[Wilsonta]

HELP!! We are in an adoption placement beginning adoption with 2 boys, 5 & 6. The younger appears to have RAD & ADHD and the older appears to have RAD, ODD & is sexually reactive. (He could also be bipolar). No official assessment has been made but we are working to get them assessed. We are in Oklahoma and up to this point thought the state was really working with us. However, I got advice that we should not complete adoption without having them properly assessed & knowing the state will pay for residential care if ever needed. Yesterday, our caseworker informed me that they will NOT pay for residential care. The state provides you will a monthly subsidy & Medicaid health insurance for each child. She said we would have to find someone to take Medicaid. Also, her tone with me was very defensive with put me off guard as well. This is NOT the response I've gotten about anything else with her & not what I expected. The state says they view these kids as ours onced the adoption if final. So, we told her we wanted to put our adoption on hold until we could make a decision because she said the state will not budge on this. Then, the blow came this morning when I get a call back from Dr.'s office who specializes in attachment. They no longer take Medicaid. And to have the kids assessed for attachment is $500-$1200 per kid. He is the best in the area. So, I call our caseworker back & tell her that this is the problem I was talking about. She said (point blank) that the only option is using Medicaid or private insurance (which will not cover all the costs and may not be approved). She is going to look into this for us to see if there is another place to go. I mentioned again how the quality of care was important to me & I felt that if this doctor is the best, I want to be there. Also, it doesn't make sense that they will not pay for it when lack of care or termination of adoption later means the state will pay more ultimately (and the kids pay as well). I found out, too, that if something ever happens where there is violence in our home & someone isn't safe to live with & Medicaid won't pay (rather we cannot locate a facility to take Medicaid) and we are forced to take them back to the state to get them care, the ONLY option is to terminate the adoption through court, then we pay child support for them (instead of maintaining the adoption & them paying for care - ODD & UNFAIR??). She said we should decide if we want to terminate NOW due to this problem & I said "It doesn't make sense that the state would rather pay more money by re-placing the kids KNOWING that they may never be reached then. It's NOT logical." But, this is how Oklahoma operates & she seemed to have no problem having the adoption disrupted rather then help. She told me she had no power to do anything about helping pay for this since it's the state's rules. Other then disrupt, are there any options our there for us? Any advice? Please help!!!

[lucyjoy]

YOu could pay for the assesment then take the facts back to the worker asking for the subsidy needed for their care. YOu could try involving the GAL. The problem is, at 5 and 6 they know they can find a family willing to take these kids. Did the therapist who quit taking the medicaid know of anyone else willing to do the assessment that would have any kind of training? Have you talked to the SWer's supervisor?

[dadfor2]

wilsonta,

i have been through what your going through now. First off, i had to do all the foot work for my sons.

it was the hardest thing i ever had to do. We decided to hold off on adopted our children until we figured out what we were dealing with

do you have a childrens hospital in your area?

both kids are on state insurance. You need to get them in counseling ASAP. From there, you can get a psych evals, neuro testing, etc.

your children are allowed services, all services, and you should not be paying for anything, except the parking and the gas.

This was the toughest part for us. we got the kids, and then everything seemed to fall apart.

where was all the support we were going to get?

one of the things i had to do is switch my hats, not only was i a parent, but had to become their case worker. Pending on what we were dealing with, i had to keep changing hats

its hard. I wouldnt worry about what is wrong with the children right now...take one step at a time and get them in counseling.

from there, the counselor can help you get services.

i know our social worker used to say "well, their testing, well they feel safe to let it all out, your doing a great job, it will pass....etc."

i use to say to her..."well, you dont have to live with these kids."

again, you should not pay for anything, they are not legally your children. They do have health insurance, and thats what you should use to get them services.

dadfor2

[Wilsonta]

