Adoption Process and Foster Care – Insights, Best Practices, Trends and Challenges

Adoption Process and Foster Care – Insights, Best Practices, Trends and Challenges

Adoption Journey

The adoption process is a long process whether the adoption is private, through foster care, or an international adoption. A brief overview of each step in the adoption process is provided and then several insights around various aspects of that step are detailed. While there is a focus on adopting through foster care adoption, the insights provided for each step of the process have been selected because a number of them are equally relevant to all types of adoption. There are a number of issues faced by adoptive parents including dealing with the trauma the child has faced, issues around the birth parents, not fitting in, the child tying to understand adoption, and the lack of paid parental leave. All of these are common issues in adoptions. Finally, a demographic profile of adoptive parents details the type of families adopting children in the US today.

THE ADOPTIVE PARENTS JOURNEY

Initial Interest

This is the initial phase of adoption where prospective parents find out about the process and what it entails.

  • International adoption is an option for those looking to adopt children, but it is not as simple as the media makes out. Many countries have now closed their borders to adoption, looking for solutions within their own borders. The Hague Convention has also limited the number of international adoptions because they are working to implement changes in different countries, so children can remain in their own countries.
  • There are a number of strict rules that must be adhered to when adopting internationally. A number of countries have rules relating to parental age, marital status, health, number of children in the house, and income. In most instances, the adoptive parents will need to travel to the country to pick up the children. Some countries require the parents and child to live together for a period before allowing the child to travel to the adoptive parents home country.
  • The most important thing a prospective parent can do when considering adoption is to educate themselves about the process. There are a wide range of resources available online to do this. Prospective parents are able to join the community of adoptive parents on Facebook that has more that 190,000 adoptive parents in it. This is an invaluable resource where people who have firsthand knowledge can offer advice and support.
  • In recent years, thee has been a trend toward openness in adoption. This means that the adoptive child’s birth and adoptive families remain in contact. Recent research suggests that this has a positive impact on the child. It is not always easy for the adoptive parents as contact may be frequent or infrequent, remote or direct, and vary overtime. The question of openness is something that prospective parents must educate themselves fully around, so they can make an informed decision whether they agree to an open process or not,

Fostering to Adopt

This part of the process sees the prospective adoptive parents go through the process of applying and being accepted to foster to adopt.

  • The criteria for adopting from foster care in the US mean that almost any family can be considered. In most states, prospective parents can be married or single; in fact, single parents account for around 29% of foster care adoptions. The main criteria to satisfy are that the prospective parents can provide permanent placement, a safe home, and support the child’s physical, health, educational, and social needs.
  • There are approximately 125,000 children that are currently awaiting adoption in the US. Most will wait on average four years for an adoptive family. In 2018, 25% of the children who left foster care were adopted. 51% of the children adopted in 2018 were adopted by their foster parents. 26% were over 9 years of age when they were adopted.
  • 17,844 children or 7% of those leaving foster care in 2018 aged out of the foster care system. This means they will start adult life with none of the financial or emotional supports that other children receive from their families. 70% of children in foster care want to attend college. For those that age out of the system, 25% will not have a High School diploma, and only 6% will complete college.
  • Most of the foster care children that are available for adoption are over 2, with most over 8. It can be frustrating for parents waiting to adopt watching the parents being given the opportunity to take corrective action, and knowing any failure will be at the expense of the child. This can be a traumatic process for the children, and prospective parents need to be able to cope with this trauma in the future.
  • Developing a good relationship with the local foster care agency can assist because there is a preference for placing children in homes that are close to their original homes. The local office may have foster care training and resources available that can assist in determining if fostering to adopt is the best pathway. Families wishing to adopt must be clear from the start, as this will assist in the placement process.

Adoption Process

This part of the process involves making the application and undergoing the assessments required to gain approval to adopt.

  • It is a fundamental requirement that every parent looking to adopt a child in the US undergo a home assessment. This is usually completed by a social worker licensed in the state of adoption. The social worker will interview the parents in their home, interview the family, and ensure that the prospective parents can provide the child a safe home.
  • Working with an adoption specialist can assist in simplifying the process. There is a considerable amount of paperwork that needs to be completed. This will form the basis of the adoption plan. It is important that prospective parents have had the opportunity to get advice prior to completing the paperwork, as key decisions such as whether an open adoption is agreed to need to be made at this time.
  • When choosing an adoption specialist it is important to know exactly what services they will provide and what the cost of those services are. There are considerable differences in the level of service and the cost between different agencies. Prospective parents are best served by specialists that are closely aligned with their local area. It is important to remember that the cheapest specialist may not necessarily be the best specialist.

Post Adoption Adjustment

This is the immediate period after adoption, where checks are made to ensure the child is safe prior to the adoption being finalized.

  • There is a post-adoption supervision period where social workers visit the home and assess both the parent’s and child’s adjustment to the adoption. The visits are similar to the initial home assessment. Usually, an average of three post-adoption visits are required before the adoption is finalized.
  • Families can access post-adoption services. The services are available in each state. The first port of call for adoptive parents should be their placement agency, who can put them in contact with the appropriate agency. Adoptive parents should consider talking with other adoptive parents as the insight that they can provide can be invaluable.
  • Post-adoption depression is not uncommon. Often the process of adoption is emotional with many highs or lows. The final steps in the adoption process can result in a range of different feelings by the new parents. Although it is not a formally recognized condition it is thought post-adoption depression impacts on as many as 65% of adoptive mothers. The signs and symptoms are similar to that of depression.

INSIGHTS AROUND ISSUES FACED BY ADOPTIVE PARENTS

Ongoing Effects of Trauma

  • Many children adopted through foster care in the US have suffered trauma at various points in their lives. The trauma can be caused by neglect, violence, or separation from their families.
  • It is estimated up to 80% of children who have been in foster care have suffered some form of trauma that has resulted in a mental health issue. One in four children that have been in foster care will exhibit signs of post-traumatic stress disorder.
  • The trauma can result in behavioral, psychological, and emotional difficulties, which have the potential to impact on the adoptive family as a whole.
  • Getting help for the child on an individual level and the family as a whole is essential in addressing this issue. Many states offer support services that are equipped to deal with these issues, and that can assist the adoptive parents in these instances. The key for the adoptive parents being patient with the child and getting the necessary help required.

