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The California AAP 2 form plays a crucial role in the Adoption Assistance Program, which is designed to support families who adopt children with special needs. This form is essential for initiating or modifying financial assistance related to the adoption process. It requires the submission of important details, including the child’s adoptive name, birthdate, and the dates of adoption finalization and initial agreement. Families must indicate if they are starting a new case, changing payment amounts, or reporting any changes in circumstances. The form also addresses health insurance status and outlines the payment structure, ensuring that families receive the appropriate support for their unique situations. By filling out this form accurately, families can secure the necessary resources to provide a loving and stable home for their adopted children.

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

PAYMENT INSTRUCTIONS ADOPTION ASSISTANCE PROGRAM

DISTRIBUTION:

Original

:

County Welfare Department

Copy

:

Agency File

 

 

 

 

 

AAP PAYMENT CASE NUMBER

 

 

 

 

 

STATE ADOPTIONS CASE NUMBER

 

 

ADA

 

 

 

 

 

ADOPTION AGENCY CASE NUMBER

 

 

 

CHILD’S ADOPTIVE NAME

CHILD’S BIRTHDATE

Adoption Finalization Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date initial AAP Agreement (AD 4320) was signed:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This is a: (Check applicable items) Please send Notice of Action for the following checked items.

 

 

 

 

 

 

 

New case; Form AAP 4, Eligibility Certification - Adoption Assistance Program

■ Change in amount or duration of payment due to:

 

 

 

 

 

 

 

 

is attached, please send Notice of Action.

 

 

 

 

 

 

 

 

 

(Check (✔) one)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

■ Denial, please send Notice of Action.

 

 

 

 

 

 

 

 

 

 

 

 

Completed reassessment.

 

 

 

 

 

 

 

 

 

 

 

 

■ Change in need or circumstances.

■ Deferred payment agreement, please send Notice of Action.

 

 

 

 

Case Terminated.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

■ Change in child’s name, payee name or address.

 

 

 

 

 

 

 

 

 

Benefit Extension

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Overpayment requiring collection.

 

 

 

 

 

 

 

 

 

 

 

 

 

■ Child/youth has a mental or physical disability

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

■ Child/youth meets one of the five participation

Reason for the denial, termination or overpayment to be stated on the Notice of Action:

 

 

 

 

criteria per Welfare and Institutions Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 11403(b)(1) through (5)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please start or change payments as follows:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total monthly payment amount: ■ $

 

 

or ■ No cash payment, Medi-Cal only

 

 

 

 

 

 

 

The following checked rate structure equals the total monthly payment amount:

 

 

 

 

 

 

 

AAP Basic Rate: $

 

 

 

Specialized Care Increment: $

 

 

 

 

 

 

 

 

Dual Agency Rate: $

 

 

 

Supplemental Rate: $

 

 

 

 

 

 

 

 

■ Rate Classification Level (RCL):

 

 

■ State Approved Facility Rate: $

 

 

 

 

 

 

 

 

Start date:

 

 

 

 

 

 

 

Date of Reassessment:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If applicable, check one:

The child is placed outside of the adoptive home: Name of the out-of-home placement facility:

One check to be issued to the facility.

Two checks to be issued:

$

 

 

to be paid to the facility

$

 

 

to be paid to the adoptive parent

 

 

The child is eligible to receive Wraparound services: Name of Wraparound provider:

One check to be issued to the provider.

Two checks to be issued:

$

 

to be paid to the Wraparound provider

$

 

to be paid to the adoptive parent

Health Insurance

The family reports that the child has no health insurance.

The family reports that the child has health insurance with:__________________________________________________________________

PAYEE NAME

 

 

SIGNATURE OF AUTHORIZED OFFICIAL OF ADOPTION AGENCY

 

 

 

 

 

 

 

 

 

 

 

 

PAYEE ADDRESS

(NO.)

