Department for Community Based Services

Standards of Practice Online Manual

31.11 Title IV-E Adoption Assistance

Cabinet for Health and Family Services

Department for Community Based Services
Division of Protection and Permanency
Standards of Practice Online Manual
Chapter 31-Standards of Practice Regarding Title IV-E, Medicaid and Other Applicable Benefits
31.11 Title IV-E Adoption Assistance

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Legal Authority/Introduction



The CBW:

  1. Assures that the necessary documents for eligibility are submitted in accordance to SOP 31.2 Title IV-E Eligibility and Reimbursability;
  2. Notifies the SSW regarding the child’s IV-E eligibility status within five (5) working days of the determination;
  3. Maintains an IV-E adoption assistance case record that contains documentation to support a child’s eligibility;
  4. Contacts the SSW to verify age and legal responsibility of the child in order to redetermine ongoing eligibility in accordance with  SOP 31.4 Reimbursability and Annual Redetermination Under Title IV-E Foster Care on the annual anniversary of the approval date of the IV-E adoption assistance;
  5. Accepts and processes the applications for Medicaid, COBRA, and ICAMA coverage from adoptive parents that have moved to Kentucky from other states;
  6. Discontinues IV-E adoption assistance when notified by the SSW in accordance with SOP 31.2 Title IV-E Eligibility and Reimbursability.  

Practice Guidance

  • To be eligible for title IV-E adoption assistance, the following criteria are met:
    • The child is under the age of eighteen (18); or
    • The child is over eighteen (18) and less than twenty-one (21) years of age and has been determined to be permanently and totally disabled by a medical review team (MRT); and
    • The child has a relationship to the AFDC program or the Supplemental Security Income (SSI) program.
  • Beginning in fiscal year 2010, IV-E eligibility requires the child:
    • Enter an adoption assistance agreement under section 473 of the title IV-E plan (section 473(e)(1)(B)) during any fiscal year the child attained the applicable age for that fiscal year before the end of the fiscal year;
    • Enters an adoption assistance agreement, at any age, when the child:
      • Is a sibling of a child who is an applicable child for the fiscal year under paragraphs 473(e)(1) or (2); and
      • Is to be placed in the same adoption placement as their sibling who is an applicable child for the fiscal year; and
      • Meets the requirements of section 473(a)(2)(A)(ii); or
    • Enters an adoption assistance agreement, at any age, if the child has been in foster care under the responsibility of the Cabinet, for at least sixty (60) consecutive months and meets requirements of the title IV-E plan (473(a)(2)(A)(ii))
    • The child maintains eligibility as long as the ongoing criteria of age and legal responsibility are met.
  • There is no income eligibililty requirement (means test) for the adoptive parents in determining eligibility for adoption assistance payments.

  • A written adoption assistance agreement between the state agency and the prospective parent(s) of a minor child is in effect when all signatures are obtained on the agreement with the prospective adoptive parent(s).
  • The agreement must be signed prior to the adoption finalization.
  • A copy of the signed agreement is given to each party.
  • The agreement, at a minimum specifies:
    • The duration of the agreement;
    • The nature and amount of payment, services and assistance;
    • The child’s eligibility for Medicaid services under title XIX and social services under title XX (effective October 1, 1983);
    • The agreement will remain in effect regardless of the state in which the child is a resident at any given time (if made on or after October 1, 1983); and
    • Kentucky’s obligation to remain financially responsible for any medical and social services agreed to under the terms of the agreement, if the child moves to another state, and such services are not available in the receiving state (if the agreement was entered into after October 1, 1983).


  • The child meets special needs criteria if:
    • The state determines that the child cannot or may not be returned to the home of the child’s parents (e.g. parental rights are terminated);
    • The child has a specific special need that indicates that the child cannot be placed with adoptive parents without providing adoption assistance. Such problems may include ethnic background, age or the presence of factors such as medical conditions, or physical, mental or emotional disabilities, a sibling group of three or more or a child who has experienced severe, physical or sexual abuse or whose background includes mental illness; and
    • A reasonable, but unsuccessful effort was made to place the child with appropriate adoptive parents without providing adoption assistance. This criterion need not be met if the state can show that such a placement effort is not in the best interests of the child, because of the existence of significant emotional ties with prospective parents while in their care as a foster child.


  • No payments may be made if the adoptive parents are no longer legally and financially responsible for the support of the child, or if the child is no longer receiving any support from the parents.


  • In cases where the child is eligible for both SSI and title IV-E and there is concurrent receipt of payments from both programs, "the child's SSI payment will be reduced dollar for dollar without application of any exclusion", thus decreasing the SSI benefit by the amount of the title IV-E payment (SSI Program Operations Manual). To reiterate, concurrent receipt is subject to the SSI rule that the SSI payment will be reduced by the amount of the foster care payment.
  • Once the adoption is finalized, the adoptive parent’s income is taken into consideration when determining the child’s continuing eligibility for SSI.


  • Children with special needs adopted after October 1, 1997, who were initially eligible for IV-E adoption assistance and whose adoptions were dissolved, will be able to continue their IV-E eligibility when adopted again.



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