Adoption
Subsidy

South Carolina State Subsidy Profile

Updated May 2008

State Subsidy Contact Person

Cathy Fitz
Department of Social Services
Division of Human Services, Adoption
P.O. Box 1520
Columbia, SC 29202
Phone: 803-898-7561/ 800-922-2504
Fax: 803-898-7641
E-mail: cathy.fitz@dss.sc.us

NACAC Subsidy Representative (parent/volunteer)

Gail Groomster
SC Council on Adoptable Children
2527 Millwood Ave., Suite A2
Columbia, SC 29205
Phone: 803-256-2622
Fax: 803-256-2767
E-mail: gail-coac@sc.rr.com

Ursula S. Kelly
SC Council on Adoptable Children
(same contact as above)
E-mail: ursula-coac@sc.rr.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.state.sc.us/dss/adoption/index.html

See also The Photo Album of Adoptive Children, Linking Children with Families Adoption Album presented in a notebook format with headings listed vertically along the right-hand margin, link: http://www.state.sc.us/dss/adoption/album/intro.htm

South Carolina’s state-specific medical assistance:
http://www.dhhs.state.sc.us/dhhsnew/index.asp

South Carolina’s adoption assistance:
http://www.state.sc.us/dss/adoption/subsidy.html

South Carolina Statute §20-7-1900 through §20-7-1970, Supplemental Benefits to Assure Adoption.
http://www.scstatehouse.net/code/t20c007.htm

South Carolina Code of Regulations 114-4380, Supplemental Benefits for Adoption and Medical Assistance
http://www.scstatehouse.net/coderegs/c114.htm#114-4380

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 legally free child for whom reasonable but unsuccessful efforts have been made to place without subsidy except where it would be against the best interest of the child because of significant emotional ties with foster parents and the child meets one or more of the following criteria:

1. African American or of blended racial heritage and six years or older
2. Caucasian and ten years of age or older
3. African American or of blended racial heritage and a member of a sibling group of two or more children, one of whom is at least six years of age
4. African American or of blended racial heritage and a member of a sibling group of three or more children of any age
5. Caucasian and a member of a sibling group or three or more children, one of whom is at least six years of age
6. Caucasian and a member of a sibling group of four or more children of any age
7. Member of a sibling group that includes a special needs child
8. Physical, mental or emotional handicap
9. At risk of developing a physical, mental or emotional handicap due to a condition existing before adoption

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 and in the custody of the state of South Carolina for placement.

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

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

Children are assessed on a case-by-case basis.

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.

South Carolina reimburses “reasonable and necessary adoption fees, court costs, attorney fees, and other expenses which are directly related to the legal adoption of a child with special needs and which are not incurred in violation of State or Federal law,” including mileage and lodging involved in visiting the child before placement occurs. Payment can be made directly to providers or to families as reimbursement.

The costs are reimbursable up to $1,500 per child and are entered on the Adoption Subsidy Agreement. The Adoption Subsidy Agreement must be signed prior to legalization.

Children who are adopted internationally may be eligible if they meet the special needs definition and there is an Adoption Subsidy Agreement in place prior to finalization in the foreign country.

6. What Medicaid services are available in South Carolina?

Covered Services:

• Outpatient Hospital
• Physician
• Inpatient Physician Visits
• Rural Health Clinic
• Family Planning
• Laboratory and X-ray
• Prescription Drugs
• Ambulance Transportation
• Podiatrist
• Home and Community-Based Services
• Skilled Nursing Facility
• Intermediate Care Facility
• Home Health Care
• Inpatient Hospital—Medicaid will pay for a maximum of three (3) inpatient hospital stays per fiscal year. Inpatient hospital stays are not limited for individuals who are under age 21.
• Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program. This program provides free medical check-ups for all Medicaid eligible children (under the age of 21) and treatment for medical problems.
• Vision Care—The vision care program will pay for one vision test during any 12 month period of time. This program will also pay for eyeglasses for children under age 21 (only one (1) pair of glasses and one (1) replacement or repair during a 12 month period).
• Dental—For people under the age 21, Medicaid can pay for dental check-ups and other dental services through the EPSDT program. For people age 21 and over, Medicaid will pay for emergency dental services only.
• Inpatient Psychiatric Services for Individuals Under the Age of 21—The need for this care must be medically documented and, in some cases, the need for care must have prior approval
• Mental Health Clinic—Many outpatient mental health clinic services are covered, including counseling to people who are emotionally or mentally disturbed, drug or alcohol abusers and some mentally retarded people.
• Case Management—This service is available to non-institutionalized mentally retarded individuals, emotionally disturbed children, certain pregnant women, and other targeted groups.
• Durable Medical Equipment—Medicaid will pay for such things as hospital beds, wheelchairs, oxygen, leg and back braces, artificial limbs, and other equipment that is necessary for medical reasons. The equipment must be prescribed by a doctor, and most equipment must be approved in advance by the Medicaid Program.
• Medical Transportation—Medicaid can pay for a van or a volunteer driver to take patients to medical appointments if the medical services to be received are covered by Medicaid.
• Therapy—Therapy can be provided in the following situations as ordered by a physician: (a) in a nursing home; (b) as a Home Health Service; (c) as an inpatient in a hospital which has a certified therapy department, and therapy may be continued at the hospital as an outpatient if ordered by the doctor; (d) by an independent therapist for individuals under age 21.

