New York State Subsidy Forms

The NYS OCFS Adoption Subsidy Agreement forms are available on the OCFS website. (See links below) The forms  were redesigned in 2002, in 2007, and again in 2009  to consolidate previous forms, improve language and instruction, and make changes to reflect current policy and practice. Prospective adoptive parents should read the completed forms and instructions carefully before signing the agreement as they contain important information about agreed upon rates, eligibility, reporting requirements, and post-finalization amendments to the agreement.  See 09-OCFS-ADM-14 for an explanation of 2009 changes which impact subsidy eligibility and the approval process.   Areas of particular interest and importance include:

1. The note in the introductory section of the Subsidy Agreement Form emphasizes:

  • the adoptive family’s right to consult an attorney;
  • the adoptive family must sign and receive a copy of the Agreement
  • the application must be submitted and receive final approval by OCFS/NYSAS before finalization of the adoption; and
  • the Interstate Compact on the Placement of Children (ICPC) much be completed for all out-of -state adoptions

2. Section VII (adjustment of maintenance payments) of the Subsidy agreement provides clarification that subsidy rates will increase whenever the applicable local social services district increases the room and board rate and/or the clothing replacement allowance; and that a request from the adoptive parent (s) for a rate adjustment must be accompanied by an “amended agreement,” not a new application.

3. Appendix A, (pages 12-13) is an excellent summary of NYS regulations and adoptive parent rights and reporting obligations. See 09-OCFS-ADM-11 for a further explanation of annual reporting policy and procedures.

  • Item 1, paragraph 2, of Appendix A clarifies that subsidy will continue until the child’s 21st birthday (provided that the adoptive parent remains legally responsible for the child and provides any support to the child) and the parents obligation to notify the social services district if the adoptive parent is no longer providing any support or legally responsible for support of the child.
  • Item 5, of Appendix A, (bolded/added in 2002) provides parents with clear notification of their obligation to inform the social services district of any changes in the residential or dependency status of the child and the possibility that they may be required to provide financial support for any who returns to foster care.

5. See the following forms at 

  • LDSS-4623A Adoption Subsidy and Non-Recurring Adoption Expenses Agreement – Initial Application
  • LDSS-4623-Glossary for Adoption Subsidy Agreement
  • LDSS-4623B Adoption Subsidy and Non-Recuring Adoption Expenses Agreement – Post Fianalization Application
  • LDSS-4623C-1 Adoption Subsidy and Non-Recurring Adoption Expenses Agreement – Technical Amendment
  • LDSS-4623C-2 Adoption Subsidy and Non-Recurring Adoption Expenses Agreement – Upgrade or Substantive Amendment.
  • LDSS-4623D Adoption Subsidy and Non-Recurring Adoption Expenses Agreement – Non-Recurring Adoption Expenses Reimbursement Form

Source: NYS Office of Children and Family Services

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