FamilyRightsRadio.net/AdoptedChildsWorth
How much an Adopted Child is worth!
(North Carolina as a model)


Posted by: "PJ or Brian" ravenwaverider@yahoo.com   ravenwaverider
Fri Jan 25, 2008 3:19 pm (PST)
http://www.nacac.org/adoptionsubsidy/stateprofiles/northcarolina.html


North Carolina State Subsidy Profile
Updated May 2006
State Subsidy Contact Person
Tamika Williams
DHR/DSS - Adoptions
2409 Mail Service Center
Raleigh, NC 27699-2409
Phone: 919-733-9464
Fax: 919-733-305
E-Mail: Tamika.Williams@ncmail.net
NACAC Subsidy Representative (parent/volunteer)
Wanda & Tony Douglas
Alexander Youth Network Foster Parent Assoc
3529 Mallard Cove Court
Charlotte, NC 28269
Phone: 704-599-0052
Fax: 704-599-2912
E-mail: wandadouglas@bellsouth.net and
tonydouglas1@bellsouth.net

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Adoption subsidies are available for children with special needs. Federal subsidies were created by Congress (through Public Law 96-272—the Adoption Assistance and Child Welfare Act of 1980) to encourage the adoption of special needs children and remove the financial disincentives to adoption for the families. Children may receive a federally funded subsidy under Title IV-E or a State-funded subsidy as per state guidelines.

Below we have outlined information related to definitions of special needs, benefits available, and procedures in your state. Answers to select questions were made available by the Association of Administrators of the Interstate Compact on Adoption and Medical Assistance (AAICAMA) through the Child Welfare Information Gateway (http://www.childwelfare.gov). Profiles for each state’s subsidy program are available on our web site at http://www.nacac.org.
 If you have additional questions, please call the North American Council on Adoptable Children (NACAC) at
651-644-3036 or our subsidy help line at 800-470-6665, 

If you have state-specific questions, please call your State Subsidy Contact Person or the NACAC Subsidy Representative (listed above) for more information.

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Adoption Resources on the Web:
http://www.dhhs.state.nc.us/dss/adopt/
North Carolina’s state-specific medical assistance:
http://www.dhhs.state.nc.us/dma/consinfo.htm
North Carolina’s adoption assistance:
http://www.dhhs.state.nc.us/dss/c_srv/cserv_adopt.htm
See the third and fourth paragraphs for details.

1. What specific factors or conditions does your State consider to determine that a child cannot be placed with adoptive parents without providing financial assistance? ("What is your State definition of special needs?")
A child with special needs is defined as a child that has at least one of the following needs or circumstances that may be a barrier to placement or adoption without financial assistance:
a. Age
b. Member of a minority or ethnic group
c. Member of a sibling group to be placed together
d. Known and diagnosed medical, mental, or emotional conditions that will require periodic treatment or therapy of a medical or remedial nature
e. Need for placement with a known and approved family
Note: Children must be legally free for adoption and in the placement responsibility of a North Carolina agency authorized to place children to be eligible for adoption assistance. Placement responsibility must currently be with that of a North Carolina agency authorized to place children for adoption, or have been at the time of the filing of the adoption petition, or with an agency that subsequently placed the child in the custody of a person now pursuing adoption of that child.

2. What are the eligibility criteria for the State-funded adoption assistance program?
In order to be eligible for state-funded adoption assistance a child must be a special needs child as defined above, in the placement responsibility of a North Carolina agency authorized to place children or had been in the placement responsibility of a North Carolina agency and custody was given to person who is pursuing adoption, and the child is legally free for adoption.

3. The maximum basic monthly adoption assistance maintenance payment in North Carolina is:
Basic rates (effective July 1st, 2004):
Age
Rate
0-5
$390
6-12
$440
13+
$490

4. Specialized rates are based on the extraordinary needs of the child, and/or the additional parenting skill needed to raise the child. If North Carolina offers these rates, the criteria used to define them are as follows:
Specialized rates: Beginning 7-1-95, special provisions can be made for HIV children, including:
$800
(indeterminate HIV status)
$1,000
(confirmed HIV-infected, asymptomatic)
$1,200
(confirmed HIV-infected, symptomatic)
$1,600
(terminally ill with complex care needs) 

5. Parents can receive payment or reimbursement for certain nonrecurring adoption expenses directly related to the finalization of an adoption. Below are the allowed expenses and the limit per child.
“Nonrecurring adoption costs” mean reasonable and necessary adoption fees, court costs, and attorney's fees incurred by adoptive parents and directly related to the legal adoption of an eligible child. Other nonrecurring costs include those associated with the adoptive home study, physical and psychological examinations, transportation and reasonable costs of food and lodging for the child and/or adoptive parents, and post-placement supervision.
The reimbursement limit is $2,000 per child.

