Preserve Subsidy Supports: Protect Children's Best Interest
from the Winter 2006 Adoptalk
by Diane Riggs and Joe Kroll
Neither the federal 2006 budget reconciliation bill nor President Bush’s 2007 budget proposal offered good news for state child welfare budgets, many of which are already tight. But in these times of fiscal stress, legislators and officials must take great care to honor legal and moral commitments to vulnerable children—including their commitment to support foster children with special needs after they are adopted. In the face of ongoing threats to adoption subsidy programs, parents, child welfare professionals, and advocates must redouble efforts to safeguard the supports that help children succeed in adoptive families.
Cutting Corners on Subsidies
Every child who is eligible for an adoption subsidy has had a rough start in life. Most birth families who lose a child to foster care have few resources, and usually a judge has determined that the child is unsafe with his family due to neglect or abuse. Some children have disabilities that qualify them for Supplemental Security Income (SSI) benefits. All have, or at risk for developing, special needs.
Unfortunately, some states—when asked to consider a change to the subsidy program or when a budget crunch strikes—have seized on ill-advised opportunities to cut costs:
- Changes to medical assistance programs can hurt children adopted from foster care. Cuts to Florida’s Medicaid program last September, for example, reduced the number of covered medications, including some that address behavior disorders common to children adopted from foster care.
- In spring 2005, Missouri Governor Matt Blunt signed a Medicaid reform bill into law that included troubling changes to the state subsidy program. Currently stayed under a court order (the case goes to trial in late April), the law would allow the state to restrict adoption subsidy benefits based on an adoptive family’s income, retroactively void existing state subsidy contracts with adoptive parents who fail to meet new income guidelines, and limit all federal and state subsidy contracts to one year.
- To reduce the number of subsidy-eligible children, other states have altered special needs definitions.
State Administrators Can Help Adopted Children
When facing hard choices, state administrators can be fiscally responsible while fulfilling their obligation to aid foster children with special needs who join adoptive families. States can:
Maximize Title IV-E eligibility. Children who are eligible for Title IV-E benefits can receive federal adoption assistance. The federal government will reimburse at least 50 percent of the state’s subsidy costs for these children.
When states do not make the effort to qualify needy children for federal assistance, they lose millions of dollars in federal funding. In 2001, for instance, the Division of Family Services in Jackson County, Missouri failed to complete 19 percent of its IV-E determinations and re-determinations. That 19 percent translated into a loss of $14 million that could have been used to support children who have special needs.
Use deferred agreements in concert with a “high-risk” special needs definition. Deferred subsidy agreements, typically used when a child is at high-risk for developing future problems, give families peace of mind, and can save states money. Such agreements initially include a Medicaid card but no monthly stipend. If the child develops problems down the road, parents can then negotiate an appropriate monthly subsidy without having to initiate an administrative fair hearing—a process that costs states both time and money.
Keep special needs definitions fair and flexible. Subsidies are intended to help harder-to-place children find permanent families. Each state, when setting its special needs criteria, must make certain that the subsidy program is carefully crafted to fully support all children who are harder to place for adoption, especially those who cannot be readily placed due to a lack of placement resources.
Child Welfare Professionals Can Advocate for Support
To protect adoptive families, John Levesque—Maine’s former adoption manager—recommends that subsidy program administrators proactively teach legislators that adoption assistance “is an incredible investment in permanent families for our children.” Legislators should never believe that the state is “paying families to adopt.” The fact that subsidy costs are going up (and outstripping foster care costs in at least 10 states) is good news; it means that more children are finding secure new families, and fewer children are stuck in foster care limbo.
Erin Sullivan Sutton, director of the Child Safety and Permanency Division of Minnesota’s Department of Human Services, adds that children must be the focal point of all discussions about adoption assistance: “We try to tell the story about who the children are, what their needs are, why adoption is important, and why the state has an obligation to provide financial assistance to parents who adopt children with special needs.”
Administrators and workers must educate government officials and legislators about struggles that adoptive parents and children face. They should share stories of families who have survived hard times and, thanks to ongoing support, have watched their children overcome early challenges and thrive. In addition, officials and legislators should be aware that the federal subsidy program is an entitlement precisely because children in care have serious special needs that make them harder to place.
Supervisors and managers should also take the lead in reminding workers why each adoption subsidy is negotiated individually. The idea is to find the right level of assistance to address a particular child’s unique needs, not to get adoptive parents to agree to as little assistance as possible without considering the child’s current and future needs.
Parents Must Protect Their Children's Best Interests
Melanie Scheetz, an adoptive parent and head of the Foster and Adoptive Care Coalition of St. Louis, Missouri, believes parents should be on the front lines of the battle to preserve and enhance adoption subsidy programs. After all, they know better than anyone the real challenges of raising adopted children who have special needs. Constituents who share compelling stories can help legislators fight ill-advised changes to subsidy and medical assistance programs, and champion improvements.
Parents must also learn all they can to better advocate for their children, and address their children’s specific issues. Foster/adoptive parents may be able to provide information about the birth family that can make their child eligible for Title IV-E assistance. Pre-adoptive families can also ask workers to apply for SSI.
This January, Maryland increased its foster care and adoption assistance rates by $25 a month, and requested another increase for next year. Granted, the increase was the state’s first since July 1990, but it was nonetheless a welcome change, and a sign that states can do more to help children in and adopted from foster care. Working together, motivated parents, committed child welfare professionals, educated legislators, and forward thinking government officials can help to ensure that state budgets are not balanced by harming children who have endured great hardship and, at the same time, limiting the prospects of foster children who still need adoptive families.