30.3.1  Negotiating a New Adoption Subsidy Agreement

1. When approaching the negotiation of a new Adoption Subsidy Agreement, CD AD,with prospective adoptive parent(s), the prospective adoptive parent(s) are to be given the Adoption Subsidy Program Brochure, CS-350, and given an opportunity to ask questions about the subsidy program.  They are then to be asked to complete the Application for Adoption Subsidy, CD APP AD.  With the assistance of the worker, the physical, mental health, dental and emotional needs of the child are to be fully documented on the Application for Adoption Subsidy, CD APP AD, and, subsequent to the meeting, in the narrative portion of the subsidy record for present and future reference.

Private child-placing agencies that are approaching the negotiation of a new adoption subsidy Agreement are to forward the application for adoption subsidy to their local Children's Division staff for review of eligibility.  The Children's Division should then send back, within 10 working days, a letter approving the child's eligibility as well as approval to proceed with negotiation of the Adoption Subsidy Agreement, CD AD, or a letter denying the child's eligibility.  A copy of the letter as well as the Application for Adoption Subsidy, CD APP AD, is to be kept in an adoption subsidy file in the local Children's Division office.

Children's Division staff, Foster Care case management staff and private child-placing agencies who have been given approval to proceed with the negotiation of the Adoption Subsidy Agreement, CD AD, should then discuss with the family the needs for which the family feels they can assume responsibility.  It is not necessary for staff to document the detailed income and expenses of the adoptive family nor shall a means test be used.  Staff should fully discuss with the family their many resources; emotional, physical and financial, and encourage them to utilize these resources.  Staff should also review with families the community resources available to meet the child’s needs and make referrals as appropriate.  The goal of the negotiation should be to review with the family the current and anticipated needs of the child and to prepare the family for what lies ahead in a collaborative with the agency, planning for the current needs through completion of the Adoption Subsidy Agreement; CD AD, as well as acknowledging the potential future needs by fully documenting on the Application for Adoption Subsidy, CD APP AD.

At the time of the initial negotiation of the Adoption Subsidy Agreement, CD AD, the family should be advised that this Agreement will continue in effect until the last day of the month of the child’s 18th birthday.  If no changes are necessary during the life of the Agreement, no further action is necessary.  If changes are required, an amendment section will be completed within the body of the contract.  Each amendment is made to the Agreement as a whole and the entire completed Adoption Subsidy Agreement, CD AD, will need to accompany every amendment when sent to the Contract Management Unit (CMU).

At the time of the initial negotiation of the Adoption Subsidy Agreement the parent(s) should be advised that an adoption subsidy may be approved to continue up to age 21 when a documented physical, dental or mental health need exists that requires care beyond the age of 18.  These 18+ Adoption Subsidy Agreements, CD AD 18 are negotiated, on an annual basis, with the family according to the youth’s current needs and in the spirit of transitioning the youth from subsidy services to adult services to insure all necessary services are in place for the youth's success when subsidy is no longer available.

At the time of the initial negotiation the parent(s) should also be advised that an Agreement must be approved by signature of the Division Director prior to payment being made.

Adoptive parent(s) should also be advised of their right to file an appeal, as specified in the subsidy contract, on all or any part of an Adoption Subsidy Agreement that is denied by the Division Director.  Their request for appeal must be received within 10 days of their written notice of the denial decision.

2. Adoption Subsidy Agreements are legally binding contracts.  Contact should be made with families at least annually to insure that the best services to children and families are being provided, however no change will be necessary to the basic subsidy package included in the Agreement, nor will any changes be made if no request is made by the adoptive parent(s).  The Agreement shall remain in effect until the end of the month of the child's 18th birthday, unless they are terminated as a result of the parent(s) request or reasons for termination listed in the contract.

If approved time-limited services beyond the basic subsidy package expire on the Agreement or a new service needs to be added, an amendment must be developed between the family and the agency for payment for services to be made.

3. The adoptive parent should be encouraged to make application for Supplemental Security Income (SSI) with the local Social Security Administration (SSA) office for any potentially eligible children.

Adoptive parent(s) accepting a child for adoptive placement who is eligible for Title IV-E adoption subsidy, have the right to determine whether SSI or adoption subsidy IV-E would be more appropriate to meet the maintenance payment for the child in the context of his/her and their circumstances.  Parents of children who receive state-only funded adoption subsidy may receive both.  The adoptive parent of the IV-E child may also receive both funds; however, parents should be advised that the Social Security office may reduce the SSI amount the child receives, dollar for dollar, by the amount the child is receiving in subsidy maintenance.  If the family decides to accept SSI, the Children’s Service Worker will need to update the client’s fund code from ‘04-Adoption Subsidy IV-E to ‘05-Adoption Subsidy FFP’, and update the Title XIX begin date simultaneously to reflect when fund “05” begins.

