Updated June 2020

Below you can find information about the adoption assistance benefits that may be available to families who adopt children from foster care in Iowa. Adoption subsidy policies and practices are, for the most part, dependent on the state where the child was in foster care before the adoption.

State Contact

Laura Leise
Department of Human Services (DHS)
1305 East Walnut
Hoover Bldg., 5th floor
Des Moines, IA 50319

NACAC Volunteer

Rick and Jean Hess
OURS Thru Adoption
Davenport, IA 52803

What Is Adoption Subsidy?

Parents who are thinking about or are in the process of adopting a child with special needs from foster care should know about adoption assistance (also known as adoption subsidy). Federal (Title IV-E) and state (often called non-IV-E) adoption assistance programs are designed to help parents meet their adopted children’s varied, and often costly, needs. Children can qualify for federal adoption assistance or state assistance, depending on the child’s history. Adoption subsidy policies and practices are, for the most part, dependent on the state in which the child was in foster care before the adoption.

Below is information related to definitions of special needs, benefits available, and procedures in Iowa. 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. Profiles for other states’ subsidy programs are available. If you have additional questions, please contact NACAC at 651-644-3036, 800-470-6665, or 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.

For more information on Title IV-E eligibility, view our fact sheet Eligibility and Benefits for Federal Adoption Assistance.

Adoption resources on the web:

Iowa’s state-specific medical assistance information:

Iowa statutes §600.17-600.23:

Iowa administrative code 441–201:

Who is Eligible for Adoption Assistance or Subsidy?

1. How does Iowa define special needs to determine eligibility?

A child with special needs is a child who has at least one of the following needs or circumstances that may be a barrier to placement or adoption without financial assistance:

  • Any child five years of age or older
  • Member of a sibling group of three or more children placed in the same adoptive home
  • Medically diagnosed disability that substantially limits one of more major life activity, requires professional treatment, assistance in self-care, or the purchase of special equipment
  • Diagnosed by a qualified mental health professional to have a psychiatric condition that impairs the child’s mental, intellectual, or social functioning, and for which the child requires professional services
  • Diagnosed by a qualified mental health professional to have a behavioral or emotional disorder characterized by situationally inappropriate behavior that deviates substantially from behavior appropriate to the child’s age or significantly interferes with child’s intellectual social and personal adjustment
  • Determined to be intellectually disabled by a qualified professional.

Children must be legally free for adoption, in the guardianship of the state of Iowa, a county, or a child-placing agency licensed by the state immediately prior to adoption to be eligible for adoption assistance.

2. Does the state-only funded adoption assistance program differ in any way from the Title IV-E program?


3. Are children adopted from private agencies in Iowa eligible for adoption assistance?

Yes. Private agencies must provide documentation of eligibility to the Department of Human Services (DHS).

What Supports and Services Are Available?

Monthly Payments

4. What is the maximum basic daily adoption assistance maintenance payment in Iowa?

Rates effective July 1, 2013:

Age Daily Rate
0-5 $16.78
6-11 $17.45
12-15 $19.10
16+ $19.35

The subsidy payment amount is negotiated between the family and the DHS adoption worker, based on the needs of the child and the family’s ability to meet these needs. When funds are available, adoption assistance rates are maintained at 65 percent of the USDA estimate of the cost of raising a child in the Midwest.

5. Does Iowa provide specialized rates (based on the extraordinary needs of the child or the additional parenting skill needed to raise the child)?

Children specifically defined as having physical, mental, or emotional problems are eligible for a special monthly maintenance allowance both in foster care and in adoption assistance. The specialized adoption assistance rate is determined while the child is in foster care based on the completion of a behavioral needs assessment. This additional payment must be authorized while the child is in foster care before the adoptive placement. Families may request a review of the adoption subsidy rate if there is a substantial change in the family’s or child’s circumstances.

The three levels, established based on the behavioral needs assessment, are:

  • Level 1 — an additional payment of $4.81 per day
  • Level 2 — an additional payment of $9.62 per day
  • Level 3 — an additional payment of $14.44 per day

In addition, families who adopt a sibling group of three or more may receive a one-time payment of up to $500 to help with transition expenses.

6. When do adoption assistance payments begin?

Adoption assistance payments and benefits may begin when the Adoption Placement Agreement and the Adoption Subsidy Agreement are completed and signed by all parties.

