Not all children born with disabilities grow up with their biological family. Many children across California and the rest of the country come to their parents through adoption, foster care, or the intersection of both: foster-to-adopt. Adopting a child from foster care looks different state to state and even county to county, with many state and local agencies, organizations, and caseworkers that prospective parents will engage with before a child from the foster system even steps foot in their home. Families looking to support children as part of the foster system are known as resource families. You may be more familiar with the term foster parent, but that term is slowly becoming phased out in favor of the more inclusive term resource family, which can include foster parents, adoptive parents, or relative kinship caregivers.
Whether you’re just starting to consider fostering a child with a disability in California or you’re already moving toward adoption, questions are part of the process. To learn more about the nuances of fostering a child with a disability with the long-term intention to adopt, as well as the resources available to resource and adoptive families, we spoke to Judy Mandolfo, the family resource coordinator from the California Alliance of Caregivers (CAC); Janet Sherwood, attorney and co-founder of Advokids legal resource organization; Eileen Devine, licensed social worker, consultant, and creator of the Brain First parenting approach; and Shannon Iacobacci, MS, a foster-adoptive parent, IEP consultant, and FASD specialist, and founder of Embracing the Brain.
Every year, hundreds of thousands of American children spend some degree of time in the foster care system. How they got there varies — children can enter foster care due to abuse within the home, neglect, incarceration of their parents, substance abuse by their parents, or a documented inability of their biological parents to care for them. And a disproportionate number of children in foster care have some form of disability. They are more likely to end up in foster care than their nondisabled peers and less likely than their nondisabled peers to be adopted. Additionally, children who spend an extended amount of time in foster care tend to have worse outcomes across multiple spheres of their lives.
Children with disabilities who enter the foster care system are considered or labeled to have “special needs,” but not every child in foster care who has or is labeled “special needs” has a disability.
Note: while we don’t use the term special needs at Undivided, it is the official term in foster care and adoption. And it doesn’t refer only to kids with disabilities; the term is used to identify the higher-support needs of a child in foster care that may impact their adoption. This means that many children in foster care are considered to have special needs “due to their age, ethnic heritage, need to be placed with siblings, and physical, mental/cognitive, and emotional problems that may be genetic, the result of abuse and neglect, or the result of multiple moves in foster care.” Put plainly, children who have suffered intense trauma and/or abuse, children who are racial minorities, and children who are older are all considered to have special needs, in addition to children with disabilities, but these children may not have a disability themselves. For this article, we will be referring to children in foster care with disabilities that fall under one of the thirteen IEP-qualifying categories identified by the Individuals with Disabilities Education Act, such as autism or an intellectual disability, as well as conditions in the DSM-5 such as depression, manifestations of trauma, and other medical diagnoses like fetal alcohol spectrum disorder (FASD).
It’s hard to track the exact number of children who enter foster care with a specific disability or medical condition. Sometimes this is because a child does not receive an accurate diagnosis until they are evaluated by a child welfare agency or placed with a resource family. There’s also the fact that, according to the California Health Report, California’s Department of Social Services does not keep consistent records of children in foster care with disabilities.
Children with diagnosed disabilities or who are suspected to have disabilities can represent between a third and a half of children in foster care in a given year, depending on how the data is interpreted and defined, with the most common disabilities being autism, cerebral palsy, intellectual disability, developmental disability, fetal alcohol spectrum disorder (FASD), emotional disability, and Down syndrome. However, a resource family may be contacted about taking a child into their home whose disability hasn’t been diagnosed or documented in their medical history.
For example, this article by The Transmitter states that “children with autism are 2.4 times more likely, and children with intellectual disability 1.9 times more likely, to enter foster care than typical children,” while a recent analysis published in JAMA Pediatrics indicates that around 9% of children in foster care have intellectual and developmental disabilities. Other research sources indicate that around 22% of children in foster care in a given year receive a disability or medical diagnosis, but that does not account for the many children in foster care whose disabilities go undiagnosed.