The kids have been in counseling the entire time we've had them. The foster parents had the older one in therapy, but we insisted that both needed it. After having them for 4-1/2 months, we found out that the older one was preping on the younger one. The therapist who was already seeing the older one for a year MISSED this entirely. Even though we felt they had a good therapist who was concerned, we decided to move them to work with someone who had more of a specialty with sexual behavior. The older one has started group therapy as well so he goes twice a week. BUT, what I see is both kids "playing the therapy game". It seems to have NO impact on their behavior. And from my reading & research, this is true for RAD kids. If you don't have a foundation to build on, you can't accomplish anything - you have to go back & rebuild the foundation. And right now, I feel the therapy is "standard" building on no foundation. And the therapist doesn't really understand or see everything I am telling him. For instance, I told him how the younger once has told my husband he's going to chop me up when he's big. The therapist didn't seem bothered by this. He seem to feel it was normal. BUT, he has thoughts of killing, etc. alot & it is NOT normal along with all the other symtoms of RAD. I'm just saying until we can assess them properly by an attachment specialist, I think therapy is going NOWHERE!

[aMarylandfamily]

It seems like you are re-telling our story and if hindsight were 20/20 we would have held off from finalization and are recommending you do that too ... you are not hurting anyone by doing so ... other than the statistics the state would like to meet.

While different in many ways, it felt like you were summarizing our story. Our placement at age 12 was presented to us as an emotionally disturbed child by environment with ADHD which was being treated with medication. Realistically as we learned two years later his diagnosis is "onset childhood bi-polar" and possible dissociative disorder. RAD was never officially placed in his Axis IV but probably should be! He was and would be today a good placement initially until you learn the extent of his needs and services required ... even when reading his file as his good times are really good! And yes - it will never be understood why a finalized child is eligible for less services than a foster care child! Most placements come with Medicaid and although tricky in locating reliable medical services that take same they do ... if your children are Title IV eligible that expands the Medicaid coverages even further. Any adoption agreement can be modified to include Medicaid with residential services accommodations or account for financial assistance for same even though they'll tell you they don't!

If you finalize on these children it may, as in our case, become necessary to transfer care and custody back to the state to attain the necessary services (Medicaid covered all of residential but only a portion of foster care if in our custody) especially if the child were to become a danger to himself or a danger to others (one is already a danger to others by predatating on a sibling)and child support is required (they often try and match the amount to the subsidy awarded to avoid any further hardship on the family when possible). While we had many misgivings prior to doing so we now have no regrets as the violence escalates and it would have been directed fatally at another child in the home or myself.

This doesn't mean you have to disrupt ... it just means that alot of facts and details need to be resolved before you finalize - and don't let anyone bully you into it. If for some reason, the state feels it easier to move the child that will be a sign that their support won't be there at all through times of crisis especially if the child turns this into a fiasco of accusing you of abusing him and believe me they all do that too and you need to know who to turn to and that they will be there. Maryland has been wonderful ... wishing too things could be different but there and if your state reps/sw's are not, proceed with even more caution. Losing the child to residential or even another placement (our child will probably never return home) is painful but not as painful as an act of violence after the fact that can't be taken back.

Sorry this is so wordy ... go with your gut feelings and know there are those of us here who are in or have been in your shoes and we can help ... advice is wonderful especially when given lots of it to equip yourself with knowledge to use whatever you need whenever!


Since you are not getting the therapeutic support you so need I will tell you that a child exhibiting behaviors you report may not vent anger or violence he is spewing but will be a scary candidate for violence towards himself.

[aMarylandfamily]

Hit the submit button when working on the last paragraph to add ... one thing with children who are exhibiting the behaviors you are describing is the violence they spew if often directed at themselves at some point ... I would have thought at one point that our child would never hurt himself but quickly changed my mind the first and second time he attempted suicide only to be following by prevoking peers "to homicide him" and take the pain away. Your kids will most likely turn out just fine ... if they have the services and advocate needed ... you for however long possible ... and if shortened know that without you even this much of a cry for assistance for them might never be made ... and it takes more courage to love by doing something than avoiding reality.

Take care and stay strong ... you can do whatever is needed!