6. What Medicaid services are available in North Carolina?
Covered services include:
Hospitalization (pre-admission review is required before hospitalization for non-emergency care)
Inpatient laboratory and X-ray services
Hospice care
Care through home health agencies
Nurse midwife services
Treatment in psychiatric hospitals and mental health centers
Prescription drugs
Medical examinations and treatment
Ambulance transportation (when medically necessary)
A total of 24 visits per year will be covered for the following services:
Physicians
Hospital outpatient
Outpatient laboratory and X-ray
Podiatrists
Chiropractors
Osteopaths
Eye examinations
Clinic services
Family planning services
Hearing aid services 

The following services may be covered with prior approval:
Care in a skilled nursing or intermediate care facility
Durable medical equipment
Limited dental services and medically necessary orthodontia
Eyeglasses
Hearing aids
Personal care services in the home

7. Children who have federally funded (Title IV-E) subsidy are automatically eligible for Medicaid benefits. However, it is the state's decision whether state-funded (non-Title IV-E) children are eligible for Medicaid benefits inNorth Carolina. Below is information on the Medicaid benefits available for state-funded children.
Yes. As of 10-1-94, all children, including non-IV-E children, became eligible for Medicaid. Children adopted before and after 10-1-94 are now eligible for Medicaid benefits. 

8. What mental health services are provided by your State?
Mental health services for children in North Carolina are administered by the DHHS Division of Medical Assistance (DMA) and include the following examples
:inpatient and outpatient hospitalization, including treatment in psychiatric hospitals and mental health centers, inpatient and outpatient substance abuse programs, diagnostic services, therapies, physician’s services and prescription drugs. 
Mental health services may require prior approval before services can be received.
North Carolina’s general Medicaid: http://www.dhhs.state.nc.us/dma/consinfo.htm and
Frequently Asked Questions on the Family and Children’s Medicaid: http://www.dhhs.state.nc.us/dma/fcfaqs.htm.
Note: Not all services may be available in all cases. Contact your adoption assistance worker or medical assistance specialist for information regarding process, eligibility, availability, and duration of services.

9. Does your State provide additional finances or services for medical or therapeutic needs not covered under your State medical plan to children receiving adoption assistance?
Special needs children with chronic mental or physical conditions or illness may receive services in addition to those covered under North Carolina’s Medicaid plan if services are medically necessary and receive precertification under the Early and Periodic Screening, Diagnosis and Treatment program (EPSDT). Contact your Medicaid caseworker for more details on EPSDT.

North Carolina also has vendor payment for medical and therapeutic services, HIV Supplemental Payments, and Supplemental Special Children Adoption Incentive Fund for child with severe medical and rehabilitative needs. Supplemental Special Children Adoption Incentive Fund is limited to county participation and is therefore not available to all children.

Note: Not all services may be available in all cases. Contact your adoption assistance worker for information regarding process, eligibility, availability, and duration of services.

10. What types of post adoption services are available in your State and how do you find out more about them?
Post adoption services in North Carolina are administered through the Department of Health and Human Services, Division of Social Services and private and family organizations. Post adoption services include the following examples:

Information and referral
Support groups
Advocacy
Respite Care
Local departments of social services and four contract private adoption agencies provide post adoption services. Not all services are available in all counties. Contact the department of social services in the county of residency or State Post Adoption Services Contact for availability and access or Tamika Williams at tamika.williams@ncmail.net or 919-733-9464.
County directory: http://www.dhhs.state.nc.us/dss/local/.
Respite Care is not a discrete service offered through the adoption assistance program. It may be a Title XX service offered by some counties, or it may be available through other funding streams, including the “Vendor Payments” program. In addition, many private organizations offer a variety of respite options. See the ARCH National Respite Network Respite Locator Service, search by state to locate North Carolina's respite programs: http://www.respitelocator.org.
Note: Not all services may be available in all cases. Contact your adoption assistance worker or post adoption services contact for information regarding process, eligibility, availability, and duration of services.

11. If the additional assistance (listed above in questions #8 -10) is to cover specific services (e.g., counseling/mental health services, respite care, etc.), must these services be explicitly identified in the adoption assistance agreement?
No. Previously existing conditions must be detailed in the agreement, but it is not necessary to identify specific services in the agreement. However, services must be related to treatment needs, and treatment needs should be related to the special needs and pre-existing conditions that are identified in the adoption assistance agreement.

12. How are residential treatment costs covered (if at all) for adoptive families? What procedures must a family follow to receive these services?
Residential treatment costs (up to $2,400 per year) may be covered under the “Vendor Payments” program. This vendor payment provision can also be used for respite care.

Medicaid may cover a residential facility’s treatment program component.

13. A deferred adoption assistance agreement is one in which the initial monthly maintenance amount is $0. Does North Carolina offer such agreements?
Yes, North Carolina offers deferred adoption assistance.