In addition to an IDEA-defined disability, many children coming into a home from foster care also experience trauma and subsequent mental health challenges, which can compound the challenges they experience with their disability. We dive deeper into the intersection of disability, trauma, and mental health for foster care youth in our follow-up article Supporting a Child with Disabilities When Fostering to Adopt.
Wondering how adoption from foster care works? Here’s a quick overview of the different paths, including foster-to-adopt, straight adoption, and kinship adoption.
Licensing to become a resource family
The first step in fostering and/or adopting from foster care in California is for the prospective parent or parents to acquire their license as a resource family, which is the official term for foster families in California. If adoption after fostering is the family’s intent, they will need to complete all necessary steps and procedures of the state’s Resource Family Approval (RFA) program, which outlines the processes that prospective resource families must complete before they are eligible to foster, let alone adopt, a child. The California Department of Social Services (CDSS) has a list of agencies within each county from which resource families can get their license, but families can also work with local Foster Family Agencies that are licensed by CDSS.
Before beginning the process, there are some basic requirements that prospective resource and adoptive families should consider, such as the size of their home and their financial stability. Ideally, agencies want to place children with disabilities with experienced resource families, but as we’ll explain later about the matching process, first-time parents can make their preferences or openness to fostering (and adopt) children with disabilities known once they are licensed. Both Devine and Iacobacci, who have themselves adopted children with disabilities, encourage prospective parents to start with an introspective assessment of themselves.
“You may have to get uncomfortable and change in order to support your child, and not all parents are willing to do that,” says Iacobacci. “If you’re not willing to change, then maybe adopting a child or fostering a child with a disability is not for you, and that’s okay. Know your limits and don’t apologize for that, because the one that you’re hurting the most is the child that’s coming into your home and the family members in your home. Really know your boundaries, as far as what you’re willing to do and what changes you’re willing to make to support the kids coming into your home.”
Once prospective parents have clarity for themselves about what responsibilities they are willing to take on, they can apply for their RFA license. The process entails:
An in-depth home study and family evaluation. The home study and evaluation make up one of the most important steps for resource families who want to adopt a child. This process can take several weeks (or more), as it involves:
a. Extensive background checks, including criminal background, fingerprinting, DMV reports, a health questionnaire, and a psychosocial assessment.
b. A review of the family’s financial documents and proof of their ownership or lawful rental of their living space.
c. Interviews with the prospective parents, any other children living in the house (biological or not), and multiple character references to evaluate the family’s lifestyle, expectations, and preparedness.
d. Visits to the home by a social worker to determine whether the environment is suitable for a child from the foster system.
Training
A key component of RFA licensing is the pre-licensing training. This training is generally administered by a foster family agency (FFA) that collaborates with the county’s welfare agency and consists of a minimum of 12 hours (though sources say around 30 hours is typical). As the CDSS explains, “FFAs are organized and operated on a non-profit basis and are engaged in the following activities: recruiting, certifying, and training foster parents, providing professional support to foster parents, and finding homes or other temporary or permanent placements for children who require more intensive care." Training will cover a variety of topics related to the foster and adoption process, including but not limited to:
The rights and limitations of the resource family in home, medical, and school settings
All resource families will receive B-tier, also called Level 1, training, which includes the subjects listed above, and must complete at least twelve additional hours of training annually to maintain their license. However, for children in foster care with documented disabilities or complex medical needs, sources say that the initial training often does not provide enough depth for parents to understand the full scope of a child’s needs.
“Thirty hours might seem like a lot of training, but when you’re talking about information on how your home should run, how to communicate with social workers . . . how to communicate with court, what court forms can you file, about attachment, discipline, trauma, self-care . . .” says Mandolfo. “There’s a lot of topics to cover just in that amount of time. You’re really just touching on it.”
Mandolfo finds that, through her work at CAC, prospective parents tend to have similar questions that aren’t always covered in training. The bigger-picture topics that parents should consider researching beyond the scope of training are:
Depending on the child’s medical and disability needs, not every resource family may be qualified to have a child placed with them based on the training they received during the RFA process.