[Wilsonta]

thanks. I will likely postpone the adoption finalization although I did feel pressure by our caseworker to move forward or end it now. I thought that was odd. I mean, building a lifelong family & investing your lives in this takes time to be sure you are making all the right decisions for you & the kids. I also need to find the strength within me to either know I can re-adjust my life goals or send them on their way.

I would say I'm going through the greiving process now with depression, distress, etc. so it's hard to know if I am going in the right direction. I feel we are at a standstill until we get the proper diagnosis. Without that, our thoughts about RAD, etc. don't mean much! And parenting these kids has it's own challenges. Right now, we don't have to proper tools to parent them. I get confused when reading info that says don't get in power stuggles when they are constantly bringing them on. Then, I'm left thinking do I just let them get away with bad behavior because I know where they are trying to take me? It's frustrating. We have finally made sure to keep anger out of it from our side which is helping!

One other question I have - Does anyone have statistics, facts about the recovery rate or if they will ever lead normal lives? Can they develop a conscience where there wasn't one before? Can these kids truly be saved? And what quality of life can they have? Also, has anyone used Biofeedback & did it help? And what can I look for that they are attaching if at all? I need encouragement at this point & maybe some parenting tips because we have one of each type of RAD - anxious (in your face power stuggles) & differential (easier to live with, but deep seeded anger & harder to reach).

I would appreciate any advice! Thanks again!

[dadfor2]

i do believe that state insurance that your children are on, does not cover any attachement therapy.

i agree with everything that marylandfamily said. DO NOT finalize until you are 100% comfortable with the placement.

these children are still considered foster children and the state is responisible for them.

they will not remove them, they have no place for them to go.

dadfor2

[aMarylandfamily]

It's me again!

A friend of mine used Biofeedback for two of her four children (all ADHD - possible Bi-Polar) during crisis periods involving their parents divorce - one it worked great for - the other not at all ... so like most everything in life - trying it would be a gamble.

Have been thinking about you since posting this afternoon - hoping my words relayed my message which basically is caution but determination to get these children services should be your priority (and I would hope the caseworker too) without the pressure to finalize ... kids with these needs are very hard to place and can guess that if these needs were presented to you today you would have to do some careful thinking and they would be a conditional placement ... which is ok. Just remember - they now have record that you know what their needs are and if they can get finalization done without any conditions (i.e., a clause for financial assistance for mental health needs as they arise) then they do have you and you won't be able to request services beyond that point.

A family we are close with who also does foster care took in a girl, age 10, with similar needs as a foster-to-adopt placement with the hope they would be the difference only to encounter the need for residential services shortly after placement (about 3 months) where the child did wonderfully - exceeding goals, expectations, etc. only to return back to their family and within about 3 months time go into a major regression ... removed and placed within a group home situation where she is blossoming and prospering again beyond anyone's hope ... so yes, these kids can succeed and do well and even lead successful and productive lives once their level of comfortable in and with life is identified and they stay within those realms ... not easy for us to undertstand as we like you are here with open hearts and open homes to love, care and share and they fail but reality and once accepted the proper energies can be directed in the proper routes.

Again wordy -sorry - hope this helps alot of those emotions that you are experiencing ... remember as I said to love while getting help at whatever level of care is love with courage and you have lots of it ... for now and the future - today, tomorrow and maybe even next week!

Take care.

[Wilsonta]

aMarylandfamily-

Could you give me more information on Title IV? Medicaid with residential services, etc? I would like to know where I can get more information.

I appreicate all the advice.

[lucyjoy]

In most cases, with the right therapy and parenting, these children can and do heal. They can and do lead normal, healthy lives and form relationships with others. There are some that do not, but I believe they are the minority. The biggest key is the right therapy and the right parenting(which can vary from family to family and child to child, but must be based on attachment).

As for avoiding power struggles, removing the anger like you've done is great. Don't struggle, but don't ignore the behavior. Natural consequences or imposed consequences related to the behavior are given or allowed. NO arguing, no rescuing. Jim Faye and Foster Cline's Parenting With Love and Logic as well as Nancy Thomas' When Love is not enough have good examples.

