Tracking #2008-01120 
Final adoption following publication 12/5/08, eff. 2/1/09

08041101.rtf
[08041101.doc]

(12 CCR 2509-1)

[Instructions:  insert both paragraphs before line 15717769.]
Revisions to Section 7.202.52 were adopted as emergency at the 12/5/2008 State Board meeting (Rule-making# 08-8-27-2), with an effective date of 1/1/2009. Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Administration. 
Revisions to Sections 7.001.42, 7.001.43, 7.001.45, 7.001.46, 7.202.52, 7.203.2 through 7.203.24, 7.203.31, 7.203.32, 7.306.11, 7.306.13, 7.306.14, 7.306.2, 7.306.22, 7.306.3, 7.306.31, 7.306.34, 7.306.4 through 7.306.45, 7.306.5 through 7.306.59. 7.306.6, 7.402.1, 7.402.2, 7.402.3, 7.402.4, and 7.404 were final adoption following publication at the 12/5/2008 State Board meeting (Rule-making#’s 08-4-11-1 and 08-8-27-2), with an effective date of 2/1/2009. Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Administration. 

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[Instructions:  replace lines 1035887 through 1035936.] 
7.001.42  Title IV-E Adoption Assistance Agreements [Rev. eff. 2/1/09]
Title IV-E funds are available for adoption assistance payments to adopting parents for children that meet certain requirements. 
This section has been moved in order to consolidate in one location all rules related to adoption assistance. Refer to Section 7.306.4. 
7.001.43  Title IV-E Eligibility - Foster Care Placement of a Child Under a Subsidized Adoption Assistance Agreement [Rev. eff. 2/1/09]
This section has been moved in order to consolidate rules related to adoption assistance in one location. Refer to Section 7.306.4. 
7.001.44  Supplemental Security Income (SSI) [Rev. eff. 8/1/99]
Supplemental Security Income is a federal monthly award granted to a child 0–21 years of age who has a verified disability.
A.  Recipients of Social Security death benefits (SSA) or Supplemental Security Disability Income for Dependents (SSDI) shall not be coded in this fund source.
B.  The county department shall make application to the Social Security Administration for any child who is believed to meet Supplemental Security Income eligibility criteria. Application for Supplemental Security Income is required for all children enrolled in the Children's Habilitation Residential Program (CHRP) waiver.
C.  Concurrent eligibility for Title IV-E foster care and Supplemental Security Income (SSI) is allowed.
D.  Required Time Frames - Application for benefits shall begin within 45 calendar days of the child's out-of-home placement in appropriate cases.
7.001.45  Title IV-A Emergency Assistance [Rev. eff. 2/1/09]
The county department shall determine eligibility for the Title IV-A Emergency Assistance Program anytime services are provided or purchased for families with children at risk of placement or when the worker transfers an intake case for on-going services. 
A.  Eligibility Factors
The eligibility determination shall be documented on the state prescribed form and shall include:
1.  Whether an emergency exists, defined as the removal of a child from his or her home into publicly funded care or state or county supervision, or risk of such removal as determined by the responsible state or county agency officials.
2.  Whether the child has lived with a relative anytime within the 6 months preceding the Title IV-A Emergency Assistance application. See the Income Maintenance manual for requirements of relative (9 CCR 2503-1).
3.  Whether the family's total gross annual income is under $75,000.
B.  Maintenance of Effort (MOE)
Expenditures of services to or on behalf of eligible members of an Emergency Assistance eligible family can be attributed to the State's TANF Maintenance of Effort requirement if a child is living in the household with the parent or other adult relative. The Maintenance of Effort entitlement shall be recorded in the automated case management system if a case is opened for the child.
C.  Required Time Frames
The county shall complete the eligibility determination within 3 business days of case opening. The eligibility effective date can be no earlier than the date when the application is initiated.
7.001.46  Without Regard to Income [Rev. eff. 2/1/09]
The Without Regard to Income entitlement shall be the default funding stream when a case is opened in the automated case management system.

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(12 CCR 2509-3)

[Instructions:  replace lines 1035290 through 1035344.] 
7.203.2  CHILD WITH ADOPTION ASSISTANCE [Rev. eff. 2/1/09]
Section 7.203.2:  first section has been moved in order to consolidate all rules related to adoption assistance in one location. Refer to Section 7.306.4. 
7.203.3  CHILD WITH MEDICAID ONLY SERVICES
7.203.31  Target Groups [Rev. eff. 2/1/09]
A.  Children in foster care who have been determined IV-E eligible and have moved into or out of Colorado.
B.  Children for whom an adoption assistance agreement is in effect and who have moved into or out of Colorado. See Section 7.306.4 for details regarding children with adoption assistance. 
C.  Children eligible for Home and Community Based Services or Home Health Care Services as defined in Section 8.500 of the Department of Health Care Policy and Financing's Medical Assistance manual (10 CCR 2505-10). Children enrolled in the Home and Community Based-Developmentally Disabled Waiver Program administered through Community Centered Boards and the Department of Human Services, Developmental Disabilities Services, are not eligible for services in this target group.
7.203.32  Intake/Assessment [Rev. eff. 2/1/09]
For children moving to Colorado, the county department shall:
A.  Verify from the Interstate Compact on the Placement of Children (ICPC) request from the sending state that the child is eligible for IV-E foster care from the state of origin.
B.  Make two copies of the adoption assistance agreement, retaining one for the child's file and forwarding the other to the State Department.
C.  Enter child’s information into the automated case management system and verify that a Medicaid card has been sent to the foster care provider.
D.  Notify the foster care provider using the SS-4 Form that the child is eligible for Medicaid only from Colorado. In addition, advise the provider to notify the county department if foster care is stopped by the originating state or of any change of address.
E.  Verify annually from the state of origin that the child is eligible for Medicaid. 
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(12 CCR 2509-4)

[Instructions:  replace lines 1011389 through 1011414.] 
7.306.11  Evaluation of Child's Needs [Rev. eff. 2/1/09]
A.  The county department shall assess the child's readiness for adoption.
B.  The county department shall make thorough efforts to place siblings together in adoption and document such efforts in the Family Services Plan. When the child is part of a sibling group and the sibling group is being placed out of the home, if the county department locates an appropriate, capable, willing, and available joint placement for all of the children in the sibling group, it shall be presumed that placement of the entire sibling group in the joint placement is in the best interests of the children. Such presumption may be rebutted by the county by a preponderance of evidence that placement of the entire sibling group in the joint placement is not in the best interests of a child or of the children. 
C.  If the current caregiver is an appropriate resource, the worker will complete the Colorado Adoption Resource Registry (CARR) exclusion form and send the form to the State’s adoption unit. 
D.  Available resources for adoption shall be assessed and a recruitment plan developed if there is no adoptive family identified. Recruitment efforts begin when the permanency goal becomes adoption and should use all resources available. The county shall document, in the Family Services Plan, efforts to recruit and locate a permanent home for any child whose parental rights have been terminated and who is in the guardianship of the county with the right to consent to adoption. 
7.306.12  Child's Right to Information
Information regarding a child's birth family shall be maintained in the adoption record.
7.306.13  Child's Social Study [Rev. eff. 2/1/09]
Social history and medical information shall be collected on all children whose parental rights are relinquished or terminated. 
A.  Basic information shall include, but not be limited to: 
1.  Birth certificate
2.  Legal custody documents 
3.  Record of placements
4.  Family, social, educational, medical and genetic history
5.  Emotional, psychological and developmental evaluations.
B.  Information in the record should be updated when changes occur or additional information is available that would affect the child's readiness for adoption . 

