Exhibit – State of Oklahoma Letter to Adoption Assistance Recipients
OKLAHOMA DEPARTMENT OF HUMAN SERVICES
Sequoyah Memorial Office Building
P.O. Box 25352
Oklahoma City, Okla. 73125
Month DD, YYYY
Dear Adoptive Parent(s):
Our records show that _________ will turn 19 on _______. Oklahoma State law provides
that such assistance will terminate upon attainment of age 19 effective with the last
day of the child's birth month except where (1) the child has applied for Supplemental Security Income (SSI) with the Social
Security Administration (SSA); (2) the SSI application is pending or has been denied;
and (3) if denied SSI, the child's needs, conditions, or behaviors meet the criteria
for difficulty of care (DOC) IV or V. Not later than 60 days prior to the child reaching
the age of 19, the adoptive parent(s) must provide OKDHS with the following.
Documentation that a formal application for SSI has been received by the SSA and is pending or has been denied;
If the SSI application is pending with SSA, the adoptive parent(s) must provide documentation monthly to OKDHS that
demonstrates due diligence in providing to SSA the necessary information to timely
process the child's SSI application (NOTE: SSA will provided an claims "receipt" when
you file for SSI. Keep this as evidence of "due diligence."); OR
If the SSI application has been denied by SSA, the adoptive parent(s) must provide medical or psychological evidence that
demonstrates the child's needs, conditions, or behaviors meet the criteria for DOC
IV or V.
When contacting SSA to file an application for SSI, the adoptive parent will need
to make two things very clear:
Tell SSA that
you must file a formal application
for SSI; and
Tell the SSA representative
that the adoption assistance for _______ is
funded with _______ funds.
NOTE: The source of adoption assistance funding affects how SSA counts this assistance
when determining SSI eligibility. If the SSA representative has any questions about
why you must have a formal application or about the adoption assistance funding, tell them that there is a POMS
operating instruction at SI DAL00830.415.
Failure to comply with these instructions results in termination of adoption assistance
payments on the child's 19th birthday or on the month following failure to provide documentation on a pending
SSI application, whichever occurs first. Adoption
Assistance payments terminate when SSI payments are approved. If
SSI is denied, Adoption Assistance will continue only if the child's needs, conditions, or behaviors meet the criteria for DOC IV or V. However, in no event will Adoption Assistance continue
after the child reaches the age of 21.
Should you have any questions please contact your subsidy worker .
Margaret DeVault, LSW
Programs Manager, Adoption Assistance