Adoption
Subsidy

West Virginia State Subsidy Profile

Updated March 2006

State Subsidy Contact Person

Ms. B.J. Miller
Dept. of Health & Human Resources (DHHR)
Children and Adult Services
350 Capitol Street, Room 691
Charleston, WV 25301-3704
Phone: 304-558-3431
Fax: 304-558-4563
E-mail: Bobbyjmiller@wvdhhr.org

NACAC Subsidy Representative (parent/volunteer)

Mildred Mairs
Children’s Home Society of West Virginia
1145 Greenbrier St.
Charleston, WV 25311
Office: 304-345-3894 or 800-854-1544
Fax: 304-345-3899
E-mail: arcchs@childhswv.org

Patty Stern
290 Atlas St
Martinsburg, WV 25404
Phone: 304-263-9220
E-mail: kbstern@comcast.net

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.wvdhhr.org/oss/adoption/
http://www.wvdhhr.org/oss/adoption/adoption_faq.asp

West Virginia’s state-specific medical assistance:

http://www.wvdhhr.org/bms/

http://www.wvdhhr.org/bms/oMedPolicyCor/
bms_hcpc_guide_to_medicaid.htm (Your Guide to Medicaid)

http://www.wvdhhr.org/bhhf/mrddwaiver (mental retardation and developmentally delayed Medicaid services)

http://www.wvdhhr.org/mcfh/ (special medical services for populations such as birth to three or children with specialty health care needs)

West Virginia’s adoption assistance:

West Virginia’s adoption assistance:
http://www.wvdhhr.org/bcf/policy/adoption/Adoption_Policy.pdf (starting on page 109) and http://www.wvdhhr.org/oss/adoption/adoption_faq.asp (See Frequently Asked Questions, Question #19, Is financial help available for adoptive parents to care for children?)

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. Eight years of age and older and under the age of eighteen
2. Member of minority group/heritage and three years of age and older
3. Member of a sibling group of two or more children to be adopted together
4. An emotional, physical, mental or medical disability
5. Any combination of the above
6. Other, such as documented risk factor (ex. parental substance abuse while child was in utero)

Note: Children must be legally free for adoption and a dependent of the Department of Health and Human Resources in the custody of the state of West Virginia or a child welfare agency licensed to place children for adoption in West Virginia to be eligible for adoption assistance. (Title IV-E and state-funded)

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, legally free for adoption, and a dependent of the Department of Health and Human Resources in the custody of the state of West Virginia or a child welfare agency licensed to place children for adoption in West Virginia. (Title IV-E and state-funded)

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

The maximum allowable adoption assistance payment is currently $600 per month for those children adopted after July 1, 2003.   This is the same rate as the DHHR family foster care maintenance rate.  For children residing in specialized therapeutic foster care homes, the maximum allowable adoption assistance payment is comparable to the foster care maintenance payment provided by the specialized child placing agency.

Exceptional rates: $764.00 (This rate only applies to children currently eligible for the Specialized Family Care Program formally known as the Medley-at-Risk Program.

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

The specialized and exceptional rate is based primarily on the maintenance payment that is currently paid to the family caring for a child who is eligible for either the Specialized Family Care formally known as the Medley-At-Risk Program or a specialized/therapeutic foster care home rate. No other specific criteria exist. Determinations are made on a case-by-case basis, based on documentation of the child's special needs and maintenance payment.

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.

Allowable expenses include: court costs, adoption fees, attorney fees, costs of the adoptive home study (including health and psychological examinations), supervision of placement costs prior to adoption, and transportation, food, and lodging when necessary to complete the adoptive placement or the adoption finalization process.

The total combined nonrecurring expenses for all of the items listed above cannot exceed $1000 and is reimbursable after finalization upon receipt of the final decree and invoices for services rendered.

The reimbursement limit $1,000 per child.  Application and approval of nonrecurring adoption costs must be made prior to finalization.

6. What Medicaid services are available in West Virginia?

The child is eligible for all Medicaid services offered or pre-authorized in West Virginia by the Office of Medical Services.

The state contact is Barbara White, Office of Medical Services, 304-558-1718.

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

All non-IV-E West Virginia children who receive adoption assistance are eligible for Medicaid. Medicaid is also available to non-IV-E children from other states if they receive adoption assistance. Medicaid benefits are the same for all eligible children.

