Adoption Assistance pays certain costs, including adoption subsidy maintenance, associated with the adoption of a child with “special needs.”
Title IV-E of the Social Security Act gives Federal Adoption Assistance reimbursements to DHS for a “special needs” adopted child including:
A child who was or would have been eligible for SSI, Placement Maintenance or AFDC (under the 7/16/96 criteria) in the month the adoption petition was filed
A child who had met the AFDC-relatedness criteria in the month of the child was first removed from the home
The County Children and Youth Agency (CCYA) gives State Adoption Assistance for a child who is not eligible for Title IV-E Federal Adoption Assistance.
Federal Child Welfare legislation provides MA for any child who has an adoption assistance agreement in place. The coverage applies to Title IV-E, Federal Adoption Assistance (Program Status Code 32) and State Adoption Assistance (Program Status Code 34).
Determine the child's eligibility for Title IV-E Adoption Assistance or State Adoption Assistance.
Complete the CY 61 and sends the form to the local CAO. The one local CAO has the active MA case.
Coordinate the opening of MA in the county where the adoptive family is living and the closing of MA in the local CAO so there is no loss of MA coverage.
FAX (and then mail) the CY 61 to the CAO of the adoptive family.
In all cases where Foster care leads to Adoption (including private adoption), regardless of any name or other change or the availability of Federal /State Adoption Assistance, the CAO will do the following:
Zero the SSN in all Foster Care closings that lead to Adoption.
Close the eligibility for the child's existing record in e-CIS.
Register an application in MCI (including the child's new name (if changed) and Social Security Number (SSN). use the original SSN if the child does not have a new one.
If an unduplicated screen is presented, select the "new recipient" option. If the system does not allow that option, the most likely cause is that zeroing out the SSN has not been completed.
Call the CIS hotline for instructions if unable to resolve the clearance issue, and have a new individual number assigned.
On CAADSP, select a new record number so that there is no association of the child's new identity with the pre-existing case.
If the adoption family wants to change the child's name, and they have provided verification per MA Handbook Chapter 378, the CAO will change the name in e-CIS in the adoption case.
The adoptive parent should be encouraged to apply for a new SSN number for the child, per Supplemental Handbook Chapter 850.6. With a new name and SSN, the automated file clear function in MCI, will automatically assign a new recipient number.
When the child is authorized in the Adoption category, and has been assigned a new recipient number a new ACCESS Card should be issued.
If the CAO determines that a recipient of Medical Assistance (MA), has been adopted, has managed care coverage issues (as verified through a comparison of both CQIMCP screens for the old and new recipient numbers), and wants to maintain the Managed Care Organization (MCO) coverage, the CAO should submit an "Adoption CAO Correction of MCO Coverage" form. This form is located on the Health Choices Intranet at: http://dpwintra.dpw.state.pa.us/HealthChoices/custom/general/forms/form_cao_adoption.asp
The CAO should fill out the form using the child's adopted and birth information and, under the "additional comments" section, they should include the child's old demographic information to insure continuity of care. The form, with the new recipient information, must be submitted in the same month in which the old record is closed. Otherwise, there will be a break in MCO coverage.
The CAO should coordinate/cooperate with the CCYA from the placing county for case changes or reviews. Although no renewal is required, do not assume the child is eligible. The CCYA determines MA eligibility for Federal or State Adoption Assistance, and eligibility decisions should be directed to that agency.
The CAO will issue ACCESS cards to children who were eligible for Title IV-E Adoption Assistance in another state. The Title IV-E program requires states to provide MA coverage to these children. Issues the ACCESS card using the procedures in Section 850.7, Out -of-State Placements.
Confidentiality requirements of Chapter 930, Safeguarding Information must be strictly followed. Under no circumstance is any information to be given to a parent about the new identity or whereabouts of the adopted child.
The CCYA determines a child’s eligibility for Title IV-E Adoption Assistance. A child must have a financial need and other factors when adoption proceedings begin.
The child is categorically eligible for Title IV-E Adoption Assistance if he or she was eligible for Title IV-E Placement Maintenance or SSI.
If the child is not categorically eligible for Federal Adoption Assistance, a determination of AFDC-relatedness is required. The CAO determines AFDC-relatedness based on the July 16, 1996 rules, certified in the same way as Title IV-E Placement Maintenance.
The CCYA will use the CY 61 to communicate with the CAO about Adoption Assistance.
The CY 61 will be completed as follows:
If the CCYA determines that the child is categorically eligible for Title IV-E Adoption Assistance, the CCYA completes the CY 61 and sends it to the CAO. The CAO will authorize MA in the correct category and program status code.
If the CCYA determines that the child is not categorically eligible for Title IV-E Adoption Assistance, the CCYA completes the CY 61 and sends it to the CAO. Completion of the AFDC-relatedness section is notice to the CAO that an AFDC-relatedness certification is needed to make a final determination of Title IV-E Adoption Assistance eligibility.
If the CY 61 shows that the child currently lives with a specified relative, the CAO determines whether the child’s income and resources meet the AFDC eligibility criteria of July 16, 1996.
If the child does not live with a specified relative or does not meet other AFDC eligibility criteria, the CAO determines if the child was initially removed from a home that would have met the AFDC eligibility criteria of July 16, 1996.
The CAO completes the CAO certification on the CY 61 and returns it to the CCYA.
The CCYA completes the final determination of eligibility for Federal Adoption Assistance or State Adoption Assistance and sends a copy to the CAO.
The CAO authorizes MA in the appropriate category, using the appropriate program status code.
When the CCYA indicates State Adoption Assistance on the CY 61, the CAO authorizes MA in the appropriate category, with the appropriate program status code.
For Federal and State Adoption Assistance, MA continues until one of the following criteria is met:
The child reaches 18 years of age
The adoptive parents are no longer financially supporting the child
Court action determines the parents no longer legally responsible for the child
The adoptive parents request termination of adoption assistance
When the CAO discontinues MA for an Adoption Assistance child, it will determine MA eligibility based on the family income according to NMP or MNO procedures.
Only the income actually contributed to the child by the parents is counted in determining MA eligibility in a MNO-MA category.
Reviewed July 30, 2013