by Toni Hoy
The Thomson Reuters recent article “The Child Exchange” certainly got everyone talking. It even managed to get the attention of some of our congressmen, despite a government shut-down. The best thing about this article is that it started a dialogue about the issue of adoptive permanency. The worst thing about it is that it focuses on the resulting issue rather than the perpetuating problem—lack of access to and funding for child mental and behavioral health services.
Even our state legislators took swift action to shut down “rehoming.” I find it odd that while parents brought the issue of lack of access to services to the state agencies and legislators over and over again, year after year, no one paid attention until a couple of transient child predators navigated their way into a site that was created to help parents after governments failed them.
In truth, Illinois doesn’t have a “rehoming” problem at all. Yep, that’s right. None, whatsoever. How do I know that? Because I field a fair amount of the contacts from parents who are looking for services and can’t get them—somewhere in the neighborhood of about a dozen per month. Allow me to reveal my approach to helping them.
What I do:
- I listen to their story and empathize with their situation
- I help them understand our fragmented and broken system so that they may make the best decision for their family
- I lead them to state agencies that I think may help
- I lead them to other resources they may not be aware of
- If all that fails, I send them to CRSA
- If all that fails, I lead them to attorneys who are the most likely to help them
- If all that fails, the parents are forced into relinquishment and there is nothing I can do but try to support them through the horror of it
What I don’t do:
- I never tell them what to do
- I never sent them to “rehoming” sites, though I was aware of their existence
I would guess that if I sent parents to the “rehoming” sites, we’d have a pretty big “rehoming problem.”
But since I didn’t do that, the real reason we don’t have a “rehoming problem” in Illinois is because, if you follow my approach to advocacy as outlined above, it’s easy to see that what we really have is a pretty big “relinquishment problem.”
Wait a minute? Isn’t “relinquishment” another form of “rehoming?” Of course it is. It’s just our own state government doing the “rehoming.” Why do they do it? Because it’s financially convenient. It allows them to draw down federal funding for a child’s care because he is now a state ward. But, no one thinks “rehoming” by the government social service agencies is outrageous enough to hold legislative hearings and release congressional statements, because if the government is doing it, it must be a good thing, right? The government has become desensitized to involuntary relinquishment to the degree that they’ve deemed it acceptable and the general populous hasn’t noticed that the decades-old practice is child recycling at its best.
Now that we’ve established that government initiated “rehoming” is just cruel as parent “rehoming” via the internet, let me elaborate on why I never sent anyone to those sites.
I DON’T BELIEVE ANY FORM OF “REHOMING” IS APPROPRIATE BEFORE THE CHILD HAS RECEIVED MEDICALLY NECESSARY TREATMENT AND THE FAMILY IS FULLY SUPPORTED IN RAISING HIM.
I don’t believe it’s okay for the parents to do it any more than I believe it’s okay for the government to do it because some children will never recover from yet another disrupted placement.
Does that mean that I believe no adoption should ever be disrupted or dissolved? No, I didn’t say that. I said, “before the child has received medically necessary treatment and the family is fully supported in raising him.” If those steps have been taken and there is still no resolution, then yes, the adoption should be disrupted or dissolved. Each situation has to be treated on its own merits and with a family driven approach. This isn’t one size fits all. If the placement is disrupted there should be plenty of support and grief counseling for the child and the family to promote healing.
Contrary to popular belief, shutting down the “rehoming” sites won’t solve the “rehoming problem.” Providing intensive trauma and attachment based mental health services will. By offering pre-adoptively traumatized children desperately needed services which promote relational healing and helping them integrate into their families, we cut off the supply to the “rehoming” circuit, thus destroying the demand. You can’t shut down something that doesn’t exist.
Illinois doesn’t have a “rehoming problem” because I never sent any children to be “rehomed,” rather I did my best to lead families to appropriate services and supported them along their journey. At the same time, I have advocated for systems that work that don’t entail the re-traumatization of punishing families and recycling children.
