Creating a Family: Talk about Adoption & Foster Care

Foster Care Subsidies: What is Reasonable and How to Negotiate

May 02, 2019 Creating a Family
Creating a Family: Talk about Adoption & Foster Care
Foster Care Subsidies: What is Reasonable and How to Negotiate
Show Notes Transcript

What type of assistance or subsidies are available for parents adopting a child from foster care? Who determines the amount of a monthly adoption subsidy and how can parents negotiate for a fair amount? Host Dawn Davenport, Executive Director of Creating a Family, the national foster care & adoption education and support nonprofit, interviews Josh Kroll, Project Coordinator for the Adoption Subsidy Resource Center at the North American Council on Adoptable Children.

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Speaker 1:

[inaudible]

Speaker 2:

welcome to creating a family talk about adoption and foster care. Today we're going to be talking about adoption subsidies for those who adopt from foster care, uh, negotiating these subsidies as important topic a WHO's eligible. We're going to cover it all today with Josh[inaudible]. He is the project coordinator of the adoption Subsidy Resource Center at the North American Council on adoptable children. Welcome Josh to creating a family. We are so glad to have you.

Speaker 3:

Thank you. Glad to be back.

Speaker 2:

We are going to be talking today about adoption subsidies. What the beginning, let's talk about what are, what do we mean by adoption subsidies?

Speaker 3:

So when people talk about adoption subsidies, it usually includes at least one, if not all. Three of these, uh, supports. Um, one is an ongoing financial support paid generally monthly that people call adoption subsidy, adoption assistance, a p, lots of different names, stipend maintenance per diem. Um, that's the first part. The second part is, um, medicaid and that generally comes in almost all circumstances. And then the last one is the reimbursement of nonrecurring adoption expenses. And that can be, um, often, um, fully for attorney fees, but it also could help with other costs that are for the adoption process.

Speaker 2:

And by that last one, reimbursement of nonrecurring adoption expenses. That one is not an ongoing monthly that is intended for, um, the, the actual adoption itself. Am I correct there?

Speaker 3:

Correct.

Speaker 2:

Okay. So excellent. And we should also mention, although certainly not the topic of this course would be, uh, you're also eligible for the, uh, adoption tax credit, the federal adoption tax credit. Um, we have other courses on that and, and uh, neck North American council on adoptable children has a lots of information on that as well. Uh, so all of those, so that's just throwing that out there as, as another thing to be thinking about. All right. Is there, well, first of all, who is eligible for adoption? Well, all of these adoptions subsidies to financial, the Medicaid and the reimbursement.

Speaker 3:

So the state, the states administer the program and in some states the states delegated down to the counties, but the state set the rules, um, on who is eligible and PR. It's designed for children in the public foster care system. Um, although some private domestic adoptions could be eligible. Um, and it's going to vary greatly from state to state. It's for children who are considered hard to place or special needs. And what that is in each state varies a lot.

Speaker 2:

All right. Now, um, the, I'm sure everyone's ears of immediately perked up when they think that private domestic infant adoption might be eligible in the states. And I heard what you said, that it's only in some states, uh, and when the states that it is allowed, what, is that just any adoption or is it only adopting of adoption of a child that they consider special needs

Speaker 3:

for the private domestic adoptions? Um, those children typically are going to have to be either SSI eligible prior to finalization, and then the family will have to apply in their state of residency, even if the child's place from another state, um, and then get approved. And there are ways that states, um, have created some hurdles, um, maybe intentionally, maybe not intentionally to make it even more challenging to do it. It's no state will categorically say that a private domestics not eligible, but they definitely can make it a more challenging. Um, and then the other population is children who receive title four e that's federal funding title for a adoption assistance in a previous adoption. So like if I adopted a child and my adoption dissolves or I pass away in Don, you decide to adopt that child and that child, I got title four e adoption assistance, that child wouldn't have to reenter the foster care system. You could just do a straight attorney adoption of that child. But since you live in North Carolina, you're going to have to apply for adoption assistance with the state of North Carolina, um, for that reduction.

Speaker 2:

So the, the adoption assistance are you telling me doesn't follow the Child? So I said, so Billy, uh, was adopted in Illinois and, and Billy Billy's adoptive parents have adoption assistance from the state of Illinois. That adoption dissolves. Billy is readopted from, uh, let's say a family in New York. Um, would the original adoption assistance that was being provided by the state of Illinois follow Billy into this, into his new home or not?

Speaker 3:

Nope. They would have to apply in the new one. There are a handful of states. I think off the top of my head, the ones I can think of, New York, New Jersey, Minnesota, I think on a time limited basis in Nebraska may extend it even after, um, like an adoptive parents death. Um, but in, in most cases it would terminate in the situation you described.

Speaker 2:

So it doesn't follow the child per se. It's, it is to the family, which seems kind of counterintuitive but

Speaker 3:

well there, there are parties to the contract and if you know, if their parental rights have terminated, that's grounds for it to end. That makes sense. Cause there's a contract between your parents

Speaker 2:

and the state. You had said that the, uh, in some states it may be possible for a child adopted not through foster care child adopted privately to get adoption assistance if there s s I eligible. So what do you mean by s s I l l eligibility.

Speaker 3:

Um, so the social security administration for people with severe disabilities that don't have a work record, which our children, they don't have work records. Um, you know, they can play the little bombs. Yeah. The, the, the families or the, uh, um, or the agencies. And oftentimes it's easier if it's the agencies can apply for supplemental security income based on the disability of the child. Um, common ones you might see in, in our world of adoption. Uh, Down's syndrome, cerebral palsy, maybe spinal Bifida, Down's syndrome is probably the most common one I hear of. Um, with those are things that if they're able to get SSI for the child before finalization, um, then they can apply for, um, adoption assistance with them, with the state that they live in, the adoptive parents.

