CODES/REFERENCES

N/A

 REQUIREMENTS

The Division of Family and Children Services (DFCS) shall:

1. Consider a request for an adoption assistance specialized rate for a child who has a significant level of mental, emotional and physical disability which requires care and services that cannot be adequately compensated by the basic adoption assistance rate and Medicaid.
2. Ensure the following requirements are met prior to considering an adoption assistance specialized rate:
   1. The adoption assistance application for a specialized rate is submitted at the same time as the adoption assistance application for a basic rate. EXCEPTION: An adoption assistance application for a specialized rate in Georgia SHINES can be submitted following the approval of the adoption assistance application for basic rate when a child is later determined to have additional problems and treatment needs.
   2. An application for Supplemental Security Income (SSI) benefits was submitted for the child and the Social Security Administration (SSA) has rendered an eligibility determination of either approved or denied. 
   3. NOTE: This requirement only applies to children who are determined by the Revenue Maximization Unit (Rev Max) to have an adoption funding type of state- funded.

   4. A child who is in a DFCS foster home must be currently approved for a specialized foster care per diem by the Care Coordination Treatment Unit (CCTU) and have a current Memorandum indicating such. 

      NOTE: If the child doesn’t have a current specialized foster care per diem rate approval, an application for both a specialized foster care per diem rate and an adoption assistance specialized rate must be submitted simultaneously to both CCTU and Social Services Administration Unit (SSAU) with all supporting documentation. See policy 16.5 Room Board and Watchful Oversight: Specialized Foster Care Per Diem for procedures for submitting a request to CCTU for specialized foster care rate per diem.

   5. A child who is placed in a child placing agency (CPA) foster home is approved by CCTU for an additional Room Board and Watchful Oversight (RBWO) waiver amount, above the basic per diem, and has a current RBWO Program Destination Waiver indicating such.
3. Ensure the assigned adoption specialized rate does not exceed the amount the child receives in a family foster home or for a child not placed in a family foster home, the adoption assistance rate does not exceed the rate the child would receive if he/she were placed in a family foster home.

 PROCEDURES

The Social Services Case Manager (SSCM) will:

1. Provide the following required supporting information when submitting an adoption assistance application for a specialized rate to SSAU:

   1. For a child in a child care institution (CCI):
      1. RBWO memorandum from CCTU indicating the child is currently receiving a higher foster care rate; and
      2. A copy of the completed Universal Application.
   2. For a child in a CPA foster home:
      1. RBWO memorandum from CCTU indicating the child is currently receiving a higher foster care rate; and
      2. A copy of the completed Universal Application; and
      3. Caregiver Effort Declaration; or
      4. A signed written statement from the foster parent regarding the care requirements.
   3. For a child in a DFCS foster home:
      1. Specialized foster care per diem memorandum from CCTU indicating the child is currently receiving a higher foster care rate; and
      2. A copy of the completed Universal Application; and
      3. Caregiver Effort of Declaration; or

      4. A signed written statement from the foster parent regarding the care requirements. 

         NOTE: The specialized foster care per diem memorandum is not required for a child in DFCS custody if the SSCM is submitting the application for specialized foster care per diem and the specialized adoption assistance rate simultaneously.

   d. For a child in a Relative home:

   1. A copy of the completed Universal Application; and
   2. Caregiver Effort of Declaration; or
   3. A signed written statement from the relative parent regarding the care requirements.

   e. An Adoption Assistance Treatment Professional Report completed and signed by the child’s treatment professional and dated within 90 days of the Adoption Assistance Application; 

   EXCEPTION: Upon request from the SSCM, the SSAU Program Consultant will consider accepting an Adoption Assistance Treatment Professional Report form dated within 180 days, if the SSCM can verify that the child’s level of needs and treatment services have not changed since the date the form was completed.

   f. The most recent psychological evaluation(s) to support child’s diagnosis, unless such evaluation(s) has been deemed not medically necessary by Amerigroup; or

   g. The most recent developmental evaluation(s) to support the developmental diagnosis, unless such evaluation(s) has been deemed not medically necessary by Amerigroup; and

   h. The most recent medical evaluation(s) to support significant medical diagnosis unless such evaluation(s) has been deemed not medically necessary by Amerigroup; and

   i. Other relevant current documentation such as the Trauma Assessment, Individualized Education Plan (IEP) and Babies Can’t Wait assessments if applicable; and

   j. Documentation that SSI benefits have been applied for and either approved or denied; and 

   NOTE: This procedure only applies to children who are determined by Rev Max to have an adoption funding type of state-funded.

   k. Documentation of any sources of income for the child, such as Social Security Retirement, Survivors or Disability Insurance benefits (RSDI) if applicable.

