Children’s Division

Interstate Compact on Adoption & Medical Assistance

The Interstate Compact on Adoption and Medical Assistance (ICAMA) assures the continued provision of all of the benefits of an adoption subsidy agreement, regardless of the state of residence of the child. ICAMA is designed to prevent and overcome artificial barriers that may prevent adoptive families from receiving medical assistance mandated by adoption agreements. ICAMA provides that the state where the adoptive family resides will furnish Medicaid program services to the special needs child, if the child came from a compact member state. Forty eight states and the District of Columbia, including Missouri, are ICAMA members.

A child with special needs may receive the benefits of an adoption subsidy agreement until age 18 or age 21, if the state determines that the child’s mental or physical handicaps warrant the continuation of assistance beyond age 18.

Medical assistance, including Medicaid program services, is expressly dealt with in the Compact. Other services and benefits when provided on an interstate basis may be implemented pursuant to the Compact or by supplementary agreements developed pursuant to Articles IV and VI of the Compact.

Who Is Eligible?

Children determined eligible for subsidized adoption by Missouri or another Compact member state.