Title IV-E is a section of the Social Security Act, which addresses federal payments for foster care and adoption assistance. In Alaska, the Office of Children's Services Division (OCS) determines a child's eligibility for Title IV-E Foster Care and Title IV-E Adoption Assistance. OCS is responsible for making sure a child meets all criteria before being enrolled as a Title IV-E recipient, and the financial determination that is based on AFDC policy in effect on July 16, 1996. The rules for determining Title IV-E eligibility are found in the AFDC Manual Section 395.



The State of Alaska may approve tribal entities to access Title IV-E funding to pay for foster care in tribally licensed homes. Below are a list of tribes in Alaska authorized to determine a tribal foster child's eligibility for Title IV-E funding;

 Cook Inlet Tribal Council, Inc.
 Central Council of the Tlingit and Haida Indian Tribes of Alaska
 Tanana Chiefs Conference
 Association Village Council Presidents
 Maniilaq Association
 Aleutian Pribilof Islands Association, Inc.
 Kawerak, Inc.
 Bristol Bay Native Association
 Nome Eskimo Community (MOU w/Kawerak 2006)
 Orutsaramiut Native Council

Children for whom a Title IV-E adoption assistance agreement is in effect and children who receive Title IV-E foster care payments are eligible for Medicaid if they meet the Medicaid requirements of enumeration, assignment of rights, U.S. citizenship or qualified alien status, and Citizenship Status Declaration (CSD).


A child in a state-only adoption assistance agreement (not a Title IV-E adoption assistance agreement) may be eligible for Medicaid. See section 830.





Title IV-E Adoption Assistance: This group includes all children for whom a Title IV-E subsidized adoption agreement is in effect, whether or not an adoption assistance payment is being made or a judicial decree of adoption has been issued.


Title IV-E Foster Care: This group includes all children who receive Title IV-E foster care maintenance payments.



829 B.         RESIDENCY


The state of residence for these children is the state where the child lives, even if the adoption assistance agreement or foster care payment originates from another state. Verification of Title IV-E eligibility from the originating state may be provided by the foster or adoptive parents or by the originating state's Title IV-E agency. If a child in the custody of OCS is not Title IV-E eligible and the child is placed out of state in a foster home or institution, that child remains a resident of Alaska for Medicaid purposes.





OCS administers the Title IV-E program in Alaska and is responsible for applying for and processing Medicaid for these children, cooperating with CSSD, for those Title IV-E subsidized adoption and foster care cases under their jurisdiction, including foster care cases originating out-of-state. Foster care cases originating out of state will be handled by OCS under the terms of the Interstate Compact on the Placement of Children (ICPC) agreement. OCS will also apply for and process Medicaid for children with Title IV-E assistance who are not incarcerated but under the guardianship of DJJ. If the child is incarcerated, follow manual section 815 D (1).


For children under Title IV-E and state-only adoption assistance agreements originating in other states, the adoptive parents are responsible for applying and providing necessary information and verifications from the other state, including a copy of the adoption assistance agreement. Application would be made on the Gen 50C, but the parental income would not be considered.





Title IV-E adoption assistance cases must be renewed at least once every 12 months. A renewal is not required; verification that the adoption assistance agreement remains in effect is considered sufficient. Foster Care cases are renewed every 6 months along with the OCS Title IV-B case renewal.


The social worker is responsible for notifying the OCS eligibility caseworker between renewal periods if a Title IV-E Foster Care or Title IV-E Adoption Assistance child has a change in status that affects the child's eligibility for Title IV-E assistance.





Occasionally a Title IV-E Foster Care child will become a Title IV-E Adoption Assistance child. When this occurs, the OCS regional IV-E designee will inform the ET of the change in status. The Adoption Coordinator supplies a copy of the subsidized adoption agreement. (The adoption does not need to be final for the child's status to change; a signed adoption agreement in effect is all that is required.)


The ET must take action to:









Title IV-E foster care cases should have the local OCS office's mailing address entered in the eligibility system so they will receive all notices and renewals. Upon request, Medicaid coupons may also be mailed to the foster parents.


Title IV-E adoption assistance cases will use the OCS central office address:


Office of Children's Services

Adoption Program Coordinator

PO Box 110630

Juneau, Alaska 99811-0630



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MC #10 (09/19)