Foster parents like us willingly pay a heavy price. The GOP wants us to pay more.
Photo: Nishant Choksi
One day in the summer of 2009, during a walk alongside a neighborhood creek with my wife and our one-year-old son, I mused out loud that maybe we should become foster parents. I had just finished seminary and was working part-time. We weren’t quite ready for a second child of our own, and though we had long considered adopting, it seemed like more than we could commit to at that unsettled moment in our careers. What we did have was a house in the suburbs of Chicago, a pair of modest middle-class incomes, relatively flexible work schedules, bleeding-heart tendencies, and a son whose newly docile sleep habits and sweet disposition probably made us feel more seasoned at parenting than we really were. Fostering seemed like a good way for us to help meet an urgent social need, even if only for a while. “Somebody has to do it,” I remember saying.
After hearing me out, my wife agreed that we should look into it. A couple more walks and some days of research later, she was driving the process more vigorously than I was. She requested all the information, got us fingerprinted, and sent out our reference forms. By spring, we were licensed by the state to receive a child.
It was nonetheless a shock when someone from the Illinois Department of Children and Family Services interrupted my dentist appointment one afternoon that summer with a phone call to ask if I wanted to add a one-year-old girl to our household. The baby had come into the hospital a few days earlier under circumstances that aroused the suspicions of the staff, so the state had taken her into temporary emergency custody. She would be released from the hospital that evening to the first available foster home that agreed to take her.
Not being in the habit of doubling the number of children under our care without my wife’s full participation, I frantically called and texted her. After a long ten minutes with no response, I decided to say yes to the state investigator, knowing that my wife would be more upset with me if I let the girl go elsewhere. (“Never mind, said yes,” she read on her phone after getting out of the pool at the gym.)
That left us about four hours total for nesting—about the amount of time we had spent discussing the relative merits of different breast-pump models when we were expecting the birth of our son. We bought some formula and baby food, shoved some books out of the way in our spare room, and updated our Facebook status. Then my wife went to pick the little girl up from the hospital and came home at seven p.m.
Sophia turned out to be somewhat less than a year old, small and toothless, with sparse, wispy black hair. (Some details throughout this story, including Sophia’s name, have necessarily been changed. A foster child’s case is confidential, and a foster home is in some cases a kind of safe house.) We have a picture from that first night: our son, then age two, is looking down at her warily while she sits in my lap gumming a rattle from Ten Thousand Villages, wearing a stained onesie and a fiberglass cast that covers her right leg. The only thing we knew about her injury was that it had somehow brought her to our house. It was the first time I’d seen a baby with a broken bone.
Sophia slept poorly. Within a week I had settled into a nightly routine of driving her out to the western reaches of the Chicago suburbs to lull her unconscious. She did not cry, but only shrieked at discomfort or confusion. She did not like to be held. But these challenges were, it quickly became clear, only half the struggle in our new role.
In a way that we never really anticipated, welcoming Sophia into our home led us into the wilderness of red tape and frustration navigated every day by low-income parents who struggle to raise children with the critical help of government programs. That same week, the office of the bone specialist who had treated Sophia’s broken leg at the hospital tried to get out of scheduling her for an urgent follow-up appointment. Like many medical practices, his endeavored at all costs to avoid working for Medicaid’s paltry reimbursement rates. (The office went so far as to deny ever having treated her; eventually, however, they gave in.) We went through a similar amount of stress trying to put Sophia into daycare. We had to run down a pile of government paperwork, prove our employment, and then simply wait and hope that our daycare center would accept the state’s stingy pay. And yet, frustrated as we were, we couldn’t exactly blame the doctors and daycare providers for being heartless. As the state’s stinginess pushes more of the costs of caring for foster children onto them, it’s no surprise that they start to balk.
It’s a major bureaucratic process to remove a child from her home and family. The state insures the child, pays for daycare, investigates the claims of abuse, and retains legal custody, but it cannot actually put a baby to bed at night. And so, on the other side of this most intimate public-private partnership are usually people like us, left alone with a stranger’s child and a garbage bag full of clothes and wondering what’s going to happen next. And what happens next depends, to a stomach-churning degree, on the state’s willingness and ability to keep up its half of the bargain.