During the time children received out-of-home care services, they may have been eligible for a SSI grant.  Upon adoption, they may be determined eligible for a limited SSI grant, or ineligible for SSI because of this program's requirements and parental income.

A child, Title IV-E or non IV-E, covered by an Adoption Subsidy Agreement, who is eligible for SSI is also eligible for MO HealthNet- FFP.  In this case, fund category "05" is reported on the Alternative Care Client Information screen/SS-61 in FACES.  If the child becomes ineligible for SSI, the child's fund category shall be changed to "03-Adoption Subsidy HDN (state only)" or "04-Adoption Subsidy IV-E" depending on the child's eligibility for IV-E prior to the final adoption.

A child, who is not Title IV-E eligible, but has a state-funded adoption assistance Agreement, has been determined by the state to have special medical, mental health or rehabilitative needs and cannot be placed for adoption without medical assistance, is eligible for MO HealthNet-FFP (fund code 05) for adoption.

OASDI benefits used for the cost of the child's care while in other types of out-of-home care can be received by the child after adoption.  Adoptive parent(s) are encouraged to make application for these benefits with the SSA office before making use of either of the Division's IV-E or HDN funding resources for a child's subsidy.  Workers should make prospective adoptive parent(s) aware of this resource and assist them in making application when indicated.

A subsidy Agreement can be developed using Title IV-E or HDN funds along with the OASDI grant if needed.

Prior to final adoption, staff must assure that the child's KIDS account, if any, does not exceed $999.99.  If it exceeds this amount, the fund category must be changed to "03" until the amount is below $999.99.

As required by the Adoption Subsidy Agreement, CD AD, adoptive parent(s) have the responsibility for reporting changes of income and/or resources to the Social Security office.  In addition to this, staff should confirm if the child remains SSI eligible whenever in contact with the family.

Adoptive parents should be advised that the Children’s Division Revenue Maximization unit will notify the Social Security Administration when final adoption occurs.  This will result in the immediate termination of the Children’s Division as payee for SSI/OASDI.  To avoid a lapse in payment, application by the adoptive parent(s) should be made promptly.

4. The date Adoption Subsidy Agreements are signed is important in relationship to the court's adoption proceedings.  Adoption subsidy must be in place before finalization of the adoption, meaning the adoption Agreement must be signed by both the adoptive parent(s) and Children's Division Director prior to finalization.
5. Prior to adoption subsidy funding being utilized a referral must be made to the IV-E Eligibility Specialist to determine the fund code for subsidy.  A child’s placement type must be changed just before the referral to the Eligibility Specialist for determination of the subsidy fund code is made.  At the time of the placement change to ADF, ADO, ADR or FAH the fund code should be changed to 12 for the placement change to be accepted.  These changes must be indicated on the child’s Alternative Care Client Information screen in FACES for the Eligibility Specialist to make a determination.  In addition, the adoption subsidy contract must be approved and in the contracting system.  Termination of Parental Rights (TPR) must be shown on the Alternative Care Client Information screen and the adoption petition must have been filed.  Within 5 days of this placement type change, the referral must be made to the Eligibility Specialist.

At this point the child’s plan is adoption, the necessary steps have been taken for adoption subsidy funding, and foster care funds and Professional Parent incentives are no longer appropriate.

Prior to the subsidy funding determination, the worker may have indicated the pre-adoptive placement on the Alternative Care Client Information screen without changing the placement type.

The Eligibility Specialist needs the following information in order to complete a determination.  If the child is from a private agency, the worker from the private agency is to obtain this information for the CD’s referring worker: 

• A copy of the Title IV-E/FFP Referral, (CS-IV-E-FFP-1) is to be filed in the family’s subsidy record to provide documentation of the eligibility determination.
• Information about the home from which the child was removed;
• Removal petition;
• Court order that placed the child in the agency’s custody;
• Date the adoption petition was filed;
• Date TPR occurred;
• Date adoptive placement began; and
• Begin date on the adoption subsidy contract.

The Eligibility Specialist (ES) may determine fund code eligibility and authorize payment from adoption subsidy fund codes (fund codes 03, 04 and 05) and are the only staff who have authority to change adoption subsidy fund codes and may only do so after the following criteria have been met:

