In 1999 the legislature established funding for permanent guardianship subsidy (PGS) to assist families willing to assume this responsibility. Additional funding was designated for those guardianships established pursuant to K.S.A. Chapter 38, Article 15 (permanent guardians). Starting January 1, 2007, the CINC Code changed the name to Permanent Custodian. PCS is not an entitlement for any recipient or potential recipient.

6111 Eligibilityle Requirement for Children

Children may be considered for the permanent custodianship subsidy if they are age 14 and over, are part of a sibling group that has one child age 14 and over, or have other extenuating circumstances that make adoption not a reasonable option. The Director of Children and Family Services must approve eligibility for children for whom extenuating circumstances exist that make adoption not a reasonable option. Permanent custodianship subsidy ends when a child is 18 unless still in high school, the child becomes emancipated, dies or otherwise ceases to need support, the child no longer resides with the permanent custodian, or the permanent custodian fails to complete and return the annual review.

Children who were approved for permanent custodianship subsidy prior to July 1, 2008 can continue to receive the subsidy.

The permanent custodianship subsidy is not an entitlement program and the child must meet all of the following criteria:

be in the custody of the Secretary of SRS with or without parental rights terminated at the time permanent custodianship is established;
a court order appointing a permanent custodian;
not receiving SSI; and
the permanent custodian meets eligibility to receive TAF as defined by EES (KEESM 2220 - Living with a Caretaker).

The custodian may apply for Temporary Assistance to Families (TAF) on behalf of the child. Non-relative guardians (see KEESM 2220 Living with a Caretaker) may apply for TAF. This assistance will supplement the subsidy payment. EES will exempt the subsidy payment in determining the TAF benefit amount. All other applicable income for the child will be considered in determining both the subsidy and TAF payment.

6112 Type and Amount of Subsidy

A. Maximum Monthly Subsidy Payment

The maximum monthly subsidy payment cannot exceed $300, for permanent custodianships/guardianships granted on or after 7-1-06. It may be adjusted lower depending on the income and resources of the child. Children shall not receive subsidy if their countable income exceeds $300 per month. Once the subsidy amount is established it does not change unless there is a change in the child's circumstances.

B. Medical Card

Kan Be Healthy Screens and all Medicaid rules are applicable. The child will continue to receive a foster care medical card, during the period of time a permanent custodianship subsidy payment is made. Refer to Section 3410A of the E & P Manual. The parent's family health insurance is applicable if parental rights are not terminated. Custodians are expected to include the child on their family medical insurance plans, if the coverage is available.

C. Income of the Child

Disregard $186.00 per month of the child's income when determining eligibility for permanent custodianship subsidy.

Income to consider shall include but is not limited to:

Social Security Survivors Benefits (SSA);

Child Support;

Income for the child from a trust or annuity

Other benefits, e.g. railroad or veterans benefits.

Permanent custodians are expected to apply to be the payee for benefits on behalf of the child. For PRNT children, parents will need to agree to the transfer of payee. The amount of benefits may affect the amount of subsidy and TAF payment.

6113 Exempt Income and Resources

The following income and resources shall be exempt in determining eligibility for PCS

earned income of the child;

resources of the child;

inaccessible trusts of the child;

income and resources of the permanent custodian and spouse;

income and resources of the parent; and

TAF benefits received for the child.

6114 Eligibility Determination

A limited number of permanent custodianship slots are available. Prior approval from central office must be obtained before entering into a custodianship subsidy agreement with a individual or family. The Case Management Provider case manager shall:

a. Submit the CFS 4027A Request for Permanent Custody, a letter from the prospective permanent custodian explaining why they want to be the custodian, and a letter from the child (if age 14 or over) confirming they are in agreement with the plan to the CFS Permanent Custodianship Specialist and the Regional SRS Office;

b. After approval is received, complete the CFS 4026, Permanent Custodianship Subsidy Agreement, with the custodian (the custodian signs the agreement and SRS will sign when it is submitted to Children and Family Services);

c. Obtain a copy of the Journal Entry of Permanent Custodianship or Letter of Custodianship from the court;

d. Determine that other applicable requirements are met;

e. Complete CFS 4027, Referral for Payment;

f. Submit all the above to Children and Family Services Custodianship Specialist and the Regional SRS Office

g. Notify CFS Permanent Custodianship Specialist if they become aware there is a change in address of guardian

Regional SRS staff shall:

a. Determine eligibility for medical assistance

b. Send the CFS 4028-Annual Permanent Custodianship Report to the guardians to complete

c. Submit to CFS Permanent Custodianship Specialist the completed Annual Permanent Guardianship Report, CFS 4028;

d. Notify CFS Permanent Custodianship Specialist if they become aware there is a change in address of guardian

6115 Permanent Custodianship Subsidy Agreement

The Permanent Custodianship Subsidy Agreement, CFS 4026, shall be signed by the designated guardian(s) in the presence of a case manager.

A. The case manager shall explain to the family:

1. the purpose of the subsidy, their financial and social responsibilities;

2. the terms of the agreement;

3. the duration of the agreement.

4. that should the family fail to complete and return the review the case shall be closed.

5. that monies will be recouped by CFS if sent in error after subsidy should have terminated.

B. The custodian(s) shall:

1. Apply for other financial benefits for the child, e.g., SSI or veteran's benefits;

2. Notify SRS immediately of any changes in the child's living situation;

3. Advise SRS immediately if the custodianship is set aside or they cease to be legally or financially responsible for the child;

4. Advise SRS when the child reaches 18 and has completed high school;

5. Advise SRS when the child becomes emancipated;

6. Advise SRS if the child dies, or otherwise ceases to need support; and

7. Cooperate fully with SRS in an annual review.

6116 Termination of Permanent Custodianship Subsidy

A. Permanent Custodianship Subsidy shall not continue beyond the month in which:

1. the child reaches 18 (unless the youth is still in high school; then subsidy may continue until the youth graduates);

2. the child becomes emancipated, dies or otherwise ceases to need support;

3. the child no longer resides with the custodian;

4. an annual review is due and the custodian fails to complete and return it.