When dealing with workers that don't get it, I have found it helpful to get Nancy Thomas' audio tapes for them to listen too.
It seems to help.

[aMarylandfamily]

If you put Okalhoma Title IV Eligibiity into a search engine (I generally prefer google myself) you will find several sites relative to information on this ... you might want to determine if these kids are Title IV ... they may already be - it is ruled often by the hearings held at removal from their birth home.

I will note however that I re-peeked at http://www.nacac.org/AAPchart.html website which details what states cover what and Oklahoma does not seem to be one of the more generous states - they do not offer residential at all if I am reading it correctly and therefore your finalization/adoption assistance (or subsidy) agreement would have to contain a clause to cover any costs associated with medical treatment beyond what is covered by Medicaid including mental health be paid by the State ... and they will balk at it first believe me but if they don't want to relocate these children (and I can't imagine they would but again if they do ... it may be in your best interest as you don't know at this young age what services will be needed in the future and if you can't meet their needs you are doing them an injustice ... know that sounds painful but speaking with first hand experience know that most families cannot afford the $500+ per day residential fee which does not include therapy, education and/or medication costs).

As an additional note - you may also want to do some research on the Voluntary Placement Acts which detail placement into foster care if services are ever required ... this is often activated when the child may need extended services but will be returning home ... in our case it was an uncertaintly ... most likely not a probability and therefore direct care and custody had to be transferred back to the State.

Let me know if you have any further questions ... as said it usually just happens and most sibling groups are considered Title IV ... Title IV for information is just a program that reimburses the state with federal funds allotted for such programs ... if they aren't Title IV you may also ask what needs to be done to have them presented for same for eligibility ... a mound of red tape but the states are usually receptive as it means less $$ from their budgets.

[Wilsonta]

Thanks for the great advice & information. I called my attorney today to put our finalization on hold until further notice. And just in time as our first court date is Monday. We will go ahead & do that one, but not set a final date until we have this resolved.

My attorney also recommended I set an appointment with the attachment specialist & try to get him to evaluate the kids on a private pay (and reduce the cost of it). If he's compassionate, maybe we can still get the kids evaluted there. My attorney said she would definitely try to get the kids in there instead of a second rate place.

Can you explain the Title IV to me as well. What does Title IV say? And what does it mean beyond fed funds. Does this mean the state could re-negociate our subsidy to cover costs? What does it all mean & where do I find all this info? Thanks.

[aMarylandfamily]

http://msxml.us.info.com/infocom.us2...C-WX6610040740

www.acf.dhhs.gov/programs/cb/programs/4efc.htm

/www.acf.hhs.gov/programs/cb/cwrp/final/primary/ok.pdf

http://library.adoption.com/Subsidie...le/5582/1.html


Hello again -

The above web sites should give you a good start and the first one I believe has several links ... one thing to remember is Title IV-E eligibility is not contingent on your income for Medicaid - it is on the child's who generally has $0 income unless they receive Social Security but that shouldn't disqualify them - it just adjusts the rate to where you get the exact amount you would have
originally - it just comes from more than one pot. Hope this helps!

As/if the adoption finalization gets closer you should be requested to fill out an Adoption Assistance application and that is where the future expectations for needs are listed and/or a clause written in to address the what if's ... a general statement is usually acceptable but it depends on your worker, county, state. Remember the more questions you ask the better armed you are!

I would definitely get them re-evaluated ... is your home study/license through this office or the State itself or a private agency ... usually at finalization part of the adoption assistance agreement contains a "one time incurred reimburseable expenses" section (general limit of anywhere from 1,000 - 5,000) which may be able to absorb the costs you put out ... or get receipts - if you go through with finalization - these costs are generated into the adoption deductions at tax time.

Again - hope this helps - feel like I'm all over with your requests for information but know that you need to read anything and everything and when you get to the sections that affect you (in the middle I'm sure somewhere) you'll know you have what you need.

keep me posted!

