Foster care reimbursement rates in Missouri among lowest in US

A foster mom at home

COLUMBIA — Karen Anderson has been a foster parent for 31 years.

“It goes back so far that I don’t even really remember now,” she said. “But I wanted to make a difference for children.”

Anderson has been a foster parent for so long that she hasn’t even kept track of how many children she’s taken in over the years. She estimates, though, that the number is around 180.

Anderson, 55, has seen a lot change in her tenure as a level B, formerly known as a “career-level,” foster parent. One thing that has been consistent over her three decades of foster parenting is the low compensation she gets from the state.

“The payment rate in ’93 (for level B foster parents) was $45 a day that you had the child in your home,” she said. “That has been raised over that 17 years to — now I believe it’s $48 a day.”

Foster care in Missouri is split among three levels of care, and those working in each receive different amounts of compensation determined by Missouri law.

Traditional foster parents take in regular children without extraordinary needs. All foster parents start at this level and receive anywhere from $332 to $372 a month, depending on the age of the child.

Level A, or “behavioral” foster care, is the next level and involves caring for children who have behavioral and emotional problems, such as difficulties controlling anger. Level A foster parents are trained by state counselors and therapists, and they must have at least one year of experience as a traditional foster parent. Level A foster parents receive $732 a month.

Children who require Level B, or "career" foster care, have severe emotional and behavioral needs. Level B foster parents have several hours more training than Level A foster parents and have served as traditional foster parents for at least two years. They must be willing to devote most of their time and energy to their foster children and receive $48 every day a child is in their home.

“It does not come close to covering the actual expense,” said Ron Fauss, foster parent and board member of Foster Parents Association of Missouri. “That’s why there are so many other groups … to help fill in the gaps.”

One such group is Hope Chest for Kids, which provides clothing, educational assistance and food when needed. Anderson said Hope Chest for Kids provides a food pantry that foster families regularly use.

“At one time we had five children in our house ages 5 or under, and the number of hot dogs and chicken nuggets that type of group can blow through is mind-boggling,” Fauss said.

The Central Missouri Foster Care and Adoption Association is a not-for-profit that provides programs for foster families to fill the gaps between state compensation and need. Deanna Alonso is the executive director. She is also a former foster parent — now adoptive parent — and understands the costs of raising a foster child.

“The typical amount to raise a child in 2010 is $38,000,” Alonso said.

After deducting food, clothing and shelter expenses from foster care payments, parents are left with about 50 cents a day, she said.

“Any kind of extracurriculars a child wants to do — say it’s sports or dance or whatnot — it would have to come out of the parents’ pocket,” she said. “And that is really hard to do.”

This is especially difficult for career foster parents, who are limited to part-time jobs because of the commitments they've made to the children in their care.

“It has to be a very flexible job or a work-from-home thing because the child still has to be your first priority,” Anderson said.

Anderson earns some income for training other foster parents in a program called STARS, which stands for specialized training assessment and resources and support. Every foster parent must have the training.

Anderson's husband also works.

“I won’t say we’re hurting because I’m a big believer in God, and God provides for us what we need, and we’ve been provided for a lot of different ways,” she said. “But that doesn’t mean that I don’t think the state could do a better job at taking care of their children.”

The numbers appear to back up Anderson. In a 2007 national survey, Missouri ranked 48th in the United States for foster care reimbursement, above only Nebraska and Ohio.

The survey was conducted by Children’s Rights, the National Foster Parents Association and the University of Maryland School of Social Work. The study identified the "minimum adequate rates for children" specific to each state and based on an analysis of the real costs of providing care. This includes food, clothing, shelter, daily supervision, school supplies, insurance and travel.

The average amount of reimbursement across all ages in Missouri for 2007 was $227 per month. The average minimum adequate rate across all ages was $711.

Since the study was published, foster care advocacy groups such as the Missouri Coalition of Children's Agencies, the Missouri Foster Care and Adoption Association and the St. Louis Foster and Adoptive Coalition used the study for extensive lobbying. In June 2008, Gov. Jay Nixon signed a bill increasing funding for foster care reimbursement by $1 million. It raised rates by an average of $12.67 across all ages but only for traditional foster care.

Foster parents can be reimbursed for several special expenses beyond basic compensation. The state compensates parents for transportation to and from medical care, counseling, visits with birth parents and court. Missouri also provides a yearly clothing allowance for each foster child, ranging from $250 to $480 and depending on the age of the child. Neither the clothing allowance nor the transportation reimbursements factor into Missouri’s overall ranking, but foster parents say neither is adequate for covering children's needs.

“You can’t get a pair of shoes and a coat and two pairs of jeans for less than a couple hundred dollars,” Alonso said. “That’s the reason why the majority of foster children you see are wearing tattered and ripped up clothing and things like that because nobody can afford this kind of stuff.”

Additionally, Medicaid covers doctor’s visits and mandatory counseling. But that presents an entirely different issue. Last year, the United States passed a comprehensive health care overhaul. Under the new legislation, children are able to stay under their parents’ health care plans until they reach 25. But foster children who have aged out of the system are covered by Medicaid only until they reach 21.

“Well, the child welfare system (is) these children’s parents,” Alonso said. “So they need to allot these children the accessibility of staying on the health insurance until they’re 25.”

After former foster children reach 21, they are expected to find jobs that will cover health care expenses. But often they fail to do so.

Alonso said that 267 children aged out of foster care in Missouri without any outside support this past year. Although she said there is no way to track those people, the state often hears about them if they check into a hospital, go to a homeless shelter or land in jail.

“Over half of them are now homeless or incarcerated,” Alonso said. “Some have even passed on. So we’ve got a huge crisis with homeless foster children being released without having a concrete plan for them.”

Missouri also needs more foster parents. In 2007 there were 11,344 children in foster care and 7,904 licensed foster homes in the state. Fauss said Missouri has trouble retaining foster parents.

“It’s very mentally and emotionally fatiguing,” he said, adding that one of the goals of the Foster Parent Association of Missouri is to enhance retention and recruitment.

Alonso believes low reimbursement is among the reasons so few people want to become foster parents.

“If it takes X amount of dollars to raise a child and meet (his or her) basic needs … you need to make sure that package looks good for these parents to be able to provide for these children,” she said. She also believes reimbursement remains low because it's not a legislative priority.

State Sen. Jolie Justus, D-Kansas City, has advocated for foster care in the past, Alonso said, but central Missouri lawmakers have done little for the cause.

“We’re not seeing anybody lobby for this area at all,” she said. “The entire state as a whole needs to have lobbyists from every corner of Missouri going up (to the Capitol) to fight for reimbursement changes.”

In the end, Fauss is a foster parent despite the money. He’s been a foster parent for little more than a year now, and as the executive director of the newly formed Foster Parents Association of Missouri, he hopes to dispel common misconceptions about  foster care.

Some people believe foster parents are in it for the money, he said. “There are so many other ways to make much more money that is not nearly as emotionally taxing as being a foster parent. Money is, in no way, shape or form, a consideration as to why anyone is a foster parent.”

Anderson said she doesn't consider the money, either.

“The best part is making a ... difference for a child that makes a big difference for them,” she said. “Just those little glimpses you get from them when they learn something they didn’t know. Just seeing a child come in, and over the course of months or years they just sort of grow and blossom.

“And that, to me, is the best thing about foster care.”

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