen Hylton at 405-521-3679.

Oklahoma also 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 medical benefits are available for state-funded children? (Children who have federally funded/Title IV-E adoption assistance are automatically eligible for Medicaid benefits.)

When a child is in an adoptive home before adoption and has unusual medical needs that 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.

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

11. What mental health services are available?

Public mental health services for children in Oklahoma are administered by DHS’s Health Care Authority and may include mental health services (psychological, psychiatric services, or emotional/psychological/behavioral counseling), outpatient and inpatient hospitalization, substance abuse services and prescription drugs. Oklahoma offers all medical services compensable through the state’s Medicaid program. Some services require prior authorization by the Oklahoma Health Care Authority (OHCA). More information, is available at and .

Children receiving Supplemental Security Insurance disability payments may be eligible for additional services through the Disabled Children’s Program. More information is available at
Please note that 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.

Other Benefits

12. In Oklahoma, what nonrecurring adoption expenses directly related to the finalization of an adoption may be reimbursed?

Families adopting children who meet the definition of special needs may be able to be reimbursed for their nonrecurring adoption expenses such as 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.

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

Typically, the reimbursement limit is $1,200 per child. Oklahoma will consider payment of up to a maximum of $2,000 per child in either of the following cases:

  • The child had an order terminating parental rights.
  • The child had an order determining the child eligible for adoption without the consent of a biological parent.

13. Is child care available? If yes, who is eligible and how do families access child care?

Child care services may paid by DHS as a part of the Special Service Subsidies if all of the following are true:

  • The child is five years of age or younger.
  • The child is adopted through OKDHS or a federally recognized Indian tribe.
  • The child has been adopted by the parent applying for benefits.
  • The adoptive parent applying for benefits has fully executed Form 04AN002E, Adoption Assistance Agreement, that lists child care as an adoption assistance benefit for the child and includes Form 04AN033E, Post-Adoption Child Care Referral, when the child resides in Oklahoma.
  • The parent’s employment has been verified and child care has been approved for only the days and hours the adoptive parent works. In a two-parent family, care may be approved for sleep time when one parent works days and the other parent works during normal night time sleep hours.

The Special Service Subsidy for child care is negotiated between OKDHS and the adoptive parent(s), but cannot exceed the one-star child care center rate.  The benefit must be approved by the Post-Adoption Services Section and included on the Adoption Assistance Agreement.

14. Is respite care available? If yes, who is eligible and how do families access respite care?

Parents who adopted through DHS may be eligible for respite vouches from the Oklahoma Respite Resource Network. More information is available at
Many private organizations offer respite options. Parents can call Karen Poteet at 405-521-2475 for referral information. Additional options can be found by searching for Oklahoma resources at the ARCH National Respite Network Respite Locator Service:

15. Is residential treatment available? If yes, who is eligible and how do families access residential treatment 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.

16. What other post-adoption services are available in Oklahoma and how do families find out more about them?

Post-adoption services in Oklahoma are administered by DHS and provided by DHS and private groups. Post-adoption services may include:

  • Information and referral
  • Educational/training programs
  • Educational materials/library
  • Support groups
  • Advocacy
  • Residential treatment
  • Home-based services
  • Mediation/search/reunion services

More information is available at

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, parents can contact Oklahoma Swift at 877-OKSWIFT (877-657-9438) or the designated Swift adoption specialist in their county of residence. Additional information is also available from Jacquelyn Hill-Anderson at 405-522-4487.

The state has many adoptive parent groups, with information provided by DHS.

Reunion services are available through the DHS Confidential Intermediary Search Program. More information is available at

Not all services may be available in all cases. Parents should contact their adoption assistance worker or post-adoption services contact for information regarding process, eligibility, availability, and duration of services. DHS county offices are elisted at

17. If the assistance listed above in questions 13 to 16 are for specific services, must these services be explicitly identified in the adoption assistance agreement?

Yes for childcare, but not for the other services.

What Should Families Know about Applying for Adoption assistance?

18. Who initiates the adoption assistance agreement?

The adoption specialist.

19. Who makes the final determination on an adoption assistance agreement?

The adoption specialist help families apply for and negotiate monthly payments. The Adoption Assistance Review Committee determines eligibility.

20. How do families request adoption assistance after finalization of an adoption?

Parents can contact the DHS Adoption Assistance Program at 405-522-4487 to request an application packet. For children who are not IV-E eligible, parents can apply for benefits for children in cases where a pre-existing condition was unknown at the time of the adoption has now 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.

Benefits for children who are Title IV-E eligible may be approved if 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 Jacquelyn Hill-Anderson, programs manager, Oklahoma Department of Human Services, at 405-522-4487.

How Can a Family Adjust an Adoption Assistance Agreement?

21. Can adoptive parents ask to change an adoption assistance agreement?

Adoption assistance agreements may be changed and the adoption assistance payment amount adjusted periodically when warranted by a change in the family’s circumstances or the child’s needs. Any change to the adoption assistance agreement must be with the agreement of the adoptive parent(s).
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. Parents can request more information from the local DHS office, which are listed at

22. What steps does a family go through to appeal an adoption assistance decision in Oklahoma?

Adoptive parents can request a fair hearing whenever a DHS 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 13MP005E, Resource Family Request for a Fair Hearing. The form must be submitted within 30 days of an adverse decision. Parents can request the form from their adoption assistance worker. Additional information is available at or


What Else Do Families Need to Know?

23. How is the adoption assistance program operated and funded in Oklahoma?

The program is state supervised/state administered, which 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 62.30% in Oklahoma. This is known as the Federal Financial Participation (FFP) rate. The remaining cost of the program is funded entirely by state funds.

24. Does Oklahoma operate a subsidized guardianship program?

There is no Title IV-E subsidized guardianship program in the state. However, a limited Supported Permanency with Relatives program is available. To be eligible, a 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. The monthly stipend is based on the standard foster care rate. Financial assistance for obtaining legal guardianship is provided. Additional  information about the program may be obtained from Amy White, program manager, at 918-599-8894. The policy is also available at (search for 340:75-6-31.4).

25. Does Oklahoma offer a tuition waiver program?

College tuition waivers are available for children placed for adoption by DHS or Oklahoma tribal custody if the children were in foster care for nine months between the ages of 16 and 18. Eligible schools include any Oklahoma public college or university and 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 his or her degree, whichever comes first.

In addition, the state offers the Oklahoma Higher Education Access Program (OHLAP). If students are enrolled in OHLAP during 8th, 9th or 10th grade, maintain a 2.5 GPA, and meet behavioral requirements (such as being drug free and violence free at school), their tuition expenses are covered 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.

For more information on the college tuition waivers or the OHLAP, parents can contact Cathy Connelly at 405-521-6671 or

26. Does Oklahoma offer a state adoption tax credit?

An Oklahoma resident may deduct from his or her income nonrecurring adoption expenses not to exceed $20,000 per calendar year. The expenses must be deducted in the year they were incurred. Nonrecurring adoption expenses means adoption fees, court costs, medical expenses, attorney fees, and expenses directly related to the legal process of adoption of a child.



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