Families who want to foster and adopt a child with a disability and/or complex medical needs can seek out different tiers of RFA training or independent courses. Higher-level training, sometimes called D- and F-tier (depending on the county, they may refer to it in numerical levels, i.e. Level 2 or 3), requires around twice as many hours as B-tier training does, and they provide more comprehensive training about children’s behavioral and medical needs, including those related to specific disabilities. D-tier trainings, for example, deal more directly with children who may have emotional disabilities and present more intense mental health needs, such as suicide risk, violent outbursts, and difficulties connecting with their resource family or peers.
Some local agencies offer specialized training for resource families looking to foster and adopt children with disabilities. Northern California–based Alternative Family Services has a Parenting for Permanency training program for prospective resource families who want to foster and adopt a child with a disability and/or complex medical needs, in addition to offering individualized family support services.
“I think the most successful adoptive parents are the ones who do their own research and are proactive about looking [and] trying to find out what’s out there and how to resource them,” says Sherwood. Research can include contacting your local Regional Center, which has extensive resources and information on youth in foster care; seeking out webinars and courses hosted by state and county agencies; reading books related to the needs of the child; attending conferences and events about children with disabilities in foster care; and connecting with parenting groups. We will provide a more in-depth list of resources at the end of this article.
Matching children with disabilities to resource families
Resource families can make their desire to foster and adopt a child with disabilities known on their formal RFA application. They can also let their local county agency or licensed FFA know after they have been licensed. While matching a child with disabilities to the right resource family may sound like an elaborate process, sources say that it often comes down to who is willing and available to take the child.
The standard procedure will vary by county, but most counties in California have some version of a Matching Coordination Unit that evaluates foster and adoptive families based on the child’s needs. Ideally, the county and the child’s social worker will conduct a series of assessments similar to the Level of Care assessments — mental health, physical health, development milestones — to determine the best family match for the child. Resource families with both experience and specialized training are prioritized for children in foster care who have higher support needs, but the urgency to place a child in a home may cause the county and agency to skip some steps in the process. Additionally, the full scope of a child’s needs may not become apparent until they have had more time in a home environment with a resource family.
“It’s up to the county agency to explain to [resource families] when they’re making a placement,” says Sherwood. “Not necessarily during training, but when they make a placement, they’re calling people and saying, ‘I have a child who has the following [conditions]. You think you can meet their needs?’“ If the resource family agrees and their license is up to date, the agency may place the child in the home immediately, even if the family does not have specialized training in that child’s individual needs.
In this clip, Mandolfo explains more about how agencies navigate the matching process with resource parents.
How do a child’s disability or medical needs impact the foster-to-adopt process?
Mandolfo and Sherwood agree that the foster care system in California (and most likely across the country) is both overwhelmed and understaffed, which can create unforeseen kinks in the desired timeline a resource family may want when fostering and adopting a child in their care.
A child’s disability and/or medical needs can impact the foster-adopt process in ways that do not apply to nondisabled children at nearly every step. Some aspects, such as matching, may appear to go quicker, while the process of negotiating government assistance can take far longer than anticipated. Resource families seeking to foster and adopt a child with disabilities may have an easier time matching because, as we mentioned earlier, children with disabilities are adopted less often than nondisabled children. But if a child’s disability has not been adequately documented before the match, it can be harder to get the required care and resources for a diagnosis, and in turn, the necessary services to help them thrive. Sherwood and Mandolfo also acknowledge that agencies do not always provide resource families with the child’s full medical history out of fear that the child will not receive a long-term placement due to the stigma attached to their disability.
In some cases “[the county] doesn’t know about the kids’ issues, and they don’t share that information with the [agency],” says Sherwood. “Or even if they do, they don’t share the information with the prospective caregiver. I’ve heard of this situation many times, where they’re afraid if they tell the caregiver in advance about the kids’ problems, the caregiver will have preconceived notions and then therefore won’t take the kids.”