The provider can tell the families what is and is not covered. Recipients can also call the SC Medical Programs Line at 888-549-0820.

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

Non-Title IV-E eligible special needs children who are eligible for a state funded adoption subsidy will receive Medicaid. Available benefits do not differ between IV-E eligible and non-Title IV-E eligible children.

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

Public mental health services for children in South Carolina are administered by the Department of Mental Health (DMH), Division of Children, Adolescents and Their Families (DCAF) and include the following examples: assessment, case management services, day treatment, out-patient treatment (counseling/therapy), in-patient hospitalization, wraparound services, residential treatment services (in-patient general psychiatric and substance abuse units), school-based services, Youthful Sexual Offenders Program, and Intensive Family Services and Multi-Systemic Therapy (MST) Initiatives.

Services are largely provided through the DMH’s network of seventeen local community mental health centers. DMH seeks to provide services in as natural and comfortable a setting for the family and child as possible, such as in the school or home. DMH’s vision is to develop a statewide system of services that is child centered, family focused, community based, and culturally competent.

See Division of Children, Adolescents and Families: http://www.state.sc.us/dmh/caf/index.htm and

Service Delivery System: http://www.state.sc.us/dmh/caf/services.htm for detailed program information.

See also the child and adolescent mental health: http://www.state.sc.us/dmh/clinical/child.htm for mental heath issue definitions/diagnosis information.

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?

Supplemental Benefits for Medical Assistance (SBMA) is available for conditions that preexisted adoption finalization. Adoptive families must request this benefit at the time the adoption assistance agreement is drafted and signed. The amount of the benefit is determined through negotiation between the agency and the adoptive family. SBMA is available to meet children’s physical, emotional, and psychological needs unable to be met under any other resource, public or private. Availability is limited to children placed through the South Carolina Department of Social Services. These funds may cover medical, rehabilitative and psychological counseling expenses that are not covered by the Medicaid card, private insurance, or other resources. All other resources should be exhausted before the SBMA request is made.

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 South Carolina are available through the Department of Social Services (DSS), private agencies, and family organizations. Post adoption services include the following examples:

• Information and referral
• Educational programs
• Educational material
• Support Groups
• Therapeutic intervention
• Advocacy
• Respite Care
• Residential treatment
• Search services (reunion register)

South Carolina has an Adoption Preservation (AP) program to serve adoptive families. AP services primarily consist of linking families to existing resources, case management, support services, and counseling.

Parents Reaching Out to Parents (PRO-Parents) is a group that provides advocacy for families working with the school systems to meet the needs of their adoptive child. A state agency known as South Carolina Protection and Advocacy also helps adoptive families manage system issues. DSS local county offices locator and state contacts: http://www.state.sc.us/dss/counties.html.

Parent organizations exist to assist families in addressing the concerns particular to adoption. The South Carolina Council on Adoptable Children provides support services, photolisting of available children, and an annual conference for parents and others involved in adoption.
Respite Care— Families should contact the Adoption Subsidy Coordinator at 803-898-7561 or toll-free in South Carolina at 800-922-2504 for more information.

In addition, many organizations provide a variety of respite options. See the ARCH National Respite Network Respite Locator Service, search by state to locate South Carolina’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?

Specific services are not specified on the Adoption Subsidy Agreement. Conditions which will be covered are identified in the Adoption Subsidy Agreement. If, after the adoption is finalized, the child is diagnosed with a preexisting condition, the Adoption Subsidy Agreement may be amended to include the condition. Documentation from a certified physician or therapist is required.

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

Families should contact the adoption office in their county of residence or the Special Needs Administrator (803-898-7561) when residential treatment services are needed. Staff will direct these requests for residential treatment services appropriately.

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

Yes, South Carolina offers deferred adoption assistance. Adoptive parents and the state must sign the adoption assistance agreement prior to adoption finalization with a payment level of zero indicated in the agreement. The payment rate can be raised in the future to meet the changing needs of the adopted child.

