The ICAMA is a contract among member states and U.S. territories.  The ICAMA ensures the delivery of Medicaid and other post-adoption services to Adoption Assistance Program (AAP) eligible children when their families move across state lines.  California joined the ICAMA under Welfare and Institutions Code Sections 16170-16177.

The AAP provides financial and medical benefits.  The AAP is designed to make it easier for families to adopt special needs children, thereby providing permanent homes for children who would otherwise remain in foster care.  For more information regarding the AAP in California, see Adoptions Assistance Program.


In 1980, Congress passed the Adoption Assistance and Child Welfare Act, Public Law (PL) 96-272, which established the AAP and provided federal funding for financial and medical assistance.  Adoption Assistance Program-eligible children were automatically entitled to receive Medicaid from the state that entered into an adoption assistance agreement with the child’s family.  In addition, PL 96-272 required states to protect the interests of adopted special needs children in interstate situations.

In 1985, the Consolidated Omnibus Budget Reconciliation Act (COBRA) required states to grant Medicaid eligibility to children whose families signed an adoption assistance agreement with another state.  However, COBRA did not provide for implementation of this requirement.  The COBRA also gave states the choice of providing Medicaid to non-federally eligible children receiving state adoption assistance.

In the mid-1980’s, the ICAMA was drafted to create a framework for the interstate cooperation originally envisioned in PL 96-272.  The ICAMA provides uniformity and consistency of policy and procedures when either a special needs child is adopted by a family in another state or the adoptive family moves to another state.  The ICAMA resolves the differences in each state’s Medicaid program.  The ICAMA procedures ensure that statutory and program requirements are met.  While ICAMA promotes reciprocity of medical services, not all states provide Medicaid coverage to non-federally eligible children who have a signed adoption assistance agreement from another state.

Currently, 49 states including the District of Columbia are members of the ICAMA, New York is an associate member.  Each member state has an ICAMA Compact Administrator.  This person works with both in-state and out-of-state officials to ensure the provision of benefits and services for adopted special needs children, to process the ICAMA forms, and to serve as an information resource.  In California, a Staff Services Manager (SSM I) in the California Department of Social Services (CDSS), Children and Family Services Division (CFSD), and a SSM I in the Department of Health Care Services (DHCS), Medical Services Division, serve as Co-Compact Administrators.

The ICAMA administrators formed the Association of Administrators for the Interstate Compact on Adoption and Medical Assistance (AAICAMA).  The AAICAMA provides technical and legal assistance, training, and information to adoption professionals regarding issues related to both interstate and intrastate adoptions.  For additional information, the AAICAMA may be contacted at:

727 15th Street, NW, 12th Floor 
Washington, DC  20005
Phone (202) 913-3226
Sharon McCartney, Director
Email: smccartney@aaicama.org

Contact Us

Adoptions Assistance Program and Monitoring Unit
744 P Street, MS 8-12-521
Sacramento, CA 95814
(833) 421-8511
(833) 421-8505 FAX
Email: ICAMA@dss.ca.gov

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