Patience is a virtue, and it becomes a necessity when you’re considering adopting a child with a disability from foster care. Even if the resource family plans to adopt as soon as the child is placed with them, there is a mandatory six-month period (at least) where the resource family must foster the child under the supervision of an agency before the adoption can be finalized. Many foster and adoption agencies estimate it can take between one and two years to finalize the adoption of a child from foster care due to multiple factors, including the set timeline of court dates, the termination of the biological parents’ parental rights, and the potential for interventions by the child’s relatives for a kinship foster and/or adoption. Sherwood estimates that for children with disabilities, it can take even longer due to the negotiation of post-adoption assistance and other services that we will discuss later in the article.
De facto parents and psychological parents
One way resource families can make their intentions to adopt a child clear to their local agency is by seeking legal status as de facto parents. As Sherwood explains it, children in foster care naturally form bonds with the adults in their lives who provide them with everything that a parent does, including love, care, resources, and shelter, creating a bond that the courts and foster care system refer to as a “psychological parent.”
“Children need a parent, whether it’s their biological parent or someone else,” Sherwood says. “But the person who becomes the child’s psychological parent is entitled to seek de facto parent status. Caregivers who are looking to provide permanency should the child not be reunified [with their biological family] should start attending hearings as soon as they’re allowed to do so, which is, generally speaking, the first review hearing. . . . They should be going to every review case, every review hearing, because that puts the agency on notice and the court on notice that these people are committed to this child.”
If granted by the court, this status, which requires filing specific paperwork, provides resource families with additional procedural rights, including participation in future court hearings that pertain to the child, Sherwood says. The caveat for de facto parent status, however, is that it may create friction with the child’s social worker and court-appointed attorney. It can signal to the county that the resource family is seeking adoption before respecting the potential for reunification, “which may result in the county agency seeking another placement for that child or, in extreme cases, the child is abruptly and often illegally removed from that placement with that family with no advance notice,” Sherwood tells us.
When applying for their RFA license, resource families have choices regarding a foster-to-adopt placement or a straight adoption of a child from foster care. A straight adoption has some commonalities with foster-to-adoption, such as the required six months of fostering the child before the formal adoption process can begin. But unlike foster-to-adopt, a straight adoption involves children whose biological families have already had their parental rights terminated. Straight adoption also differs from fostering before adoption in that the child will receive services through the California Department of Social Services for far less time, and parents may not get as clear a picture of what services their child will need in the long term.
“You still go through all of the fostering process. It just makes a difference at what point they place a child with you,” says Mandolfo. “You can come in and say, ‘I’m willing to adopt, but I want to foster.’ So if the child becomes available [to adopt], you can decide whether you’re going to adopt that child. Or you can come in and say, ‘I just want to adopt,’ which means they’ll place a child in your home that either is available to adopt or is nearly available, like they’ve reached the point where you know parental rights are about to be terminated.”
Sherwood adds, “Once the court has terminated parental rights, the agency adoption unit makes an official adoptive placement. Generally speaking, the child, under adoption law, has to be in the home for six months before the adoption can be finalized. But there are exceptions if the child was in the home of the prospective adoptive parent as a foster child before that.”
We must note here that families requesting a straight adoption may need to adjust their expectations in terms of the child they can ultimately adopt. For example, families hoping to adopt a newborn or a very young infant are unlikely to be able to do a straight adoption, as the biological parents’ rights are rarely (as in approximately 1% of the time) terminated or relinquished at birth. Nearly half of children in foster care are between the ages of six and fifteen, so resource families looking to adopt quickly should first consider if they are prepared to embrace the full scope of what adopting an older child entails (more on this later!).
If you have a family member who needs an adoptive placement, you may be able to do a kinship adoption, which can be a quicker process than matching with a child in foster care who is not related to you. The foster system focuses first on reuniting the child with their biological parents; when that isn’t an option, the next most desirable outcome is for the child to find placement with a family member, which is a kinship placement. If there are no kinship placements available for the child, the county or agency will then look for a placement among their available resource families. When the caregiver for a child in foster care is a relative, the foster and adoption process is often streamlined and provides the child with more stability during the placement transition. Research also indicates that children in kinship care and adoption experience better health, mental health, behavioral, and academic outcomes than those with non-relative placements.
