The cost of fostering

We recently had a new foster kiddo join our family for a while throwing us back into the thick of the foster care rollercoaster. We’ve had an active license for the last six years, but when we finalized the adoption of our last munchkin in January of last year, we thought we were done with the exception of the odd here and there babysitting gigs for our friends who are still foster parents and need licensed caregivers in order to have respite care for their munchkins.

Imagine my husband’s surprise when he got a weird text message from our friends in New Mexico congratulating him on our new basketball team (the running joke between our two families has always been that we had enough kids to field our own sports teams). Apparently I sort of forgot to inform my husband that we had temporarily taken in a new kid (actually two of them) while he was out of town – okay, in my defense, it was only supposed to be overnight and he was out of town at the time. I probably should have known that when Tenille told me it was only overnight that it really wasn’t (we’ve had that happen every single time but once), but I have an almost pathological inability to say no when placement calls me. But I digress.

The story I’m writing about here is actually one of numbers. After having been out of the “real” foster game for a few years, I’d forgotten just how much work in involved in the first couple of weeks of a new child joining a family. But let me break some of it down for you here. Please understand that this post is not a complaint about the amount of time or money we spend on taking kids in – it’s simply to illustrate the realities behind why we have such a hard time recruiting and retaining good foster families.

Once the Department decides to shelter a child(ren), the Department has to have the case heard before a judge the next business morning in an emergency shelter hearing so that the Department can have the legal ability to shelter the child until the adjudication hearing. This requires that the child be transported as the courts have now decided that the children have a right to be heard in court (this includes infants – I guess the judges like hearing their cries?) though in the 15 times I’ve been present during the shelter hearing I’ve never once had the judge actually speak to any of my children – even our most recent addition who is four and a half and old enough to talk to the judge. In fact, this judge specifically asked me to take all of the children out of the court room into the play area because they were disrupting court – which served to irritate me because what was the use in making the child attend if you’re not going to pay any attention to them? Even when the hearing is the first one on the docket, you end up being in court for several hours – so if you’re a full time employee, be prepared to burn some annual leave.

When removed from their family of origin, foster kids are required to see a doctor within 72 hours as a way for the system to have a baseline of what their current health status is. However, in certain parts of Florida, the managed care entity responsible for ensuring that these kids have access to a doctor did a horrible job of rolling out its new plan, and thus there are simply no available doctors to see our kids. It took 11 days to get the very first available doctor’s appointment for my new child – officially 192 hours longer than mandated. Oops! Because I was not the person who made the appointment, I was unable to attend this visit due to a meeting at work I simply could not reschedule so my child had to be transported by yet another unfamiliar person to a doctor’s visit that required four shots from a doctor she had never seen before to be comforted by a person she had no relationship with whatsoever.

The results of that visit showed that she needed specialist appointments that simply could not be arranged locally – so I did something not many people have the ability to do – I added her to my private insurance to gain access to a whole slew of medical practitioners that were not available to her on the Sunshine plan. This will cost me money out of pocket, but I would rather do that and have access to good LOCAL doctors than have her suffer or have to be transported to Panama City or further for medical appointments. I was fortunate to be able to do this because she also has a slew of dental issues that need to be addressed and there are no local dentists who take the Sunshine plan either (okay, I may be exaggerating here – there is one dentist but that office can’t make appointments for months so I don’t count them). So to take her to her establishing appointment with both the primary care physician and the dentist both took about a half a day of my workday.