7.306.14  Colorado Adoption Resource Registry (CARR) [Rev. eff. 2/1/09]
A.  Referral to Colorado Adoption Resource Registry
The county department shall submit a Child's Profile for photo listing or a Request for Exclusion to the Colorado Adoption Resource Registry:
1.  If no adoptive home has been found for the child within 90 calendar days following relinquishment or termination of the parent-child relationship.
2.  Following a disruption of an adoptive placement before legal finalization. The child shall be listed or excluded 90 calendar days from the date of the disruption. 
3.  Registration with CARR
a.  A copy of the CARR form shall be sent via mail, email or fax to the State adoption unit. 
b.  A second copy of the CARR form and a clear, close-up picture of the child (and his/her siblings if the children are to be placed together) shall be sent to the adoption exchange for the purpose of featuring in various media resources. 
4.  Make a diligent search of the child’s record for possible permanent placement(s) or other permanent connections. Any possible resources should be interviewed as to their willingness and/or availability as a placement for the child. 
5.  Interview the child regarding possible permanent placement resources. 
B.  Exclusion from Colorado Adoption Resource Registry
The county department may decide that the best interest of the child will not be served by a Colorado Adoption Resource Registry photo listing. The county department shall determine the reason for the exclusion from listing and send the Request for Exclusion to the State adoption unit. The county shall use the following criteria for determining reasons for exclusion:
1.  An adoptive family has been found for the child or the foster parents will petition to adopt within 90 calendar days of the date the child is legally free for adoption. If the foster parents do not petition to adopt within the 90 calendar days, the child(ren) shall be photo listed with the Colorado Adoption Resource Registry and another family will be recruited for the child(ren). If there is a compelling reason that the county department and State adoption unit agree is appropriate for delaying filing of the adoption petition, this reason is to be submitted to the State adoption unit by the county department. The State adoption unit will review the foster care placement until such time as the petition to adopt is filed or the child is photo listed with the Colorado Adoption Resource Registry.
If an approved family has been identified as an adoptive home for a child and if the child has not moved into the adoptive placement within 90 calendar days of termination, the county shall photo list the child with the Colorado Adoption Resource Registry. If there is a compelling reason that the county department and the State adoption unit agree is appropriate for delaying filing of the adoption petition, this reason is to be submitted to the state review team by the county department. If the compelling reason for delaying filing the petition is approved, the state review team will review the foster care placement until such time as the petition to adopt is filed or the child is photo listed with the Colorado Adoption Resource Registry.
2.  The child is: 
a.  One whose court-approved permanency goal is legal guardian-ship or other planned permanent living arrangement.
b.  Placed with a relative or a relative is being considered as a placement resource for the child (adoption or foster care). All relatives who are providing care for a child who is legally free for adoption shall be counseled by a professional who is knowledgeable about permanency options regarding the importance of permanency through adoption, guardianship, or permanent custody. When a relative is being considered, the placement shall be made 90 calendar days from the date the child is legally free for adoption unless there is a documented extenuating circumstance.
c.  The CARR exclusion will be considered and approved or denied by the State adoption unit. Following are conditions that are not necessarily appropriate for denying any child the possibility of a permanent placement or a permanent connection in his/her life.
1)  Placement in a residential child care facility, detention or corrective center, or mental hospital, and placement is not indicated by the treatment plan for the child. The county department is required to photo list a child with the Colorado Adoption Resource Registry 90 calendar days prior to discharge from the facility if the plan is for the child to return to a group home or family foster home.
2)  In therapy and adoptive placement is not indicated by the treatment plan for the child. The county department shall provide the review team with documentation that a therapist and others (e.g., guardians ad litem) have determined that it would not be in the child's best interest to recruit an adoptive home.
3)  One who is still being evaluated by specialists. The county department shall photo list the child(ren) with the Colorado Adoption Resource Registry if the evaluation is not completed within 90 calendar days of termination of parental rights.
4)  Twelve (12) years or older and is refusing adoption. The child shall be counseled by a professional who is knowledgeable about adoption and permanency for teens, recognizing that their consent is still required to proceed with an adoption. 

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[Instructions:  replace lines 1011421 through 1011424.] 
7.306.2  PLACEMENT SERVICES [Rev. eff. 2/1/09]
The county department shall: 
A.  Conduct a face-to-face presentation interview with the prospective adoptive parent(s). If the adoptive resource is a two-parent family, both parents shall be present for the interview. The presentation interview shall be recorded via some type of audio-recording device. Two copies of the recording shall be made. 
1.  One copy shall be kept with the child’s file. 
2.  The second copy shall be provided to the prospective adoptive family to accompany all of the written documentation that the family receives at the end of the presentation interview. 
B.  The county department shall provide all non-identifying information contained in the child's record to the prospective adoptive parent(s). 
C.  All of the information provided (physically and verbally) shall be documented on the State’s approved form, signed by the family, then placed in the child’s record. 
D.  If the family decides at a later time not to move forward with adoption or maintain a permanent relationship with the child, all information provided to the prospective adoptive family must be returned to the agency. 
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[Instructions:  replace lines 1011434 through 1011443.] 
7.306.22  Social Security Benefits for Children in Adoptive Placement [Rev. eff. 2/1/09]
A.  The county department shall inform adoptive parents of the potential eligibility for Social Security benefits of any child placed with them for adoption. 
B.  When a child becomes eligible for Social Security benefits and the child is receiving adoption assistance, the family must inform the agency of the receipt of these benefits. 
7.306.3  POST-PLACEMENT SERVICES [Rev. eff. 2/1/09]
Following placement, the county department shall:
A.  Provide services to the child and the adoptive parents to integrate the child into the family, unless the child is eligible for and receiving other post legal adoption services.
B.  Review the information sharing acknowledgment form with the adoptive parent(s);  all parties shall date and initial it before the finalization of the adoption.
C.  Inform the family of the legal procedure for adoption, and complete and submit a report to the court regarding the adoptive placement as required by the Colorado Children's Code.
D.  Place a copy of the adoption petition and the final decree of adoption in the child's record. 
E.  Close finalized adoption records of children for whom the county consented to the adoption and maintain in a secure location in the county department. Within ninety (90) days of the final adoption hearing, the county department shall prepare the adoption record for closing. All information related to the child and adoptive family gathered during the adoptive process shall be included in the closed (sealed) finalized adoption record. 
7.306.31  Adoption Assistance [Rev. eff. 2/1/09]
Adoption assistance is a post-placement service (see Adoption Assistance Services, Section 7.306.4). 