2. Upload all supporting information into Georgia SHINES External Documentation within 72 hours of receipt.
3. Complete the adoption assistance application for a specialized rate using procedures outlined in policy 12.2 Adoption Assistance: Adoption Assistance Application.

NOTE: The SSCM may contact the SSAU Program Consultant for assistance in expediting the application when efforts to obtain any of the above required evaluation(s)/statements have failed due to lack of cooperation by the treatment provider or due to Amerigroup not approving an evaluation based on “medical necessity” criteria.

 PRACTICE GUIDANCE

An adoption assistance specialized rate application for a child whose adoption funding type is determined by Rev Max to be state-funded will not be considered without documentation that SSI benefits have been applied for and either approved or denied. SSI applications may take up to four to six months for the Social Security Administration to process, and thus should be submitted to the SSA well in advance of specialized rate requests. This will prevent potential delays in the placement of children in adoptive homes. When applying for SSI benefits, the Social Services Case Manager must present documentation to the Social Security Administration as to whether the child’s adoption funding type is state-funded or Title IV-E based on the Rev Max determination, because this has a significant bearing on the child’s SSI eligibility.

If a child in foster care who has a specialized adoption assistance rate moves to a different foster care placement resource or has a situation where the foster care rate becomes lower than the specialized adoption assistance rate, SSAU should be immediately notified so that the specialized adoption assistance rate can be adjusted or terminated in Georgia SHINES.

The specialized adoption assistance rate will be re-applied for annually until adoptive placement occurs. These processes ensure that the adoption assistance rate does not exceed the foster home board rate, in accordance with Federal Title IV-E policy requirements. If at the time of submitting a request for adoption assistance specialized rate the RBWO waiver or specialized foster care rate approval will expire within 60 days or less, it is recommended that the Social Services Case Manager also re-apply for the RBWO waiver/specialized foster care rate (see policy 16.1 Room Board and Watchful Oversight: Program Designation and 16.5 Room Board and Watchful Oversight: Specialized Foster Care Per Diem for requirements and procedures on submitting a request for a higher foster care rate).

Babies Can't Wait

Babies Can’t Wait is Georgia’s early intervention program for infants and toddlers with developmental delays and disabilities and their families. It is a federally-mandated program under the Individuals with Disabilities Education Act (IDEA), which provides a framework for coordinating developmental, educational, and community support within natural environments for children under three and their families.

Basic Rate (Adoption Assistance)

This is the basic monthly rate which is provided for children who qualify for adoption assistance.

Child Care Institution (CCI)

Child care institutions provide care, supervision, and oversight in a residential setting, including neighborhood-based group homes, campus-based arrangements, and self-contained facilities.

Child Placing Agency (CPA)

A CPA is a private agency that places children in foster homes for temporary individualized care, supervision and oversight in a resource family setting. CPAs make arrangements to assess the placement regarding the appropriateness of the room, board and watchful oversight that the prospective foster family will provide. The agency’s employees and the CPA’s foster parents work as a team to provide a stabilizing and nurturing environment that promotes safety, well-being and permanency.

Individualized Education Plan (IEP)

The Individualized Education Plan (IEP) is an individualized document designed for one student that guides the delivery of special education supports and services for the student with a disability. The IEP creates an opportunity for teachers, parents, school administrators, related services personnel and students (when appropriate) to work together to improve educational results for children with disabilities.

Supplemental Security Income (SSI)

Supplemental Security Income is a monthly benefit for persons who are disabled or who have functional limitations as determined by the Social Security Administration.

The Universal Application

For DFCS staff the Universal Application can be completed in Georgia SHINES in the FCC/ADO stage under the Placement Tab. Many of the fields on the Universal Application pre- populate with data already entered into Georgia SHINES. To take full advantage of this feature, prior to launching the Universal Application in Georgia SHINES, thoroughly complete the Person Detail, Health Detail, and Education Detail pages. For RBWO providers, the Universal Application must be completed outside of Georgia SHINES. For a child who has already been adopted and an adoption assistance rate increase is being renegotiated, the Universal Application must also be completed outside of Georgia SHINES.

FORMS AND TOOLS 

Adoption Assistance Treatment Professional Report 

Caregiver Effort Declaration

Universal Application