The two kids that came to me that night had nothing with them but a ratty teddy bear, two books, a pair of panties two sizes too small, a pair of pants two sizes too small, a bag of cookies, a box of almond milk and six diapers. When we figured out one of the kids would be staying (likely for a very long time) it became necessary to try to get some clothes and supplies for her for everyday use. Since I’ve never had an older female child, I did not already have a stash of larger sized clothing. We’ve only ever taken in babies – I didn’t even have a bed that was big enough for her permanently (or even longer term). Fortunately, our local foster and adoptive parent association runs a small supply closet and I was able to get two outfits in her size and our licensing agency just happened to have an extra bed we could use for her – otherwise I would have had to run out to purchase those things (and I would have willingly). My fabulous coworkers even pitched in and got her three more outfits, some sock and undies. I ended up having to buy school supplies, a nap blanket and mat, a lunch sack and thermos, and enough outfits to get us through the rest of the week, a pair of shoes and some pajamas. The grand total for day one of her arrival was already sitting at $200 and change.

The week we got back from the trip I will tell you about in a minute (in the middle of the third week kidlet had become part of our family), the case manager finally got us the clothing and shoe voucher we had asked for so that we could supplement and fill in what we didn’t already have. A $50 voucher to Marshall’s for clothing and a $50 voucher to Beall’s Outlet for shoes are what the department provided. While better than nothing – for families who do not have the means that we do at their disposal – this wouldn’t have gone very far.

To recap so far, already we’re sitting at two full days off of work to get through necessary appointments and $200+ out of pocket for basic expenses and a late set of vouchers for an additional $100 at stores whose prices are rather inflated. An addition to our private insurance as the state provided insurance plan was inadequate to handle the needs of the child in my care. And I won’t disclose how much emotional chocolate I may or may not have consumed in this time period to handle the emotional rollercoaster I’m personally on over the course of this journey.

My family had already planned a Disney vacation for the week after munchkin joined us. It was obvious munchkin wasn’t going anywhere anytime soon because we’re out of foster homes locally – and quite frankly, unless a home came available that could take all four of them permanently (did I mention she’s part of a sibling group of four) I wouldn’t want her to move because each move is highly traumatic to kids. It wouldn’t have been right to exclude her from the trip we had already planned because she is part of our family now. We couldn’t back out of our trip or reschedule it because it was already paid for – so we simply bought her tickets to go with us – another $180 expense. She had a fabulous time and the whole family had a much more enjoyable trip for having her with us.

Here we are now at week three of munchkin joining our family. I can’t really remember a time when she wasn’t part of our family – and my kids have all embraced her as one of us. My husband adores her as does all of the extended family who have met her. Her daycare teachers love her. Our friends love her. She’s’ one of the best things to have happened to our family since Elie joined our family two years ago. But I haven’t even begun to touch on the emotional toil going on in our family in the last three weeks.

Initially, there was a lot of fear, chaos and even some anger as my husband was a little peeved with me when he first got the news I had taken a new child in. I was also a little off kilter as the placement phone call came at 1 AM and the kids arrived at 3 AM when I have to be up for work by 4 AM. Court is ALWAYS stressful – so add in a(n) (un)healthy dose of high stress from court and then the utter chaos of trying to get your house situated for a little life to join you when you were clearly not planning for it. My husband was returning from a weeklong trip to the D.C. area during a nasty weather system and my kids were all out of sorts from having a new little person joining our clan. Toss in a smattering of sobbing from our new kiddo as she started to figure out that she wasn’t going to be with her mommy again for a while, some missed visitations, and a nice little tummy bug to boot – let’s just say that fostering isn’t for the faint of heart.

Recently, I’ve had people discuss with me that they feel people foster simply for the money. They go on and on and on about how foster parents make so much money housing other people’s kids. I’ve always taken offense to those statements – but after we finalized the adoption of our last kiddo I started focusing more on my own family and less on the system of care (though trust me, I’ve not given up on changing the system). But after this last three weeks, when one of my very misguided friends tried to barb me by saying “at least we would be making some more money now” I actually went off the deep end on her a little. You see, the average board rate reimbursement for foster care in Florida is $439 a month, split up on a daily rate it’s $14.16 a day. On the very first day my new munchkin came to me I’d already spent over $200 just to meet her basic immediate needs. Setting up daycare there is a $75 registration fee and a $65 supply fee. The Early Learning Coalition referral only pays about $16-22 a day towards day care for kids in care and most day care centers cost between $25-50 a day. At one center we were paying over $600 a month out of pocket just for day care costs alone.