So it was with an unusual sense of urgency and dread that our family watched the 2010 Republican wave and the austerity budgeting that has followed in ceaseless progression. When Paul Ryan’s budget, approved by 235 Republicans in the House, proposed dramatic cuts to federal Medicaid spending, it was as if they were trying to make it even more hopeless for us to find a doctor to treat Sophia’s health problems. When Scott Walker in Wisconsin sought to cut the workforce that administers foster care in his state, we went up to Madison to join the protests in solidarity, because we knew how helpless we would be if there were no caseworker on the other end of the phone to answer our own urgent pleas for help and guidance. And the threats have continued, as House Republicans repeatedly propose cutting trillions of dollars in domestic spending to reduce the debt while making room for sustained upper-income tax cuts. The way this hits home for us is simple. A foster parent joins hands with the state in order to take care of a dispossessed child. For the last year, the state has been trying to slip free of our grasp.
When you tell someone that you’re a foster parent, the response often goes something like: “I could never do that; I would get too attached to the kids.” While superficially admiring, this line takes on an odd ring after a while, with its implication that we must be emotionless creatures. While the idea of an elite corps of radically detached substitute parents may hold a certain appeal, my wife and I came into the system out of a sense of attachment bordering on the maudlin. She had been a chaplain in a juvenile detention center and I used to run programs for at-risk youth in Chicago schools. Children who are afraid of their own homes leave an impression.
Foster parenting had been in the back of my own mind since my family first started telling stories about my grandfather. He went into his first foster home in 1932, when he was twelve years old. The “orphan trains” that brought an estimated 200,000 big-city children to the farms of the Midwest since 1854 had only stopped running three years earlier. In agrarian America, home-based foster care often functioned as a way to match orphaned or abandoned children with homes that needed additional labor. This approach, mercenary though it may seem in our more sentimental age, often counted as a meaningful improvement over orphanages and homelessness. (The population in foster homes did not exceed the population in orphanages until 1950.) My grandfather, whose biological mother had herself lived in an orphanage for five years, did not, however, appreciate the historical dialectic at work. He ran away from a series of foster homes where he had been housed in barns and worked like a hired hand. Then he landed with a pious Roman Catholic family in Kiel, Wisconsin. There, the only woman he ever called “Mother,” whom he met when he was fifteen, prioritized his graduation from high school over farm chores. What they had managed to do for him, I wanted to do for someone else.
A lot has changed since then. The county cold-called local families to see if they would take my grandfather; in the decades that followed, foster homes would increasingly be licensed and professionally supervised. State and federal support for the children in foster care replaced local charities. Abuse and maltreatment became more rigorously defined and aggressively pursued. Perhaps most importantly, children generally stopped providing needed labor for the household economy and began requiring financial and emotional investments unknown to the farm families of Depression-era Calumet County. (I sometimes wonder what my grandfather would think if he saw me diligently encouraging our foster daughter to waltz with a teddy bear at a Music Together class.)
When my wife and I took a nine-week training course as part of our preparation for becoming foster parents, we got a glimpse of our peers in the program. We were not a notably diverse group. Five married couples and two individuals, all of us churchgoers and late-model-car owners, all but one of us white, all but the youngest of us with biological children of our own. No one missed their turn to bring refreshments for the class. We epitomized the combination of genuine earnestness and social privilege that has driven child welfare in America from the start. The sessions took place in a small evangelical social agency’s suburban office, whose pastels and wood accents only added to the facade of gentility. But then the classes started, and we began learning things like how to respond to the behavior of children who had been raped by their parents. The operative lesson seemed to be that our earnest sentiment and social privilege were bound to be tested. “We don’t want you to have problems and call up your caseworker and say, ‘Come pick them up, it’s not working out,’ ” the trainer told us—an acknowledgment that such a temptation would arise, and that nothing short of adequate preparation and commitment would stop us from yielding to it.
