441—201.6 (600) Types of subsidy.
	 201.6(1) Special services only.
	  a.   	 Reimbursement to the adoptive family or direct payment made to a provider is suspended from January 1, 2010, to June 30, 2010, for any special services negotiated in that period except for nonrecurring expenses as defined in subparagraph (7).
	 (1) 	 Outpatient counseling or therapy services. Reimbursement for outpatient individual or family services may be provided from a non-Medicaid provider only with approval from the service area manager or designee and when one of the following applies:
	  1. 	 The services are not available from a Medicaid provider within a reasonable distance from the family.
	  2. 	 The child and the family were already receiving therapy or counseling from a non-Medicaid provider and it would not be in the child’s best interest to disrupt the services.
	  3. 	 Available Medicaid providers lack experience in working with foster, adoptive, or blended families.
Reimbursement to non-Medicaid providers shall be limited to the Medicaid rate.
	 (2) 	 Expenses for transportation, lodging, or per diem related to preplacement visits, not to exceed $2000 per family.
	 (3) 	 Medical services not covered by the Medicaid program shall be limited to an additional premium amount due to the child’s special needs to include the child in the family’s health insurance coverage group. An adoption subsidy payment shall not supplement the Medicaid payment rate to a Medicaid provider or a non-Medicaid provider.
	 (4) 	 Child care, if the family has entered into a presubsidy or subsidy agreement on or before June 30, 2004, that contains a provision for child care reimbursement. Child care subsidy payments shall not exceed the maximum rates established in 441—paragraph 170.4(7)“a” for the child’s age and type of care, unless the department grants a waiver under rule 441—1.8(17A,217). Child care services are available through the child care assistance program to families that meet the requirements of 441—Chapter 170.
	 (5) 	 Medical transportation not covered by Medicaid and the family’s lodging and meals, if necessary, when the child is receiving specialized care or the child and family are required to stay overnight as part of a treatment plan.
	 (6) 	 Supplies and equipment as required by the child’s special needs and unavailable through other resources. When a sibling group of three or more are placed together, a one-time-only payment can be made, not to exceed $500 per child. When home modifications have been authorized to accommodate a child’s special needs and the family later sells the house, the family shall repay the department an amount equal to the increase in the equity value of the home attributable to the modifications.
	 (7) 	 Nonrecurring expenses. Payment for nonrecurring expenses is limited to a total of $500 per child for attorney fees, court costs and other related legal expenses. Nonrecurring expenses may be paid when the adoptive family has negotiated an Adoption Subsidy Agreement, Form 470-0747, or an Agreement to Future Adoption Subsidy, Form 470-0762.
	 (8) 	 Funeral benefits at the amount allowed for a foster child in accordance with 441—subrule 156.8(5).
	  b.   	 The need for special services shall be established by a report in the child’s record from the private or public agency which had guardianship of the child, and substantiating information from specialists as defined in rule 441—201.2(600).
	  c.   	 Any single special service and any special service delivered over a 12-month period costing $500 or more shall have prior approval from the central office adoption program manager prior to expending program funds.
	  d.   	 For all Medicaid covered services the department shall reimburse at the same rate and duration as Medicaid as set forth in rule 441—79.1(249A).
	 201.6(2) Maintenance only. A monthly payment to assist with room, board, clothing and spending money may be provided, as determined under rule 441—201.5(600). The child will also be eligible for medical assistance pursuant to 441—Chapter 75.
	 201.6(3) Maintenance and special services. For special needs children, a special services subsidy may also be included when a maintenance subsidy is provided.
[ARC 8451B, IAB 1/13/10, effective 1/1/10]