1. Termination of Parental Rights has been granted on at least 2 parents or the parents are deceased;
2. The family has been identified as the adoptive placement as shown in the placement information section of the Alternative Care Client Information screen/SS-61.
3. An adoption petition has been filed with the court; and
4. An Adoption Subsidy Agreement has been approved and entered into the contract management system.
6. Subsidy Agreements may be reassessed at the request of the adoptive parent(s) when changes in the needs of the child or the circumstances of the family are indicated.
7. Adoptive parent(s) are expected and required to cooperate in the review process for services that expire and need to be re-authorized.  Such cooperation includes supplying information regarding the family and the eligible child's circumstances as determined by the Division to be needed.  This information will be used to establish the services and amount of payment for the services included in the agreement.  This information must be supplied to the Division within 30 days of the request.
8. Relatives, with the exception of a biological parent or step-parent, are eligible for an adoption subsidy.  Such subsidies are to be handled as if an unrelated family was adopting the child.
9. To meet costs for a service that may be needed anytime after the final decree, but before the child's 18th birthday, adoption subsidy Agreements including only MO HealthNet should be completed prior to the granting of the final decree.  These are considered deferred Agreements and are intended to serve those children with a guarded prognosis because of drug exposure, familial history of mental illness or other genetic predisposition, for whom an adoptive family may need future assistance in meeting the cost of special needs, but who may not require such assistance at the time of placement or adoption completion.  It is important that the condition or special needs or the circumstances of the guarded prognosis of the child exist at the time the child is placed with the family, and are well documented on the Application for Adoption Subsidy, CD APP AD.  An amendment to the Agreement must be processed to authorize payment for additional services when/if they are needed.

Upon a change in the subsidy Agreement via an amendment, the worker shall note the change and negotiation around the change in the narrative section of the subsidy file.

10. For confidentiality purposes, the child's name used in all business and record keeping transactions should be the name stipulated in the final decree of adoption.  This includes the records of the Children’s Division as well as the records used by vendors from whom we are purchasing a service as a part of the Adoption Subsidy Agreement.  All records should be changed after the final decree except for the first Application for Adoption Subsidy, CD APP AD, and the Adoption Subsidy Agreement, CD AD.  When preparing a new amendment there is space indicated to include the adopted name as well as a new DCN (Departmental Client Number).
11. When reviewing an Agreement after the final decree of adoption is granted, information from other treatment and rehabilitative service providers may be required by the Division.  This information must be obtained by the adoptive parent(s) and provided to the Division within 30 days of the request being made as indicated in the Agreement.
12. Agency staff should refer adoptive parents who request information regarding reporting adoption subsidy payments for income tax purposes to the Internal Revenue Service or their individual tax preparer.

30.3.2   Negotiating a New 18+ Adoption Subsidy Agreement

1. Six months prior to a youth’s, (who is covered by a subsidy agreement), 18th birthday, a determination should be made as to whether or not the youth has a documented physical, dental or mental health need that requires care through a subsidy Agreement beyond the age of 18.
2. Complete the 18+ Adoption Subsidy Agreement, CD AD 18, and attach the documentation of need from the youth's physician, psychiatrist, etc.
3. Discuss with the adoptive family the need to transition the youth from adoption subsidy to adult community services to meet the youth's needs and provide referral information and assistance with obtaining these services as needed.
   
   
   In addition, the family should be advised they are required to apply for and participate in all such programs and services as may be reasonably necessary to meet the needs of the youth as indicated in the contract.
4. Submit the 18+ Adoption Subsidy, CD AD 18, for approval at least 30 days prior to the expiration date of the Adoption Subsidy Agreement, CD AD, so no lapse in services occurs.
  

30.3.3   Negotiating a New Subsidized Guardianship Agreement

1. When approaching the negotiation of a new Subsidized Guardianship Agreement, CD SG, with guardian(s) or prospective guardian(s), they are to be given the Adoption Subsidy Program Brochure, CD-350, and given an opportunity to ask questions about the subsidy program.  They are then to be asked to complete the Application for Subsidized Guardianship, CD APP SG.  With the assistance of the worker; the physical, mental health, dental and emotional needs of the child are to be fully documented on the Application for Subsidized Guardianship, CD APP SG, and, subsequent to the meeting, in the narrative portion of the subsidy record for present and future reference.

   Private child-placing agencies that are approaching the negotiation of a new guardianship Agreement are to forward the application for guardianship subsidy to their local Children's Division staff for review of eligibility.  The Children's Division should then send back a letter, within 10 working days, approving the child's eligibility and approval to proceed with negotiation of the Subsidized Guardianship Agreement, CD SG, or a letter denying the child's eligibility.  A copy of the letter as well as the Application for Subsidized Guardianship, CD APP SG, is to be kept in a subsidy file in the local Children's Division office.

   Children's Division staff, foster care case management staff and private child-placing agencies that have been given approval to proceed with the negotiation of the Subsidized Guardianship Agreement, CD SG, should then discuss with the family the needs for which the family feels they can assume responsibility.  It is not necessary for staff to document the detailed income and expenses of the guardian(s) nor shall a means test be used.  Staff should fully discuss with the family their many resources; emotional, physical and financial, and encourage them to utilize these resources.  Staff should also review with families the community resources available to meet the child’s needs and make referrals as appropriate.  The goal of the negotiation should be to review with the family the current and anticipated needs of the child to prepare the family for what lies ahead.  These needs are to be fully documented on the Application for Subsidized Guardianship, CD APP SG, and in the record for present and future reference.

