Title IV-E, Medicaid, and Other Applicable Benefits

(Revised 09-01-2000)

Title IV-E  
Eligibility
 
Required Title IV-E Judicial Determination
 
AFDC Relatedness Test
 
Reimbursability & Six Month Redetermination Under Title IV-E Foster Care 
Legal Responsibility
 
Reasonable Efforts
 
Best Interest Determination for a Voluntary Commitment Agreement
 
Concurrent Receipt of Title IV-E and SSI
 
Reimbursable Placement
 
Need
 
Deprivation
 
Age
 
Monitoring
 
Child Support and Title IV-E
 
Medicaid
 
Title IV-E Adoption Assistance

Title IV-E

Public Law 96-272, the Adoption Assistance and Child Welfare Act of 1980, became effective June 17, 1980. It amended Title IV of the Social Security Act to establish a new Part E, which provides for Federal payments to the states for foster care maintenance and adoption assistance payments made on behalf of certain eligible children. The objectives of this legislation are:

  1. To improve the quality of care provided to children in substitute care;
  2. To reduce the number of children who are removed from their own homes for placement in substitute care. Substitute care includes foster family, group home and institutional care;
  3. To return children from substitute care to their homes as soon as conditions in the home permit; and
  4. To facilitate the adoption or other permanent placement for those children who cannot be returned to their own homes.

There are two major components of Title IV-E: Eligibility and Reimbursability. Eligibility does not automatically confer federal benefits. The reimbursability criteria shall be met for the state to receive federal support for the child.

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ELIGIBILITY

Eligibility is determined on a one-time basis when the child enters care. Once established, a child’s eligibility continues as long as the child remains under the care and responsibility of the Department.

A child shall meet two eligibility requirements for Title IV-E foster care:

  1. The child entered care (a) by a voluntary commitment agreement or (b) as the result of a court order with judicial determinations (1) (in the removal order) that it is in the best interest of the child to be removed or that it is contrary to the welfare of the child to remain in the home and (2) (within 60 days of placement) that reasonable efforts to prevent the child’s removal from the home were made or were not required. If a removal order is obtained and the child is not removed within 30 days of that order, it is necessary to obtain a new order (not necessarily commitment) authorizing removal of the child from the home which contains both contrary to welfare or best interest language and the reasonable efforts language.
  2. The child shall have lived with a parent or other specified relative within six months prior to the month of removal and shall have had a relationship to the AFDC program (per State AFDC rules as in force on July 16, 1996) in the month the agency worker signed the petition which led to the child’s removal from the home, or during the month the voluntary commitment was signed by the parent(s).

Title IV-E eligibility starts on the date the child is removed, when all other eligibility factors are present, or the month the voluntary commitment was signed. There are only two instances where a child in continuous care shall lose eligibility for IV-E:

  1. When the child reaches the age limit for the program; or,
  2. When the child came into care as the result of a voluntary commitment agreement and the Cabinet fails to acquire a court order with best interest granting custody of the child to the Cabinet within 180 days of the date of the agreement.

Title IV-E eligibility shall be determined by the Children’s Benefits Worker in the district that has family case responsibility. When a child is placed in another district, the Title IV-E case shall be maintained in the district that has family case responsibility.

Social Service Worker responsibilities are:

  1. Assisting the Children’s Benefits Worker in determining eligibility.
  2. Notifying the Children’s Benefits Worker on the day the agency assumes legal responsibility for the supervision and care of the child.
  3. Within ten working days submit the DSS-1259, Benefits Action Transmittal, complete the TWIST electronic DSS-1260, Title IV-E and Child Support Referral, all petitions and court orders relating to custody and/or child support, and various other documents relating to the child’s legal and placement status as listed on the Benefits Action Transmittal.
  4. Notifying the Children’s Benefits Worker of all changes in placement status, custody status and AFDC relatedness (in effect July 16, 1996 in DSI policy that affect a child’s eligibility and reimbursability for IV-E within 10 working days.

