Updated August 2019

Below you can find information about the adoption assistance benefits that may be available to families who adopt children from foster care in Nebraska. 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

Olivia Biggs
Department of Health and Human Services
301 Centennial Mall South
Lincoln, NE 68509

NACAC Volunteer

Felicia Nelsen
Nebraska Foster & Adoptive Parent Association
Lincoln, NE 68521
402-476-2273 or 877-257-0176

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 Nebraska. 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 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:

Nebraska’s state-specific medical assistance links:

Nebraska’s adoption assistance links:

Nebraska Revised Statute 43-117 to 43-118.1:

Who is Eligible for Adoption Assistance or Subsidy?

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

A child with special needs is defined as a child who meets all three of the criteria below:

  1. The child cannot or should not be returned to the home of his or her parents,
  2. The child cannot be placed for adoption without assistance because of one or more of the following factors:
    1. Is over the age of seven (if age is the only criteria)
    2. Is a member of a sibling group of three or more children to be placed together
    3. Has a behavioral, emotional, physical, or mental disability
  3. Reasonable but unsuccessful efforts were made to place the child with appropriate adoptive parents without providing adoption assistance. This criteria is not required when such placement would not be in the child’s best interest.

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

To be eligible for state-funded adoption assistance, a child must meet the special needs definition above, be legally free for adoption, and be a ward of Nebraska in the custody of the Department of Health and Human Services at the time the adoption petition is filed.

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

Yes, but only for federal Title IV-E assistance. Children adopted from private agencies are not eligible for state-only adoption assistance. For wards of private agencies, private agency workers complete all necessary forms and send them to the central office adoption specialist rather than the subsidies being processed through local office staff.

What Supports and Services Are Available?

Assistance can include Medicaid, Social Service Block Grant services, and monthly maintenance payments designed to meet the child’s day-to-day needs. The monthly payment must be less than the amount the child would have received if the child was in foster care through DHHS at the time of the adoption subsidy agreement was signed.

Monthly Payments

4. What is the maximum basic monthly adoption assistance maintenance payment in Nebraska?

The monthly adoption assistance payment is determined through use of the Nebraska Caregiver Responsibilities (NCR) form, which takes into account the child’s age, needs and caregiver’s responsibilities. The amount must be less than the payment would be if the child had remained in foster care, even if just $0.10 per day less.

NCR Rates – Effective July 1, 2014
NCR Points 0-5 years old 6-11 years old 12+ years old
3 $20/day $27.50/day $35/day
4-5 $23/day $30.50/day $38/day
6-9 $25/day $32.50/day $40/day

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

The NRC form identifies any of the child’s special needs that require extra work or effort by the caregiver. There are 8 “Life of Child” categories and each has a level of care from L1–basic foster care, to L2–increased involvement, to L3–Highest level of responsibility. Each level is assigned points and some Life of Child categories are weighted higher than others. Each category has a box at the bottom for the caregiver to describe their responsibilities in meeting the child’s needs as identified by selecting L2 to L3 levels of care. Caregivers don’t have to provide the descriptions of care for L1 levels of care. When totaled, the points, in combination with the child’s age, determine the amount of the payment. The NCR form is usually completed by the child’s foster care workers.

6. When do adoption assistance payments begin?

Adoption assistance payments and benefits begin after adoption finalization.

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

A child who is covered by federal adoption assistance is eligible to continue receiving assistance until age 19 if any of the following criteria are met:

  1. The child is completing secondary education or a program leading to an equivalent credential.
  2. The child is enrolled in an institution that provides post-secondary or vocational education.
  3. The child is participating in a program or activity designed to promote, or remove barriers to, employment.
  4. The child is employed for at least 80 hours per month.
  5. The child is incapable of doing any of the above activities due to a medical condition.

If the child does not meet the criteria for continuation of federal adoption assistance and the parents are legally responsible and financially supporting the child, the adoption assistance will be funded by the state from age 18 to age 19.

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


Medical Care

9. What Medicaid services are available in Nebraska?

You may contact Olivia Biggs (contact information listed at the top of this profile) can provide information about and help accessing information regarding Nebraska Medicaid coverage. For more information about Medicaid services visit http://dhhs.ne.gov/Pages/Medicaid-Services.aspx.

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.)

