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Foster Care and Adoption; Balancing Incentives and Improving Outcomes

By Edited Nov 26, 2016 0 0

Barriers to Our Goals

As American citizens, we want the rising generation to be successful.  We want our children and those around them to contribute to society and live happy, stable lives.  Many children are not born into families or circumstances that nurture this type of life.  Foster care and adoption systems have been utilized to take these less-fortunate children and place them in more ideal living situations to alter their life outcomes.  These programs are extremely costly to tax-payers and there are a limited number of households that are willing and able to house these children in need.  Monetary incentives to foster parents can help start the process of getting children into foster homes, but when it comes to a permanent adoptive home there is little incentive.  Consequently, foster children tend to stay foster children.  They don’t get the needed stability having a number of different parents.  Our goal as a society is to raise generations of children that are nurtured in loving, permanent homes. The controversy begins when this goal collides with expense.  The issues and debates that accompany this topic are complex and numerous and there is no simple answer, but there is an answer.  This the subject of my research.

Successful adults are raised by supportive families.  When a child is raised by someone that is not their parent, their chances of success decrease.  For this reason, the aim of most adoption agencies are to unite children with blood relatives.  Thus, maintaining the likelihood of these children growing up to be responsible adults.  This is a worthy goal.  However, the Department of Children and Families (DCF) of Florida reported that only 40% of 3,000 children eligible for adoption were adopted by relatives and 20% were not adopted at all (Scott, Lee and Harrell).  Where are these children ending up? 

The University of Chicago has arguably done the most extensive research on this very topic. The progress of 141 teens in Wisconsin was monitored after being removed from foster care after their 18th birthday.  They reported that almost 40% of these teens were unemployed, 22% had moved four or more times in 12 to 18 months after leaving foster care.  More than 25% of males and 10% of females had been incarcerated at some point (Vogel).  Every child deserves the chance to be adopted before they turn eighteen.  The government could increase chances of adoption by offering would-be adoptive parents “concrete assistance” (Scott, Lee and Harrell).  It is true that money is paid to foster parents, however the level of financial support dramatically declines and nearly disappears once foster parents adopt.

Real Example

This has been illustrated by my own family. My mother and father in Utah who were fostering two young children, Amanda and Tommy, ages four and two.  Both children have various medical and mental difficulties due to drug use of their birth mother.  Tommy suffered from RSV as well as daily violent asthma attacks and required twenty minute albuterol treatments several times a day.  The foster care system provided my family with a nebulizer which vaporized the albuterol to be inhaled.  My parents asked for a cordless nebulizer so we could leave our home but we were refused because of the cost.  With the refusal, my parents requested that the children be picked up and taken back into the custody of the state.  In order to keep the children in the custody of the state, a cordless nebulizer was delivered to our doorstep the very next day.  Amanda and Tommy are now my little brother and sister.  We adopted them a short time after.  Unfortunately, after the adoption the medical needs of my siblings did not stop, but the financial aid did.  What is the state saying to perspective adoptive parents?  It seems as though the state would do anything to keep the children in foster care but as soon as the adoption papers are signed the efforts desist.  This becomes especially expensive for adoptive parents when the children have mental and emotional disorders.  It is estimated that between 30 and 85% of youth in foster care have significant emotional disturbances (Galehouse, Herrick and Raphel).  Financial support goes from being needed to absolutely necessary when mental and emotional problems complicate an adoption.

Arguments

It could be said that the federal and state governments have already incentivized adoption. The Adoption and Safe Families Act of 1997 (ASFA) authorized an increase of incentives to states who increased the number of adoptions above a certain baseline; 4,000 dollars would be awarded to every child adopted from foster care and 6,000 dollars to each child if they have special needs (Allen and Bissell). With the help of state adoption agencies, adoptions nationwide went from about 27,700 in 1995 to 51,000 in 2005 (Hansen).  Although the near doubling of adoptions in a decade may seem like a success, those parents weren’t receiving long-term financial incentives as were foster parents.  6,000 dollars would barely cover the copays for medical needs of a child with mental illness.  If the goal is to increase the number of adoptions, why aren’t perspective adoptive parents receiving sustaining support?  I suggest that the government direct more money toward supporting adoptions long-term rather than supporting long-term foster care. 

There are several states that have changed or are moving towards changing the age at which children become too old for foster care from 18 to 21 and this has been associated with higher rates of college attendance (Dworsky, Ahrens and Courtney).  Although this may assist in the eventual societal contribution of men and women formerly in foster care, it is my opinion that youth that are adopted by a traditional, stable family will be more likely than foster children to become educated, contributing citizens.  I agree that it would be advantageous if foster care were extended to young adults up to the age of 21 because it would more closely model after the traditional family. Most people continue to receive support from parents after the age of 18.  Wouldn’t it be that much more essential for children that have likely had troubled childhood without their birth parents to continue to be aided by the foster care system?

Financial Impact

Financial needs of foster children and adopted children are largely medical expenses.  Because such a high percentage have special needs and mental disorders, they require a higher level of care than other children in similar circumstances.

Although foster children are automatically covered by Medicaid, simple eligibility is not enough to satisfy the substantial health care needs of foster children.  An article published by Princeton University stated that the “. . .barriers that impact all foster families applying for Medicaid. . .include the difficulty in finding health care providers who will accept Medicaid (due to the program's low payment rates, burdensome administration require- ments, and inefficient payment systems) and ensuring continuity of care, especially when foster children are moved frequently from one neighborhood or community to another” (Allen and Bissell).

Although I am not a financial expert, I believe that in the interest of foster children nationwide it is our responsibility as citizens desiring a bright and productive future of the rising generation, to reconsider the placement of funds.  If this great country can provide a satisfactory arrangement for a less than satisfactory living situation for a foster child, that same arrangement can be shifted to an adopted child and made more than satisfactory.

Conclusion

My brother and sister’s psychiatrist told my family that children with Amanda and Tommy’s mental disabilities reach their twenty-fifth birthday, they are usually in prison and if they don’t reach their twenty-fifth birthday they have usually committed suicide.  I understand that not all children foster children will have the same outcome.  But I do know that the living situation into which my brother and sister were adopted could not have been more suited.  There is no better place for a foster child with special needs to reside than in their own adoptive family.

Although I support the proposed age changes and agree that they would improve the quality of care that foster children receive, that quality will always be surpassed by an adoptive family.  I have faith that the rising generation can have a higher chance of being successful contributing citizens despite their situation during early childhood.  The future for these children can be altered.

References

Allen, MaryLee and Mary Bissell. "Safety and Stability for Foster Children: The Policy Context." The Future of Children 14.1 (2004): 48-73. Web. October 2013.

Dworsky, Amy, Kym Ahrens and Mark Courtney. "Health Insurance and Use of Family Planning Services among Current and Former Foster Youth: Implications of the Health Care Reform Law." Journal of Health Politics, Policy and Law 38.2 (2013): 421-439. Web.

Galehouse, P, C Herrick and S Raphel. "Position Statement On Foster Care International Society of Psychiatric-Mental Health Nurses." Journal of Child and Adolescent Psychiatric Nursing 23.1 (2010): 36-39. Document.

Hansen, Mary Eschelbach. "State-Designated Special Needs, Post-Adoption Support, and State Fiscal Stress." 1 November 2007. Pubmed Central. Web. 31 October 2013.

Scott, Diane L., et al. "Permanency for Children in Foster Care: Issues and Barriers for Adoption." Child & Youth Services 34.3 (2013): 290-307. Web.

Vogel, Carl. "Extending Foster Care." 2013. University of Chicago School of Social Service Administration. Document. 31 October 2013.

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