   At the time of the initial negotiation of the Subsidized Guardianship Agreement,
   the guardian(s) should be advised that a Subsidized Guardianship Agreement, CD SG, may be approved to continue up to age 18 only.  There will be no legal guardianship Agreements approved beyond the last day of the month of the 18th birthday under any circumstances.

2. Subsidized Guardianship Agreements are legally binding contracts.  Contact should be made at least annually to insure that the best services to children and families are being provided, however no change will be necessary to the Agreement if no request is made by the guardian(s).

   If approved services beyond the basic subsidy package expire on the Agreement, an amendment must be developed between the family and the agency for payment for services to continue.

   Upon a change in the subsidy Agreement via an amendment, the worker shall note the change and negotiation around the change in the narrative section of the subsidy file.

3. The legal guardian(s) should be encouraged to make application for SSI with the local SSA office for any potentially eligible children.

   During the time children received out-of-home care services, they may have been eligible for a SSI grant.  Upon subsidized guardianship being granted, they may be determined eligible for a limited SSI grant, or ineligible for SSI because of this program's requirements.

   A child that has a Subsidized Guardianship Agreement, has been determined by the state to have special medical, mental health or rehabilitative needs, and cannot be placed for guardianship without medical assistance and is eligible for MO HealthNet.

   As required by the Subsidized Guardianship Agreement, subsidized guardians have responsibility for reporting changes of income and/or resources to the Social Security office.  In addition to this, staff should confirm if the child remains SSI eligible when conducting the annual review.

   The guardian(s) should be advised that the Children’s Division Revenue Maximization Unit will notify the Social Security Administration when guardianship occurs or when they are advised of the guardianship.  This will result in the immediate termination of the Children’s Division as payee for SSI/OASDI.  To avoid a lapse in payment, application by the guardian(s) should be made promptly.

4. Subsidized Guardianship Agreements may be completed and approved prior to the guardianship being awarded as long as the goal is guardianship by the family that is signing the Subsidized Guardianship Agreement.  The Agreement, however, cannot go into effect until after the guardianship is awarded and the fund code "06" has been entered by the worker in FACES.  A copy of the order of legal guardianship shall be sent to CMU with the Subsidized Guardianship Agreement.  If negotiated prior to the guardianship being established, the order shall be sent to CMU when the Alternative Care Client Information screen is changed.  The legal guardianship begin date on the Alternative Care Client Information screen shall be the date the guardianship was awarded.  Fund code “06” is automatically entered by the system in cases of subsidized guardianship.

   Expenses to be paid under the Subsidized Guardianship Agreement will only occur after the legal guardianship has been granted by the probate court to a qualified relative as defined by Missouri Statute 453.072.

5. Subsidy Agreements may be reassessed at the request of the legal guardian(s) when changes in the needs of the child or the circumstances of the family are indicated.
6. Legal Guardian(s) are expected and required to cooperate in the review process for services that expire and need to be re-authorized.  Such cooperation includes supplying information regarding the family and the eligible child's circumstances as determined by the Division to be needed.  This information will be used to establish the services and amount of payment for the services included in the Agreement.  This information must be supplied to the Division within 30 days of the request. 
7. For legal guardianship subsidy, a grandparent, aunt, uncle, adult sibling, or adult first cousin must have obtained legal guardianship of the eligible child.
8. To meet costs for a service that may be needed anytime after the guardianship is granted, but before the child's 18th birthday, Subsidized Guardianship Agreements including only MO HealthNet should be completed prior to the granting of the guardianship.  These are considered deferred Agreements and are intended to serve those children for whom a guardianship family may need future assistance in meeting the cost of special needs, but who may not require such assistance at the time of placement or establishment of the guardianship.  It is important that the condition or special needs of the child exist at the time the child is placed with the family and are well documented on the Application for Subsidized Guardianship, CD APP SG.  An amendment to the Agreement must be processed to authorize payment for additional services when/if they are needed.

   Upon a change in the Subsidized Guardianship Agreement via an amendment, the worker shall note the change and negotiation around the change in the narrative section of the subsidy file.

9. When reviewing an Agreement after the legal guardianship has been obtained, information from other treatment and rehabilitative service providers may be required by the Division.  This information may be obtained by the guardian(s) and provided to the Division within 30 days of the request being made as indicated in the Agreement.
10. Agency staff should refer legal guardians who request information regarding reporting subsidized guardianship payments for income tax purposes to the Internal Revenue Service or their individual tax preparer.