13.43 Adoption Assistance Renegotiation



Practice Guidance

  • ​​Adoption assistance may be renegotiated at any time upon the request of the adoptive parent. 
  • A monthly subsidy does not automatically increase as the child becomes older or the foster care per diem changes.
  • Requested changes are effective no earlier than the date of the adoptive parents’ request. 
  • Extraordinary medical expense requests, which have caused financial hardship on the family, may be retroactively dated no earlier than July 1 of the current state fiscal year.​


  1. ​​Renegotiation of an adoption assistance agreement: 
    1. May be requested by the Cabinet for Health and Family Services (CHFS/Cabinet) or the adoptive parent before or after the adoption is finalized; and 
    2. Is contingent on compliance with the eligibility criteria, compliance with annual family contact, and a notice of change in circumstance related to the adoption assistance payments. Please refer to SOP 13.44 for determination if the change in circumstance qualifies for a suspension or termination of adoption assistance. 1 
  2. If the conditions are met, to prevent an adoption disruption, the Cabinet shall discuss renegotiating reimbursement for extraordinary medical expenses requested by an adoptive parent of a child with special needs: 
    1. After the adoption is final; and 
    2. Through state-funded adoption assistance. 
  3. A move out of state or country by the child with special needs or the adoptive parent of the child with special needs shall not change the adoption assistance payments. 2 
  4. The SSW completes the following tasks when an adoptive family requests a renegotiation in their adoption subsidy (assistance and/or extraordinary medical): 
    1. Evaluates the situation; 
    2. Obtains documentation concerning special needs or conditions; 
    3. Ensures that if a care plus rate is being requested by the adoptive family, that the documentation regarding the child's mental health and behaviors has been reviewed to determine if the additional support will help prevent a placement disruption. The SSW then completes the following tasks to determine eligibility: 
      1. Leveling of the child (refer to SOP 13.45.3); 
      2. Determine if the child meets the requirements for care plus; 3 
      3. Determine the adoptive family training requirements. The adoptive family: 
        1. Is currently or was previously a therapeutic foster home through a child-placing agency; 
        2. Is currently or was previously a care plus DCBS foster home; or 
        3. Must complete care plus training through DCBS. 
    4. Negotiates the subsidy with the family; 
    5. Prepares an Adoption Assistance Renegotiation Form and a new DPP-1258 and/or DPP-1258C; 
    6. Forwards through supervisory and administrative channels for approval by the service region administrator or designee; 
    7. If approved, obtains the adoptive family’s signature on the DPP-1258 and/or DPP-1258C, and distributes to the adoptive family, children’s benefits worker, and regional billing specialist; or 
    8. If denied, provides the family with a DPP-154 Protection and Permanency Service Appeal, and informs the family of their right to file a service complaint as outlined in SOP 30.1 Service Appeals. 4 
  5. When a child qualifies for PAPSS services, staff should refer to SOP 13.45.3 regarding renegotiating adoption assistance to one ($1) dollar for PAPSS to begin. 5 
  6. When PAPSS services are completed, staff should refer to SOP 13.45.3 to resume the adoption assistance to the rate prior to PAPSS involvement. ​5 
  7. When a request is made for a child to be considered as disabled by the medical review team (MRT) for adoption assistance services to continue through the age of twenty-one (21), staff should refer to SOP 13.46.1. 5​​


  1. ​​Compliance with the annual family contact only applies to state-funded adoptions. 
  2. A Medicaid card is available for all children who have a completed DPP-1258. Discuss which children are eligible for a Medicaid card, with the adoptive family and the Kentucky Integrated Health Insurance Premium Payment (KI-HIPP). When a child is enrolled, this Medicaid benefit will cover the premium cost for their private health insurance. Please refer to the Kentucky Integrated Health Insurance Premium Payment (KI-HIPP)​ link for enrollment details. The child may retain the Kentucky Medicaid card if moving out of Kentucky. (refer to AAICAMA for more information). Please review the Adoption Assistance Handbook for additional details and potential impact on the child’s medical coverage. 
  3. A child is considered to be care plus eligible based on having a LOC assignment of a two (2) and meets at least one of the following criteria (also outlined in SOP 4.10.1): 
    1. Displays aggressive, destructive, or disruptive behavior; 
    2. Has a diagnosed emotional or behavioral problem; 
    3. Is scheduled to be released from a treatment facility; 
    4. Is at risk of being placed in a more restrictive setting; 
    5. Is at risk of institutionalization; or 
    6. Has experienced numerous placement disruptions. 
  4. A request for review must be submitted by the adoptive/prospective adoptive family to the Cabinet no later than thirty (30) calendar days from the date that the DPP-154 was issued or the date of the occurrence of the disputed action.
  5. ​​​​​ Staff refers to designated DCBS regional staff (e.g. R&C worker, intake worker, investigative worker, ongoing worker). The specific worker responsible is determined by regional protocol.


​7/25 Footnote 3 edited to add LOC two (2) and delete LOC three (3),LOC four (4),and LOC five (5).  ​