Children’s Benefits Worker responsibilities are:

  1. Accepting referrals for the determination of initial eligibility for Medicaid and Title IV-E eligibility..
  2. Notifying Family Support via TWIST /KAMES interface or e-mail within two working days after notification of placement.
  3. Assuring that the necessary documents for eligibility and reimbursability are submitted.
  4. Maintaining a IV-E case record that contains information and documentation to support a child’s eligibility and reimbursability.
  5. Coordinating with Social Service Worker in determining ongoing reimbursability.
  6. Discontinuing eligibility within two working days after notification from Social Service Worker.
  7. Coordinating and exchanging information with the Central Office IV-E Program Coordinator and the local Family Support office.
  8. Sharing updated policy and procedure information with regional staff.
  9. Determining Medicaid eligibility for children not eligible for Title IV-E.

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REQUIRED TITLE IV-E JUDICIAL DETERMINATION

First, in the order that initially removes a child from his home, referred to as the removal order, the court shall specify that continuation in the home is contrary to the welfare of the child, or best interest language. A removal order may be a temporary custody order or an emergency custody order. Second, in any order within the first 60 days of the child’s placement, the court must explicitly state that reasonable efforts were made or were not required to prevent the child’s removal for one of the reasons specified in federal law and regulations. When either (a) the welfare/best interest language or (b) the reasonable efforts language is not contained in the judge’s order or court transcript within the required time, then the child is not IV-E eligible for as long as the child remains continuously out of the home. Except in the case of home visitation, each time a child is returned to and removed from the home, a new court order with the required IV-E judicial determinations must be obtained. Occasionally a child in out-of-home care is returned to the removal home for the purpose of a trial visit, and then it becomes necessary to remove the child. It is not necessary to obtain a new court order authorizing the second removal if the Social Service Worker has documented in a Visitation Agreement within the Case Plan for Out-of-Home Care, OOHC-1281, that the purpose of the child’s placement in the removal home is for a trial visit. If the child’s trial visit extends beyond six months, then it is necessary to obtain a new court order authorizing removal which contains the required judicial determinations, unless the court has ordered a longer trial home visit.

Social Service Worker responsibilities are:

  1. Ensuring that a specific request for the required IV-E judicial determination is included in the petition that leads to the removal of the child.
  2. Preparing the DSS-1259, Benefits Action Transmittal package, and attaching it to the petition and resultant court order or voluntary commitment agreement for submission to the Children’s Benefits Worker.
  3. Obtaining a judicial determination from the court, within 180 days of the date of the voluntary commitment agreement, that continued placement is in the child’s best interest for those children removed from their home pursuant to a voluntary commitment.

Children’s Benefits Worker responsibility is:

Determining whether the submitted court orders and voluntary commitment agreement meet the IV-E requirements, and notifying the Social Service Worker when an order or agreement is not acceptable. Providing notice to the Social Service Worker at 120 days into a voluntary commitment agreement.

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AFDC RELATEDNESS TEST

To be eligible for Title IV-E under AFDC rules as in force on July 16, 1996, the foster child must meet technical and financial eligibility factors. The month during which the child shall meet the IV-E AFDC-relatedness test is the month during which a voluntary commitment agreement was signed by the parent(s) or the month during which the petition that led to the child’s removal from the home was signed by an agency official. This is the eligibility month. (NOTE: the date that the child entered care does not necessarily define the time for which the child shall have met the AFDC relatedness test. Rather, it is the petition which directly led to the custody or supervision which defines the petition date for purposes of determining whether the child meets the AFDC-relatedness test.) A temporary custody petition may lead to temporary placement, which is then followed by a petition for continued placement. Assuming the child remained in a placement supervised by the department during the time between the temporary custody placement and the date of the court order granting continued placement, it is the temporary custody petition which determines the eligibility month. If the petition leading to the removal is not filed within six months of the commitment or custody order, the month of the commitment or custody order is the "removal month" looked to for eligibility determination. A child meets AFDC-relatedness when one of the following two tests is met:

  1. The child was eligible for AFDC (according to July 16, 1996 rules) in the removal home in which the child lived during the removal month; or
  2. The child did not live with a specified relative in the removal month, but did live with such a relative in any of the preceding six months, and the child would have been eligible for AFDC (according to July 16, 1996 rules) in that relative’s home during that month had an application been made.