B. The case manager is responsible for forwarding all information that would result in termination to the CFS Permanent Custodianship Specialist and the Regional SRS Office immediately upon receipt of the information.

6120 Annual Report

Permanent Custodianship subsidy does not require an annual eligibility re-determination. An annual report shall be made to determine if any changes in the circumstances of the child exist. The annual report shall coincide with the anniversary date of the beginning of the Permanent Custodianship Subsidy and a copy of that report is due in the CFS office by that date.

SRS staff shall send to the family on an annual basis the CFS 4028 Custodianship Annual Report. This form is to be returned within 30 days to SRS staff, the form shall be reviewed and a copy shall be forwarded immediately to the CFS Permanent Custodianship Specialist, and the original will be placed in the case file.

6130 Payment Procedures

6131 Monthly Grant Payments

Monthly grant payments are made to the custodian, Children continue to be eligible for the foster care medical card and shall be maintained in the KAECSES foster care system.

A. The PCS payment shall be initiated beginning the first of the month in which the custodianship is granted and shall continue for the duration of the child's subsidy eligibility.

B. The CFS 4027A, Request for Permanent Custodianship Subsidy, shall be sent to CFS to initiate the payment.

C. The CFS 4027A, Request for Permanent Custodianship, is also used by the Regional Office to establish changes in the KAECSES System per Eligibility and Payments Manual Section 8300 Program Type = Foster Care (FC) Legal Status Code = (10) Non-Kansas Custody; Source of Funding (GA) Guardianship.

D. Failure to submit the CFS 4028 Custodianship Annual Report to the case manager in a timely manner may result in automatic stoppage of payment to the custodian.

6132 Referral to Child Support Enforcement

Parents whose rights have not been terminated shall be referred to Child Support Enforcement (CSE) for the collection of support. CSE may receive referral from both EES and CFS. The establishment of a permanent custodianship subsidy case shall be noted on the narrative section of the CHSE Screen in KAECSES.

6200 Adoption Assistance

Adoption Assistance is a program designed to remove barriers to the adoption of children with special needs, who otherwise could not be adopted. The intent of the program is to assist the adoptive family in meeting the special and ordinary needs of a child.

The adoption assistance program can provide medical services to the child through Kansas Medicaid Services and the family may receive monthly cash subsidy, special subsidy payment, and non-recurring expense reimbursement.

This program is authorized by state and federal statutes and regulations. Kansas implemented a state adoption assistance program in 1970. The state only adoption assistance program is codified in KSA 38-319 through 38-329. The Title IV-E of the Social Security Act was modified to include federal financial participation in adoption assistance through the Adoption Assistance and Child Welfare Act of 1980, Public Law 96-272. The Tax Reform Act of 1986, Public Law 99-514 amended the Title IV-E adoption assistance program to provide 50 percent matching funds for non-recurring expenses associated with the costs of adopting a child. The Adoption and Safe Family Act of 1997, Public Law 105-89 further modified the requirements for Title IV-E adoption assistance.

It is the policy of this agency to operate both the state and federal programs the same. Adoption subsidy and medical assistance shall be provided for eligible children regardless of the funding source.

6210 Eligibility Requirement for Children

Eligibility for adoption assistance is based on the needs of the child, not the resources of the family. The familys resources can be considered when determining the type and amount of assistance. The child's eligibility for adoption assistance shall be documented on the CFS 4019, Eligibility for Adoption Subsidy.

Children in custody of the Secretary or a licensed child placing agency, (if they otherwise meet the eligibility criteria specified below) may be eligible for one or more of the following types of adoption assistance: Title XIX Medicaid, monthly subsidy payment, special subsidy payment, and non-recurring expenses. Children who are eligible for SSI or who have been in a prior IV-E adoption that dissolved can also be eligible.

Once determined eligible for Title IV-E adoption assistance, a child is eligible up to age 18. The Secretary has the option to continue to provide assistance up to the age of 21 if the agency determines that the child has a mental or physical disability which warrants continued adoption assistance. If the child does not have such a disability, the child is not eligible for Title IV-E adoption assistance beyond the age of 18.

If the youth is still in high school, state funded adoption assistance may continue beyond age 18 until graduated from high school or turns 21, as long as the youth continues to be dependent upon his or her parents for support. In these cases federally funded cases must be transferred to the state funded program. See EPM section 3223.

Children placed by the courts, adoption brokers, parents and other individuals are rarely eligible for on-going (monthly subsidy payment) adoption assistance; even if they were previously in state custody. Children adopted internationally are rarely eligible for on-going assistance. These children may be eligible for non-recurring adoption expenses if a special need is documented prior to the finalization of the adoption. (See PPM section 6254).

If post termination, children adopted by their birth parent are not eligible for adoption assistance.

Both the state funded and the federally funded Title IV-E Adoption Assistance programs require that the adoption assistance agreements be signed prior to the finalization of the adoption.

To be eligible for on-going adoption assistance, the following criteria shall be met:

A. Establish the Child is Legally Free for Adoption

SRS shall establish the child is legally free for adoption. Journal Entries documenting the termination of parental rights and/or copies of the voluntary relinquishments shall be maintained in the case file. (Children are only eligible for adoption assistance where parental rights have been terminated through a judicial termination of parental rights or the parents have voluntarily relinquished to the Secretary).