Promote healing from pre-adoptive trauma. Preserve permanency. Make the “rehoming” overseers friends of the Maytag repairmen. If we did it right, there’d be nothing for them to do.
by Toni Hoy
“What’s love got to do with it? Got to do with it? What’s love, but a second hand emotion?” Remember that old Tina Turner lyric?
I was thinking about love a lot today in relation to kids with attachment disorders.
The Bible talks about four kinds of love; eros (ear-ose), phileo (fie-lee-oh), agape(ah-gah-pay) and storge(store-gay).
Eros is a passionate love that rouses passion and excitement. A mother’s or father’s face lights up the minute he lay eyes on his child, regardless of whether his child came to him by birth, adoption, or some other means. Gazing upon his slumbering child, a parent falls in love with his child over and over again. Eros love evokes parental feelings of protection, and nurturing. A parent feels this love for his child from the very first moment of the relationship.
Storge is the ubiquity of brotherly love. It’s the kind of love that we have for our extended families and our close friends. We widen our breadth of storge love when our child enters our family.
Phileo differs from storge love in that it is casual and friendly. It is a love that is comfortable and familiar and one that develops over periods of time. We hang onto family photos and old shoes out of phileo love because they are things that we treasure. Phileo love is easily taken for granted. It is so familiar that we expect that it will exist even when we don’t nurture it. When we say, “I love you,” as a matter of course, we are expressing phileo love. We don’t consciously think about the fact that we love our children because our love for them exists day after day and year after year.
Agape love is selfless and unconditional. It’s the kind of love that allows us to forgive when we find that our child has lied to us, stolen from us, or hurt us deeply in some way. For many of us who have faced relentless and emotionally draining challenges in parenting our children with weak or non-existent attachment, agape love circles our hearts back to eros, storge, and phileo love.
But which types of love do our children feel for us and for our other children? Does a detached, non-empathetic child feel any kind of love despite the outpouring of love from his family?
Appropriately attached children inherently have eros love. When parents nurture their child’s eros love, it evolves into storge and phileo love, and usually maturing into agape love. Attached children seek to attain favor in their parent’s eyes, culminating in a relationship that allows them to forgive parental mistakes and misgivings and ultimately responding with their own agape love.
Mistrust, control, and manipulation are words that align with children with poor attachment capability. Such words are faint or non-existent with healthy love relationships. Children must have attachment with their parents or caregivers in order to feel and express any kind of love. If they are capable of any kind of love, perhaps it’s eros love as they easily attach and express love to complete strangers.
Just as attachment does not come easily for the detached child, neither does storge, phileo, nor agape love. Holding the understanding of how love grows and evolves aids us in dealing with our own expectations of what love should look like as we parent a detached child.
As bonds strengthen, children gain with them the ability to reach for loves that are unfamiliar to them—storge, phileo, and the ultimate love—agape.
As popular as the Reuter’s article has been, based upon the response from parents who were interviewed or asked to be interviewed, it would seem Megan Twohey’s account is highly biased, purposely reflecting negatively on adoptive parents with severely disordered children.
From Glenna Mueller, who was duped by the Eason’s
I have to agree with the other posters here. You have managed to manipulate and massacre some very heartfelt feelings that we as desperate parents have openly shared with you. You report how we “gave” our children to monsters. You failed to report the things that were happening in our homes and the fact that all our cries for help fell on deaf ears by the professionals. The numerous hours of counseling, the constant calls from the schools, the Dr. appointments etc. When I adopted my son, I did so because I had room in my heart for another child, I had hopes and dreams for him just like all parents do for their children. Those hopes and dreams were shattered. I loved my son and I still love him, I was ill prepared to parent him and his background. You failed to mention that I have continued contact with him and his LEGAL guardians.He loves his Mom and Dad. Yes, I made a huge mistake with Nicole and Randy, I would NEVER intentionally place any of my children in harms way. You came in here expressing sympathy and a desire to understand why it all happened, we explained that all to you and then you twist it all around to portray us as evil, uncaring and heartless! You failed to mention that I have eight other children that are (for the most part) happy and well adjusted, and yes, I stayed home to raise them all, and yes, their adoption subsidies allowed me that luxury. You failed to mention that now that they are nearly all grown, I am a full time college student looking forward to a full time career outside of raising my children. You have however managed to open some very raw wounds for me and the other children. Perhaps you could have reported on the lack of support we as adoptive parents receive once the children are placed with us, or the lack of information that is shared with us about our children’s backgrounds before the final adoption. This is a sad situation for all involved but you were certainly able to turn that around too. I hope you are proud of yourself. Please leave us alone and leave my son and his family alone too, we are trying to move on and wish you’d do the same.
