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Interstate Compact on Adoption and Medical Assistance (ICAMA)

An agreement between member states that governs the interstate delivery of medical services and adoption subsidies for adopted special needs children.

This compact is newer than the Interstate Compact on the Placement of Children. Adopted in 1986 by nine states, the following 36 states are members as of this writing, according to the American Public Human Services Association.

Alabama, Alaska, Arizona, Arkansas, Colorado, Delaware, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, Ohio, Oklahoma, Rhode Island, South Carolina, South Dakota, Texas, Utah, Virginia, Washington, West Virginia and Wisconsin.

The reason for the creation of ICAMA was to protect special needs children who move across state lines and ensure they continue to receive appropriate medical assistance and subsidies. According to a booklet published by the American Public Human Services Association, "Adoption opportunities for children with handicaps or other special needs are limited at best. It is often necessary to expand the search for prospective adoptive parents to other states."

When a family moves or a child is relocated to another state, the child has a Medicaid card from the placing state; however, medical providers are often reluctant to accept Medicaid from another state. As a result, member states will provide a Medicaid card from the state to which the child has relocated.

States may either join ICAMA by an enaction of the state legislature, or an executive branch official may act for the state and sign the compact. (See also interstate adoption.)

For further information on ICAMA or to request a copy of A Guide to the Interstate Compact on Adoption and Medical Assistance, contact

Secretariat to the AAICAMA
American Public Human Services Association
810 First St. NE, Suite 500
Washington, DC 20002-4205
(202) 682-0100

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