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

Public mental health services for children in West Virginia are administered by the Department of Health and Human Resources, Bureau for Bureau for Behavioral Health and Facilities which is divided into four divisions: Adult Mental Health, Children’s Services, Alcoholism and Drug Abuse, and Mental Retardation and Development Disabilities. Behavioral Health Services, Children’s Services include the following examples: crisis services, special outreach to schools, in-patient hospitalization, counseling, prescription medication, and innovative projects which model the best practice for serving children with serious emotional disorders and their families.

The Division of Children's Services (DCS) is located within the Department of Health and Human Resources, Bureau for Behavioral Health and Health Facilities. The address is:

350 Capitol Street, Room 350
Charleston, WV 25301-3702

or phone: 304-558-0627.

The Office of Behavioral Health Services (OBHS) : http://www.wvdhhr.org/bhhf/prof.asp.

Division for Children’s Services (DCS): http://www.wvdhhr.org/bhhf/dcs_welcome.asp and

DCS contact information: http://www.wvdhhr.org/bhhf/dcs_whoweare.asp.

For developmental disabilities information, see the OBHS Division for Developmental Disabilities: http://www.wvdhhr.org/bhhf/mrdd.asp.

Note: Not all services may be available in all cases. Contact your adoption assistance worker, adoption specialist, local mental health provider, 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?

West Virginia has a program known as Adoption Assistance Conditional Services. Funding is available for time-specified, short-term assistance to meet medical expenses not covered by Medicaid (except for therapeutic hospitalization). Need for such services must be based on conditions preexisting adoption finalization and should be included in the adoption assistance agreement. Funding can also be used for respite care and special educational needs/services not met by the Department of Education. Assistance is granted on a case-by-case basis and is subject to the availability of funds. Financial support for extraordinary needs or services is subject to the approval of the administrative management team. Contact the adoption assistance program specialist for program specifics.

Note: Not all services may be available in all cases. Contact your adoption assistance program specialist 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 West Virginia are administered by the Department of Health and Human Resources, Services, Bureau for Children and Families and contracted through private agencies or individuals who have completed post adoptive training.  Post Adoption Services include the following examples:

1. Information and referral
2. Educational programs
3. Educational materials
4. Support groups
5. Therapeutic intervention
6. Counseling
7. Emergency Respite Care (in-home/group)
8. Mediation/search services (mutual agreement network)

Post adoption services in West Virginia are referred to as Adoption Preservation Services.  All families of children receiving adoption assistance are notified by letter of the availability of post adoptive services, either at adoption finalization or upon moving into the state.  Included in the letter is a list of post adoptive service providers for families to contact their provider of choice directly.  For a list of post adoption service providers, contact your adoption assistance worker, home finder, adoption specialist or the local Bureau for Children and Families county office.  The adoptive parent may request information and/or referral from either the state office or from one of the adoption workers or homefinders in the field. County office locator: http://www.wvdhhr.org/bcf/county/ or contact state office personnel Laura Harbert or Bobby Miller, phone: 304-558-7980, address:

Children and Adult Services
350 Capitol Street, Room 691
Charleston, WV 25301-3704

Adoptive parents may also do a self-referral. The adoptive parent is provided with a list of certified providers, the counties serviced, and services offered. They may choose the one they are most comfortable with and contract them directly. The provider provides the service and contacts the Post Adoption Specialist for an approved invoice with which to bill the Department.  The following are the active providers currently providing Adoption Preservation Services:

• Burlington United Methodist Family Services
• Braley and Thompson
• Counseling and Consulting, Ltd.
• Rosey Futures Social Work Services
• WV Youth Advocate Program
• Timberline Services

See the Frequently Asked Questions: http://www.adoptawvchild.org (Question #20, Are there supports for adoptive parents?) and the Adoption Calendar for information: http://www.wvdhhr.org/oss/adoption/adoption_calendar/diary.asp.

Respite Care—Conditional Payments or Time-limited subsidies or reimbursements may be requested to cover the costs of respite care up to 48 hours per month.  Requests for conditional payments are approved on a case-by-case basis.  These payments will be revised in the near future.

