Ky.gov
Effective: 3/19/2025

13.40 Approval of Adoption Assistance

Legal Authority

Introduction

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Practice Guidance

  • The adoption subsidy amount shall not exceed the amount paid for foster care maintenance for the same child or exceed the foster care per diem reimbursement established by the Department for Community Based Services (DCBS) (including medically complex rates and care plus rates). Children who are adopted with a level of care (LOC) one (1) shall qualify for up to the advanced rate. Children who are adopted with a LOC two (2) or three (3) shall qualify for up to the care plus or medically complex rate. A private child-placing (PCP) adoptive family meets the care plus standard for children with a LOC two (2) or three (3). 
  • For a PCP family to receive an advanced rate, they shall be approved for at least one (1) year. 
  • A child placed in therapeutic foster care shall not receive an adoption subsidy in excess of the DCBS care plus rates unless: 
    • The amount is determined necessary to meet the child’s needs; and 
    • The amount is approved by the DCBS commissioner or designee through an Adoption Monthly Payment Exception memo and includes supporting documentation. 
  • A child is eligible for the care plus rate if they have a LOC of two (2) or three (3) and meets at least one of the following criteria (also outlined in SOP 4.10.1 DCBS Care Plus​): 
    • Displays aggressive, destructive, or disruptive behavior; 
    • Has a diagnosed emotional or behavioral problem; 
    • Is scheduled to be released from a treatment facility; 
    • Is at ​​​​​​risk of being placed in a more restrictive setting; 
    • Is at risk of institutionalization; or 
    • Has experienced numerous placement disruptions. 
  • Child care services are paid by the adoptive parents and reimbursed monthly only with a paid receipt as verified by the child care provider. 
  • Child care reimbursements are only available for children under the age of thirteen (13); or thirteen (13) years of age and older if there is an established need due to a physical, emotional, or developmental need of the child, and with documentation provided from a physician or qualified mental health professional (QMHP) as defined in KRS 202A.011​ stating the child is physically or mentally incapable of caring for themselves. 1​
  •  Adoption assistance may be requested for the following: 
    • Reimbursement of child care services for full-time or part-time working foster and adoptive parents who work a minimum of twenty (20) hours per week and with annual employment verification or adoptive parents pursuing higher education. 2
    • Transportation, if mileage for health care treatment needs exceeds the yearly mileage for foster care rates. (See Non-Medical Transportation Calculator for DCBS Foster Parents) 
    • Orthodontia with a dentist or physician’s verification that the child’s medical or dental need exists and are medically necessary, and verification was obtained prior to the adoption finalization and a co-payment of fifty (50) percent of the cost. 
    • Reimbursement of funeral and burial expenses for a medically complex child who had a terminal medical diagnosis documented by a treating physician prior to an adoption being finalized, not to exceed four thousand five hundred dollars ($4,500). 
    • Tutoring not to exceed twenty-five ($25) dollars per hour for no more than two (2) hours per week. Personnel other than immediate family must provide reimbursable tutoring, for which qualifications are verified by the SSW​. Tutoring may be approved for a child who: 
      • Has an individual education plan (IEP); OR 
      • Is two (2) or more grade levels behind chronological age; and 
      • With need and unavailability of services as documented by the child’s school. 
    • Evidence-based or evidence-informed health services after Medicaid and private health insurance have been exhausted, such as: 
      • Counseling; 
      • Expressive or art therapy; 
      • Behavioral therapy; 
      • Physical therapy; 
      • Occupational therapy; 
      • Speech therapy; 
      • Prescribed medication (excluding over-the-counter medication); or 
      • Special equipment. ​​​​​
  • A Kentucky medical assistance card is available to all children who have a DPP-1258 Adoption Assistance Agreement/DPP-1​258D Adoption Assistance Agreement for Parenting Youth. The adoption subsidy Kentucky medical assistance card is approved through the children's benefits worker (CBW) when the adoption is finalized, and the child's agency case is sealed. ​3
  • ​ Respite care is not cumulative; this should be submitted monthly for reimbursement. Respite care is offered to a child approved for: 
    • Medically complex or care plus rates prior to adoption finalization, at two (2) respite dates per child, per month; or
    • Specialized medically complex rate prior to adoption finalization, at three (3) respite days per child, per month.​​
  • ​A family cannot receive the supplemental services or enhanced rate for adoption subsidy. These rates should be used on a temporary basis during a period of crisis.  


