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Connecticut State Subsidy Profile Updated August 2007 State Subsidy Contact Person Sandy Matlack NACAC Subsidy Representative (parent/volunteer) Lynn Gabbard Adoption subsidies are available for children with special needs. Federal subsidies were created by Congress (through Public Law 96-272—the Adoption Assistance and Child Welfare Act of 1980) to encourage the adoption of special needs children and remove the financial disincentives to adoption for the families. Children may receive a federally funded subsidy under Title IV-E or a state-funded subsidy as per state guidelines. Below we have outlined information related to definitions of special needs, benefits available, and procedures in your state. Answers to select questions were made available by the Association of Administrators of the Interstate Compact on Adoption and Medical Assistance (AAICAMA) through the Child Welfare Information Gateway (www.childwelfare.gov). Profiles for each state’s subsidy program are available on our web site at www.nacac.org. If you have additional questions, please call the North American Council on Adoptable Children (NACAC) at 651-644-3036 or our subsidy help line at 800-470-6665, or e-mail us at adoption.assistance@nacac.org. If you have state-specific questions, please call your State Subsidy Contact Person or the NACAC Subsidy Representative (listed above) for more information. Adoption Resources on the Web: www.state.ct.us/dcf/FASU/FASU_index.htm Connecticut’s state-specific medical assistance: Connecticut’s adoption assistance: www.state.ct.us/dcf/FASU/FASU_Subsidized_Adoption.htm 1. What specific factors or conditions does your State consider to determine that a child cannot be placed with adoptive parents without providing financial assistance? ("What is your State definition of special needs?") A child with special needs is defined as a child that has at least one of the following needs or circumstances that may be a barrier to placement or adoption without financial assistance:
2. What are the eligibility criteria for the State-funded adoption assistance program? In order to be eligible for state-funded adoption assistance a child must be a special needs child as defined above. 3. The maximum basic monthly adoption assistance maintenance payment in Connecticut is:
4. Specialized rates are based on the extraordinary needs of the child, and/or the additional parenting skill needed to raise the child. If Connecticut offers these rates, the criteria used to define them are as follows: Children are defined as “medically complex” if they are: (a) diagnosed with a life threatening condition; (b) diagnosed with an injurious medical condition that results in substantial physical impairment; (c) HIV-positive; or (d) diagnosed with AIDS, and meet criteria for nursing care level of need. Specific care needs have to be required by the child to meet these criteria. 5. Parents can receive payment or reimbursement for certain nonrecurring adoption expenses directly related to the finalization of an adoption. Below are the allowed expenses and the limit per child. Expenses directly related to the adoption of a special needs child are eligible for reimbursement. For example: court fees paid in out-of-state matters, attorney fees, cost of an adoption home study (including health and psychological examinations), supervision of an adoptive placement prior to finalization, and reasonable cost for travel, lodging and food for the child and adoptive parent(s) when necessary to secure an adoptive placement. Expenses for family counseling prior to adoption or for renovations to the home to meet the needs of a handicapped child are not reimbursable. A child does not have to be Title IV-E eligible for an adoptive family to be eligible for reimbursement of nonrecurring costs. Family income is not a factor in determining eligibility for reimbursement. Families adopting through private agencies are eligible. International adoptions are not eligible. The reimbursement limit is $750 per child. 6. What Medicaid services are available in Connecticut? For information, contact HUSKY, the manager of the Medicaid program in Connecticut, at 800-656-6684. If you are calling from outside of Connecticut, call 860-656-6684. Connecticut uses Managed Care HMO providers for Medicaid for children. Adoptive parents select which plan they want for their child. 7. Children who have federally funded (Title IV-E) subsidy are automatically eligible for Medicaid benefits. However, it is the state's decision whether state-funded (non-Title IV-E) children are eligible for Medicaid benefits inConnecticut. Below is information on the Medicaid benefits available for state-funded children. Yes—IV-E and non-IV-E children receive the same medical benefits. 