B. Establish the Child Cannot Return Home

There shall be a judicial determination that the child cannot or should not be returned to the home of the parents. The court shall make a determination that it is not in the best interest of the child to be returned to the parents. Case records shall contain documentation stating why the child cannot return to his/her parents.

Documentation is based on the following evidence:

Journal entries documenting the termination of parental rights; or
Journal entries documenting that the child cannot return home.

C. Establish~~ing~~ the Special Needs of the Child

The state has determined based on a specific factor or condition of the child, it is reasonable to conclude the child cannot be placed for adoption without assistance.

To be eligible for adoption assistance the child shall have one or more specific factors or conditions which limits the adoptability of the child without adoption assistance. There shall be a linkage between the specific factor or condition and the type of subsidy needed to enable the adoptive family to meet the needs of the child. It is the responsibility of SRS staff to determine eligibility. It is the responsibility of the Case Management Provider to provide SRS with documentation of need.

The following conditions are factors used to determine if the child has special needs that require professional treatment on an ongoing basis which may make it reasonable to conclude the child cannot be placed without cash subsidy or Medicaid services.

Physical Disability

The child has a medically diagnosed disability which requires professional treatment, impairs normal functioning, and requires assistance in self-care or the purchase of special equipment. The disability is to be diagnosed by a physician, hospital, clinic or other qualified medical practitioner.

Developmental Disability

The child has significant developmental disabilities and/or delays with demonstrated need for intensive adult supervision beyond chronological age, determined through an evaluation by a licensed psychologist, diagnostic center, special education services, or other qualified professional individual.

Behavioral or Emotional Disability

The child has been diagnosed as having a psychiatric condition which impairs the child's intellectual, behavioral or social functioning. Diagnosis and prognosis shall be established by a physician, psychologist or clinical social worker.

Age of Child

The child is age 12 or older, if age is the only special needs factor.

Guarded Prognosis

Children in this category are not currently being treated for a specific disability or condition. However, there are factors in the child's genetic, health, and/or social background which are indicators that the child may develop physical, emotional or developmental problems at a later date. This pertinent information regarding the child and parents genetic and health history shall be documented in the case record.

Eligibility may be determined with a zero payment, and medical card need not be issued unless a problem arises at a later date.

Membership in a Sibling Group Placed Together

The child is a member of a sibling group of two or more children who are being placed for adoption together. For a sibling group of two, one of the siblings shall have one of the special needs factors or conditions listed above. Sibling groups of three or more who are placed together do not need to meet any other special needs criteria.

D. Establish That Reasonable Efforts Were Made to Place the Child Without Assistance

A determination shall be made that reasonable but unsuccessful efforts were made to place the child without assistance.

This criterion is not applicable if the child is being adopted by a relative or a resource family with whom a significant relationship has already been established.

The efforts made to place the child without assistance shall be documented in the case file.

Reasonable Efforts include the following initiatives:

Referral of the child to state and national adoption exchanges;
Development of individual recruitment plans;
Special Recruitment initiatives, i.e. TV, newspaper or features, etc.

It is not the intent of the agency to delay placement pursuing special recruitment efforts if an appropriate family is available who will require adoption assistance to adopt the child. It shall be documented in the staffing report why the family is the most appropriate choice for the child.

SRS may determine the child's disability is such that it is reasonable to believe that any family adopting the child would require adoption assistance, e.g., children with severe problems which require extensive care, medical attention or constant supervision. At the time the agreement with the family is developed, an inquiry shall be made of the family if they need assistance in order to adopt. It is not the intent of the agency to disrupt the placement plans if the family indicates that they need adoption assistance in order to adopt the child.

E. Documentation of Child's Eligibility

The requirements in PPM Section 6210 qualify the child for the state fund program. (See PPM section 6220 for additional requirements in order to qualify for the federally funded Title IV-E Adoption Assistance program.)

The child's eligibility for adoption assistance shall be documented on the CFS 4019, Eligibility for Adoption Subsidy. All supporting documentation is to be maintained in the case file. SRS may request supporting documentation from the Case Management Provider. Eligibility is determined while the child is in foster care and shall be maintained in the adoption assistance and financial files.

6220 Eligibility Requirements for Title IV-E Adoption Assistance

In addition to meeting the special needs criteria, one of the following criteria shall be met in order to establish a child's eligibility for Title IV-E Adoption Assistance:

A. The child's Title IV-E eligibility was established during the foster care episode which is established at the initial removal from the home.

Children voluntarily relinquished to SRS or a licensed child placing agency who have had IV-E foster care eligibility established as a result of an episode of foster care are IV-E subsidy eligible. A voluntary relinquishment may be considered a judicial removal if a petition to remove the child from his/her home is filed within six months of the date the child lived with the specified relative from who s/he was removed and there is a subsequent judicial determination that to remain in the home would be contrary to the child's welfare.

B. The child is eligible for Supplemental Security Income (SSI) prior to the finalization of the adoption. This may be met if the agency receives the final notice of SSI eligibility after the adoption is finalized and the SSI eligibility date is prior to the date of the finalization of adoption.

C. The child's parent is a minor and the minor parent's IV-E maintenance payment covers the child's cost of care while in care.

D. The child received IV-E adoption subsidy in a previous adoption placement.

6230 Establishing Eligibility After the Adoption is Finalized

Both the state funded and the federally funded Title IV-E Adoption Assistance programs require that the adoption assistance agreements be signed prior to the finalization of the adoption.