7. When a child turns 18, which benefits, if any, continue?

Adoption assistance payments and special services typically continue until a child reaches age 18, but can be extended to 21 for those youth with a diagnosed physical or mental disability. The subsidy agreement shall be reviewed when the child reaches the age of 17.5 years to determine whether the child is eligible to receive a subsidy through age 21 due to the child’s physical or mental disability. The child’s disability must be diagnosed by a physician, a qualified mental health professional, or a qualified intellectual disability professional. The diagnoses must be completed within one year before the child’s 18th birthday. A child must be a dependent of the family to be eligible to receive assistance.

8. Does Iowa offer deferred adoption assistance agreements (agreements where initial monthly maintenance amount is $0 for children at risk of developing special needs later)?

Yes. When a child is eligible for adoption assistance, but assistance is not immediately needed by the child or family or when the child is at risk of being determined a child with special needs and assistance may be needed in the future, an Agreement to Future Subsidy (Form 470-0762) can be completed. The adoptive family should also keep a copy of the Agreement to Future Subsidy and a copy of the adoption petition and decree. These documents will be used by DHS as the basis for initiating the application for adoption assistance and negotiating an Adoption Subsidy Agreement in the future. For deferred adoption assistance, the adoption petition must contain language indicating that the child is at risk of developing problems in the future and the adoptive parents desire financial assistance when the need arises. Children with an Agreement to Future Subsidy are eligible for Medicaid.

Medical Care

9. What Medicaid services are available in Iowa?

A child that is eligible for adoption assistance is also eligible for Medicaid. For more information on covered services, parents should contact member services at 800-338-8366 or https://dhs.iowa.gov/ime/members.

10. What medical benefits are available for state-funded children? (Children who have federally funded/Title IV-E adoption assistance are automatically eligible for Medicaid benefits.)

DHS provides Medicaid to all children in adoptive placements for whom the state has financial responsibility, whether they are IV-E eligible or not. Non-IV-E-eligible children who move to Iowa from other states may also be eligible under another Medicaid coverage policy.

11. What mental health services are available?

Mental health services for children in Iowa are administered through the DHS Division of Mental Health and Developmental Disabilities and may include inpatient hospitalization, outpatient hospitalization, prescription drugs, intermediate care facilities, clinics, psychologists, community mental health centers, genetic consultation clinics, day treatment, partial hospitalization, Area Education Agencies, Psychiatric Medical Institutions for Children, rehabilitative services for children, and Home & Community Based Services through waivers.

For more information on available services, visit http://www.dhs.state.ia.us/mhdd.

Not all services may be available in all cases. Parents should contact their adoption assistance worker or medical assistance specialist for information regarding process, eligibility, availability, and duration of services.

Other Benefits

12. In Iowa, what nonrecurring adoption expenses directly related to the finalization of an adoption may be reimbursed?

Adoptive parents may be reimbursed up to $500 per child for reasonable and necessary adoption fees, court costs, attorney fees and other expenses that are directly related to the legal adoption of a special needs child. The family may also be reimbursed up to $2,000 per child for pre-placement expenses. .

13. Is child care available? If yes, who is eligible and how do families access child care?


14. Is respite care available? If yes, who is eligible and how do families access respite care?

Adopted children and their families can receive five days of respite care per year. The Respite Program is administered by the Four Oaks and Lutheran Services of Iowa, find more information on this web page https://iowafosterandadoption.org/adoption-respite/

In addition, many private organizations offer respite care. The ARCH National Respite Network Respite Locator Service lists these programs at http://archrespite.org/respitelocator (then search by state).

Not all services may be available in all cases. Parents should contact their adoption subsidy worker or post-adoption services specialist for information regarding process, eligibility, availability, and duration of services.

15. Is residential treatment available? If yes, who is eligible and how do families access residential treatment services?

Inpatient residential treatment costs are not covered by the adoption assistance program. However, adoptive families may receive these services through the state’s foster care program. The child must be placed in state custody and under the jurisdiction of the juvenile court to receive residential treatment services.

16. What other post-adoption services are available in Iowa and how do families find out more about them?

Iowa provides additional finances or services for medical or therapeutic needs not covered under the state’s medical plan. This is called a special services subsidy and must be negotiated in the Adoption Subsidy Agreement. If a child’s needs or the family’s circumstances change, the family can seek to have these services added to the agreement (see question 21 about modifying the agreement). A family must use its medical insurance, Medicaid, or any free services before the subsidy funds are expended.