The AFDC relatedness test requires identification of the removal home. Normally the removal home is the home from which the child is both physically and legally removed by court action. However, in cases where, at the time of the court order, the child is living in a home other than the one from which the court orders the child to be removed, the agency must make a determination as to the removal home for eligibility purposes, in accordance with the latest federal guidance and pertinent case law. If the removal home is other than a parent’s or adoptive parent’s home, only the child’s income and resources are used to determine AFDC need. The circumstances which define Title IV-E eligibility are:

  1. Living with A Specified Relative;
  2. Deprived of Support of One or Both Parents;
  3. Need, which is an income and a resources test;
  4. US Citizen or legal alien; and
  5. Age.

REIMBURSABILITY AND ANNUAL REDETERMINATION UNDER TITLE IV-E FOSTER CARE

Once eligibility is established, the Cabinet shall determine for every month that a child is in foster care whether the child’s care was reimbursable by the Federal government. A child may lose and regain reimbursability on a frequent basis depending on changes in the child’s circumstances. Conditions of reimbursability may vary from month to month. A redetermination shall occur every twelve months to establish whether the seven reimbursability criteria are met on a month to month basis.

The seven reimbursability criteria are:

  1. Legal responsibility for the child is with the Title IV-E agency;
  2. Court certification within the last 12 months that reasonable efforts are being made to finalize a permanency plan or that reasonable efforts to reunify the child and family are not required;
  3. A court order, which contains the appropriate judicial determination, obtained within 180 days for children removed as a result of a voluntary commitment agreement;
  4. Reimbursable placement;
  5. Need;
  6. Deprivation; and
  7. Under age 18, or under age 19 if in school and expected to graduate by age 19.

The procedures for eligibility and reimbursability may occur simultaneously.

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LEGAL RESPONSIBILITY

Legal responsibility means that the Cabinet for Families and Children has legal responsibility for the care of the child. This can be established in one of two ways: through a court order or a voluntary commitment agreement. When the Cabinet gains legal custody of a child, assuming other criteria are met, IV-E foster care payments may be made on the child’s behalf.

Social Service Worker responsibilities are:

  1. Obtaining the required court order or voluntary commitment agreement establishing CFC’s legal responsibility and forwarding a copy to the Children’s Benefits Worker.
  2. Submitting copies of any court orders or voluntary commitment agreement reflecting changes in custody status to the Children’s Benefits Worker.
  3. Notifying the Children’s Benefits Worker and noting in the case record, in 10 working days, when the Cabinet relinquishes custody of a child.
  4. Timely entry of child’s placement into TWIST enter/exit screens to effectively discontinue foster care payments.

Children’s Benefits Worker responsibility is:

Reviewing the removal order (emergency custody, temporary removal, temporary custody, or commitment order) or voluntary commitment agreement to ensure the required legal responsibility is established. When it is not present, notifying the Social Service Worker to obtain the required documentation of legal responsibility.

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REASONABLE EFFORTS

The Cabinet shall make reasonable efforts to prevent or eliminate the need for removal of the child from his home or to make it possible for the child to safely return to his home in order for a child to be eligible and reimbursable under Title IV-E. To verify that the requirement has been met, the Cabinet shall provide evidence of its actions to a court of competent jurisdiction, and the judge shall rule in a court order whether the agency has in fact made reasonable efforts and in making such reasonable efforts, the child’s health and safety shall be the paramount concern. There are four possible rulings from a judge which meet the intent of the law:

  1. That a reasonable effort was made to prevent the placement prior to the placement of the child;
  2. That a lack of preventive services was reasonable; or
  3. That a reasonable effort to prevent the placement was possible, and was not made, but a reasonable effort is being made to safely return the child to his home.
  4. Reasonable efforts shall not be required if a court of competent jurisdiction has determined that
a) the parent has subjected the child to aggravated circumstance (as defined by state law, which may include but need not be limited to abandonment, torture, chronic abuse, and sexual abuse);
b) the parent has
i) committed murder of another child of the parent;
ii) committed voluntary manslaughter of another child of the parent;
iii) aided or abetted, attempted, conspired or solicited to commit such a murder or voluntary manslaughter; or
iv) committed a felony assault that results in serious bodily injury to the child or another child of the parent; or
c) the parental rights of the parent to a sibling have been terminated involuntarily.

