RELATES TO:
KRS
199.555,
205.639(17),
216B.450(5),
600.020(21),
(54),
620.020(5),
Chapter 625
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
194A.050(1) requires the
secretary to promulgate, administer, and enforce those administrative
regulations necessary to implement programs mandated by federal law or to
qualify for the receipt of federal funds and necessary to cooperate with other
state and federal agencies for the proper administration of the cabinet and its
programs.
KRS
199.555(10) requires the
cabinet to establish and promulgate by administrative regulation criteria to be
followed for the adoption of special needs children. This administrative
regulation establishes guidelines for the implementation of the state-funded
adoption assistance program for children who may otherwise grow up in foster
care.
Section 1. Definitions.
(1) "Adoption subsidy" means a payment for a
special needs child placed for adoption when an adoption assistance agreement
is complete.
(2) "Extraordinary
medical expenses" is defined by
KRS
199.555(4).
(3) "Nonrecurring adoption expenses" is
defined by
KRS
199.555(3).
(4) "Secretary" means the Secretary of the
Cabinet for Health and Family Services or de-signee.
(5) "Special needs child" is defined by
KRS
199.555(1).
(6) "State-funded adoption assistance" is
defined by
KRS
199.555(2).
Section 2. Adoption Assistance
Eligibility Criteria.
(1) The secretary shall
decide whether to pay and provide adoption assistance in accordance with
KRS
199.555(5).
(2) A special needs child shall include a
child for whom adoptive placement without financial assistance is unlikely in
accordance with
KRS
199.555(1), because the
child:
(a) Has a physical or mental
disability;
(b) Has an emotional or
behavioral disorder;
(c) Has a
recognized risk of physical, mental, or emotional disorder;
(d) Is a member of a sibling group in which
the siblings are placed together;
(e) Has had previous adoption disruption or
multiple placements;
(f) Is a
member of a racial or ethnic minority and two (2) years old or older;
or
(g)
1. Is age seven (7) or older;
2. Has a significant emotional attachment or
psychological tie to his or her foster family; and
3. The cabinet has determined should remain
with the family because it is in the best interest of the
child.
(3) To
qualify for state-funded adoption assistance in accordance with
KRS
199.555, a special needs child shall:
(a) Be committed to the Cabinet for Health
and Family Services;
(b) Not have a
parent with custody or a legal claim to the child;
(c) Be under age eighteen (18); and
(d) Not be eligible for federal Title IV-E
adoption assistance in accordance with 922 KAR
1:060, with the exception of
extraordinary medical expenses pursuant to Sections 7(1), 8, and 10(2) of this
administrative regulation.
Section 3. Parental Standards. A parent
receiving a child eligible for adoption assistance payments shall meet the same
standards as those applied to other adoptive applicants in accordance with:
Section 4. Adoption Placement Agreement.
(1) Prior to placing a child for adoption,
the prospective adoptive parent and the cabinet shall review and sign the
adoption placement agreement to set forth the terms of a child's placement with
the prospective adoptive parent.
(2) The adoption placement agreement shall
advise the prospective adoptive parent of the:
(a) Special needs of the child;
(b) Cabinet's expectations; and
(c) Services offered by the cabinet to assist
the prospective adoptive parent in the adoption process.
Section 5. Adoption Assistance
Agreement. Prior to finalization of the adoption, the prospective adoptive
parent and the cabinet shall negotiate and sign an adoption assistance
agreement in accordance with
KRS
199.555(6)that shall:
(1) Determine the nature and amount of the
adoption subsidy; and
(2) Remain in
effect until suspended or terminated in accordance with Section 6 of this
administrative regulation.
Section
6. Adoption Assistance Suspension and Termination.
(1) Except as provided in subsection (2) of
this section, the cabinet shall temporarily suspend state-funded adoption
assistance payments during the period of time the adopted child:
(a)
1.
Resides in:
a. Foster care as defined by
KRS
620.020(5);
b. A residential treatment facility as
defined by
KRS
600.020(54);
c. A psychiatric residential treatment
facility as defined by
KRS
216B.450(5);
d. A psychiatric hospital as defined by
KRS
205.639(17) beyond thirty
(30) consecutive calendar days; or
e. Detention:
(i) As defined by
KRS
600.020(21);
(ii) Outside the adoptive home; and
(iii) For a period of thirty (30) calendar
days or more; or
2. Is absent from the home of the adoptive
parents for a period of thirty (30) consecutive calendar days or more, unless
the child is absent due to medical care or school attendance; and
(b) Receives care and support for
the child's special needs from a local, state, or federal public
agency.
