Category Archives: tonsillectomy

Promises, Promises…

K looks out the front door despite being legally blind.  She has some sense of what lays in front of her.  It's a walk she does all the time.  Sometimes, we don't have to know or be able to see the details to know where we want to go.

As a society, what are we saying when we take a child from their parents? We are saying we can and will take better care of your child than the parents are taking. We only say this when we as a society feel the parents are taking dangerously bad care of the children.
We promise to take care of the children. Part of doing so has historically meant providing stable environments for the children to grow up and create loving bonds. There are many studies on the emotional impact on young children resulting from the loss of each parental bond, and yet the state feels the results of leaving a child in their current care will be worse than the damage caused by removing them from their current parent(s) for however long is needed for the situation to change in a positive way.

The problem is our ability as a state to care for these children is quietly eroding. Currently, I see two imminent threats to our current model that is already resulting in kids moving too often between families and group homes.

The first is our ability to foster children in a family setting rather than a group home. In MD where we foster, there was an average of 5,724 kids in placements outside of their biological family home in any given month. In the last year, there were also 199 new placements per month. Only an average of 4,044 foster children were in one of the 1,596 MD foster family homes.

It would seem we need more foster homes for these children, but the yearly trend is going the other way. Last year MD netted out a loss of 11 homes in which we can raise these children. The 11 may not seem like many, but it is an average over the past year. The number discounts the more distressing recent trends where MD lost 46 foster homes in the most recent three-month time-period between March and May. MD also had less foster children taken in by family in the past year too. (Stats for last two paragraphs can be found in the most recent set of Maryland Child Welfare Services Data: http://www.dhr.state.md.us/blog/?page_id=2856)

The second problem comes from how we chose to provide long-term families to children in the foster care system. Since we started foster care, the primary goal of foster care has been to reunite the children with their biological families. Removing the children has lasting impact on children’s ability to form emotional attachments. It would seem to follow then that removing the kid from both their biological families and their long-term foster families would cause further damage. So, I was not surprised by what I learned last week from Josh Kroll with the North American Council on Adoptable Children. It seems foster families are the families who historically adopt these children 57-59% of the time nationally. Foster parents are the group most likely to adopt these children and provide them with loving stable families.

Maryland (MD) used to try to remove the financial disincentive for foster parents to adopt. By disincentive, I mean MD tried to minimize the difference between what a family is paid to foster a child and the subsidy they will receive after adoption. After all, if the state is going to pay x dollars per year to raise the child, why not try to maximize what the child gets out of the deal by giving them a long-term family. After the adoption, the state can still save on many administrative costs like courts and social workers covering the care of the child, even if the adoption subsidy is close to the foster subsidy. Everyone seems to benefit under this rational.

As of July last year, this rational changed. Now according to the Department of Human Resources Social Services Administration,” Adoption assistance payments are not intended to cover every expense the family may incur to have that child as a member of the family, but rather to offset costs, such as therapy or therapeutic activities, incurred related to the child’s special needs that are reflected in their eligibility criteria for assistance.” With this change, there is a marked difference in what many families will receive in assistance if they adopt the children in their care. Logically, fewer parents will be able to adopt out of foster care, and those who do will be less able to take in/adopt additional children.  It’s worth noting from the stats above, over 5,700 kids in foster care and less than 1,600 homes means we are already depending on the foster homes to take in more than one kid.  Are the families intended to be able to provide everything for these kids when they adopt the majority of those lucky enough to be adopted?  Are we setting practical financial limits on the ability of the group most likely to adopt?

Josh Kroll provided some startling stories of what happens when adoption becomes expensive for the foster families. He told the story of his time working with Minnesota when foster care rates increased with cost of living increases, but adoption rates did not. Eventually, the adoption rate by foster families of kids in foster care fell to 20%, which is a stark contrast to the national historical 57-59% rate. Is MD heading in the same direction? I know J and I have been offered less than 45% of the support we receive as foster parents in an effort to force us to adopt K.

Are we living up to the promises we, as a society, make to children we remove from their biological families, and will we continue to be able to do so with our current policies?

Hands to Work, Hearts to God - A Shaker saying which fits my belief in foster care.
Hands to Work, Hearts to God – A Shaker saying which fits my belief in foster care.
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Resilience


There are a lot of things I have learned from my kids, but most striking to me lately is resilience.  At how many dinner tables around the world would have this conversation take place?
Daughter to my son: O, did it hurt when the Dr. took your tonsils out?
O: No, they gave me sleepy medicine and put me to sleep. It did not hurt at all.
A: Oh, I forgot they did that when I had my heart surgery!

This is just an example of a normal dinner conversation between 5 and 6 year old siblings, right?  The most amazing part is they take it for granted and say it all like it’s nothing.  The only excitement was realizing they had the experiences in common.

 My son had a tonsillectomy and eye surgery last Friday which prompted the conversation above.  He is seriously stoic when it comes to pain.  I mean he is definitely the same kid who could be convinced to apologize to the pavement after falling and hitting his head on the sidewalk.  So long as he has his video games he can be oblivious to pain.  Heck, the surgeon said he would be miserable for 10-12 days and not really want to eat much solid food.  He ate a hamburger the evening of the surgery which I would have been more impressed with had it not been my hamburger.  😉  What can I say?  We didn’t think he would eat, or if he did eat it would be from the pudding/ice cream choices he was offered.  Lol.  He doesn’t like the prescribed pain meds so  he is making do on children’s Tylenol.  Tough kid, I say.  He was scared of the cream for his eyes, but he’s actually come to like the look if not the application.
My daughter tries to help him and care for him.  When he was scared of the cream for his eyes, she wanted to have it in her eyes to show him it’s OK.  She did fine with it in her eyes (we made sure it would be fine first).  She is also very jealous that he gets cake and ice cream and jello and pudding and sprite and…all the food and drinks she likes while she has to eat normal food.  She also wants to sit and play video games all day…So she is alternating between her natural inclination to nurse him and be the jealous sister which seems more natural for a 6 year old.  Between the sleepless nights of anxiety and pains, our family just keeps on keeping on. 
As my grandma used to say, “We’re in pretty good shape for the shape we’re in,” and some of us have cool eyes to boot.
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