To put this in perspective – the per diem reimbursement the State of Florida pays a state employee when on travel is $36 a day for meals alone – that does not include the costs of hotels which is generally $85 a night or more. If it’s a travel day and you’re travelling during all four day parts, the reimbursement rate is $80. The state pays more for employees on travel status than it does for kids in care.

The emotional toll foster parents pay is also enormous. My current munchkin is very, very sad about not being with her mommy. We’ve deal with crying jags that have lasted over an hour at times where the only thing we could do is simply hold her, rock her, pat her head and remind her that she is loved and that we would do everything in our power to help ensure she could see her mom again soon – even though her mom doesn’t always show up for visitation. Dealing with a clinically depressed four year old is tough work – knowing that every little thing we say or do can either help or hinder her healing process is a huge emotional burden to carry – but we do it willingly because we know she needs us.

The changes in the relationships between me and my husband and me and my kids right now also carry a big price tag. Granted, these have been positive changes this go around – but they haven’t been with other kids we’ve fostered in the past. One of our foster babies was so high needs that she almost broke me from all the crying – that was one of the hardest three months I’ve ever endured and I come from a pretty rough childhood myself! My marriage was stressed. My other child was stressed. I was stressed. Every time we’ve taken a child in, it’s changed the dynamics of our family. I’m hopeful my kids learn from these fostering experiences that we should help our fellow humans out – but there’s also a good chance they grow up resentful of the time and energy we put into other children and families aside from our own.

The long and short of this all is that fostering is expensive – emotionally and literally. We need more families to make this investment though – because it’s an investment in the future of a child but also in the future of our society and civilization. We also need our legislators to realize that there are physical and emotional costs to these kids and to the families who care for them – so that they can adjust the supports available to the families and to the kids. And we need the system of care to become more flexible to allow for creative solutions to the needs of our kids and families. None of this will happen in a vacuum – we need more people like YOU to take the steps to help make the change too. Won’t you join me? There’s a child out there who would be grateful you made the world change for them!

A Response Regarding Responsibility

I was corresponding with one of our local Community Based Care (CBC) representatives yesterday about the responsibilities the CBCs have in placement decisions. I was particularly upset by one line of one of the emails I received that stated that "The decision to move a child as well as place a child does not always fall on the CBC's decision makers."

The more I thought about that line, the more upset I got. You see, I think it is a common practice for those of us working in dependency to throw our hands up in the air and declare that something is not our fault because the system is too big and there are so many players that we cannot control everything. I strongly disagree with that idea and think that we each have a responsibility to uphold the intent of the system to make life better for the kids in our care by holding every single player to an extremely high standard - including ourselves. I was so upset by this that I ultimately didn't sleep very well again because I kept dreaming about the issue. So when my teething one year old woke me up for the third time at 2 AM, I never really fell back into a sound sleep. So at 4 AM I composed the following response:

The more I thought about your response last night the more it got me thinking. I wanted to say something that's been on my mind for a few years now as I've worked on a lot of these types of issues both at out local level and statewide (and if you want to get truly technical, even at the interstate level).

You said in your email that the decision to move a child as well as place a child does not always fall on the CBC's decision makers, but I think that it actually does. The decisions themselves may not, but the responsibility to ensure that they are done according to best practices and in the best interests of the children does. That means that while the decision makers are not the people manning the placement phone lines and doing the day to day work of moving and placing children, they are the ones who are working on the policy practices, manning the contract management of the various partner agencies working under the auspices of the CBC's contract, and following up with the quality assurance plans that should show compliance with the state's requirements for the adequate treatment of the children and the families who care for them.

