We completed the adoption of a 5 year old severely medically needy and catastropically impaired child in February, 2010 subject to an adoption subsidy agreement that was signed in August 2009, prior to the implementation of the VEMAT.  Additionally, we are in the process of adopting a second severely medically needy child with a proposed adoption date to be scheduled sometime before the end of the calendar year.  We are encouraged that the proposed revisions to the VEMAT will address the lack of equitable subsidies for children in the medically needy category.  However, we believe the proposal must also provide guidance on how the VEMAT will apply to prior adoptions, including adoptions that were completed and subsidy agreements that were entered into prior to the implementation of the VEMAT.  

Are local social services agencies going to receive additional service administration monies for providing the social worker and supervisory 24/7 on call required by these regs?  If not, then I submit that the on call requirement of these regs is an unfunded mandate and should not be part of the regs.

The current regulation regarding use of the VEMAT to assess children’s needs and enhanced maintenance levels paid to caregivers has important strengths and some limitations. Since public comment is designed primarily to identify potential limitations, we address that area first.

There is a potential problem inherent in limiting the enhanced payment to caregivers for children placed on an emergency basis to 30 days. Often, children placed on an ‘emergency’ basis are new to the system and may come directly from their own homes from court and into foster care. Very little may be known about these children. For many, a thirty day assessment period will not be sufficient to adequately assess their needs. We would suggest a longer assessment period during which an enhanced maintenance stipend may be available to caregivers while a child’s needs may be more accurately determined.

Our understanding is that in general regulations that affect both foster care and adoption and public and private child-placing agencies should be congruent. The regulation does a reasonably good job here. It allows both public and private child-placing agencies to use the VEMAT to determine accurate levels of enhanced maintenance to caregivers for children whose needs are exceptional. The VEMAT can be used for children placed in treatment foster care whether the child-placing agencies are public or private. The regulation also allows for the VEMAT to be administered and enhanced maintenance payments to be made to non-TFC caregivers if specified supports are in place. The regulation allows this in both public and private sectors so long as the agencies involved are child-placing agencies. Such parity seems consistent with the general principle of regulatory congruence between public and private programs. It would be wise in any revision of the regulation to continue this parity but to emphasize that the child’s legal guardian – usually the local department of social services – be the entity in charge of administering the VEMAT, even if the child is referred to another child-placing agency.

Public-private parity, then, is for the most part well-articulated in the proposed regulations. However, the same congruence may not be reflected there with regard to foster care and adoption. Again, our understanding is that there should be relative regulatory parity between the two as far as is practical. We believe, then, that the VEMAT should also be used in helping to determine maintenance levels paid through adoption subsidy for adoption cases that already have been finalized. This adjustment would create more level ground between these two segments of the child welfare system.

I am not finding that this regulation is clear enough about applying this process to adoptive families. It does state it "shall be used to determine the daily supervision component of the foster care maintenence payment or the adoption assistance payment."  Then regulation then says very little about how this is to be applied to adoptive families.

I would propose that the regulation be clear that if the VEMAT tool is to be used for any adoptive family that it be used, by mandate, for ALL adoptive families.  If the Commonwealth is seeking to acheive greater consistency among all DSS and LCPAs in thier payments to families on behalf of children, everyone should be using the same tool and should be mandated to do so (a "shall" not a "may"). Even if a negotiation process is implemented with regards to Adoption Assistance, all families should start with the same tool to assess an amount from which to then negotiate.

I was please to see that the "team" of people making the decision for the child is a "shall include" and not a may. I hope to see that their is oversite of this so that all children have the appropriate advocates for them sitting at the table making decisions.  I would not be supportive of agencies picking and choosing who they want on the team. Again, consistency across the state in this regard is important.