[sak9645]

I'm not sure whether you are talking about the homestudy agency or the placement agency.

The homestudy agency must comply with all laws of the family's state of residence and the USCIS, as well as those of the foreign country. It must also use good clinical judgment. I do not know what the laws of your friend's state are, regarding medical issues, but I can imagine that a homestudy agency might want a full discussion of any illness, such as diabetes, cancer, heart disease, multiple sclerosis, etc. that could, in some people, affect lifespan or ability to parent. So if your friend has honestly disclosed (as she should) a history of something like insulin-dependent diabetes or Hepatitis B carrier state, the agency may want evidence that the person is likely to be able to parent a child effectively for the next 18 years or so.

Also, most homestudy agencies and states are very cautious about accepting people who have had a history of psychiatric illness. They usually require that anyone who has consulted a mental health practitioner get, at the very least, a letter from the therapist (MD, Ph.D., or SW) about the person's diagnosis, treatment, and prognosis. Sometimes they ask a patient to consult a therapist chosen by the agency, for a second opinion. A history of minor depression or anxiety, treated by counseling or medication, is usually not a big problem, if appropriately disclosed, but a history including a more serious problem such as bipolar disorder or any inpatient hospitalization or suicide attempt could possibly result in rejection.

As to the USCIS, it is very sensitive about substance abuse, including DUI/DWI arrests. A person who has made a stupid mistake in his/her early teens can still be approved, but there needs to be a full discussion of the issue in the person's homestudy and evidence that alcohol or drug use is not still a problem. Again, it may be necessary to get a doctor's assurance that there has been no ongoing substance abuse.

As far as the placement agency, the China Center for Adoption Affairs (the bureau of the Chinese government in Beijing that assigns all the children) has put agencies on notice that they will lose their right to place children from China if they do not adhere strictly to Chinese policies, and submit dossiers of parents who do not qualify for a child.

As a result, placement agencies are being a lot more cautious when accepting families to their China programs. If they see even the slightest thing that could raise questions, as they review the families' homestudies, they are often asking for more information. Then, they either make a decision on their own about whether to submit the family's dossier or contact the CCAA for a preliminary ruling on whether the family is acceptable.

It is quite possible that the agency is sensitive on the issue of health status, because it has had China reject families whose dossiers it has submitted. It is also possible that your friend's homestudy raised a medical question that the agency deemed worth exploring further. As an example, China has made it very clear that children will not be placed with people who are not likely to have a normal lifespan, who may have had substance abuse issues, or who have had a psychiatric illness (minor depression over an issue like infertility not included).

Sharon