In practice, this means that relatives of a child with disabilities in foster care will likely face fewer barriers to having the child placed with them. As Sherwood explains, “Relative caregivers have the same rights to participate in legal proceedings as any other resource family. What relatives do have over non-relative resource families is more rights to be considered for placement when the child is first placed in foster care, and during the reunification period, when a placement change becomes necessary, or it is otherwise in the child’s best interests to place that child with a relative.”
Kin caregivers can also have children placed with them before the caregiver has completed the necessary application and caregiver training that non-relative resource families must complete. “When it comes to kinship and relatives, that’s usually a situation where a child comes to a relative unexpectedly,” says Mandolfo. “The relative is asked, ‘Are you willing to provide permanency for this child?’”
This can also mean that “the requirements for relatives are much looser than they are for an unmatched family.” For kin caregivers of children with disabilities, this means they may not be required to complete the specialized training that prepares resource families for the complex care related to the child’s disability. Like non-related resource families, kinship caregivers also receive financial compensation at similar rates to non-related resource parents through the state’s Kin-GAP program.
Mandolfo also notes that oftentimes, family members of the child may prefer to seek guardianship for the child rather than adoption. Unlike adoption, a guardianship gives the family member temporary custody of the child without terminating the biological parents’ rights and making the potential for future reunification easier. In a guardianship, kin caregivers also have more court supervision, though the parameters of guardianship vary state to state. Once the child is placed in a kinship home, the kinship guardians and caregivers can also access trainings for the child in their care and resources through the California Kinship Navigator (CKN).
Sherwood advises resource families who are not pursuing straight adoption that foster care agencies may often defer to a kinship adoption or placement even if the child has been in the resource family’s care for an extended period. As Sherwood explains, “There are notice requirements for relatives early in each case to enable the agency to identify relatives who may be willing to provide a placement for the child, and relatives who do not receive notice have a basis for complaint and to ask to be considered belatedly for placement.” This is not a reflection of the resource family’s ability to care for the child, but a feature of the foster care system’s overarching goal, which is to reunify children with their birth families and keep them in the care of family members.
“There’s a number of cases where the child was being cared for by grandma, for example, before they came into the system. Grandma as a previous caregiver, she could prove she was the child’s psychological parent. Technically, grandmas are not allowed to be parties to dependency cases, but grandma could come in and be a party as a de facto parent if she was basically the psychological parent of that child before the child came into the system,” Sherwood explains.
This can be incredibly stressful to resource families who have cared for a child for an extended period of time. As we mentioned above, resource families have the right to petition for de facto parent status and can make a case with the court that they meet all the criteria of a psychological parent for the child. Part of this can include a bonding assessment or attachment assessment, in which an independent professional conducts a psychological evaluation of the resource family and the child to determine the bond of the child to their resource family, to help determine the best placement for the child. But even if the assessment favors the resource family, multiple sources stress that this does not guarantee that the child will stay in their care.
An option that provides the child with a stable home but still allows them access to services and funding through CDSS and Medi-Cal is guardianship. Like adoption, guardianship grants the resource family more rights that resource families do not have, but the child’s biological parents still retain the right to regain custody if they meet the assessment requirements. Dependency guardianships — “court-ordered arrangements where a judge appoints a caregiver for a child involved in the dependency (foster care) system due to abuse or neglect” — are granted by the dependency court, a specialized juvenile court. As Sherwood explains, “Resource parents may not seek guardianship from the ‘county court system’ because only the juvenile court has jurisdiction to grant a guardianship, and it is the county, not the resource family, who files the paperwork with the court.”
In Mandolfo’s experience, this discussion usually arises with teenaged children in foster care who have spent a longer time in the system and who’ve had at least one previous placement.
“If you have a child that’s fourteen years old, fifteen years old . . . I encourage the child to stay in foster care at least until they’re sixteen, because then they’re eligible for a lot more programs after eighteen,” says Mandolfo. “Free college education, assistance with living, apartment, rent . . . there’s a lot of those services that are available. If you change their status, they still stay in the home, but their status changes, they lose those benefits. For a child that’s older, the juice isn’t worth the squeeze.”