Adoptive families of children who receive adoption assistance can be reimbursed for the following:

  • outpatient counseling or therapy services not covered by the Medicaid program
  • medical services not covered by the Medicaid program, limited to additional health insurance premium amounts (due to a child’s special needs) necessary to include the child in the family’s coverage plan
  • medical transportation not covered by Medicaid and the family’s lodging and meals, if necessary, when the child is receiving specialized care or the child and family are required to stay overnight as part of a treatment plan
  • supplies and equipment as required by the child’s special needs and unavailable through other resources
  • funeral benefits at the rate allowed for a foster child.

Any single special service and any special service delivered over a 12-month period costing $500 or more requires prior approval from the adoption program manager before program funds are dispersed. Eligibility is based on the child’s special needs. Such subsidies can be provided for an eligible child even in cases where a maintenance subsidy is not needed.

Post-adoption services are provided to families who are eligible for or who receive adoption assistance. Services are provided by Iowa KidsNet, the statewide contractor for the recruitment and retention of foster/adoptive families. Services are provided in the family’s home at no cost to the family. Services may include:

  • Crisis intervention
  • Assistance in managing difficult behaviors
  • Advocacy with the school, services providers and DHS
  • Information and referral to community resources
  • Connections to other adoptive families
  • Support groups

Four Oaks and Lutheran Services of Iowa provide post adoption support.  Sign up for services on this web page, https://iowafosterandadoption.org/sign-up-for-post-adoption-support/

Iowa Foster and Adoptive Parent Association has resources for adoptive families, http://ifapa.org/.

Other programs in the state may also be of use to adoptive parents. Parents and children will need to meet each program’s specific eligibility requirements:

  • Early Periodic Screening, Diagnosis and Treatment (EPDST) is a federally funded program for children eligible for Medicaid. In Iowa the program is called EPSDT Care for Kids and families can obtain information by calling 800-369-2229.
  • Early Access is a program for an infant or toddler under the age of three who has a condition or disability that is known to have a high probability of later delays if early intervention services are not provided and the child is already experiencing a 25 percent delay in one or more areas of growth and development. Information is available at 800-779-2001) or http://educateiowa.gov/index.php?option=com_content&task=view&id=633&Itemid=597
  • The Home and Community Based Services (HCBS) Program is a waiver to Iowa’s Medicaid program. Services are provided to help people remain in their own homes or communities who would otherwise require care in medical institutions. Information can be obtained by contacting DHS at 800-338-8366 or visiting https://dhs.iowa.gov/ime/members/medicaid-a-to-z/hcbs
  • Community Mental Health Centers (CMHS) are available throughout Iowa and may be accredited to provide evaluation, outpatient treatment, day treatment, partial hospitalization, intensive outpatient treatment, emergency treatment, psychiatric rehabilitation, or support community living. For a list of accredited Mental Health Centers, call 515-281-5994.
  • Family-Centered Services are provided by DHS to address the needs and problems of children within the context of their families. Services are provided in the home and are available for children at risk for out-of home placement due to emotional or behavioral problems. Families may access these services by contacting their local DHS office, which can be found by calling 800-972-2017 or visiting http://dhs.iowa.gov/dhs_office_locator

17. If the assistance listed above in questions 13 to 16 are for specific services, must these services be explicitly identified in the adoption subsidy agreement?

Only special services must be identified in the adoption subsidy agreement.

What Should Families Know About Applying for Subsidy?

18. Who initiates the adoption assistance agreement?

The DHS adoption worker and supervisor determine whether a child is eligible for subsidy.

19. Who makes the final determination on an adoption assistance agreement?

DHS administrators make the final decision on adoption assistance benefits within 30 days of application.

20. How do families request adoption assistance after finalization of an adoption?

Families can apply for adoption assistance at the time of the adoptive placement or at any time before adoption finalization. After finalization, a family can request an administrative review to determine if: (1) facts determining the child’s eligibility were not presented before the adoption was finalized, or (2) the child enters the county, is adopted, and meets the criteria of special needs. If these conditions exist, the family may begin receiving adoption assistance benefits or payment for nonrecurring adoption expenses using state funds only.

To start the process, families may contact the adoption unit in the family’s area of residence, which can be found by calling 800-972-2017 or visiting http://dhs.iowa.gov/dhs_office_locator

How Can a Family Adjust an Adoption Assistance Agreement?