Open Adoption

  • For the adoptive parents, this issue is one of potential unease. There will always be concerns about how much involvement the birth parents should have and how appropriate their interactions with the child are. There is no guideline as to what is the appropriate type or frequency in this contact for the adoptive parents as it needs to be determined on a case by case basis. The adoptive parents are likely to be fearful that their role in the child’s life will be surpassed.
  • Only about 5% of infant adoptions in the US are closed adoptions, so the reality is this is a common issue for adoptive parents. Research has shown that birth parents typically make contact around 7 times in the first few years after the adoption, but over time this decreases, with only about 40% of birth parents still in contact after 14 years.
  • Adoptive parents must realize that the child will always (regardless of contact) be linked to the birth parents. As a result, there will always be a degree of curiosity from the child, which is not a reflection or rejection of them in any way. A relationship with birth parents will help adoptive children deal with feelings of guilt, poor self-worth, grief, and despair.
  • Adoptive parents need to support the child throughout the process of contact regardless of their personal feelings. A range of groups are available for adoptive parents to help them in dealing with this issue.

Understanding Adoption

  • Adoption is not an easy concept for many children to understand and make sense of. Over half of the children adopted experience feelings of loss, sadness, or rejection about their birth family. Over half of the children adopted experience uncomfortable questioning or teasing from other children about their adoption. This can result in emotional turmoil for the child in a range of different ways, including behavioral and psychological changes.
  • There is little difficulty integrating into the adoptive family, with the majority of adoptive children having little difficulty moving into a new family.
  • Research has found that the adoptive parents can assist a child in coming to terms with adoption through being open about the process and providing the child the information they need, at an appropriate time to make sense of the process. They need to help the child understand the adoption and how to deal with the way other children deal with them. Support and understanding are essential.
  • Due to this being a relatively common problem, many adoption agencies offer ongoing support in this regard.

Lack of Support From Work

  • One of the major difficulties when adopting is that the employment framework in the US does not recognize adoptive parents in the same manner they recognize birth parents. This means that adoptive parents are often not eligible for benefits like paid parental leave.
  • There are many expenses incurred at the time of adoption. The prospect of unpaid leave is likely to place some adoptive families in a position of financial hardship. Most adoptive parents will be entitled to leave under the Family and Medical Leave Act, it is just a question of whether adoptive parents are entitled to paid leave.
  • No information is available that provides a reliable estimate of the number of adoptive parents affected, but given the media coverage, it appears the issue is widespread.
  • The key to this issue is talking with the employer early on in the adoption process and determining the exact position. If the adoptive parents are not entitled to be paid over this period, it will enable them to at least plan for the adoption financially in advance.

Not Feeling Part of the Family

  • One relatively common issue in adoption is that the adoptive children may not feel as if they are part of the family. Part of dealing with this issue as an adoptive parent is recognizing this due to the child’s background. The child may feel they are different from the rest of the family.
  • There is no easy solution to this issue except time, love, and support. The child will often require regular reassurance that they are safe and loved. Communication and patience is key in helping the child take their place in the family.

DEMOGRAPHICS OF ADOPTIVE PARENTS

Age

  • 81% of adoptive mothers are aged 35-44. 50.7% of this group are aged 40-44. The 18-29 year old age group accounts for only 3.1% of adoptive mothers and the 30-34 year old age group, 15.8%.
  • 12% of men adopting children are aged 18-29 years of age. 29.3% are 20-34 years of age. 29.8% are 35-39 years of age and 28.9% are 40-44 years of age.
  • 11% of foster care adoptions and 13% of private adoptions are completed by parents who are over 50 years of age.

Marital Status

  • 69% of adoptions are completed by married parents.

Gender

  • The number of men adopting children is nearly double the number of women. The disproportionate number of men adopting is as a result of gay couples and men who have previously fathered children choosing to adopt.

Income Level

  • The median household income for adoptive families is $87,500.

Education

  • 70% of children adopted from foster care are adopted by parents with a level of education beyond high school. For private adoptions, 79% of adoptive parents have a level of education beyond high school. For international adoptions, the figure is 95%.

Race/Ethnicity

  • 77% of adoptive parents are white. Hispanic account for 9% of adoptive parents, while 6% are African American. 4% of adoptive parents are multi-racial.

Best Practices When Placing a Child Into a New Home

When placing a child into a new home, a children’s placement agency’s priority is placement stability. They want to make sure that the children will have the chance at a stable home, with foster parents and guardians that can continue caring for them long term. This is why placement with Kinship is always considered first, and if that cannot happen, then ongoing support to foster parents is a must.

1. Placement with Kinship

  • Placement with Kinship means placing the child with a relative and someone that they know before placing them in foster care.
  • Placing Kinship is considered a best practice because it prevents attachment, emotional, and behavioral disorders from being more prominent.
  • Kinship Placement prevents placement instability by allowing the child to remain in the home of their relative until reunification or for the remainder of their time in state custody.
  • Colorado State University created the ARCH study, aka Applied Research in Child Welfare project. The ARCH study concluded that children placed in the home of kinship care are three times less likely to experience three to four more placement settings. Kinship placement is the most stable when it comes to placing the children in a new home.
  • According to CASCW, “For cases with longer lengths of stay, children in kinship care experience fewer moves as 84% have two or fewer placements compared with 52% of children in foster care.”

2. Providing Ongoing Support for Foster Parents

  • Providing ongoing support for foster parents include financial assistance, therapy services, and help work with the birth parents.
  • This is a best practice because it helps the foster parents to have the tools they need to provide the best chance of placement stability.
  • When a child is placed in a foster home, most foster parents will have to build a relationship with the children. This can make it difficult for both the foster parents and the child in the beginning. Having the right tools to promote a relationship is crucial so that the child and foster parents can make things work.
  • In a 2004 study by Holland, Gorey, and James, “The most frequently cited reason for a failed foster placement is the inability of foster parents to manage children’s behavior problems.”
  • Foster parents need the tools to help equip them to support and handle the children with behavioral issues properly. Ongoing training for foster parents makes them more likely to continue foster parenting of the same children and more afterward.
  • Studies show that providing the proper tools for the foster parents to help the children also prevents the child from becoming an at-risk youth, and they are less likely to end up in jail at some time in their lives.
  • KEEP (Keeping foster parents supported and trained) has taken the initial training and support program and adapted it to prevent the disruption of placement. It is a 16-week group-based intervention that helps teach foster parents how to use non-harsh discipline methods as an approach of positive reinforcement. Two random controlled studies provided results that showed a more likelihood of placement stability.