Many private organizations offer a variety of respite options. See the ARCH National Respite Network Respite Locator Service, search by state to locate West Virginia’s respite programs, link: http://www.respitelocator.org/.

Adoption preservation services will soon become part of the new process for authorization of all social services in child welfare cases. The new process will be called, Socially Necessary Services, administered through the Administrative Services Organization (ASO). Socially Necessary services are interventions necessary to improve relationships and social functioning with the goal of preserving the individual’s tenure in the community or the integrity of the family or social system. Adoption Preservation Service information is not listed on the Adoption web site, however, http://www.wvdhhr.org/bcf/aso/ links Socially Necessary Services information.

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, in the initial agreement, however, later requests will be considered if funding is available and if the case record documents that the child's current needs are a result of pre-existing conditions not previously identified by the department. An addendum to the initial agreement explicitly identifying the service for which the child is eligible will be entered into.    

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

The WV Adoption Assistance Program does not pay nor contribute to the payment for residential treatment.  The family may receive such services for the child through the Medicaid program.  The residential treatment facility must be or is willing to become either be a WV Medicaid provider or a Medicaid provider in their own state in order for the child's stay and treatment to be covered through Medicaid.  The adopted child is eligible for Medicaid from WV or from the State in which the facility is located through the ICAMA program.  The family's medical practitioner is responsible for making an application through WVMI for pre-authorization for placement in an out of state or a psychiatric treatment facility.  The child must have an IEP that includes the diagnosis in order for the Department of Education to cover any out of state education cost.  If the facility is non-Medicaid, the child must come back into temporary WV DHHR custody for the family to receiveassistance in the residential cost or education cost.

The residential treatment facility and/or the medical provider must be willing to become an approved West Virginia Medicaid provider.  Payment will be made by WV Medicaid for a pre- authorized placement.  The family's state of residence must provide payment for educational services when determined necessary by the WV Board of Education.  The family may initiate services by contacting the Office of Medical Services at 304-558-1700.  Documentation of need for placement is required from the admitting licensed psychiatrist.

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

Yes, West Virginia offers deferred adoption assistance. The child must be in the custody of the Department or a licensed West Virginia Child Placing Agency and at risk of developing a special need in the future. At risk is defined as having a significant statistical or medical probability of occurrence that is not merely speculative. Several factors may be considered for the deferred determination of potential special needs when the child is healthy, developmentally on track at time of placement, appears emotionally stable, and does not seem to meet the criteria for special needs prior to adoption finalization. Factors for consideration include:

• A child with a birth family history of mental illness, mental retardation or incest
• A child who is developmentally on track but has a significant risk factor which may present itself at a later date
• A child who is displaying normal behaviors at time of placement but who has a reported history of physical or sexual abuse, and neglect, or has had multiple failed placements
• The child is a state ward
• Other

14. Does West Virginia operate a subsidized guardianship program?

Yes.  The Legal Guardianship program was established in July of 1999.  It is a program to establish permanency for children who are in the temporary or permanent custody of the department, who are 11 years old or older, for whom adoption is not the best choice, and who have formed a significant attachment with their caretaker.  The basic guidelines are similar to adoption assistance.  The maintenance payment is equivalent to the foster care maintenance payment.  The parental rights do not have to be terminated.  The amount of nonrecurring assistance cannot exceed $1,000.

Programmatic Procedures

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

Children in need of a subsidy arrangement to facilitate their adoption are identified at the local level by their individual caseworker.  Currently, decisions to accept, reject, or amend the requested benefits are made at the regional level after input from the worker, family, the family’s attorney, and sometimes the child’s Guardian Ad Litem (child’s attorney). 

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

Family income is not a determining factor. Children who receive benefits, such as SSI, RSDI, or VA, etc. may have their subsidy payments decreased by the same amount.

17. When do subsidy payments begin?

Adoption assistance payments and benefits may begin in West Virginia after adoption finalization.

The adoption assistance agreement is entered into shortly after adoption placement and establishes the payment level of assistance. During this period of trial placement of a state ward the payment is generated at that rate but the funds come from foster care.

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

Yes. These child-placing agencies are licensed for adoptive placements in West Virginia.  “Reasonable but unsuccessful efforts” to place the child without assistance must be documented.  Reasonable efforts mean (at a minimum) registering a child on the state and/or national adoption exchange and not locating an approved adoptive home.  Applications for subsidy with documentation of the child's special needs must be made and approved prior to finalization.  The child-placing agency must follow DHHR Adoption Assistance Policy and requirements for IV-E eligibility.

