• Adoption

    In the United States, more than 110,000 children with special needs are waiting for permanent families and homes. Like all children, they need the nurturing, support and advocacy that a family can provide to help them realize their hopes and dreams.

    The Complex Care Center at Cincinnati Children's provides information and resources to those interested in becoming an adoptive family for a child with special healthcare needs.
  • The Ohio Department of Jobs and Family Services (ODJFS) defines adoption as "a legal process that creates a lifelong relationship between a parent and a child who are not biologically related. The adoption of a child is approved by the Court and adoptive parents receive an adoption decree and birth certificate acknowledging that the child is a legal family member with all the rights and privileges of a birth child."

    In adoption, the term "special needs" is defined broadly and may vary by state. In general, children with special needs have a more difficult time finding families to adopt them. These children:

    • Have disabilities including mental, physical and / or behavioral challenges
    • Are at risk for for developing learning, emotional, behavioral or physical disabilities in the future
    • Are prenatally exposed to drugs or alcohol  
    • Are often older

    The American Academy of Pediatrics further defines children with special healthcare needs as "those who have or are at risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally."

    Child Welfare Information Gateway provides information on adopting a child with special needs.

    You will need to gather information and make some important decisions when you decide to adopt a child with special needs:

    • What disabilities are you prepared to handle?
    • What physical and / or emotional challenges are you able to face?
    • Do you have the financial resources to care for another child, especially one with disabilities?
    • Does your insurance policy cover all of the child's physical and emotional issues, pre-existing conditions and required therapies?    
    • Have you checked your insurance to make sure that the doctor and related health care providers are adequately covered? 
    • Are you able to find a doctor who is willing and capable of providing the level of care your child might require? 
    • Have you talked to a parent of a child with a similar condition to help you prepare for the challenges ahead?
    • Have you identified sources where you can receive the training necessary to help you support a child with special needs?
    • What age range, family background and ethnicity would fit your situation? 
    • Are you going to help your adopted child maintain contact with birth relatives?

    While every experience may be unique depending on the family, children and agency, there are certain steps that are usually taken between considering adoption and successfully welcoming a child with special health care needs into your family:

    • Learn about adoption
    • Search for and select an agency
    • Complete an adoption application
    • Begin the home study process
      • The home study is a comprehensive evaluation of you, your family and your home environment. Information is usually gathered by a social worker and is generally a required screening step in approving you as an adoptive parent.

    • Receive approval for a placement
    • Search for a child  
    • Meet and visit with the child
    • Prepare for your child's arrival
    • Network and begin building medical, educational and community supports 
    • Welcome your child into your family  
    • Finalize your adoption

    AdoptSpecialNeeds.org has information on adopting children with special needs.

    Adoption Services has information on all phases of the adoption process.

    AdoptUSKids has detailed information on the steps in adoption.

    Child Welfare Information Gateway provides extensive information on the adoption process, a fact sheet on adopting children with developmental disabilities and resources to support the adoption of children with special needs.

    Kentucky Adoption Coalition provides access to adoption resources, medical and legal assistance, counseling and advocacy.

    Kentucky Cabinet for Health and Family Services, Special Needs Adoption Program (SNAP) provides information on the adoption process.

    MedlinePlus has information on the adoption process.  

    National Adoption Center has helped find adoptive families for more than 20,000 children in the United States. They have information on the adoption process as well as extensive resources.

    North American Council on Adoptable Children provides information on the steps in the adoption process as well as a list of supporting resources.

    Ohio Adoption Guide, published by the Ohio Department of Jobs and Family Services, provides a comprehensive overview of adoption in Ohio.

    Ohio Department of Jobs and Family Services has a fact sheet on adoption.

    Ohio Legal Services provides answers to common questions about adoption.

    Ohio State Bar Association answers frequently asked questions about adoption.

    There are several ways to adopt a typical child or one with special needs:

    • Closed or open adoption
    • Public agency adoption
    • Private agency adoption
    • Independent adoption
    • International

    A closed adoption is sometimes called a traditional adoption where the birthparents and the adoptive parents do not know each other's identity, either before or after the adoption.

    In an open adoption, birthparents and adoptive parents usually exchange information, sometimes meet each other and agree to maintain some contact after the adoption.

    A public agency is supervised by a state or local Department of Health and Human Services and often has children with special needs who are looking for adoptive families. A public agency usually has more flexible eligibility requirements for adoptive parents and will often consider single parents, older parents and parents with low incomes. Placement of a child can occur in as little as a few months following a home study and approval. Because many foster parents adopt children that have been placed in their care, you may be approved as a licensed foster parent as well as a prospective adoptive parent in the same process.

    A private agency is supervised by a privately funded, licensed adoption agency, usually works with infants from the local area or neighboring states, and sometimes handles children with special needs. A private agency may have specific requirements on who can adopt, based on race, religion or age. Placement can take longer, often up to a few years following a home study and approval. 

    An independent adoption or private adoption is usually arranged through an individual, often an attorney, physician, friend or adoption counselor and can sometimes be risky and expensive. In addition, each State may have its own specific requirements. Findlaw has information on adoptions and legal assistance.

    North American Council on Adoptable Children compares different types of adoptions.

    When choosing an adoption agency, one of the first important things for you to find out is if the agency is licensed. Contact them and ask for their license number and the name and telephone number of the licensing authority. Call the licensing authority and confirm that the agency is in good standing.

    Take the time to find a public or private agency that is a good match for you. Interview an agency representative to learn more about them:

    • Who can adopt from the agency?
    • How many children and with what type of challenges have been placed in the past few years?
    • How many children are available for adoption?
    • How long is the average wait for a child?
    • What is involved in the application process?
    • Are there requirements for a home study, parenting classes, agency visits?
    • What are all the fees involved?
    • What is the policy if the family does not accept the first child offered to them?
    • What follow-up services are available, including support groups, therapy and counseling?
    • Can you be provided with some references from parents who recently adopted from the agency?

    Ohio Adoption Guide has an extensive list of questions to ask potential agencies.

    International adoptions can be a more complicated process than U.S. adoptions, with additional paperwork, waiting lists, health concerns and foreign country laws.  

    If you adopted your child in a foreign country, the Probate Court of Hamilton County allows the adoptive parents to receive an Ohio Adoption Decree and an Ohio Birth Certificate. This is called a readoption procedure and can be granted after 6 months from the date of the foreign decree of adoption. You can find additional information from the Probate Court of Hamilton County in Ohio. You can find addition information on adoption:

    • Many public agencies do not charge service fees to families who adopt children with special needs. But you may have to cover related expenses for medical care, therapy or counseling.
    • A federal adoption tax credit can be used by eligible parents who adopt children with special needs from the United States.
    • The Federal Title IV-E adoption assistance program provides monthly financial support for eligible children with special needs who are adopted.
    • A State Adoption Subsidy may be available if you adopt a child with special needs. Benefits vary by State, but may include medical, psychological or psychiatric services, counseling or residential treatment. Some States provide medical assistance through Medicaid, which may include meeting health care needs not covered through a family's private insurance policy. State Public Children Services Agencies are responsible for determining eligibility and administering the state adoption subsidy program.
    • The Post Adoption Special Services Subsidy (PASSS) Program in Ohio assists eligible adoptive families with medical, surgical, counseling, psychological, psychiatric and residential treatment services. Contact your adoption agency for information.
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