We all know that there are five thousand working parts to dependency and that the system is incredibly fluid. As a result, many times there are no true "textbook" cases, but there are human considerations for which to account. The two most recent cases I've brought to your attention do have some similarities to each other despite their being polar opposite examples - the similarities are that the consideration of the impacts to the kids and the families caring for them of actions on the part of placement and/or case management were not adequately addressed. This means that the families who were caring for children were treated with little respect. Because care giving families are not automatons who are simply paid babysitters we should afford them the respect they deserve - even in times of turmoil and quickly changing priorities. If the system wants to be able to treat families without that kind of respect, then my recommendation would be to scrap the foster home model completely and hire part-time babysitter providers who would be available at the drop of a hat, would not work as advocates for the children, and wouldn't mind being treated as "less than" - though I would caution that the expenses associated with that model would be incredibly high - both monetarily and otherwise. No one is advocating for that type of model to be put into place because everyone realizes that a home setting is truly the best setting for kids who come into care - but to keep the current model working at optimal efficiency, we need to make sure that we're being sensitive to the needs of the families in whom we place such trust. It's spelled out very clearly in the Partnership Plan. It's touted at every conference and every QPI call. We need to do everything we can to live what we preach.

My hope is that by providing the examples of cases where the system was not working optimally, we can ferret out the places for improvement and take ownership of the improvement processes. My goal is to help every single family we bring into the system, whether it's a biological family, foster family, relative or non-relative family experience the very best parts of the system without re-traumatizing them any further through poorly implemented or inadequately thought out processes.

I hope you can see where I believe that the CBC's decision makes do have the responsibility to ensure that placement decisions are done properly and with the interests of the folks directly involved (ie the children AND the families) are taken into account - not just the convenience of the transporters and case managers.

Thanks, and I'll chat with you soon, I'm sure!

I haven't gotten a reply yet - but I'm quite certain I've managed to irritate at least one person today (even though that was not my intent - honest!)!

Fostering Questions

I was asked some questions about why I decided to become a foster parent. Here are my answers!

Why did you become a foster parent?

I am an accidental foster parent actually. When my husband and I decided to start a family we ran into issues with fertility which meant that we were unable to have children biologically. We started looking into the process of adoption and decided to take the MAPP class to adopt from Children’s Home Society. My husband and I were originally only going to look into adoption when we decided to take the MAPP class, but once we got into the class and the instructors started talking about the desperate need for homes for children in care, it awakened a whole slew of feelings I had been carrying around underneath the surface about the events that unfolded in my own family. You see, while I am the only child of my mother and father, my mother had three other children in subsequent marriages – each of whom ultimately ended up in foster care themselves. Of my siblings, I alone escaped the chaos and destruction of our family and then the foster system relatively unscathed. Relatively being a subjective term here!

My husband and I committed to taking the MAPP class every Saturday for four weeks to learn what to expect from adoption and what kinds of behaviors and medical issues to expect from kids in state care. There was a lot of homework and forms to fill out, and it was a truly eye opening experience learning about the absolutely horrific things people can do to children and to each other. Much of what they discussed in class I had experienced myself in my own childhood as my mom and stepfather were abusive alcoholics, but the range of various abuse and neglect cases the instructors presented in class literally took my breath away. Aside from learning specific information about the types of trauma and abuse children who come into care suffer, we also had a lot of work to do personally by preparing ourselves to be able to handle the types of behaviors that may arise as a result of that trauma and abuse. This was also an exercise in strengthening our relationship because it forced me and Evan to deal with things about ourselves and our pasts that we would likely never have revisited if not forced to. I mean… my parents were a nightmare… and I would have been happy to leave things in the past, but we had to learn to deal with our own childhood issues to be able to help children that may be placed with us to deal with theirs.

After the second week of class, my husband and I decided that we would not simply go into the adoption track, but chose rather to become foster parents instead with the idea that if a child needed a secure home we would provide that. We also thought that if it was meant to be for a child to stay with us long term, that we had already decided we would be willing to adopt as well – and ultimately of the dozen children we’ve fostered in the last five years, we adopted three of them.