However, as a guardian, the resource family can still care for the child until they age out of the system without depriving them of key resources they can access through CDSS. If a child is still in the foster care system on their eighteenth birthday, they are eligible for a myriad of Former Foster Youth services that adopted children do not have access to. These include:
However, Mandolfo and research sources say that choosing guardianship can often impact the child’s emotional attachment to their resource family and by extension, the child’s mental health. Per a research review in the journal Children and Youth Services Review, children who age out of foster care without being adopted, being in kinship care, or having a guardian often face higher rates of homelessness, unemployment, educational struggle, and mental health challenges, as well as more limited access to care for their disability or other health conditions.
A note about the US foster care system, adoption, and the child’s biological family: The purpose of this article is to help prospective resource and adoptive families understand the complexities and nuances of fostering and adopting a child with disabilities, and equipping them with resources and insights for life pre- and post-adoption. But, as Iacobacci states, “The whole point of foster care is reunification . . . to reunite with the first family, the biological family, as much as possible.” Prospective families who want to adopt a child from foster care, regardless of whether they have a disability, must understand that each branch of the system and the people that work within it (the courts, the child’s attorney, the social workers, and the case managers) operate with the goal of reuniting a family, not creating a new one. Adopting from foster care is absolutely possible, but there are many steps that come before a child is placed with a non-related resource family, and those steps might change the experience entirely from what the parents expected.
Even in straight adoptions, all adoptions and placements from foster care involve the child’s biological family to some degree. Sources stress that, again, foster care’s ultimate goal is reunification, and resource families should not treat the child’s biological family as enemies. For resource parents who are fostering before seeking adoption, often the child’s parents will need to be part of medical decisions, educational decisions for services and accommodations, and the court proceedings. In some cases, they may not even know that their child has a disability or the level of care required to care for them.
“I think it’s crucial that biological families are informed of [their child’s specific] disability and how to support their children,” says Iacobacci. Having an informed and cordial relationship with the biological parents, as much as circumstances allow, makes it possible to provide the child with the best possible supports, regardless of their placement. “It’s not an ‘us versus them.’ As a biological parent, imagine your child’s in foster care, and you’re thinking, ‘They’re going to take my baby; they’re going to take my kid.’ As a resource parent, your job is to come alongside the biological family. You’re there to support this child through this change and this transition, but you’re also there for that family. They’re not your enemy.” Of course, not every situation may allow for open and safe communication with the biological family. If resource families feel that the biological families could pose a health or safety risk to the child (such as refusing to sign off on medical procedures, for example), they should keep a clear record of communications and relay any pertinent information to the child’s social worker.
Both the CDSS and county agencies recognize that all children in foster care, regardless of their disability, require and deserve assistance for their care in a resource family. This assistance is called their Aid to Families with Dependent Children-Foster Care (AFDC-FC); the biggest difference between AFDC-FC and the Adoption Assistance Program (AAP), which we’ll discuss later, is that AFDC-FC applies to children pre-adoption, while AAP supports families post-adoption. For children with disabilities, they are entitled to higher rates to help accommodate therapies, services, and additional resources. To access these resources, however, resource parents need to make the child’s needs known to the child’s social worker, who can help facilitate the necessary assessments to determine the appropriate rates for the family.
Major changes to the CDSS foster care system began in 2017 under the state’s Continuum of Care Reform; they aim to improve child welfare services and ensure as many children as possible in foster care find stable and permanent homes, be they with their biological parents, resource families, or adoptive parents. These reforms include a permanent tiered rate structure for rates of financial compensation that resource families receive for fostering a child and addressing the child’s needs. These rates, which begin at around $1,200 for the “basic level,” are scaled to the needs of the child per an assessment by a social worker called a Level of Care (LOC) assessment.