(STREET)

ADOPTION AGENCY MAILING ADDRESS

 

 

 

 

 

 

 

 

(CITY)

(STATE)

(ZIP)

 

 

 

 

 

 

 

 

 

PAYEE TELEPHONE NUMBER

 

 

TELEPHONE NUMBER

DATE

 

 

 

 

 

 

PAYEE EMAIL ADDRESS

 

 

 

 

 

AAP 2 (9/13)

Form Specifications

Fact Name Detail
Governing Law The California AAP 2 form is governed by the Welfare and Institutions Code Section 11403, which outlines the Adoption Assistance Program.
Purpose This form is used to request payments under the Adoption Assistance Program for eligible children in California.
Distribution The original form is submitted to the County Welfare Department, while a copy is retained in the agency file.
Eligibility Certification Form AAP 4 must be attached to certify eligibility for the Adoption Assistance Program when submitting the AAP 2 form.
Payment Structure The form allows for various payment structures, including basic rates, specialized care increments, and dual agency rates.
Health Insurance Reporting Families must report whether the child has health insurance, which affects the overall assistance provided.
Signature Requirement The form requires the signature of an authorized official from the adoption agency to validate the request for assistance.

California Aap 2: Usage Guidelines

Completing the California AAP 2 form is an important step in managing adoption assistance payments. This form collects essential information about the adoptive child and the payments required. Follow these steps carefully to ensure accurate submission.

  1. Begin by entering the Case Numbers at the top of the form: AAP Payment Case Number, State Adoptions Case Number, and ADA Adoption Agency Case Number.
  2. Fill in the Child’s Adoptive Name and Child’s Birthdate.
  3. Provide the Adoption Finalization Date and the Date Initial AAP Agreement (AD 4320) Was Signed.
  4. Check the appropriate box for the type of request you are making. Options include new case, changes in payment, denial, reassessment, and more.
  5. If applicable, attach any necessary documentation for changes or requests. Indicate this by checking the relevant boxes.
  6. Specify the Total Monthly Payment Amount by either entering the amount or checking the box for no cash payment.
  7. Break down the total payment amount by checking the appropriate rate structure boxes and entering the corresponding amounts.
  8. Provide the Start Date and, if applicable, the Date of Reassessment.
  9. If the child is placed outside of the adoptive home, check the appropriate box and provide the name of the out-of-home placement facility. Indicate how payments should be issued.
  10. If the child is eligible for Wraparound services, check the relevant box and provide the name of the Wraparound provider. Again, specify how payments should be issued.
  11. Indicate the child’s health insurance status by checking the appropriate box and providing details if the child has health insurance.
  12. Complete the Payee Name, Payee Address, and Payee Telephone Number.
  13. Ensure that the Signature of Authorized Official of Adoption Agency is included along with the Date and Payee Email Address.

Your Questions, Answered

What is the California AAP 2 form used for?

The California AAP 2 form is utilized in the Adoption Assistance Program to facilitate payment requests and changes related to adoption assistance. This form allows adoptive parents or guardians to initiate new cases, report changes in payment amounts, request benefit extensions, or terminate assistance. It is essential for ensuring that families receive the necessary financial support for the care of adopted children, especially those with special needs.

Who needs to complete the AAP 2 form?

The AAP 2 form must be completed by adoptive parents or guardians who are seeking financial assistance through the Adoption Assistance Program. This includes individuals who are initiating a new case, making changes to an existing case, or reporting circumstances that affect the amount or duration of payments. It is important that the form is filled out accurately to ensure timely processing of requests.

What information is required on the AAP 2 form?

The form requires various pieces of information, including the child’s adoptive name, birthdate, and the adoption finalization date. Additionally, it asks for details regarding the payment structure, such as the total monthly payment amount and any applicable rate classifications. It is also necessary to indicate if the child is receiving any health insurance and to provide the names of any out-of-home placement facilities or wraparound service providers, if applicable.

How does one submit the AAP 2 form?