Why people choose to become foster parents is something of a mystery. In the sparse literature on foster parents and their motivations, they report unfulfilled desires for biological children and the intention to adopt, a sense of obligation toward a family member entering the system, or the usefully vague “altruistic motivations.” One factor that turns up consistently is knowing a foster parent or being related to a foster child. Despite lingering popular impressions to the contrary, money does not seem to motivate many foster parents to participate. In most states, including Illinois, foster care reimbursement rates lag well behind the average cost of raising a child. This leaves child welfare advocates with a dilemma. Raising the board rates for foster children might attract and retain more foster parents, as well as ensure a better level of care. But it’s hard to argue for this when a substantial portion of the electorate considers foster parents to be in it for the money, and doubly hard to argue for it under conditions of severe austerity for safety net programs. (I have heard that some people do manage to turn fostering into a kind of cottage industry; I find it hard to imagine how.) “A strained economy and the perception among even a portion of the public that some foster parents are motivated by money may make enacting such legislation challenging,” a 2008 study of foster family finances suggested, “and it is likely that some people will continue to be skeptical of increasing payments for fear of incentivizing inappropriate arrangements.”
If the motives that bring foster parents into the system are hard to pin down, much less cultivate, the factors that drive them out are considerably more clear. Overburdened caseworkers and the lack of services for the children in their care are frequently mentioned. Foster parents don’t often cite low stipends as a source of frustration, but reading between the lines, it’s clear that miserly support amplifies the challenges inherent in providing care for someone else’s child. “Parents who want to make a contribution need better training and a better stipend,” Dr. Robert Goerge, an expert on foster care at the University of Chicago, told me. “So many foster parents have one kid and they’re out. They say, ‘I’d like to do it, but I need more support.’ ” A 2002 study by the federal Department of Health and Human Services put it more succinctly: “Every foster parent we spoke with said they had, at some time, considered leaving the foster care system.”
Children, once an economic necessity, have become a luxury. We are able to afford them—to feed, clothe, house, enrich, and educate them into their teens or twenties in a state of complete economic idleness—with considerable help from the development of the welfare state. This is true, albeit in different ways, for Americans across the class spectrum. The housing, health insurance, and daycare costs of middle-class and wealthy children are subsidized through the tax code. The needs of poor children are met (inasmuch as they are) through a patchwork of direct expenditures that includes Medicaid, nutrition programs, and housing vouchers. Sophia qualified for some of these services automatically by virtue of being in the foster system, and it was incumbent on us to make sure she got them.
In the basement of our county health department, two weeks after Sophia’s arrival, we waited for our first appointment with the Women, Infants, and Children (WIC) nutrition program administrators. We were the only native speakers of English on our side of the counter, and we had to contend with the alien experience of being asked to demonstrate our poverty and to provide a host of documents we did not possess. We finally established Sophia’s eligibility through a splendid transitive property of indigence whereby her Medicaid card was proof of her WIC status. Thus persuaded, a nurse examined her height, weight, and iron levels. We were handed a stack of coupons for formula, baby food, and a few other staples following a course on nutrition that a middle-class parent might be strongly tempted to find demeaning.
WIC coupons work like this: each coupon specifies both what may be purchased (usually the “least expensive brand”) and a total cash value, in case you are tempted to purchase items of your own choosing. Each coupon must be rung up separately, and no personal money may be used to top off an order (though more than once a sympathetic cashier has shaved a little off a total when I miscalculated the weight of $6 worth of fresh fruit). You can also forget about defrauding Uncle Sam by swapping the coupons for cash, since each one needs to be signed in person with a signature that matches the folder that accompanies them.
We adjusted rather quickly to being treated like morons and petty thieves by bureaucrats. The social anxiety that comes with buying welfare food among our fellow citizens was worse. Middle-class people like to think of themselves as self-sufficient. But after a few months of shopping with WIC coupons, and contemplating my own sense of shame at this, I came to realize that we are rather selective in the forms of dependence we disdain. People who would not give a second thought to claiming the child care tax credit or the mortgage interest deduction will blanch at getting a bag of frozen peas on the public dollar. A WIC order grinds the line to a halt and prompts me to feel all kinds of self-consciousness about my deportment, my children, and the purchases I make with my own money. I got to know which cashiers were least given to suspicion or contempt, and I gratuitously mentioned Sophia’s foster status to defuse my own irritation. I don’t relish using the coupons, but they really help. When poor weight gain necessitated supplementing Sophia’s diet with PediaSure (at $12 for six bottles), the coupons became more valuable still.
