Ohio's Post Adoption Special Services Subsidy or PASSS Program
The integration of PASSS with other sources of support
The PASSS Program
The Post Adoption Special Services Subsidy or PASSS program was the established in 1989, if memory serves. Adoptive family support groups from the Cincinnati area played an important advocacy role in bringing the needs for post adoptive services to the attention of the State.
Federal legislation initially envisioned the Title XX program as a source of social services for children who were eligible for Title IV-E Adoption, complementing the monthly adoption assistance payment and access to health care through Medicaid. Children who qualified for IV-E Adoption Assistance were automatically eligible for Title XX as well as Medicaid.
But Congress reformulated Title XX into a block grant and funding was quickly exhausted. I have never encountered an adoptive parent who has been able to receive services through Title XX. PASSS was established to help fund medical, mental health and other services for special needs children after they were adopted.
The state ran the program in its early years. Then it was administered by individual Ohio counties on the basis of the child and family’s residence. In 2022, PASSS was incorporated into Ohio KAN (the Ohio Kinship and Adoption Navigator), which is part of the Ohio Department of Job and Family Services (ODJFS). Ohio KAN is organized to provide support and connections to services for Kinship and Adoptive families.
Ohio PASSS regulations at OAC 5101:2-44-13 and 5101:2-44-13.1 were amended to reflect the return of the program to the state. A separate section on the Ohio KANS web site is devoted to PASSS. Adoptive parents can use the site to apply online or to download application forms.
PASSS Funding
The Ohio General Assembly appropriates a finite amount PASSS funding for each State Fiscal Year (SFY) that begins on July 1 and extends through June 30. PASSS funding for the current fiscal year is $4,165,042.00. The Ohio House Budget Bill for SFY 2024/25 (HB 33), sets aside $6,150,000 for PASSS in the upcoming State Fiscal Year beginning on July 1, 2023.
PASSS applicants may receive a maximum of $10,000 in assistance per fiscal year, unless one of the following special circumstances exists.
(1) The family's income and resources substantially decreased due to the involuntary loss of employment and the family has completed the JFS 01051 "Application for Additional Post Adoption Special Services Subsidy (PASSS) Funding for Extraordinary Circumstances."
(2) A qualified professional as described in paragraph (F)(1) of this rule recommends residential treatment, in-patient hospitalization, or therapeutic foster care to prevent disruption of the adoption. This recommendation is to be submitted along with a copy of the JFS 01051.
In such cases, an adoptive family may qualify for an additional $5,000. (See OAC 5101:2-44-13.1 (O).
NOTE: If the adoptive parents retain custody of a child who is temporarily placed in therapeutic foster care, they may also request an amendment to the existing adoption assistance agreement to negotiate a higher adoption assistance payment, commensurate with their child’s level of care.
PASSS and Adoption Assistance
Adoption Assistance as a federal IV-E program is, in essence, a pre-adoptive plan of in support of incorporating a child into a permanent family. Written agreements for monthly payments are negotiated prior to the final decree of adoption.
PASSS is a state post adoption program that is designed to supplement adoption assistance by funding medical, mental health and other services related to the adopted child’s special needs.
Adoptive parents cannot apply for PASSS prior to finalization of the adoption. PASSS funding should not play any part in the negotiation of adoption assistance payments because agencies cannot guarantee that PASSS funds will be available after the child is adopted. Accordingly, adoptive parents should not accept the possibility of PASSS funds as a replacement for, or alternative to, adoption assistance payments. PASSS is designed to function as complementary source of support, in addition to adoption assistance payments, to cover adopted children’s service needs.
The Importance of Dialogue with OhioKAN Staff
Paragraph (D) of OAC 5101:2-44-13 specifies
OhioKAN staff are to work with the adoptive family to provide assistance to the adoptive parent(s) in exploring other sources of support and services for the child prior to forwarding the application and accompanying documentation to ODJFS.
Exploring “other sources of support” can mean one of two things:
Adoption Assistance or “other sources of support.” A strategy for reducing adoption assistance. At its worst, other services are presented as alternatives to adoption assistance, without regard to their availability or relevance.
Adoption Assistance and “other sources of support.” An attempt to inform adoptive parents about types of services in addition to PASSS that might be available through other programs or agencies that are not limited to adopted children.
According to Karen McGormley of ODJFS’ Office of Children and Families,
when the state took over and developed the program with OhioKAN being the front door, we wanted to not just process PASSS applications, but wanted to also make sure families are aware of any other programs they/the child might be eligible for in addition to PASSS.
Karen McGormley continues to be a vital and trusted information source for me. I have every confidence in her commitment to developing a stronger and better coordinated network of support for Ohio’s adopted children and children in kinship care.
It is important to remember, however, that rules written for a large population often do not speak directly to a family’s specific situation. Rules must be interpreted and adoptive parents can affect OhioKANS’ interpretation of PASSS rules by presenting their children’s problems and the types of treatments or therapists best suited to effectively deal with those problems.
Example. The Role of Medicaid in the PASSS Program
The role of Medicaid in the PASSS program provides a good example of the need for dialogue between the adoptive parents and OhioKAN staff.
Paragraph M of OAC 5101:2-44-13 states, “PASSS funds are not to supplant medicaid funding if the child is eligible for coverage under the medicaid program”. Paragraph N, however, provides exceptions to the reliance on Medicaid. It says,
ODJFS may consider approving services requested under the following conditions:
(1) The child is not eligible for medicaid.
(2) The service recommended by a qualified professional for the child's treatment is not a covered service under medicaid.
(3) The service requested by the family is not covered under the family's insurance.
(4) The provider of the recommended service does not accept medicaid or is not covered by the family's insurance.
The use of Medicaid services and providers is a particularly tricky area especially when it comes to mental health services. Adoptive parents can help shape the direction of the PASSS program by acquainting OhioKAN staff with their specific problems and situations. At the same time parents can become more powerful advocates for their children by citing problems they experience in relying on Medicaid to cover their child’s mental health treatment. Here are a few examples, where a dialogue between adoptive parents and OhioKAN staff can serve as vehicle for continuous improvement in the PASSS program.
Let’s say an adopted child is reaching adolescence and is experiencing mental health problems that are exacerbated by adoption related identity issues. The adoptive parents have identified a therapist who specializes in the treatment of the type of crisis afflicting their child. This therapist does not accept Medicaid. Should the child be eligible for PASSS funding, if other therapists who accept Medicaid are available, but have less expertise and experience in treating their child’s type of problem?
What if Medicaid covers the needed services, but does not cover the recommended frequency or duration of the service? What is the role of PASSS in this case?
What if a qualified therapist who accepts Medicaid is much farther away from the adoptive family than a qualified therapist who does not accept Medicaid. Given the intensity of the recommended treatment a parent and child would have to drive hundreds of miles a week, to appointments with the Medicaid provider. What is the role of PASSS in this case?
NOTE: PASSS funds may be used to pay deductibles on services provided through health care policies if it more cost effective to do so. See OAC 5101:2-44-13.1 (T).
Appealing PASSS Decisions
Adoptive parents may appeal denials of PASSS funding by requesting a state hearing. The written denial should include an explanation of hearing rights. At this point, I am not sure if adoptive parents can request mediation to try and resolve existing disagreements prior to a hearing. I will let you know when I find out.