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

The adoption assistance is automatically terminated on the first day of the month following the child's 18th birthday. The adoptive parent may request an addendum to the initial agreement to continue the adoption assistance until the child's 21st birthday if the child is in high school or a post-secondary school. If a medical or financial subsidy continues to be needed, it may be renewed each year until the child reaches age 21 if the child has a documented physical or mental handicap. Under no circumstances shall an agreement extend beyond the child's 21st birthday.

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

The review is a self-declaration of need. The state office sends the adoptive parents a review form each year 60 days prior to the anniversary of the adoption to verify the child's need for continued subsidy and/or to report changes in the family's circumstances. Written verification of school attendance must be provided for youth 18 to 20 years old.

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

The adoptive parent may request a change in the adoption assistance agreement anytime there is a change in the circumstances of the family or the needs of the child. Such circumstances include changes in family or child resources, the special needs of the child, or the adoption assistance payment rate. Parents must submit a formal written request and provide documentation of the need for modification of the agreement. Parents can request a Conditional Service, such as tutoring, respite, or food supplement at the time of need. If the request is approved, an addendum to the initial agreement will be completed to cover a time-limited service or to extend the adoption assistance agreement until the child’s twenty-first birthday if the child is enrolled in school or disabled.

The request may be for an increase in cash assistance up to the current ceiling or it may be for a service unique to the needs of the child. Every request is considered but not all requests are approved. The Department also attempts to link the parent with an alternate resource. West Virginia has a few categories of Conditional Adoption Services that are frequently requested and have specific guidelines. Note: This eligibility process may be changing in the near future with the implementation Socially Necessary Services for all social service programs.

Please see below the criteria for frequently requested Conditional Adoption Services:

• Tutoring – The child must be a year or more behind in their age appropriate level in a subject and/or in danger of failing again; the child must have the capacity to learn; the school must be willing to identify the subject area the child needs tutoring in and be willing to work with the tutor.

• Respite – The child must require twenty-four hour, hands-on care or supervision due to a medical or behavioral diagnosed condition. A medical practitioner must write a letter stating the family is in need of respite giving the child’s diagnosis and reason the respite is needed. The doctor must also indicate the duration the family would need respite.

• Orthodontic – The child must be denied by Medicaid and provide documentation of need.

• Food Supplement – The child must have a doctor’s prescription documenting need, duration and amount needed per month. The parents must have explored all other resources.

All requests for change or services must be in writing and signed by the parent to document the type of request and date requested. Written requests can be in an informal letter with attached documentation to verify the change in need. Requests for change to the initial agreement are sent to the Adoption Assistance Program Specialist at the Division of Children and Adult Services. West Virginia does not accept requests over the phone, but will discuss the need and offer information on how to request the service or change. The type and source of substantiation of need or change is based upon the type of request. Medical needs require documentation a medical practitioner. If the need is an item normally covered by another program West Virginia must have proof of denial and appeal of the denial of the requested service before it can be considered. If it is a request for change in the cash assistance, then verification of the change in circumstances or needs must be submitted with the written letter. An administrative committee reviews extraordinary or unique requests to determine eligibility.

If the child is eligible for the requested change or service, the eligibility date is determined by the date the written request was submitted. The Adoption Assistant Program Specialist will negotiate specifics via phone and prepare an addendum to the initial adoption assistance agreement to reflect the negotiation, which is signed by all parties. If the request is denied, a letter is sent notifying the adoptive parent. Denial letters inform parents they may request a fair hearing if they do not agree with the Department’s decision. The adoptive parent is provided a grievance (fair hearing) form upon request. The adoptive parent must complete and return the form to the program specialist within ninety days of the notification of the denial. The Adoption Assistance Program Specialist will immediately submit the parent’s grievance form to the Chairman of the Board of Review who will schedule a fair hearing in the area of residence or via phone if the party resides in another state. Hearings are usually scheduled within thirty days of the request.

