Definitions of Terms
Adoption Assistance is financial assistance provided to the adoptive parents to assist in meeting the adopted child’s special needs.
Adoption Assistance Agreement is an agreement between the adoptive parents and a state, agency, or subdivision thereof, in accordance with which the adoptive parents are to receive financial assistance and services on behalf of a child with special needs.
Adoption Assistance State is the state that is the signatory to an Adoption Assistance Agreement on behalf of a particular child.
Adoptive Parents is either the singular or plural of the word “adoptive parent.”
Certification is the guarantee, as stated on the Notice of Medicaid Eligibility/Case Activation (Form 6.01) from the Compact Administrator of the Adoption Assistance State, that the attached Adoption Assistance Agreement is a true copy of the Agreement which is current and in effect.
Child with Special Needs is a child on whose behalf adoption assistance payments are being made to facilitate and maintain an adoption. A child with special needs is a child for whom a state has determined that they cannot return home and who has specific factors or conditions which make them hard to place. These factors or conditions include age, race, sibling groups, and physical, mental, and emotional disabilities. Before a child is considered a child with special needs, there must have been a reasonable effort made to place the child without adoption assistance, except for those children who are being adopted by foster parents with whom they have bonded.
COBRA is the Consolidated Omnibus Budget Reconciliation Act of 1985. COBRA mandates that children receiving title IV-E adoption assistance payments are categorically eligible to receive Medicaid in the state of residence.
COBRA Option is the provision in COBRA that allows states to provide Medicaid coverage for non-IV-E children who have special needs and are receiving state funded adoption assistance. In order for a child to be eligible for the COBRA option, the child must have a special medical or rehabilitative need, which is specified in the Adoption Assistance Agreement.
Compact Administrator is the person or persons in a state who have been designated as having responsibility for the administration of ICAMA.
EPSDT is the Early Periodic Screening, Diagnostic, and Treatment (EPSDT) Program is the child health component of Medicaid. It's required in every state and is designed to improve the health of low-income children, by financing appropriate and necessary services.
Fair Hearing is a legal, administrative procedure that provides a forum to address disagreements with agency decisions. The types of situations which would constitute grounds for a fair hearing include: (a) relevant facts regarding the child, the birth family, or child’s background were known and not presented to the adoptive parents prior to the legalization of the adoption; (b) denial of assistance which was based on a means test of the adoptive parents; (c) erroneous determination by the state that a child is ineligible for adoption assistance; and (d) failure by the state agency to advise adoptive parents of the availability of adoption assistance.
Medicaid Identification Document is a Medicaid Card.
Party State is a state that is a member of the Interstate Compact on Adoption and Medical Assistance.
Resident State is the state in which the child lives.
Third Party Insurance is any health insurance, other than Medicaid, the adoptive parents have that provides coverage for the adopted child.
Title IV-E is a federal funding source for a child who meets eligibility requirements.