The completed AAP 2 form should be submitted to the County Welfare Department or the designated agency handling adoption assistance in your area. It is important to ensure that all required sections are filled out completely and accurately to avoid delays in processing. After submission, families should keep a copy of the form for their records.

What happens after the AAP 2 form is submitted?

Once the AAP 2 form is submitted, the County Welfare Department will review the information provided. They will process the request and issue a Notice of Action, which outlines the approval or denial of the request. If there are any changes to the assistance or if additional information is needed, the agency will communicate this to the applicant. Timely follow-up may be necessary to ensure that the adoption assistance is received without interruption.

Common mistakes

Filling out the California AAP 2 form can be a straightforward process, but many individuals make common mistakes that can lead to delays or complications in their adoption assistance. Here are nine mistakes to avoid:

  1. Incomplete Information:

    Omitting critical details such as the child’s adoptive name or birthdate can cause significant delays. Ensure all fields are filled out completely.

  2. Incorrect Case Numbers:

    Double-check the case numbers provided. Using the wrong numbers can lead to confusion and misprocessing of your application.

  3. Not Checking Applicable Items:

    Failure to check the appropriate boxes for the type of request can result in processing issues. Be thorough in reviewing which items apply to your situation.

  4. Missing Signatures:

    All required signatures must be included. A missing signature can halt the processing of your form entirely.

  5. Incorrect Payment Amounts:

    Ensure that the total monthly payment amount is accurate. Mistakes here can lead to incorrect payments being issued.

  6. Neglecting Health Insurance Information:

    Clearly indicate whether the child has health insurance. Failing to provide this information can complicate the assistance process.

  7. Ignoring Deadlines:

    Be aware of any deadlines for submission. Late submissions can result in denial of benefits or assistance.

  8. Failure to Attach Required Documentation:

    If additional documents are necessary, such as the AAP 4 form, ensure they are attached. Missing documents can delay processing.

  9. Not Keeping Copies:

    Always make copies of the completed form and any documents submitted. This can be crucial for tracking and follow-up purposes.

By avoiding these common mistakes, you can help ensure a smoother process in obtaining adoption assistance in California.

Documents used along the form

The California AAP 2 form is an essential document for families involved in the Adoption Assistance Program. It helps streamline the payment process and ensures that families receive the financial support they need. Alongside this form, several other documents are often required to complete the application or update the case. Here’s a brief overview of those documents.

  • AAP 4, Eligibility Certification: This form certifies the eligibility of the child for adoption assistance. It outlines the criteria that must be met to qualify for benefits.
  • AD 4320, Initial AAP Agreement: This is the initial agreement signed by the adoptive parents and the agency. It lays out the terms of the adoption assistance, including payment amounts and duration.
  • Notice of Action: This document is sent to inform families about decisions made regarding their AAP case, such as approvals, denials, or changes in payment amounts.
  • Reassessment Form: This form is used to evaluate the ongoing needs of the child and determine if any changes in assistance are necessary over time.
  • Deferred Payment Agreement: If payments are delayed for any reason, this agreement outlines the terms under which payments will resume.
  • Benefit Extension Request: Families can use this form to request an extension of benefits if they believe they still qualify after the initial period has ended.
  • Overpayment Collection Notice: This document is issued when there has been an overpayment made to a family, detailing how the overpayment will be collected.
  • Wraparound Services Agreement: If the child requires additional support services, this agreement outlines the type of services provided and how they will be funded.
  • Health Insurance Verification: Families must provide proof of the child’s health insurance status, which may affect the type of assistance received.

Each of these documents plays a vital role in ensuring that families receive the appropriate support and that the process runs smoothly. Keeping these forms organized and readily available can help prevent delays in assistance and ensure that all necessary information is submitted accurately.

