Adoption
Subsidy

Virginia State Subsidy Profile

Updated July 2007

State Subsidy Contact Person

Pamela Fitzgerald Cooper
Virginia Department of Social Services (DSS)
7 North Eight St
Richmond, VA 23219
Phone: 804-726-7575
Fax: 804-726-7499
E-mail: pamela.cooper@dss.virginia.gov

NACAC Subsidy Representative (parent/volunteer)

Jennifer Klotz
Center for Adoptive Families
5750 Executive Dr, Ste 107
Baltimore, MD 21228
Office: 410-402-1121
Fax: 410-402-1122
E-mail: jklotz@adoptionstogether.org

If you are interested in becoming a Virginia 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.

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:

http://www.dss.virginia.gov/benefit/me_famis/index.html

Virginia’s adoption assistance:

http://www.dss.virginia.gov/family/ap/faq.html
(see the last paragraph) and special needs adoption: http://www.dss.virginia.gov/family/ap/special.html

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?")

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.

The child must have one or more of the following individual characteristics:

1. Physical, mental, or emotional condition existing prior to legal adoption;
2. Hereditary congenital problem or birth injury that could lead to substantial risk of future disability; (conditional subsidy only)
3. Six years of age or older;
4. Minority or mixed racial heritage;
5. Member of a sibling group that should not be separated, and that is ready for placement at the same time;
6. Significant emotional ties with foster parents with whom the child has resided at least 12 months when adoption is in the best interest of the child and when subsidy is necessary to consummate adoption with these foster parents.  [Note re: this last criteria: when it is the child’s only characteristic, it is applicable to state-funded subsidy only.]

A child in the custody of a local department of social services or a licensed child placing agency and is SSI eligible qualifies as a child with special needs.

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.

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

These rates are effective July 1, 2007, and are tied to foster care rates.

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

Virginia policy does allow for payments of specialized care, based on rates set at the local level.  This helps to ensure that the level of services needed by the child are provided to a child as the child moves from foster care to adoption.

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.

Any international child is not eligible to receive non-recurring fees through the Virginia policy. 

6. What Medicaid services are available in Virginia?

Services covered:

• Inpatient Hospital
• Outpatient Hospital
• Rural Health Clinic
• Lab and X-ray
• Nursing Facility
• EPSDT—Early and Periodic Screening, Diagnostic and Treatment Services Family Planning
• Physicians
• Clinic Services
• Dental
• Prescribed Drugs
• Prosthetic Devices
• Eyeglasses
• Rehabilitative Services
• Nurse-Midwife
• Case Management
• Hospice
• Extended Prenatal Services
• Emergency Hospital
• Intermediate Care Facility for the Mentally Retarded
• Physical Therapy and Related Services (PT, OT, speech, hearing and language)
• Other Practitioners (podiatry, optometry, clinical psychology)
• Home Health Care Nurse, Aide, Supplies and equipment, PT, OT, Speech and Audiology)
• Community Mental Health Services (case management, day treat/part. hospital, crisis intervention, intensive in-home services to children and adolescents, therapeutic day treatment for children, psychological rehabilitation)
• Community Mental Retardation Services (Case Management, Day Health and Rehabilitation)

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

Medicaid coverage is automatically provided for IV-E children. 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:

1. diagnosed physical, mental, and emotional disabilities;
2. diagnosed congenital problems and birth injuries;
3. diagnosed medical conditions that do not require immediate treatment, such as sickle-cell anemia;
4. medical or emotional conditions requiring regular medication, such as epilepsy, allergies, or attention deficit disorders;
5. severe visual and dental problems requiring non-routine medical treatment.
   

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 Board 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 in Virginia.  The DMAS coverage: http://www.dmas.virginia.gov/default.htm or http://www.dss.virginia.gov/benefit/medical_assistance.html

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 physical, mental or emotional disabilities are available.  Medicaid is used and 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 program. DSS post-adoption services include the following examples:

1. Information and referral
2. Educational training programs
3. Support groups
4. Respite Care
5. Counseling
6. Search services
7. Therapeutic intervention

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). Family and parent organizations also offer post adoption supports, such as the:

Adoptive/Kinship Parent Group of Southwestern Virginia (Roanoke): http://www.cccofvirginia.org or phone 540-344-2748

Fostering Adoptive Families (Charlottesville): http://Bethany.org or phone: 434-979-9631.

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

Virginia also 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: http://www.dss.state.va.us/family/tuitiongrant.html and http://www.vccs.cc.va.us/vccsasr/tuitiongrant/tuitiongrant.html

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:

1. medical, surgical, and dental care;
2. equipment such as prosthetics, braces, crutches, hearing aids, eyeglasses, etc.;
3. individual tutoring or remedial educational services, books, or equipment;
4. psychological and psychiatric evaluations and treatment;
5. speech, physical, and occupational therapy;
6. premiums for major medical insurance policies for a child if the child is not covered by a family policy;
7. residential placement (documentation that less restrictive alternatives have been assessed and ruled out must be maintained).

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?

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 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 (assuming that there is 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 to not receive adoption assistance benefits at that time. 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 kids 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 kids.  If the adoptive family does not want a subsidy, the State simply issues a Medicaid card 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.

Programmatic Procedures

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 (or by the participating licensed child-placing agency) in accordance with rules and regulations established by the Department.  If a case is appealed, the State Board of Social Services has final authority.

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

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?

Adoption assistance payments and benefits may begin at adoption placement.

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.  If it is determined that the child has a mental or physical handicap (or an educational delay resulting from such handicap) warranting the continuation of assistance, subsidy payments shall be made until the child reaches the age of 21.  If the adoption assistance agreement is continued, the child remains eligible for all benefits.

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.

Note: An adoption assistance agreement shall not be terminated if the child's condition improves but could deteriorate again.  In this case, the agreement shall be suspended without payment rather than terminated.
           

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: 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?

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.  Parents are asked to send a written request to regional hearing authorities.  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. 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.

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: http://www.dss.state.va.us/localagency/ and to Appeals and Fair Hearings: http://www.dss.state.va.us/geninfo/appeal.html

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.

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.

System Operation and Program Funding

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 decisions related to children's eligibility.

The federal contribution to Title IV-E-eligible children is 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.

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

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: http://www.dss.state.va.us/family/tuitiongrant.html and http://www.vccs.cc.va.us/vccsasr/tuitiongrant/tuitiongrant.html

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 contacts with several non-private providers to provide adoption competent mental health assessment and consultations for children who have been adopted.   Please contact Pamela Fitzgerald Cooper for the name of these providers at 804-726-7575 or at pamela.cooper@dss.virginia.gov.