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[Instructions:  replace lines 1011448 through 1011469.] 
7.306.34  Adoption Records [Rev. eff. 2/1/09]
A.  The county department shall maintain a record for the child in its custody who is approved for adoptive placement. It shall ensure that all documentation related to the child's adoption is in the record. The following must be included, but is not limited to: 
1.  Court order issued at the time of initial removal; 
2.  Voluntary placement agreement, if applicable; 
3.  Order for termination of parental rights or order for relinquishment of parental rights; 
4.  Child study (social history); 
5.  Adoptive family’s application; 
6.  Adoptive family’s home study and any updates, as necessary; 
7.  Documentation of the child’s special needs (7.306.4, A, 3, d, 1-5); 
8.  Documentation of child’s tribal affiliation, if applicable; 
9.  Time and date-stamped petition for adoption; 
10.  Final decree of adoption.
B.  Upon completion of legal adoption, the county department shall close the case on the Department's automated reporting system within 30 calendar days, unless the child receives adoption assistance.
C.  Within 90 calendar days of the date of finalization of the adoption, the county will send to the Division of Child Welfare basic data on the family and children for entry in the statewide database using the State’s approved form. This information shall be supported and reflect what is in the automated case management system.
D.  In adoption assistance cases, the county department shall maintain a separate record to include the following items as long as the adoption assistance agreement is in effect for the child and family. Upon termination of this adoption assistance agreement, the record shall be closed. 
1.  Current adoptive home study and any necessary updates; 
2.  Child's Summary and Application for Adoption Assistance; 
3.  Initial Adoption Assistance Agreement;
4.  Court Order issued at time of initial removal;
5.  Voluntary Placement Agreement, if applicable; 
6.  Subsequent Order on Review for Need of Placement, if applicable; 
7.  Review of Adoption Assistance Agreement and three year reviews of need for adoption assistance or any amendments of the original adoption assistance agreement; 
8.  Adoption Assistance Title IV-E Eligibility Determination Form;
9.  Title IV-E Foster Care Eligibility Determination Form;
10.  Title IV-E Redetermination of Eligibility Determination Form(s);
11.  A copy of the Social Security Income Eligibility Notification;
12.  Petition to Adopt time and date-stamped by the court; 
13.  Final Adoption Decree;
14.  Orders terminating parental rights;
15.  Appeal Petition of the termination and Final Order resolving appeal of the termination;
16.  Indian Child Welfare cases, if known tribal affiliation;
17.  Documentation of the child’s special needs (7.306.4, A, 3, d, 1-5); 
18.  Motion to court to expedite the date of the final hearing, if applicable. 
E.  County departments providing adoption assistance to children from private non-profit adoption agencies or relatives shall maintain in a secure location at the county the records containing the adoption assistance information listed in subsection D, above.
F.  County departments providing a subsequent adoption assistance agreement to children whose previous adoption was dissolved shall maintain, in a secure location at the county department, the records containing the adoption assistance information listed in subsection D, above. Additional required information includes: 
1.  New documentation assessing and identifying the child’s continuing special needs; and, 
2.  All of the adoption assistance forms and documentation from the previous adoptive family.
G.  County departments providing an adoption assistance agreement to children who were in foster care with their teen parents shall maintain, in a secure location at the county department, the records containing the adoption assistance information listed in subsection D, above. Additional required information must include proof of foster care payment made that includes both the child and his/her teen parent. 
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[Instructions:  replace lines 1187842 through 1011624.] 
7.306.4  ADOPTION ASSISTANCE SERVICES [Eff. 2/1/09]
Colorado operates two adoption assistance programs:  the Title IV-E program and the state and county-only (non-IV-E) program. 
A.  Applicable to both programs: 
1.  The federal government participates in adoption assistance agreements on behalf of children who meet the eligibility criteria for the Title IV-E adoption assistance program.
2.  The state and county participate in adoption assistance agreements on behalf of children who are not eligible for the Title IV-E program. 
3.  Adoption assistance is a program that provides assistance to adoptive parent(s) in certain defined and limited ways to provide for the needs of an eligible adopted child. Adoption assistance is intended to help or remove financial or other barriers to the adoption of Colorado children with special needs by providing assistance to the parent(s) in caring for and raising the child.
a.  The county department may make adoption assistance payments and/or provide Medicaid or medical assistance at the time of adoptive placement, continue them after the adoption has been finalized and continue them until the adopted child has reached the age of eighteen (18), or the age of twenty-one (21) years when the county department has determined that the child has a developmental or physical disability which warrants continuance of assistance.
b.  The determination for expiration of the agreement must be made and documented in the original negotiation and noted in the original paperwork for the adoption assistance agreement.
c.  The county department must determine that in each case a reasonable, but unsuccessful, effort to place the child for adoption has been made before negotiating adoption assistance, unless the best interests of the child would not be served by such an effort.
1)  Where appropriate, the current caregiver will be given priority as the prospective adoptive family. Reasonable effort requires listing with the Colorado Adoption Resource Registry and may include presentation in the media and consultation with the state.
2)  The only exception to this requirement is in situations where it would be against the best interests of the child, due to such factors as the existence of significant emotional ties with the prospective adoptive parents while in their care as a foster child, or adoption by a relative (in keeping with the statutory emphasis on the placement of children with relatives).
d.  There exists a specific factor or condition (special need) to conclude that the child cannot be adopted without providing adoption assistance or medical assistance. A “special need” is one or more of the following special, unusual, or significant factors that act as a barrier to the child’s adoption: 
1)  Physical disability (such as hearing, vision, or physical impairment; neurological conditions; disfiguring defects; and, heart defects).
2)  Mental disability (such as developmental delay or mental retardation, perceptual or speech/language disability, or a metabolic disorder).
3)  Developmental disability resulting in educational delays or significant learning processing difficulties.
4)  Educational disability that qualifies for section 504 of the rehabilitation act of 1973 or special education services.
5)  Emotional disturbance (such as post-traumatic stress disorder, bi-polar disorder and other diagnoses).
6)  Hereditary factors that have been documented by a physician or psychologist.
7)  High risk children (such as HIV-positive, drug-exposed, or alcohol-exposed in utero). 
8)  Other conditions that act as a serious barrier to the child’s adoption. Conditions may include, but are not limited to, a healthy child over the age of seven or a sibling group that should remain intact and medical conditions likely to require further treatment. 
9)  Ethnic background or membership in a minority group which may be difficult to place.
e.  The county department shall not use an income eligibility requirement (income means test) for the prospective adoptive parent(s) in determining eligibility for adoption assistance.
f.  Families applying for adoption of a child with special needs must be informed of the adoption assistance program. The particular agreement that is negotiated shall be based on the child’s need and the family’s circumstances.
g.  Available public programs for which the child is eligible shall be used first to address the child’s needs before an adoption assistance agreement is negotiated.
h.  The county department may authorize the following types of adoption assistance agreements: 
1)  “Long-Term Adoption Assistance Agreement” means to partially meet a child's daily needs on an indefinite basis. A long-term agreement is made when the family's financial situation precludes adoption and is unlikely to change or when a child's needs take an excessive toll on the family's financial and emotional resources. This sort of monthly payment may continue until the family's or child's circumstances change, or the agreement terminates as outlined in Termination of Adoption Assistance, Section 7.306.59, of the Adoption Assistant agreement rules. 
2)  “Time-Limited Adoption Assistance Agreement” means to partially meet the everyday needs of the child for a specified period. These are start-up costs for those things that children placed for adoption do not always have, such as sufficient clothing. Agreement partially covers unmet needs that are time limited and non-renewable.
