Monday, May 16, 2011

The Unforeseen Costs of International Special Needs Adoption, Part I

 The Final Maze just started a series on the unforeseen costs in domestically adopting children with special needs. It is a great idea. I tried and could not find information like this when we were adopting. So I'd like to take the idea and apply it to International Adoption.

As fewer and fewer children are placed for International adoption (IA) from Korea, a greater percentage of referred children have higher levels of special needs. And as the wait to bring a child home has increased (in the case of our Korean placing agency to 12-14 months after referral), increasing numbers of adoptive parents are considering children with higher levels of special needs listed with agencies that have shorter wait times, or are switching countries to special needs adoption from China.

So this seems like a good time for some candid talk about raising Internationally adopted kids with special needs. That descriptor fits two of my children. Joy has quadriplegic spastic cerebral palsy and Hope is on the Fetal Alcohol Spectrum.

At the outset of this series, let me say this: if you are considering seeking an Internationally listed child with actual or potential special needs, please search your heart, talk to some informed sources (like your social worker and/or agency) and consider whether you could domestically adopt a child with similar needs. Here are a few reasons why.

Try to mentally set aside the glamour of International adoption and seriously consider that once your child is home those International frills like homeland visits and fascinating birth culture may take a back seat to the demands of the special needs.

Here's an example. My husband and I are completely sold on the idea of immersion education to teach our kids their birth language. We are blessed to live in city which will soon have a Korean immersion elementary school with prospects of eventually serving children through high school. Sounds ideal, doesn't it? Except that two of our three Korean-born girls learn so differently from "typical" that if they attend school outside our home they will almost certainly need higher levels of specialized classroom support than a charter school can obtain by subcontracting with a local district.

So even though several years ago, we imagined that when we moved, we would be relocating closer to the immersion school, truth is that now, our number one priority is to find or build a house with an elevator.

Here's another example. Very early in our adoption journey my husband and I committed to making return trips to our children's homeland multiple times while they were growing up so they could maintain ties with the people who knew and loved them there and so it would not be a foreign place to them, but a place they knew as well as some of their friends know Disney World.

If you've been reading for a while, you know that when we made the first of our return family visits to Korea last fall, we found that Seoul was only partially accessible  for wheelchair users like Joy and that jet lag wreaked two months' havoc on Hope's neurology. Before we can take Joy back again, I will have to make a trip alone --with my AT mom friends :) --or Faith or Mercy, to be certain Joy will be able to negotiate Seoul and Pusan in a wheelchair. And we may need to wait to take Hope back for 5-6 years (when, according to today's consultation with a sleep specialist, she will likely out grow her sleep disorder).

So in the real world, my kids real-life needs trump our well-informed International adoption intentions. My husband and I could more easily keep our philosphical resolves if our special needs kids were born in Idaho or Alabama.

There are no State or Federal Adoption subsidies for the adoption of Internationally born children who have special needs. For the country programs I have investigated, that means that up-front costs for adopting a child with SNs is about the same as adopting a child without them. Most private adoption assistance (like grants) are more closely tied to family income than to the child's SNs. Further, it is no longer uncommon to adopt children with special needs so the competition for available funds is stiff.

Because domestic adoptions of kids with SNs within the United States are often subsidized, a domestic adoption may save a family most of the up-front costs of International adoption --potentially tens of thousands of dollars. Special needs adoptions within the U.S. may also come with an ongoing yearly stipend to help defray the disability-related out of pocket expenses for adopting families. This is typically not a hefty sum, but, as they say, is better than nothing.

As I will outline in future posts, these out of pocket expenses, which are almost impossible to calculate beforehand (we tried) can be daunting. Unless your family income is near the poverty line (in which case, you probably can't afford to adopt Internationally) you may not qualify for many of the low- or no-cost State and Federal programs for families with special needs kids that you will find listed on government websites.

To put that in perspective, our out-of-pocket expenses for supplemental insurance for our kids with special needs is, monthly, twenty five percent higher than our mortgage payment, or the equivalent of the net cost of an International adoption (actual costs less the tax credit) every single year.

Our children are priceless to us and God is providing for our needs. But considering the financial strain the up-front costs alone of an International adoption can place on a family, if you feel clearly led to special needs adoption, you may want to take a serious look at domestic adoption before you commit your heart overseas.

By the way, I am certainly no authority on International or domestic adoption; I can only speak from my family's experience. So  if I misrepresent anything in your experience, please say so in the comments. It may help another family make a more informed choice about adoption.


Cori said...

This is our reality. Both our sons from Korea have significant, although different, needs. Your comment on language immersion particularly hit home. It is an almost hysterical obsession of mine to give my kids their birth language, but the reality is that both have significant speech issues with ENGLISH, and it will be years before it would be practical or not counter-productive to start teaching them Korean.

The cost of therapies is also significant and often long-term. We had no idea years ago that our home choices should include a school district with a strong special needs program and an insurance plan robust enough to cover four therapy sessions a week.

It's good for people to be prepared.

Mike and Katie said...

So many good points! I've had so many people tell me they thought or were told there were no children available in the US. That's just not the case.

FosterAbba said...

Hey, thanks very much for the shout-out! I've posted something on my blog mentioning this post, because you've added some great information to the dialog.

dorothy said...

I totally agree on the very real and often unidentified cost of adopting special needs kids. I would like to mention that almost all private adoptions in the USA (as in through a private angency and not through foster care)encounter the same problems as an international adoption. If the childs needs are not 'provable' and the subsidy agreement written before the adoption is final most states will not allow parents to apply later - even if it is a serious and debilitating issue that could have been predicted. (like FASD) Unfortunatly, many states will also not allow any assistance to adoptive families unless the child was in permanent state care and diagnosed while in care(vs private foster care.) Which ends up putting many private US adoptions paying high costs for services that would have been covered if the children were adopted out of state care. Parenting kids with multiple needs can be very expensive - both from the US as well as overseas.