Sec. 07.02.12.07. Post Adoption Assistance

A. Post adoption assistance payment is a State Medicaid benefits and/or a State-funded monthly payment to adoptive families on behalf of adoptive children who have a condition that would have made them eligible for adoption assistance had the condition been known prior to finalization of their adoption.

B. A child may be eligible for post adoption assistance if:

(1) The child was in the guardianship of a Maryland public or Maryland private agency at the time of the adoption; and

(2) The child has a documented condition that existed at the time of finalization of the adoption but had not been “discovered or diagnosed,” and if the condition had been known at the time of the finalization of the adoption it would have made the child eligible for adoption assistance.

C. Payments.

(1) A post adoption assistance payment shall be determined through negotiation and agreement between a local department and the adoptive parent.

(2) The post adoption assistance payment may combine with the parent’s financial resources to assist with meeting the child’s identifiable, quantifiable current and future needs.

(3) The amount of a post adoption assistance payment may not exceed the foster care payment the parent would have received for the child if the child were in foster care at the time the adoption was finalized.

(4) The local department may determine a $0 payment is appropriate for an eligible child who otherwise qualifies for the adoption assistance, if the Administration determines that:

(a) Post adoption assistance is not needed by the parent to defray the cost of meeting the special needs of the child at the time the post adoption agreement is entered into; or

(b) The child had a physical or mental disease or disability at the time of finalization, but is not currently symptomatic.

(5) Negotiation.

(a) A local department shall negotiate the amount of the post adoption assistance based upon the needs of the child and the circumstances of the family, and the family’s ability to incorporate the child into their household.

(b) As part of the negotiation process, a local department shall assess the child’s needs based on documentation in the record or provided by the adoptive family and any additional relevant information.

(c) The negotiation process shall include a discussion of the child’s needs, the family’s circumstances, and the assistance the local department may provide to help the family provide for the special needs of the child.

(d) The local department and the family shall explore the availability of other resources to meet the child’s needs on an ongoing basis, such as SSI and other Social Security benefits, adoption tax credits, tuition waivers, and community supports that may be available.

(6) Concurrent Receipt of Benefits or Other Income.

(a) The family shall notify the Administration if the child receives other benefits while the adoption assistance agreement is in effect.

(b) If a child is eligible for SSI and State-funded post adoption assistance, the SSI shall be reduced dollar for dollar in the amount of the post adoption assistance.

(c) If the SSI Program does not reduce the SSI grant, the local department of social services shall reduce the amount of the post adoption assistance grant dollar for dollar in the amount of the SSI payment.

(d) If a child receives Social Security benefits, such as survivor’s benefits or retirement benefits, or other income, the monthly post adoption assistance may be reduced to reflect this resource.

(7) Post adoption assistance payments begin at the time the adoption assistance agreement is signed by the parties.

D. Post Adoption Assistance Agreement.

(1) A post adoption assistance agreement shall be in writing, binding on all parties, and between a local department and the family and the relevant agencies.

(2) The post adoption assistance agreement shall be on a form approved and distributed by the Administration.

(3) The adoption assistance agreement shall be signed by the director of the local department, or designee, and the family prior to payment.

E. Medical Benefits.

(1) A child who is eligible for State-funded post adoption assistance is eligible for Medicaid under Maryland’s Medicaid State plan.

(2) A State-funded post adoption assistance recipient who moves to another state may be eligible for Medicaid in the new state of residence if the state offers reciprocity for children from Maryland who have a State-funded post adoption assistance agreement.

(3) A child with an adoption assistance agreement that provides for a $0 monthly payment shall be eligible for Medicaid benefits under the Maryland Medicaid State plan.

F. Interstate Adoption.

(1) If the state public child welfare agency has responsibility for placement and care of a child prior to finalization of the adoption, that state shall be responsible for entering into the post adoption assistance agreement with the family, provided the child is an eligible child.

(2) If the State public child welfare agency did not have responsibility for placement and care of a child prior to finalization of the adoption, the post adoption assistance agreement should be applied for and made in the adoptive parents’ state of residence.

(3) The post adoption payment shall not exceed the applicable board rate in Maryland or the applicable board rate in the state of residence while the child was in foster care, whichever was higher.

(4) If the Maryland family and the child move to another state, the post adoption assistance agreement shall remain in effect.

(5) In order to protect the interests of the child, a local department shall follow the procedures established by the Interstate Compact on Adoption and Medical Assistance to facilitate the interstate coordination of benefits.

(a) The adoptive parents shall be referred by a local department to the appropriate federal Title XIX and Title XX agencies in their state of residence.

(b) The local department shall provide the state of residence with documentation regarding the child’s eligibility for Maryland Medicaid and Title XX services.

G. Death of Parents and Dissolution of an Adoption.

(1) Post adoption assistance may not be denied to a child whose adoption has dissolved or whose adoptive parents have died if the child:

(a) Received an adoption assistance during the child’s prior adoption; and

(b) Continues to meet the special needs eligibility criteria set forth in §B of this regulation.