I’m stunned and dismayed after reading your article. You were asked not to include Inga’s full name. You did not honor this.
My understanding was that Inga was to be a “sidebar,” in your own words.
Instead she is the entire chapter. You placed quite the spin on the information given to you and presented us in the worst possible light as irresponsible, intolerant people who dumped a poor orphan.
You successfully delivered your article as an expose on the plight of
foreign adoptees, but misrepresented us in a very hurtful way. After reading it, I immediately called Inga to prepare her for the possibility that she might be contacted by press. We had already been contacted by the BBC and The View out of NYC for interviews within moments of it hitting the wire. The LAST thing we want is for Inga to receive any badgering by the media!
Yes, you are accurate in saying that Inga is a survivor. And WE are
actually survivors too, Megan. You have succeeded in stirring up some very painful wounds and adding to the misperception that we contributed to Inga’s abuse and trauma. If you had mentioned that she was also placed in a number of other families within the foster care system (who were homestudied and certified) and could not be contained there either for longer than a month, it would have given a more balanced depiction of the immensity of the challenge. In fact it would have reflected the success of us managing with her the longest of anyone!
Your story is out and I’m sure you are collecting the accolades for it. I
trusted you were going to write an honest report and instead feel betrayed.
And from another parent who posted on my Toni Hoy-Author Facebook page
I was contacted by this reporter regarding one of my son’s that we were forced to return to state custody. The reporter was dishonest with us from the start, not to mention underhanded. I’m so sad that she hurt the other families, especially when an HONEST expose could likely help so many families, done the right way.
Theresa Goodman Showell
Comment by Toni Hoy-if a state forces a parent to involuntarily relinquish a child back into foster care (after denying them funds for treatment) in order for the state to draw down Title IV funds (a financial convenience for the state), isn’t that also “rehoming?” WHERE IS THE PUBLIC OUTRAGE IN THAT?????????????
Filed under: adoption, custody relinquishment, EPSDT, FASD, Fetal Alcohol Spectrum Disorder, Foster Care and Adoption, Illinois no fault dependency, psychiatric lockout, RAD, PTSD, no fault dependency, mental health, trauma, bipolar disorder, Rehoming, Second Time Foster Child | 4 Comments »
August 13, 2013
Public Comment on Promoting Adoption and Permanency from Foster Care Act
Attachment and Trauma Network Legislative Group Leader
NAMI Barrington board member
Best-selling author of “Second Time Foster Child.”
U.S. House Committee on Ways and Means, Subcommittee on Human Resources
I am an Illinois foster/adoptive parent of over 20 years, who has become a leading state and national advocate for foster and adoptive families. I serve on the board of NAMI Barrington in Illinois and lead the Legislative Group for the Attachment & Trauma Network. In addition, I was appointed by Governor Quinn to serve on the Community and Residential Services Authority, a state authority which provides technical assistance to families of children with severe emotional and behavioral disorders. I wrote “Second Time Foster Child” in 2010 after being forced to relinquish my adoptive son back into foster care after being denied my request for my son’s intensive residential mental health services as promised to him as a Medicaid entitlement under the Adoptive and Safe Families Act of 1997. I answer the calls from hundreds of families annually, aiding them in understanding state and federal systems.