A court order within 60 days of placement signifying any one of these outcomes meets the reasonable effort requirement for initial Title IV-E eligibility. From the date of the court order which includes one of these four judgments, (assuming all other eligibility criteria are met) the child becomes initially eligible and remains for the duration of the child’s placement episode. Thereafter, the court must make an additional finding at least once every twelve months that reasonable efforts to finalize permanency for the child are being made, OR that efforts to reunite the child and family are not required. If such a determination is not made, Title IV-E reimbursability ceases at the end of the twelfth month following the last judicial finding of reasonable efforts and begins again in the month when such judicial determination is once again made.

Social Service Worker responsibilities are:

  1. Preparing to discuss and present documentation (a completed DSS-1266, Affidavit of Efforts) of the preventive services that were provided to the family and when services were not provided, the reasons why. The discussion or documentation shall address the relevancy, adequacy, accessibility, availability, diligence of efforts, realistic expectations and coordination of services provided.
  2. Ensuring that the removal petition contains the request for reasonable efforts determination.
  3. Submitting court documentation of reasonable efforts to the Children’s Benefits Worker.

Children’s Benefits Worker responsibility is:

Reviewing court documentation to ensure that the reasonable efforts requirement is met, or initiating a request to the Social Service Worker for a new order.

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BEST INTEREST DETERMINATION FOR A VOLUNTARY COMMITMENT AGREEMENT

When a child is removed from the home pursuant to a voluntary commitment and the placement is expected to exceed 180 days, the agency shall file a petition seeking court ordered custody of the child. A court order containing the required IV-E judicial determination language that placement is in the child’s best interest and that reasonable efforts to prevent removal were made or are not required shall be obtained within 180 days or the child is not IV-E eligible or reimbursable for the duration of the out-of-home placement episode.

Social Service Worker responsibilities are:

  1. Filing a petition seeking a judicial determination to the effect that continued placement is in the child’s best interest within 140 days of the date of the signatures on the agreement;
  2. Monitoring the situation to ensure that a hearing on the petition is held timely and that the required court order is obtained;
  3. Submitting the court order containing the required judicial finding to the Children’s Benefits Worker;
  4. Notifying the Children’s Benefits Worker when the required judicial determination is not obtained within 180 days.

Children’s Benefits Worker responsibilities are:

  1. Establishing the date by which the required judicial determination shall be obtained for each voluntary commitment;
  2. Notifying the Social Service Worker within 120 days of the date when the judicial determination shall be obtained;
  3. Discontinuing the child’s IV-E eligibility within 180 days upon notification from the FSW that the required judicial finding has not been obtained.

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***CONCURRENT RECEIPT OF TITLE IV-E AND SSI

The Social Security Act allows reimbursement of foster care payments under Title IV-E in any month in which a child receives SSI benefits. A child may be IV-E reimbursable in a month when the child receives SSI. If a child is eligible for both SSI and IV-E benefits in a month in which the child is in foster care, the state shall report the amount of IV-E reimbursement to the Social Security Administration (SSA). When the Social Security Administration is informed that the child is receiving IV-E benefits, "the child’s SSI payment shall 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 Operation Manual). Factors to consider when determining whether to continue concurrent receipt of IV-E and SSI include:

  1. Title IV-E maintenance cost reimbursement income exceeds the SSI income limit;
  2. Suspension of SSI shall exceed one year; and
  3. The extent of the child’s disability and likelihood of receiving SSI again when the child is returned home, placed in an alternative permanent situation or reaches age 18 or 19 and is no longer eligible for Title IV-E.

The selection of concurrent receipt of IV-E or SSI shall be made with the child’s best interest in mind. The fiscal advantage to the agency is a secondary consideration. The decision to request termination or suspension of SSI benefits shall be made by the Family Services Office Supervisor with input from the Family Services Worker, Children’s Benefits Worker and the child’s parents.

Social Service Worker responsibilities are:

  1. Notifying the Children’s Benefits Worker when the FSW becomes aware that the child is in receipt of SSI; and
  2. Providing the cost of care by sending the OOHC-111A or OOHC-114 to the Children’s Benefits Worker.