3)  “Dormant” or “Medicaid Only Adoption Assistance Agreement” means there is no adoption assistance payment provided at this time. County departments shall document special needs for the child in the services record and in the State Department’s automated system that the potential need for financial adoption assistance exists and may need to be activated at a future time. 
4.  If the child is legally available for adoption and reunited with his/her birth parent(s), the child is not eligible for adoption assistance. 
5.  Medicaid is available to all Colorado children who have an adoption assistance agreement.
6.  Families who adopt children who meet the criteria for adoption assistance are eligible for non-recurring adoption expenses.
7.  The contact requirements in Section 7.001.6 shall be used prior to finalization and contacts shall be documented in the case file.
8.  Case services payments may be part of an adoption assistance agreement; these payments can be made directly to the providers of service or to the adoptive parent(s).
B.  Target groups for adoption assistance agreements: 
1.  Children whose special needs are a barrier to their adoption are legally available for adoption and are in the custody of a county department and the county has guardianship of the child with the right to consent for adoption.
2.  Children who are in the custody of a relative, tribe, or licensed non-profit child placement agency and meet the eligibility criteria to participate in one of Colorado’s adoption assistance programs.
3.  The county department, agency, tribe, or relative requesting the adoption assistance agreement is financially responsible for the care of the child.
C.  County requirements for adoption assistance: 
1.  The county department shall obtain and document the diagnoses and prognoses of the child’s needs that are barriers to the adoption.
2.  The documentation shall include, but is not limited to: 
a.  Medical
b.  Psychological
c.  Psychiatric
d.  Placement history
e.  Special needs: if the county department determines that the child is one with special needs for whom services will be purchased, it must confirm the special needs by a second opinion of a social worker, doctor, psychologist or mental health specialist who is outside the department.
f.  Other appropriate reports.
3.  The county department shall determine the child’s eligibility for adoption assistance on the State-prescribed form no later than the calendar month that the adoption petition is filed.
4.  The county department shall ensure that all parties sign the adoption assistance agreement before the adoption is finalized.
5.  The family shall be informed in writing of its right to a fair hearing. 
7.306.41  TITLE IV-E ADOPTION ASSISTANCE PROGRAM [Rev. eff. 2/1/09]
A.  Pathways to Eligibility
Title IV-E adoption assistance services may be provided to children whose special needs are a barrier to their adoption, who are legally available for adoption, and: 
1.  Are in the custody of the county department via a court-ordered removal; 
2.  Have Social Security Income (SSI) eligibility; 
3.  Are IV-E eligible in a previous adoption; 
4.  Are in mutual foster care placement with a county department; 
5.  Were initially removed via voluntary placement agreement; 
6.  Were voluntarily relinquished to a public or private licensed non-profit child placement agency; 
7.  Are in the custody of a relative and the children are IV-E eligible. 
B.  Requirements for Eligibility
1.  A child must be removed from his/her home by a court order that contains the requirements in Section 7.001.41, B. 
a.  For the purposes of Title IV-E adoption assistance only, there is no requirement for a “reasonable efforts” judicial determination; and,
b.  Aid to Families with Dependent Children (AFDC) related requirement defined in Section 7.001.41, D. 
2.  Have Social Security Income (SSI) eligibility. 
a.  This factor must be met at any time prior to finalization of the adoption.
b.  If eligible, the child may simultaneously receive SSI and Title IV-E adoption assistance payments.
c.  If a child is SSI eligible, there are no requirements for the AFDC requirements or the statement regarding efforts to place the child without adoption assistance.
3.  Are IV-E eligible in a previous adoption and the adoptive parents have relinquished, had their parental rights terminated, or died and the children are placed in a subsequent adoptive placement, then the children retain Title IV-E eligibility for adoption assistance in their new adoptive placement. Additional requirements for this pathway to eligibility include: 
a.  A new determination regarding the children’s continuing special needs.
b.  Completion of new adoption assistance agreements with the new prospective adoptive parents. 
c.  If the previous adoptive parents are deceased, a copy of the death certificate must be provided.
4.  Are in mutual foster care placement with a county department. 
a.  The children must be placed with their teen parent; and,
b.  The foster care payment included both the children and the teen parent.
5.  Are in foster care by voluntary placement agreement with a county department (a tribe or another public agency with which the state/county has a Title IV-E agreement). The child must meet the requirements outlined in Section 7.001.41, E. 
a.  There must have been at least one Title IV-E foster care maintenance payment made on behalf of the children under the voluntary placement agreement.
b.  Under this factor, there is no specified amount of time that the children must have been in foster care under the voluntary placement agreement.
6.  A child who was voluntarily relinquished to a public or private licensed non-profit agency must meet the requirements in Section 7.001.41, F., and: 
a.  A petition was filed in court to place the child outside of the home within six months of the time the child lived with the relinquishing parent; and, 
b.  A subsequent order was issued which included findings that it is in the best interests of the child to be placed out of the home; and, 
c.  Legal orders placing the child in the custody of a public or private licensed non-profit child placement agency with authority to consent to the child’s adoption. 
d.  The agency must provide documentation of the efforts the agency made to place the children for adoption without an adoption assistance agreement when the child meets the AFDC-related requirements.
7.  After children have been determined eligible for Title IV-E adoption assistance payments and/or Title IV-E Medicaid benefits, Title IV-E eligibility continues as long as there is an adoption assistance agreement in effect.
a.  Once determined eligible for Title IV-E adoption assistance, it continues as long as the children meet the requirements regardless of the family’s state of residence.
b.  Eligibility may continue even though no payments or Medicaid benefit is currently paid; therefore, maintaining the potential Title IV-E benefits if needed later.
c.  Title IV-E adoption assistance benefits and/or Title IV-E Medicaid benefits must continue until the expiration of the original agreement unless all parties to the agreement are in concurrence. This includes, but is not limited to, the situation where the family fails to complete and return paperwork related to the three-year review of the assistance agreement.
C.  Foster Care Placement of a Child Under an Adoption Assistance Agreement 
1.  Title IV-E eligibility must be determined when a child is dually placed in foster care and adoption assistance. The child does not automatically retain the Title IV-E eligibility. 
2.  The State prescribed form must be completed using the adoptive parent’s income. 
3.  The child, upon returning to the adoptive parent(s)’ home, continues to be eligible for the Title IV-E adoption assistance agreement.
D.  Eligibility Determination for Medicaid in Title IV-E Adoption Assistance
1.  Children with an effective subsidized adoption agreement are eligible for Medicaid in the state they reside. See Medical Resources section, County Procedures for Medical Coverage for Subsidized Adoption Cases (Section 7.402, et seq.). 
2.  An adoption assistance payment is not required to extend Medicaid coverage. 
3.  Colorado is a member of the Interstate Compact on Adoption and Medical Assistance. Procedures for completing and complying with the compact are in the Medical Resources section, Children Moving Out of State (Section 7.402, et seq.). 
4.  Medicaid eligibility shall be continued for IV-E eligible children who are out of the home for more than thirty (30) calendar days unless it is determined that they are eligible for Medicaid under another program by completing the State approved form. See General County Department Requirements (Section 7.402, et seq.).
5.  Medicaid eligibility for all children receiving Medicaid shall be re-determined yearly only if the child continues to be eligible for Medicaid. This can be done by completing the State prescribed form or completing a form letter that the children continue to be eligible for Medicaid. This form letter shall be sent to other states by the county department to ensure continuation of Medicaid for a child who is residing out of state. 
E.  County Process for Title IV-E Adoption Assistance Agreements
1.  Determine and document a child’s special needs and eligibility for adoption assistance.
