FAQ’s about Adoption Assistance or Subsidy

How does South Carolina define special needs to determine eligibility?

A child is considered to be special needs if the child is legally free for adoption, and reasonable but unsuccessful efforts have been made to place the child without subsidy except where it would be against the child’s best interest because of significant emotional ties with foster parents. The child must also meet one or more of the following criteria:

  • Is African American or of blended racial heritage and six years or older
  • Is Caucasian and 10 years of age or older
  • Is African American or of blended racial heritage and a member of a sibling group of two or more children, one of whom is at least six years of age
  • Is African American or of blended racial heritage and a member of a sibling group of three or more children of any age
  • Is Caucasian and a member of a sibling group or three or more children, one of whom is at least six years of age
  • Is Caucasian and a member of a sibling group of four or more children of any age
  • Is a member of a sibling group that includes a child with special needs under this definition
  • Has a physical, mental, or emotional disability
  • Is at risk of developing a physical, mental, or emotional disability due to a condition existing before adoption

Does the state-only funded adoption assistance program differ in any way from the Title IV-E program?

No, in order to be eligible for state-funded adoption assistance, a child must be a special needs child as defined above and in the custody of the state of South Carolina for placement.

Are children adopted from private agencies in South Carolina eligible for adoption assistance?

State-funded subsidy programs are only available to children placed by the South Carolina Department of Social Services. Federally funded programs may be available in some cases to special needs children placed by private agencies. However, children must meet the eligibility criteria for Title IV-E Adoption Assistance, and because of strict guidelines, few children do. Reimbursement for nonrecurring costs is available to any family who adopts a special needs child and signs an adoption assistance agreement before finalization. (See question 12 for more information.)


What Supports and Services Are Available?

Monthly Payments

What is the maximum basic monthly adoption assistance maintenance payment in South Carolina?









Does South Carolina provide specialized rates (based on the extraordinary needs of the child or the additional parenting skill needed to raise the child)?

  • Specialized rates are assessed on a case-by-case basis for each child.
  • Supplemental Benefits for Medical Assistance (SBMA) is available for conditions that existed before adoption finalization. Adoptive families must request this benefit at the time the adoption assistance agreement is drafted and signed. The benefit amount is determined through negotiation between the agency and the adoptive family.
  • SBMA is available to meet children’s physical, emotional, and psychological needs unable to be met under any other resource, public or private. Availability is limited to children placed through the South Carolina Department of Social Services. These funds may cover medical, rehabilitative, and psychological counseling expenses that are not covered by Medicaid, private insurance, or other resources. All other resources should be exhausted before the SBMA request is made.

When do adoption assistance payments begin?

Adoption assistance payments and benefits may begin at adoption placement, as long as there is a signed adoption assistance agreement in place.

When a child turns 18, which benefits, if any, continue?

Youth who receive Title IV-E adoption assistance payments will continue to receive those payments after age 18 if they have a disability that warrants continuation of adoption assistance up to age 21. The family will have to provide documentation each year of the disability.

If the youth does not have a disability that warrants continuation, then IV-E payments can continue beyond age 18 if the youth meets at least one of the following conditions:

  1. completing secondary school or the equivalent;
  2. enrolled in post-secondary or vocational school;
  3. participating in a program or activity that promotes or removes barriers to employment or
  4. determined incapable of any of the above due to a documented medical condition

If the child does not qualify for extended lV-E adoption assistance, South Carolina may provide state-funded supplemental benefits after age 18, if the child is in high school or college or job training programs full- time (at least 12 hours per semester or however the school determines full-time student status). In such cases, an Adoption Subsidy Agreement using State Supplemental Benefits Monthly Adoption Assistance Payment can be signed after the youth is 18 years old. These supplemental benefits can continue until the child’s 21st birthday as long as the family provides proof of the youth’s enrollment in full-time school or a job training program and the family’s ongoing financial responsibility for the child.

Does South Carolina offer deferred adoption assistance agreements (agreements where initial monthly maintenance amount is $0 for children at risk of developing special needs later)?

Yes. Adoptive parents and the state must sign the adoption assistance agreement before adoption finalization with a payment level of zero in the agreement. The payment rate can be raised in the future to meet the child’s changing needs.


Medical Care

What Medicaid services are available in South Carolina?

Covered Services:

  • Outpatient Hospital
  • Physician
  • Inpatient Physician Visits
  • Rural Health Clinic
  • Family Planning
  • Laboratory and X-ray
  • Prescription Drugs
  • Ambulance Transportation
  • Podiatrist
  • Home and Community-Based Services
  • Skilled Nursing Facility
  • Intermediate Care Facility
  • Home Health Care
  • Inpatient Hospital
  • Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program. This program provides free medical check-ups for all Medicaid eligible children (under the age of 21) and treatment for medical problems.
  • Vision Care—the vision care program will pay for one vision test during any 12 months. This program will also pay for one pair of eyeglasses (and one replacement pair) for children under age 21 each year.
  • Dental (through the EPSDT program)
  • Inpatient Psychiatric Services for individuals under the age of 21—the need for this care must be medically documented and, in some cases, the need for care must have prior approval.
  • Mental Health Clinic—Many outpatient mental health clinic services are covered.
  • Case Management—this service is available to non-institutionalized developmentally delayed individuals, emotionally disturbed children, and other targeted groups.
  • Durable Medical Equipment—Medicaid will pay for such things as hospital beds, wheelchairs, oxygen, leg and back braces, artificial limbs, and other equipment that is necessary for medical reasons, prescribed by a doctor, and approved in advance.
  • Medical Transportation—Medicaid can pay for a van or a volunteer driver to take patients to medical appointments if the medical services to be received are covered by Medicaid.
  • Therapy—Therapy can be provided in certain situations as ordered by a physician.