Speaker 2:

All right. Is there an income limit for receiving the adoption subsidy? Let's say a family makes a very good income, uh, and, and doesn't technically, and I'm using air quotes here, need a, the subsidy in order to support the child. Um, would they be eligible?

Speaker 3:

Technically, yes. Except there's, it's complicated, like everything in life. Um, it's complicated. Yeah. So there's, there's two types of adoption subsidy. There's the federally funded one, which means the state's getting reimbursed a portion of the dollars and then there's the non fori which the state is paying all of it. Or in some states the county and the state are paying some of it. Um, the federally one they cannot means to us. They can say, you know, Bill Gates technically could adopt a child and get adoption assistance, you know. Um, but um, the, the one exception is there are two states for the non each children. Um, Louisiana in Ohio do means tests their state program. So if you have a kid who's non 40 eligible in Louisiana or Ohio, there is an income test for the families in Ohio. It's a pretty high amount. It's not, it's not too bad tickets 110 or 130% of median income. Um, and it's based on family size. But in Louisiana it's pretty low. But there can be exceptions that can go up to the state office to over overrule that. But where, where families have more comfortable incomes will probably run into a bigger issue is, um, in the states that negotiate the rates, some states provide what the child was getting in foster care or a similar amount and there's a maximum rate. And families are just, this is what the most we can offer the child, will you take it in? The family says yes, but in other states, um, they look at the family's resources, they look at the child's needs and, um, and, and in those states there be more likely to get a lower amount, not getting nothing but be offered, uh, a substantially lower monthly amount.

Speaker 2:

Okay. Well that, that begs the, you know, the like a$64 million question are or not that anybody should be expecting that. However, then begs the bigger question, which is how is the dollar amount of the subsidy determined and by whom?

Speaker 3:

Um, it's going to be determined on the state that is providing the adoption subsidy. So for kids in the foster care system, it's the foster care system the child is in. So, um, you know, I'm in Minnesota. If I adopt little Billy from Illinois, I don't look at male Minnesota's rate structure and I don't look at Minnesota is eligibility criteria. I look at Illinois because Billy's in Illinois foster care. Um, if, um, Billy is a child with down syndrome and being prey place privately with me and gets SSI, um, you know, I'm applying here in Minnesota, then I look at Minnesota is where each structure and Minnesota's, um, eligibility criteria. So

Speaker 2:

does the state have it set that, okay, um, all children at this age with this level of need get x amount or all the families of children, uh, that meet those criteria get x amount and it's a non a non negotiable. It is a set amount that it is determined written down somewhere in state law or is it a little fuzzier as to the amount?

Speaker 3:

Um, most states have pretty concrete rate structures for foster care and that's generally the guideline for adoption subsidy. So, um, most states have a system set up like you described. So there's usually a, a basic rate. Um, and that could be for a child without very many issues. Um, and that may have a different amount based on what age they are. And then they may have, um, what's called a level of difficulty of care, specialized, um, lots of different terms, cans, um, you know, that could provide more based on the specific needs of a child. So like if I have a sibling group of two, I might have one child who's getting a basic rate because they don't generally have many needs, but their sibling has significant needs. It might getting a much higher amount. And what happens is those amounts generally are the ceiling on what the adoption assistance can be. Um, and in states that offer the same rates and don't make you negotiate, that's what the child is going to be looking at. Um, in support. Um, once they're adopted, um, some other states have structural, um, um, lower limits. Um, in Minnesota children adopted under the age of six, we'll get half of their foster care rate. That's in our state law. In Washington state kids, Nigga they negotiate, but it's up to 80% for kids, zero to four or five. And then up to nine it's 95% and then tend to 18, it's 95% of the foster care rate. Um, so it really depends on the state and how they structure things.

Speaker 2:

So how can parents find out, assuming they may or may not be a foster parent at the time, how can they find out how much they would be eligible?

Speaker 3:

Are there two? I would, I would definitely suggest they go visit the MCEC website, which is n a c a C. Dot. Org. And check out our list of state profiles. Um, you know, there's a, at a glance, which just gives a sort of a summary of the different rates, basic rates at different ages, but what folks would really want to do if they're interested in a specific child from a specific state or if they're adopting privately and they think they might adopt the private, um, a child with special needs that might get us society, they'd want to look at their specific state. Um, and we have state profiles for each state. And generally it's, I think it's question four and five, have the information on the rates, um, and may have some details on, um, even what qualifies children for certain rates depending on the state.

Speaker 2:

Yes, it's a great resource. That would be neck in a c a C. Dot. Org. Um, all right, so who you say, depending on the needs of the child, it may go up or down. Who makes a decision on the needs of the Child? Does that based on if the child is actively in therapy, um, is it dependent upon a behavior? What is it dependent upon?

Speaker 3:

It's um, I mean level of Fox home can be part of it, but really it should be based on the needs of the child. I mean this is all about the child, you know, and the reason I highlight that as sometimes people talk about themselves and asking if the child's eligible and it really shouldn't be about themselves and I want to highlight it, especially for relatives, relatives, you know, because there are a lot of kinship providers, um, they can be eligible for this being grand power on or whatever doesn't disqualify the child's eligibility, um, for adoption assistance. So those higher rates can be the physical disabilities, which are generally pretty obvious to people. But, um, a lot of the children in care have, um, had a lot of trauma, may have experienced abuse or neglect, both which are very traumatic and often I'm sad to say have behavioral issues and those are definitely a factor in higher rates.