Children’s Benefits Worker responsibilities are:

  1. Notifying the Central Office Children’s Benefits Coordinator that the child is SSI eligible and IV-E eligible and reimbursable by submitting the OOHC-1274; and
  2. Notifying the Central Office Children’s Benefits Coordinator if the child becomes IV-E non-reimbursable by submitting the OOHC-173.

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REIMBURSABLE PLACEMENT

There are five types of out-of-home placements which meet the law’s definition of a IV-E reimbursable placement:

  1. An approved foster family home;
  2. A private non-medical group home licensed by the state;
  3. A public non-medical group home or child-care facility which has a licensed capacity of less than 26 beds;
  4. A relative foster home; or
  5. Pre-adoptive placement.

Social Service Worker responsibilities are:

  1. Submitting the OOHC-111a, OOHC-114, group home letter of acceptance, and Adoption Placement Agreement and an Adoption Approval Letter to the Children’s Benefits Worker upon referral.
  2. Maintaining a placement history in the TWIST enter/exit screens on each child, which shall include an entrance and exit date for each placement on in TWIST.
  3. Submitting the OOHC-111A, OOHC-114, group home letter of acceptance or an Adoption Placement Agreement and an Adoption Approval Letter to the Children’s Benefits Worker within five working days when a child changes placement.

Children’s Benefits Worker responsibility is:

Determining whether the initial placement and all subsequent placements are reimbursable upon redetermination.

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NEED

The child shall have a financial need in AFDC terms to maintain reimbursability.

Need has two elements. First, when a child’s resources exceed $10,000 in any month (asset limit established under PL 106-169, Foster Care Independence Act of 1999), the child is not reimbursable, until the balance is spent down below $10,000. The second element of need is a child’s income. The income available to the child shall be less than the costs of the monthly maintenance in foster care. In any month where the child’s income after deductions exceeds this amount, the child is not reimbursable. In a need determination for continuing reimbursability, it is only the child’s income and resources which are considered. In the test of need in reimbursability determination, the income and resources of the child’s parents are not considered unless the parents are contributing funds to the agency for the care of the child. When the parents are contributing toward the care of the child, the contribution is considered unearned income of the child to be counted in the need determination. Also, survivors benefits and other resources may accumulate in the child’s trust fund.

Social Service Worker responsibilities are:

  1. Obtaining information regarding the child’s income, resources and deprivation factor by completing the OOHC-1260, Title IV-E and Child Support Referral; and
  2. Completing the OOHC-1265 Title IV-E Redetermination Status Report form and submitting it to the Children’s Benefits Worker.

Children’s Benefits Worker responsibilities are:

  1. Determining whether the child’s income and resources meet reimbursability criteria; and
  2. Notifying the Social Service Worker within 10 working days of the date the redetermination is due.

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DEPRIVATION

To maintain IV-E reimbursability, a child in foster care shall continually be deprived of the care and support of one or both parents. As with the eligibility determination, this means that one or both parents is absent from the removal home, unemployed, disabled, or deceased. It is possible that the deprivation may change at any time between redeterminations. When termination of parental rights (TPR) has occurred during the last six months the deprivation factor is to be changed to absence. Status of the parent does not have to be verified after TPR.

Social Service Worker responsibilities are:

  1. Notifying the Children’s Benefits Worker of any changes in deprivation;
  2. Completing the OOHC-1265, Title IV-E Redetermination Status Report.

Children’s Benefits Worker responsibilities are:

  1. Reviewing the OOHC-1265, Title IV-E Redetermination Status Report;
  2. Requesting additional information, when needed.

AGE

A child loses IV-E eligibility and reimbursability at the beginning of the month following the child’s eighteenth birthday, unless the child is enrolled full-time in high school, or any equivalent course of study, and can be reasonably expected to graduate prior to the child’s nineteenth birthday. When the child meets this expectation, reimbursement may continue until the beginning of the month following the child’s graduation.

Children’s Benefits Worker responsibility is:

Notifying the Social Service Worker and discontinuing IV-E when the child no longer meets the age requirement.

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MONITORING

Staff shall monitor the case to ensure that IV-E foster care maintenance payments are being made correctly on the child’s behalf.

