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Virginia State Subsidy Profile Updated September 2009 State Subsidy Contact Person Pamela Fitzgerald Cooper NACAC Subsidy Representative (parent/volunteer) Kathy B. Sauter 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.dss.virginia.gov/family/ap/index.html Virginia’s state-specific medical assistance: Virginia’s adoption assistance: http://www.dss.virginia.gov/family/ap/faq.html Code of Virginia, Title 63.2, Chapter 13 Adoption Assistance for Children with Special Needs, §63.2-1300 through §63.2-1304 Virginia Administrative Code 22VAC40-260-10 Definitions and 22VAC40-260-20 Subsidy Virginia Department of Social Services Adoption Agency Placement Manual, Section 8 Subsidy
The child must be under 18 years of age, in the custody of a local department of social services or a licensed child placing agency at the time the petition for adoption is filed, legally free for adoption through termination of all parental rights and placed by the agency with the prospective adoptive family for the purpose of adoption. One exception to the criteria for a child to be in agency custody and placed by the agency with prospective adoptive family is when a foster parent with whom the child has resided for 18 months files a petition for adoption. The child must still meet the definition of a child with special needs. The child must have one or more of the following individual characteristics:
A child eligible for SSI at the time the adoption petition is initiated is eligible for adoption assistance as a child with special need. An adoption assistance agreement must be in effect before the adoption is finalized. This child does not have to be in the custody of a public or private agency at the time of application for 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 child with special needs as defined above and be in the custody of a public or private child placing agency. 3. The maximum basic monthly adoption assistance maintenance payment is:
Virginia has established a rate structure process that will go into effect October 1, 2009. The rate structuring process will identify the behavior, mental, physical needs of the child and determine the additional daily supervision or enhance maintenance payment that will be provided to a family on behalf of a child. 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 shall include: (a) reasonable and necessary fees of adoption agencies; (b) transportation and other expenses incurred by adoptive parents related to the placement of the child (expenses may be paid for more than one visit); (c) court costs related to filing an adoption petition; (d) attorney fees directly related to finalizing the adoption. A bill or receipt shall be submitted before payment can be made. The agency shall not be responsible for bills or receipts submitted later than six months after the end of the month in which the expense was incurred. The reimbursement limit is up to $2,000 per child per placement. A child adopted from another country is not eligible to receive adoption assistance or non-recurring fees. 6. What Medicaid services are available in Virginia? Services covered:
For more information on Medicaid, contact the county adoption worker or unit from which your adoption assistance agreement originated. 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 Virginia. Below is information on the Medicaid benefits available for state-funded children. Medicaid coverage is automatically provided for IV-E children with an adoption assistance agreement in effect. Medicaid may be continued after adoption for children receiving state-funded subsidies when, at the time of placement, the child possesses certain medical or rehabilitative conditions for which s/he is receiving treatment. These conditions include, but are not limited to:
8. What mental health services are provided by your State? Public mental health services for children in Virginia are administered through the Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services through 40 Community Services Boards across the state. Services are covered through a family sliding fee, insurance, Medicaid, or a state funded special services program. For eligible children, Medicaid provides community mental health services such as case management, day treatment/partial hospital, crisis intervention, intensive in-home services to children and adolescents, therapeutic day treatment for children, and psychological rehabilitation for eligible children. Medicaid services are provided through the Department of Medical Assistance Services (DMAS) in Virginia. The DMAS coverage link: http://www.dmas.virginia.gov/default.htm 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? Any medical service needed by the child as a result of the child’s special need (physical, mental or emotional disabilities) are available. The family insurance and/or Medicaid is used first and then any additional health needs are covered through Special Service Payments funded by the state. Funds are available for special services that are unavailable through the family’s private insurance or through an alternate resource. Services include the following examples: medical care, physical equipment, remedial educational services, psychological and psychiatric evaluations and treatment, and residential treatment. Receipts for services must be submitted for payment to local DSS agency within six months of the end of the month services were received. 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 Virginia are administered by the Department of Social Services through the Adoptive Family Preservation Services (AFP) program. This program is administered through a contract with United Methodist Family Services and may include the following post-adoption services:
For post adoption services, parents are directed to first contact the Adoptive Preservation Services Program’s Intake and Assessment Team at 888-821-HOPE (4673). Many private organizations offer a variety of respite options. See the ARCH National Respite Network Respite Locator Service, search by state to locate Virginia’s respite programs, link: http://www.respitelocator.org Special Service Payments—Payments to provide special services to a child which the adoptive parents cannot afford and which are not covered by insurance or otherwise, including, but not limited to:
Payments for special services are negotiated with the adoptive parents taking into consideration alternative resources available to defray costs involved. The agency shall not be responsible for bills or receipts submitted later than six months after the end of the month in which the service was rendered. 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? No. Post Adoption services provided by the AFP program, medical or mental health services provided by Medicaid or mental health services provided by the Community Services Boards (CSB) do not have to be included in the adoption assistance agreement, if these services are provided to other citizens without cost. Medical and mental health services that are not covered by Medicaid must be included in the adoption assistance agreement to receive payment or reimbursement. 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 costs may be covered under Medicaid when the eligible child meets the medical necessity criteria of Medicaid and/or under the “Special Service Payments” program (with documentation that less restrictive alternatives have been assessed and ruled out). 13. A deferred adoption assistance agreement is one in which the initial monthly maintenance amount is $0. Does Virginia offer such agreements? Yes, Virginia offers deferred adoption assistance. Virginia refers to these agreements as “conditional agreements.” This means the child meets Virginia’s definition of special needs, but the adoptive parents have chosen not to receive adoption assistance benefits at the time of the agreement. The conditional agreement allows the family to apply in the future for either Title IV-E adoption assistance or state adoption assistance at any time before the child reaches eighteen years of age. Conditional agreements shall be used for non-IV-E children when services are not needed or wanted at the time of placement, but may be needed later. Conditional agreements allow the adoptive parents to apply for a state-funded subsidy after the final order of adoption according to the documentation of the condition. Conditional subsidy agreements do not require annual certification. Conditional agreements are not necessary for IV-E children. If the adoptive family does not want a subsidy, the State issues a Medicaid card with an effective adoption assistance agreement for their adoptive child. The family can choose to use or not use the card; this essentially functions as a deferred agreement. The family can come back later for subsidy if needs arise. 14. Does Virginia operate a subsidized guardianship program? Not at the present time.
15. Who makes the final determination of a child's subsidy eligibility in Virginia? What roles, if any, do workers and administrators at the county, district, or regional level play in eligibility determination and/or assistance negotiation? Qualification for subsidy payments shall be determined by the local board in accordance with rules and regulations established by the Department. If a case is appealed, it is brought to the Hearing Authority in the State Department of Social Services. 16. Will Virginia consider my family income to determine my child's eligibility for an adoption subsidy? Income of the adoptive parents is not to be considered in determining eligibility for subsidy. However, family income (and expenses) is considered in determining the amount and type of payment. There are no formal income guidelines. 17. When do subsidy payments begin? For children in custody of a local department or private child placing agency, the adoption assistance payments and benefits may begin at adoption placement with an effective adoption assistance agreement. 18. Do children adopted from private agencies in Virginia receive the same subsidies as those children adopted from public agencies? Yes, if the child meets all eligibility criteria. 19. When my child turns 18, which benefits, if any, are available to our family? Subsidy payments shall cease when the child reaches age 18, unless it is determined that the child has a mental or physical handicap, or an educational delay resulting from such handicap warranting the continuation. These payments may continue until the child reaches age 21 or finish high school according to the adoption assistance agreement. 20. A child's adoption assistance agreement may be periodically reviewed by the state. What is the typical process used in Virginia? Adoptive parents shall submit annually to the local board within 30 days of the anniversary date of the approved agreement an affidavit which certifies that the child's condition (requiring subsidy) continues to exist. The agency is responsible for sending a letter to the adoptive parent(s) two months prior to the anniversary date informing them that the affidavit is due. The adoptive parent may request a review of the agreement at any time to meet the child’s special needs. Note: An adoption assistance agreement shall not be terminated if the child's condition improves but could deteriorate again. The adoptive parent must agree with the termination. 