Speaker 2:

But, but if the child is not actively in therapy, what does, what do the negotiators, what do the social workers, what do they rely on in determining that if the child is, is, if the child is in therapy for the child, is not in therapy, is there needs to be a report by the therapist? Is it a report by the parents on what they're saying? How do they know

Speaker 3:

it's going to depend on the state? Um, I mean, majority of kids that qualify for this are adopted from the foster care system and there are high numbers adopted by the foster parents, but for those who are, I mean, they're probably going to have that information if you're not already fostering this child. Um, they're going to have that information available. Um, that's to you. But it really depends on how the state reports, you know, determines things. I mean, another thing that some seats do, they factor in the time the parent spends with the child. Like here in Minnesota, you know, they use a term, I don't know if they still use it anymore, but in the past they used to activities of daily living based on the child's age. You know, if you've got a eight year old that still can't get themselves dressed in the morning and you've got to spend time being on top of that, um, you know, that's something that may factor into a little higher rate than just the basic rate. Um, but that's stuff that, you know, the, the Tom, what has to be reporting on, I mean this is, you know, it's government. Everything has to be recorded, um, to justify these higher rates.

Speaker 2:

So does it behoove a foster parent who is considering adopting or anyone who is considering adopting from foster care to be thinking in terms of, of making a case for why the child's needs are what the child actually needs. And again, I will go back to stressing what you're saying. This is not about mercenary foster parents trying to get everything they could possibly get. Just sting us that they can go sit around and eat bon bons or go to the Caribbean or something. This is for, because there is a concern that the child will need care and they want to be able to provide the care for the child. So should they be making notes, talking with the child's therapist, um, uh, w whomever I teachers or whatever as to what others are seeing as far as the child's needs.

Speaker 3:

It was a foster parent. I would, if I knew, I would talk to experienced parents in my area. And talk about what my child's needs are and talk about, hey, this is the rate the child's getting now. This, this seem appropriate to you. You know, because there's a lot of experiences, also a lot of human factor in how things are done. I mean, there is an estate in this country where there, you know, it probably depends how something has written up can make a difference between one rate or another. Um, and, and so I would definitely focus on that. And you know, if you've got a younger child, um, that's starting to present some things, but no one's diagnosed it yet, I would see if I could get a diagnosis in case that increases the ceiling for the child. Um, most states, um, families can renegotiate adoption assistance. So, you know, when you've got a really young child that no one wants to make a diagnosis, that's not going to be a really big issue. But, um, you know, it's, it's sometimes the negotiation processes and fun. So you might want to try and get as much done as you can. But I mean if you got a kid that's under three that's qualifying, they may, um, they may not really want to do any diagnosis yet until the kids school age. I mean, that's a real big issue the families face. Okay.

Speaker 2:

Let me pause here to remind everyone that you are listening to creating a family talk about adoption and foster care. And today we're talking with Josh[inaudible] with the North American Council on adoptable children and we're talking about adoption subsidies for adoptions primarily through foster care. This show is

Speaker 4:

underwritten by our corporate sponsor, jockey being family calling all adoption agencies. They want you to know that it is, one of the services that they provide is to, uh, is their backpack program. And in this wonderful cute customized back packages initialed with the child's name. Um, they, uh, they parents get material, the child of course gets, which really gets the chocolates, the backpack that gets in global, the bear and a blanket. Uh, but inside also there was a tote bag and it's full of parenting resources for the parents themselves to help them transition into a adoption. And this is open to all adoptions, uh, regardless of whether they're from, uh, international or domestic or foster care. Uh, so if you know of a family who is adopting or if you

Speaker 2:

or a family who is adopting and would like for your agency to participate, contact jockey being family, just go to their website. Probably the easiest thing, which is jockey being family.com. And you can click on there a backpack program and there's a place for the agency to register. So pop over there and make sure you are, you're doing that because it's a great resource. Uh, I'm glad you raised the issue, Josh, about situations where the child was either too young to be displaying needs or to be diagnosed or it's not displaying the need. But the parents have reason to believe that the child may have needs as they age. A common scenario is, um, would be prenatal exposures. They're either the child was born dependent or not. Uh, because we know that the impact of, of prenatal exposures is not necessarily connected to whether or not the child was born dependent on the unit. Neonatal Abstinence Syndrome is present or not. So, but that parents may know that the birth mom used alcohol or drugs through her pregnancy and have reason to believe, uh, that the child may be impacted. But at this point it's too young because honestly if some of those impacts do not show until school age, so what's apparent to do then when they want to be proactive to make certain that they can provide services as soon as possible, uh, for their child. Um, but at this point they have no reason the child's too young and they don't want to have to renegotiate because that's hard and you don't have much bargaining. But once you know it's your child at that point and you don't have much bargaining power on the renegotiation. So what should parents do then to try to make certain that that there is something, even if they don't want it now, they just want it there to get without having to go through the renegotiation. Is that possible?