Over those first few months, Sophia’s broken bone healed, her complexion brightened, and her sleep habits settled down a little. Our son fell for her even harder than my wife and I did. By Christmas they were inseparable, laughing when the other laughed and going together, Spartacus style, into time out when the other was being punished. Even after her initial injury healed, however, Sophia was a sick little girl. In the fall she had a string of ear infections that brought us to the doctor at least twice a month. A specialist determined that she needed ear tubes and was willing to take Medicaid. But this time it was the state that was unwilling to pay—a fact we learned only days before the surgery was scheduled to take place. We ended up leading an impromptu lobbying effort with Sophia’s caseworkers to change the minds of the state’s Medicaid bureaucracy, an HMO of the damned. They relented, in the nick of time, and Sophia was spared more months of perforated eardrums.
We had the same procedure done for our son less than a year and a half earlier with much less drama. But his health care is secured by private insurance and subsidized by a huge income tax exclusion. Sophia’s health care will only become harder to secure as providers leave the field and state Medicaid programs face tightening budgets.
Both the subsidy for our son and the expenditure for our daughter expand the scope of the federal government, and both impact the deficit in the same way. Yet when the time came to strike a deal over taxes and spending in order to increase the debt ceiling in August, the expenditures that support the children of the poor were on the table while the expenditures that support the children of the middle class and wealthy, thanks to the unwavering insistence of Republican lawmakers, were not.
As the “super committee” goes to work, the same story is set to be repeated. The White House successfully insulated Medicaid from the “trigger” mechanism that will produce automatic cuts should the committee fail to reach an agreement. But in that scenario every other program for poor children will get hammered, from WIC to early childhood development assessment. At the same time, plummeting federal aid to the states will tempt state-level lawmakers to cut into their half of the Medicaid spending formula. Either way, the interests of poor children—and the tools that make modern foster parenting possible—are coming to a dangerous pass.
The reward for persistence in foster parenting tends to be more requests to provide foster parenting. In March, a caseworker asked if we would take two brothers, a one-year-old and a five-year-old, for ten days while their foster family took a vacation. “Well,” my wife said reluctantly, “ask the other foster families, and if you really need us ”
“We really need you,” she was told.
Three weeks later, we welcomed the two brothers into our home—which, with our son and foster daughter, already did not feel short on children. The boys came with fistfuls of prescription drugs, grocery bags full of clothes, state Medicaid cards, and a list of phone numbers. That was pretty much it. The one-year-old needed daily breathing treatments with a nebulizer, a face-mask contraption that helps asthmatic children inhale their albuterol while looking like tiny Darth Vaders. And the poor state of his older brother’s teeth shocked us. At bedtime, the older boy craved all the most sentimental storybooks we had about parental love. After I had read him the story Snuggle Puppy three times, enduring halitosis that no amount of brushing could conquer, and tucked him in and said good night, he simply sat in bed and recited it to himself. Outnumbered three to one, our son insisted that he, too, was “a foster boy,” and would not be persuaded otherwise.
Eventually the baby came down with conjunctivitis and I took him to the doctor. (Setting up the appointment required some haggling about who I was and whether he could be prescribed anything.) The nurses practically wept to see him, oozing prodigiously from his nose and eyes and limp from low oxygen levels. In his weakened state, he needed frequent and large doses of albuterol (twenty vials over the next three days). His doctor gave me the most tepid of reassurances: “He’s not doing great, but he’s doing well enough to go home.” And home—or what passes for it in this child’s life—is where we went. His brother woke up early the next morning to throw up, which he did repeatedly and with an uncanny lack of complaint. My parents, who had come from out of town to help me, supervised the emptying of his vomit receptacles while I caught up on some work. The next day, the boys’ regular foster mom—whose long-planned vacation had been taken up answering my frantic calls—picked them up.