A. Factors to Consider when Establishing Post-Finalization Eligibility

State and Federal Guidelines allow exceptions to this requirement under certain circumstances:

Failure by SRS staff and/or Case Management or Adoption Provider staff involved to advise the adoptive parents of the availability of adoption assistance for a child with special needs.

SRS is not required to notify the parents of children placed by private/agencies and is not liable for a private child placing agency's failure to inform prospective adoptive parents of the child's special needs.

Erroneous determination that a child did not meet eligibility requirements.
There existed, unknown or undiagnosed, conditions of the child at the time of placement, which if known, would have created eligibility for assistance. For example heart conditions, genetic factors that do not show up until a later date or emotional traumas such as prior sexual abuse which contribute to problem behaviors as children reach different developmental milestones.
Relevant facts regarding the child, or the child's background, were known but were not presented to the adoptive parents prior to the finalization of the adoption.

B. Procedures Related to the Determination of Post- Finalization Eligibility for Title IV-E Eligible Children

SRS staff shall make every effort to establish that the child was eligible for basic Title IV-E funding at the time the child came into foster care. This eligibility shall be maintained in the case record.

Federal Adoption Assistance regulations for Title IV-E specify that the assistance case shall be opened prior to the finalization of the adoption. When it is not opened prior to finalization federal regulations require denial and a fair hearing to determine through an appeal process that the required circumstances exist to allow post finalization eligibility. If adoption assistance is approved the effective date shall be no earlier than the date the parent(s) requested adoption assistance.

Families are to submit their written request for post-finalization adoption assistance approval to the regional SRS office. Upon receipt of this request the worker shall:

Deny the request for adoption assistance because the adoption has been finalized.
Provide the family with written notification of the denial and their right to appeal to the Office of Administrative Fair Hearings.
Provide the family with the appropriate appeal forms.
SRS may request supporting documentation from the family and and/or the agency responsible for placing the child.
Prepare a summary of the case with the necessary attachments, including, but not necessarily limited to: medical records, psychological reports, etc., reflecting the agency's position concerning the recommendation.
Hold a staffing where all supporting documentation is reviewed and a recommendation prepared for the fair hearing.
Provide the Administrative Fair Hearing Officer with a recommendation. If the child would be otherwise IV-E eligible and the agency supports the adoption assistance request, the agency shall recommend adoption assistance to the Administrative Fair Hearing Officer.

C. Procedures Related to the Determination of Post Finalization for State Funded Adoption Assistance.

In those situations where the child is not eligible for Title IV-E Adoption Assistance, SRS has determined that when one of the above conditions exists which merits the opening of an adoption assistance case; it is not necessary for the family to request an administrative fair hearing. The following procedures shall be followed:

The SRS staff shall conduct a staffing review with supporting documentation to determine if the criteria of one of the factors above exists which would determine the child's eligibility at the time of placement.
Submit request to the CFS Program Administrator for approval of state funded adoption assistance.
State funded assistance shall not be used to circumvent the fair hearing process for potentially eligible Title IV-E children.
If the agency denies approval, the family shall be provided with information about their right to request an Administrative Fair Hearing.

6240 The Application and Approval for Adoption Assistance

SRS is the agency responsible for determining eligibility for adoption assistance, for negotiating the amount and type of assistance with the family, and for the execution and signing of all agreements. The family shall have face-to-face contact with the social worker executing the agreements whenever possible. The SRS social worker is responsible for assuring that the family understands the services provided by the program and the limits of the program. Adoption assistance is intended to encourage the adoption of special needs children and minimize the financial barriers. It is different from foster care, as it does not reimburse the family for the total costs for caring for the child. Families shall receive this type of information before they make a decision to adopt and before the adoption agreements are signed.

Eligibility is based on the needs of the child and not the resources of the family. The agency shall not use any universal form of a means test or use any type of grid or scale to determine the amount of assistance. However, the family's resources may be taken into consideration when determining the amount and type of assistance. Determination is always based on the individual needs of the child and the family's ability to meet these needs.

A. Responsibilities of the Case Management Provider

The Case Management Provider shall inform the prospective adoptive parents of the availability of adoption assistance, but shall not discuss specifics of the agreement with the family; nor shall they commit SRS to specific services or a certain amount of cash.

The Case Management Provider shall:

Provide SRS with information needed by the agency to make an informed decision with the family concerning the type and amount of assistance required by the family to adopt the child;
Complete the Referral for Adoption Assistance form, CFS 4024, and submit the form to SRS at least two weeks prior to the date planned to sign the Adoption Placement Agreement;
Provide the family with information about the adoption assistance program.

B. Responsibilities of SRS Staff

Based on the information provided by the Case Management Provider, the SRS staff responsible for eligibility determination shall:

Review forms CFS 4019 (Eligibility for Adoption Assistance) and CFS 4024 (Referral for Adoption Assistance) and the documentation attached to these forms to make this decision (See Eligibility and Payment Manual Section 3260 Title IV-E Adoption Subsidy for additional information regarding eligibility criteria):
Determine the funding program (state funded or Title IV-E) assistance or services shall be provided;
Determine eligibility for medical assistance (refer to Section 3410A of E & P Manual), if part of the adoption support plan

C. Negotiating the Agreement

The SRS staff person responsible for negotiating the agreement with the family shall:

Verify the child's financial eligibility including special issues such as HCBS eligibility, SSI, etc.
Review with the family the special needs of the child to help them understand the scope of the needs of the child and the impact it will have on their family's resources.
Discuss with the family the purpose and parameters of the adoption assistance program. Explain the differences between foster care payments and adoption assistance.
Review the family budget and information regarding the other resources available to the family. Help determine what portion of the cost, if any, of the child's needs the family can meet. Inquire whether the family will need adoption assistance in order to adopt the child.
Discuss the type and negotiate the amount of assistance needed to meet the needs of the child.
Families may but are not required to purchase a separate policy on behalf of the child or add the child to their family health insurance. If the child is added to the family's health insurance, obtain the name of the insurance company and policy number. When billing Medicaid, the family's health insurance is always billed first.
Educational services in Kansas are to be provided by the public school system. The Kansas Adoption Assistance Program does not pay for private schooling. If the child is eligible for an Individual Education Plan (IEP), a number of services may be provided to the child. Families are encouraged to explore these resources. Public schools are mandated to provide services for certain eligible children. Adoption Assistance does not pay for privately purchased educational enhancement programs, or services which are normally provided to children who attend public schools.
Community services should be explored with the family. Such services may be available through: Public Health Departments, Community Mental Health Agencies, support groups and/or service programs for families with children who have a specific special need, e.g., Muscular Dystrophy, Spinal Bifida, etc. Some of these organizations will provide equipment, counseling, day camps and other such services to the child.
Financial resources of the child shall be considered. This includes such things as life insurance and annuities, social security benefits through the birth family's claim, and veterans and railroad benefits. Adoption does not make the child ineligible for such benefits. Adoption does not limit a child's right to inherit from the birth family. Neither does adoption limit the child's eligibility for Social Security benefits from the birth parent's claim. If an adoptive parent elects to draw benefits from a birth parents Social Security claim, they cannot, at a later date, draw benefits for the adopted child from their own claim.
Consider the current and future needs of the child when arriving at a specific amount of cash assistance and services the family will need. Some children have very few needs at the point of adoption but the prognosis is that they may have more expensive needs at a later date, e.g., a heart condition that will require surgery at a later date, a sexually abused child who will require additional therapy during adolescence, etc.

It is expected the adoption assistance plan shall reflect these needs. While the agency cannot commit to increasing the subsidy amount at a certain point in time, the agency can commit to renegotiating the amount if the needs of the child and the family's ability to meet these needs change.

If the Region and the family are unable to come to an agreement on the amount of subsidy, the Regional office may contact the Children and Family Services Adoption Assistance Program Manager for assistance in the negotiation. The Regional Office makes the decision about the amount of the subsidy and handles any appeals that may result.

The Adoption Assistance Agreement, CFS 4022, shall be signed after the Adoption Placement Agreement, CFS 2810. Although this may be executed during the same meeting with the family, the details of the subsidy agreement shall be negotiated prior to the signing of the placement agreements

6250 Types of Adoption Assistance

There are four types of adoption assistance. The types of assistance the family receives shall be determined by the above referenced negotiation process. It shall not be assumed all families will need all types of assistance.

6251 Medical Services

The Adoption and Safe Families Act requires health care coverage be provided for any special needs child for whom there is an adoption assistance agreement. It is important that the family understand the benefits and limitations of the Kansas Medicaid Program.

Each regional office has a Medicaid liaison who shall be consulted for information regarding Medicaid services. Health Care Policy will assist in obtaining information regarding available medical services for specific children. Booklets and brochures are available through that Division for families. Additional information can be found in the Kansas Medical Services Manual.

6252 Monthly Cash Subsidy Payments

Many families will receive a monthly subsidy payment to help them meet the costs of providing for the child's special and ordinary needs, including child care. The amount of payment may vary from family to family depending upon the needs of the child and the family's ability to meet those needs. For the most part, it is expected that the family will assume the responsibility for expenses like food, clothing, shelter, entertainment, etc. The family determines how the monthly cash subsidy payment will be spent.

Once the amount of subsidy has been agreed to by the family and agency, the amount will not change unless mutually agreed to by both parties. Adoption subsidy does not automatically increase as the child gets older. The expectation is that the amount will be unchanged during the life of the agreement. However, the family may request the subsidy amount be reviewed if the needs of the child change, or if their ability to meet those needs changes.

A. Monthly Subsidy Rates

The maximum amount of subsidy is $500, unless a child is eligible for SSI prior to adoption finalization. (See section 6252B.) The monthly payments shall be based on the needs of the child and the resources of the family and can range $0 to $500.

Factors to consider when determining the amount of subsidy include:

Cost of medical transportation;
Cost of adding the child to private health insurance;
Special equipment or other non-medical supplies needed by the child not covered through other resources (e.g., disposable diapers for children past toilet training age, non-prescription medication recommend by the doctor, etc);
Cost of day care.
Number of children in the sibling group to be adopted; (In certain situations where families are adopting large sibling groups, the added cost of food, clothing, and shelter may be taken into consideration when arriving at a subsidy amount.);
Costs of special enrichment programs to benefit the child;
Other costs unique to the needs of the child;
Home improvements required due to the child's special needs.

B. SSI Eligible Children

For those children who were determined SSI eligible prior to adoption, the maximum amount of subsidy payment is the SSI rate, at the time of signing the adoption assistance agreement. The current rate is posted on the Social Security Administration web site at www.socialsecurity.gov/.

SSI Eligible Children pre-finalization. Adoptive parents (including relatives) may be eligible for Title IV-E adoption payments of up to the SSI rate. An adoptive subsidy agreement shall be established whether the adoptive parents receive the SSI payment or a IV-E payment. The most common arrangement is for the agency to make a IV-E payment to the adoptive parents and collect the SSI as child support.

SSI Eligible Children post-finalization. Most children who are eligible for SSI in foster care may not be eligible for SSI once they are adopted because the family's resources shall be taken into consideration. At finalization and release from SRS custody, the adoptive family has the option to request to become payee of the child's SSI benefit, if child continues to be SSI eligible. The SSI payment shall be reduced by the amount of the adoption subsidy payment.

