An adoption subsidy is available to a child who is designated as having special needs (section 453.065, RSMo) and who does not have an adoptive family readily available. Guardianship subsidy is available to a qualified relative or qualified close nonrelated people (section 453.072, RSMo) who are granted legal guardianship of the child in the same manner as such subsidies are available for adoptive parents. Subsidies are available to children in the care of the Children’s Division, Division of Youth Services, Department of Mental Health and licensed child-placing agencies at the time of placement for guardianship or adoption.
Adoption subsidy services may be used to assist in providing permanency for children through adoption who, because of their special needs, might not otherwise be adopted, and for whom a family is not readily available.
Subsidized guardianship services may be used to assist any grandparent, aunt, uncle, adult sibling of the child, adult first cousin of the child, or any other person, whose life is so intermingled with the child such that the relationship is similar to a family relationship; who has obtained legal guardianship for eligible children.
Legal Basis and Funding Source
The Missouri Adoption Subsidy Program is authorized by sections 453.065, 453.073 and 453.074, RSMo, and permits the Division to make subsidy payments on behalf of eligible special needs children to adoptive families to cover maintenance, medical and dental care, and other special expenses.
This program was first effective September 28, 1973. Legislation passed by the 83rd General Assembly and effective September 28, 1985, authorized the Division to use adoption subsidy funds also for children in the custody of the Department of Mental Health (DMH) and the Division of Youth Services (DYS) at the time of their placement for adoption. This legislation also clarified that children in the custody of a dually licensed private child-placing agency are eligible for an adoption subsidy. A subsidy authorized for such children uses Division adoption subsidy appropriations and Division guidelines to administer the program.
Title IV-E of the Social Security Act, modified through the Adoption Assistance and Child Welfare Act of 1980 (P.L. 96-272), authorized Federal Financial Participation (FFP) in an adoption subsidy if the child, while in the custody of the Children’s Division, was eligible for IV-E alternative care. Also, this eligibility automatically causes the child to be eligible for the Missouri Medical/Dental Services (MO HealthNet) program. Children, eligible for SSI and covered by an adoption subsidy Agreement, are also eligible for MO HealthNet.
The Consolidated Budget Reconciliation Act of 1986 (COBRA), also known as P.L. 99-272, authorized several amendments to Titles IV-E and XIX of the Social Security Act, effective October 1, 1986. These amendments permit the child who is eligible for adoption subsidy IV-E to receive Title XIX (MO HealthNet) and Title XX services in the state of residence as long as there is an adoption subsidy Agreement in place with the original state of residence. Also, these amendments eliminated the requirement that a Title IV-E child must receive a maintenance payment to receive MO HealthNet.
The Missouri legislature enacted legislation, effective September 28, 1985, permitting the Division to become a signatory state to the Interstate Compact for Adoption and Medical Assistance (ICAMA). Missouri became a signatory state in January 1986. For the member states, this compact authorized the IV-E child to receive medical assistance through Medicaid from the resident state. The intent is to assure that no break occurs in the child’s receipt of medical assistance when the child moves to another state.
The Tax Reform Act of 1986 (P.L. 99-514) also authorized, effective January 1, 1987, payment for maintenance for eligible Title IV-E children to begin with the date of placement as long as there is an adoption subsidy Agreement signed by the Division Director. This amendment to Title IV-E of the Social Security Act eliminated the previous requirement that eligible children be in the custody of the adoptive parent(s) for the purpose of adoption to use Title IV-E funds.
P.L. 99-514 requires states to pay certain nonrecurring expenses of all special needs children who meet the eligibility requirements.
The Adoption and Safe Families Act (ASFA) of 1997 requires that state medical assistance coverage or MO HealthNet is provided for children who have a state-funded adoption assistance agreement. A child who has been determined by the state to have special medical, mental health or rehabilitative need cannot be placed for adoption without medical assistance. This is also part of the requirement for waiver demonstration incentive payments.
Funding for the Division’s program is derived from three (3) sources:
- Appropriations made from Missouri’s general revenue;
- Appropriations authorized through Title IV-E of the Social Security Act; and
- Appropriations authorized under Title XIX of the Social Security Act.
Other possible funding sources for a subsidy plan are Veteran’s Assistance (VA) administered by the U.S. Veteran’s Administration, Supplemental Security Income (SSI), and the Old Age Survivors and Dependents Insurance (OASDI) programs administered by the federal Social Security Administration (SSA). In rare instances, a specific child may have other sources of income that will follow the child into adoption.
The Legal Guardianship Subsidy Program is authorized by Missouri legislation. Senate Bill 1 was effective August 28, 1999.
The Foster Connections to Success and Increasing Adoptions Act HR6893 effective October 1, 2008 modified Title IV-E of the Social Security Act authorizing Federal Financial Participation (FFP) in guardianship subsidy if the child, while in the custody of the Children’s Division, was eligible for IV-E alternative care.
The guardianship subsidy program is authorized by 453.072 RSMo, which was modified by Senate Bill 47, which changed the individuals eligible for guardianship subsidy. According to this statute, any subsidies available to adoptive parents pursuant to section 453.073 and section 453.074 shall also be available to a qualified relative of a child or a qualified close nonrelated person who is granted legal guardianship of the child in the same manner as such subsidies are available for adoptive parents. Legal guardianship ends when the youth reaches age 18, therefore the legal guardianship subsidy is only available through a youth’s 18th birthday.
As used in this section, “relative” means any grandparent, aunt, uncle, adult sibling, adult first cousin or any other person related to the child by blood or affinity
As used in this section, “close nonrelated person” means any nonrelated person whose life is so intermingled with the child such that the relationship is similar to a family relationship.
Successor guardian provisions, authorized by P.L. 113-183, were signed into law on September 29, 2014 which amended titles IV-B and IV-E of the Social Security Act. P.L. 113-183 requires continuation of title IV-E guardianship assistance payments if the guardian dies or is incapacitated and a successor legal guardian is named in the agreement or any amendments to the agreement (section 473(d)(3)(C) of the Act).
Related Practice Alerts and Memos:
7-1-19 – CD19-52 – FY20 Rate Increases
12-4-19 – PA19-AD-06 – Transitional Living Placements and Subsidy Agreements
1-10-20 – PA20-AD-01 – Legal Fees for AD and LG Subsidies
10-29-2020 – PA20-AD-06 – Child Summary
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