2.  Utilize financial information regarding the family including assets, liabilities and insurance benefits in negotiating the initial agreement, and any subsequent increases in adoption assistance.
3.  The adoption assistance agreement shall be established in accordance with the county department’s written policy. The policy shall outline the criteria used for determining the amount of adoption assistance. 
4.  It is not permissible for a county to include a statement in the adoption assistance agreement that IV-E adoption assistance payments and/or services are subject to the appropriation of state funds.
5.  Make a good faith effort to negotiate an adoption assistance agreement with the adoptive parent(s). The county shall base the negotiation on the special needs of the child and the circumstances of the adoptive parent(s). If the parties cannot come to an agreement, the county department shall establish the subsidy amount. If the family disagrees with the decision, a fair hearing can be requested. 
6.  Negotiate with the adoptive parents to request the amount that is needed by the family to meet the child's special needs. This may be less than the amount for which the child qualifies. 
7.  The county shall establish a maximum amount that could be provided to a family. The amount shall be no more than the rate that is being paid for the child’s current out-of-home care or that would have been paid if the child were in paid out-of-home care today. The monthly respite care payment that is provided under the foster care program is not a benefit under the adoption assistance program.
8.  If a child with developmental disabilities is receiving an allowance in addition to the foster care payment at the time the child is placed for adoption, the allowance may continue under the adoption assistance program if the child continues to meet the criteria outlined in “Child with Adoption assistance”, Section 7.306.4, A.
9.  County departments who pay more than the county’s foster care rate based on the child’s original or amended adoption assistance agreement shall reimburse the State for eighty percent (80%) of the payment that is over the foster care rate. 
10.  Use the State prescribed forms to document the negotiated agreement for IV-E adoption assistance and attach supporting documentation. 
11.  Complete and sign the adoption assistance agreement form specifying: 
a.  The dollar amount of the adoption assistance being provided, if applicable.
b.  The duration date of the agreement: 
1)  Until the adopted child reaches the age of 18 years; or,
2)  21 years in the case of a child who is physically or mentally handicapped; or,
3)  On a case-by-case basis, the duration of an agreement may be sooner than this time. All parties must be in agreement with the earlier termination date.
c.  The services and dates of services that are covered by an effective adoption assistance agreement. 
d.  That the adoption assistance agreement must be signed and dated by all parties prior to the effective date of the agreement and before the adoption is finalized. If the county fails to completely execute the initial adoption assistance agreement prior to the effective date and prior to the finalization of the adoption, the assistance payment will become non-reimbursable by the State and IV-E moneys.
12.  Review the agreement every three years from the date of the initial agreement.
a.  Any change in the adoption assistance agreement shall be related to the original barrier(s), identified at the time the decision was made that adoption assistance was needed. 
b.  In Title IV-E adoption assistance agreements, the agreement cannot be changed in any way without the agreement of all parties. The only exception is when there is an across-the-board reduction or increase in the foster care maintenance payment rate.  In that circumstance, the State may adjust the adoption assistance payment without the adoptive parent(s)’ concurrence. 
c.  The county department shall not add additional needs for adoption assistance payment after the adoption decree has been issued that is not directly related to the originally identified special needs of the child, or unless genetic in nature.
13.  The county or adoptive family may at any time negotiate changes to an existing adoption assistance agreement based on information related to the child’s original condition or the family’s circumstances.
F.  There are situations after finalization when adoptive parents can request a state level fair hearing before an Administrative Law Judge concerning the adopted child’s eligibility for adoption assistance benefits or the amount of those benefits. These situations include, but are not limited to: 
1.  Relevant facts regarding the child that were known and not presented to the adoptive parent(s) prior to the finalization of the adoption.
2.  Denial of assistance based upon a means test of the adoptive family.
3.  Erroneous determination that a child is ineligible for adoption assistance.
4.  Denial of a request for a change in payment level due to a change in the adoptive parent(s)’ circumstances.
5.  Failure by the county or a non-profit child placement agency to advise the adoptive parent(s) about the availability of adoption assistance for children who have been identified with special needs.
6.  Decrease in the amount of adoption assistance without the concurrence of the adoptive parent(s) (for Title IV-E adoption assistance agreements, only).
7.306.42  Non-Title IV-E Adoption Assistance [Rev. eff. 2/1/09]
A.  Pathways to Eligibility
The following are ways to become eligible for non-Title IV-E adoption assistance: 
1.  The county department has guardianship of the person (children) with the authority to consent to adoption. 
2.  The county department has guardianship of the person (children) with the right to consent to adoption, but the current caregiver has custody of the children.
3.  The child(ren) is not a citizen or a qualified alien but is being adopted by a U.S. citizen or qualified alien.
4.  The child was not IV-E eligible in foster care.
5.  The child was placed in foster care with the county department via voluntary placement agreement with the county, but: 
a.  There was no subsequent petition with the court and a court order within 180 days of living with his/her specified relative that includes the “best interest” or “contrary to the welfare” language; or, 
b.  There was no foster care payment made while in care under the voluntary placement agreement.
B.  Foster Care Placement of a Child Under an Adoption Assistance Agreement
1.  The State prescribed form must be completed to determine IV-E eligibility using the adoptive parent(s)’ income.
2.  The child, upon returning to the adoptive parent(s)’ home, returns to the previous non-IV-E adoption assistance agreement. 
C.  Eligibility Determination for Medicaid in Non-Title IV-E Eligible
1.  Colorado children who are eligible for an adoption assistance agreement, but are not IV-E eligible are eligible for Medicaid in Colorado or reciprocal states, only.
2.  An adoption assistance payment is not required to extend Medicaid coverage.
3.  Medicaid eligibility may or may not be continued for non-IV-E eligible children who are out of the home for more than thirty (30) calendar days depending on the county’s individual policy. 
4.  Medicaid eligibility for all children receiving Medicaid shall be redetermined yearly only if the child continues to be eligible for Medicaid. This can be done by completing the State prescribed form.
D.  Non-Title IV-E Adoption Assistance Payments
1.  Determine and document a child’s special needs and eligibility for adoption assistance.
2. Utilize financial information regarding the family including assets, liabilities and insurance benefits in negotiating the initial agreement, and any subsequent increases in adoption assistance.
3.  The adoption assistance agreement shall be established in accordance with the county department’s written policy. The policy shall outline the criteria used for determining the amount of adoption assistance.
4.  Make a good faith effort to negotiate an adoption assistance agreement with the adoptive parent(s). The county shall base the negotiation on the special needs of the child and the circumstances of the adoptive parent(s). If the parties cannot come to an agreement, the county department shall establish the adoption assistance amount. If the family disagrees with the decision, a fair hearing can be requested. 
5.  Negotiate with the adoptive parents to request the amount that is needed by the family to meet the child's special needs; this may be less than the amount for which the child qualifies. 
6.  The county shall establish a maximum amount that could be provided to a family. The monthly respite care payment that is provided under the foster care program is not a benefit under the adoption assistance program. 
7.  If a child with developmental disabilities is receiving an allowance in addition to the foster care payment at the time the child is placed for adoption, the allowance may continue under the adoption assistance program if the child continues to meet the criteria outlined in “Child with Adoption assistance”, Section 7.306.4, A, 3, d. 
8.  County departments who pay more than the county’s foster care rate based on the child’s original or amended adoption assistance agreement shall reimburse the State for eighty percent (80%) of the payment that is over the foster care rate. 
9.  Use the State prescribed forms to document the negotiated agreement for non-Title IV-E adoption assistance, and attach supporting documentation. 
10.  Complete and sign the Adoption assistance Agreement form specifying: 