Children at age 18 who are eligible for SSI and receiving Title IV-E Adoption Assistance. Title IV-E adoption assistance ends at age 18, or age 21 if it has been determined that the child has a mental or physical handicap which warrants the continuation of assistance until that time. At the age of 18, a youth as a household of one, is eligible to apply for lifelong SSI benefits. If the youth has physical or mental conditions that indicate the likelihood of eligibility for lifelong benefits, families should be encouraged to apply for SSI benefits on behalf of the youth once he/she reaches age 18.

C. Home and Community Based Services (HCBS) Eligible Children

Children who receive in-home services through the Home and Community Based Services (HCBS) Waiver while in foster care continue to be eligible for such services after adoption. Adoptive parents shall not receive the Residential Care payment through HCBS. These cases may meet the "extraordinary circumstances" for an exception described in section 6270.

D. Subsidy Payments in Excess of Standardized Amounts.

An exception to the standardized amounts may be made in extraordinary circumstances. Prior approval is required by Children and Family Services Adoption Assistance Program Manager. All requests shall be made in writing. See Section 6270.

6253 Special Service Payments

A special service payment may be authorized on a time-limited or one-time only basis if the child has a specific need which cannot be met through the Medicaid program, the monthly subsidy payment or other resources. The service payment for special purchase of goods or services shall be specified on the Adoption Assistance Agreement, CFS 4022. Specify and document the service and length of time the service shall be purchased, or the goods to be purchased. (See Handbook of Services for details on purchasing special services or goods). If a need is identified at a later date, a new agreement shall be developed and signed.

Payments for such goods or services are not covered under the Title IV-E Adoption Assistance program, and shall be purchased from all state funds (non-IV-E adoption support.).

A. Time Limited Services

Time limited services may be approved by regional staff for a six month period. See Eligibility & Payment Manual Section 4210.

B. One-Time Only Purchases

Unique one-time only purchases are limited to $1000 per child. Such purchases may include:

Beds and chest of drawers for families who adopt three or more children;
Special equipment for children with handicaps or development disabilities not covered by other resources;
Home modifications to make the house handicapped accessible, i.e., building ramps or widening doors etc.;
Lifts for vans, SRS does not purchase vans;
Respite care.

See Eligibility & Payment Manual Section 2123 for purchasing requirements.

6254 Non-recurring Adoption Expenses

The Tax Reform Act of 1986 established the provision for reimbursing families for expenses associated with the finalization of adoptions. Any family who adopts a Kansas child who has special needs is eligible to apply for such funds. Applications may be taken from families who adopt through SRS, licensed child placing agencies, adoption brokers, i.e., attorneys, doctors, ministers, etc, or by direct consent from the parents. Families may be reimbursed up to $2,000 for the expenses associated with the placement of each child and finalization of the adoption. Payments cannot be made until the adoption is finalized. An assistance agreement shall be signed prior to finalization and the child shall not be receiving adoption subsidy from another state. (See the Eligibility & Payment Manual Section 4220 for information on the Application Process and Allowable Reimbursements.).

6260 Developing the Adoption Assistance Agreement

Once the family and SRS worker have agreed upon the amount and type of assistance the CFS 4022, Adoption Assistance Agreement, can be signed. It shall be signed by the parent(s) prior to the finalization of the adoption. It may be signed at the same time the adoption agreement is signed.

6261 Terms of the Agreement

Every effort shall be made to assure the family understands the terms of the adoption assistance agreement. The terms of the agreement are legally binding. If the child has specific medical or emotional needs that created the original eligibility for adoption assistance and SRS has agreed to meet those needs, it shall be so noted on the agreement. The agreement shall not be changed without the mutual agreement of SRS and the family. A new agreement is required for all subsequent changes. The SRS staff person negotiating and executing the agreement shall:

A. Explain to the family why the child is eligible for adoption assistance;

B. Review with the family the responsibilities of each party;

C. Specify the type and amount of assistance;

D. Explain the purpose, amount and time limit for special service payments;

E. Specify the duration of the agreement, and terms of the contract;

F. Explain that the terms of the contract will be fulfilled regardless of where the family resides;

G. Explain the limitations of the adoption assistance program, e.g. there are no automatic increases in the payment as the child gets older, Medicaid coverage is not the same in all states;

H. Explain that the family may request that the subsidy amount be reviewed if the needs of the child change or if the parents ability to meet those needs change:

I. Specify that the agreement remains in effect regardless of the family's state of residence. (See Section 9600 for additional information.)

6262 Effective Date of the Agreement

Initial Assistance Agreement

The effective date of the initial assistance agreement shall be the date the adoption assistance agreement is signed.

A new agreement is required for all subsequent changes. The effective date of a renegotiated assistance agreement shall be the first of the month following the month the agreement is signed.

Approval for Subsidy Post Finalization

For those cases where a cash subsidy has been approved after the adoption decree has been granted, the effective date of the agreement is the date the family made their initial request for assistance.

Duration of the Agreement

The adoption assistance agreement remains in effect until the child reaches age 18, unless the agreement is time limited based on the needs of the child and circumstances of the adoptive parents. Assistance may continue past age 18 until age 21, if the child has a physical or mental disability which warrants continuation beyond age 18. The case record shall contain documentation of the physical or mental reason such continuation of assistance is needed.

If the youth is still in high school, adoption assistance, under the state funded program, may continue beyond age 18 until the youth graduates from high school as long as the youth continues to be dependent upon his or her parents for support. Staff shall encourage families to apply for Supplemental Security Insurance (SSI) on behalf of the youth, once he/she reaches age 18, if the youth has physical or mental conditions which indicate the likelihood of eligibility for that program. The SRS worker shall also help the family explore community resources and adult services programs for youth with serious mental or physical disabilities.