(2) State-funded
adoption assistance shall be renegotiated in accordance with 922 KAR
1:530,
Section 3(2).
(3) State-funded
adoption assistance payments shall be terminated in accordance with
KRS
199.555(8) if the:
(a) Adoptive parent:
1. Is no longer legally responsible for the
special needs child in accordance with KRS Chapter 625;
2. Becomes deceased; or
3. Requests discontinuation of the adoption
assistance payments; or
(b) Special needs child:
1. Becomes deceased;
2. Marries;
3. Gains full-time employment;
4. Is considered an emancipated
minor;
5. Is inducted into military
service;
6. Reaches age eighteen
(18); or
7. If the child is
enrolled in high school, reaches:
a. Age
nineteen (19); or
b. The month of
the child's high school graduation, if the child's graduation precedes the
child's 19th birthday.
Section 7. Adoption Assistance Payments.
(1) State-funded adoption assistance payments
may include:
(a) Extraordinary medical
expenses in accordance with
KRS
199.555;
(b) Nonrecurring adoption expenses not to
exceed $1,000 incurred in the adoption of a child who is considered a special
needs child; and
(c) An adoption
subsidy.
(2) An adoption
assistance payment shall begin on the date that the adoption placement
agreement and adoption assistance agreement are signed by the adoptive parent
and the cabinet.
(3) The amount of
the state-funded adoption assistance payment shall not exceed the amount paid
for foster care maintenance for the same child, in accordance with
KRS
199.555(7), including
medically fragile, specialized medically fragile, and care plus foster care per
diem reimbursements established by the Department for Community Based
Services.
(4) A child placed in
therapeutic foster care, as described in 922 KAR
1:310, shall not be eligible
to receive adoption assistance payments in excess of:
(a) A care plus foster care per diem
reimbursement established by the Department for Community Based Services;
or
(b) The therapeutic foster care
per diem reimbursed by the child-placing agency on behalf of the child if the:
1. Dollar amount is necessary to meet the
child's needs; and
2. Commissioner
or designee approves.
Section 8. Covered Extraordinary Medical
Services.
(1)
(a) Copayments for covered extraordinary
medical expenses shall be required using the adopted parent household's
adjusted gross income in relation to Kentucky's estimated median household
income established by the United States Census Bureau.
(b) To the extent state resources allow, the
cabinet shall annually adjust the estimated median income used for copayment
calculations concurrent with the United States Census Bureau.
(c) Unless otherwise noted in this section,
copayments shall be as established in this paragraph.
1. A copayment for extraordinary medical
services shall not be required from an adoptive parent whose household's
adjusted gross income is at or below 100 percent of Kentucky's estimated median
household income.
2. A ten (10)
percent copayment for extraordinary medical services shall be required from an
adoptive parent whose household's adjusted gross income is over 100 percent,
but less than 150 percent, of Kentucky's estimated median household
income.
3. A fifteen (15) percent
copayment for extraordinary medical services shall be required from an adoptive
parent whose household's adjusted gross income is over 150 percent, but less
than 200 percent, of Kentucky's estimated median household income.
4. A twenty (20) percent copayment for
extraordinary medical services shall be required from an adoptive parent whose
household's adjusted gross income is over 200 percent of Kentucky's estimated
median household income.
(2) A verifiable receipt and service provider
contact information shall be submitted prior to reimbursement for services
listed in this section.
(3)
Copayments shall be deducted from each monthly receipt that is submitted for
payment of a covered extraordinary medical service.