a.  The dollar amount of the adoption assistance being provided, if applicable.
b.  Duration of the agreement: 
1)  In non-Title IV-E adoption assistance agreements, duration is decided by county policy, according to the special needs of the child and family circumstances. It may not continue past the child’s 21st birthday. 
2)  On a case-by-case basis, the duration of an agreement may be sooner than this time. All parties must be in agreement with the earlier termination date. 
3)  In the case of a child who turns eighteen (18), is still in high school, and has been eligible for Title IV-E adoption assistance, the child’s eligibility must be changed from Title IV-E. New forms must be completed to reflect the change in the child’s eligibility. 
c.  The services and dates of services that are covered by an effective adoption assistance agreement. 
d.  That the adoption assistance agreement must be signed and dated by all parties prior to the effective date of the agreement and before the adoption is finalized. If the county fails to completely execute the initial adoption assistance agreement prior to the effective date and prior to the finalization of the adoption, the assistance payment will become non-reimbursable by the State.
11.  Review the agreement every three years from the date of the initial agreement.
a.  Any change in the adoption assistance agreement shall be related to the original barrier(s), identified at the time the decision was made that adoption assistance was needed.
b.  In non-Title IV-E adoption assistance agreements, any changes must be made related to the special needs of the child, the family circumstances and county policy.
c.  The county department shall not add additional needs for adoption assistance payment after the adoption decree has been issued that is not directly related to the originally-identified special needs of the child, unless they are genetic in nature.
12.  The county or adoptive family may at any time negotiate changes to an existing adoption assistance agreement based on information related to the child’s original condition or the family’s circumstances.
7.306.43  State Monitoring/Sanction Process of Adoption Assistance Programs in Counties [Rev. eff. 2/1/09]
Monitoring will be conducted annually on county departments by State Child Welfare staff using a risk-based approach looking at the number and kinds of complaints received by consumers, advocates or the general public. 
A.  The state will randomly select cases from the adoption assistance caseload.
B.  Each county will be given three opportunities to pass the review before a fiscal sanction is established. 
1.  Counties passing the initial Stage I review will be reviewed every three years. 
2.  If the county fails the initial review, a Stage II review will be conducted in the second year. 
3.  If the Stage II review is failed, the county will go to a Stage III the next year.
C.  At each stage, the county will be given an opportunity to provide information to the state that will enable the case that is out of compliance to pass the review.
D.  A county failing the review will be offered technical assistance based on issues identified during the review and will be required to develop a corrective action plan.
E.  If the county fails all three stages, the reviewed cases that are out of compliance in the third stage will be converted to county-only funding in the third year.
7.306.44  Basis for Establishing the Amount of an Adoption Assistance Subsidy [Rev. eff. 2/1/09]
This section has been moved in order to consolidate rules related to adoption assistance in one location. Refer to Sections 7.306.41 and 7.306.42. 
7.306.45  Authorized Types of Adoption Assistance Subsidies [Rev. eff. 2/1/09]
This section has been moved in order to consolidate rules related to adoption assistance in one location. Refer to Section 7.306.4. 
7.306.5  INSTRUCTIONS FOR REIMBURSEMENT OF ADOPTION ASSISTANCE SERVICES
7.306.51  Medical Payments in Adoption Assistance Agreements
7.306.511  General Provisions [Rev. eff. 2/1/09]
A.  Medical adoption assistance agreement payments are made directly to adoptive parents for a service already received or to a vendor for treatment of a physical or developmental disabilities or emotional disturbance. A medical adoption assistance agreement shall relate directly to the barrier or barriers identified at the time the initial agreement is approved.
B.  Medical adoption assistance agreements are not available for treatment of any physical or developmental disability or emotional disturbance diagnosed after finalization of the adoption.
C.  Medical adoption assistance agreements may be used to supplement any other available resource such as an adoptive family's private insurance that pays part but not all for the child's treatment (physical, mental, and emotional).
D.  Medical adoption assistance agreements can only be used for Medicaid cases if the service requested is something that would not be covered under the State Medicaid Plan and relates to the direct barrier/need identified at the time the child is placed for adoption.
E.  Adoption assistance payments for medical services shall reflect the reasonable costs of those services in the child's community.
7.306.52  Reimbursable and Non-Reimbursable Adoption Assistance Case Services [Rev. eff. 2/1/09]
Case services are a type of purchased program services that support a case plan for children in out-of-home placement or an adoption assistance agreement. 
Case services are provided to meet a child's special needs identified when the child is placed for adoption and which are not covered by the adoption assistance or Medicaid assistance agreements. 
To be eligible for case services in an adoption assistance agreement, the State prescribed form outlining the agreement must be in place and the case open in the Department's automated reporting system as an adoption assistance case. 
A.  Medical   Eff  01/01/2007
1.  Orthodontia   Eff  01/01/2007
a.  Cosmetic reasons - not reimbursable.   Eff  01/01/2007
b.  Special needs directly related to the reason for which the child was classified as special needs, e.g. cleft palate or injury related to an abuse will be reimbursable.   Eff  01/01/2007
2.  Eye Glasses 
Eyeglasses are not reimbursable using case services dollars as Medicaid pays for one pair of glasses per year. 
Payment for additional eye glasses in a year or contacts related to the child's special needs identified at the time of the initial adoption assistance agreement are reimbursable. 
3.  Medication 
a.  Routine that is not related to the child's special needs-not reimbursable. 
b.  If related to child's special needs-reimbursable. The medication must be prescribed by a licensed physician and related to the special need identified at the time the child was approved for adoption assistance. 
4.  Special Therapies - Speech, Occupational, and Physical   Eff  01/01/2007
a.  If not available through other community and family resources-reimbursable. School-age children should receive these services through the school system.   Eff  01/01/2007
b.  When these services are available in hospitals and clinics–not reimbursable as Medicaid covers these costs.   Eff  01/01/2007
5.  Special Equipment 
Special medical needs/equipment, as prescribed by a physician may be reimbursable. 
For severely physically challenged children, special exceptions should not exceed $2,000 without a supervisor's written authorization. 
B.  Psychological Services   Eff  01/01/2007
1.  Time-limited out-patient therapy for children living in states that do not accept Medicaid for this service-reimbursable, if related to the child's special needs and a written plan is obtained from the service provider which contains:   Eff  01/01/2007
a.  Diagnosis.   Eff  01/01/2007
b.  Prognosis.   Eff  01/01/2007
c.  Length of service.   Eff  01/01/2007
d.  Individuals who will be seen in therapy.   Eff  01/01/2007
e.  A cap on the amount of money to be spent for the psychological exam or therapy.   Eff  01/01/2007
f.  Frequency of contact (i.e., once a week, twice a month, etc.).   Eff  01/01/2007
g.  Type of therapy being provided (i.e., individual, group, family, etc.).   Eff  01/01/2007
2.  If time-limited out-patient therapy is available using Medicaid – not reimbursable.   Eff  01/01/2007
3.  Day treatment - not reimbursable as Medicaid provides for this service.   Eff  01/01/2007
4.  Residential child care facility - not reimbursable as Medicaid provides for this service.   Eff  01/01/2007
5.  In-patient psychiatric hospitalization - not reimbursable as Medicaid provides for this service.   Eff  01/01/2007
(Children who are Medicaid eligible may receive some in-patient psychiatric services under the Medicaid Program.)   Eff  01/01/2007
C.  Educational Costs
1.  Tutoring-not reimbursable.
School systems are mandated to provide all children with special needs a free appropriate public education.
2.  School tuition-not reimbursable.
There will be no reimbursement for tuition expenses through the adoption assistance program. If the family wants the child to remain in his/her current private school placement, this is an expense for which they are responsible.
D.  Respite and Day Care
1.  Respite Care-reimbursable.
2.  Day Care-not reimbursable except for IV-E children. If day care services are needed and the child is IV-E eligible at the time of adoption, the family should be referred for day care services as they are eligible for Title XX services.
E.  Other Adoption Assistance Case Services