6263 Renegotiating the Terms of the Agreement

The terms of the agreement cannot be terminated, suspended or changed without the concurrence of the adoptive family and SRS. Either party may request to renegotiate terms of the agreement. A change in the terms of the agreement requires a new agreement be signed. No changes are to be made to the original agreement. All agreements are to be maintained in the case file with the most recent on top.

Renegotiation at the Request of the Parents

The family may request an increase in the amount of subsidy due to changes in the needs of the child, or due to the fact that the needs of the child were underestimated during the initial negotiations. The family shall provide documentation related to changes in the needs of the child.

Renegotiation at the Request of the Agency

SRS may request a renegotiation if significant changes in the circumstances of the child or family are reported.

When a child is in residential care for over thirty (30) days, the agency should request that the family accept a reduction in the amount of subsidy, or volunteer to reimburse SRS a portion of the subsidy to help defray the cost of the child's care. (See Section 6280.C)

It is the intent of the agency to maintain the family unit, even if the child is in out of the home for treatment purposes. Therefore, when renegotiating the adoption assistance agreement with the family, staff shall take into consideration what expenses the family will continue to meet on behalf of the child, e.g., travel to visit the child, clothing, spending allowance, etc.

6264 Unilateral Termination of the Agreement

The adoption assistance agreement may be terminated under two conditions:

Documentation that the family is no longer legally responsible for the child.

The adoption assistance agreement can be terminated if the family is no longer legally responsible for the child. This occurs only if the family's parental rights were relinquished or terminated by the court.

Placement in foster care is not grounds to unilaterally terminate an agreement. As long as the family is working toward reunification of the child, assistance can continue. Referrals are not to be made to Child Support Enforcement.

Documentation the family is no longer supporting the child.

The adoption assistance case shall be closed when the child has reached age 18 and has graduated from high school, has established a home of his or her own, becomes emancipated, married, or has joined the military service. The adoption assistance case shall closed upon the death of a child or the adoptive parent(s), but shall remain open if one parent dies. Adoption assistance shall not continue past the youth's twenty-first (21) birthday.

If the youth is still in high school, adoption assistance may continue, under the state funded program, beyond 18 until graduating form high school or turns 21, as long as the youth continues to be dependent upon his or her parents for support. In these cases federally funded cases shall be transferred to the state funded program. For procedures refer to EPM section 4300.

Adoption Assistance shall continue for youth beyond age 18 if the youth's physical or mental disability warrants continuation. Prior approval shall be obtained each year to extend the adoption assistance plan beyond the youth's eighteenth birthday. Prior to the youth's eighteenth birthday, the adoptive parents may submit information to the regional SRS office documenting the youth has a physical or mental disability warranting continued adoption assistance.

If the agency receives documentation the family no longer legally or financially supports the youth, SRS shall provide the adoptive parents with thirty days written notice to close the adoption assistance case. The written notice shall provide the basis for the decision to close the case, and inform them of their right to request a fair hearing. (See Section 0230 for the Fair Hearing process.)

6270 Dispute Resolution

When the family is requesting over and above the subsidy rate per PPM section 6252 A and B, or need goods or services beyond the usual scope of the program, a request to the CFS Adoption Assistance Program Manager for an adoption assistance exception may be made by the regional SRS staff. Federal requirements state that the amount of the adoption assistance payment cannot exceed the amount that a child would have received if he or she had been in a family foster home, but otherwise must be determined through agreement between the state or local title IV-E agency. The following dispute resolution procedures may be utilized for both original subsidy negotiations and renegotiations.

A. Procedures Related to Requesting Central Review and Approval

Regional Office SRS staff are responsible for collecting and reviewing all supporting documentation necessary to do a full evaluation of the request. They shall deny the request based on the information provided or forward a written request for an exception to the CFS Adoption Assistance Program Manager. Staff shall forward a written accounting of what the family perceives they need. The family shall write a letter explaining why they need cash, goods, or services. If this is a renegotiation, the family shall describe how the needs of the child or the circumstances of the family have changed. A family budget or list of the family's resources to be considered when determining the amount of assistance shall be included.

Depending on the complexities of the case, Regional Office SRS staff may collect supporting documentation from:

Physicians/therapists who can provide a summary of the special needs of the child.
The Case Management Provider responsible for completing the child's social history and other file data.
Other applicable resources such as school reports and any other similarly appropriate information.

SRS staff may visit the family in their home to make a more complete assessment of the child's needs, request the family supply them with additional documentation if needed, and help the family access needed services.

Regional Office SRS staff shall review documentation to ensure the family is receiving all types of adoption assistance to the fullest extent possible (medical services through Medicaid, services through school, HCBS services, behavioral management services, etc.) by:

Reviewing the parent's request with the Medicaid liaison to determine if Medicaid will cover needed services. At a minimum, local staff shall explore the following options with Medicaid; prior authorization, pre-determination (if the child is less than 21 years of age and current on his or her KBH screen), and enrolling the in state or out-of-state provider as a Medicaid provider.
Exploring additional mental health evaluations and or services.

Regional Office SRS staff shall evaluate the request by considering such things as:

Does the documentation support the fact that the child's needs are the cause of increased expenses?
Are the parents requesting money for items which a parent is generally responsible for providing, i.e. clothing, food, etc.?
What prior treatment or services has the family tried? Was there success or failure and why?

Regional Office SRS staff shall provide central office with copies of documentation and its recommendations which include:

The dollar amount determined to be reasonable to meet the family's request.
The rationale or justification for the decision.
Copies of all pertinent documentation.

