1. A. Definitions.

   1. 1. Supplemental Benefits: State funded payments for the care and support of an adopted child.
   2. 2. The Department: The South Carolina Department of Social Services.
   3. 3. Family: The adoptive family who is adopting or has adopted a child, or the caregiver.
   4. 4. Caregiver: The person who provides care and support after the death or disability of the adoptive parent(s).
   5. 5. Child: A person under the age of 18 or a person age 18, 19, or 20 who meets the education or employment requirements of Section 63-7-2710 or who is incapable of meeting such requirements due to a physical, intellectual, emotional, or psychiatric condition that limits participation in education or employment activities.
   6. 6. Adoption Assistance Agreement: An Adoption Subsidy Agreement or contract between an adoptive family and the Department or another adoption assistance state for ongoing or time limited financial support through federal or state public funds.

   7. 7. Special Needs Child: For the purpose of adoption, means children who fall into one or more of the following categories:

      1. (a) children who are members of a sibling group;
      2. (b) children of marginalized ethnic backgrounds, except for purposes of Section 63-9-60(B)
      3. (c) children aged six or older; or
      4. (d) children with physical, mental, or emotional disabilities.
   8. 8. ICAMA: The Interstate Compact on Adoption and Medical Assistance.
   9. 9. Medical Assistance Identification: Medicaid Card.
   10. 10. Prior Approval: Required authorization for payment of Supplemental Benefits funds for costs associated with the known conditions stated in the Adoption Subsidy Agreement that are not covered after Medicaid, private insurance, educational, and other funding sources have been explored and ruled out.

2. B. Eligibility Requirements for Supplemental Benefits.

   1. 1. The child has been placed for adoption by the Department.

   2. 2. The child must be legally free for adoption and one of the following provisions apply:

      1. (a) is a special needs child pursuant to Section 63-9-30;
      2. (b) is at high risk of developing a physical, mental, or emotional disability;
      3. (c) is one for whom other factors, as determined by the department, interfere with the child’s ability to be placed for adoption;
      4. (d) has established significant emotional ties with prospective adoptive parents while in their care as a foster child, and it is considered by the agency to be in the best interest of the child to be adopted by the foster parents.

3. C. Eligibility Requirements for Medicaid Coverage.

   1. 1. The initial adoption assistance agreement for state or federal public funds must have been signed by the family and the authorized agency representative prior to adoption finalization.
   2. 2. The family must have a current adoption assistance agreement for federally funded adoption assistance or for state funded adoption assistance based on the child’s medical or rehabilitative needs.

4. D. Family Responsibilities.

   1. 1. The family shall notify the Department within ten working days of changes in the child’s condition or the family’s circumstances that may affect the adoption assistance agreement in any way.
   2. 2. The family shall use all other available resources, including Medicaid, before using Supplemental Benefits payments for medical, rehabilitative or other treatment services.
   3. 3. The family shall cooperate with the Department by signing and returning the adoption assistance agreement promptly.
   4. 4. The family shall notify the Department within ten working days if they are no longer legally responsible for supporting the child or if they are no longer financially supporting the child.
   5. 5. The family must obtain prior approval to receive Supplemental Benefits for Medical Assistance costs associated with known conditions stated in the Adoption Subsidy Agreement that are not covered by Medicaid, private insurance, educational, or other funding sources that have been explored and ruled out. Experimental services, services that are not approved by governmental agencies or national professional associations concerned with such services, and services that are not associated with diagnoses or conditions stated in the Adoption Subsidy Agreement are not reimbursable under this program.
   6. 6. A family that has an agreement with another state may be asked to provide proof that the agreement is still in force to receive Medicaid or other services in South Carolina through ICAMA.

5. E. Supplemental Benefits Payments.

   1. 1. Payments may begin as soon as the child has been placed adoptively and agreements have been executed.
   2. 2. Payments may be delayed until the child’s needs increase and the family can no longer meet those needs from their own resources.
   3. 3. Payments terminate at age 21 if the Department determines the child has a mental or physical disability which warrants the continuation of Supplemental Benefits, at age 18 or age 19, 20, or 21, as applicable, if the child meets requirements of the extended foster care program as set forth in Title 63, Chapter 7, Article 8. The Department requires annual proof that a child aged 18-21 meets requirements for the continuation of Supplemental Benefits by the last day of the child’s birth month.
   4. 4. In no case may Supplemental Benefits continue beyond a child’s 21^st birthday.
   5. 5. All Supplemental Benefits terminate at the death of the child or at the death or disability of the adoptive parents, unless the disability results in placement of the child with a caregiver.
   6. 6. Supplemental Benefits may be paid to a caregiver with the approval of the Department.
   7. 7. Supplemental Benefits may not exceed that which is reasonable for treatment services or allowable for a child under foster family care.
   8. 8. Supplemental Benefits may be reduced, terminated or left the same, if the family begins receiving other cash benefits on behalf of the child, i.e., Social Security benefits. Any reduction or termination will be negotiated with the family, but the final determination will be made by the Department.
   9. 9. With prior approval, the family may be reimbursed for the child’s medical expenses for conditions covered in the adoption assistance agreement and that are not paid by private insurance, Medicaid or other resources.

6. F. Overpayments.

   1. 1. The family who has received an overpayment shall be required to reimburse the Department.
   2. 2. The Department reserves the right to recoup overpayments from future payments.

7. G. Supplemental Benefits Appeals.

   1. 1. The family has the right to appeal any decision made by the Department on Supplemental Benefits both before and after finalization of the adoption, according to the Department’s approved fair hearing appeal process.
   2. 2. The family will be informed of its right to a judicial review in accordance with the Administrative Procedures Act.

8. H. ICAMA Appeals.

   The family has the right to appeal decisions made about adoption assistance and/or services as specified in the adoption assistance agreement according to the policies and procedures in the state which entered into the agreement or the state in which the child lives, if appropriate.

Statutory Authority

1976 Code Sections 63-9-1700 through 63-9-1810 and Sections 63-9-2000 through 63-9-2050

HISTORY: Added by State Register Volume 16, Issue No. 4, eff April 24, 1992. Amended by SCSR 49-5 Doc. No. 5315, eff May 23, 2025.