Foster Care – Insights and Challenges

Challenges Faced by Foster Parents

1. Licensing and Process Challenges

  • From the beginning, foster parents may have to overcome many process and regulatory challenges that come along with being a foster parent. First, foster parents must obtain a license and be approved as foster parents by the state, which requires a number of steps and jumping through hoops. “The process varies by state, but in most cases foster parents must attend classes, complete a home study, and ensure their homes meet licensing standards. The home study process may involve extensive interviews about everything from the foster family’s financial situation to the foster parents’ upbringing. This process is meant to ensure that foster parents are stable in terms of their health, finances, and relationships so they can provide a safe home.” In addition, the parents may need to provide a background check and references. A home inspection may be conducted, and repairs may be necessary if the home does not meet the state’s standards.
  • Even if foster parents make it through these steps and get approved to bring foster children into their home, they continue to be required to adhere to a number of rules and regulations, which can be quite restrictive. “For example, medication and alcohol may need to be stored in locked cabinets. Children in foster care might not be allowed to go on boats or attend overnight visits at other people’s homes. Children in foster care also might not be allowed out of state. And they may not be able to be left with a friend or family member, even for a short period of time. They may have to be placed in a licensed daycare only—which may make an out-of-state vacation impossible as foster parents may not have childcare.” These regulations can place a burden on the foster family. In addition, foster parents are typically not the child’s legal guardian, meaning that for anything requiring a legal guardian the foster parent must contact the legal guardian and make arrangements. This can make even simple things, like getting a permission slip signed for a field trip, quite difficult.

2. Burnout

  • If you are feeling exhausted, run down, depressed, unmotivated, hopeless or powerless, or even feel like running away, you may be experiencing burn out.” Burnout is a common challenge faced by foster parents as the work of foster parenting can be physically and emotionally exhausting, with little time for rest or for self-care. Like all parenting, foster parenting is time-consuming. In addition, foster children are often dealing with challenges themselves as they cope with the trauma that resulted in their being placed in foster care. As the foster parents try to cope with this and help the children manage it, they can become emotionally exhausted. One study found that 33% of foster parents reported that they felt the training on how to cope with burnout was inadequate.
  • Experts in the field recommend that foster parents make time for themselves, away from their foster children, as much as possible to prevent burnout. Adopt US Kids recommends that parents hire a babysitter to take time away, or take advantage of respite care programs that are available in many states for foster parents. “Respite care is short-term care of a child in order to give the regular caregiver a break. Each state or county has its own procedures for foster parents to get respite care.” The Child Welfare Information Gateway has a list of respite care resources, as does the ARCH National Respite Network and Resource Center.
  • In addition, experts recommend that foster parents adjust their lifestyle as needed if they are feeling overwhelmed, stressed, and exhausted. Dietary changes and exercise can help reduce stress. Further, foster parents can seek the help and solidarity of foster parent support groups.

3. Reunification or Separation

  • The ultimate goal of the foster system is first to reunite the foster children with their biological parents, and secondarily to get the children adopted into a permanent home. In addition, there is a lot of uncertainty in the foster care system and children can b relocated for a number of reasons. Due to these reasons, foster parents often face the challenge of being separated from their foster children. This may be a difficult transition and a painful separation for everyone involved. If it’s a case of reunification, the foster parents may be worried that the child will end up in an unsafe environment again. And in any case, the foster parents may experience grief and other difficult emotions when they are separated from the foster child(ren). In many cases, the foster parents may no longer have contact with the child after they leave their home, and may not even know what happens to the child after that point, which can add to the grief and worry the foster parent may experience.
  • Foster families who take in several children in foster care may experience frequent disruptions to their family life. Children in foster care may constantly come and go—and sometimes kids who previously moved out may move back in if their new placement doesn’t work out.”
  • Some experts advocate for structural changes to the foster care system that would create more stability for everyone involved. On the individual level, foster parents can take advantage of resources such as foster parent support groups, grief counseling, and respite care.

Adoption Rates

  • According to the US Department of Health and Human Services, 61,000 foster children were adopted in 2018. Of those, 51% were adopted by their foster parents.
  • There are a total of 437,000 children in the US foster care system, meaning that the number adopted by their foster parents only represents 7% of the total (0.51×61,000/437,000=0.07). Of those 437,000, only 125,000 are actually eligible for adoption; so of those 125,000, 25% were adopted by their foster parents (0.51×61,000/125,000=0.25).

Organizations

  • The National Foster Parents Association is an advocacy group for foster parents. Their mission is “to be a respected national voice for foster, kinship, and adoptive families through networking, education, and advocacy.” Their activities include advocacy; education and training; providing services and support to foster families; and promoting a positive image of family foster care.
  • The Child Welfare Information Gateway provides a collection of resources for foster parents and families. This organization “promotes the safety, permanency, and well-being of children, youth, and families by connecting child welfare, adoption, and related professionals as well as the public to information, resources, and tools covering topics on child welfare, child abuse and neglect, out-of-home care, adoption, and more.” The organization also provides an interactive map of state-by-state resources for foster families.
  • Sesame Street in Communities is an organization supporting foster families and care providers through resources and partnerships. “Sesame Street in Communities builds on our almost 50-year commitment to addressing kids’ developmental, physical, and emotional needs. Our time-tested research model and thorough testing with families and providers ensures that these resources have a measurable impact in the lives of parents and children.” The organization also has local partnerships and collaboration to reach families.

Adoption/Foster Care Trends

Trends in foster care and adoption seem to take time to gain momentum and remain trends for some time. This is the case with both of the trends identified in this report. The first trend has seen more families adopt children from foster care. As a result, 2018 set a record in this area. The second trend has been developing for over a decade. It is the trend toward open adoptions. Although initially there was considerable opposition, it is now becoming the norm. The insights provided are based on 2018 data, which is currently the most up to date.

