[marythemom]

We live in Texas and are adopting a sibling pair from Nebraska. They have lived with us a little over one year now. The boy spent the last 6 months in residential treatment due to his severe aggression and mood swings. He's been home three weeks. Our private insurance paid for only 4 days of RTC. The state of Nebraska paid for the rest. TX wouldn't have paid for any of it - particularly not at this well-known (expensive) facility.

We were assured though that when our children's adoptions were final that we would have Texas Medicaid (which we will) and that we would have Nebraska Medicaid as a backup. We found out 5 days before our daughter's finalization was finally going to take place, that we would not have NE Medicaid as a backup! This was HUGE to us since TX pays for VERY little and has almost no RTC care. Nebraska covers up to 18 months in RTC (at the time our son had been in RTC for 5 months already and odds are pretty good he'll need it again!). We asked them to hold off on the adoption until we could resolve some of this.

NE's post adoption services are built into their Medicaid. TX provides those separately from their Medicaid. Since our kids are out of state - they do not qualify for any state-funded post adoption services (which is the only kind we would have access to)! NE has said that we get TX Medicaid and that should be enough! We've tried explaining the differences.

NE has finally said they will put the "up to 18 months of RTC" into the subsidy, if we can prove that we've exhausted all other alternatives, but they are not planning on helping in any way with the post adoption services (caseworker or case management if needed, respite, psychiatric hospitalization, training, education...).

At one point we were told that if adopted, our son has an 80% chance of a disruption - due to his severe issues. Frankly, his sister is not much better (just smaller and less aggressive - he's 5'9" and 200lbs and has been since he was 11). They are now 12 and 14, both have PTSD, bipolar, ADHD, oppositional defiant disorder (for her), conduct disorder (for him), both are years behind in school and have attachment issues (he's RAD). They will both be in therapy for years and I do not think we've seen the last of his issues with the law. We need a LOT of support.

We're at our wits end. To think, we thought we were LUCKY because we had kids from out of state and therefore were going to get better services. The only thing we knew we were missing out on was that TX provides in-state college tuition and NE doesn't.

The NE caseworker thinks we should be ecstatic that we got the RTC coverage (and we are), but I feel like we're about to be tossed into the middle of the ocean with lead weights in our shoes instead of getting the leaky life raft we were promised!

I can't get our adoption attorney to return my calls. When I mentioned this earlier she just said. Oh that's too bad. We told her we wanted to delay the finalization until we'd heard back from NE, and now I can't get her to return my calls.

So who can I/ should I talk to about this? Should I just accept the inevitable and finalize our daughter's adoption? (Our son isnt' eligible for finalization until he's been home 6 months - and we want to be sure he's safe before we finalize anyway.). Advice?!

Mary
mom to D(14) and his sister C(12) - hoping to finalize soon!
and bio kids K(11) and T(almost 9)
If "that which doesn't kill us makes us stronger..." just call me Superwoman!

[Lylac]

mary, the way it worked with my two out of state adoptions is..once they are placed in an out of state home, the medicaid automatcally stopped from the kids state. And our state took over.

I know you've battling this for a long time now... and it sucks

[Again!]

Texas doesn't pay for "almost no" RTC, it pays for NO RTC. 10,000/month, private pay. Just FYI.

[DianeScraps]

I would say don't finalize till they can fix it. It sounds like it will be a nightmare, but if you finalize and don't have what you know you need, seems like you have a much bigger nightmare.

[MomwithFive]

<<Since our kids are out of state - they do not qualify for any state-funded post adoption services >>

Are the kids eligible for title-iv funding? I would look into that as then they would receive better health coverage I believe. Maybe someone else knows better than me. I wouldn't finalize until you were offered more help. They say 80% chance of disruption and then offer no help?? Doesn't make sense.

[marythemom]

Medicaid - Nebraska is not a reciprocity state, but TX is. This means that when the adoption is final the kids switch to TX Medicaid. Until then they have NE Medicaid. Currently NE pays for anything our insurance doesn't (including co-pays on meds, but not appointments). That stops once the adoption is final.

We have good health insurance and it includes mental health. So far we've had no issues with this. We own our own company so we can make sure that we have health care with excellent coverage.

I do not know anything about Title IV.

We were in the process of switching Texas agencies from one that only handles basic children to one that specializes in therapeutic level children. The therapeutic level agency is the one that predicted an 80% chance of disruption. Based on that prediction and D's history of physical aggression the new agency turned us down because of the high risk and liability issues.

What post-adoption services should I /can I ask for?!

Mary
mom to D(14) out of RTC 1 month and better, but not great - and his sister C(12) in therapy today began discussing wanting to go "goth" and her obsession with blood and the color black in between rants about a teacher who is "picking on her" and how she wants to hit her, but won't.
also bio kids K(11) and T(my baby turned 9 last week!)

