NYS Regulations Governing Eligibility for
Special and Exceptional Subsidy Rates

The following information summarizes the regulations for special and exceptional rate eligibility, pursuant to New York State Department of Social Services regulations, Sections 427.2, 427.6, and 427.15. The regulations were effective August 1990.

The special rate is applicable for a child who:

• suffers from pronounced physical conditions and a physician certifies that the child requires a high degree of physical care; or
• is awaiting a family court hearing on a PINS or JD petition or is adjudicated a PINS or JD; or
• has been diagnosed by a qualified psychiatrist or psychologist as being moderately developmentally disabled, emotionally disturbed or having a behavioral disorder which requires a high degree of supervision; or
• is a refugee or Cuban/Haitian entrant and is unable to function successfully in the community; or
• entered foster care directly from inpatient hospital care. This child is eligible for the special rate for one year. After that, eligibility depends on meeting one of the other conditions; or
• has an equivalent condition as determined by the local commissioner.

Before August 1990, the special rate could be paid for children who were adjudicated abused or neglected or who were awaiting a Family Court hearing on an abuse or neglect petition, children who were unmarried expectant mothers, or children who were family-care patients from the Department of Mental Hygiene. As of August 1990, however, children can qualify for the special rate based only on the particular needs listed above.

In order to receive the special rate, adoptive or foster parents must participate in at least 4 hours of agency training per year, actively participate in case conferences, and have the necessary training and background to care for the child.

The exceptional rate is applicable for a child who:

• requires, as certified by a physician, 24-hour a day care provided by qualified nurses or persons supervised by qualified nurses; or
• has severe behavior problems characterized by the infliction of violence on themselves, other persons or their physical surroundings, and who has been certified by a qualified psychiatrist or psychologist as requiring high levels of individual supervision in the home; or
• has been diagnosed by a qualified physician as having severe mental illness, such as child schizophrenia, severe developmental disabilities, brain damage or autism; or
• has been diagnosed by a physician as having AIDS or HIV-related illness. If a child tests positive for HIV infection then seroconverts to negative, the child remains eligible for the exceptional rate for one year. After that, eligibility depends on meeting one of the other conditions; or
• has an equivalent condition as determined by the local commissioner.

To receive the exceptional rate, adoptive or foster parents must participate in at least 5 hours of training per year, actively participate in case conferences, and have the necessary training and background to care for the child.

All social services districts are required to have a schedule of rates for foster family care in the normal (basic), special, and exceptional categories.]

The family should contact the agency that originally placed the child with them to discuss the situation.

Adoptive families who are successful in seeking higher rates usually can establish that the child is eligible for a special or exceptional rate. However, families should recognize that the problems that qualify children for these higher rates must be significant and be well documented.

* See excerpts from Tompkins County Department of Social Services "Explanation of Mild, Moderate and Severe Level on Application to Adopt (DSS-857) and Definition of Disability Categories" for further discussion and examples.

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New York State Citizens' Coalition for Children, Inc.
607-272-0034 • fax 607-272-0035
office@nysccc.org
08/04/04