More Families Choosing to Adopt Through Foster Care

  • Over time there has been a decrease in the number of domestic infant adoptions; as a result, there has been an increase in the number of families that are choosing to adopt through the foster care system.
  • The Adoption and Safe Families Act was enacted in 1997, introducing time limits around permanency when the rights of the parents have been terminated. The impact has seen more families looking to adopt children from foster care.
  • One advantage of adopting from foster care is the cost. It costs significantly less to adopt from foster care than it does to adopt a child through a private arrangement. State governments or child welfare agencies usually arrange foster care adoptions.
  • The number of foster care adoptions in West Virginia, Arizona, and Montana has increased by more than 50% in recent years. The median age of foster care adoption is 8 years.
  • The trend to adopt through foster care is having an impact on the lives of the children who are in foster care. Just over half of the children who enter foster care will be returned to their parents. The remainder of the children can be adopted. The trend to adopt from foster care has seen the number of adoptions increase. This means that children are less likely to suffer the negative consequences of being in foster care long-term.
  • Foster care adoptions are completed through either a public or private agency. The impact of the trend is that more families are looking to complete programs that assist in dealing with trauma. This is because several states require a program of this nature to be completed, as so many of the children in foster care are dealing with some sort of trauma.
  • This trend has not impacted significantly on adoption organizations as the adoptions are completed through either a public agency or an agency that has contracted to the state to complete this work. Often there is no cost to the prospective parents.

Open Adoptions more Acceptable

  • Back in the 1980s, when the concept of open adoption was introduced in Texas, it met some staunch opposition. Social workers raised doubts over the chances of a successful adoption id the adoptive family was to stay in direct contact with the birth mother and father.
  • In many states and with many agencies, it took many years before they started operating an open adoption policy. The practice starting building momentum as a trend when research began to illustrate the benefits for the children. As a result, both agencies and families are more comfortable with the children maintaining contact with their birth parents.
  • One adoptive father, Will Duncan, explains, “The more I thought about it, I realized all my other relationships that are healthy are based on openness and honesty without somebody mediating them. So why should this be any different?”
  • The reality is that with the internet and social media, even if the adoptive parents do not agree to open adoption, there is an inevitability that the child will seek out the birth parents. One of the advantages of open adoption is that this can be done in a planned manner that is in the best interests of the child.
  • It is a complex trend as some adoptive parents find the process threatening, some may feel that it means they will have to compete to get the attention of the child, and some think that contact will only result in feelings of grief and loss for the child As time has passed there has been a realization from all parties concerned that these feelings will exist regardless of whether the birth parents are involved or not.
  • The contact does not have to be overwhelming. It could be just the exchange of letters or social media messages, or it could be contact in person. Recent research has shown that maintaining contact with the birth parents is beneficial for the adoptive parents and helps them make the required post-adoption adjustments.
  • This trend has had some impact on adoption agencies, as some are involved in helping to facilitate contact between the children and their birth parents. Still, the level of involvement and work varies, with some agencies experiencing little change in workload or costs when the adoption is open.
  • In many respects, open adoption is slowly becoming the new norm, and the reality is that in the last few years, agencies have adjusted to accommodate this trend.
  • If the adoptive parents are undertaking courses or similar before adopting, this is an area that they can get advice and training on.

Insights into Foster Care and Adoption

  • In the year ended 30 September 2019, 687,000 children were involved with Child Protective Services. Of this number 437,000 were in care at the end of the 2018 financial year.
  • In 2018, 263,00 children entered the system, while 250,000 exited it.
  • 71,300 parents had their parental rights terminated. 125,000 children are currently waiting for adoption and 61,300 children were adopted.
  • The number of children in the system waiting to be adopted has remained steady between 26% and 28% over the last decade.
  • Adoption figures have been steadily increasing over the last five years. 2018 marked a record high with 25% of the discharges from the service being adoptions.
  • West Virginia has the highest number of foster care adoptions with a rate of 19.04 per 10,000. The US national average is 5.10 per 10,000.

Best Practices in Successful Placements

Two best practices for adoption and foster care agencies to create successful adoptions are the availability of a 24/7 contact and the use of evidence-based parental training programs.

1. Provide 24/7 Contact

  • Placements are more successful when foster and adoptive parents are provided with a 24/7 crisis support contact.
  • One program that offers continuous on-call support has a foster family retention rate of 97%, well above the national average.
  • The New Jersey Mobile Response and Stabilization Service offers behavioral health assistance to “any family anywhere in the state of New Jersey, at any time: 24 hours a day, 7 days a week, 365 days a year.” In doing so, the program has “maintained 94 percent of children in their living situation at the time of service, including children who are involved with the child welfare system.”
  • Without this access to crisis services, children may need to be removed from the home and re-located to places like costly group homes or another foster-family, which can be more work and therefore more costly for case workers.

2. Evidence-Based Parental Training Programs

  • One best practice to ensure stable, successful placements for foster children and adoption is the availability of evidence-based programs that support the foster or adoptive parents.
  • One example is Treatment Foster Care Oregon (TFCO), which “treats adolescents, preschoolers, children, and youth with mental health issues who are in foster care. Designed to decrease negative behaviors while increasing positive social behavior, TFCO is shown to significantly increase successful placements and to decrease the number of placement moves.”
  • Additionally, Parent Child Interaction Therapy (PCIT) is a “parent-training program based on attachment and social learning theory that can be used in the foster care context for young children with emotional and behavioral challenges. PCIT has resulted in reductions in children’s behavioral problems at home and at school and risk for child physical abuse; improvements in how parents and caregivers listen, talk, and interact with their children, including reductions in corporal punishment and physically coercive parenting approaches and parental stress; and increased resource parent tolerance of child problems over time.”
  • Studies have found that these types of interventions “increased chances of a positive exit (e.g., parent/child reunification) and mitigated the risk-enhancing effect of a history of multiple placements.”
  • Multiple placements of children raises costs for child welfare agencies due to the increase in work-hours required for each placement. One study found that “each placement change required an average of over 25 hours of casework and support staff time to process the change of placement, including time in identifying and placing a child in a new setting, staff meetings, court reports, and accompanying paper work.” Therefore, by decreasing the number of placements by offering an evidence-based training program, agencies can effectively reduce their cost.
  • Additionally, these training programs can improve the retention of foster families, of which only 40% continue after their first year. The National Council for Adoption found that “when trained parents continue to foster, it means a more stable foster care experience for the child, dramatically improved outcomes for our kids, and a substantial savings of fiscal dollars. To reverse the system’s terrible retention rates and prevent burnout, foster parents need smart support, peer encouragement, and cutting-edge training that sets realistic expectations.”

Top Challenges for Foster Care Agencies

Four top challenges for foster care agencies, selected based on numerous expert mentions, are an increase in the number of foster children, limited funding for reunification, a lack of foster homes, and a national social worker shortage.

