1. (1) A child qualifies for a monthly subsidy when the following requirements are met:

   1. (a) a child meets the qualifying factors for adoption assistance listed in Section R512-43-3;
   2. (b) a child meets the definition of child in public foster care, qualifies for SSI, or a child had a previous IV-E agreement or state adoption assistance agreement; and
   3. (c) a child's eligibility for SSI is established no later than the time adoption proceedings are initiated.
2. (2) The amount of monthly subsidy to be paid for a child is based on a child's present and long-term care and treatment needs and available resources, including the family's ability to meet the needs of a child. A combination of the parents' resources and subsidy should cover the ordinary and special needs expenses of a child projected over an extended period.
3. (3) The amount of the monthly subsidy may not exceed the payment that would be made if a child was placed in a foster family home at the point in time when the agreement is being initiated or revised.
4. (4) The amount of monthly subsidy may increase or decrease when a child's level of need or the family's ability to meet those needs changes. The family or Child and Family Services worker may initiate a request for a change in the amount of subsidy up to two times per fiscal year, when needs or resources change.
5. (5) If the adoptive family is receiving post adoption services and has an open Child and Family Services case, a change in the amount of subsidy may be initiated at any time during the open case to address service needs.
6. (6) For a child in public foster care, the requested amount of monthly subsidy is negotiated between the adoptive parent and the Child and Family Services worker. Before subsidy negotiation, the adoptive parents must have reviewed a child's case file information and discussed in depth with the Child and Family Services worker what will be needed after a child leaves state's custody.
7. (7) The amount of the monthly subsidy is subject to the approval of the regional adoption assistance committee. If the requested amount is not granted, the adoptive parent has a right to appeal as stated in Section R512-43-12.
8. (8) Utilizing the level of need criteria specified in Section R512-43-5, the Child and Family Services worker and adoptive family identify a child's level of need.
9. (9) The Child and Family Services worker and adoptive family shall identify the applicable monthly subsidy payment range, according to a child's specified level of need, as specified in Section R512-43-5.
10. (10) The Child and Family Services worker and adoptive family shall negotiate the amount of monthly subsidy to be requested from the regional adoption assistance committee. The requested monthly subsidy amount may not exceed the maximum amount for the specific level of need identified for a child nor the maximum amount that a child would receive if placed in a foster family home.
11. (11) The identified need level for a child and requested amount of monthly subsidy shall be presented to the regional adoption assistance committee for approval. If the requested amount is not approved or is reduced by the committee, Child and Family Services shall send a written notice to the adoptive parents within 30 days informing them of the process to request a fair hearing.
12. (12) The level of need is determined by considering a child's age, history, physical, mental, emotional, and social functioning and needs, and any other relevant factors. Frequency of occurrence, duration, severity, and number of needs or problem areas are also considered.
13. (13) The presence of a particular issue listed within a designated level does not mandate that a child be categorized at that level as a child's needs, taken as a whole, determine the level selected for a child.

14. (14) The level of need is classified into three categories.

    1. (a) Level one applies to a child with a minimal number and severity of needs. It is expected that most of these issues will improve with time, and significant improvement may be anticipated over the course of the adoption.

       1. (i) For children ages five and under issues may include feeding problems, aggressive or self destructive behavior, victimization from sexual abuse, victimization from physical abuse; or no more than one developmental delay in fine motor, gross motor, cognitive or social and emotional domains.
       2. (ii) For children ages six through 18, issues may include social conflict, physical aggression, minor sexual reactivity, need for education resource classes or tutoring, minor medical problems requiring ongoing monitoring, or mental health issues requiring time limited counseling.

    2. (b) Level two applies to a child with a moderate number and severity of needs.

       1. (i) It is expected that a number of these issues are long-term in nature and may intensify or worsen if not managed carefully, and it is also expected that the adoptive family and child will be working with them over the course of the adoption.
       2. (ii) Outside provider support will probably continue to be needed during the adoption.
       3. (iii) For children ages five and under, issues may include developmental delays in two or more areas of fine motor, gross motor, cognitive or social and emotional domains; diagnosis of failure to thrive; moderate genetic disease or physical disability condition; or physical aggression expressed several times a week, including superficial injury to self or others.
       4. (iv) For children ages six to 18, issues may include daily social conflict or serious withdrawn behavior; moderate risk of harm to self or others due to physically aggressive behavior; emotional or psychological issues with a mental health diagnosis requiring ongoing counseling sessions over an extended period; moderate sexual reactivity or perpetration; chronic patterns of being destructive to items or property; cruelty to animals; mild cognitive disability, autism, or fetal alcohol spectrum disorder with ongoing need for special education services; and physical disabilities requiring ongoing attendant care or other caretaker support.

    3. (c) Level three applies to a child with a significant number or high severity of needs.