(2) If an adoption dissolves or the parents die, post adoption assistance may be paid on behalf of a child to a subsequent caretaker if:

(a) The child continues to meet the special needs criteria;

(b) The caretaker assumes guardianship of the child; and

(c) A local department determines that the caretaker is able to provide appropriate care for the child.

H. Annual Redetermination.

(1) A local department shall confirm a child’s continued eligibility for post adoption assistance annually.

(2) At least 90 days prior to the renewal due date, a local department shall send a written request for the required information necessary for redetermination.

(3) At least 60 days prior to the annual renewal due date, an adoptive family shall submit documentation to enable the local department to determine that:

(a) The family is still legally and financially responsible for the care of the child at the time of the redetermination;

(b) The child continues to meet the special needs criteria; and

(c) The current amount of the post adoption assistance payment is appropriate.

(4) The family shall submit the following documents:

(a) If the child is younger than 18 years old and not required to attend school due to age, proof of routine medical care provided to the child within 6 months prior to the renewal date;

(b) If the child is younger than 18 years old and of the age where school attendance is compulsory:

(i) A current report card;

(ii) Documentation of current participation in a home and hospital educational program approved by the educational agency in the child’s place of residence; or

(iii) Documentation that the child is currently incapable of attending school on a full-time basis due to a documented medical condition of the child;

(c) If the child is enrolled in a home school program approved by the educational agency in the child’s place of residence, proof of current enrollment in the program and proof of routine medical care provided to the child within 6 months prior to the renewal date; or

(d) If the child is 18 years old or older:

(i) Documentation that the child has a mental or physical disability warranting the continuation of the assistance; or

(ii) Completing secondary education or a program leading to an equivalent credential; or

(iii) Enrolled in an institution which provides post-secondary or vocational education; or

(iv) Participating in a program or activity designed to promote, or remove barriers to employment; or

(v) Employed at least 80 hours per month; or

(vi) Incapable of doing any of the above described activities due to a medical condition.

(5) Suspension.

(a) A local department shall suspend the post adoption assistance because of the following:

(i) The adoptive family’s failure to return the required information for renewal to the department;

(ii) A child who was adopted re-enters foster care.

(b) At least 30 days before the planned suspension, the local department shall send the adoptive parent a notice that includes:

(i) The intent to suspend the adoption assistance;

(ii) The specific regulations providing grounds for suspension; and

(iii) A statement describing the adoptive family’s right to appeal.

(c) If the payment is suspended due to family’s failure to return the required information for renewal to the local department, the payment shall be reinstated on the date the adoptive family provides the required documentation.

I. Renegotiation of Post Adoption Assistance.

(1) The amount of the post adoption assistance may be renegotiated at the request of the adoptive parent or the local department at any time while the post adoption assistance agreement is in effect.

(2) To assist in the renegotiation process, the local department shall request information from the adoptive family regarding any changes in circumstances that would justify an adjustment in the amount of post adoption assistance, such information may include:

(a) School reports;

(b) Psychological evaluations;

(c) Medical reports;

(d) Costs and descriptions of services needed for the child, including documentation that services are not covered by the current post adoption assistance amount or by medical assistance or community resources; and

(e) The amount of the adjustment requested.

(3) The renegotiated post adoption assistance amount may not exceed the foster care payment the adoptive parent received when the child was in out-of-home care.

(4) Changes in the adoption assistance amount shall be approved by the Administration.

(5) If a child receives Social Security benefits, such as survivor’s benefits, retirement benefits, or old age benefits, the State-funded monthly post adoption assistance payment may be reduced to reflect receipt of this resource.

J. Termination of Post Adoption Assistance.

(1) State-funded post adoption assistance may be terminated upon the occurrence of any of the following conditions:

(a) A child re-enters out-of-home placement;

(b) A legally responsible adoptive parent no longer provides significant financial support to the child;

(c) An adoptive parent’s rights have been terminated;

(d) The adoptive parent dies and there is no suitable subsequent caregiver;

(e) The child’s 18th birthday if the child does not meet the conditions of §J(2) of this regulation.

(2) The adoptive child may continue to receive post adoption assistance until their 21st birthday provided that subsequent to the child’s 18th birthday the child has a mental or physical disability warranting the continuation of the assistance; or the child is:

(a) Completing secondary education or a program leading to an equivalent credential;

(b) Enrolled in an institution which provides post-secondary or vocational education;

(c) Participating in a program or activity designed to promote, or remove barriers to, employment;

(d) Employed at least 80 hours per month; or

(e) Incapable of doing any of the above described activities due to a medical condition.

(3) At least 30 days before the planned termination, the local department shall send the adoptive parent a notice that includes:

(a) The intent to terminate the adoption assistance;

(b) A statement of the specific regulation cited as ground for termination; and

(c) A statement describing the adoptive family’s right to appeal.