Speaker 3:

Well, there are quite a few states that provide, um, what they call$0 million or divert deferred or dormant or we might use other terms, high risk agreements and those provide$0 million. So if the child's not meeting any other category because, um, I just want to mention that it's not just disabilities, but also there can be an age component. It's as low as one for a little Billy and Illinois, um, to as high as 12 and Kansas or a couple states without an each component and siblings being adopted. So if I'm adopting a kid, um, who was prenatally exposed with their sibling, that child more likely than not is going to be eligible for adoption. Sybil subsidy because they're being adopted as a sibling group. But let's say it's a child that isn't being adopted with the sibling, has him at the age criteria, um, and otherwise isn't meeting any other, the, the state's criteria. Some states also still have, um, race as a criteria. Um, and so the states, and there's quite a few of them, it's probably private guessing. At least half. I'm should do a summary at some point. Um, but quite a few states have these$0 million agreements that basically they say, here you have an adoption assistance agreement. It gives you no monthly payment. Most of the time it's going to give Medicaid, um, and probably nonrecurring. Um, and what that does is it provides that safety net so that if later on problems arise, when you can start making diagnosis in and things are starting to show up, you can then go back to the state and say, you know, my child now has x, y, or z. We need to get the monthly payments started. Um, and so that's, um, it's a great safety net and then, you know, the states are doing it to make the process easier to go back and provide that help. Um, so that's what I would encourage. Um, in our profiles question, I believe it's seven or eight, I think it's eight on our, each state profile addresses that. Um, does the state provide such an agreement?

Speaker 2:

It's certainly something to consider. And if you never need it, then fine. It just never comes into effect. But if a third grade, you may say for instance, third grade, you start seeing that your child is really struggling with some of the higher level thinking skills that kick in at that point and is falling behind and you're wanting to hire a tutor or wanting to put them in a special school for kids with learning differences or whatever, um, that that's at the time you might be able to go back and uh, reinstitute the changed it from a$0 million to a whatever that the state offers a for children with that, with that, Nate,

Speaker 3:

the one thing I will highlight on there, there are some states specifically say the thing that activates it has to be something that they could tie to before the adoption. You know, so like if, if I get into a car accident with little Billy and he now was in a wheelchair, that's not going to qualify. But if they determine that he's on the fetal alcohol spectrum disorder, but no one ever knew that mom was drinking, then you know, that would qualify because that clearly predated the adoption. So that's just a little wrinkle that some states have.

Speaker 2:

Yeah, I would think that would be the standard one. So the challenge for the parent is to make certain with the diagnosis that the, um, if they have this information and if they can get this diagnosis that the child's struggles in the case we just mentioned might be connected to prenatal exposure or trauma or abuse or neglect or whatever it was that the child may have experienced before. All right. Does the money have to be spent directly and solely on the foster child or could it also be used to benefit the whole family or the foster child? Only tangentially, you know, such as adding on a bedroom so that the kids don't have to share. Um, or something along those lines. Uh, what can the money be used for?

Speaker 3:

Um, pretty much for anything. The family has to financially support the child, but they're unlike social security administration. Like I'm the representative payee. Um, for someone who's getting social security benefits, I have to document how I'm spending that money on that person. The adoption assistance does not require that. Um, and in federal law it talks about, um, it's to meet the needs of the child and federal policy talks about ordinary and special needs of the child, including things like child care. Um, but a federal policy also says that there is no accounting the state can require of how exactly the money is spent. Um, but to use it however the family feels is best to fit the child into the household. But they have to financially support the child.

Speaker 2:

Can they, can they commingle the money? Do they, can they just take some money each month and put it into the general family banking, accounting. It's used for everything else that's, you know, all the other bills that come in. Is that possible as well?

Speaker 3:

It is. Okay. Cause it's, it's technically a payment to the parents. Um, I actually had a case in the last couple of years in Wisconsin where a mom was saving it up in a general family fund. And then when they went to divorce, the, uh, the divorcing spouse was going after that money that had been saved up from the adoption subsidy payments. I don't know a way to fight that one, but I'm not an expert on a spousal. I'm divorced and assets splitting.

Speaker 2:

Well and that changes significantly by state too. But it sounds like in the case that you're familiar with, it was considered just part of the family money and did not follow that the child exclusively to the whichever parent that child was living with them. Does that how that one turned out? Yeah. Yeah.

Speaker 3:

I don't know if they're, if it's totally been resolved yet. Interesting people and I always call me back, especially if it's bad news. So he is a storyteller and ends up, I, I uh, yeah, I, I have limits in what I find out from people in the world.

Speaker 2:

Yeah. Okay. Well, I guess that medicine, uh, can you give us an estimate, uh, where the state's range knowing that there is some flexibility on how much, uh, depending on what state you're in, your child may be eligible for knowing full well that you're saying that, that the higher amounts usually go to older children, sibling groups with special, with a diagnosed special needs.

Speaker 3:

Uh, I mean, technically zero at the lower end. Um, you know, some states negotiate pretty low rates. Um, even, um, without the, you know, at risk category, um, there's probably, um, definitely over a thousand in quite a few places for, you know, like medically fragile children and in some places is going to be over too. Um, but not super common. There's, it's hard to say. It really depends on the specific state. Um, but, um, over a thousand is definitely, um, unless you're in a really IX, you know, high cost of living area, um, and even some of those, it's not going to be that high. Um, you know, for a basic rate, um, it's, you know, eight or 900 is going to be at the very top end for basic rates. Um, um, but more common, you know, anywhere from three to 500 for a basic rate in a lot of states.

Speaker 2:

[inaudible] like you point out, this is not intended to take away the cost of parenting and raising a child is supposed to be, as the name implies, a subsidy to help pay for the, some of the added costs that this child might have by virtue of the fact of their experience in the foster care system.