Adoption assistance case services for either IV-E or non-IV-E may be provided for a specified time to provide needed services, such as, but not limited to, transportation to facilitate adoptive placement. It is required that these time-limited services/funds are clearly provided on a case-by-case basis. This requirement must be clearly documented in the agreement. 
7.306.53  Non-Recurring Adoption Expenses [Rev. eff. 2/1/09]
A.  Reimbursement for the following non-recurring adoption expenses, not to exceed $800 per child, is available to parents adopting children with special needs:
1.  Legal fees.
2.  Adoption fees.
3.  Other expenses related to the legal adoption of the child(ren).
B.  The county department shall decide if an adopted child for whom reimbursement is being requested meets the criteria as a special needs child.
C.  The county department shall use the State-prescribed forms for children not in the department's custody.
D.  The county department shall use the State-prescribed forms for children in the department's custody.
E.  If no county department holds custody, reimbursement for the non-recurring adoption expenses will be based on the adoptive family's county of residence.
F.  Colorado will provide non-recurring adoption assistance payment up to $800 per child for children adopted internationally or through a private licensed non-profit adoption agency when the family has been able to: 
1.  Make application prior to the adoption.
2.  Provide evidence of the child’s special needs.
3.  Provide evidence that the agency did child specific recruitment for the child identified.
4. Provide evidence the family has an approved home study.
5.  Provide an itemized statement of the expenses to be reimbursed.
7.306.54  Continuing Adoption Assistance Agreements Beyond Age Eighteen [Rev. eff. 2/1/09]
A.  If a child is 18 years of age and has not graduated with a high school equivalency or vocational training, the county may continue the adoption assistance under the State and county-only program until the child finishes high school/vocational training or is 21 years of age. The county shall document in the record that the child is enrolled full-time in high school or vocational training and are making progress in the program.
B.  If the child is eligible for a Title IV-E adoption assistance until the age of eighteen (18), that agreement must be terminated. Any new non-Title IV-E agreement must be signed by the county and the family upon or prior to the child’s 18th birthday. 
C.  A child who is identified in the original adoption assistance agreement as being developmentally disabled or physically handicapped, is between the age of 18-21, and continues to live at home, may continue to be eligible for the adoption assistance program as long as these disabilities were identified and documented in the original agreement paperwork or is genetic in nature.
D.  If a county continues adoption assistance beyond the child’s 18th birthday without the child meeting the criteria in A or B, above, the county will be sanctioned for the adoption assistance payments made beyond the child’s 18th birthday.
7.306.55  Post-Legal Adoption Services [Rev. eff. 2/1/09]
The county of residence shall offer Core services to eligible families with an adoption assistance agreement according to the needs of the family.
7.306.56  Accepting and Processing Applications for Adoption Assistance from Child Placement Agencies [Rev. eff. 2/1/09]
A.  Colorado non-profit licensed adoption agencies can access adoption assistance if the child is in their custody and meets Title IV-E eligibility, as outlined in Section 7.001.41.
B.  The county department where the adoptive family lives will process the application for subsidy.
C.  If the child is being placed out-of-state, the state in which the family resides will process the application.
D.  The county department reviews the material submitted by the child placement agency and determines the child's eligibility for Title IV-E adoption assistance.
E.  The county department shall advise the child placement agency and the family in writing within ten working days of the date of approval or denial and inform the family of its right to appeal the decision.
F.  After the county department approves the adoption assistance, it shall open the case on the Department's automated reporting system.
G.  Approved adoption assistance payments may begin as of the date of the signing of the agreement. The child placement agency is responsible for any costs before the initiation of the adoption assistance agreement and prior to finalization. 
H.  Adoption assistance available to the eligible child are: 
1.  Medicaid (Title XIX).
2.  Adoption assistance payment.
3.  Non-recurring adoption expenses.
I.  Before finalization of the adoption, the child placement agency that arranged the adoption retains responsibility for continued services to the adoptive family should they be requested.
J.  The county department shall terminate adoption assistance payments and eligibility for Medicaid as outlined in Termination of Subsidy (7.306.59) and Title IV-E (7.306.41) sections.
7.306.57  Review of Eligibility for All Ongoing Adoption Assistance Agreements [Rev. eff. 2/1/09]
The county shall review the current agreement every three years.
A.  The county department shall initiate the written notice of the review for adoption assistance sixty (60) days prior to the three-year anniversary of the agreement.
B.  The adoptive family may request a review of the agreement prior to the three-year review if changes in the needs of the child or family circumstances occur.
C.  Any changes in the needs of the child shall relate to the original barrier(s), identified at the time the decision was made that adoption assistance was needed. The county department shall not add additional needs for adoption assistance payments after the adoption decree has been issued unless genetic in nature.
7.306.58  Reinstatement of Subsidy [Rev. eff. 2/1/09]
A.  Non-Title IV-E adoption assistance agreements may be reinstated if the services requested relate to the child's special needs which were identified at the time of the original subsidy.
B.  Reinstatement of adoption assistance agreements is not possible if the original adoptive parents no longer have legal custody of the child.
C.  When adoptive parents have relinquished, have had their parental rights terminated, or have died and the child is placed in a subsequent adoptive placement, then the child retains IV-E eligibility for reinstatement of the adoption assistance agreement in his/her new adoptive placement.
7.306.59  Termination of Subsidy [Rev. eff. 2/1/09]
A.  The county department shall terminate adoption assistance agreements when the: 
1.  Family requests payments end; or,
2.  Child reaches age 18 or until age 21, if the county has determined that the child has a developmental or physical disability which warrants continuation of assistance; or,
3.  Adoptive parent(s) are no longer legally responsible for the support of the child; or,
4.  Child is no longer receiving any support from the adoptive family; or,
5.  County of responsibility verifies the child's death, or marriage.
B.  Procedures for Adoption Assistance Payment, Adoption Case Services and Medicaid Adoption Assistance Agreement
1.  When the child is receiving a non-Title IV-E adoption assistance agreement and the child is absent from the home for over 30 calendar days, the adoption assistance payment and adoption case services will be discontinued. (See Section 7.404, regarding Placement Fees for out-of-home care.) If the child is in placement in a facility where he/she comes home for holidays or visits, this is not to be used as justification for continuing the non-Title IV-E agreement. A state/county non-Title IV-E agreement can only be resumed when the child is returned home and the out-of-home placement has been discontinued on the Department's automated reporting system.
2.  Children with a Title IV-E adoption assistance agreement who are out of the home for more than 30 calendar days will continue to receive an adoption assistance payment if it is a part of the child's adoption agreement. (See Section 7.404 regarding placement fees for out-of-home care.)
3.  Medicaid eligibility shall continue for Title IV-E eligible children who are out of the home for more than 30 calendar days unless it is determined that they are eligible for Medicaid under another program by completing the State prescribed form (see County Department Requirements, Section 7.402.2). 
7.306.6  RIGHT TO APPEAL [Rev. eff. 2/1/09]
A.  When the county department denies an application for adoption subsidy, or reduces or terminates the subsidy grant, the applicant or recipient shall have a right to appeal. See Section 3.850 of the Income Maintenance staff manual on Appeal and State Hearing (9 CCR 2503-1).
B.  When a family who has been denied Title IV-E Subsidized Adoption benefits requests a state level Fair Hearing, it is the responsibility of the Administrative Law Judge to determine whether the applicant or recipient was wrongly denied eligibility or whether the amount of the subsidy was determined correctly. (See Section 7.306.41, E, for fair hearing circumstances.)
C.  The adoptive parents have the burden of proving extenuating circumstances and adoption assistance eligibility at a state level Fair Hearing. The state and or/its designee can provide factual information to assist the family in establishing eligibility for Title IV-E adoption assistance.
D.  When either state or federal law requires or results in a reduction or deletion of services, a hearing need not be granted.