I concur with the draft legislation to:
1. Extend the authorization of the program through FY 2016;
2. Add an award for placements with legal guardians;
3. Provide awards based on improvements in the rate of adoption and other permanent placements, even as the number of children in foster care declines; and
4. Require States to report on savings resulting from the ongoing phase-out of certain federal adoption assistance eligibility requirements, and to use at least 20 percent of such savings for post-adoption services.
While this bill is much needed, it does not speak strongly enough to the issue of adoption permanency; thus, I would like to expand on item #4.
In the early 2000’s, the state of Illinois led the nation in adoptions, winning several awards. Now that the bulk of those children are teens and adolescents, we are seeing a disturbing trend towards “second time foster children,” not only in Illinois, but also nationally, where children are forcibly being recycled back into foster care to access funds for intensive mental health services.
The Adoption and Safe Families Act of 1997 (ASFA) provided subsidies for adoptive families, along with Medicaid to provide for medically necessary treatment. This provision was crafted to provide for treatment due to pre-adoptive trauma, including severe abuse, neglect, and pre-natal substance abuse effect. The Child Welfare League of America reports that more than 80% of foster children have emotional, developmental, or behavioral difficulties.
However, states are illegally failing to provide for intensive treatment, including residential placements as needed, as required under the Early, Periodic, Screening, Diagnostic, and Treatment (EPSDT) provision of Medicaid, as required by federal law. As a result, states are forcing parents to trade custody for treatment by recycling children back into foster care via an involuntary psychiatric lockout, so that states may draw down federal funding in order to recoup costs associated with expensive treatment. While financially convenient for states, there are devastating consequences for children and parents.
A 1999 NAMI study called “Families on the Brink: The Impact of Ignoring Children with Serious Mental Illness” showed that about 20% of families surveyed were forced to relinquish custody of their children in exchange for treatment. The NAMI study was confirmed by the GAO report in 2001, “Child Welfare and Juvenile Justice – Federal Agencies Could Play a Stronger Role in Helping States Reduce the Number of Children Placed Solely to Obtain Mental Health Services” which reported that 12,700 families were forced to relinquish custody of their children in exchange for mental health services in 2001. The GAO report did not include all states including states with the most populations. A Freedom of Information Act in Illinois reports a rising trend in the numbers of relinquishments:
2010 104 (more than 1 per county / 2 children per week)
Illinois denies having custody relinquishment statistics for 2011 and 2012.
When children are denied funding for therapeutically recommended treatment, often parents are forced into the Devil’s Deal—of choosing between being charged with child endangerment for failing to protect siblings and other children when bringing an unsafe child home, or charges of neglect for refusing to bring the child home on the grounds they cannot protect the family. States that fail to provide for the “first time foster child’s” clinical needs default the child to child welfare and juvenile justice systems which have no proper channels to process the case of a sick child in a healthy family. Thus, those same systems process families using the same laws and protocols that are used for abusive and neglectful parents, processing them along child welfare and juvenile justice channels in the same manner as abusers. Adoptive parents are subject to scrutiny under the child abuse lens including:
- Child abuse investigation
- Unwarranted and repeated interrogations
- Supervised visits
- Neglect, abuse, or felony charges
- Monthly home safety inspections
- Threats of having siblings removed
- Threats of complete termination of parental rights
- Limited or non-existent parental decision-making for educational, clinical, social, and familial decisions
- Excessive child support payments
- Excessive legal fees
While the channel that supports “second time foster children” places extreme mental and emotional duress on adoptive parents and siblings, there are worse ramifications for the pre-adoptively traumatized child.
Children who were promised permanency through adoption become wards of the state for a second time. Like their parents, they are also subject to repeated interrogations, supervised visits and home safety inspections. The process deepens mistrust of adults and results in feelings of guilt that their loving parents are being punished in exchange for their treatment. Disrupted permanency leads to lack of self- worth, disrupts bonding and attachment therapies, delays healing, and places the child in direct legal opposition to his parents in court. Soon, a host of strangers act “en loco parentis” or in lieu of parents, including:
- Caseworker who acts as parent for residential and clinical placement
- Guardian ad Litem who acts as legal representative
- CASA who represents the child’s interests to the judge
- Educational surrogate who acts as the child’s educational parent
Legal savvy parents have discovered that the children are legally entitled to medically necessary treatment under the EPSDT provision of Medicaid, as provided to them under the post-adoption subsidy as a mechanism for preserving their permanency. In hitting the wall in accessing therapeutically recommended services, many parents have resorted to suing their state agencies in order to access funding for treatment while preserving their child’s permanency. Sadly, children are often housed in temporary shelters for months while funding battles are fought.