Speaker 3:

I mean, if you want, you can think of it is right now just for the kids in foster care, the state is the legal parent and it's like they're paying child support to the adoptive family

Speaker 2:

[inaudible] cause they adopted parent. Um, but for the adoption, the state would be continuing to pay for the child, all of the child's living expenses. And so, yeah. Okay. All right. You had mentioned that there were three, uh, we mentioned primarily three types of subsidies. One was the financial assistance, the second one you mentioned was uh, uh, Medicaid. And then the third one you mentioned was reimbursement of nod reoccurring adoption expenses. Let's talk about Medicaid. Does Medicaid, do all states include automatically include children on who are adopted through foster care and coverage under Medicaid?

Speaker 3:

No. So the kids who get title four e adoption assistance in every state will get medicaid. And that's even if they move to another state because that's one of the rules with that federal dot. Those federal dollars. Okay. So you get federal dollars, the kid has to and has an adoption assistance agreement. The kid is on Medicaid, they can't do anything about that. Okay. And if you have private insurance, you can make that, um, secondary you're not required to. I mean, as healthcare gets more expensive for families and individuals, sometimes it, you know, you don't want to put the child on your private insurance because of the how expensive it would be. Um, kids who receive non fori adoption assistance. Most states will provide medicaid. I know off the top of my head, Alabama and Virginia and I, and there might be just a couple more. They require the child have some sort of disability that warrants medicaid for the non 40 kids. Um, so if the kid gets it adoption assistance because they're hard to place, um, but they're not fori eligible, they may not get medicaid. And in some of those states, the other place that it's messy with the non 40 kids is moving states. So if you get Medicaid from whatever state you live in or you or you know, and you decide to move, um, you, you adopted a kid in your home state. Um, I'm in Minnesota, I adopt in Minnesota and I decide I'm tired of Minnesota winter, so I'm going to move down to Florida because hurricane seem easier and what's here, right. I should joke about that to North Carolina, but um, at least it seems warmer. Let's book. It's definitely going to be warmer. Um, yeah. So I moved down to Florida. What I need to do in that situation as I need to contact the state of Minnesota, um, in our state we have specialists and tell them I'm moving so they can send the paperwork from Saint Paul to Tallahassee and get Medicaid set up in the new state. So it's the interstate compact on adoption medical assistants. And so whoever's paying the adoption subsidy, you need to contact them so they can send the paperwork over and get the Medicaid set up in the new state. Now when it's Fori not a problem, works in every state when it's nine 40, all but four states will provide it. Well it's sort of seven. Um, we'll start with the four states. There's four states that will not provide medicaid to kids who get non fori adoption subsidy from another state and those states currently our Hawaii, Nevada, New Mexico and Illinois. So those four states, if I'm in Minnesota, adopted on four kid and I moved to New Mexico, I'm not going to get title 40. I'm not going to get Medicaid for that child. Um, if I moved to Arizona, I would, um, now Iowa, um, Pennsylvania, New York, we'll do it for kids from all states except from those four states. So if I adopt a kid from New Mexico in Minnesota getting on 40 subsidy, that kid will get Medicaid in Minnesota because Minnesota is awesome. But I then move to Illinois. Um, I won't get Medicaid in that state or not Illinois, sorry. Wrong state. I moved to Iowa. Um, Iowa will not do it because it's a New Mexico kid, but they would for a Minnesota kid. So that's messy.

Speaker 2:

If you won't do it for our kids, we're not going to do it for you.

Speaker 3:

Yeah. Yeah. So then you're talking about, that's the messy part.

Speaker 2:

Um, so you're talking about children and the term you're using is non title four e eligible. What type of kids is that typically include what kids would be eligible under their state but for subsidies but not from the federal subsidy under title.

Speaker 3:

So for kids to be title four e eligible, they either have to be an infant born to a foster child who is receiving title four e foster care payments that cover both the foster parent and the infant that make the infant title four e for adoption subsidy. Um, they're eligible for SSI. They were adopted, um, previously and receive title four e adoption assistance in their previous adoption or they were found to be AFS, afd AFTC eligible, which is the old welfare program, aid to families with dependent children. Um, that ended in 1996 but they still use those income guidelines. The states still do a f d a f d c determinations in the month of removal. So those are the old ways. There are three new ways that started in o nine. Um, and that is kids who've been in care more than five years. Um, kids who are at the time it was 16, now it's kids over the age of two. Um, or um, kids who are being adopted with siblings who meet either been in care for five years or over the age of two. Um, and the age of two is going to be for a couple more years. Um, it had actually gone down to zero, but a federal law rolled back to age too. So if I'm adopting Billy and Billy's little sister Sally from Illinois and they're not for free because they didn't meet the AFC AFTC determination the month they removed. Um, but Billy is three now, Billy will be, Sally will be able to piggyback on Billy Beane three to make them both for eligible. So it's going to be a very small population, but it's still, um, there's still kids out there that would meet that situation

Speaker 2:

who would not be for eligible.

Speaker 3:

Correct. That's the summary. Thank you for clearing. Yeah. The other, the other thing is, um, to qualify for 40, and this is very rare. I like f partially if it's not an issue that we don't hear calls, but there were two, two instances in 21 years of doing this where I've heard where the judicial determination was done wrong when the child was removed into foster care and that invalidated the child's eligibility for Fori regardless of that laundry list I just gave. But that's very rare because it's pretty, should be pretty boring. Boiler Plate language by the child protection services.

