The Application Of Ohio's Special Needs Categories to IV-E Adoption Assistance
Special Needs is the Rule, Not the Exception
In our last post, I wrote there are essentially two eligibility requirements for Title IV-E Adoption Assistance.
Children must be placed by a public or private agency, unless they they meet one of the disability standards for SSI. (See “The SSI Path to Title IV-E Adoption Assistance,” April 27, 2023).
Children must meet one of the special needs definitions set forth in Ohio Administrative Code (OAC) rule 5101:2-49-03.
Today, I want to explore the application of the term special needs to adoption assistance eligibility. Despite changes in the special needs language in Ohio Administrative Code (OAC) rule 5101:2-49-03 over the years, parents who adopt children from Ohio’s foster care system should expect their child to be considered special needs. For decades, nearly all children adopted from foster care have been defined as special needs. It is also common for infants placed through adoption through private agencies to be considered special needs, if only because their family history indicates a substantial risk for future problems that they may be too young to express.
Some Reasons For Expecting A Child Adopted from Foster Care Will Be Classified as Special Needs
There are a number of possible reasons.
There is a kind of general acknowledgement that children who are placed in foster care and are not reunited with their biological parents suffer significant trauma.
The federal law lists examples of special needs including “(ethnic background, age, or membership in a minority or sibling, the presence of factors such as medical conditions or physical, mental, or emotional handicaps). States may elaborate or modify special needs definitions. But, a state’s special needs definitions may not be more restrictive than the federal guidelines. This principle results in relatively generous interpretation of special needs.
Special needs is a threshold eligibility standard for adoption assistance. The medical, developmental or psychological expression of the child’s special needs can range from relatively moderate to quite severe.
The confirmation that a child qualifies as special needs and is eligible for adoption assistance does not determine the amount of adoption assistance. After a child is deemed eligible, the amount of adoption assistance is supposed to be negotiated, based on the nature and extent of the child’s needs and the family’s circumstances.
The purpose of the federal adoption assistance law is to support permanent families for children who would otherwise remain in foster care. A restrictive application of special needs definitions would undermine the law’s intent.
Medical, Developmental and Psychological Related Special Needs
The special needs language in OAC rule 5101:2-49-03 looks rather formidable at first glance. It resembles Disability standards for Children’s SSI. However, for the reasons discussed above, there is a difference between the description of the special needs categories and their application. As we noted earlier, children don’t emerge from the foster care system unscathed. Nearly every child enters adoptive placement with a problem or family history that meets the practical test for special needs.
When considering the “disability related” special needs in OAC 5101:2-49-03, remember,
The child’s special needs status is well documented by the time a foster child is free for adoption. In most cases, the county agency will have already concluded that the child is special needs and eligible for IV-E Adoption Assistance.
If an agency requests a confirmation from a “qualified” provider, the formal diagnosis of a specific illness or condition is not required by federal law. The description of a behavior pattern, developmental deficit or other problem that poses an obstacle to the child’s success integration into a permanent family should be sufficient.
Other “Situational” Special Needs Categories in Ohio
In addition to the “disability related” special needs, such as medical problems, developmental problems, learning deficits, mental health conditions and “substantial risk” for one of those problems, Ohio has a number of oher special needs categories that might be termed “situational.” Once again, The common criteria is whether the state has determined the special needs definition or category presents an obstacle to a successful adoptive placement.
Take the category of “age”, for example. Ohio has set the age of six or older as a special needs category. The assumption is that there are sufficient families willing and able to adopt children under 6 years of age, children with no other types of special needs. The following are other more situational special needs categories found in OAC 5101:2-49-03.
(a) The child is part of a sibling group being adopted together or is placed in the same adoptive placement of a sibling previously adopted.
(b) The child is a member of a minority, racial or ethnic group making it difficult to place the child for adoption. However, if the child is between the age of newborn and twelve months the child shall be also diagnosed to have one of the conditions outlined in paragraph (A)(2)(g) or (A)(2)(h) of this rule.
(c) The child is six years old or older.
(d) The child has remained in the permanent custody of a PCSA or PCPA for more than one year before an adoptive placement.
(e) The child has been in the home of the prospective adoptive parent(s) for at least six consecutive months directly preceding the adoptive placement and the child would experience severe separation and loss if placed in another setting due to significant ties with the prospective adoptive parent(s). The emotional ties shall be assessed and documented by a qualified mental health professional.
(f) The child has experienced a previous adoption disruption or three or more substitute care placements while in the custody of a PCSA or PCPA.
(h) The child or the child's biological family has a social or medical history establishing a substantial risk for developing one of the conditions as described in paragraph (A)(2)(g) of this rule. The substantial risk makes it difficult to place the child for adoption without the provision of AA. A qualified professional shall determine the substantial risk, as defined in paragraph (B) of this rule. A child is not at substantial risk if the child's biological parent(s) social and medical history cannot be determined.
Thanks, Phil. That has been my experience as well.
Thank you for sharing this “special needs” designation information with all of us, Tim! All too often, “special needs” is being used as category of expenses that agencies use to limit adoption assistance payments. In fact, the “special needs” designation, as you’ve pointed out, is simply the qualification for eligibility for Title IV-E Adoption Assistance. I would be interested to see data on how many adoptive parents in Ohio have been told by public agencies that AA can only be utilized for expenses directly related to “special needs” and also those expenses not already covered by Medicaid coverage. I know that in the five children that I have adopted from foster care that I’ve been told that AA is to be used to meet “special needs” and that typical life needs and family circumstances are not to be considered.