Similar forms

  • California AAP 4 Form: Similar to the AAP 2, the AAP 4 form is used to certify eligibility for the Adoption Assistance Program. It helps determine if a child qualifies for assistance based on their specific needs and circumstances.
  • AD 4320 Form: This form is the initial agreement for Adoption Assistance. Like the AAP 2, it outlines the terms of financial support provided to adoptive families, ensuring clarity on the benefits offered.
  • Notice of Action: This document communicates decisions regarding changes in assistance. It serves a similar purpose to the AAP 2 by informing families about any adjustments to their payments or eligibility status.
  • Reassessment Form: Used to evaluate ongoing eligibility for assistance, this form is akin to the AAP 2 in that it addresses changes in a child's needs or circumstances that may affect their support.
  • Deferred Payment Agreement: This document outlines arrangements for delayed payments. It shares similarities with the AAP 2 by detailing specific conditions under which payments may be modified or postponed.

Dos and Don'ts

When filling out the California AAP 2 form, it is important to follow specific guidelines to ensure accuracy and compliance. Below is a list of seven things to do and not to do during this process.

  • Do provide accurate information regarding the child's adoptive name and birthdate.
  • Do check all applicable items carefully to ensure the correct selection of services.
  • Do sign the form where indicated to validate the submission.
  • Do specify the total monthly payment amount clearly, including any applicable rates.
  • Don't leave any sections blank; all relevant fields must be completed.
  • Don't provide false or misleading information, as this can lead to denial or termination of benefits.
  • Don't forget to include the date of reassessment if applicable, as this is crucial for processing.

Misconceptions

Understanding the California AAP 2 form can be challenging, and misconceptions can lead to confusion. Here are seven common misunderstandings about this important document:

  1. It is only for new adoptions. Many believe that the AAP 2 form is only relevant for new adoptions. In reality, it is also used for changes in payment amounts, duration, or circumstances related to existing adoption assistance cases.
  2. Submitting the form guarantees payment. While the AAP 2 form is essential for requesting assistance, submitting it does not automatically guarantee that payments will be approved. Each case is reviewed individually, and eligibility criteria must be met.
  3. All children qualify for the same payment amount. This is a misconception. Payment amounts can vary based on the child’s needs, age, and other factors. The form allows for different rate structures to be selected based on these criteria.
  4. Changes to the adoption situation don’t need to be reported. It is crucial to report any changes in circumstances, such as a change in the child’s name or address. Failing to do so can lead to delays or interruptions in assistance.
  5. The AAP 2 form is only for financial assistance. While it primarily deals with payment requests, the form also addresses other services, like Wraparound services, which can be critical for supporting the child's needs.
  6. Health insurance information is not necessary. Some may think that health insurance details are irrelevant. However, the form requires this information to ensure that the child’s healthcare needs are adequately met.
  7. Once the form is submitted, no further action is needed. This is misleading. After submitting the AAP 2 form, it’s important to follow up with the appropriate agency to confirm receipt and check on the status of the request.

Clearing up these misconceptions can help ensure that families receive the support they need during the adoption process. Understanding the AAP 2 form is a vital step in navigating adoption assistance in California.

Key takeaways

Understanding the California AAP 2 form is essential for families involved in the Adoption Assistance Program. Here are some key takeaways to help you navigate the process:

  • Purpose of the Form: The AAP 2 form is used to request or change payments related to adoption assistance.
  • Eligibility Certification: Ensure that you check the appropriate boxes to indicate whether this is a new case or if there are changes in payment amounts.
  • Payment Amount: Clearly state the total monthly payment amount. You can choose to receive cash payments or only Medi-Cal benefits.
  • Documentation: Attach any necessary documents that support your request, such as a completed reassessment or information about changes in circumstances.
  • Health Insurance Information: Indicate whether the child has health insurance and provide the necessary details if applicable.
  • Signature Requirement: The form must be signed by an authorized official from the adoption agency to be valid.
  • Submission: Send the completed form to the County Welfare Department to ensure that your request is processed promptly.

Filling out this form accurately is crucial for receiving the support your family needs. If you have questions, consider reaching out to your adoption agency for assistance.