Adoption
Subsidy

Vermont State Subsidy Profile

Updated January 2007

State Subsidy Contact Person

Diane Dexter
Social Services Division
103 South Main Street
Waterbury, VT 05671-6531
Phone: 802-241-2142; Fax: 802-241-2407
E-mail: ddexter@srs.state.vt.us

NACAC Subsidy Representative (parent/volunteer)

Currently, there is no Vermont representative. If you or someone you know would like to volunteer to help families learn more about adoption assistance, please call Jeanette Wiedemeier Bower at NACAC, 651-644-3036 or adoption.assistance@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.projectfamilyvt.org/

Vermont’s state-specific medical assistance links:

http://www.path.state.vt.us/ and http://www.path.state.vt.us/Programs_Pages/Healthcare/medicaid.htm

Vermont’s adoption assistance links:

http://www.projectfamilyvt.org/a_availableSupport.html
(See adoption subsidy under Financial Support)

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. Four years of age or older
2. Race or ethnic background and three years of age or older
3. Member of a sibling group of two or more children being adopted by the same family
4. Medical condition/disability
5. Physical, mental, emotional or psychological disability

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 care and custody of the state of Vermont.

3. The maximum basic monthly adoption assistance maintenance payment in Vermont 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 Vermont offers these rates, the criteria used to define them are as follows:

Our “leveling” system is based on the foster parents' skill.  Level I is least skilled, Level III is most skilled, according to training and experience.

For a small number of children, we create individual “wrap-around” budgets when no other source of payment is available. These children have intensive medical, emotional, and/or behavioral needs.

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 are expenses directly related to the legal adoption of a child with special needs that have not been reimbursed from other sources or funds. They include reasonable and necessary adoption fees, court fees, attorney fees, costs of an adoption homestudy, health and psychological examinations, supervision of a placement prior to adoption, and the reasonable costs of lodging and food for the child and/or parents when necessary to complete the placement process.

Families must apply and be found eligible prior to finalization.  International adoptees are eligible if they meet all other program criteria.

The reimbursement limit is $2,000 per child

6. What Medicaid services are available in Vermont?

Covered Services:

• Inpatient hospital
• Nursing home
• Outpatient services
• Emergency care
• Prescriptions
• Family planning
• Transportation
• Ambulance
• Doctor—Coverage is limited to five office visits per month; Services include: routine check-ups, diagnostic tests, treatment, immunizations, and drugs that cannot be self-administered.
• Mental Hospital Care—Medicaid covers medically necessary care in a mental hospital for persons under age 21 or over age 65. However, the State of Vermont services children under the age of 18 in mental hospitals only when no appropriate alternative can be found.
• Service for Persons with Mental Retardation—Medicaid covers care in Intermediate Care Facilities for the Mentally Retarded.
• Home Health Care—skilled nursing visits, aide visits, therapy visits, hospice care, other necessary supplies and appliances.
• Vision—Medicaid covers eye examinations by optometrists or ophthalmologists every two years.
• Dental—Dental services for children from birth to age 21 provided in participating dentists' offices. Most preventive and restorative care is covered including: examinations, x-rays, cleaning, fillings, and sealants. Orthodontic care may be provided for children in certain situations. Ask your dentist about coverage.
• Mental Health—Medicaid covers the following services: psychotherapy, group therapy, day treatment, day hospital, chemotherapy, emergency care, evaluation, diagnosis, case management, and transportation.
• Psychological and Psychiatric Services—Medicaid covers psychotherapy by a private practicing psychologist or psychiatrist up to $500 per calendar year.
• Chiropractic—Medicaid covers only the treatment known as manual manipulation of the spine to correct a subluxation. Coverage is limited to 10 treatments in any calendar year.
• Cosmetic Surgery—Medicaid covers cosmetic surgery only if necessary for prompt repair of accidental injury or to improve the function of a malformed body part.
• Other Covered Services—(a) Lab tests ordered by a doctor; (b) Limited foot care from a podiatrist; (c) Medically necessary wheelchairs, braces, artificial limbs, and diabetic supplies; and (d) Professional (non-residential) services in approved alcohol and drug treatment centers.

