Monday, May 16, 2011

The Costs of Special Needs Adoption - Part I

This week, I will be writing a short series about the costs involved in special needs fostering and adoption. Although many costs are pretty obvious, there are others that prospective foster and adoptive parents might not consider ahead of time. Some of these things we were made aware of before we started fostering, but many we didn't learn about until it was too late.

In today's post, I am going to discuss the financial impact of fostering or adopting special needs children. It is important to realize that kids, even one's own healthy biological children, can be costly. The costs involved in feeding and clothing a child can sometimes be surprising, even for the most thrifty and clever families. It is important to realize that the foster care and adoption assistance stipends offered in most states aren't enough to decently feed, house, and clothe your average kid. Subsidies are especially lacking for younger children, and generally aren't enough to keep the little ones in diapers or formula.

So, if one is planning to foster or adopt, one needs to be prepared for the fact that the subsidy money won't cover all out-of-pocket expenses. Although many parents may think they are prepared for this, sometimes they find themselves taken by surprise.

This problem can often seem worse when a child is first placed. It is not uncommon for kids to arrive with nothing more than the clothes on their backs, but initial clothing vouchers and stipends are often late in coming. For an unprepared foster family, this can create an unexpected burden on the family budget.

When one is parenting a special-needs child, there are often many costs that go far beyond what one would expect. Children with physical, intellectual, or emotional problems often can require an unexpected number of medical visits, therapies and other interventions, not all of which are fully covered by the provided state-sponsored or any private insurance the family might have. Although the more seriously affected kids might qualify for difficulty of care subsidies, even those aren't always enough to cover medical supplies, medications, insurance co-payments, respite, or the cost of residential care.

Although direct, out-of-pocket costs can often be unexpected, it is the hidden financial costs of fostering and adopting that can be a larger surprise. Prospective parents generally have an idea of the direct costs they will face when they foster or adopt, but they do not always realize that fostering or adopting special needs kids can have a big impact on a family's ability to earn an income.

The biggest impact a special-needs child can have on a family is in terms of scheduling. Many kids have multiple appointments per week, including trips to court, therapy, medical appointments, parent/teacher conferences and birth family visits. Most, if not all, of these appointments will need to be scheduled during business hours, and will require a parent to take time off from work. The number of appointments can seriously interfere with a parent's ability do his or her job, making it very difficult for a two-income or single-parent household to maintain its standard of living.

Even when one has an understanding boss, it still can be hard, especially if a parent is dealing with a child with emotional or behavioral problems. Bosses and clients tend to have a limit to the number of times they can expect sudden absences because of family crises. Once in a while can be forgiven, but woe to the employee who has an extremely difficult child.

Self-employment can help with this problem, but even that has limits. Most self-employed people still need to meet their customers' obligations. It can be very tough when one finds themselves participating in intensive in-home therapeutic interventions that can take up to as much as eight hours per week. It is extremely hard to keep up with work when one is running around from appointment to appointment, many of which can be emotionally exhausting.

In addition to interfering with one's ability to work, special-needs kids coming from overseas orphanages or the domestic foster care system frequently come bundled with emotional or behavioral problems. In addition to the expected costs of therapy and medications, it is not uncommon for kids to steal or deliberately destroy things of value. Parents do not expect to pay for serious damage done to their home by their children. Some kids will slash tires, punch holes in walls, shatter windows, break furniture, or deliberately urinate or defecate in places other than the toilet.

In some cases, not only will kids destroy a family's home, but they will do damage to the neighborhood as well. Parents can easily find themselves paying for damages to their own home, and for damages done to the property of others. Although foster parents often enjoy limited liability from the damages their troubled kids might do to others, they are rarely reimbursed for the damages their kids cause to their homes and property.

Part of the problem with fostering or adopting special needs children is that one rarely is given full information about a child to be able to properly plan for these costs. More often than not, a family doesn't realize the extent of a child's needs, and the costs associated with those needs, until they are already committed. By then, it can be too late, sometimes because an adoption has already been finalized, and sometimes because a disruption would be too painful for everyone involved.

Next up: The Social Costs of Special Needs Adoption


  1. Regarding the subsidies: We were not even told about the subsidies while going through the adoption process. We would have gone through with it regardless, but that should have been standard information. WE had to teach the social worker about it, once we found out. I'm grateful we have it, particularly the medical care.

    Really looking forward to what you have to say about social costs. For us, that's been even more "expensive" that the things with a price tag.

  2. My daughter qualified for a behavioral subsidy but nobody told me that until I figured it out a couple of years later. The missing work thing is a big one. I worked from home when I was actively fostering, I don't think that I could do it now with a full time job. Even now, I miss a lot of work to deal with "crisis" calls from my oldest. Another possible cost is to meet the household regulations, different places have strange regulations and I've known people who have had to spend a lot of money on fences or renovations to the house because of procedural issues.

  3. (I'm playing instigator... post this or don't - I won't be upset either way).

    Your lurkers as well as some other readers might say that if you are wanting to become foster or adoptive parents (or parents in general) that you should assume and expect to take on all financial responsibilities for your children no matter what the cost. Parents who bore their own children must take on the financial hardship when they realize they are expecting and their medical conditions may be unknown as well.

    As much as this is true, I have a hard time buying into that argument. Before becoming a parent or even considering it, you should sit down with your partner or spouse and discuss: what you want, what you can handle, what is unacceptable, parenting skills and experience you have as well as comparing how you want to parent children who come into your home. Knowing just what you can and can't handle and what will be acceptable and unacceptable in your home can really help determine what "types" of children you will consider fostering or adopting. For example, if you have no experience or knowledge on how to raise a child with FAS, then it may not be best for you to consider children with that disease.

    But just as important as knowing what you and your spouse can handle is having the social workers and "system" be open and honest with you about what symptoms and diagnosis about the children they would like to place with you. If you are being told the child has no issues (mental or behaviorally), you accept the child, come to love the child and decide to adopt... only to then to see the child's psychological and mental behavior change - it may come as a shock to realize that the things the child now needs to be healthy and productive is very expensive and may not be covered under the families insurance or even the child's medical insurance.

    The truth is, some folks just can't afford to get their children every possible medical test out there. The parents needs to make sure that they can keep a house over their head, clothes on their back and food in their mouths. As much as they'd love to be able to take care of their own children and get them the "best money can buy"... not all families are able to do that. That doesn't make them bad parents - it just means they need to work within their limits.

    My partner and I both worked full-time. However, I made significantly less than she so we decided it was better for me to take our "daughter" to therapy and doctors appointments after she was diagnosed with RAD. I was usually the one who attended court as well (for the same financial reason as well as because I worked 2 blocks from the courthouse while she worked a 1/2 hour away). For a while it appeared my time off from work to deal with the medical issues of my "daughter" were no issue... but as time went by, it became apparent that my absences were an issue.

    Subsidies to help cover the costs of the foster child before or after adoption (or even if they remain in foster care) do not even come CLOSE to paying for the necessities of the child. Like you said, many of these children come into our homes with nothing but the clothes on their back. And with social services being a month behind in reimbursement payments - the money comes out of your pocket if you want to make sure these kids have toothbrushes, clothes, school supplies, shoes, etc.


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