There are five different domains for a Level of Care assessment, which encompass the child’s physical, emotional and behavioral, health, education, and permanency needs, sometimes referred to as the Levels of Care Matrix. There are four scaled levels of care, with the basic rate also called Level 1, and scores are determined by the demonstrable need of the child for additional time and services across the five domains — e.g., the child may require consistent occupational therapy, mental health services, or educational supports. Most children with disabilities in foster care are considered at least a Level 2, meaning they are eligible for higher rates and more comprehensive services. But Mandolfo says that resource families have to be prepared to push back on lowballing by the county.
“The state sets the rates,” says Mandolfo, “but LOC is not something that is openly shared with the families. So, for example, if you have a child [with a disability] and [the family is] going to adopt, there’s a rate that the foster family receives. . . . Typically, the family is just told what the rate is, but they’re not told how the rate is made. What’s supposed to happen is the social worker will assess the child’s needs with information from the foster family, school, and whatever other resources the social worker can collect. The social worker will go through the domains, answer the questions, come up with a score, a number score,” which then sets the child’s LOC rate and establishes what services they need for their disability.
“It is a little ambiguous, that’s why there should be communication between the social worker and the family doing the care to set the scores,” Mandolfo continues. “They’re not told that their input is a big part of the rate system. So oftentimes, children receive a rate level that is not equivalent to what it should be, and the foster family doesn’t know that.”
Most children with disabilities will likely also qualify for specialized care from the CDSS and can receive additional funding, called a Specialized Care Increment (SCI), pending a formal evaluation by a social worker, licensed medical professional, or mental health professional. Resource parents can, for example, use the SCI toward their child’s physical therapy, occupational therapy, or other services related to their disability. A child’s eligibility for SCI must be renewed annually, so resource families should maintain records and documents of all services or changes their child receives. Resource families who plan to adopt a child with a previous placement should also absolutely investigate what the child’s LOC was in their prior placement, because often the change in placement will reduce the child’s LOC and SCI back to basic levels.
“Whatever their rate is as a foster child in the foster home should be the same rate that goes with them to the prospective adoptive parents’ home. So if you’re receiving a higher level in the LOC — maybe they’re receiving a Level 3 with a specialized care increment — they might go to their new adoptive home at a base level. If the adoptive home doesn’t know what the child was previously getting, they don’t know to ask,” adds Mandolfo. “It’s actually an entitlement for the child to keep the same rate. There’ll be a new assessment, and then there’s a decision made, but more often than not, the rate is lowered, and if you don’t know, you don’t know.”
Prospective resource families should also be aware that the current rates for resource families are amidst a process of restructuring. The passing of Assembly Bill 161 in 2024 established a new tiered rate structure that, per the CDSS, aims to allocate funds “so that they are based on the child’s assessed level of needs and strengths, and not based on the placement type.” The targeted date of implementing this new structure is July 1, 2027, and it will directly benefit resource families of children with disabilities.
Dual agency rates
Children in foster care with documented disabilities already receiving Kin-GAP, AFDC-FC, or post-adoption assistance (more on this later!) may also qualify for additional financial assistance and services through their local Regional Center (RC), under what is called a dual agency rate. As of 2025, resource families may receive a dual agency rate of approximately $1,500 for children under three years old and approximately $3,400 for children three and older; if eligible, resource families may also receive a supplement to the dual agency rate of up to $1,000. Note: these rates apply only to children with developmental disabilities (including autism, cerebral palsy, and intellectual disabilities) as defined by the Lanterman Act, as well as conditions similar to a developmental disability, such as Down syndrome or FASD.
Though resource families have limitations on their child’s educational and medical rights (again, more on this later!), they have the right to apply for an intake assessment for Regional Center services if they believe their child meets eligibility criteria. This eligibility, it should be noted, may not become apparent on the first assessment. Depending on the child’s disability, or the specific symptoms of their FASD and/or prenatal drug exposure, their needs may increase with age. If your child did not qualify for Regional Center services for the 0-3 years program, but you suspect that they qualify as an older child, don’t give up! They can still be evaluated at any age if they demonstrate need.