For persons under age 21 ONLY:

• Hearing aids and exams
• Hearing aid repairs
• Children's health check-up services under the EPSDT program
• Smoking cessation products such as nicotine patches and nicorette gum.

For more information on Medicaid services, call 802-241-3978.

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

Available benefits do not differ for IV-E and non-IV-E children.       

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

Public mental health services for children in Vermont are administered by the Agency of Human Services, Department of Developmental and Mental Health Services (DDMHS) and include the following examples: Core Capacity Services-immediate crisis response; clinic-based treatment; outreach treatment; family support; prevention, screening, referral and community consultation.  Statewide Capacity Services—emergency or hospital diversion beds; intensive residential service, hospital inpatient services.

Children's Mental Health Services works with designated agencies in each region to assure delivery of effective behavioral health treatment and supports as well as prevention and early intervention services through a family-centered system of care for all children and families in the state. The Child, Adolescent and Family Mental Health treatment system is organized around the five core capacity services listed above that are available within each geographic area of the state as well as several statewide capacities for intensive residential and/or psychiatric hospital placements. The services are available separately or in combination for a youth and their family, depending on their desires and needs.

Child, Adolescent and Family Mental Health Services: http://healthvermont.gov/mh/programs/cafu/child-services.aspx and

DMHS Programs and Services: http://healthvermont.gov/mh/programs/mhprograms.aspx

or phone 802-652-2000.

Mental Health Factsheets:
http://healthvermont.gov/mh/facts/quick-fact-mh.aspx

See also Crisis Contact numbers: http://healthvermont.gov/mh/contact/crisis-numbers.aspx

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?

Vermont offers what is known as Payments for Special Services. Funding is available for AHS to provide support for specific special services, to include the following examples: psychological care, psychiatric care, and dental and medical services. Funding is only available after adoptive parents have exhausted all resources, both public and private, including the family’s private health insurance.

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 Vermont are administered by the AHS, Department for Children and Families (DCF), Family Services Division (FSD). Services are contracted through a collection of private agencies in a Post Adoption Consortium and independent and parent organizations. Post-adoption services include the following examples:

1. Information and referral
2. Educational programs
3. Educational materials
4. Support programs
5. Respite Care
6. Residential treatment
7. Therapeutic intervention
8. State Registry (mediation/search services)
9. Therapy
10. Advocacy

The Parent to Parent Program connects families to services and to other families for support. The Post Adoption Consortium connects families to agencies that provide post adoption support services. See Vermont’s Adoption Handbook: http://www.projectfamilyvt.org/pdfs/AdoptionHandbook.pdf

(See Page 32, #3: Post-Adoption Services for a list of services and Page 34, Vermont ADOPTION Consortium, for a listing of service providers in your area.) Providers include:

Casey Family Services:
Office: White River Junction, 800-607-1400 or 802-649-1400
Office: Waterbury, 800-244-1408 or 802-655-6688

Easter Seals Vermont
Office: Berlin, 802-223-4744
Office: Shelburne, 802-985-0158 

Lund Family Center
Office: Burlington, 800-693-1741 or 802-864-7467

Northeast Kingdom Human Svcs.
Office: St. Johnsbury, 800-649-0118
Office: Newport, 802-334-6744

Northeastern Family Institute (NFI)
Office: Williston, 802-658-0040

Vermont Children’s Aid Society
Office: Winooski, 802-655-0006
Office: Woodstock, 802-457-3084

Contact local Department offices: http://www.dcf.state.vt.us/fsd/districtoffices.html.

To contact the Vermont Adoption Registry: http://www.dcf.state.vt.us/fsd/registry.html

Respite Care—There is limited respite available through the Department of Mental Health. The family must fill out a request for services with their local, county mental health clinic. In some situations we have included respite in the Adoption Assistance agreement for a time-limited basis (i.e., 6-12 months). This is to be renegotiated during the annual recertification process.