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Procedure

  1. ​​The recruitment and certification (R&C) worker discusses with the adoptive family extraordinary medical services. 4 
  2. The R&C worker submits a request for child care to the service region administrator (SRA) or designee that includes documentation from a qualified mental health professional (QMHP)​ or doctor of the therapeutic need for the service for non-working adoptive home parents or for those children in need of child care who are age thirteen (13) and older. 5 
  3. The SRA or designee conducts a special review of these approved requests every six (6) months. 6 
  4. The R&C worker informs the adoptive parents that approved child care co-payments will mirror those established by the Division of Child Care (DCC) in Kentucky Administrative Regulation 922 KAR 2:160​ and adjustments in reimbursable amounts can be made at any time as also outlined in the child care section of the DPP-1258C​ Adoption Assistance Agreement for Extraordinary Medical Expenses. 
  5. The R&C worker submits the request for approval of adoption assistance, extraordinary medical expenses, and non-reoccurring adoption expenses through the R&C supervisor to the SRA or designee. The packet should include the following: 
    1. Approval letter; 
    2. Memo for approval; 
    3. Adoption Assistance Coversheet (the number of household members excludes foster children in the home); 
    4. Adoption Assistance Request for each child; 
    5. DPP-1258/DPP-1258D for each child; 
    6. DPP-1258C​ for each child; 
    7. Non-Recurring Adoption Expense Request per sibling group; 
    8. DPP-1258A per sibling group; 
    9. Any other necessary documentation to determine eligibility (LOC, PCC rate, etc.); and
    10. DPP-157​ or the KY KARES Final Results registry results.  
  6. Upon approval by the SRA or designee, the DPP-1258 Adoption Assistance Agreement/DPP-1258D, the DPP-1258C Adoption Assistance Agreement for Extraordinary Medical Expenses, and the DPP-1258A Adoption Assistance Agreement Non-Reoccurring Adoption Expenses are signed by all parties and copies are distributed to the adoptive family, CBW, and CHFSAdptionsubsidy@ky.gov. 
  7. Pre-adoptive assistance begins on the effective date of the Adoption Assistance Agreement contracts and the DPP-195 Adoptive Placement Agreement form, though the dates of the approval signatures may vary from the effective date. The effective date must be either the first (1st) or the fifteenth (15th) of the month. 
  8. The R&C worker reviews the information and forwards the bill and finalization documentation, along with a copy of the DPP-1258A Adoption Assistance Agreement Non-Recurring Adoption Expenses to the Division of Administration and Financial Management (DAFM), in central office for payment. 7 ​
Calculating Adoption Monthly Maintenance for PCP Adoptions

  1. SSW requests from the PCP agency the current rate that the prospective adoptive parent is receiving, and the current LOC of the child. 
  2. If the child is a LOC one (1) the family shall continue to receive the current daily rate that is received from the PCP. However, the family shall not receive more than the advanced DCBS rate. 
  3. If the child is a LOC two (2) or three (3), the family shall continue to receive the current daily rate that is received from the PCP. However, the family shall not receive more than the DCBS advanced care plus rate. 
  4. If the child is deemed medically complex the family shall continue to receive the current daily rate that is received from the PCP. However, the family shall not receive more than the established DCBS medically complex rate, (i.e., specialized medically complex, degreed medically complex, etc.) 8 
  5. The calculating formula to determine monthly maintenance rate is as follows: daily amount multiplied (x) by 365 divided (÷) by 12 equals (=) monthly maintenance amount (round to nearest dollar). 9
Calculating Adoption Monthly Maintenance for Adoptions Involving a Parenting Youth ​
  1. SSW verifies that the eligible child is also a parent and meets requirements as outlined in SOP 4.6 Parenting Youth in Foster Care. 
  2. The monthly maintenance should include the daily parenting youth supplement for the minor child. 
  3. The monthly maintenance calculation is based upon the eligible child’s daily rate to the family, plus the daily parenting youth supplement of twenty-four dollars ($24). The calculating formula to determine the monthly maintenance rate is as follows: daily amount plus (+) 24 dollars per day multiplied (x) by 365 divided (÷) by 12 equals (=) monthly maintenance amount (round to nearest dollar) 
  4. The SSW completes the DPP-1258D Adoption Assistance Agreement for Parenting Youth. 
  5. Commissioner approval must also be obtained using the Adoption Monthly Payment Exception for Parenting Youth Supplement memo template.

