830 ELIGIBILITY UNDER STATE-ONLY ADOPTION ASSISTANCE AGREEMENT
The state-only adoption assistance program is administered by the Office of Children's Services (OCS) and funded entirely by the State. Eligibility for the program is determined by OCS with financial eligibility for the Under 21 Medicaid category determined by DPA.
An individual under 18 with special medical or rehabilitative needs who has a state-only adoption agreement in effect, and who is not eligible for Title IV-E adoption assistance, is eligible for Medicaid if, immediately prior to execution of the adoption assistance agreement, the child:
1) Received Medicaid from any state or would have been eligible to receive Medicaid under any existing Alaska Medicaid eligibility category, if application had been made; or
2) Would have been eligible to receive Medicaid if the filing unit rules and income eligibility standards for Title IV-E Foster Care had been used (the child does not have to be in Title IV-E Foster Care).
The child must also meet the Medicaid requirements of enumeration, assignment of rights, citizenship or legal alien status, and Citizenship Status Declaration (CSD).
Pregnant Women: For OCS reporting purposes, it is preferable for children who are also of an age to qualify for Denali KidCare, to receive Medicaid under the state-only adoption assistance category.
830 A. INITIAL APPLICATION AND ELIGIBILITY DECISION
Children who are eligible to receive Medicaid because they receive a subsidy under a state-only adoption assistance agreement will usually be receiving Medicaid already under another subtype, such as Juvenile Court Ordered (JC). However, occasionally a child will not be a Medicaid recipient when the adoption agreement is being finalized. Follow these procedures for the applicable circumstance:
1) Non-recipient child: OCS Adoption Assistance Coordinator submits a GEN 33 to the OCS eligibility caseworker with a memo verifying a pending adoption assistance agreement. The caseworker determines eligibility for any category of Medicaid. If eligible regardless of state-only adoption status, the caseworker opens the case using the appropriate Medicaid subtype and eligibility code, and requests a copy of the signed adoption assistance agreement.
If the child is not eligible under another eligibility category, the caseworker may then determine eligibility using the filing unit rules and income eligibility standards for Title IV-E Foster Care. However, do not apply the Title IV-E Foster Care income eligibility test. Send the appropriate notice (denial or request for adoption assistance agreement) to the adoption program coordinator at the address listed below. Do not authorize benefits until the adoption assistance agreement is final.
2) Recipient child: OCS will provide the eligibility caseworker with a copy of the signed adoption assistance agreement. The caseworker must make the EIS changes as outlined below in the EIS Information section.
Once OCS has applied for the child under the State-Only Adoption Assistance eligibility category or a child has been converted to this category, all correspondence regarding Medicaid eligibility must be mailed to:
Adoption Program Coordinator
Office of Children's Services
PO Box 110630
Juneau, AK 99811-0630
Medicaid benefits must also be mailed to the adoptive parents by entering the adoptive parent's address information.
No child should be placed in this eligibility category until the signed adoption assistance agreement has been received. If Medicaid is approved but a signed adoption assistance agreement is not received, the child may continue to receive Medicaid using the eligibility rules for any other appropriate Medicaid coverage.
The child's name must be changed on the system if the adoption has resulted in a name change. Also, the MERI screen must reflect any insurance coverage the child may now have available through the adoptive parents.
Like Title IV-E Adoption Assistance cases, state-only adoption assistance Medicaid cases must be renewed at least annually. State-only cases must be renewed by August 31 of each year. A renewal form (GEN 33A or GEN 72) is NOT required.
By July 31 of each year, the OCS Adoption Program Coordinator must submit a list of children receiving state-only adoption assistance and provide for each child:
1) Adoption assistance agreement effective through date;
2) Physical location;
3) Medical insurance information; and
4) Child's Social Security Number.
When this list is received from OCS, the caseworker must recertify Medicaid eligibility for each child whose adoption assistance agreement is still in effect and whose residence and medical insurance information is complete. The caseworker then authorizes ongoing Medicaid and sets the review date to the next August 31 and sends a notice to the OCS Adoption Program Coordinator, informing him/her that Medicaid eligibility continues for the child.
Changes: OCS is responsible for notifying the ET between renewal periods if a state-only adoption assistance agreement child has a change in status that affects eligibility for Medicaid assistance, including a change of name or address of the child or a change in the medical insurance available to the child. Changes in income are not relevant to this category.
Residence: If a child leaves Alaska, the state-only adoption subsidy will follow the child, but the Medicaid eligibility in Alaska must be terminated. If the child moves to a state that offers Medicaid for state-only subsidized adoption cases as part of its Medicaid State Plan, the child should apply for Medicaid in that state. If a child receiving Medicaid through state-only adoption assistance agreement from another state moves to Alaska, the child may be eligible for Medicaid in Alaska.
Subsidized adoptions (Title IV-E and state-only) originating outside of Alaska do not involve OCS , so the adoptive parent is responsible for applying for Medicaid coverage for the child. Coverage is subject to proper notification and verification of the adoption assistance agreement from the state providing the subsidy.
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