       1. (i) It is expected that these issues will not moderate and may become more severe over time.
       2. (ii) A child's level of need may require personal attendant care or specialized care outside of the home, when prescribed by a professional.
       3. (iii) For children ages five and under issues may include severe life threatening medical issues; moderate or severe cognitive disability, autism, or fetal alcohol spectrum disorder; serious developmental delays in three or more areas of fine or gross motor, cognitive or social and emotional domains; anticipated need for ongoing support for activities of daily living, such as feeding, dressing and self care; or high levels of threat for harm to self or others due to aggressive behaviors.
       4. (iv) For children ages six to 18 issues may include moderate or severe retardation or autism; life threatening medical issues; severe physical disabilities not expected to improve over time; predatory sexual perpetration; high risk of serious injury to self or others due to aggressive behavior; serious attempts or threats of suicide; severely inhibiting diagnosed mental health disorders diagnosed within the past year that limit normal social and emotional development, such as a need for ongoing self contained or special education services.
15. (15) The regional adoption assistance committee must approve the level of need identified for a child.

16. (16) A child's need level may be increased in severity by one level if the adoption assistance committee determines that a child's permanency may be compromised due to financial barriers to a child's adoption and if at least one of the following circumstances apply:

    1. (a) a child has been in state custody for longer than 24 months;
    2. (b) a child is nine years of age or older; or
    3. (c) a child is part of a sibling group of three or more children being placed together for adoption.
17. (17) Each level of need corresponds to a dollar range in the amount of monthly subsidy that may be paid for a child, with the specific amount based upon the individual child's needs and the family's ability to meet those needs.
18. (18) The monthly subsidy amount for an individual child may not exceed the maximum amount for the payment range applicable to a child's level of need.
19. (19) A family may choose to defer receipt of a monthly subsidy that a child qualifies for, with the option to initiate a monthly subsidy at a later date.
20. (20) A family may choose to receive a lesser amount than would be allowable for a child's level of need at a given point in time.
21. (21) Monthly subsidy payments for a child's needs categorized as level one may range from 0% to 40% of the maximum maintenance payment that could be paid for a child in a foster family home.
22. (22) Monthly subsidy payments for a child's needs categorized as level two may range from 20% to 70% of the maximum maintenance payment that could be paid for a child in a foster family home.
23. (23) Monthly subsidy payments for a child's needs categorized as level three may range from 50% to 100% of the maximum maintenance payment that could be paid for a child in a foster family home.
24. (24) For extraordinary, infrequent, or uncommon documented needs that cannot be covered by a monthly subsidy or state medical assistance, refer to supplemental adoption assistance in Section R512-43-7.
25. (25) The two funding sources for the monthly subsidy are Title IV-E adoption assistance and state adoption assistance funds. A child's eligibility determines which funding source is used for payment.

26. (26) Title IV-E adoption assistance shall be considered first for the monthly subsidy. To receive Title IV-E adoption assistance, a child with special needs shall meet at least one of the following federal requirements:

    1. (a) a child is determined eligible for SSI for a disability by the Social Security Administration before the initiation of adoption proceedings;
    2. (b) a child in foster care who meets the age criteria defined by the federal fiscal year qualifies for Title IV-E adoption assistance if other enhanced eligibility criteria is met;
    3. (c) a child in foster care who has been in foster care for any previous 60 consecutive months may qualify for Title IV-E adoption assistance if other enhanced eligibility criteria is met;
    4. (d) a child in foster care who is a sibling of another child in foster care who qualifies under the enhanced age criteria and is being adopted into the same family may qualify for Title IV-E adoption assistance if other enhanced eligibility criteria is met;
    5. (e) the removal home for a child in public foster care received, or would have been eligible to receive, AFDC before removal, and a child was removed from the home as a result of a judicial determination that remaining in the home would be contrary to a child's welfare;
    6. (f) a child was voluntarily placed for foster care with the state, and was or would have been AFDC eligible during voluntary placement if application had been made, a child lived with a specified relative within the six months before the voluntary placement, and Title IV-E foster care maintenance payments were made on behalf of a child;
    7. (g) a child's needs were met through foster care maintenance payments made to and for a child's minor parents as provided by Subsection 475(4)(B), Social Security Act; or
    8. (h) a child had a previous IV-E adoption assistance agreement.
27. (27) The adoptive family may use state adoption assistance funds for the monthly subsidy if a qualified child is not eligible for Title IV-E adoption assistance.

28. (28) The monthly subsidy may be used according to the parents' discretion. Examples of the uses of the monthly subsidy payment are:

    1. (a) medical, dental, or mental health services not paid for by the state medical assistance or family insurance;
    2. (b) special equipment for physically or mentally challenged children;
    3. (c) respite care;
    4. (d) child care;
    5. (e) therapeutic equipment;
    6. (f) minor renovation of the home to meet special needs of a child;
    7. (g) damage and repairs;

    8. (h) speech therapy;

       1. (i) tutoring;
    9. (j) specialized preschool based on needs of a child;

    10. (k) private school;

        1. (l) exceptional basic needs such as special food, clothing, and shelter;
    11. (m) visitations with biological relatives; and
    12. (n) cultural and heritage activities and information.
29. (29) The adoption assistance agreement will specify a child's eligibility for Title XIX and Title XX services, if available.

KEY: adoption, child welfare, foster care

Date of Last Change: June 11, 2025

Notice of Continuation: July 28, 2025

Authorizing, and Implemented or Interpreted Law: 80-2-301; 80-2-302; 80-2-801; 80-2-806; 80-2-807