[Matthew'sMom]

We are foster parents in San Antonio, Texas. We are adopting our second placement. We have had him since he was 1 month old. He is now 3. Long story which I won't go into. Anyway, I have read about pre-adoption physicals. He is fetal alcohol and very small for his age. His speech is somewhat understandable on a good day. His social skills are somewhat behind. I am working on the adoption subsidy and have read about pre-adoption physicals. According to his worker in the adoption unit, even though he was born positive to drugs and has been diagnosed fetal alcohol and failure to thrive, we need more documentation! That's not enough.

His gastro doctor up and left his practice and our little guy's medical records cannot be located. To get an appointment with the gastro doctor, of which there is only one in San Antonio that accepts Medicaid, will be close to a year for an appointment.

We were informed at a conference that you can have pre-adoption physicals performed to attach to your adoption subsidy. I don't know where to start the search to find this. Has anyone ever had this done before an adoption? I'm at a loss for trying to gather documentation.

Matthew's Mom

As Matthew says..."you've got to play"

[texastanya]

Due to the neccessity of getting documentation quickly, you may want to consider finding a Pediatric GE that could see your son earlier and just pay him rather than just using a medicaid doctor. I know it would be an expense, but in the long run, I'm sure it would be worth it.

Best of luck,

[LadyBugz]

It would be time consuming, but probably cheaper than a $400 GI visit. Do you have other records that would corroborate his needs? For instance, prescription scripts. Hospital stays. School records. Counselor records. Early Childhood Intervention records. Or a note from his pedi saying what all the GI has done, which the pedi would really just be getting from you.

My understanding of the subsidy is that you attach all you can, then they call you and haggle--almost like over a used car. You get to *talk* quite a lot in the process. It isn't all on paper.

[Matthew'sMom]

We only have 2 remaining Pediatric Gastro doctors in San Antonio. They are picking up the slack from the disappearing doctor who didn't leave his medical records behind. I found a prescription from the Pediasure that listed the diagnosis as failure to thrive and other things.


This subsidy paperwork is intimidating. I've heard about the haggling. It's not about the money, it's about what he's going to need in the near future.

I don't know to stay with the state or start looking for agencies. This privatization is still uncertain as to when it will hit San Antonio. I hate to wait until the last minute when agencies get busy with all the state foster parents, but I feel guilty leaving case workers and home development workers that I've known for 4 years.

Matthew'sMom

[TexasJingles]

I have a question...

Wasn't all of his medical paid by medicaid? If so, they would have a record of all the visits, medicines and what-not. It might help.

As far as subsidy... speaking as someone that's just gone through all of it... we didn't have to have one piece of "documentation".

I had receipts for most things (I will know better next time!!! Save every single receipt in a large manilla envelope!!! But not because I needed to prove anything, just to help me remember how much we actually spent!). Mostly, I just wrote a LOT! My 3 did a lot of damage to the house during their "foster" period (tantrums) and I just estimated what it cost, divided into a monthly amount, and assigned it to the one that did the damage. Divided it by all 3 when they all did it.
I put in line after line about what's going on in school, and not. I worded it like "T has a documented history of aggressive, self-injurious behaviors at school and his IEP states he needs a small teacher-student ratio. He may need a private school that specializes in managing his behavior". I did not put in there that since he's been with us, he's been an angel at school because we never know when that phone is going to ring. And last week it did! He got into a fight on one day and 3 days later was throwing things around the room. I don't think we'll need to change schools, but we just never know (and they're expensive!!! I just looked... $7,000 + for a year! OUCH!!! Max subsidy is $545 a month!).

And, it's not like this subsidy will be the last word on it. It's reviewed at LEAST every 5 years. So, let's say that your child has XYZ now and you get some subsidy for that, but when they hit school and other things start showing up, and you need special things or tutoring or whatever, you just pick up the phone and talk to your subsidy worker.

Also, although I know of people that "haggled"... I didn't need to. I had put in the application everything I could think of (she said she's never seen one so full! I even wrote up the side of the margin when I ran out of room! haha). The reason I did was because she told me that she really didn't know anything about the kids. She gets a record from the caseworker that states what level they are (basic or moderate, etc) and that's about it. So, any info you can include in the application will really help the subsidy worker.

Hope some of this helps. Good luck!