(4) Services covered by the extraordinary
medical program may include:
(a) Orthodontia
with a:
1. Copayment of fifty (50) percent of
the cost; and
2. Dentist or
physician's verification that the child's medical or dental need existed prior
to the adoption finalization;
(b) Transportation if mileage for health
treatment needs exceed the yearly mileage for foster care rates;
(c) Child care services:
1. For a full-time or part-time working
parent who works a minimum of twenty (20) hours per week;
2. For a non-working parent with
documentation from a qualified professional, as defined by
KRS
202B.010(12), of the
therapeutic need for the service;
3. With fees paid to the child care provider
by the adoptive parent and reimbursed by the cabinet only after the cabinet
receives a paid receipt as verified from the child care provider;
4. With annual employment verification
provided to the cabinet by a working adoptive parent;
5. Reimbursed at a rate based on the age of
the child and certification of the provider in accordance with 922 KAR
2:160;
and
6. Ending upon the child
reaching age thirteen (13), unless documentation from a medical or mental
health professional stating the diagnosed need for continuance of the child
care is:
a. Provided upon the child reaching
age thirteen (13); and
b. Submitted
every six (6) months to the cabinet's social service worker;
(d) Tutoring:
1. Not to exceed twenty-five (25) dollars per
hour for no more than two (2) hours per week;
2. Provided by personnel other than immediate
family, for which qualifications are verified by a social services
worker;
3. For a child:
a. With an individual education plan (IEP);
and
b. Two (2) or more grade level
years behind chronological age; and
4. With need and unavailability of services
as documented by the child's school;
(e) Respite care:
1. Offered to a child approved for the
medically complex or care plus rates prior to adoption finalization, at two (2)
respite days per child per month;
2. Offered to a child approved for the
specialized medically fragile rate prior to adoption fina-lization, at three
(3) respite days per month per child;
3. That shall not be cumulative;
and
4. Submitted monthly for
reimbursement; and
(f)
Evidence-based or evidence-informed health services after Medicaid and private
health insurance have been exhausted, such as:
1. Counseling;
2. Expressive or art therapy;
3. Behavioral therapy;
4. Physical therapy;
5. Occupational therapy;
6. Speech therapy;
7. Medication; or
8. Special equipment.
Section 9.
Annual Family Contact.
(1) Annual contact
with the adoptive family shall be made by mail or home visit to determine that
the:
(a) Child remains in the adoptive
home;
(b) Parent continues to
provide care and support for the child; and
(c) Adoption assistance payments continue to
meet the special needs of the child.
(2) The cabinet may conduct a home visit
after an adoption assistance annual contact is made by mail:
(a) If:
1.
The adoptive parent requests a home visit;
2. The special needs of the child change, as
indicated by the adoptive parent;
3. Attempts to update information by
additional mail or phone contact have failed; or
4. The cabinet receives information that is
contrary to the information verified by the adoptive parent during the annual
contact; or
(b) In
accordance with 922 KAR
1:330.
Section 10. Adoption Assistance
Renegotiation.
(1) Renegotiation of an
adoption assistance agreement:
(a) May be
requested by the cabinet or the adoptive parent before or after the adoption is
finalized; and
(b) Is contingent on
compliance with Sections 2(2), 6, 9, and 12 of this administrative
regulation.
(2) If
conditions in
KRS
199.555(6) are met, the
cabinet shall reimburse extraordinary medical expenses requested by an adoptive
parent of a special needs child to prevent disruption of the adoption:
(a) After the adoption is final;
and
(b) Through state funded
adoption assistance.
(3)
A move of the special needs child or the adoptive parent of the special needs
child out of the state or country shall have no effect on the child's
eligibility for state funded adoption assistance payments.
(4) If an adoption assistance payment is
changed through renegotiation, the cabinet and adoptive parent shall sign a new
adoption assistance agreement.
Section 11. Service Appeal. An applicant for
adoption assistance payments or an adoptive family aggrieved by a cabinet
action shall be granted an administrative hearing in accordance with 922 KAR
1:320.
Section 12. Notice of
Change.
(1) Cabinet staff shall provide
notice of a reduction, discontinuance, or termination of adoption assistance
payments:
(a) Ten (10) calendar days in
advance; and
(b) In accordance with
922 KAR
1:320, Section 6.
(2) An adoptive parent shall notify the
cabinet of any changes in circumstances that would make the adoptive parent
ineligible for adoption assistance payments or change the amount of the
adoption assistance payment as described in
KRS
199.555(9) and Section 6 of
this administrative regulation.
Section 13. State-funded Adoption Assistance
Limitation. The number of state-funded adoption assistance cases and the amount
of state-funded adoption assistance payments paid per case shall be limited by
available funds for the state-funded adoption assistance program.
Section 14. Training. Contingent upon the
availability of funding, the Department for Community Based Services shall
offer training to adoptive parents receiving state-funded adoption assistance
consistent with training offered to foster home parents as specified in 922 KAR
1:495.