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

Adoptive parents can request a fair hearing whenever there is disagreement with a DHHR decision that affects their child’s adoption assistance benefits. Parents are advised of their right to a fair hearing and may request a fair hearing if they are denied or dissatisfied with any service. The adoption assistance/DHHR worker will provide a hearing request form that the parent must complete and return to the worker. Parents are initially offered a pre-hearing conference with the supervisor and the worker. If the issue not resolved at the pre-hearing conference, the completed fair hearing form is then forwarded to the Board of Review for assignment to a hearing officer. Social Service Complaints and Social Service Grievance Hearings:

http://www.wvdhhr.org/bcf/ssgrievance.asp and http://www.wvdhhr.org/oig/bor/.

The right to a fair hearing is explained verbally by the homefinders and adoption workers during the homestudy and placement process and is also on all the social service forms that the adoptive parents sign, including the adoption assistance agreement, and on any denial notification. The chairman of the board registers the grievance and then notifies the appropriate program specialist in the Division of Children and Adult Services of a request for a fair hearing. A conference is arranged to review the case to determine whether policy and procedures were appropriately applied in the situation raised by the grievance. If policy or procedure was not followed then the state concedes. If it was followed then the Chairman will assign the case to the appropriate State Hearing officer. The hearing is usually scheduled within thirty days of the request and all parties are notified at least ten days prior to the date of the hearing. The hearing will be conducted and after all information is presented the hearing officer will attempt to reconcile the differences. If no agreement is reached, the hearing officer will make a decision in the form of a summary with a cover letter within fifteen working days. An adoptive parent may make a grievance within ninety days of a perceived adverse action regarding treatment by departmental personnel, any concern related to social services received or denied, denial of cash or medical assistance or an increase thereof, or denial of a post-finalization application for adoption assistance.

The initial fair hearing request is sent to the staff person whose decision resulted in the adoptive parent’s dissatisfaction. The staff person and their supervisor review the situation with the parent to resolve the problem. If no solution is achieved the supervisor will assist the parent in completing the grievance form. The form is submitted immediately to the Chairman of the Board of Review. Parents may also submit this form themselves or may make a complaint in the form of a letter to the Chairman of the Board of Review. The Supervisor must submit a grievance form after the grievance is assigned to a hearing officer. Parents must call or write their social service adoption worker, their supervisor, or contact the Board of Review directly to request a fair hearing. The Department must receive the hearing request within ninety days of the mailing date of the notice of action being protested. The Board of Review will send the parent a notice giving the date, time, and place of the hearing after the request for a hearing is received. This notice will be sent at least ten days before the hearing. The notice also explain to parents what to do if they cannot come to the hearing as scheduled. Parents may bring witnesses, friends, relatives, or a lawyer to assist in the presentation of their case. Everyone presenting testimony will be sworn in. The hearing officer will record the hearing and listen to both sides but will not make a decision at the hearing. Instead, parents will receive a written decision and transcript in the mail, issued by the hearing officer within fifteen days of the hearing. If a parent disagrees with the hearing decision, the written decision will explain how to contest the decision through an appeal.

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.

Under most circumstances, a post-finalization subsidy is unavailable. State law requires approval of the agreement prior to finalization.  However, if the family has adopted a child in the custody of DHHR or a licensed child placing agency and feels that they were not informed of the child's potential eligibility for adoption assistance, were refused, or denied an application in error or based on extenuating circumstances, the family can appeal. 

System Operation and Program Funding

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

The program is state supervised/state administered.

County Level—Determines child's eligibility, recommends amount of financial and medical assistance, reviews initial agreement with family, and provides some post-legal services.

Regional Level—Reviews all applications for approval; prepares the adoption assistance agreement and consent.

State Level—Obtains authorization for payment, generates monthly assistance and medical cards, approves applications for and payment of nonrecurring expenses, conducts yearly reviews, provides information and referral, and provides training and technical assistance to local staff.

The federal contribution to Title IV-E-eligible children is 72.82% in West Virginia. This is known as the Federal Financial Participation (FFP) rate. The remaining cost of the program is funded entirely with state funds.

The Adoption Assistance program for the non-IV-E-eligible children and the Legal Guardianship Program are funded entirely by state funds.

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

West Virginia has a tuition waiver program available. It is limited to children residing in a foster care setting when they graduate from high school, starting with the graduating class of 2000.  It is available in state-supported colleges only. The application can be obtained from the college of choice.