Ky.gov
Effective: 3/19/2025

13.46.1 Continuation of Title IV-E Adoption Assistance After Age 18

Legal Authority

Introduction

​​​​​​​​​​

Adoptive parents may be eligible for continuation of title IV-E adoption assistance after the age of eighteen (18), if either circumstance is present:
  1. ​The child has a signed adoption assistance agreement on or after the youth’s sixteenth (16th) birthday and is:
    1. ​Completing secondary education or a program leading to an equivalent credential;
    2. Enrolled in an institution that provides post-secondary or vocational education;
    3. Participating in a program or activity designed to promote or remove barriers to employment; or
    4. Employed for at least eighty (80) hours per month. 
  2. ​An adopted child may have a disability as determined by the Social Security Administration (SSA) or by a Cabinet for Health and Family Services (CHFS/Cabinet) medical review team (MRT) that allows for the continuation of title IV-E adoption assistance after the age of eighteen (18). A disability includes the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment(s) and can be expected to result in death or last for a continuous period of not less than twelve (12) months.

    ​​​​​​​The Department for Disability Determination Services (DDS) MRT considers the following factors at least six (6) months prior to the youth’s eighteenth (18th) birthday to allow or deny a disability determination for an adopted child:​​​​​​​
    • ​The youth’s medical history and medical testimony, including information relating to the alleged physical or mental disability, illness, or impairment as to whether the youth's ability to gain full-time employment or pursue opportunities within a state or federal education program is reduced; and 
    • The youth’s age, employment history, education, and effect of the physical or mental condition on the ability to care for and support self.​​


Practice Guidance

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Procedure

The recruitment and certification (R&C) worker:
​
  1. ​Contacts the adoptive family receiving title IV-E adoption assistance as outlined below or ensures that the adoptive parent(s) have a current email address entered into TWIST so that the adoptive family receives the proper notifications.
    1. For youth who have a signed Adoptive Placement Agreement on or after their sixteenth (16th) birthday, the family is informed (when the youth is age seventeen (17) years, nine (9) months) that the youth may be eligible for continued adoption assistance up to age twenty-one (21) if the youth meets at least one (1) of the below criteria:
      1. ​Completing secondary education or a program leading to an equivalent credential; 
      2. Enrolled in an institution that provides post-secondary or vocational education;
      3. Participating in a program or activity designed to promote or remove barriers to employment; or
      4. Employed for at least eighty (80) hours per month.
  2. ​Ensures the adoptive family provides verification of eligibility for extended subsidy benefits once every six (6) months as outlined below: 1
    1. ​Secondary, post-secondary or vocational education;
      1. Class or course schedule;
      2. Report card, grades;
      3. Enrollment verification, school letter, acceptance letter, instructor or trainer letter;
      4. Class, course payment, tuition verification, loan verification;
      5. Certification of attendance.
    2. Program or activity to promote or remove barriers: 
      1. ​Participation confirmation via letter or listing of topics or activities covered; 
      2. Certification of attendance.  ​
    3. Employment: 
      1. ​Employer verification letter;
      2. Paystub;
      3. W-2.
  3. ​​​When the youth becomes age seventeen (17), provide the family with initial information concerning the SSA and/or MRT review process. A review is only applicable for title IV-E subsidy. Please see the Subsidy Extension due to Medical Disability Letter. 
  4. Provides the DPP-601 Referral for Determination of Disability to Continue IV-E Funded Adoption Assistance, MRT-15 Procedural Instructions, and MRT-15 Release of Information, at the request of the adoptive family, for continuation of subsidy through the age of twenty-one (21) based on the youth's disability; 
  5. ​Requests that the adoptive family provide current supporting documentation​ (within one (1) year) including, but not limited to: 2
    1. ​Educational testing; 
    2. Individual education plans (IEPs); 
    3. Medical records; or 
    4. Psychiatric hospital records;
  6. Reviews the provided information and forwards the DPP-601, MRT-15, applicable supporting documentation, and a copy of the family's DPP-1258 Adoption Assistance Agreement to central office staff for consideration by the MRT. ​The R&C worker should contact​ the Adoption Services Branch at 502-564-2147 to obtain the name of a contact person and the mailing address for the required documentation submission. 
  7. Should take the following actions if a disability determination is denied: 
    1. ​​Consult with Adoption Services Branch staff; 
    2. Refer the youth for further assessment when necessary; and 
    3. Follow procedures outlined in SOP 13.44 Discontinuance of Adoption Assistance
  8. ​Contacts the children’s benefits worker (CBW) to ensure continuation of Medicaid for the youth until age ​twenty-one (21) if a disability determination is approved. When the MRT makes a disability determination, a report is provided to the Adoption Services Branch. The Adoption Services Branch forwards the report to the R&C worker and the adoptive family.3
  9. Should discuss the following with the family if the SSA makes the determination that the child is disabled. 
    • Supplemental security income (SSI) is an entitlement benefit that is based on a child's disability and is income tested. Public Law 110-351 removed the means-tested eligibility criteria for an applicable child. Adoptive parents should contact the SSA with any questions. 
    • If a child receives both SSI and adoption assistance subsidy, the SSI benefit will be reduced "dollar for dollar" by the amount of the monthly adoption subsidy. 4
    • In most cases, the amount of the adoption assistance subsidy exceeds the amount of the SSI benefit. The adoption assistance subsidy is time-limited. However, the SSI benefits may be available for the duration of the youth's life. Adoptive families should be advised to consider both outcomes when deciding which benefit to choose.5



