Adoption Assistance Agreement - Minnesota Department Of Human Services (Page 4 of 8) in pdf

e. Respite care (reimbursement limited to a maximum of 504 hours annually at the respite care

rate set by the county social service agency)

A portion of burial expenses, if a child’s special needs result in their death (maximum

reimbursement of $1,000)

g. Camping programs adapted to meet the child’s special needs (reimbursement limited to a

maximum of two weeks of camp per year)

h. Specialized communication equipment prescribed through the public school district, but not

covered by educational, vocational, or other rehabilitation services

Alterations to the family home or vehicle to accommodate a child’s special physical needs

(three itemized estimates of the cost must be submitted with requests to accommodate special

physical needs).

The adoptive parent(s) agrees to obtain written authorization from the Adoption Assistance

Program at least 30 days before making an expenditure for which reimbursement will be sought.

Failure to obtain prior authorization will result in denial of payment for the expense.

The adoptive parent(s) agrees to submit requests for reimbursement of services on a monthly

basis. The state fiscal year ends on June 30. Reimbursement requests for expenditures between

July 1 and June 30 of a given fiscal year must be submitted by August 29 of the subsequent fiscal

year for reimbursement.

Reimbursements are subject to Adoption Assistance Program rules and adoptive parent(s) may be

required to apply for services through their county social service agency before receiving

reimbursement. Eligibility for services from the county social service agency may be considered

in authorizing approvals for reimbursement.

Nonrecurring Adoption Expenses

The commissioner agrees to reimburse the adoptive parent(s) for expenses that are reasonable and

necessary for an adoption to occur, subject to a maximum of $2,000. The expenses must directly relate to

the legal adoption of a child, not be incurred in violation of state or federal law, and not reimbursed from

other sources or funds. Reimbursement requests for these expenses must be received by the Adoption

Assistance Program within 21 months of the date of the final decree of adoption.

Collection of Overpayments

Any adoption assistance paid to the adoptive parent(s) in excess of the payment due is recoverable by the

commissioner, even when the overpayment was caused by agency error or circumstances outside the

responsibility and control of the family or service provider. If it is determined by the commissioner that

an overpayment was made to the adoptive parent(s), the commissioner shall have authority to collect the

overpayment through a mutual agreement with the adoptive parent(s). If this results in an unsuccessful

collection, the commissioner shall have authority to pursue other collection efforts. Adoption assistance

amounts covered by this section include basic maintenance needs payments, monthly supplemental

maintenance needs payments, reimbursement of non-recurring adoption expenses, and reimbursement of

special non-medical costs.

II.

Notification of Change

The adoptive parent(s) agrees to notify the commissioner in writing within 30 days of the following

changes for the duration of this agreement:

•

Change in the family’s address

•

Change in a child’s legal guardian(s)

•

Child’s completion of high school, if this occurs after a child attains age 18

Page 4 of 8

Adoption Assistance Agreement - Minnesota Department Of Human Services Page 4

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