Speaker 2:

Yeah. You would think so. I need to also think if there was a mistake that that would be, you know, correct. It could be correctable, but I guess like you say, that's the exception, not the rule. Okay. All right. So for Medicaid and the advantages to being under Medicaid are, uh, it's, it's good coverage and it's, uh, and, and the parents aren't having to pay for it. Are there other advantages or other things that are included in Medicaid that, uh, well, depending on[inaudible], depending on how, uh, what type of insurance the parents have, medicaid might well be better. Um, so are there other reasons that children would need, would parents would want their kids on Medicaid?

Speaker 3:

Um, from what I've heard, I'm not a health policy expert at all, but from what I've heard, it seems like a lot of children who have been in foster care have quite a few, um, behavioral issues. Not all of them, thankfully. Um, but quite a few do. And I believe private insurance tends to have more limits on how much mental health or counseling services you can get than Medicaid seems to. That's my impression. I don't know if you're familiar or not there. Um,

Speaker 2:

it's certainly my impression as well, depending on, um, and it, you know, there are some phenomenal insurance plans out there and they seem to be for in larger companies that have more competitive workforces and so they, they're, they have very good health insurance, uh, and, and it's, uh, sometimes it's not terribly expensive to put children on them. So those would be the exception. But if you're buying your insurance independently, you're darn right, it is more expensive to get. I mean, all of that can be, it's definitely more expensive. The more you add, the better your coverage.

Speaker 3:

Well, I mean, the other thing is, I mean, if you have your child on private insurance, sometimes there can be conflict from what I've heard with who gets billed for what Medicaid should be second. And then it gets a bigger mess of someone's military. And it's trickier because both of them tried to go secondary, you know, Medicaid and, um, and, and tri care. Um, but I mean, I would always keep a child on it. And you know, like if you have copays and you have, um, yeah, if you have copays, I think a lot of times if you have double insurance for the child, you may not have those copays, which doesn't hurt. Um, I mean, the other, the other hard part with like the therapy, the counseling stuff is sometimes the best of those folks don't take Medicaid. You know, there's definitely some attachment therapists out there that are wonderful just what the child needs, but you got to pay out of pocket for, um, you know, that's

Speaker 2:

in theory where the adoption subsidy would come in that, uh, because yeah, you're right. Uh, particularly some of the mental health providers. Um, we don't, um, you're, you had at, you had a great segue for me, uh, in, for our next question, which was, if you've got Medicaid and tricare, is that which one? Uh, which one takes the lead?

Speaker 3:

I don't remember. I think it might be Medicaid, but I'm not sure I would talk with, okay. I would truck with the military people because they'll probably, uh, probably more experienced with the intersection then Medicaid people, you know.

Speaker 2:

Yeah. And then you've got a better content as humans at the end of that phone call. Yeah. Yeah. So yeah, that's what you would do if you're in the military and you have tricare and you have a question on how it intersects with, uh, Medicaid, uh, contact the, you're the Millican military rep who, who you usually ask your questions about tri care too. Okay. All right. What type of other things might be included in adoption assistance kind of in generally? And the one that's coming to mind is in my mind, uh, is, uh, college tuition discounts are our waivers for state schools. Uh, not all states do it, but some do. Um, how many, I mean, is that, uh, that becoming more common, less common?

Speaker 3:

I don't think it's becoming more common, um, but it's, it's definitely out there. Um, Texas, Florida, Massachusetts, Connecticut have really good programs. Kentucky to, um, Maryland, Virginia or a little more limited. And those are the ones I can think of off the top of my head. There's some other programs. I think Oklahoma has something, but I can't remember how it works. It's a little different than like Texas and Florida. They have a tuition waiver program. So if the kids adopted from the foster care system, so those all these kids who might qualify for adoption assistance through, you know, being SSI eligible that they're not going to qualify because this is for kids that were in the state care. Um, and what those states do is they, um, you know, you didn't have to look each specific one because they all work a little differently, but they waive the fees. Intuitions for going to, um, colleges, um, public state colleges or universities in those states and usually include community colleges also.

Speaker 2:

And, and if you adopt a child from another state, the subsidy is being paid by the state that had custody of the child that you adopted. Um, you live in, uh, Virginia and you adopt a child in West Virginia. West Virginia would be paying the subsidy. What about for college? No. Um, well

Speaker 3:

you got to reverse it, but yeah, I mean like I was talking last week to someone who lives in Georgia, adopted a kid from Florida. It's like, yes, you there. The kid will have the Florida tuition waiver program, but they have to go back to Florida and go to a Florida state school. It doesn't, there's no, no one has reciprocity. The only one that I've seen is Connecticut and I have to do a little digging on it, but I just don't get any calls. It looks like there's May work outside of Connecticut, but I'm not entirely sure. They're the only one that looks like it might work for not Connecticut schools. Wow. And Kentucky. I know this one specifically, they will waive the instate tuition fees, but if I live, you know, in Cincinnati, Ohio, and I want my kid to go to some school across the river and Covington and I get the tuition waver, I'm an out of state student. I got to pay the difference between the outstate in instate rate. The instate part gets covered with the waiver. But the difference I would have to pay for[inaudible]

Speaker 2:

it, you know when you said at the beginning it's complicated. Yeah, it's complicated.

Speaker 3:

But it's funny because this is all my brain. That's the craziest part.

Speaker 4:

Oh Gosh. I wouldn't want to be in your brain.