Footnotes

  1. The family only needs to provide one form of documentation and not all items listed as examples.  
  2. ​​​​The adoptive family should return the requested documentation six (6) months prior to the youth's eighteenth (18) birthday. 
  3. The Adoption Services Branch and the R&C worker should not discuss back payments with the adoptive family. The family should be advised to contact the Division of Administration and Financial Management (DAFM) branch manager with questions related to any back payment. 
  4. ​​​​​​​​​For children receiving adoption assistance under title IV-E who do not meet the criteria to be an applicable child, if those children receive both SSI (which is an entitlement, but is based on a child's disability and is income tested) and adoption assistance, the SSI benefit is reduced dollar for dollar by the amount of the monthly subsidy. In almost all cases, the amount of the subsidy exceeds the amount of the SSI.
  5. The adoptive family is responsible for applying for SSI.  This can be done by contacting the SSA or by starting an online application at The United States Socal Security Administration (ssa.gov)​. 

Documents

Revisions

​3/19/2025

  1. ​​​Contacts the family When the youth becomes age seventeen (17) provides the family with initial information concerning the SSA and/or MRT review process. A review is only applicable for title IV-E subsidy. Please see the Subsidy Extension due to Medical Disability Letter. ​
​
    1. For youth who have a signed Adoptive Placement Agreement on or after their sixteenth (16th) birthday, the family is informed (when the youth is age seventeen (17) years, nine (9) months) that the youth may be eligible for continued adoption assistance up to age twenty-one (21) if the youth meets at least one (1) of the below criteria:
      1. ​Completing secondary education or a program leading to an equivalent credential; 
      2. Enrolled in an institution that provides post-secondary or vocational education;
      3. Participating in a program or activity designed to promote or remove barriers to employment; or
      4. Employed for at least eighty (80) hours per month.
​​​2.  Ensures the adoptive family provides verification of eligibility for extended subsidy benefits once every six (6) months as outlined below: 1
    1. ​Secondary, post-secondary or vocational education;
      1. Class or course schedule;
      2. Report card, grades;
      3. Enrollment verification, school letter, acceptance letter, instructor or trainer letter;
      4. Class, course payment, tuition verification, loan verification;
      5. Certification of attendance.
    2. Program or activity to promote or remove barriers: 
      1. ​Participation confirmation via letter or listing of topics or activities covered; 
      2. Certification of attendance.  ​
    3. Employment: 
      1. ​Employer verification letter;
      2. Paystub;
      3. W-2.
​​​4.  Provides the DPP-601 Referral for Determination of Disability to Continue IV-E Funded Adoption Assistance, MRT-15 Procedural Instructions, and MRT-15 Release of Information, at the request of the adoptive family, for continuation of subsidy through the age of twenty-one (21) based on the youth's disability; 

Footnote
​1.  The family only needs to provide one form of documentation and not all items listed as examples.