21. Can adoption assistance agreements be modified if requested by adoptive parents? An adoptive parent can request a change in the adoption assistance agreement whenever there are changes in the condition of the child or the circumstances of the adoptive parents. To request a change, the family is directed to contact the agency that is a party to the agreement. Virginia’s Department of Social Services (DSS) local offices link: http://www.dss.state.va.us/localagency/. DSS link to Appeals and Fair Hearings: http://www.dss.state.va.us/geninfo/appeal.html, http://www.dss.virginia.gov/division/appeals/ and http://www.dss.virginia.gov/appeals/bp.html 22. What are the exact steps a family must go through to access the fair hearing/appeal process in Virginia? Appeal procedures proceed in four steps: (1) conference with local agency; (2) review by state hearings officer; (3) review by the Appeals Review Panel; and (4) circuit court. You can read policy on the appeal process in the Virginia Department of Social Services Adoption Agency Placement Manual, Section 9 Appeals: http://www.dss.virginia.gov/files/division/dfs/ap/manual/effective_07-2009/Chapterc2009section9.pdf Adoptive parents can request a fair hearing at any time they believe the local DSS agency has taken inappropriate action in the application of a policy or law. First they should contact their local agency to request a formal conference. Based on the result of that conference, if the family still feels that the local agency has made a decision that they are not satisfied with, then they should send a written request to: Appeals and Fair Hearing Unit Parents are assigned an impartial hearing officer who will review the case, hear their concerns, and make a decision in the matter. Hearing officers are located in the Richmond Central Office, four regional offices (Virginia Beach, Warrenton, Roanoke, Abingdon), and the Lynchburg Child Support Enforcement District Office. Cases are assigned cases by one of the three appeal categories: child support, benefits and services (including adoption assistance), and child protective services. For more information concerning the appeal of a specific local agency decision, contact the local office of the Virginia Department of Social Services. Local offices are listed in the Government Listings in the phone book under "Social Services." DSS local office locator link: http://www.dss.state.va.us/localagency/ and link to Appeals and Fair Hearings: http://www.dss.state.va.us/geninfo/appeal.html 23. Families may request an adoption subsidy after the finalization of an adoption under certain circumstances. Below is the process by which families access a subsidy after finalization. An application for adoption assistance shall be submitted with a written diagnosis that is not older than 12 months. The family may apply for a state subsidy only. Children for whom subsidy application are made after finalization of adoption are not eligible for Medicaid, unless the family income is eligible for Medicaid. Families should contact Pamela Fitzgerald Cooper (804) 726-7575 at the Department of Social Services for more information.
24. How is the subsidy program operated and funded in Virginia? The program is state supervised/locally administered. This means that personnel at the state office are responsible for making policy decisions regarding the adoption assistance program, and provide guidance to local offices. The local offices make all decisions related to children's eligibility and negotiates the payments and services with the adoptive parent. The federal contribution to Title IV-E-eligible children is generally about 50.00% in Virginia. This is known as the Federal Financial Participation (FFP) rate. The remaining cost of the program is funded entirely with state general funds. Children not eligible for Title IV-E funds are financed 100% by state general funds. 25. Below are other programs that may differentiate Virginia's adoption assistance program from others around the country. The Adoptive Family Preservation Services Program in Virginia provides family support and family stabilization services to families. Please contact the 1-888-821-HOPE (4673). Virginia contracts with a private provider to provide adoption competent mental health assessment and consultations for children who have been adopted. Please contact Pamela Fitzgerald Cooper for the name of this provider at 804-726-7575 or at pamela.cooper@dss.virginia.gov. Virginia offers a Tuition Grant Program for Foster Care and Special Needs Adoption Recipients. This tuition grant program provides tuition and fees at any Virginia community college for high school graduates or general education development (GED) completers who were in foster care in the custody of a social services agency or were considered a special needs adoption at the time of graduation or GED completion. For eligibility and application information on the Tuition Grant Program, link: http://www.dss.virginia.gov/family/fc/community_college.html and http://www.dss.virginia.gov/family/fc/education_training.cgi The Virginia ETV Program—You may be eligible for funding of up to $5,000 per year while you are in college or a vocational or technical training program! You may qualify if:
To find out more about the specific eligibility requirements for your state, contact your caseworker or:
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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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