CFS staff are responsible for reviewing and analyzing all documentation and responding to the written request from the regional office. Depending on the complexities of the case documentation may be reviewed by a panel of CFS managers or Health Care Policy staff for their evaluation and recommendation. A written decision shall be made by CFS and provided to the Regional SRS Office. The Regional SRS Office shall send the decision to the family within 14 business days.

B. These procedures are to be followed at case opening or any time there after for the duration of the case, whenever the family requests cash assistance, goods or services which would constitute an exception to SRS policy governing adoption assistance.

6280 Annual Review of the Adoption Assistance Case

A. The Purpose of the Review

An annual review shall determine if the family continues to be legally or financially responsible for the child. It is not a re-determination of eligibility for adoption assistance.

B. Procedures Related to the Annual Review of Adoption Assistance

Send the family the CFS 4023, Adoption Subsidy Review.
Advise the family they have thirty (30) days to return the form.
If the family fails to return the review within 30 days, provide the family written notification the case may be suspended or closed if the CFS 4023 is not returned within 30 days.
Follow up with those who did not respond by initiating efforts to obtain the needed information
The adoption assistance can not be reduced or suspended solely because the adoptive parents fail to respond to the annual review. Once the child receives IV-E adoption assistance, adoption assistance continues until either the adoptive parents agree to a change or the adoptive parents are no longer legally or financially responsible for the child.
Refer to Section 6264: Unilateral Termination of the Agreement.

C. Children Temporarily Out of the Adoptive Home

For children temporarily placed in a Psychiatric Residential Treatment Facility (PRTF) the cost of the treatment will be paid through Medicaid, provided the child meets the eligibility criteria.

For children temporarily placed in a non-Medicaid placement, the payment for placement shall be negotiated and agreed between the family and Regional SRS Office.

SRS shall request the family to help pay for the child's care, or agree to a decrease in the amount of the monthly adoption subsidy payment.

SRS shall consider the following when determining what is a reasonable amount of reduction in adoption subsidy payment:

Travel and lodging costs to visit with child and participate in therapy;

Incidental expenses for the child while in care:

Long distance telephone calls associated with the child's treatment or to communicate with the child;

Other unusual expenses.

The adoption assistance case cannot be closed or the amount of subsidy decreased without a mutual agreement of the family, provied they remain financially or legally responsible for the child.

If a specials needs child(ren) was in the Secretary's custody, the adoptive family shall not be referred to Child Support Enforcement. The CFS Program Administrator or designee may make an exception if the family refuses to either contribute to the costs of the child's care or to a reduction in adoption subsidy payments.

SRS shall review the adoption subsidy payment when the child returns home, unless the family agrees to the amount of adoption subsidy received immediately preceding the child's out of home placement. SRS may negotiate a higher amount if the child's needs or the family's ability to meet the child's needs have changed.

6290 Transfer of Files

The service case and shall be maintained in the office originally responsible for the case. Once the adoption has been finalized and the attorney fees have been paid, the financial and adoption assistance cases are transferred to the SRS office where the family resides. The complete financial record, all documentation leading to determination that the child is eligible for either the state or federally funded adoption assistance, and all copies of pertinent case information, i.e., social history, family assessment, background, health, psychological reports, etc., shall be sent to the new region. The adoption assistance case file shall include logs of any renegotiations that occurred prior to the transfer. The new regional office may request that the service case be sent to them by the original regional office if the new region has a need for it. This information is important to the new adoption assistance expert in the event that there is a request for a renegotiation of the adoption assistance agreement.

6300 FACTS Subsidies Procedures

6310 Permanent Custodianship Subsidy

If a family is approved for permanent custodianship subsidy, enter the subsidy as a service action on RESP on the child’s FP plan. The service requested is securing a member grant (SG). Enter a Service Action of IN05P for cash only subsidy or medical and cash subsidy with a source of guardian (GRD). Initiate (IN) the responsibility status with the date the permanent custodianship subsidy agreement is signed. Authorize max units of 1 and indicate a type of monthly (M). Enter the amount of subsidy in the charge unit field. Enter the name of the custodian on the PROM screen with a provider type of GRD. Enter a Service Action of IN05N for medical only with a source of guardian (GRD). Initiate the responsibility status with the date the permanent custodianship subsidy agreement is signed.

6320 Recording Adoption Subsidy Information

Monthly cash subsidy information is recorded on a child’s ADOP and RESP screens. Non recurring adoption reimbursement is only recorded on ADOP. If non recurring adoption reimbursement is not known at the time of discharge, leave reimbursement amount blank. Once the monthly subsidy is determined, maintain this activity as a service action on RESP. A child must have a special needs to be eligible to receive an adoption subsidy; therefore, if an adoption subsidy is being entered, a special needs must be entered as outlined in PPM section 5581.

A. Children Who Receive Medical Card Only Subsidy

B. Children Who Receive Both Monthly Cash Subsidy Payments and Medical Card

Enter a service request to secure member grants (SG) with an achievement date eleven months from the date on the CFS 4022 Adoption Assistance Agreement. Enter a service action code of AO05P with service source of subsided adoptive parent (SAP). Enter the name of the adoptive parents in the description field, initiate the status with an effective date the subsidy was effective per CFS 4022. Enter the caseload number of the worker with responsibility for the subsidy case, and the start date that worker began responsibility for that subsidy case. The worker start date can not be prior to the effective date of the subsidy service action. Family structure code does not need to be completed. Enter an authorized max unit of 1, with a monthly type (M) and unit reflecting the cash amount of monthly support and effective date from the CFS 4022. Co pay information is not completed. At this time (prior to finalization), link the provider to an family foster parent (FFP) provider number on PROM.