Families that adopt troubled or high-needs foster kids in Colorado receive inconsistent and often meager financial support from a state program that lacks sufficient oversight, the state’s child protection ombudsman said in an investigative report Wednesday.
“Adoption subsidies,” which are meant to help families adopt foster children with mental health issues, disabilities or behavioral problems, are negotiated by families with the state’s 59 county child welfare departments.
State training and guidelines are inadequate, there is no online portal for families to learn about adoption financial assistance, and some counties are misinterpreting state and federal standards, according to the report from the Office of Colorado’s Child Protection Ombudsman.
Parents who adopt are receiving far less financial support than foster parents, the 16-month investigation found. The average adoption subsidy statewide was 56 percent lower than the average foster care rate.
Families repeatedly told the ombudsman’s office they were not prepared for the “dramatic decrease” in monthly assistance rates when moving from foster care to adoption.
“We’re talking about finding permanent homes for children and more importantly, we want those children to stay in those homes,” Ombudsman Stephanie Villafuerte said, noting more family support helps avoid adoption disruptions.
The monthly cash subsidies, which can help pay for therapy, medical equipment or assistance for children with severe food allergies, vary by as much as $500 per month from county to county for children with similar needs, the ombudsman found.
In Mesa County, which finalized 47 adoptions in 2015, the average monthly subsidy was $435. In Larimer County, which finalized 28 adoptions that year, the average subsidy was $45. The average was so much lower in Larimer County because 25 of the 28 adoptions came with no cash subsidy — only the children’s enrollment in Medicaid, the government health insurance program that covers foster kids as well as the needy and disabled.
El Paso County’s adoption subsidy average was $313, while Adams County’s was $168.
Colorado spent $25.9 million in federal, state and local funds in fiscal 2017 to support children, youths and families through adoption assistance.
The report, which includes 14 recommendations for the legislature and the state child welfare division, focuses on consistency in information and funding formulas across all counties.
Some counties set subsidy-rate caps depending on the age of the child, typically with older children receiving more money. Other counties base subsidies on the needs or “difficulty of care” of the child. Some counties allow a family’s attorney and other professionals to participate in subsidy negotiations; others do not.
The federal government initiated adoption subsidies in the 1980s in an effort to find permanent homes for foster children with high physical or emotional needs.
In Colorado, 683 adoptions were finalized in 2015. Of those, about one quarter did not come with cash subsidies, only the enrollment of the children in Medicaid. It was not clear, however, how many of those families asked for a cash subsidy.
Among the more than two dozen families interviewed by the ombudsman’s office, several said they were frustrated with receiving only Medicaid for their adoptive children. Their key concern is that many mental health care providers don’t accept Medicaid insurance, meaning families have to pay out of pocket.
One family said their adopted child became violent and at age 10 began running away from home in the middle of the night. The child was placed on a 72-hour mental health hold, but the family could not find a residential treatment center that would accept Medicaid.
A directory of post-adoption mental health professionals maintained by the nonprofit Adoption Exchange lists 88 professionals in 12 counties. Of those, just 32 accept Medicaid and none are in rural areas, the ombudsman found.
It’s not the first time the Colorado Department of Human Services has heard concerns about the adoption subsidy program. In 2002, the state auditor’s office asked the department to improve its practices.
“It’s concerning to me that it has indeed been 15 years that these problems have been ongoing and have not been fully resolved,” Villafuerte said. But, she said, the ombudsman’s investigation did not focus on a single state agency as previous reviews have done and has the ability to bring together county departments, nonprofit child advocacy groups, families and multiple state agencies to improve the system.
“It’s about all of us who touch the lives of these kids and families,” she said.
State human services officials said they welcomed the ombudsman’s investigation and would create a strategic plan to fix the problems and assign people to “ensure the recommendations are met.”
Paige Rosemond, associate director of programs for the state Office of Children, Youth and Families, also agreed it has taken too long to make improvements suggested in the 2002 state audit, and that’s why the department was quick to agree to all of the ombudsman’s recommendations. “We need to strengthen post-adoption services and delivery,” she said.