Adoption assistance is medical benefits, and in appropriate cases a monthly payment, provided to adoptive families on behalf of eligible children to help the family defray the costs of meeting a child’s special needs. The Administration shall offer adoption assistance to the parent of an eligible child that meets the eligibility criteria for an applicable child or a nonapplicable child. An eligible child shall be under the guardianship of a local department or a licensed private placement agency, or have been adopted in a consensual adoption pursuant to Family Law Article, §5-338, Annotated Code of Maryland. IV-E Child Eligibility Criteria. A child who is not a citizen or resident of the United States and who was either adopted outside the United States or brought to the United States for the purpose of being adopted may not be considered an applicable child, unless: The adoption dissolves or the adoptive parent dies; and The child is subsequently adopted from out-of-home placement. The Administration shall determine that a child is an applicable child, has special needs, and meets certain placement or medical criteria prior to an adoption in order for a child to receive IV-E adoption assistance. A child is an applicable child if: The child is: 6 years old or older in fiscal year 2015; 4 years old or older in fiscal year 2016; or In federal fiscal year 2017, when a child of any age will meet the criterion; The child has been in foster care under the responsibility of the Title IV-E agency for at least 60 consecutive months; or The child is the sibling of a child that meets either the age or time in foster care requirements in §D(3)(a) and (b) of this regulation, and the siblings are placed in the same adoptive placement. Special needs for an applicable child exist when the child cannot or should not be returned to the home of the parent and: The child meets all medical or disability requirements for SSI, or one of the special needs factors exist; and Reasonable but unsuccessful efforts have been made to place the child without assistance, unless the child is being adopted by their foster parent and has significant emotional ties with that person. An applicable child meets placement or medical criteria if: The child is in the care of a public agency or a licensed child placement agency or tribe pursuant to: An involuntary removal in accordance with a judicial determination that it is contrary to the child’s welfare to remain in the home; A voluntary placement agreement; or A voluntary relinquishment; The child meets all medical and disability eligibility requirements of SSI; The child was residing in a foster family home or childcare institution with their minor parent, and the minor parent was removed from the home pursuant to either: An involuntary removal in accordance with a judicial determination that it was contrary to the child’s welfare to remain in the home; or A voluntary placement agreement or a voluntary relinquishment; or The child was eligible for adoption assistance in a prior adoption and is now being subsequently adopted because the adoptive parents have died or their parental rights have been terminated. Nonapplicable Child Eligibility Criteria. A nonapplicable child is a child that does not meet the applicable child criteria as detailed in §D of this regulation. A nonapplicable child will be eligible for IV-E adoption assistance if the child is a special needs child and the child meets certain placement or medical criteria prior to the adoption. Special needs for a nonapplicable child exist when: The child cannot or should not be returned to the home of the parent; One of the special needs factors exists; and Reasonable but unsuccessful efforts have been made to place the child without adoption assistance, unless the child is being adopted by their foster parent who provided foster care services and has significant emotional ties with that person. A nonapplicable child meets the placement or medical criteria prior to the adoption if: The child is Aid to Families with Dependent Children eligible at the time of removal pursuant to: An involuntary removal in accordance with a judicial determination it is contrary to the child’s welfare to remain in the home; or A voluntary placement agreement wherein the child received IV-E foster care payments in that placement; The child is eligible for SSI; The child’s minor parent was in foster care and received foster care maintenance payments that covered the minor parent and the child; or The child was eligible for adoption assistance in a prior adoption and is now being subsequently adopted because the adoptive parents have died or their parental rights have been terminated. Payments. The adoption assistance payment shall be determined through negotiation and agreement between the local department and the adoptive parent. The adoption assistance payment may be combined with the parent’s financial resources to assist with meeting the child’s identifiable, quantifiable current and future needs. The amount and duration of the payment: Shall be based on the needs of the child and the circumstances of the family; and May not exceed the foster care payment received by the foster parents for the child. The amount of the adoption assistance payment for a medically fragile child adopted by his or her treatment foster parents may not exceed the foster care payment received by the treatment foster parents up to a maximum of $2,000. The local department may determine a $0 payment is appropriate in certain circumstances, including: Adoption assistance is not needed by the parent at