[Empty_Nest]

I'm curious why you want to finalize. I would drag it out as long as possible. Disruption is much more difficult once the child is legally yours, and there's a lot less support available. The state does not want to take responsibility for your children, and you may be faced with an impossible situation and perhaps legal trouble if you try to put them into foster care or "abandon" them in any way.

I hope your two younger kids will be able to stay safe and sane living in the chaos your two older ones create. Good luck with that. Have you weighed the cost to them vs. any potential but unlikely gains for the other two?

Sorry to be negative but BTDT, still wearing the scars. We thought we could 'fix' ours, too, but they just ended up dragging the rest of the family down with them.

Check the wording very carefully if anyone agrees to pay for mental health services after finalization. We were naive when we finalized and they promised us they would pay 'up to $1,200/yr' (this was the eighties but that was still a laughable amount) but in order to get them to pay anything, we had to be able to prove the therapy was needed due to factors relating to the adoption. How do you prove that? So essentially, that was an empty promise.

Good luck. I mean that sincerely. I hope you are able to help these kids, and keep a safe and healthy relationship with the others, too.

[marythemom]

I really do. We will have to think long and hard before we consider finalizing on D, and with his RAD we may never do so. His sister however is finally attached to this family and doing so well. She needs this final step and we aren't as concerned about her.

We are only finalizing on C at this point, but they are drawing up subsidies, etc. on both children so we want to be sure that we ask for is adequate.

We would love to get away from the constant home inspections and other paperwork, but we will not do it to the detriment of the family.

If D loses it and goes back to his old ways, we will send him back to Nebraska. It will hurt (us) like crazy and will threaten C's stability (biomom dumped him into foster care first, then her less than a year later), but we would do it rather than go back to the way things were.

Thanks for the response! I am already very concerned about the wording on the subsidy. We can't afford a subsidy attorney (and don't know where to even start looking anyway), but they've already mentioned that we have to "exhaust all other resources" on the RTC and I want to find out what that means. Most places, like school district, are more likely to say he doesn't need it so they don't have to pay. Our private insurance paid for 4 days of the 6 months he was there.

Mary
mom to
D born July '93, adoptive placement from Nebraska to our home in Texas -November '96, entered RTC July '07. returned to our home January '08.
C born April '95, adoptive placement from Nebraska to our home in Texas -November '96, hoping to finalize soon.
K, born into our family July '96.
T, born into our family February '99.

"Keep your face to the sunshine and you cannot see the shadow. It's what sunflowers do." - Helen Keller

[Empty_Nest]

Originally Posted by marythemom

I am already very concerned about the wording on the subsidy. We can't afford a subsidy attorney

IMO, you can't afford not to have one. You already know how expensive even a short stay in a treatment center is, and that's what you are already fighting the state(s) about.

You also said your daughter's problems are almost as severe as your son's. If you can delay finalizing, it seems like it would be prudent to put that off till the last possible day you can.

Is there a free or inexpensive public attorney somewhere in your area that could help you? Ask your local adoption worker first for ideas. She or he may know of someone, or may even be able to help you read through the terms of the subsidy agreement. Look in the phone book under county and/or state services and see if there is a listing for legal aid or something like that. Or just call the main number and ask if there is any low-cost legal help available.

Good luck.

[MomwithFive]

<<It will hurt (us) like crazy and will threaten C's stability >>

It sounds like waiting to finalize on both would be the best for your family. There seems to be so much uncertainty there and I would want as much stability as possible before finalization. jmo
It seems you are in a hard situation, I am sending good thoughts your way...

[itsallrelative]

Your state sounds a lot like mine, Florida. We adopted two kids from NC and experienced the same barriers. I am also a Guardian ad Litem; every state has them and your kids should have been assigned one from Nebraska, with a courtesy GAL in Texas. A GAL's job is to represent the best interests of the child ONLY, not the parents, state, etc... Contact the GAL office in Nebraska. Each child also has the right to legal representation if necessary; this may be one of those cases- request information about a court appointed attorney through the GAL office as well. Hope this helps and good luck.

[marythemom]

I contacted the kids' NE GAL. She says she cannot help because even though technically the subsidy is for the children it doesn't work that way. She suggested we ask our TX adoption attorney for advice.

Unfortunately, we are all frustrated with our local adoption attorney. She won't return calls or e-mails (except occasionally at 4am!). Nebraska has already paid her so we can't really switch.

The kids do not have a TX GAL and no one has ever mentioned it as an option. I had their TX caseworker look over the subsidy and she said the amount is more than they would get if they were TX children. TX post adoption services aren't that great anyway and we will have the RTC in writing. So far they might even be giving us an additional monthly amount for respite ($167), but that is only in the "rough draft" of the subsidy and might be removed.