**********

(12 CCR 2509-5)

[Instructions:  replace lines 1504511 through 1426815.] 
7.402.1  PROVISION OF SERVICES 
Subject to certain income and resource limitations, medical assistance through the Colorado Medicaid program must be provided to certain children receiving child welfare services as follows: 
A.  Children for whom the county department is assuming full or partial financial responsibility. 
1.  Children in foster care, including those who are in independent living situations subsequent to being in foster care; 
2.  Youth committed to the Department of Human Services, Division of Youth Corrections, who are placed in a non-secure community based residential facility or in independent living situations; 
3.  Children who have a current, signed subsidized adoption agreement; 
4.  Children receiving Core services who otherwise would be in foster care; 
5.  Children in subsidized adoption, including adoption placements out of state, who are IV-E eligible or where the state option is in effect until the receiving state can provide Medicaid; 
6.  Children from Colorado placed in an out of state out-of-home placement by a Colorado county. IV-E eligible children receive Colorado Medicaid until the receiving state can provide Medicaid; 
7.  Children eligible for Supplemental Security Income, even if they are not receiving cash benefits, who are placed in an out of state foster care setting until the receiving state can provide Medicaid. 
B.  Certain children from other states who are placed in Colorado by that state. 
1.  Children eligible for adoption assistance placed in Colorado by another state; 
2.  Children placed in an out-of-home placement in Colorado by another state; 
3.  Children who are eligible for Supplemental Security Income placed in an out-of-home placement in Colorado by another state. 
C.  Children who are receiving child welfare services, living in their own home or the home of a designated relative, and the county department is not assuming full or partial financial responsibility for their care, may be eligible for coverage under other Colorado Medicaid programs for families and children. 
D.  Former foster care or adoption assistance youth who emancipated from foster care or adoption assistance at age eighteen (18) or after and are under age twenty-one (21), and for whom the state made foster care or adoption assistance payments in the month the youth turned age eighteen. 
7.402.2  COUNTY DEPARTMENT RESPONSIBILITY [Rev. eff. 2/1/09]
The county department shall be responsible for determining eligibility for Colorado Medicaid. For children for whom the county department is assuming full or partial financial responsibility through an out-of-home placement or Core services, the county department shall: 
A.  Determine Medicaid eligibility at the time the child enters out-of-home placement or begins receiving Core services.
B.  Determine if a child entering out-of-home care is covered by medical insurance and notify the Department of Health Care Policy and Financing of such coverage in the manner prescribed by the Division of Third Party Resources.
C.  Determine eligibility in the manner prescribed by the state Department of Human Services.
D.  For children in out-of-home placement, consider income and resource limitations as set forth in Section 8.101 through 8.104 of the Department of Health Care Policy and Financing's Medical Assistance manual (10 CCR 2505-10), considering the child as a household of one.
E.  For children receiving Core services and residing with the custodial parent(s), consider income and resource limitations as set forth in Section 8.101 through 8.104 of the Department of Health Care Policy and Financing's Medical Assistance manual (10 CCR 2505-10), considering income and resources of the family unit. Medicaid eligibility determination for children receiving Core services is required only if it appears the household income or resources will not preclude eligibility.
F.  Enroll the child using the appropriate data system no later than 90 calendar days after assuming full or partial responsibility for the child.
For children voluntarily placed in out-of-home care who were Medicaid eligible prior to placement, the caseworker shall coordinate Medicaid coverage with the eligibility technician. If it appears that the out-of-home placement will last longer than 90 calendar days, the child shall be enrolled in child welfare Medicaid.
G.  Redetermine eligibility for Medicaid at such time as may be required.
H.  For children receiving an adoption assistance from a Colorado county when the child is being placed into another county in Colorado, the county of residence where the child is placed shall be responsible for opening the Medicaid case.
I.  Discontinue Medicaid eligibility on the date the child is removed from the out-of-home placement and the county department is no longer assuming full or partial financial responsibility for the child.
J.  Discontinue Medicaid when an adoption is finalized, unless the child is receiving adoption assistance and/or otherwise entitled to continued Medicaid coverage.
K.  Develop another plan to meet the child's medical needs when a child for whom the county department is assuming full or partial financial responsibility through an out-of-home placement is ineligible for Medicaid. If the child is ineligible because of personal income, that income shall first be applied to the provision of medical care, either by the direct purchase of medical care or by the purchase of medical insurance.
L.  Determine Medicaid eligibility for foster care or adoption assistance youth who emancipated from foster care or adoption assistance at age eighteen (18) or after and are under age twenty-one (21), and for whom the state made foster care payments or adoption assistance payments in the month the youth turned age eighteen. Enter the determination into the state automated system within ninety (90) days of the determination. 
7.402.3  MEDICAID FOR CHILDREN COVERED BY THE INTERSTATE COMPACT ON THE PLACEMENT OF CHILDREN [Rev. eff. 2/1/09]
A.  Children moving to Colorado:
1.  The county department shall establish eligibility for Medicaid for IV-E eligible children moving form another state into Colorado for out-of-home care when the state or origin provides verification of IV-E eligibility. The letter of verification shall contain the date of discontinuation of medical assistance from the state of origin.
2.  Medicaid eligibility in Colorado shall begin the month following the discontinuation of medical assistance by the state of origin.
3.  Medical assistance for children who are not IV-E eligible and who are moving to Colorado for out-of-home care is the responsibility of the state of origin.
B.  Children moving from Colorado:
1.  The county department shall establish eligibility for Medicaid for IV-E eligible children moving to another state from Colorado for out-of-home care. The county department shall provide the receiving state verification of IV-E eligibility and notification of the last date of Medicaid coverage under Colorado Medicaid.
2.  Children from Colorado who are not IV-E eligible and who move to another state for out-of-home placement must have a plan for medical assistance in place prior to placement out of state.
3.  The county department shall provide the Interstate Compact on Adoption and Medical Assistance (ICAMA) forms and a copy of the adoption assistance agreement to the receiving state within the same month when the change from foster care to adoption occurs.
7.402.4  Medicaid for Children Covered by the Interstate Compact on Adoptions and Medical Assistance (ICAMA) [Rev. eff. 2/1/09]
A.  Children moving to Colorado: 
1.  The county department shall establish eligibility for Medicaid for children moving from another state into Colorado who have a current adoption assistance agreement in effect from the state or origin. The state of origin shall provide completed Interstate Compact on Adoptions and Medical Assistance forms and a copy of the current adoption assistance agreement. The letter of verification shall contain the date of discontinuation of medical assistance from the state of origin.
2.  Medicaid eligibility in Colorado shall begin the month following the discontinuation of medical assistance by the state of origin.
B.  Children moving from Colorado: 
1.  IV-E Adoption Assistance
For children who have a current adoption assistance agreement who are moving out of state, the county department shall provide the state adoptions program staff with duplicate copies of the completed ICAMA forms and a copy of the current adoption assistance agreement.
2.  Non-Title IV-E Adoption Assistance
a.  For children who are moving to a reciprocal state and have a current adoption assistance agreement, the county department shall provide the State adoptions program staff with duplicate copies of the completed ICAMA forms and a copy of the current adoption assistance agreement. 
b.  For children who are moving to a state that is not reciprocal with Colorado’s non-Title IV-E Medicaid, the county shall provide medical insurance for the child. This arrangement shall be negotiated with the family as to how the insurance will be provided. 

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[Instructions: replace lines 1426863 through 1426881.]
7.404  FEES [Rev. eff. 2/1/09]
A.  Fees shall be determined and collected as applicable for the following services in each program area:
1.  Special Circumstance Child Care
2.  Foster care.
3.  Adoptive studies.
4.  Core Services Program services as defined in the state approved Core Services Program plan.
5.  Medical care paid by the county that is not reimbursed by the state.
6.  Other services, such as case services, or custody evaluations.
B.  When both foster care and Core Services Program Services are simultaneously being provided or purchased, the foster care fee schedule shall be applied to the cost of both programs.
C.  Categories excluded from fee collection:
1.  Colorado Works categories, except for Supplemental Security Income eligible children in foster care and whose parents are not Colorado Works recipients.
2.  Individuals whose income is deemed to a Colorado Works household.
3.  Adoptive families who have an approved but inactive adoption assistance agreement and the child is in out-of-home placement.
D.  Once the amount of fee is determined, the full amount is to be paid up to the cost of services.
E.  Fees shall be determined for adoptive families as follows: 
1.  Adoptive families who have an approved Colorado non-Title IV-E adoption assistance agreement, but are currently not receiving adoption assistance payments and the child is in out-of-home placement, are excluded from fee collection.
2.  Adoptive families living out of Colorado who have an approved non-Title IV-E adoption assistance agreement whose child is in out-of-home care and the family is being charged a placement fee may request continuation of the adoption assistance payments to assist in the cost associated with the child's out-of-home placement. The plan for the child shall be reunification with the family.
3.  Adoptive families who have an approved Colorado non-Title IV-E adoption assistance agreement and the child is in out-of-home placement shall be assessed a placement fee not to exceed the amount of the adoption assistance payment they are receiving under their adoption assistance agreement.
4.  Adoptive families who have an approved Title IV-E adoption assistance agreement and the child is in out-of-home placement shall be assessed a fee not to exceed the amount of the adoption assistance payment they are receiving under their adoption assistance agreement.

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