the time the adoption is finalized to defray the cost of meeting the child’s special needs; or The child is at risk of developing a physical or mental disease or disability, but is not currently symptomatic. Allowances, paid to the resource parents in addition to the foster care payment, such as those for transportation, day care, or camp, or differential amounts paid to resource parents in certain counties, may not be included in the negotiated adoption assistance rate. Negotiation. The local department shall negotiate the amount of the adoption assistance based upon the: Needs of the child; The circumstances of the family; and The family’s ability to incorporate the child into their household. As a part of the negotiation process, the local department shall assess the child’s needs based on: Documentation in the record; Documentation provided by the adoptive family; and Any additional relevant information. The negotiation process shall include a discussion of: The child’s needs and the family’s circumstances; and The assistance the local department may provide to help the family assume primary financial responsibility for the child. The local department and the adoptive parent shall explore the availability of other resources such as SSI and other Social Security benefits, adoption tax credits, educational or vocational training assistance, and community supports that may be available to meet the child’s needs on an ongoing basis after the adoption is finalized. Concurrent Receipt of Benefits. The local department shall advise the family that, if the nonapplicable child receives SSI and adoption assistance at the same time, the SSI benefits will be reduced on a dollar-for-dollar basis in the amount of the IV-E adoption assistance. If a child receives other Social Security benefits, such as survivor’s benefits, retirement benefits, or old age benefits, the amount of these benefits may be considered when negotiating the amount of the adoption assistance. The adoptive family shall report their receipt of adoption assistance to the Social Security Administration. The family shall report their receipt of benefits to the Administration while the adoption assistance agreement is in effect. Adoption assistance payments shall become effective on the date the adoption is finalized. If the local department makes an overpayment through error or some other means, the local department may recover the over payment. Adoption Assistance Agreement. An adoption assistance agreement shall be: In writing; Binding on all parties; On a form approved and distributed by the Administration; and Signed by the director of the local department or designee and the adoptive parent prior to the finalization of the adoption. If the Maryland adoptive parent and the child move to another state: The adoption assistance agreement shall remain in effect; The adoptive parent shall be referred by the local department to the appropriate federal Title XIX and Title XX agencies in the adoptive parent’s state of residence; and The local department shall provide the state of residence with documentation regarding the child’s eligibility for Medicaid and Title XX services as provided by the state of residence. Medical Benefits. A child who has an adoption assistance agreement in effect is eligible for Medicaid benefits under the state Medicaid plan in his or her state of residence. Children who have an adoption assistance agreement that provides for a $0 monthly payment shall be eligible for Medicaid. Interstate Adoption. If the State public child welfare agency has responsibility for placement and care of a child prior to finalization of the adoption, that State shall be responsible for entering into the adoption assistance agreement with the family, provided the child is an eligible child. If the State public child welfare agency does not have responsibility for placement and care of a child, the adoption assistance agreement should be applied for and made in the adoptive parents’ State of residence. In that event, the public child welfare agency in the adoptive parents’ State of residence is responsible for determining whether the child meets the definition of special needs, entering into the adoption assistance agreement and paying the subsidy, consistent with the way public benefits are paid in other programs. An adoption assistance payment shall not exceed the foster care payment received by the foster parents for the child. In order to protect the interests of the child, the local department shall follow the procedures established by the Interstate Compact on Adoption Medical Assistance to facilitate the interstate coordination of benefits. The adoptive parent shall be referred by the local department to the appropriate federal Title XIX and Title XX agencies in their state of residence or tribal service area. The local department shall provide the state of residence or tribal service area with documentation regarding the child’s eligibility for Medicaid and Title XX services as provided by the state of residence, or tribal service area. Death of Adoptive Parents or Dissolution of the Adoption. If a child is receiving IV-E adoption assistance and the adoptive parents die or the parental rights of the adoptive parents are terminated, the adoption assistance may be paid on behalf of the child: In a subsequent adoption; and If the child continues to meet the special needs factor criteria; and The Adoption Assistance Agreement is signed by the Director or designee and the subsequent adoptive parent prior to the finalization of the adoption. Annual Redetermination. A