Speaker 3:

Let me add one more thing. Cause we talked about the state programs. There are two federal programs that apply to kids adopted from foster care in any state, regardless of whether they have a tuition waiver program or not. So kids who are adopted at age 13 or older basically work in foster care can apply as an independent student student on their Fasfa form. So that free application for federal student aid, they would not have to put parental income. And then kids who are in foster care at age 16 and older but still adopted, they can apply for education and training voucher funds, um, through the, what independent living program. And that's available to them because they were in foster care at age 16 or older. So those are going to apply in any state. I don't know how ETV the Education Training Fund works. If you're across state lines, you know, if you've been adopted from the state you were in foster care in, um, but the, the free application to student federal student aid is an independent student, shouldn't be a big problem. Um, no matter where you are. But those are two other programs that are, um, available for kids, adopted anywhere in the country at older ages from foster care

Speaker 2:

and both are big deals because for example, the Fafsa, your, if it's the child's income, the child May, we'll have zero income. And if they have much from, you know, flipping burgers at McDonald's, it still wouldn't be a lot. Um, so the percentage, and it's not, oftentimes it's grants, not loans. So, um, if for especially for, you know, you'd have a higher percentage of grants, not loans. So that's something to certainly consider at that point. Okay. Excellent.

Speaker 4:

Well, let me policy or to remind you that this show is brought to you by the support of our partners. And these are agencies that believe in our mission of providing unbiased, accurate information, uh, to both pre and post adoptive families. Two of our wonderful partners, our children's connection, an adoption agency providing services for domestic infant adoption and embryo donation in his option throughout the u s as well as providing home studies and post adoption support to families in Texas. We also have spent shape and they are a licensed and accredited nonprofit organization and the New York City Metro area that has been offering adoption services for more than wait for it 100 years. That's amazing. They're robust. Post adoption services provides birth parents, adoptive parents and adoptee as supportive community and a connection to professionals.

Speaker 2:

Uh, so we thank our partners for making this show possible. So thank you. How can people get information about what their state usually grants for adoption subsidies as well as what their state does as far as, um, uh, college tuition and Medicaid and all of that. Um, we've, you've mentioned the, uh, neck in acac.org North America, North American Council on adoptable children.org. Um, it's a wonderful resource. So we mentioned that a, what else? Where else can people get information?

Speaker 3:

Um, I mean the child welfare.gov does have a more limited profile. Um, so they have some information. Um, you can check your state websites. The sometimes are really great in sometimes like, okay, I can exaggerate if it goes here. I mean, children families who are adopting, who are doing the foster to adopt program are probably getting a basic overview of the program when they're going through the process. Um, obviously if I'm going through the process in my state and I'm not getting a placement that I'm interested in, I start looking broader, like on adopt us kids website or you know, northwest adoption shades or someone else's. Um, I might not have much background on what that state does have a child I'm interested in and I'm going to need to do some research. But, um, you know, our website is, is pretty well designed, are our surveys to answer the questions that we think because we talked to thousands and tens of thousands of people that families are really looking for.

Speaker 2:

Yeah, man, it's an excellent resource. I agree. Um, so what should a parent, what should parents do if they believe that the adoption subsidy that's being offered is not enough?

Speaker 3:

It's going to depend on why they think that if they think my child should qualify. Like if I'm here in Minnesota where we, you know, outside of our structural issue for the kids under six at permanency, if I think that my child, um, assessment didn't include some things that, you know, ended up with the lower assessment, I'm going to want to see what the rules on doing an assessment. And if the agreement is done and executed, I'm going to have to wait six months until after finalization to get a reassessment if it's not executed. But, you know, it's been proposed, I could ask for a reevaluation of the time, but if I'm in like, Ohio in my county is offering 250 but I was getting 800 a month and in foster care, um, then it's a different issue of trying to say what the needs are in and advocating in the negotiation process. So it really, it depends like, like everything here, it depends on the situation. Um, I mean the one thing I will say is I probably answer around a thousand calls a year on this and do some trainings so people can call me because I know how the state's work. Um, and can give tips specific to their state or what's going on. And if I don't, we do have volunteers in quite a few states who often, no. Some things that I don't know, um, about those specific states cause trying to track 50 states is a bit of work and keep it all in my brain. Yeah. I'm going to suggest you get a computer, you know, to, what are they? I do have a lot in my brain, like I'm not checking any notes and everything I'm telling you today.

Speaker 2:

Yeah, I believe that actually. Um, so how would people reach you?

Speaker 3:

Um, they can call us toll free(800) 470-6665 and we got a new phone system. So my extension is changed since last time. Um, it's one, one five, so it's(800) 470-6665 extension one one five or my email is Josh, k, j o s h k at Nasdaq, and a c a c.org. And if you call here, you forget the extension, you talk about subsea, they will quickly get you to me. Alissa gone for like vacation or something. Um, those calls, no one else is going to try and,

Speaker 2:

yeah, don't worry. They will go to,

Speaker 3:

yeah, well, no other, we, we have some other stuff that will help, but this is, I'm the coordinator for a reason and that's my primary

Speaker 2:

John. So how is residential treatment covered? Let's assume that,

Speaker 3:

I know it's, it's, it's the thing that,

Speaker 2:

it's the bugaboo. I mean, it's the thing that we, that we hear probably some of the most questions about, so how is residential treatment coverage? You've got a child who is really struggling and, uh, either you've made the decision or doctors have made the decision and your family's rounding and residential treatment is being considered. What then,

