Department for Community Based Services

Standards of Practice Online Manual

13.46.1 Continuation of Title IV-E Adoption Assistance After Age 18

Cabinet for Health and Family Services

Department for Community Based Services
Division of Protection and Permanency
Standards of Practice Online Manual
Chapter 13-Adoption Services
13.46.1 Continuation of Title IV-E Adoption Assistance After Age 18

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Legal Authority/Introduction


An adopted child may have a disability as determined by the Social Security Administration (SSA) or by a Cabinet medical review team that allows for continuation of Title IV-E adoption assistance after the age of eighteen (18).  Disability includes an inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment(s) and can be expected to result in death or last for a continuous period of not less than twelve (12) months. 

The Department for Disability Determination Services (DDS) medical review team (MRT) considers the following factors at least six (6) months prior to the youth’s eighteenth (18th) birthday to allow or deny a disability determination for an adopted child:

  • The child’s medical history and medical testimony, including information relating to the alleged physical or mental disability, illness, or impairment as to whether the child’s ability to gain full-time employment or pursue opportunities within a state or federal education program are reduced;
  • The child’s age, employment history, education, and effect of the physical or mental condition on the ability to care and support self.


The R&C worker: 

  1. Provides the DPP-601 Referral for Determination of Disability to Continue IV-E Funded Adoption Assistance, MRT-15 Procedural Instructions, and MRT-15 Release of Information to the adoptive family for completion;
  2. Requests that the adoptive family provide current (within one (1) year) supporting documentation including, but not limited to:
    1. Educational testing;
    2. Individual education plans (IEPs);
    3. Medical records; or
    4. Psychiatric hospital records;
  3. Reviews the provided information and forwards the DPP-601, MRT-15 and applicable supporting documentation to the following address for consideration by the medical review team:

    Adoption Services Branch
    275 East Main Street, 3C-E
    Frankfort, Kentucky 40621
  4. Is permitted to take the following actions if a disability determination is denied:
    1. Consult with Adoption Services Branch staff;
    2. Refer the youth for further assessment of abilities when necessary; and
    3. Follows procedures outlined in SOP 13.44 Discontinuance of Adoption Assistance;
  5. Contacts the child’s children’s benefits worker (CBW) in order to ensure continuation of the child’s medical card to age twenty-one (21) if disability determination is approved. 
  6. When the medical review team makes a disability determination, a report is provided to the Adoption Services Branch. 
  7. Adoption Services Branch staff forwards the report to the R&C worker and the adoptive family.




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