8. What mental health services are provided by your State? Public mental health services for children in Connecticut are administered through the Connecticut Department of Children and Families. DCF has legal authority to provide for children's mental health services and operates Riverview Hospital for Children and Youth, High Meadows Residential Treatment Center, and the Connecticut Children’s Place. Through Connecticut Community KidCare, the Department also provides funding for a broad array of clinical and other services in the community, including Child Guidance Clinics, Extended Day Treatment Programs, Emergency Mobile Psychiatric Services, Respite Care, Family Advocacy and Intensive Case Management. Children and families can access state-operated or state-funded community services directly or through referrals from providers in the mental health system. Services are provided on a sliding scale, and the majority of service providers are affiliated with a variety of health insurance plans. Contact the Division of Mental Health at 860-550-6561 for more information. Connecticut Medicaid (HUSKY, Healthcare for Uninsured Kids and Youth, Part A) offers mental health services including inpatient psychiatric care, outpatient mental health services, prescription medication, mobile crisis services, and substance abuse services. HUSKY: www.huskyhealth.com/about.htm and Frequently Asked Questions: www.huskyhealth.com/faqs.htm. A second program, known as HUSKY Plus, provides supplemental benefits for certain Children with Special Health Care Needs ranging in age from birth to their nineteenth birthday. Children with special health care needs are children who have, or are at elevated risk for, chronic conditions they were born with or later acquired, including physical, developmental, behavioral and emotional conditions. These children require health and related services (not educational and recreational) of a type and amount not usually required by children of the same age. There are two Husky Plus Programs, one Physical and one Behavioral. Husky Plus: http://www.huskyhealth.com/guide.htm or call 877-284-8759 or 800-842-4524 TTD/TTY for hearing impaired for more information. Note: Not all services may be available in all cases. Contact your adoption assistance worker or medical assistance specialist for information regarding process, eligibility, availability, and duration of services. 9. Does your State provide additional finances or services for medical or therapeutic needs not covered under your State medical plan to children receiving adoption assistance? Adoptive parents can request additional payments for medically necessary services or items that were not part of the adoption assistance agreement. The only way to receive an adoption assistance increase is through a diagnosis of “medically complex” as all adoption assistance monetary payments are made at the maximum amount permitted at the time of the child’s adoption finalization. If a child’s condition becomes what is referred to as “medically complex”, parents can request to increase to the rate available for children with this diagnosis. Payments can be on a one-time basis for a specific purpose or an on-going payment, depending on the nature of the need and request. Examples of need are van modifications for a handicapped child and specialized therapy not covered by Medicaid and therapeutic respite. Note: Not all services may be available in all cases. Contact your adoption assistance worker for information regarding process, eligibility, availability, and duration of services. 10. What types of post adoption services are available in your State and how do you find out more about them? Post adoption services in Connecticut are overseen by the DCF, Office of Foster and Adoptive Services and received through outside agencies. Post adoption services include the following examples:
The Connecticut DCF contracts with licensed child-placing agencies to serve parents who adopt a difficult-to-place child. Known as the Permanency Placement Services Program (PPSP), the services are provided on a case-by-case basis at the recommendation of the child's caseworker and with the approval of the DCF regional supervisor. Services in Connecticut are not designated specifically as post adoption services. Some services are received through the Connecticut Association for Foster and Adoptive Parents (CAFAP) and others are received through the Voluntary Services program. The Voluntary Services include day treatment, partial hospitalization and residential placement. DCF area offices and facilities locator: www.state.ct.us/dcf/area_offices.htm. To access post adoption services, adoptive families must self-refer through the agency Hotline, phone number: 800-842-2288. Connecticut DCF allotted funds in 2005 for the development of an Adoption Assistance Program of post finalization services for any adoptive family in CT. This program is operated by the University of CT Health Center, in Farmington, CT. Families refer themselves for confidential services at no cost. The services provided are varied and designed to meet the needs of the child and family. The toll free number is 877-679-1961. Casey Family Services provide post adoption support services in two locations, Bridgeport and Hartford. See links to In Your Area, Hartford, Connecticut, Services Offered, Post Adoption Services: Respite Care—Payment for respite services is available. The need and provision for respite care must be documented in the adoption assistance agreement. The family must secure their own respite provider. In addition, any private organizations offer a variety of respite options. See the ARCH National Respite Network Respite Locator Service, search by state to locate Connecticut’s respite programs: http://www.respitelocator.org/. Note: Not all services may be available in all cases. Contact your adoption assistance worker or post adoption services contact for information regarding process, eligibility, availability, and duration of services. 