21. Can adoptive parents ask to change an adoption assistance agreement?

An adoptive parent can request a change in an adoption assistance agreement whenever the child’s needs or the family’s circumstances change. To initiate a change in the agreement, the adoptive parent should contact, in writing or by phone, the adoption unit in their DHS Area Office. To find a local office, see the phone number and link under question 20.

There is no established format for the change request. The DHS worker who responds to the family will specify what documentation is needed to support the change in order to make a determination regarding the request. The family will be provided with the decision regarding the request via the Adoption Notice of Decision, Form 470-0745. If the family disagrees with the decision, they can follow the instructions in the Notice to seek a fair hearing (see more information in question 22).

22. What steps does a family go through to appeal an adoption assistance decision in Iowa?

Adoptive parents can request an appeal (called a fair hearing) whenever they are dissatisfied with any action or failure to act with regard to an application for adoption services, services that the family is receiving, or because such assistance has been denied, reduced, or terminated. The request for fair hearing must be submitted in writing to the DHS Appeals Unit. Families can submit the request electronically via the DHS website https://dhs.iowa.gov/dhs_office_locator or by mailing the request to:

Appeals Unit
Hoover State Office Building
1305 E. Walnut,
Des Moines, IA 50319

There is no specified format required for the appeal request letter, but it must be filed within 30 calendar days of the decision or before the Adoption Notice of Decision’s effective date, whichever is later.

A family may obtain assistance in formulating the appeal request from the local DHS office. DHS will determine whether an appeal may be granted a hearing. If a hearing is not granted, the family will be notified in writing of the reason and the procedures for challenging that decision.

If an appeal hearing is granted, the adoptive family will be notified of the time and place. At the hearing, the parents (or a representative) may explain their disagreement. A family may choose to hire an attorney at their own expense. Families may also contact the Legal Services Corporation of Iowa, at 800-532-1275. If parents have questions about the process, they can call DHS collect at 515-281-8774 or 515-281-3094.

See question 20 for how to find the local DHS office.

What Else do Families Need to Know?

23. How is the adoption assistance program operated and funded in Iowa?

The program is state supervised and state administered. Adoption staff are located in county offices across the state. This means that both policy and eligibility decisions are made by personnel at the state office.

The subsidy program is funded with state and federal funds (IV-E). The federal contribution to Title IV-E-eligible children (known as the Federal Financial Participation or FFP rate) is 57.93 percent in Iowa. The remaining cost of the program is funded with state funds.

24. Does Iowa operate a subsidized guardianship program?

Iowa does not currently operate a subsidized guardianship program.

25. Does Iowa offer a tuition waiver program?

Through Iowa’s Education Training Voucher Program, adopted youth may be eligible for funding of up to $5,000 per year while in college or a vocational or technical training program if they:

  • are 18, 19 or 20 years old,
  • are a U.S. citizen or qualified non-citizen,
  • were in foster care as a teenager or were adopted from foster care with adoption finalization after their 16th birthday, and
  • have been accepted into or are enrolled in a degree, certificate or other program at a college, university, technical or vocational school and you show progress towards that degree or certificate.

More information is available from the adoption worker or from:

Tonia Smith, ETV Coordinator
Iowa College Student Aid Commission
Dept. of Human Services – Adult, Children & Family Services
1305 E. Walnut Street
Des Moines, IA 50319-0114

26. Does Iowa offer a state adoption tax credit?


27. Does Iowa have any program to support an adoptee whose adoptive parents die until the child is adopted again?


28. What is the payment schedule for adoption assistance? Who do I contact if I haven’t received my payment? Can I receive my adoption assistance through direct deposit?

DHS staff must be approved by staff and they are able to do that by the first of the month. Usually checks are mailed out by the 5th of the month, and direct deposit payments are completed by the 9th of the month. Holidays and weekends can alter the specific date in a month.  Iowa Foster and Adoptive Parent Association has a schedule for payments here http://ifapa.org/resources/documents/DHSDatePaymentTable.pdf

If a family is having an issue with their payment or wish to set up direct deposit, they should contact their subsidy worker. If they are not sure who their subsidy worker is, they should contact their local DHS office or contact Laura Leise at 515-281-8799 or lleise@dhs.state.ia.us.

29. What else differentiates Iowa’s adoption assistance program from others around the country?

Three items distinguish Iowa’s adoption assistance program from other state’s programs:

  • The special services subsidy (question 16)
  • The one-time payment for sibling groups of three or more (question 5)
  • Families can be reimbursed up to $2,000 per family for transportation, lodging, or per diem related to preplacement visits (question 12)

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