1. Increasing Number of Foster Children

  • The increase in the number of children needing foster care placements is putting a burden on foster agencies.
  • In a 2017 report, the US Dept of Health and Human Services reported an increase in the number of foster children in the US for a fourth year in a row. The increase is mostly due to the national drug abuse and opioid crisis, as well as an increase in child neglect (potentially stemming from that crisis).
  • The increase has helped create a lack of sufficient foster families, a need for increased funding, and larger caseloads for social workers.
  • Agencies are also developing programs designed specifically for families dealing with drug addiction “with the goal of decreasing the number of children having to enter care.”

2. Limited Funding for Reunification

  • Foster care agencies have limited funding for reunification programs.
  • Due to a series of complicated funding requirements and incentives, the government now spends 10 times the amount on foster care and adoption than it does on reunification services.
  • The affect this has on foster agencies is a decrease in the number of reunifications (total reunification percentage dropped from 53% in 2007 to 49% in 2017) and an increase in the number of re-entrys from previous reunified families.

3. Lack of Foster Homes

  • The lack of foster homes in the US has been described as “a crisis level shortage.” This lack of foster homes means that children will be placed in less-desired placements like hotels, residential shelters, or even left in questionable home environments.
  • The lack of homes is exacerbated by the fact that 60% of foster families quit after their first year, and even more quit after their second year.
  • In 2015, more than 56,000 children were in group home placements, which on average cost 10x more than family placement.
  • For agencies, this means social workers are having to spend more time recruiting foster families and identifying alternative placements for children rather than the more beneficial tasks of “family engagement, case planning, service coordination, and intervention delivery.”
  • Additionally, lack of foster homes can contribute to “sibling separation, school changes, and placement instability.”

4. National Social Worker Shortage

  • There is a national social worker shortage, especially in rural areas.
  • Experts state that the number of social worker jobs is growing by 11% over the next decade, and by 2025 there will be a lack of 10,000 full-time social workers.
  • The lack of social workers is caused by a combination of high educational requirements, a lack of funding for workers in rural areas, the complexity of the job, and the fact that many current social workers are nearing retirement age.
  • The shortage leads to “higher caseloads for child welfare workers, higher burnout and turnover, and decreased quality of services for children and families.”

Top Challenges for Adoption Agencies

Four top challenges for adoption agencies, selected based on expert mentions, are an increase in the number of children waiting to be adopted from foster care, a decrease in international adoptions, high rates of behavioral and mental health challenges in children waiting to be adopted and the challenge of placing older children into adoptive families. Due to a limited amount of information available, challenges were determined by only one expert mention as long as data was available to illustrate the challenge. If no hard data was available, the challenge was mentioned by at least two credible sources.

1. Increase in the Number of Children Waiting to be Adopted

  • The number of children waiting to be adopted from foster care in the US increased from 123,800 in FY 2017 to 125,400 in FY 2018. In 2016, 116,508 children were waiting to be adopted from foster care.
  • Overall, the percentage of children in foster care with the goal of adoption increased to 27% in 2017 from 24% in 2007.
  • In order to deal with these increases, adoption agencies have increased recruitment efforts to find permanent placements and increased financial incentives for permanent placements, all of which mean more money being spent to try to find permanent placements for an increasingly large number of children.

2. Increasing International Challenges

  • International adoptions have decreased, due to increasing international restrictions.
  • The decrease in international adoptions has proved an insurmountable loss of income for some adoption agencies, which downsized. For example, “Virginia-based America World Adoption, which has offices in 21 states, has seen its caseload drop by more than 50 percent over a decade.” As such, they decreased staff and have a longer processing time for adoptions to be completed.

3. Behavioral and Mental Health Problems

  • Children with behavioral or mental health challenges are less likely to be adopted, and for those that do get adopted, they wait longer for an adoption to happen.
  • This can be challenging for agencies since these children require longer stays in foster care and increased pre- and post-adoption services including medication, and therefore these challenges increased the cost of caring for these children.

4. Age

  • The average age of children waiting to be adopted in higher than that of those being adopted, meaning older children have a low likelihood of ever being adopted.
  • With older children being harder to place, agencies must care for them for longer periods of time and work harder to find a placement family. Additionally, children who age out of the system without being adopted are at higher risk for negative outcomes like “homelessness, unemployment, early parenting, substance abuse or incarceration” than those with families.

Adoption and/or Foster Care Legislation – United States:

Modern adoption in the United States is regulated at the federal level by the Child Abuse Prevention and Treatment Act, but most policies are mandated at state level. Insights into the history of CAPTA, commonalities in adoption policies among states, LGBT adoptions, and the current costs of adoption in the United States are outlined below.

Legislative History of Adoption: CAPTA

  • Introduced in 1974, the Child Abuse Prevention and Treatment Act (CAPTA) requires federal agencies to issue or amend policies regarding adoptions and foster care. CAPTA has consistently strengthened government policies to assist in the adoption and foster care programs in the United States.
  • Laws issued by CAPTA prompt reactive laws and implementation of new or revised policies from states.
  • Provisions of CAPTA address placement of children who come from abusive families, children with special needs, children of parents suffering from addiction, as well as efforts to prevent racial or economic discrimination in the placement process.
  • CAPTA also establishes tax credits for states and adoptive parents who follow certain guidelines around discrimination and allows the enforcement of fines for states that fail to meet discrimination and other federal standards.

Common State Law Principles

  • All states adhere to certain principles regarding adoption in the United States. These include the transfer of parental rights and responsibilities from biological parents to adoptive parents.
  • Adoptions must be carried out with the consent of the child’s biological parents.
  • A state’s ultimate responsibility regarding adoptions are to represent the best interest of child.
  • Confidentiality is a key principle of adoptions in the legal system.
  • States hold the principle that adoptions are permanent, and that the new parents are permanently guardians of the adopted child.

Laws Regarding LGBTQ Rights and Adoption

  • Currently in the United States, over 16,000 gay and lesbian couples have adopted 22,000 children.
  • Due to federal mandates, same-sex couples in every state can petition for adoption. Some states require proof of the couple’s legally recognized relationship in the form of a civil union, marriage, or other legal binding.
  • The city of Philadelphia stopped using an adoption agency, Catholic Social Services, to place children for adoption due to the agency’s policy against placing children in homes with same-sex couples.
  • Philadelphia’s Court of Appeals unanimously voted against the agency as it did not conform to the city’s nondiscrimination policies. The Supreme Court will take on the case.