Contingencies and Clarifications

  1. ​If the adoptive family requests payment to a private attorney, the attorney submits the bill for services and a copy of the adoption judgment to the R&C worker who processed the adoption assistance.​

Footnotes

  1. Documentation should include diagnoses and descriptions related to the child’s physical and/or mental incapacity to care for themselves and their need for supervision. 
  2. Verification documentation is reviewed during initial and annual contact. Approved childcare rates cannot exceed the rates established by DCC. When possible, adoptive parents are encouraged to utilize public preschool services for children of appropriate ages. 
  3. Adoptive parents should report any name, Social Security number, and/or address changes to the CBW. The child may retain the Kentucky medical card if moving out of Kentucky, please refer to The Association of Administrators of Interstate Compact on Adoption and Medical Assistance. Please review the Adoption Assistance Handbook for additional details and potential impact on the child’s medical coverage.  ​
  4. Discuss with the adoptive family the Kentucky Integrated Health Insurance Premium Payment (KI-HIPP) for an adoptive child(ren) who is eligible for a medical card. This Medicaid benefit will cover the premium cost for private health insurance when they enroll in this program. Please refer to the KI-HIPP link for enrolling details.  ​
  5. Children approved by the medical review team (MRT) as physically or mentally disabled may be eligible for child care through age nineteen (19). 
  6. The family must submit documentation to the R&C worker every six (6) months. Approved childcare rates cannot exceed those established by DCC. When possible, adoptive parents are encouraged to utilize public preschool services for children of appropriate ages. 
  7. All non-recurring adoption expense reimbursement must be approved prior to the finalization of the adoption and cannot exceed two thousand dollars ($2,000) per child. 
  8. Children can only be deemed specialized medically complex by the Medical Support Section. Please refer to SOP 12.18.3 Medically Complex Home ​for degreed home requirements. 
  9. Examples of calculations: 
    1. ​The child is a LOC three (3), and the PCP daily rate to the family is $33 per day. $33 multiplied (x) by 365 days equals (=) $12,045 per year. That amount divided (÷) by 12 months equals (=) $1,003.75, which rounds up to $1,004 per month. The family continues to receive the same amount in adoption subsidy because the daily per diem is less than the established DCBS rate.  
    2. The child is age seven (7), a LOC two (2), and the PCP rate to the family is $60 per day. In this scenario, DCBS staff should utilize the corresponding DCBS rate, which would be $53.42 per day, $19,498 per year, and $1,625 per month. The family cannot receive an adoption subsidy that exceeds the established DCBS rate.  
    3. The child is age seven (7), a LOC one (1), and the PCP rate to the family is $40 per day. In this scenario, the family would receive $29.57 per day multiplied (x) by 365 days, which equals (=) $10,793 per year divided (÷) by 12 months, which​ equals (=) $902 per month. Because the youth's LOC is one (1) and the youth is seven (7) years old, the family will receive the basic advanced rate. The family cannot receive​ a rate that exceeds the established DCBS rate.  ​

Documents

Revisions

​7/20/2022 Edits regarding subsidy calculations based on the new LOC scale.  Staff are also instructed to include the DPP- 157 or KARES final results registry in the subsidy packet for audit purposes.​

7/1/2024

​A family cannot receive the supplemental services or enhanced rate for adoption subsidy. These rates should be used on a temporary basis during a period of crisis.  

The family continues to receive the same amount in adoption subsidy because the daily per diem is less than the established DCBS rate

3/19/2025

  • Orthodontia with a dentist or physician’s verification that the child’s medical or dental need exists is medically necessary, and verification was obtained prior to the adoption finalization and a co-payment of fifty (50) percent of the cost. 
  • ​Reimbursement of funeral and burial expenses for a medically complex child who had a terminal medical diagnosis documented by a treating physician prior to an adoption being finalized, not to exceed four thousand five hundred dollars $4,500. ​
  • Prescribed medication (excluding over-the-counter medication)​
7.  All non-recurring adoption expense reimbursement must be approved prior to the finalization of the adoption and cannot exceed one two thousand dollars ($2,000) ($1,000) per child. ​