Speaker 3:

um, you gotta talk to whatever government agency in your area. Um, where you live, um, you might, if you have adoption subsidy from another state, you might talk to them and everybody does it a little different. But most states, um, most states if they're doing it, um, in any way, shape or form, um, Medicaid's going to be part of it. But you might get department of Mental Health, um, you're, you're going to be talking about trying to get various funding streams to help cover the placement. Um, and you're probably, the state will probably try and go after the adoption subsidy. Um, by seeking child support, they're not going to cut it off. You don't want it to be cut off because if they cut it off, um, unless it's a suspend, um, it's just going to create problems later, especially if the child can get better and be reunified. Um, so it's, I mean it's one of those things I'm happy to talk with folks on and share what I've heard about that. What your state has done. If, if Matt, if you've got Medicaid for the child, which you should, um, if you have Medicaid for the child in Medicaid saying they're not going to help at all with finding anything. And the hard part is, you know, sometimes Medicaid will help with a placement, but you don't feel the placements meet the needs of the child. That won't really help. Um, that is a different battle. But there's a group that helps fight for people with disabilities. There's a chapter in every state and they're either called disability rights or protection and advocacy and you can find your state chapter on the n as in Nancy, D as in David, r as in Ronald and as in Nancy M. Dot. Org website, the national disability rights network. Um, and that that's a way to help work with an organization to do that. One of the California's we are, they can make the adoption subsidy for up to 18 months go up to like seven,$8,000. I don't get it. It creates a problem with families who adopted from other states living in California trying to get help because they, their solutions are a little different. Um, but generally it's trying to look at what sort of services in talking with broader, you know, take off the adoption blinders, see what other community resources, what mental health resources might help. Don't think the child welfare system is the only resource to solve this problem. Um, the other issue, you probably hear this little two, and this is, I don't have a great answer to this other than trying to get states to change their laws is what happens if the facility says we can't do anymore. This child is not progressing. We're going to return the child. And you feel that child is still not safe to come back in your home. Like could actually harm family. Um, you know, in the family says we're not going to take the child back. And then does the state pursue abandonment or neglect charges against the adoptive family who would otherwise be charged with endangering another child in the family if they took the child home? I mean it's, it's a catch 22 that I don't have an answer for. Um, but you know, we might have resources or connections in the state that might be able to help families navigate that situation.

Speaker 2:

I will say that it w it is certainly being discussed now, certainly more than it was even five years ago. Um, so it's, I think most people are aware of that, that it's, I guess this is to put it mildly, a conundrum, um, that it is that catch 22 that parents are caught in. So, um, yeah, contact the agency, uh, or from whom you adopted and start working there. Um, and that would be the first stop for that. So what all do you think will change with the implementation or the families first at, uh, both about subsidies is also, and also about post adoption services in general. So let's start first about families first and if it has any impact on not just subsidies but subsidies, uh, Medicaid, college, the whole thing.

Speaker 3:

I'm not sure. I'm not as versed on the families first egg. Sorry to say. That's been more, uh, my boss, Mary Boo. I mean, I know the biggest impact was it rolled back. The applicable age, you know, I said was two had gotten down to zero and came back to two. That's the biggest change that directly impacted adoption subsidy. Um, neck is always, um, been a huge proponent of post adoption services because a check is nice, the check can really help make a difference, but a lot of times that check is not even close to enough. Um, and, and sometimes it's not even, you know, like helping cover the cost of residential treatment, which usually that adoption subsidy not game would come close to, but also not feeling isolated and alone in the world. Um, you know, their parents I've talked to who I don't feel like I helped at all, but when they told me their story and they knew that I understood in like didn't say there were crazy. The like this happens to other people that I think relieved them a little bit. Um, so we do a lot with parents support groups, but also like can families get respite? I mean respite is huge cause families eat a break, especially with children with extreme behavioral issues but also other times too. Um, but I don't know all the funding streams. I think did it do more dedicated funding for post op? Did it say that a certain percentage had to be in? Yeah. Okay.

Speaker 2:

Yeah. So the expectation is that there will be more money going to a posted option, uh, for, for certain that's the um, factors that I think a requirement that a set percentage of adoption assistance money has to go to the post adoption and it can be used by families, by adoptive families. If you can also be, some of the purposes can also of course be used by by birth families. Okay.

Speaker 3:

Yeah. I mean the one thing, the one thing is yes, there is, one of the things is if we can get to states, and the hard part is if we can get information about dissolved adoptions are these residential treatments is um, family preservation services. That can be, you can be used to help keep adoptions together when they're strained. I mean that that is something, but the key is how to, I mean for listeners, it's like what is your state doing? Do you know? Probably not. Are you involved with organizations that are going to help focus how the state does that? Because if you don't, that money is probably going to be spent before you even might try and access it. You know, big part of advocacy is being at the table when they start giving up the money. I'm not like, oh, they're getting money. What are, let's start talking. Who Do we talk to about this? Um,

Speaker 2:

no, you're exactly right. And so that's, that's all going to be coming down the pike in the next year or so. So, yeah. Excellent. Well, thank you so much Josh. Scroll for being with us today to talk about adoption subsidies for adoptions primarily through foster care. Uh, as always, the views expressed in this show are those of the guests and not reflecting, do not necessarily reflect the position of creating a family, our partners, our underwriters, and keep in nine that the information given in this interview is general advice to understand how it applies to your specific situation. You need to work with your adoption professional. I am sure everybody is going to want to, uh, contact Josh to get more information and, uh, had the website is Nasdaq and a c a c. Dot. Org or as he pointed out, you can, uh, uh, email him directly at Josh k at[inaudible] Dot Org. Thank you so much for being with us today and I will see you next week.