Adoption Costs

  • In the United States, all adoptions must be finalized in a court in the United States. The cost to prepare documentation for court is anywhere from $500 to $2,000. The cost for legal representation, such as a lawyer, may range from $2,500 to $12,000.
  • Using the public foster care system, adoption costs are $0-$2,500.
  • Using a lawyer to complete the adoption process costs $15,000-$40,000, which covers the medical expenses of birth, lawyers for both biological and adoptive parents, court fees, home studies, and other associated expenses.
  • Adopting through an agency costs $20,000-$45,000 to cover organizational costs, legal expenses, and medical bills.

Intercountry Adoption

  • Intercountry adoptions are complicated and may be challenging to navigate. Prospective American parents hoping to adopt foreign children must observe Federal laws, state laws, Conventions, and the laws of the child’s country of origin.
  • In the U.S., these adoptions are handled by the U.S. Citizenship and Immigration Services (USCIS), which is part of the Department of Homeland Security. The USCIS will determine if parents are eligible to bring an adopted child into the country and if the child is eligible to be adopted.
  • The requirements change according to the country of origin, but there are some minimal standards that parents must meet to be eligible under the Federal law, regardless of the child’s nationality: If the prospective parent is unmarried, he or she must be at least 25 years old and a U.S. citizen; if it is a couple, one of the parents must be a U.S. citizen, and the other must be either a citizen or in legal status in the U.S.; and prospective parents must go to the process of determining if they are suitable to adopt, including criminal background checks, fingerprinting, and a home study. If the parent qualifies to adopt under Federal law, they must then meet their home state’s requirements.

The Hague Convention

  • The Hague Convention is an international agreement to safeguard intercountry adoption established in 1993. The U.S. signed the Convention in 1994, and it is in full force since 2008. It applies to all U.S. citizens adopting children who are residents in countries that are part of the Convention.
  • The Convention establishes requirements for the process and the children. There are five primary elements to the adoptee classification, besides country-specific requirements:
  • 1. The child must be under 16 at the time the prospective parents fill the Form I-800. The I-800 form is a “Petition to Classify Convention Adoptee as an Immediate Relative,” and it is filled with the USCSI.
  • 2. The parents must be a married couple or unmarried U.S. citizen that the USCIS has found suitable and eligible to adopt (the previous minimal standards apply here).
  • 3. The Central Authority of the country of origin has determined that the child is eligible for the adoption, and proposed an adoption placement that has been accepted. At this point, the child must not have been adopted or been placed in the custody of the prospective parents.
  • 4. The child’s birth parents or legal custodians have freely expressed their consent in written form, irrevocably consenting to the termination of their legal relationship with the child and agreeing to the child’s emigration and adoption.
  • 5. If the child’s last legal custodians were two living birth parents who signed the irrevocable consent to adoption, those parents must be incapable of providing proper care for the child.
  • Typically, when the requirements are met, the USCSI provisionally approves the Form I-800. The consular officer at the U.S. Embassy or Consulate will send an Article 5/17 letter to Central Authority in the child’s country of origin, stating that the parents are suitable and eligible to adopt and that the child is eligible to enter and reside in the U.S. As a result, the court is allowed to grant a full and final adoption or custody order.
  • After the adoption is completed, the Embassy will complete the final adjudication of the petition. Considering there are no obstacles, the consular officer issues the final approval of the Form I-800 petition, issuing either a Hague Adoption Certificate or Hague Custody Certificate, and the child receives an immigrant visa.
  • In Convention adoptions, before the final adoption, the USCIS determines whether a child appears eligible to immigrate to the U.S. as a “Convention adoptee.” A U.S. consular officer also defines whether the child appears to satisfy the criteria for visa eligibility before the adoption is finalized in the country of origin. This will allow the prospective adoptive parents to know ahead of time whether the child seems to be eligible to enter the United States. The procedure varies according to the country of origin.
  • The U.S. Intercountry Adoption Act of 2000 (IAA) requires the Department of State to verify every adoption in the U.S. completed under the Convention, ensuring it complies with the Convention, the IAA, and the country’s regulations.

Immigration and Nationality Act (INA)

  • Under the Immigration and Nationality Act (INA), children from non-Convention countries must meet the definition of orphan to be adopted and immigrate to the U.S. Prospective adoptive parents must file a Form I-600 (Petition to Classify Orphan as an Immediate Relative) with a USCIS to finalize the immigration process for a child from a non-Convention country.
  • Like adoptions that fall in The Hague Convention, to immigrate a child as an orphan, the parents must meet the same requirements to be eligible. To qualify as an orphan under the INA, the child must at least meet the following requirements (others may apply according to the case/country):
  • 1. The child must be under 16 years old, or under 18 years old if they have a sibling under the age of 16 who has been adopted or will be adopted by the same parents, at the time the Form I-600 petition is filed.
  • 2. The child must either have no parents due to “death or disappearance of, abandonment or desertion by, or separation or loss from, both parents” or have a sole parent who is incapable of caring properly for the child and has given its irrevocably written consent for emigration and adoption.
  • 3. The prospective adoptive parents must complete the final adoption in the country of origin or obtain legal custody of the child for emigration and adoption in the U.S.
  • 4. The child must be adopted by a married U.S. citizen (or unmarried citizen at least 25 years old), with the intent of “forming a bona fide parent/child relationship.”
  • The Bureau of Consular Affairs warns prospective parents that not all children in orphanages or children’s homes are adoptable and that there are many variables from country to country, including the Pre-Adoption Immigration Review program, which may affect the order in which the adoption process occurs.

Adoption Agencies and Intercountry Adoptions

  • Not all adoption agencies can handle Hague adoptions. Only adoption service providers that have been approved or accredited on a Federal level may offer certain services for Convention adoptions. The Intercountry Adoption Accreditation and Maintenance Entity (IAAME) evaluates the agencies using “uniform standards that work to ensure professional and ethical practices.
  • The accreditation regulations went into effect on April 1, 2008. Initially, the regulations were only applied to Convention cases, but in 2013, President Obama signed the Intercountry Adoption Universal Accreditation Act of 2012 (UAA), which mandated that the accreditation provisions of the Intercountry Adoption Act (IAA) apply to “orphan” cases subject to INA.
  • Organizations and individuals must be accredited, approved, supervised, or exempt, to provide any of the following services:
  • 1. Identifying the child for adoption and arranging the adoption.
  • 2. Securing the consent to termination of parental rights and adoption.
  • 3. Performing background studies on the child and prospective parents, and reporting on such studies, making a non-judicial determination of the parent’s ability to care for the child and proper placement.
  • 4. Monitoring after the child has been placed with the adoptive family until the final adoption.
  • 5. Assuming custody of the child and providing childcare or other social services when necessary if there is a disruption before the final adoption.
  • The agencies are required to itemize and disclose, in writing, the fees and estimated expenses associated with the adoption from a Convention Country before the process begins. Outside of the estimated fees, the adoption service provider is only allowed to charge for unforeseen expenses under specific circumstances.
  • Important to note that U.S. accreditation is not an automatic permission to provide adoption services in other countries of origin. Some countries may insist the adoption services are handled by governmental authorities instead of agencies, for example. Other countries may have their own laws and requirements.

