NORTH CAROLINA ADOPTION ASSISTANCE AGREEMENTAdoption Assistance Agreement • July 30th, 2024
VIRGINIA ADOPTION ASSISTANCE AGREEMENTAdoption Assistance Agreement • June 19th, 2018
This child has the following special needs documented by a qualified professional and established by the local department. Diagnoses listed on the agreement must match what's listed on the application.
DATE: 11/30/2009 4:27 PMAdoption Assistance Agreement • June 18th, 2024
DATE: 05/19/2014 8:47 AMAdoption Assistance Agreement • July 18th, 2024
ADOPTION ASSISTANCE AGREEMENT Child’s Name: ________________ DOB: _________Adoption Assistance Agreement • November 7th, 2020
This agreement is being executed on this date, prior to the finalization of the adoption, for the purpose of adoption assistance and/or medical services for the said child under the provisions of the Social Security Act and the Kansas adoption assistance law. This agreement is supplemental to an adoption placement agreement.
94947 Tennessee Department of Children’s Services Adoption Assistance AgreementAdoption Assistance Agreement • September 4th, 2020
ADOPTION ASSISTANCE AGREEMENTAdoption Assistance Agreement • August 17th, 2005
The following agreement has been entered into by and between the Department of Children and Family Services, hereinafter called “the Department,” and
COMMONWEALTH OF KENTUCKY CABINET FOR HEALTH AND FAMILY SERVICES DEPARTMENT FOR COMMUNITY BASED SERVICES ADOPTION ASSISTANCE AGREEMENTAdoption Assistance Agreement • December 25th, 2020
THIS AGREEMENT, made and entered into as of the day of , 20 by and between the Commonwealth of Kentucky, Cabinet for Health and Family Services, Department for Community Based Services, hereinafter referred to as the Cabinet, and
INTRODUCTIONAdoption Assistance Agreement • May 5th, 2020
Adoption assistance and adoption medical subsidy agreements expire on the child’s 18th birthday. The expiration of the agreement causes payments to end and subsidy-related Medicaid to close at
DATE: 09/08/2006 10:23 AMAdoption Assistance Agreement • December 21st, 2023
Adoption Assistance Agreement:Adoption Assistance Agreement • June 14th, 2022
Heartland for Children has a Post Adoption Services worker that is available to assist adoptive parents. It is vital if an adoptive family feels they may need counseling or other service for their family, they contact the post adoptions worker to discuss and
ContractAdoption Assistance Agreement • October 5th, 2022
RCW 74.13A.120 Interstate agreements for adoption of children with special needs—Medical assistance for children residing in this state—Penalty for fraudulent claims. (1) A child with special needs who resides in this state and is the subject of an adoption assistance agreement with another state is entitled to receive a medical assistance identification card from this state upon the filing with the department of a certified copy of the adoption assistance agreement obtained from the adoption assistance state. In accordance with regulations of the medical assistance administration, the adoptive parents are required at least annually to show that the agreement is still in force or has been renewed.
DATE: 03/14/2014 2:26 PMAdoption Assistance Agreement • September 13th, 2023
ContractAdoption Assistance Agreement • May 29th, 2012
ACF U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children, Youth and Families Administration for Children and Families 1. Log No: ACYF-PI-83-08 2. Issuance Date: August 10, 1983 3. Originating Office: Children's Bureau 4. Key Words: Adoption Assistance Agreements Entered Into, On or AfterOctober 1, 1983
DATE: 11/30/2009 4:27 PMAdoption Assistance Agreement • May 26th, 2023
Effective 9/1/2022Adoption Assistance Agreement • September 1st, 2022
ContractAdoption Assistance Agreement • August 24th, 2019
DATE: 12/12/2017 9:52 AMAdoption Assistance Agreement • June 29th, 2018
CASE OPENINGAdoption Assistance Agreement • December 19th, 2022
The adoption worker is responsible for informing the Adoption and Guardianship Assistance Office (AGAO) of the child’s adoptive placement immediately after the PCA 320, Order Placing Child After Consent has been signed. Adoption assistance, nonrecurring adoption expenses, and/or adoption medical subsidy case opening is processed when all of the following have been completed:
ADOPTION ASSISTANCE PROGRAM (AAP) AGREEMENTAdoption Assistance Agreement • November 8th, 2022
NOTICE: This agreement describes the adoption assistance benefit that you will receive for your adopted child. If you agree, please sign the agreement and return it to the adoption agency. If you disagree, please contact the adoption agency. If you and the agency cannot reach an agreement, you will receive a Notice of Action which explains how to request a state hearing to resolve the matter.