Social Service Worker responsibilities are:

  1. Notifying the Children’s Benefits Worker of any changes which may affect reimbursability status.

Children’s Benefits Worker responsibilities are:

  1. Making the reimbursability determination for each month in the twelve month period and completing IV-E Redetermination form, OOHC-1262;

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CHILD SUPPORT AND TITLE IV-E

Parents shall be responsible for the financial and medical support of their children even when the child is found eligible for Title IV-E.

The Children’s Benefits Worker responsibility is:

  1. Submitting completed OOYC-1260, Title IV-E and Child Support Referral form to, the regional DCSE office, for the county in which the child was removed.
  2. Submitting completed OOHC 1263, Title IV-E and Child Support Change of Status, to the regional DCSE office, for the county in which the child was removed.

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MEDICAID

The Department for Community Based Services shall be responsible for maintaining compliance with Medicaid regulations pursuant to KRS - 205.510 through 205.630.

TITLE IV-E ADOPTION ASSISTANCE

To be eligible for Title IV-E Adoption Assistance, the following criteria shall be met:

There shall be a written adoption assistance agreement between the State agency and the prospective parents of a minor child. It shall be signed and in effect at the time of the final decree of adoption. A copy of the signed agreement shall be given to each party. The agreement shall, at a minimum specify:

  1. The duration of the agreement;
  2. The nature and amount of payment, services and assistance;
  3. That the child is eligible for Medicaid services under Title XIX and social services under Title XX (effective October 1, 1983);
  4. That the agreement (if made on or after October 1, 1983) shall remain in effect regardless of the State in which the child is a resident at any given time; and
  5. That Kentucky shall remain financially responsible for any medical and social services agreed to be provided 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 shall meet Special Needs Criteria; three criteria shall be met:

  1. The state shall determine that the child cannot or may not be returned to the home of his parents (e.g., parental rights are terminated);
  2. The child shall have a specific special need which 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
  3. The state shall show that 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.

The child shall have a relationship to the AFDC program or the Supplemental Security Income Program (SSI).

The child shall maintain eligibility as long as the on-going criteria of age and legal responsibility are met.

Age: To receive adoption assistance payments, a child shall be under the age of 18.

Legal Responsibility: 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.

A child may receive Title IV-E Adoption Subsidy payments and SSI benefits concurrently. When there is concurrent receipt of payments from both programs, SSI shall count dollar-for-dollar, the amount of the IV-E Adoption Assistance, thus decreasing the SSI benefit by the amount of the adoption assistance payment. In addition, the adoption assistance payment shall be reduced to reflect the amount of SSI received.

Once the adoption is finalized, the 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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Social Service Worker responsibilities are:

  1. Verifying Title IV-E eligibility or receipt of SSI with the Children’s Benefits Worker prior to requesting the adoption assistance.
  2. Notifying the Children’s Benefits Worker within 10 working days after the finalization of the adoption by submitting the Benefits Action Transmittal, OOHC-1259, with attached copies of the assistance request, assistance agreement, TPR, adoption petition and the letter of verification of the judgment.
  3. Providing information of age and legal responsibility for on-going eligibility, upon request from the Children’s Benefits Worker .
  4. Notifying the Children’s Benefits Worker within five days of change of address.
  5. Notifying the Children’s Benefits Worker within five days of an adoptive family moving to another state. In conjunction with the Children’s Benefits Worker, coordinating Medicaid benefits, COBRA and ICAMA, with the appropriate contact person in the other state.
  6. Notifying the Children’s Benefits Worker within five days of the closure of the adoption assistance.

Children’s Benefits Worker responsibilities are:

  1. Assuring that the necessary documents for eligibility are submitted.
  2. Determining the child’s IV-E adoption assistance eligibility.
  3. Notifying the R & C worker regarding the child’s IV-E eligibility status within five working days.
  4. Maintaining a IV-E adoption assistance case record that contains documentation to support a child’s eligibility.
  5. On the yearly anniversary of the approval date of IV-E adoption assistance, contact the R & C worker to verify age and legal responsibility of the child to redetermine on-going eligibility.
  6. Accepting and processing applications for Medicaid coverage, COBRA, from adoptive parents that have moved to Kentucky from other states.
  7. Discontinuing IV-E adoption assistance when notified by the R & C worker.

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