11. If the additional assistance (listed above in questions #8 -10) is to cover specific services (e.g., counseling/mental health services, respite care, etc.), must these services be explicitly identified in the adoption assistance agreement? Yes. 12. How are residential treatment costs covered (if at all) for adoptive families? What procedures must a family follow to receive these services? Families who reside in state and receive Connecticut adoption assistance may apply for the Voluntary Services Program (which include residential services). If eligible, the parental contribution towards the cost of placement is waived, but subsidy is suspended when DCF is paying the residential facility. Contact Sandy Matlack, DCF adoption manager, at 860-550-6392 for further information. 13. A deferred adoption assistance agreement is one in which the initial monthly maintenance amount is $0. Does Connecticut offer such agreements? No, Connecticut does not offer deferred adoption assistance. Connecticut, does, however, have a Subsidy After Finalization. The Subsidy After Finalization option is for children who develop a handicapping condition after adoption finalization that is directly related to conditions existing prior to adoption or genetically related conditions that were undiagnosed at the time of adoption. 14. Does Connecticut operate a subsidized guardianship program? Yes. The program is only for children currently in Connecticut foster care with a licensed relative. The program is for the benefit of those children who 1) are in the care of custody of the Department; 2) have been in foster care for at least 12 months (the 12 months do not have to be continuous, but may be a cumulative total of time in which a child has been in foster care); 3) are living with the relative caregiver who is requesting the subsidy; 4) have been living with such relative caregiver for at least 12 months (the 12 months do not have to be continuous, but may be a cumulative total of time in which a child has lived with the relative caregiver). There are three types of subsidies available under this program:
The child is eligible for the above subsidies until he/she reaches 18 years of age, or 21 years of age if he child is in full-time attendance at a secondary school, technical school or college or is in a state-accredited job training program.
15. Who makes the final determination of a child's subsidy eligibility in Connecticut? What roles, if any, do workers and administrators at the county, district, or regional level play in eligibility determination and/or assistance negotiation? Subsidy eligibility is recommended by the program supervisor based on criteria submitted by the social worker and social work supervisor or the private Connecticut adoption agency staff. Each case is reviewed by the subsidy manager/supervisor at the central office level before being submitted for the commissioner's signature. For all subsidized adoption cases, a finding of Title IV-E eligibility or ineligibility will be made. 16. Will Connecticut consider my family income to determine my child's eligibility for an adoption subsidy? Family income and resources are not considered when determining the monthly subsidy amount, but may be considered when determining the need for additional services for which out of pocket payments would be needed to fund those services. 17. When do subsidy payments begin? Adoption assistance payments and benefits may begin in Connecticut after adoption finalization. 18. Do children adopted from private agencies in Connecticut receive the same subsidies as those children adopted from public agencies? Yes. Private agencies complete the same paperwork as DCF social workers when determining subsidy eligibility. These subsidy requests are submitted directly to the DCF Central Office. 19. When my child turns 18, which benefits, if any, are available to our family? Medical coverage (state funded) is provided until age 21 for CT residents. Medical expense subsidies may continue until children reach age 21. 20. A child's adoption assistance agreement may be periodically reviewed by the state. What is the typical process used in Connecticut? Families sign a new subsidy agreement biennially (beginning October 2000), certifying that the child is still living with them and that the family supports the child. Families must return this agreement for the subsidy to continue. 