The family’s health care provider can explain what is and is not covered. Recipients can also call the South Carolina Medical Programs Line at 888-549-0820.

What medical benefits are available for state-funded children? (Children who have federally funded/Title IV-E adoption assistance are automatically eligible for Medicaid benefits.)

State-funded children will receive Medicaid. Available benefits do not differ between IV-E eligible and non-IV-E eligible children unless a State funded child moves with his/her family to a State that does not practice reciprocity – meaning they will not provide Medicaid to the child.

What mental health services are available?

Public mental health services for children in South Carolina are administered by the Department of Mental Health (DMH), Division of Children, Adolescents and Their Families (DCAF) and may include assessment, case management services, day treatment, outpatient treatment (counseling/therapy), inpatient hospitalization, wraparound services, residential treatment services (inpatient general psychiatric and substance abuse units), school-based services, Youthful Sexual Offenders Program, and Intensive Family Services and Multi-Systemic Therapy (MST) Initiatives.

Services are largely provided through the DMH’s network of 17 local community mental health centers. DMH seeks to provide services in as natural and comfortable a setting for the family and child as possible, such as in the school or home. DMH’s vision is to develop a statewide system of services that is child centered, family focused, community based, and culturally competent.


Other Benefits

In South Carolina, what nonrecurring adoption expenses directly related to the finalization of an adoption may be reimbursed?

  • South Carolina reimburses up to $1,500 per child in reasonable and necessary adoption fees, court costs, attorney fees, and other expenses which are directly related to the legal adoption of a child with special needs and which are not incurred in violation of state or federal law. These expenses can include mileage and lodging involved in visiting the child before placement occurs. Payment can be made directly to providers or to families as reimbursement.
  • The amount to be reimbursed must be listed on the adoption assistance agreement, which must be signed before finalization.
  • DSS provides private attorneys, representing prospective adoptive parents of children in foster care, a monetary incentive to finalize their adoptions in a timely manner. Learn more here.

Is childcare available? If yes, who is eligible and how do families access child care?

Childcare is not available after finalization. Before finalization, parents would need to discuss with their adoption worker whether childcare may be covered.

Is respite care available? If yes, who is eligible and how do families access respite care?

Up to $500 of SMBA can be used per authorization year for respite.  To determine if respite services are available, families should contact their adoption worker

Is residential treatment available? If yes, who is eligible and how do families access residential treatment services?

Families should contact the post-legal services worker in the regional adoption office that covers their county of residence.


What Should Families Know About Applying For Subsidy?

Who Initiates the adoption assistance agreement

The regional adoption specialist will begin the negotiation process with the family for families who adopt through DSS, but for families who are applying for subsidy/nonrecurring for their privately adopted child, they would go through the State Adoption Office directly to sign an adoption subsidy agreement.

Who makes the final determination on an adoption assistance agreement?

The state office must give final approval to negotiations made between the family and regional adoption specialist.

How do families request adoption assistance after finalization of an adoption?

Families should contact the Adoption office at (803) 898-3956.

How Can a Family Adjust an Adoption Assistance Agreement?

Can adoptive parents ask to change an adoption assistance agreement?

Adoptive parents can request a modification in the adoption assistance agreement whenever there is a change in the child’s needs. If the child is found to have a preexisting condition after the adoption assistance agreement is finalized, the agreement may be amended to include the condition. Families must submit for review a written request detailing the need for change to the regional adoption specialist, if the adoption is not final or the Adoption Subsidy Coordinator, if the adoption is final. Medical or therapeutic documentation from a therapist or physician supporting the need must accompany the request.

What steps does a family go through to appeal an adoption assistance decision in South Carolina?

  • Adoptive parents can request a fair hearing whenever there is disagreement with a Department of Social Services (DSS) decision that affects their child’s adoption assistance benefits. Parents must submit requests for fair hearings in writing to the Office of Administrative Hearings and Individual and Provider Rights (OAH) within 30 days of their receipt of an adverse DSS decision. OAH will usually schedule a hearing within 30 to 90 days after the initial request for fair hearing. A three-member committee consisting of a hearing officer and two members appointed by the State DSS Director conducts hearings. Final decisions are issued within 30 days from the conclusion of the hearing and sent by certified mail to the adoptive parents.
  • Visit here for more information on Fair Hearings.
  • Parents should send written requests for fair hearings to the address below or should call 800-311-7220 (TTY 800-311-7219) for information.
  • South Carolina Department of Social Services
    Individual and Provider Rights
    Office of Administrative Hearings
    P.O. Box 1520
    Columbia, SC 29202-1520


What Else do Families Need to Know?

How is the adoption assistance program operated and funded in South Carolina?

  • The program is state administered and supervised.
  • In South Carolina, the federal contribution to Title IV-E-eligible children is 70.57 percent (known as the Federal Financial Participation or FFP rate). The remaining cost of the program is funded with state funds. Supplemental Benefits and Supplemental Benefits for Medical Assistance (SBMA) are entirely funded by the state.

Does South Carolina operate a subsidized guardianship program?


Does South Carolina offer a tuition waiver program?

No, but some adopted youth can receive up to $5,000 per year through the Education and Training Voucher Program (if funds are available). 
If a foster youth was adopted after their 16th birthday, then they are eligible for ETV funds. They must be in college and have not reached the age of 21. Youth are eligible until age 23 if they are enrolled in post-secondary education and were already participating in the ETV program. 
To find out more about the specific eligibility requirements, parents can contact their worker or an independent living coordinators.

Child Welfare Services Transformation

Best Outcomes for Children and Families

Do you have a complaint regarding services being provided to a child by a state agency? Please submit your complaint by phone (1-800-206-1957) or an electronic submission form here with the South Carolina Department of Children's Advocacy.