Multiethnic Placement Act

  • Enacted in 1994 and modified in 1996, the Multiethnic Placement Act (MEPA) is the first Federal law to address the issues of race in adoption by prohibiting agencies that received federal funds to deny transracial adoptions based on race.
  • The law intends to decrease the length of time that the child has to wait to be adopted, to facilitate the recruitment and retention of foster and adoptive parents, and to eliminate discrimination based on race, color, or national origin.
  • To achieve these goals, the MEPA has three basic provisions:
  • 1. States and entities involved in foster care and adoption placements that receive any federal financial assistance are prohibited from delaying or denying a child’s foster care or adoptive placement based on the child’s or parent’s race, color, or national origin.
  • 2. It is prohibited to deny individuals the opportunity to become a foster or adoptive parent based on race, color or nationality.
  • 3. States must recruit foster and adoptive parents who reflect the diversity of the children in the state who need placement to remain eligible to receive federal assistance.
  • All state and county child welfare agencies that receive federal title IV-E and title IV-B funds are subjected to MEPA. Private and public agencies that receive federal funds from any source directly or through sub grant from a state, county, or another agency are also subject to the act.

Family First Prevention Services Act

  • Signed by President Trump in 2018, the Family First Prevention Services Act aims to diminish the number of children entering foster care by providing substance abuse treatments, mental health services, among others.
  • Before the Act, states could use federal Title IV-E funds, which is the primary source of federal funding for foster care, only after the child has entered foster care. As of October 2019, states have the option to claim federal reimbursement for approved prevention services designed to let children stay with their parents, including evidence-based in-home parenting training, and mental health and substance abuse treatment.
  • The Act also seeks to reduce the use of congregate or group care for children by limiting federal funds. With limited exceptions, states will not receive reimbursement from the federal government for children placed in group settings for more than two weeks. This means that existing IV-E funding for children and youth in group settings will be limited to the “first two weeks of placement unless the child/youth has particular specified permissible needs that necessitate a group placement.”
  • Qualified residential treatment programs must use the trauma-informed model and employ registered or licensed nursing staff. The child must be formally evaluated within 30 days to determine if family members can meet their needs.
  • Institutions that are exempt from the two-week limitation are usually limited to 12-month placements. Additionally, to be eligible for federal reimbursement, the Act generally limits the number of children allowed in a foster home to six.

Adoption and/or Foster Care Policy Issues – United States: Part One

While child rights advocates and government officials have made great strides in finding safe homes for children in need of care, debates about the process for doing so abound in the United States. Currently, the issues of adoption discrimination, birth parent rights, and Native American adoption have evoked controversy across the country. Equally contentious is the debate about family reunification versus placement in the foster care system.

Discriminatory Adoption Laws

  • Throughout the U.S., lawmakers and child advocates strive to balance the rights of prospective adoptive and foster parents, the belief systems and mission statements of private agencies, and the desperate need for children to find safe homes.
  • Across the country, states have enacted laws that protect the rights of adoption and foster care agencies to place children in care situations that are aligned with the agency’s religious values.
  • Currently, discriminatory adoption and foster care laws exist in North Dakota, South Dakota, Michigan, Kansas, Oklahoma, Texas, Mississippi, Tennessee, Alabama, South Carolina, and Virginia. Discriminatory Bills are currently pending in Colorado, Iowa, Missouri, Georgia, and Massachusetts. The states of Oregon, California, Wisconsin, Washington, D.C., Delaware, New York, Maryland, and Rhode Island have laws that prohibit discrimination against LGBTQ parents seeking to adopt or provide foster care.
  • Senator Paul Rose of Tennessee, a proponent of laws that protect the rights of the agencies, believes that organizations should not be required to “participate in a child placement” if doing so would conflict with that agency’s written policies or “religious or moral convictions.
  • One adoption agency in Michigan with a religious mission said that it would be impossible for their staff to grant a written certification for an unmarried or same-sex couple. This would not only put their funding from religious donors in jeopardy, but would completely disavow the basis of their organization.
  • Opponents argue that the laws allow agencies to legally disregard qualified prospective families seeking to adopt or foster. Despite this “license to discriminate,” the agencies would still receive funding from the government. They also argue that the laws prevent at-risk children from being placed more quickly into a loving home. LGBTQ children are particularly at risk of being placed in a home that does not understand or support their emotional struggles. The Tennessee Equality Project, an LGBTQ advocacy group, has opposed such bills in its state.

Birth Parent Rights

  • The Preserving Family Bonds Act in New York, currently vetoed by Governor Cuomo, would allow judges to order that an adoptive child must remain in contact with a biological parent when the situation is advantageous to the child. The order ignores the rights and feelings of the adoptive parent and the children. Currently in New York, judges are not allowed to grant any contact after parent’s rights have been terminated. The legislation was passionately debated and the issue is still being argued at the national level.
  • Child welfare workers support the legislation, as they believe that children benefit from continued contact with biological parents. They indicate that 95 percent of infant adoptions are open. They also claim that numerous studies indicate that open adoption is beneficial to children, who are less inclined to misdirect blame and harbor resentment towards their adoptive parents. They also argue that there is a distinct advantage for adopted children to know about family and medical history.
  • Jeremy Kohomban, President and Chief Executive of the Children’s Village, a nonprofit foster care agency, is also a proponent of such legislation. He worries that biological parents whose parental rights have been terminated are usually black, and that family courts have an obligation to consider the impact of adoption and foster care decisions on black families.
  • Bill Baccaglini, President and Chief Executive of the New York Foundling, a nonprofit foster care agency, opposed the bill. He argued that the law did not protect the rights of adoptive parents, who are also experiencing an emotionally tumultuous time. He also questioned the safety of the adoptive families when angry biological parents have access to them.
  • David Hansell, Commissioner of the New York City Administration for Children’s Services, the agency which oversees foster care and adoption in New York, said that the law could “hamper the recruitment” of potential foster and adoptive parents. This would cause children to remain in foster care even longer.