21. Can adoption assistance agreements be modified if requested by adoptive parents? Adoptive parents may appeal any decision to deny, modify, or discontinue adoption assistance benefits. Requests for modification must be made in writing and documentation of need, cost, and medical necessity must accompany the request. Adoptive families in Connecticut usually receive the maximum payment allowed for the age of the child at the onset of adoption assistance, so that increases are only available when the state legislative rate increases for a Cost of Living Adjustment. Adoptive parents are provided with timely written notice of proposed actions regarding adoption assistance benefits. Send requests to the Commissioner of the Department of Children and Families to seek a hearing before the Subsidized Adoption Review Board. The hearing will be conducted according to the Uniform Procedures Act. See Question #22 for further explanation of the fair hearing process. 22. What are the exact steps a family must go through to access the fair hearing/appeal process in Connecticut? Requests for fair hearing in Connecticut are made by contacting the Hearings Unit of the Department of Children and Families. DCF area offices locator: www.state.ct.us/dcf/area_offices.htm. Any proposal to discontinue, reduce, or suspend adoption assistance benefits, other than for state law reasons, are sent to the adoptive parent in writing prior to taking any action that would affect a child’s benefits. Parents have fourteen days to respond in writing to the proposal if they wish to ask for a hearing and the proposed action will not occur before a hearing is held and a fair hearing determination made. If a parent does not respond to the proposed action within fourteen days, the action will be taken, but parents continue to have up to sixty days from the date of the notice of proposed action to request a fair hearing. Adoptive parents are instructed to write a letter requesting a hearing or to use the form included in the original notice of intended action to notify the Hearings Unit in writing of the desire for a fair hearing. Hearings may only be requested for a proposed reduction, suspension, or termination of adoption assistance. An assigned Hearings Unit staff member will contact the parent seeking a fair hearing to schedule a hearing at a convenient time and the actual hearing is conducted by the Hearings Unit staff. From there, adoption assistance hearings are held before the Subsidy Review Board, a Governor-appointed board of three hearing officers that hear the case and issue a written determination within ninety days of the hearing date. Send hearing request forms to: Department of Children and Families 23. Families may request a subsidy after the finalization of an adoption under certain circumstances. Below is the process by which families access a subsidy after finalization. Families make a written application stating the reasons for the subsidy. In the case of a private agency adoption, DCF requests records from the closed file. If the adoption is through DCF, the records are retrieved from a DCF storage facility. DCF reviews records to determine if the child's condition is related to circumstances present prior to the finalization. DCF grants medical-only or financial/medical subsidies (state funded) based on the current needs of the child and supporting documentation and whether it is related to a pre-finalization circumstance or condition, and in relation to the family’s resources and the child’s treatment needs. Subsidized Adoption Unit System Operation and Program Funding 24. How is the subsidy program operated and funded in Connecticut? The program is state supervised/state administered. This means that both policy and eligibility decisions are made by personnel at the state office. All subsidy cases are centrally administered. The federal contribution to Title IV-E-eligible children is 50.00% in Connecticut. This is known as the Federal Financial Participation (FFP) rate. The remaining cost of the program is funded entirely with state funds. 25. Below are other programs that may delineate Connecticut's adoption assistance program from others around the country. DCF provides a “medical coverage only” subsidy for children who are considered “at high risk for developing a mental or physical disability,” but who are currently not considered to have special needs. The CT legislature approved funds in 2005/06 indefinitely, for any child adopted from the DCF foster care system after 12/31/04, to assist that child and their parent with the cost of post secondary education. DCF will provide financial assistance towards the cost for any degree/accredited program after high school that the adopted child is accepted into, provided it is full time status, up to the annual cost of the University of CT, including tuition, fees, room and board, at any school. More information can be obtained from the DCF Subsidy Unit. |
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North American Council on Adoptable Children (NACAC)
970 Raymond Avenue, Suite 106
St. Paul, MN 55114
phone: 651-644-3036
fax: 651-644-9848
e-mail: info@nacac.org
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