Building Bridges Across State Lines: The Interstate...

Building Bridges Across State Lines: The Interstate Compact on AdoptionThe Interstate Compact on Adoption

and Medical Assistance (ICAMA)

ICAMA Administration TrainingMarch 14, 2016

© Association of Administrators on the Interstate Compact on Adoption and Medical Assistance - AAICAMA

Background: Wh ICAMA d d?Why was ICAMA needed?

In the 1970‐80’s, both states and federal government realized:

F ili f ll ki d i i l bil f ll ki d ―Families of all kinds are increasingly mobile for all kinds of reasons

More children adopted from foster care being placed ―More children adopted from foster care—being placed outside their ‘home’ state or moving with their forever families

―Often these children lost their access to Medicaid in the new state (Because child had to use Medicaid card from AA state)

2Association of Administrators on the Interstate Compact on Adoption and Medical Assistance ‐AAICAMA

Federal Government Enacted 2 Laws to Helpp1980 Adoption Assistance and Child

Welfare Act (P.L. 96‐272)First Law1980 Adoption Assistance and Child Welfare Act(P.L. 96‐272)―Established a federal Adoption Assistance program

under title IV E of the Social Security Act under title IV‐E of the Social Security Act AND Mandated that states safeguard children’s ―Mandated that states safeguard children s interests in interstate situations. Sect. 475 (3) (B) stipulates:

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stipulates:

Association of Administrators on the Interstate Compact on Adoption and Medical Assistance ‐AAICAMA

Federal Government Enacted 2 Laws to Helpp

‘…the agreement shall remain in effect regardless of the State of which the adoptive parents are

id i i A h ll residents at any given time. Agreement shall contain provisions for the protection (under an

interstate compact approved by the Secretary) of the interests interstate compact approved by the Secretary) of the interests of the child in cases where the adoptive parents and child move to another State while the agreement is effective.Link: http://www.ssa.gov/OP_Home/ssact/title04/0475.htm


Federal Government Enacted 2 Laws to Helpp1985 Consolidated Omnibus Budget Reconciliation Act (COBRA)

Second Law1985 Consolidated Omnibus Budget Reconciliation A (COBRA) i d i i i b

( )

Act (COBRA) contained 2 important provisions about Medicaid



― Mandated that Medicaid for title IV‐E eligible*

( )

children be provided by the child’s state of residence

DAND― Gave states the option of providing Medicaid to

hild i i g t t f d d (i IV E ) AAchildren receiving state‐funded (i.e., non IV‐E ) AA.

*foster care and Adoption Assistance (AA)

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*foster care and Adoption Assistance (AA)



Title IV‐E eligible children would now receive Medi id e i e f o the t te he e the li ed

( )

Medicaid services from the state where they lived but……COBRA legislation did NOT provide any mechanismto make this happen


Enter the ICAMA!!!ICAMA!!!

The Interstate Compact on Adoption and Medical Assistance was written.

In 1986: ―13 states enabled the ICAMA 3―Formed AAICAMA (our association ♥)―Received a grant from the Children’s Bureau to work Received a grant from the Children s Bureau to work

with the remaining 38 states to enable the compact


Interstate Compact on Adoption d M di l A i tand Medical Assistance

ICAMA provides the legal and administrative framework and structure to meet mandates of PL 96‐272 for AA‐eligible children in 49 states*.

*New York is an Associate Member of AAICAMA; Wyoming is the only non-member state

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Both abide by ICAMA processes and use ICAMA forms.


Interstate Compactsp

A i t t t t iAn interstate compact is:

― an agreement between 2 or more states that bi d th t th t i ibind them to the compact provisions.

― enacted into state law and has the force of law d b h iamong and between the enacting states.

―supersedes any conflicting state laws.

THEREFORE:



The ICAMA

―is an agreement among 49 signatory states g g g y

― binds these states to the compact provisions

is state law in 49 states ― is state law in 49 states

―has the force of law among 49 states

―supersedes any conflicting state laws



ICAMA —Article IIPurpose

a) Strengthen protections for the interests of children with special needs on behalf of whom adoption assistance is committed to be paid when such children are in or move committed to be paid, when such children are in or move to states other than the one committed to provide adoption assistance.

b) Provide substantive assurances and operating procedures which will promote the delivery of medical and other services to children on an interstate basis thru and other services to children on an interstate basis thru adoption assistance programs established by the laws the states which are parties to this Compact.*

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*ICAMA forms and processes Association of Administrators on the Interstate Compact on Adoption and Medical Assistance ‐AAICAMA


The ICAMA applies hen:Application

The ICAMA applies when:—There is an adoption assistance or IV‐E GAP

agreement in effect agreement in effect AND

—ONE of the following is true:g• Child moves with family to another state while

the agreement is in effect.or• Child is initially placed for adoption with a

family in another state

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family in another state.Association of Administrators on the Interstate Compact on Adoption and Medical Assistance ‐AAICAMA


Application

ICAMA facilitates Medicaid provision

—only for children with active adoption assistance or title IV‐E GAP agreements

AND

—only in interstate cases



Work

How does the ICAMA meet its purposes?