14. Does North Carolina operate a subsidized guardianship program?
Several counties in North Carolina participate in the IV-E Waiver Demonstration and offer subsidized guardianship as a permanency option.

Programmatic Procedures

15. Who makes the final determination of a child's subsidy eligibility in North Carolina? What roles, if any, do workers and administrators at the county, district, or regional level play in eligibility determination and/or assistance negotiation?
The local department of social services that has or had legal custody and placement responsibility for the child has responsibility for determining assistance eligibility.

16. Will North Carolina consider my family income to determine my child's eligibility for an adoption subsidy?
The amount of family income is not a determinant (i.e. there is no means test).

17. When do subsidy payments begin?
Adoption assistance payments and benefits may begin in North Carolina after adoption finalization.

18. Do children adopted from private agencies in North Carolina receive the same subsidies as those children adopted from public agencies?
Yes. Private agency workers are responsible for sending documentation of the child's eligibility to county office adoption staff. Private agency staff work with the county that has placement responsibility for the child, or the home county where that private agency is located. Call Tamika Williams, DSS, for further details 919-733-9464.

19. When my child turns 18, which benefits, if any, are available to our family?
None.

20. A child's adoption assistance agreement may be periodically reviewed by the state. What is the typical process used in North Carolina?
Adoption agreements are not renewed on an annual basis. Annually, a periodic review letter is sent out to remind families to contact the agency if there are changes in their legal or financial responsibility.

21. Can adoption assistance agreements be modified if requested by adoptive parents?
Adoption assistance agreements include the state mandated cash payment rate based on the age of the child and no adjustment can be made to the State standardized rates. Adoptive parents are directed to contact their local Department of Heath and Human Services to request a change in an adoption assistance agreement. County directory: http://www.dhhs.state.nc.us/dss/local/index.htm.

22. What are the exact steps a family must go through to access the fair hearing/appeal process in North Carolina?
Adoptive parents have the right to appeal a decision any time adoption assistance benefits have been denied, reduced, or terminated. Requests for a fair hearing or appeal of a decision must be made in writing to the local department of social services. Within five days of receiving notification of the request, the county department of social services must notify the parents that a hearing will be held and hold the hearing. A local hearing officer will review the case and render a decision. If the decision is unfavorable to the parents, the agency will advise parents that they can appeal to the state. Parents have fifteen days (15) of the mailing of the agency’s letter to request a State appeal. 

If parents wish to appeal the agency’s decision, the agency will submit required materials to the State Hearings and Appeals Section. The Hearing Officer will make arrangements with the parents and agency for the date and time of the hearing. Following the hearing, the Hearing Officer will notify the parents of the parents of the decision. If parents are dissatisfied with the decision, their appeal for review can be submitted to the Chief of the Hearings and Appeals Section.
If the final decision of the Hearing and Appeals Section is unfavorable to the parents, they can then appeal to North Carolina’s Superior Court, provided such appeal is filed within thirty days of the receipt of the final decision. Contact the local county office, directory: http://www.dhhs.state.nc.us/dss/local/index.htm.

23. Families may request a subsidy after the finalization of an adoption under certain circumstances. Below is the process by which families access a subsidy after finalization.
Families must work with the local departments of social services to access a subsidy after finalization. A family can contact the local department of social services and request adoption assistance benefits based on the child’s special needs. The local department of social services will hold a fair hearing regarding the request. If a family is successful in a fair hearing, their local social worker will process all of the necessary paperwork on behalf of the family. All data entry is done at that level. Subsidy checks are sent from the state office.

System Operation and Program Funding

24. How is the subsidy program operated and funded in North Carolina?
The program is state supervised/county administered. This means that personnel at the state office are responsible for making policy decisions regarding the adoption assistance program, and providing guidance to county offices. The counties make decisions related to children’s eligibility. North Carolina has 100 county departments of social services, all of which are mandated by law to provide adoption services.
The federal contribution to Title IV-E-eligible children is 63.49% in North Carolina. This is known as the Federal Financial Participation (FFP) rate. The remaining cost of the program is funded with 16.7% state funds and 16.7% county funds.

25. Below are other programs that may differentiate North Carolina's adoption assistance program from others around the country.
Children who were adopted after the age of 16 or children who remain in foster care after their 16th birthday are eligible for the Education Voucher. Information may be obtained from www.statevoucher.org, click on NC.
For additional information, please contact:
Joan McAllister
LINKS Coordinator
919-733-2580
Joan.McAllister@ncmail.net

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North American Council on Adoptable Children (NACAC)
970 Raymond Avenue, Suite 106
St. Paul, MN 55114
phone: 651-644-3036
fax: 651-644-9848
e-mail: info@nacac.org
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