CHILDREN AND FAMILIES AND ADOPTIVE PARENTS REGARDING SUBSIDY ADOPTION ASSISTANCE AGREEMENT BETWEEN THE DEPARTMENT OFAdoption Assistance Agreement • January 2nd, 2019
Commented [AJ1]: #1 CHANGE: Please look at the table layout in the current template versus this new template design document; the table columns, etc. have changed andneed adjustments to match this draft. Commented [AJ2]: #2 User selected check box. Commented [AJ3]: #3 ADD: User selected check box. IMPORTANT NOTE: By not having this pre-fill, which would require a change to the page, the user could technically check both boxes; check boxes on the templatethat are user selected to not disable if one is selected. Commented [AJ4]: #4 User entered text field on the template; does not pre-fill from anywhere. Commented [AJ5]: #5 Pre-fills from the Effective Date field on the Adoption Subsidy Agreement Information page. Commented [AJ6]: #6 CHANGE: Change Name of Adoptive Father to Name of Prospective Parent 1, but it will still pre-fill from the Father field since it is not an MVP storyfor the existing AAA page. Commented [AJ7]: #7 CHANGE: Change Name of Adoptive Mother to Name of Prospective
DATE: 03/14/2014 2:41 PMAdoption Assistance Agreement • September 9th, 2021
E AND R AMENDMENTS TO LB 1062Adoption Assistance Agreement • March 27th, 2012
Effective 5/3/2023Adoption Assistance Agreement • May 3rd, 2023
26B-3-141 Medical assistance from division or Department of Workforce Services and compliance under adoption assistance interstate compact -- Penalty for fraudulent claim.
October 2009 VOLUME VII, SECTION III, CHAPTER C Section 8- Page iAdoption Assistance Agreement • May 5th, 2020
NON-RECURRING ADOPTION ASSISTANCE AGREEMENTAdoption Assistance Agreement • November 2nd, 2012
This adoption assistance agreement, effective on (MMDDYY), by and between the Kansas Department for Children and Families, (hereinafter referred to as DCF),
ADOPTION ASSISTANCEAdoption Assistance Agreement • September 13th, 2013
ADDENDUM TO THE ADOPTION ASSISTANCE AGREEMENTAdoption Assistance Agreement • October 4th, 2017
This addendum is to be used in conjunction with the Virginia Adoption Assistance Agreement that was effective on between , the local department, and, , adoptive parent(s).
COMMONWEALTH OF KENTUCKY CABINET FOR HEALTH AND FAMILY SERVICES DEPARTMENT FOR COMMUNITY BASED SERVICES ADOPTION ASSISTANCE AGREEMENT NON-RECURRING ADOPTION EXPENSESAdoption Assistance Agreement • January 6th, 2021
THIS AGREEMENT, made and entered into as of the 1st day of , 2 , by and between the Commonwealth of Kentucky, Cabinet for Health and Family Services, Department for Community Based Services, hereinafter referred to as the Cabinet, and
Adoption Assistance Agreement Amendment Payment Reduction / TerminationAdoption Assistance Agreement • June 20th, 2016
This amendment to the original Adoption Assistance Agreement, DCF-F-CFS0074-E, is entered into by and between the Department of Children and Families, Division of Safety and Permanence (hereinafter called the department),
Tennessee Department of Children’s Services Adoption Assistance Agreement Title IV-E Fostering Connections, Effective on or after January 1, 2023 for Youth 16 or olderAdoption Assistance Agreement • December 29th, 2022
Adoptive Parent Last Name: Adoptive Parent First Name: Adoptive Parent Address: Adoptive Parent Email Address: Adoptive Parent Phone Number:
ADOPTION ASSISTANCE AGREEMENT BETWEEN THE DEPARTMENT OF CHILDREN AND FAMILIES AND ADOPTIVE PARENTS REGARDING SUBSIDY PAYMENTS AND SERVICESAdoption Assistance Agreement • December 6th, 2020
Type and Amount of Subsidy / Service Medicaid Non-Recurring Adoption Expenses Projected Costs Reason for Medical Subsidy
259A.35 TERMINATION OF AGREEMENT.Adoption Assistance Agreement • October 12th, 2022
Subdivision 1. Reasons for termination. (a) An adoption assistance agreement shall terminate in any of the following circumstances:
Adoption Assistance Agreement for State Funded Subsidy PaymentsAdoption Assistance Agreement • March 9th, 2015
ADOPTION ASSISTANCE AGREEMENT BETWEEN THE DEPARTMENT OF CHILDREN AND FAMILIES AND ADOPTIVE PARENTS REGARDING SUBSIDY PAYMENTS AND SERVICESAdoption Assistance Agreement • November 25th, 2020
Type and Amount of Subsidy / Service Maintenance: IV-E $ Maintenance: NON IV-E $ Maintenance: IV-E $ MEDICAID ONLY Maintenance: NON IV-E $ MEDICAID ONLY TANF $ Medical Assistance $ Medicaid? Non-Recurring Adoption Expenses Projected Cost Reason for Medical Assistance