local department shall review a child’s continued eligibility for adoption assistance on an annual basis. The adoptive parent shall notify the local department of circumstances that would make them ineligible for adoption assistance payments or for adoption assistance payments in a different amount. A local department shall send a redetermination packet to the adoptive family at least 90 days prior to the annual renewal due date. At least 60 days prior to the annual renewal due date, an adoptive family shall submit documentation to the local department to enable the department to confirm the child’s continued eligibility for adoption assistance at the current adoption assistance rate. Education, vocational training, and disability documentation for a child younger than 18 years old includes: Proof of routine medical care provided to the child within 6 months prior to the renewal date for the child who is not required to attend school due to age; Proof of enrollment and attendance for the child who is of the age where school attendance is compulsory in the form of: A current report card; Documentation of current participation in a home and hospital educational program approved by the educational agency in the child’s place of residence; or Documentation that the child is currently incapable of attending school on a full-time basis due to a documented medical condition of the child; or Proof of current enrollment in the program and proof of routine medical care provided to the child within 6 months prior to the renewal date for the child who is enrolled in a home school program approved by the educational agency in the child’s place of residence. Education, vocational training, and disability documentation for a child 18 years old or older includes: Documentation of a current mental or physical disability that warrants the continuation of adoption assistance; or If the child began receiving adoption assistance after reaching 16 years of age, documentation of: Enrollment in school; Participation in a program or activity that promotes or reduces barriers to employment; Employment for at least 80 hours per month; or A medical condition due to which the child is incapable of any of these activities. If an adoptive family’s failure to return the required information for renewal to the local department leads the Department to conclude that one of the bases for terminating the adoption assistance as stated in §M of this regulation exists, the local department may terminate the adoption assistance. The family must be given a letter of intended action that contains a statement regarding the right to appeal the determination. Renegotiation of Adoption Assistance. The amount of the adoption assistance may be renegotiated at the request of the adoptive parent or the local department at any time while the adoption assistance agreement is in effect. To assist in the renegotiation process, the local department shall request information from the adoptive family regarding any changes in circumstances that would justify an adjustment in the amount of adoption assistance, such as the child’s entry into out-of-home placement, and such information may include: School reports; Psychological evaluations; Medical reports; Costs and descriptions of services needed for the child, including documentation that services are not covered by the current adoption assistance amount or by medical assistance or community resources; and The amount of the adjustment requested. The renegotiated adoption assistance amount may not exceed the foster care payment the foster parent received when the child was in foster care. Changes in the adoption assistance amount shall be agreed to by the adoptive parent and approved by the Administration. If a child receives other Social Security benefits, such as survivor’s benefits, retirement benefits, or old age benefits, the IV-E monthly adoption assistance payment may not be reduced to reflect receipt of this resource unless the adoptive parent agrees to the reduction. Termination of IV-E Adoption Assistance. IV-E adoption assistance for an adoptive child shall be terminated when the adoptive child is 18 years old unless: The adoptive child who the local department has determined to have a mental or physical disability that warrants the continuation of assistance may continue to receive IV-E adoption assistance until age 21; or The adoptive child who was 16 years old or older when the adoption assistance payments began may continue to receive IV-E adoption assistance until age 21 provided that subsequent to the child’s 18th birthday the child is: The child is completing secondary education or a program leading to an equivalent credential; The child is enrolled in an institution which provides post-secondary or vocational education;; The child is participating in a program or activity designed to promote, or remove barriers to, employment; The child is employed for at least 80 hours per month; or The child is incapable of doing any of the above described activities due to a medical condition. IV-E adoption assistance shall be terminated when: The adoptive parents or the adoptive child dies; The adoptive parent is no longer legally responsible for the child; or The adoptive parent is no longer providing any financial support to the child. At least 30 days before the planned termination, the local department shall send the adoptive parent a notice that includes: The intent to terminate the adoption assistance; The specific regulations providing grounds for termination; and A statement describing the adoptive family’s right to appeal.