At this point we've decided just to go ahead with our daughter's adoption - she needs it desperately. It is effecting her attachment negatively to have this drawn out this long. We got the major thing we were concerned about (RTC), and we never really got any other support anyway (our TX adoption agency is not capable of handling special needs children - only basic).

Our daughter will be 13 on April 13th so we were hoping to suggest finalizing on her birthday, but it's on a Sunday this year. Oh well.

We will probably delay our son's adoption for quite awhile. Between being a young teenager and having RAD, he's not sure he wants to be adopted anyway, and we need to be absolutely sure that life doesn't go back to the chaos it was before RTC and all the med changes. C needs the security of the finalization to feel safe and fully connected. I don't think it will make a difference to D.

Better get some sleep! It's going to be a long week.

Mary
Mom to D(14), C(12), K(11) and T(9)
"We may not have it all together, but together we have it all!"

[itsallrelative]

I would not dismiss what the others have said. The two we adopted from NC have wreaked havoc on our other children. The oldest turned 18, scammed a few church member families into their drama and after using them, has moved in with her drug dealing boyfriend. Her sibling, who we still have at our home is a RAD kid and in desparate need of more intense theapy (he's been in outpatient therapy the past four years he's been with us -lol), but we too have not found a way to fund those services. NC has a supplemental fund, up to $2400 a year for each kid, but we have to cover the rest. That amount doesn't even begin to cover it. He was recently arrested for stealing chicken from the deli @ Walmart!

How old are your kids? We have been told numerous times, post-adoption, affordable RAD therapy (meaning insurance covered) is only a valid solution before age ten. After ten, the therapies seem to loose their effectiveness. We have looked into Wilderness camps, etc, but again the money is an issue. FL, our state, even has a Sheriff's ranch, at a very reasonable cost which is having some good reults with teens. but because of the long waiting list to be on the waiting list. our son will age out (their program is at least a yr to 1 1/2 yr committment)

Good luck to you, and again, I would check into a legal representative for your son. He has the right to an attorney to represent his best interests and believe me, the state's attorney is not focused on that.

[marythemom]

Our son has RAD, PTSD, bipolar, conduct disorder, ADHD, symptoms of borderline personality disorder... he is now 14. We have good private insurance that covers all but a co-pay ($25) of his weekly therapy and monthly visits to the psychiatrist. It only covered 4-5 days of the RTC though - that's why we insisted that NE will have to pay for it if/when we adopt him.

His sister is now 12. She came to us over a year ago with attachment issues (and PTSD, depression, oppositional defiant disorder, ADHD, enueresis and encopresis and symptoms of borderline personality disorder). They'd been with us 8 months when D went to the RTC. His sister immediately began doing better and started attaching to us (she's in attachment therapy - he's not because of his age and our inability to find one that could work with him).

Our younger bio children (now 9 and 11) were traumatized like the rest of the family by D's out of control behaviors. They are very resilient and seem to have completely recovered in the 6 months he was gone and the 2 months he's been home. We had to reassure C that even if D lost it completely and had to go back to NE that she would stay with us forever - she needed to hear that and it's one reason we want to finalize on her as soon as possible.

D came out of RTC on all new meds and while he's still got issues from his traumatic childhood and is still RAD, he is no longer the seething volcano that he was. We're still holding our breath though, and will NOT finalize until we are sure that this is as bad as it's going to get (if that makes sense).

Mary
mom to D(14) and C(12) here from NE since 11/06
and bio kids K(11) and T(9)
If "that which doesn't kill us makes us stronger"... just call me Superwoman!

[msmeliss]

We are in TX also w/bio 16 & 19 yr olds. Spent three years in the maze of interstate placement then adoption with my 8 & 11 yr old niece and nephew. We have experienced exactly the same frustrations as you have w/medicaid, uneducated attorney, etc. We finally gave in, finalized the adoption and insured privately.

Both your teens should be determined as Title IV on your adoption subsidy agreement. It is designated to children that are adopted as special needs (older, sibling placement, documented RAD etc.) This is a "federal" program that is supposed to help advocate for your children's rights. Both NE and TX participate in this and legally must abide by the Interstate Compact Act. If your attorney isn't familiar w/interstate adoptions (ours wasn't) they won't see the importance of this classification. In a perfect world NE should give your children the "same" medical benefits (mentally and physically) in TX that he would receive in NE. Contact the ICAMA rep for TX and they may be able to help you navigate your way. Also under Title IV they should qualify for free college tuition in Texas.

I admire your commitment and dedication. We now have a blended family of six that keeps me constantly on my toes.