Children who receive state-funded adoption assistance may also medical services through Nebraska Medicaid. To be eligible for Special Needs Medicaid, the child must have a special needs that has both a current and on-going treatment plan that has been verified by a medical doctor. If approved the child will receive Nebraska Medicaid. If the child is denied eligibility for Special Needs Medicaid, the parent(s) can apply for Nebraska Medicaid based on their income and assets. If they are still ineligible for Nebraska Medicaid based on family income and assets, they must seek medical insurance through the private market.

If a child lives outside of Nebraska, the child will receive medical benefits from that state as long as that state offers benefits to children adopted from another state.

11. What mental health services are available?

For current information about mental health services that can be provided, visit the Nebraska Department of Health and Human Services Division of Behavioral Health web site at http://dhhs.ne.gov/Pages/Behavioral-Health.aspx.

Nebraska offers a 24-hour help line for families whose children are experiencing behavioral health challenges. For assistance, call 888-866-8660.

Mental health services through Medicaid are administered by Magellan, Nebraska’s managed care contractor. Magellan will determine the types of services to be provided based on the child’s need.

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 Nebraska, what nonrecurring adoption expenses directly related to the finalization of an adoption may be reimbursed?

Parents may be reimbursed for up to $1,500 in nonrecurring adoption expenses such as reasonable and necessary adoption fees, court costs, attorney fees, and other expenses directly related to the legal adoption of the child that have not been reimbursed from any other source of funds. The child need not have been adopted through an adoption agency to qualify for nonrecurring cost reimbursement.

For those adopting children who are wards of DHHS, expenses generally paid directly by DHHS. For private agency or private adoptions, reimbursement generally is made to the adoptive parent as outlined in the adoption agreement.

Children who are not citizens or residents of the U.S. and were either adopted in another country or brought to this country for purposes of adoption are ineligible for adoption assistance. A child originally adopted internationally may become eligible if the child meets the eligibility criteria after the disruption of the international adoption.

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

Child care may be included in the adoption assistance agreement and is provided using the Child Care Subsidy rules and regulations. For example, adoptive parents must meet the “need” criterion, which generally means that they work outside of the home or attend school in pursuit of an undergraduate degree. Payment generally does not continue once the child reaches the age of 13, unless the child has a documented special need that results in the need for continuing child care.

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


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

Generally this service is available only as provided under the Medicaid program for which the child is eligible.

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

Nebraska also offers what is known as a Special Service Subsidy. Funds are allocated on a one-time basis for a specific service or item for a specified period of time. Services or items must relate to the child’s special needs as indicated in the original adoption assistance agreement and are only available if no other program or resource exists to meet the child’s need. Examples of such services and items include specially designed furniture, house modifications, and transportation expenses to medical services. Modifications to the home must be recommended by The Assistive Technology Partnership, an agency contracted by DHHS. The specific modification and the estimated cost must be included in the original adoption assistance agreement and approved by the Central Office adoption specialist before the adoption finalization.

Nebraska also has a contract with the Nebraska Foster and Adoptive Parent Association (877-257-0176 or 402-476-2273) or www.nfapa.org, which provides mentoring and support groups for adoptive families.

As required by law, DHHS also offers post-adoption and post-guardianship case management services for adoptive and guardianship families of former state wards. DHHS has contracted with Lutheran Family Services and Nebraska Children’s Home Society, which developed Right Turn to help families who seek support after adopting or providing guardianship for children in foster care. As part of a family plan, Right Turn offers six core services to families—case management, respite, training, mentoring, mental health care, and support groups.

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

To be covered under adoption assistance, any services to be provided must be included in the agreement prior to finalization. Post-adoption services through Right Turn do not have to be listed in the agreement, as they are available by law to any person who adopted a DHHS ward and has in existence a valid subsidized adoption (or subsidized guardianship) agreement.

What Should Families Know About Applying for Subsidy?

18. Who initiates the adoption assistance agreement?

During the placement process or the post-placement period, the child’s worker and supervisor determine whether the child might be eligible for adoption assistance. If so, the worker will discuss that possibility with the family. At any point in the process, a foster or adoptive family can also ask the worker to assess the child’s eligibility for adoption assistance.

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

In most cases, adoption staff in each service area approve the adoption assistance. The Adoption Specialist and Central Office approve adoption assistance for children in the custody of private agencies, those whose adoptions are private, and those who were previously adopted with Title IV-E adoption assistance.