Tell us a moment in your life that led you to take part in foster care.

As my husband and I were going through licensing, we read more and more stories about the abuses children were experiencing. I had endured many of those same things myself and spent the majority of my adult life trying to work through the feelings of fear, worthlessness and anger that I felt as a result of how my parents behaved and treated me and my siblings. When I was an early teen, I finally got free of my mother and step father when my paternal grandmother and aunt stepped in to care for me. But my siblings were not so lucky and had to stay in the situation they were in. They were parentally kidnapped by their father and were missing for several years before ultimately being removed by DCF in another state some years later after my stepfather tried to murder my sister. I was still too young really to step in to try to save my siblings, but it didn’t mean that I didn’t want to. I was in my early twenties when my siblings came into the care of DCF in Massachusetts, and as a result of the abuse I had grown up in as well, I was not a mature twenty something – more like an angry teen. I was not equipped to handle the behaviors my siblings exhibited nor was I equipped to handle the emotional needs they had. I was not able to take them in or help them recover from their ordeal – but neither really was the system of care they were in. Both of them ended up in multiple foster homes and group home settings – and both of them ended up aging out of care with no safety net in place. My youngest sister ended up in the same situation as things between our mother and her father continued to deteriorate and DCF Massachusetts stepped in to remove her as well. After dealing with my own failure to help protect my own siblings, when faced with the idea that I could do something now to help keep this from happening to another child, I knew that we could help - even if we only ended up helping one child, I felt like it could help me heal some of the old wounds I still felt about my own siblings.

What do you think the state of the child welfare system says about Florida, and about the times we live in?

Anytime you deal with a vulnerable population and you fail to protect them, it says something very sad about your society. In Florida, we have not done even an adequate job of protecting our vulnerable populations – particularly our children. We’ve had an increase in the number of children and families on the radar of DCF yet we’ve not funded services to these children adequately. The staff charged with working these cases (whether CPIs, case managers, transporters, supervisors) are not trained very well, they do not have the tools necessary to do their jobs efficiently, and sometimes they cannot get to everything that needs to be done. As a result, what happens is we have this group of children and families on our radar who we know need help. We know they’re in danger. Yet we do not have the mechanisms in place to keep harm from coming to them. And I am not saying that money is the salvo to fix the problems here – it’s not. It’s about supporting the children and the families who care for them appropriately – which means supporting the people working in the system of care – all of the people working in the system of care, not just the child protective investigators (though that is a good start).

We also have a backwards mindset as a state when it comes to child welfare. We continue to see children as an extension of their parents – chattel almost – rather than seeing them as human beings who have rights themselves. So instead of working to do what is best for the children to help them grow up strong and healthy, we place the emphasis on keeping a family together – even if that means keeping a child in a situation that is dangerous or unhealthy. I hear judges and legislators talking about cases of termination of parental rights as the death penalty of child welfare cases, but these same judges and legislators do not live in the homes with the children and see the physical and psychological devastation the effects of a broken system of care have on their daily life and ultimately who they grow up to be. We know the research shows that exposure to violence and neglect have a detrimental effect on children, yet we somehow have come to the conclusion that we do more harm or damage by removing children from these situations – and I think we’re wrong about that in some cases. I’m not saying we should take all children away from all families – but I definitely think that the notion that some situations can be fixed by an inadequate safety plan is tantamount to sticking our heads in the sand to a real and dangerous situation – one that has lifelong, real life consequences!