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

If an award above the regular monthly rate is given, it is usually identified as covering a particular need (e.g., therapy, respite care, orthodontia, etc.).

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

Adoption subsidy can be used to pay room and board costs. Mental Health (through Medicaid) pays therapeutic costs. The Department of Education covers the educational component.

The current process is for families to complete an application for referral to the Case Review Committee, Department of Social Services, Education and Mental Health. The contact person is Marion Paris (802-241-2131).

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

Yes, Vermont offers deferred adoption assistance.  Children must meet the special needs criteria or be at risk of developing a special need and the adoptive family must apply prior to adoption finalization.  Termination of parental rights on both parents must be complete and documentation of efforts to place the child without assistance must be made by the placing agency.  Eligibility determinations for deferred assistance are made on a case-by-case basis and children must meet Title IV-E/SSI eligibility criteria.

14. Does Vermont operate a subsidized guardianship program?

No.

Programmatic Procedures

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

The adoption chief makes the final eligibility determination.  Adoption social workers from private agencies negotiate subsidies with families.

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

No.

17. When do subsidy payments begin?

Adoption assistance payments and benefits may begin at the time of placement if the child is free for adoption.  Usually benefits begin when the adoption is finalization.

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

Yes, but only for children who are SSI or IV-E eligible.           

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

Assistance stops when a child reaches 18, unless the child has a mental or physical handicap that warrants continuation of assistance to age 21. Some families with non-handicapped children may be approved for continuance beyond their child's 18th birthday if their child is still in high school and they are a low-income family.            

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

Agreements for ongoing assistance and special services shall be reviewed every three years to age 16, then reviewed annually. Adoptive parents must cooperate in such reviews, certifying that the child is still in their care, that a subsidy is still needed, etc.

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

Adoptive parents can request a change in the adoption assistance agreement at any time.  Whenever a significant change occurs in a child’s special needs that relates to the need for which adoption assistance was granted, parents can request make a request for modification of the agreement.  Requests for changes in the adoption assistance agreement, both increases and decreases in assistance, must be in writing and have the adoptive parent(s) signature(s).  To make a request to increase adoption assistance, the adoptive family must first make use of any and all available community supports and substantiate the need for the increase.  Parents must include information detailing the community supports and agencies the family has already contacted for assistance, the results of those contacts, any school or psychological evaluations, and information from therapists, doctors or social workers working with the child and family. The written request for change must outline what is needed, an estimate of cost, what portion (if any) of the cost will be funded by community supports, what portion (if any) will be funded by the family, and what portion parents are seeking from the state. The request must also detail the estimated duration of services/costs. Requests should be sent to the Adoption Manager. Adoption assistance agreements are reviewed every three years before the child is sixteen years of age and annually after the age of sixteen. Adoption assistance will terminate under the three following conditions: the child no longer lives in the home, the family no longer supports the child, or the family no longer has care and custody of the child.

Vermont DCF Department Contacts locator: http://www.dcf.state.vt.us/fsd/districtoffices.html.

For information regarding adoption, contact the Central Office at the following address:

103 South Main Street
Waterbury, Vermont 05671-2401
phone: 802-241-2131

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

Adoptive parents can request a fair hearing any time an Agency of Human Services decision affects their child’s adoption assistance benefits. Parents are sent letters informing them of intended Agency action that will affect their child’s benefits and the letter provides information and contacts to appeal the decision through fair hearing heard by the Human Services Board. Families may contact the Adoption Chief, for information on Vermont’s fair hearing process and procedures, phone 802-241-2142.

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.

To start the process, families should contact Diane Dexter, Adoption Chief (802-241-2142) to file an application with FSD. Families should explain in the application why they did not make a request for subsidy prior to the legal finalization of the adoption. FSD will review the request and issue a response. The family would then be able to appeal a negative decision to the Human Services board. However, they must demonstrate eligibility under the federal
Title IV-E.

System Operation and Program Funding

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

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 58.93% in Vermont. This is known as the Federal Financial Participation (FFP) rate. The remaining cost of the program is funded entirely with state funds.

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

None.