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

Nebraska law allows approval of state-only adoption assistance after finalization only in the following situation: DHHS will pay the treatment costs for the care of an adopted minor child that are the result of an illness or condition if all of the following conditions apply:

  1. Within three years after the decree of adoption is entered the child is diagnosed as having a physical or mental illness or condition that predates the adoption.
  2. The child was adopted through DHHS.
  3. DHHS did not inform the adopting parents of such condition before the adoption (this condition can be met even if DHHS’s reason for not sharing was that DHHS did not know).
  4. The condition is of such nature as to require medical, psychological, or psychiatric treatment and is more extensive than ordinary childhood illness.
  5. The child was a ward of DHHS at the time of the adoption.

Parents should contact the adoption staff member who finalized the adoption if they believe the child is eligible and their situation meets these criteria.

How Can a Family Adjust an Adoption Assistance Agreement?

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

Adoptive parents can request a change in the adoption assistance agreement at any time. Changes may be made at the adoptive family’s request whenever there are changes in child’s needs, family circumstances, or when a change in law or regulation indicates the need for a modification of the agreement. Requests must be made in writing to the adoption assistance worker, and parents must submit information substantiating the change. There are specific requirements for that documentation, for example, a report from a medical provider must be no more than 6 months old.

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

The guardian has the right to an administrative appeal if DHHS denies the application for subsidy, reduces or terminates the agreement, or denies the parent’s/guardian’s request for an increase in maintenance.

Parents must file the appeal in writing within 30 days of receiving the change, denial, or termination. Parents send the request for a fair hearing to the local office.

What Else do Families Need to Know?

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

The program is state supervised/state administered. Policy decisions are made by personnel at the state office, in coordination and collaboration with field staff, and adoption assistance agreements are approved at one of the five service area offices.

Federal adoption assistance and non-recurring adoption assistance payments are funded by federal funds, with a required state match. State adoption assistance maintenance payments are funded by state funds, with the accompanying Medicaid and Child Care funded with a combination of federal and state funds.

24. Does Nebraska operate a subsidized guardianship program?

Yes, the program is designed to ensure that financial barriers or costs associated with the child’s needs do not prevent the permanency option of guardianship for the child. There are two types of subsidized guardianship, the Federal Kinship Guardianship Assistance or Guardianship Assistance Program (GAP) and State Subsidized Guardianship, each with distinct eligibility requirements.

For more information, parents should contact Olivia Biggs (see contact information at the top of the profile).

25. Does Nebraska offer a tuition waiver program?

No. However, DHHS has a contracted partnership with Central Plains Center for Services to improve the odds for the success of foster youth through the Education and Training Voucher (ETV) Program and the youth’s pursuit of post-secondary education and training. Youth adopted at age 16 or older are typically eligible for the ETV program. For more information, visit http://www.central-plains.org/etv.html

26. Does Nebraska offer a state adoption tax credit?


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

Yes, in 2012 legislature passed a law that adoption assistance can continue after the death of the adoptive parent(s) with the following provisions:

  1. All adoption subsidy agreements for children who are wards of DHHS at the time of finalization MUST include designation by the adoptive parent of a guardian for the child in the event that the adoptive parent (if only one) or adoptive parents (if two) die while the agreement remains in effect. The agreement should also contain an assignment of the assistance to the guardian or conservator upon the death of the parent or parents.
  2. For adoptions completed without an assignment to a guardian or conservator:
    1. The child can continue to receive medical services or other non-monetary services as specified in the agreement, including child care for the caregiver, for up to six months.
    2. Eligibility for financial assistance specified in the agreement (maintenance and respite) can continue for up to six months following the death of the adoptive parent(s). Payment can be made only to a guardian or conservator appointed by the court. Once the guardian or conservator is appointed, payments will be made retroactively to the date of the adoptive parents’ deaths.
  3. For adoptions completed with an assignment to a guardian or conservator:
    1. The child can continue to receive medical or other non-monetary services as specified in the agreement, including child care for the caregiver.
    2. Eligibility for financial assistance specified in the agreement (maintenance and respite) can continue for the time frame established in the original agreement (e.g., age of majority) if the child continues to remain eligible for subsidy as specified in DHHS regulations. Payments can be made only after someone has been appointed as guardian or conservator by the court. Once the guardian is appointed, payments will be made retroactively to the date of the adoptive parents’ deaths.
      When a child receiving a State Adoption Subsidy under the above provisions is placed with DHHS or another child placement agency, payment of financial assistance under the subsidy agreement ceases.

28. What else differentiates Nebraska’s adoption assistance program from others around the country?


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