I also think by not fully funding and fully supporting our system of child welfare that we’re re-victimizing the children we’re trying to protect. I’ve been the parent who had to comfort a child whose nervous system was shot from so much prenatal exposure to drugs and alcohol that they could not adequately regulate basic life processes. Yet when that same set of parents had their sixth child (all five of the others were already in care), the state had to scramble and work really hard to prove to a judge that the situation this child came into was extremely dangerous for that child to go home to – and they almost we not able to remove her because the judge felt like the extreme history of drug and alcohol abuse, chronic homelessness, mental health issues and domestic violence were not a safety issue. I’ve had to pick the pieces up for an eight month old child after they’ve had to spend ten hours on the road to a visitation with a biological parent twice a week – only to not have their diapers changed but once and fed only four ounces in that time by the transporter, visitation supervisor, case manager and biological parent. When we fail to remove children from situations that are extremely volatile and dangerous and then fail to adequately service the ones we do remove, we re-victimize our children over and over again. This is how we have multiple generations of families with the repeated patterns of behavior that cause DCF involvement in the first place. My family is a prime example of this systematic breakdown of the system! I should have been taken from my family many, many times but never was and so I had to suffer the physical and mental abuses doled out by my mom and stepfather. My siblings should have been given stable placements and had case workers who supported them as they grew up, yet they were repeatedly moved from home to home to institutional setting instead. My middle sister is doing well now finally – after a lot of counseling and hard work on her part, my brother is really damaged and will likely not do much better – and my youngest sister had her own child removed by DCF and has only now been able to regain custody of her. I worry that my niece will end up repeating this pattern again someday.

It says to me that our state either does not care about the future of our children or that we’re too immersed in things that are of minor importance comparatively when we don’t do everything we can to protect our children.

How does putting the focus on case planning instead of the CPIs improve Florida's child welfare system?

It seems like the focus of child welfare policy lately has been on the up front battle of investigations and the supporting the child protective investigators. While this is a good start, if we logically think about what happens next, we must figure out that if we already do not have enough resources to care for the families in the system currently, that we’re not going to be able to handle the influx that will necessarily come when we bring more families into care. There needs to be a huge push to fully support the case managers and attorneys who handle the cases once they leave the investigative part of the process too. Otherwise, you bring families into a system that will only end up removing children but not putting mechanisms in place to help heal those families with no mechanisms in place to achieve permanency for those children. There should never be a case where a child has to linger in the system for years with no end in sight – either fix the situation that caused the removal and return the child or if the situation is not fixable or if the fix drags on and on and on because no one thinks progress is important – then move to permanency.

Part of the problem with child welfare as I’ve been witness to personally, is that the turn over for staff is so high and the burn out rate so great, that there’s no longevity for institutional knowledge. By the time a case manager is fully trained and has the ability to make excellent judgment calls on case planning, we’ve thrown such a high case load at them that they’re so overwhelmed and underpaid that they leave for less stress and more money. Understandably! If we focused on supporting the case management/legal aspect of the system as well as what’s been suggested for the investigative portion, then we may be able to have staff trained well enough to actually design case plan activities that would work to help change the unsafe behaviors. If the unsafe behaviors change, then the children get to go home. Having enough and well trained case managers and attorneys would also decrease the caseload of each individual case manager allowing them to be more supportive of the individuals in their care. A case manager with 30 or 40 kids on their case load cannot possibly know all of the details of each case and be alert to the behaviors that are sometimes subtle but indicative of dangerous things to come. They also cannot be as in tuned to the timeframes of the families on their caseload when they have to manage so many different families. Our two youngest children’s cases were complex and had so many chronic problems that the case manager literally had to send referrals out for services once a week. For the family associated with only two of the children on her caseload, I’m quite sure she had to spend at least five or six hours a week dedicated to that case alone – and she had at least thirty children on her load. That is simply too much for one person to manage adequately – though I will say she is one of the shining gold stars of case management in how dedicated she was!

We have to do better as a state – there’s no other way to put this! With our growing population and beautiful places to live, we’re going to always have people want to call Florida home. We need to be sure that we figure out a way to help make that paradise that so many people come here looking for isn’t just a shattered dream!