14. Does South Carolina operate a subsidized guardianship program?

No.

Programmatic Procedures

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

All new adoption cases are evaluated for potential Title IV-E eligibility. In general, the adoption specialist and area supervisor make the determination of the child's subsidy eligibility. Post-legalization requests are reviewed in the state office by the Special Needs Coordinator.

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

There are no family income or resource guidelines. Each case is reviewed and considered based on the needs of the child and the circumstances of the family.

17. When do subsidy payments begin?

Adoption assistance payments and benefits may begin at adoption placement, if there is a signed Adoption Subsidy Agreement in place.

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

State-funded subsidy programs are only available to children placed by the South Carolina Department of Social Services. Federally funded programs may be available in some cases to special needs children placed by private agencies. Children must meet the eligibility criteria for Title IV-E Adoption Assistance; however, because of strict guidelines, few children do.

Reimbursement for nonrecurring costs is available to any family who adopts a special needs child and signs an Adoption Subsidy Agreement prior to finalization.

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

Supplemental Benefits can continue until the child's 21st birthday with proof of full-time school enrollment and the family's confirmation of ongoing financial responsibility for the child. Title IV-E eligible children can continue to receive financial assistance until the child’s 21st birthday if the child continues to have a handicapping condition and the family continues to have ongoing financial responsibility for the child.

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

Each year, in the month of the child’s birthday anniversary, for children who are nearing 18, 19 or 20 years of age, the family is contacted and asked to provide proof of school attendance or IV-E disability.

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

Adoptive parents can request a modification in the Adoption Assistance Agreement whenever there is a change in the family’s circumstances or the needs of the child. If the child is found to have a preexisting condition after the Adoption Assistance Agreement is finalized, the agreement may be amended to include the condition. A written request detailing the need for change must be submitted to the adoption assistance worker or the Special Needs Coordinator for review. Medical or therapeutic documentation from a therapist or physician supporting the need must accompany the request for modification. A parent can appeal an adverse decision by contacting the South Carolina Department of Social Services, Individual and Provider Rights, Office of Administrative Hearings, PO Box 1520, Columbia, SC 29202. See also Question 22 for complete information regarding fair hearings.

DSS local county offices locator and state contacts: http://www.state.sc.us/dss/counties.html

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

Adoptive parents can request a fair hearing whenever there is disagreement with a Department of Social Services (DSS) decision that affects their child’s adoption assistance benefits. Requests for fair hearings must be in writing and sent to the Office of Administrative Hearings and Individual and Provider Rights (OAH) within thirty days of a family’s receipt of an adverse DSS decision. OAH will usually schedule a hearing within ninety days (between thirty and ninety) after the initial request for fair hearing. A three-member committee consisting of a hearing officer and two members appointed by the State DSS Director conducts hearings. Final decisions are issued within thirty days from the conclusion of the hearing and sent by certified mail to the adoptive parents.

See the link below for more information: http://www.state.sc.us/dss/forms/files/2410.pdf

Send written requests for fair hearings to the address below or phone: 800-311-7220 or TTY 800-311-7219 for information.

South Carolina Department of Social Services
Individual and Provider Rights
Office of Administrative Hearings
P.O. Box 1520
Columbia, SC 29202-1520

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.

Families should contact the Adoption Subsidy Coordinator at 803-898-7561.

System Operation and Program Funding

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

The program is state administered/locally supervised. There are four adoption offices that provide services for ten to fourteen counties each.

The federal contribution to Title IV-E-eligible children is 69.79 percent in South Carolina. This is known as the Federal Financial Participation (FFP) rate. The remaining cost of the program is funded entirely with state funds. Supplemental Benefits and Supplemental Benefits for Medical Assistance (SBMA) are entirely funded by the State.

25. Below are other programs that may delineate South Carolina's adoption assistance program from others around the country.

Families may be eligible for a $2,000 income deduction on their South Carolina individual income tax return if they have adopted a special needs child and are solely responsible for the child’s support. For more information, to go www.state.sc.us/dss or call 803-898-7561 or 800-922-2504 (toll free in SC).

South Carolina ETV Program—Youth can receive up to $5,000 per year as long as funds are available through the Education and Training Voucher Program.

DSS Form 30198 (Jan. 08) edition is the only form to be used to make requests for youth. Only youth in the custody of the Department of Social Services with independent living as part of the case plan or youth who were in the custody of DSS at 18 years of age are eligible for these funds. Youth are eligible for ETV funds as long as they are in college and have not reached the age of 21, even if they are not in care. Youth are eligible until age 23 if they are enrolled in post secondary education and already participating in the ETV program. If a foster youth was adopted on or after their 16th birthday, then they are eligible for ETV funds.