Native American at-risk Children

  • The Indian Child Welfare Act (ICWA) of 1978 is a federal law that oversees the removal and placement of American Indian children in the state’s custody. ICWA gives tribes legal authority in child welfare cases and determines the required criteria for foster and adoptive homes. As such, ICWA prefers to place Indian children with relatives or other Indian families. The justification for the law was a set of studies that revealed that one third of Native American children had been removed from their homes by non-tribal public and private agencies. Most children were then placed in foster and adoptive homes without a Native American present, often far from their homes. Many lost touch with their own families and were abused.
  • A debate about the law gained national attention in 2019 when a Texas judge, U.S. District Judge Reed O’Connor, ruled that ICWA illegally gave Native American families “preferential treatment” in adoption cases for Native American children. He stated that they were afforded preferential treatment because of their race, which violates the Fifth Amendment’s “equal protection guarantee.”
  • Proponents of Judge O’Connor’s ruling against ICWA include non-Native American families who have tried to adopt American Indian children. Several lawsuits against ICWA, many of which were prompted by such families, have focused on questions of race, tribal sovereignty and the role of the federal government in the lives of Native Americans. One lawyer who represented a family challenging ICWA informed the court that a child was physically torn out of the adoptive parents’ arms because they were not Native American. The states of Louisiana and Indiana have joined Texas in challenging the law.
  • Native American activists oppose the Judge’s ruling. They fear that the judge’s ruling may jeopardize Native American children, who are at an increased risk of being removed from their families (as compared to non-Native American children). Dan Lewerenz and Erin Dougherty Lynch, attorneys with the Native American Rights Fund, have indicated that if the ruling is upheld, decades of legal precedent regarding tribal sovereignty is in jeopardy.

Foster Care: Reunification or Placement

  • The emphasis on reunification of families has been debated on a national level, but a recent investigation in New York City brought this issue to the forefront of foster care policy discussions. The Department of Investigation in New York City released a report in 2018 that exposed that many children who have been removed from their homes are later abused by their parents during visitation or trial home stays. As a result of the report, the Department of Investigation issued 12 recommendations for corrective action to the New York Administration for Children’s Services.
  • The report indicates that in 2016 and 2017, about 1,100 foster children were maltreated after placement, usually by a biological parent. Foster parents were the perpetrators in only 19 percent of these incidents. One third of cases in which children were removed from their home involved a parent with a substance abuse addiction problem. Some analysts believe that child protection agencies appear to tolerate this situation because of their bias towards family reunification.
  • Jeremy Kohomban, President and CEO of the Children’s Village, a foster child advocacy organization and Ron Haskins, Co-Director of the Center on Children and Families at Brookings, oppose the recommendations issued by the Administration. They argue that once children are removed from their homes, a new placement will not ensure proper childhood development or safety. They also contend that children placed in foster care are usually from poor minority backgrounds who are likely to age out of the foster care system. They believe that reunification reduces the risk of negative outcomes.
  • James Dwyer, Professor of Law at William and Mary, argues that safety should take precedence over keeping African-American families together.
  • The Family First Prevention Services Act (FFPSA), was enacted into law in February 2018. This legislation allows states to use federal funds to provide mental health and substance abuse support, parenting skills programs, and support for caregivers to at-risk families. The hope is that this support will prevent the need for foster care placements at all, thus bringing this debate to a close.

Access to Birth Certificates

  • To date, there is actual no legal precedent across the US for gaining access to one’s records, even after age 18.
  • However, there is debate over maintaining the privacy of the birth parents. For decades, states and adoption agencies assumed perpetual confidentially by sealing records permanently. In several states, adoptees have to petition the court (an expensive, long process) to gain access to their records. Only nine states recognize the right to unrestricted access to an original birth certificate.
  • The NACAC (North American Council on Adoptable Children) believes adoptees should be able to access their personal records, though their policy statement is that this should be at the age of “majority or legal emancipation”.
  • Some thought leaders feel that being able to access to information about oneself is a fundamental human right.
  • One alternative would be mutual consent registries, where if everyone consents, information can be accessed sooner.
  • Some parties feel that an adoptee’s right to access their birth certificate even before the age of 18 should be examined.

Privatization

  • The NACAC understands that private agencies are a necessary part of the adoption and foster care process. However, they are concerned that this process can diminish the public responsibility towards foster children.
  • There is concern that children’s best interests could be sacrificed for financial gain or efficiency.
  • A recent Congressional review confirmed this is already happening. Several companies are accused of cutting corners to enhance profits.
  • States lack sufficient oversight capabilities in order to catch these actions before it’s too late.
  • The debate comes from states feeling they need to privatize to cut costs and reform their systems.

Support for Youth Aging Out of Care

  • As children “age out“, e.g. reach the age of majority (usually 18 but sometimes 21), they no longer have official placement with a foster family.
  • Children suddenly left without that support network are vulnerable to homelessness, unemployment, criminal behavior and more.
  • The debate is that government should be providing transitory services to give ongoing support.
  • While the U.S. Fostering Connections to Success and Increasing Adoptions Act of 2008 did increase the opportunities for states to support some children until the age of 21, the NACAC believes policy should be expanded to support all foster care youth until 21. They also demand additional funding, healthcare coverage, support services, tuition waiver programs and other services that can support older foster care youth.
  • It is not so much that there is a debate about this issue, but that governments have responded that they do not have adequate funds to offer all the support services called for.

Abuse

  • The foster system is vulnerable to allegations of abuse. Therefore, it is imperative that allegations are investigated thoroughly, families should be instructed on how to avoid abuse, and youth should be informed on how to keep themselves safe.
  • Studies show that children in foster care are much more likely to be abused. More than half of sex trafficking victims in the US came from foster homes.
  • It can be difficult for agencies to balance potential long-term harm by removing the child(ren) versus risk of harm from abuse or neglect.
  • The NACAC feels that foster placements should generally be preserved, preferring to remove the offender (if an isolated person) if possible.
  • Focus for Health wants stricter protocols in place to deal with this issue. This includes stricter screening and more extensive measures to combat and prosecute abuse.
  • Some officials, however, deny there is a problem. One state official recent told Iowa state legislators that only 1 in 333 foster care kids had been abused. These figures came from internal DHS reviews rather than independent assessments.

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