Through 2 key resources:Through 2 key resources:1. The day‐to‐day work is done by ICAMA

Professionals in every state. (Hurrah!!).y ( )

2. Via use of ICAMA’s standard Forms and procedures .

Under the Compact, use of uniform ICAMA forms and procedures is a lawful obligation for all states.



ICAMA Professionals

ICAMA professionals are at the center of the work of the compact.

They accomplish the purposes of ICAMA everyday by working closely with:

―State and local colleagues across the country

d i f ili―Adoptive families

―AAICAMA and secretariat staff



ICAMA Professionals

Every day, ICAMA professionals use standard forms to ensure that children living outside the AA/GAP state

i i t t d i ICAMA t ff receive uninterrupted services. ICAMA staff :

―Exchange information on AA/GAP children placed/moving to a new state using the standard form/processes

―Provide the residence state complete and accurate AA/GAP eligibility information to facilitate Medicaid

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receipt in the new stateAssociation of Administrators on the Interstate Compact on Adoption and Medical Assistance ‐AAICAMA


ICAMA Professionals―Ensure proper documentation (agreement) is

attached

―Sign the ICAMA form (which IS a legal document) to certify that information is accurate and eligibility meets federal requirements.



ICAMA ProfessionalsDo not hesitate to contact their colleagues to clarify,

coordinate or check on information …

(Sometimes there’s no substitute for a phone call)


ICAMA 702 Form7

Working with Families

ICAMA 7.02 is a cover letter to parents or guardians that informs parents that an ICAMA 7.00 was sent to R id * d idResidence state* and provides:

―Basis of the child’s eligibility for Medicaid ( l / f d d )(i.e., title IV‐E AA/GAP or state‐funded AA)

―The implications of this eligibility on the child’s receipt of Medicaid in the new state

*Parents also receive a copy of the 7.00 for their records


ICAMA 702 Form7


―Names of states that don’t extend COBRA‐reciprocity (Medicaid) to state‐funded AA children

―Reminder that it may take some time before a Medicaid card is received but child is eligible to

d d b f h d dreceive Medicaid services before the card is received

―State contact information for the parents/guardian


ICAMA 702 (a)7 ( )


ICAMA 7.02(a) offers helpful information and tips for parents adopting or moving interstate

Examples :• notify adoption worker as soon as a move is plannedh f hild’ AA GAP t • have a copy of child’s AA or GAP agreement •what to do if a need for emergency medical care arises before a Medicaid card is issued• understand that Medicaid services are different in each state• see the AAICAMA website for additional information


ICAMA 702 and 702 (a)7 7 ( )


These forms are both available in Spanish.

To download a copy of the 702 and 702(a) go to: py ( ) ghttp://www.aaicama.org


Association of Administrators of the Interstate Compact on Adoption and Medical AssistanceCompact on Adoption and Medical Assistance

AAICAMA

AAICAMA’s Mission: To facilitate and improve the padministration of the ICAMA; and to promote sound adoption policy and train ICAMA professionals


Association of Administrators of the Interstate Compact on Adoption and Medical AssistanceCompact on Adoption and Medical Assistance

AAICAMA

Interstate Services Education

AAICAMA’s Services:

Mediation /FacilitationTechnical Assistance

Legal/policy guidance

ICAMA Administration TrainingMedicaid TrainingAll‐state TeleconferencesLegal/policy guidance

Effective practicesResearch

f f d l l l

AAICAMA Website Annual Meetings

Impact of federal law & policyState AA Page Updates


Remember:ICAMA Professionals

The heart of the ICAMA process is a The heart of the ICAMA process is a child with special needs


A Child with Special Needs…p

ICAMA Professionals…often has multiple health issues and needs Medicaid quickly.

…depends on their adoptive parents to obtain the critically needed medical services they often need.

…depends on the work you do everyday to help to ensure the success and stability of their forever f ilifamilies.


Building Bridges Across State Lines: The Interstate...

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