The Interstate Compact on Adoption and Medical Assistance (ICAMA) is a binding agreement involving member states and U.S. territories to facilitate provision of Medicaid coverage to each other’s recipients of Title IV-E adoption assistance when the child lives in a state or territory other than the one that negotiated the adoption assistance agreement.

ICAMA also contains provisions for member states and territories to provide Medicaid coverage to other members’ adoption assistance recipients who are eligible for non-Title IV-E Medicaid coverage under a Medicaid option for adoption assistance.

Not all member states provide coverage. By state law, Texas is a member of ICAMA and provides coverage regardless of the sending state’s policy.

Communication between Members

States and territories that are members of ICAMA use standardized forms and procedures to communicate between and among states and territories to facilitate provision of medical assistance to adoption assistance recipients.

The Blue Iron system is the electronic system that member states and territories use to record and transfer information related to ICAMA.

Each state has a compact administrator and deputy compact administrators. Administrators are responsible for receiving and coordinating requests for ICAMA services and giving access to the Blue Iron system. In Texas, CPS State Office staff members in the Federal and State Support Unit perform these ICAMA functions.

Requests

DFPS staff members who receive requests from other states for ICAMA services normally direct them to the DFPS deputy compact administrator by using the Blue Iron system. The administrator routes the requests to the appropriate regional compact coordinator, who then sends them to an adoption assistance eligibility specialist.

When the child is placed by a public child welfare agency, the state that placed the child is responsible for determining the child’s eligibility for adoption assistance and providing documentation of eligibility to Texas DFPS.