[DeedyDavis]

Wow,

I read all the posts...I think you are talking about my kids...

We have seven adopted children, one at 13 months the others were from age 3.5 to age 10.5.

I have asked that question of many social workers, counselors and clergy...Will they EVER develop a conscience?

Some did, some did not...But all are much better people than they were and only two chose to live the life style of the biological parents...

I assure you it did not happen overnight...nor in a few weeks, nor in a few months...it took years. My philosphy is this...If we don't do it ...who will...

I understand the worry of finances but the child's need is where my heart is...My family, my friends told me to give them back...The two children who acted out the have turned out to be the best adults...

Yes they did counseling...6.5 years of it...we got nowhere...I turned to my pastor...in less than two years of counseling with our pastor...immersing them in church programs...we had totally different kids...our own lives were changed for the better as well.

I know the horrible feeling of hearing, "I am going to chop you up."...That kid who is the best and most affectionate now is the one who used to wake me up holding a knife over me.

This kid was 5.5 when he arrived with a sibling of 7.5 years of age. His Dx was sociopath...for the life of me I cannot figure out how a baby of 5 years old can be a sociopath...

I kept him in "mommy jail" that is...he could not ever be out of my sight...he was a danger to other children, animals...His school was VERY glad we decided to home school him.

Today, he is in the army awaiting transport to Iraq., graduated from high school and a PT college program...and an advocate of human rights

I overheard him telling the youngest two kids, before he left for the army, "Don't be giving mom a hard time, she's the closest thing to a saint you're ever going to meet." This from the boy who wanted to be my murderer

Yes, I am proud of what we have done, but as I used to tell my SW...for every little effort we make, the kids have to make ten times that amount.

They came to us with no clue of what is right and what is wrong. They must have felt terrible about themselves... but they certainly were not going to trust any adult trying to teach them...every step forward had to be painful for them...Many of the things they were comfortable doing simply were not acceptable in society. In fact many of those things were illegal.

Some things they were used to doing or seeing were given acceptable names to hide the illegal affair. For example one day I said I wanted to make some french bread. I told the sibling, of the child I was just speaking of, to get out the flour, yeast, etc. and we proceeded to make the dough... She is a really smart kid...all A's from K through college....she looked at me like I had lost my last brain. She said, "That's not how my mother and my Aunt make French bread."

Stupid me, I thought well maybe they braid the bread or whatever differently...wanting to make them feel at home with the comfort of a little of their old life incorporated into their new life, I dumbly asked her to show me how they do it. Her explanation of making french bread included a mirror, "flour", a razor blade and a needle.... made her read a dozen or more cookbooks...on breadmaking and got a professional from the DARE program to explain her bio mom's recipe.

My point is they're kids and they just don't know what's wrong and what is right...all kids are born with 0 intelligence...we have to put it there ...by ourselves or by providing the education resources necessary...With our kind of kids it takes a heck of a lot more work...but it can be done.

Your post shows you have the care and the determination to get the job done...and mind you, I did not say it was going to be easy....but it certainly was worth it to see them as adults now.

My social worker (adoption worker) said they have the power to give up to Level IV services without even checking with a supervisor...they did this for one child for me...all I asked for, actually.

We did our adoptions in CA...and it's a standard clause in all our finalization papers that whatever services we may need in the future would be provided for...All of our adoptions were through fost/adopt county programs...we only used a private lawyer, once, to protect the child.

Furthermore to the credit of the social services in our county, Merced, our adoption workers were there for us whenever we needed anything from just somebody to lend a shoulder to helping us find appropriate services.

Some of the kids workers (most from other counties) would periodlically write or call to ask if there was anything "their" kid needed...LONG after the adoptions were finalized.

I think the suggestion you go to the worker's supervisor is a good one...since, ultimately, the program is really a federal one, I cannot understand why the rules elsewhere would be that much different. AND, it's a possiblity that worker may not be adeqautely informed. There is also an appeals board at every agency if it takes that.

Good luck and remember the ball is in YOUR court because they don't want our kids back

Deedy