Foster parenting takes a heavy toll on the idealism that drives it. We worked ourselves up to do a good deed for these boys, but it could hardly have seemed like a mercy to them. They were relatively new to foster care and had already been through one failed placement. Ours was the fourth roof they’d slept under in six weeks. We were just another pair of adults with an expired futon mattress, mismatched sheets, and unknown motives. Foster children obviously have suspicions about adults. “My parents don’t love me,” the five-year-old confided to my wife one night, after a day of gamely spinning fantasies about all the things they do for him. “I’m sure they do love you,” she told him, “but they can’t take care of you right now.” It was true, but it was cold comfort to a small boy.
Over a year later, Sophia is a vivacious chatterbox of a girl. The daycare staff who once quailed at her arrival now treat her as the darling of the paint-smock set. Visits to the doctor are, mercifully, rarer than they once were. And the economics of fostering have become a familiar part of our family’s accounting. She receives monthly WIC coupons for four gallons of milk, two loaves of whole-wheat bread, a jar of peanut butter, a dozen eggs, 36 ounces of cereal, 128 ounces of juice, and $6 worth of fresh, frozen, or canned fruits and vegetables each month (for a grand total not to exceed $49.41). The state sends us a reimbursement check for $392 each month for her care. Her doctor visits are paid for by Medicaid, as are prescriptions that would otherwise cost us hundreds of dollars out of pocket. The state pays for her to be transported to and from visits with her biological parents, and for her daycare. A caseworker supervises our home and handles our calls for help when Sophia has night terrors or a visit with her parents goes badly. A part-time nurse at the health department works with us to manage her health care. The state is paying for her dance class, and as she gets older, the state will send her to summer camp.
On the other side of the ledger, we’ve spent hundreds of dollars on diapers, clothing, and toys. We bought a lot of PediaSure and multivitamins when her growth was poor, and we paid for her prescriptions when we had an urgent need and were out of state (Medicaid does not travel well). We pay for all the food she eats apart from what WIC provides, including meals out prompted by desperation or celebration. We’ve thrown her two birthday parties. Cumulatively, we’ve driven her hundreds of miles for doctor appointments, and hundreds more to get her to sleep. We’ve spent five mornings in the basement WIC office when we were supposed to be working. And naturally we have given her whatever share of a happy, enriching childhood that we can, with countless trips to the zoo and the DuPage Children’s Museum.
It’s an irony of foster care in America that the only politician who has made this juggling act visible in recent years should be Michele Bachmann. The Minnesota congresswoman and Tea Party firebrand has often invoked her experience as a foster mother to twenty-three young women. She represents both the genuine evangelical zeal for at-risk kids that sustains the system and the hostility to social programs that threatens it. All of those girls were on Medicaid, which Bachmann voted to cut dramatically. The private virtue we claim to admire can’t escape its dependence on the public weal.
These days, when our kids instinctively comfort each other after a tumble at the town swimming pool, it’s easy enough to forget that our family is accidental and probably temporary. Parental affection can stretch itself farther than I could have imagined in those early days of round-the-clock shrieking. But we can never go long without realizing that Sophia’s difficult tendencies do not come from us, that she is likely to leave us someday, and that we are operating at the limits of our emotional, economic, and social capacity. Without a commitment by the state to cover the basic costs of her care, we would, like every other foster family, be asking ourselves daily whether we could keep doing it.
As social programs are unwound, foster parents watch our families being unwound with them. For most of us, our “altruistic motivations” always threaten to outstrip our resources. Foster parenting teaches us how to live as so many low-income families already live—check to check, coupon to coupon, appointment to appointment. The difference is that most foster parents hold middle-class passports, and they can cut short their sojourn among WIC recipients and Medicaid administrators at any time. No one knows what exactly will happen to Sophia and the nearly half-million kids in her situation if they exercise that privilege. If Republican lawmakers have their way, we may well find out.
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