My husband and I filed the first EPSDT lawsuit in Illinois in 2010, which was settled seven months later. Our suit was followed by numerous other EPSDT law suits, many of which are currently pending in federal courts. Technology allows legal information to pass between families nationally, which has generated a new trend in legal maneuvering and a national barrage of federal EPSDT lawsuits.
The demise of the “second time foster child” is preventable. If a state can draw down federal funding for medically necessary services for a foster child, the state should also be able to draw down federal funding for the very same child as an adoptive child. The ability to allow money to follow the child will preserve his permanency, a vital concern for a former ward. In addition, I recommend that the legal EPSDT wording (§ 1396d(a) “…if a practitioner of the healing arts deems that a treatment is medically necessary to correct or ameliorate a condition, the state must provide it, whether or not it is covered under any other state plan…if they cannot provide it, they must arrange for it…”) be inserted into the Promoting Adoption and Permanency from Foster Care Act, as a directive for the 20% savings of adoption eligibility phase-out funding streams. This allocates state funding towards the express purpose of adoption permanency and the abolishment of involuntary custody relinquishment. In addition, I recommend that this new act include a financial incentive for states which report a zero rate of involuntary custody relinquishment or by passing new state laws which prohibit the barbaric and longstanding practice of involuntary custody relinquishment for mental healthcare. To provide for accountability, states should be required to track and report numbers of involuntary relinquishments. In summary, I recommend that relative to the permanency component of this proposed act, item #4 as stated above be expanded to include the following:
- Amend Title IV to allow for funding to follow a former ward into adoption
- States direct the 20% savings of phase out funding towards the purpose of abolishing custody relinquishment
- Mandate that states track and report numbers of involuntary relinquishments
- Add a financial incentive for states reporting zero rates of involuntary relinquishments
Initially, I wrote “Second Time Foster Child” as a vehicle to tell my own story. It’s a book about a boy who achieved permanency through adoption and who became a “second time foster child” in order to obtain residential treatment due to the trauma that he sustained prior to becoming a “first time foster child.” It’s a story of involuntary custody relinquishment in exchange for intensive mental health services.
The first half of the book is our family story—it’s about what it’s like to live with a child who, through no fault of his own, has severe cases of Reactive Attachment Disorder, post-traumatic stress disorder, and an alphabet soup of other mental health diagnoses. It’s about our family’s dead-end journey towards accessing appropriate treatment for him. The second half of the book is the government’s story. It chronicles how such a case defaults to the wrong state systems and exactly how it is processed through them. It also speaks clearly to the emotional turmoil and mal-effect to the child and family through the disruption, so much so, that it will touch every emotion that you have in reading it. The story ends with much of what is included in this letter—the importance of preserving permanency and what state and federal laws need to change to adhere to the original promises and intents of the Adoption and Safe Families Act—safety, PERMANENCY, and well-being. While it began as my family’s story, through it, thousands of families across the nation have thanked me for telling their story through my own. Annually, I hear from hundreds of adoptive parents forced into the Sophie’s choice of choosing between vital mental health services or adoption permanency.
In summary, the Attachment and Trauma Network supports the proposed draft legislation, but would like to see additional items added to address adoption permanency, which enhance funding streams to states with the aimed purpose of supporting adoption permanency and alleviating involuntary relinquishment for mental healthcare, while requiring accountability for permanency outcomes.
Attachment & Trauma Network Group Leader
NAMI Barrington Board of Directors
Send your comments to AdoptionIncentives@mail.house.gov by August 30th, 2013