Once a child in foster care has begun receiving Regional Center services, resource families can begin the application for a dual agency rate. Due to the coordination and documentation required between Regional Centers, the resource family, the county, and the child’s social worker, resource families should contact their local Regional Center and the child's assigned social worker to begin the application process as soon as they have a clear sense of their child’s disability and needs. Sherwood advises that actually getting the dual agency rate can be hard and may require legal escalation and working with the child’s attorney and social worker to petition the court.
“It takes cooperation between the county and the Regional Center, which often doesn’t happen; getting them to work together is often very difficult and extremely frustrating for caregivers,” she says. But, “sometimes when they have to explain it to the judge, they get more reasonable.” She recommends that resource parents create paper trails for all interactions with the child’s social worker, supervisor, and chain of command at the agency in addition to documenting the child’s needs in a JV-290 — The Caregiver Information Form, and it should be used by all caregivers, whether or not they are relatives. . “If worse comes to worst and they go to court, then they’ve got all this documentation of how they tried to get people to do the right thing and they wouldn’t,” she adds.
Medi-Cal coverage and medical rights of resource families
Resource families cannot add their child to the family’s health insurance plan until the adoption has been finalized and they have been granted parental rights, but all children in foster care in California are immediately eligible for Medi-Cal when they enter the foster system and begin living with a resource family. This means that all services, treatments, and medications will be covered at no cost to the resource family fostering the child; this is not related to their LOC rates. Resource parents can access the child’s Health Passport, which should contain information on their medical and educational history, such as medications they have previously been prescribed, their healthcare providers, and services they receive at school.
While resource families are the child’s day-to-day caregivers, and by extension those who facilitate all the medical assessments and appointments related to a child’s disability, they do not have final say on a child’s medical rights. This means that resource families must provide documentation for medical visits, administering medications, and referrals to providers that the child may need for their disability, such as occupational or speech therapy. But final say will always go to the biological parent unless the court determines otherwise.
“We have to document everything. If I give you a teaspoon of Tylenol, it’s gotta be written down on a form,” says Iacobacci. “I had a child in my care [and] it was highly necessary for an emergency surgery. I could not authorize that as a resource parent. I could not sign away or say anything. What we had to do was find the biological family and have the parents sign off on the documentation. If there was no way to get hold of the parent, then the social worker or an attorney would walk it to court . . . and get the judge to sign off, and then the court would have ordered the surgery to take place. Yes, you can take your child to the pediatrician, but the [biological] parents have the medical rights.”
But while the resource family may not have medical rights for the child in their care, they can still establish relationships with the child’s health care providers and document the child’s needs to the social worker. Devine says that maintaining consistent relationships with providers, such as pediatricians, therapists, and other resource professionals, helps create stability for the child, which in turn leads to better health outcomes.
Post-adoption, “the adoptive parents become the child’s legal parent and have all the rights of a legal parent, regardless of what rights the biological parent may have had,” Sherwood explains. This grants them full parental rights over the child’s medical care and education, but it also changes the supports that the family receives from CDSS and local agencies. Iacobacci notes that some families may choose alternative caregiving options over adoption because of the change in supports provided for the child in their care: “it’ll be like jumping off a cliff in terms of the resources [they] will lose.”
Big changes include ending the child’s relationship with their primary social worker and case manager, a connection they may have had for years. Funding for particular supports the child may have been receiving prior to adoption will also change, so parents need to prepare for transitioning their child to new providers well before the adoption is finalized. Some services for resource parents, such as respite (think of it like paid childcare for resource parents who need a little time away), will end. But sources say that many post-adoption services exist for adoptive families that simply aren’t communicated well by the county.
One of the best things adoptive parents can do is connect with other resource and adoptive families. We have some formal organizations listed at the end of this article, but seeking out local groups on Facebook and other social media platforms can help put adoptive parents face-to-face with others who have gone through this same unique experience. Some even gather around specific disabilities or conditions the adoptive children live with, such as the Neonatal Abstinence Syndrome Support group, or the nonprofit Generation O, that helps connect parents of children who have been exposed to opioids. As with any online community, not every member may get along, but they can provide compassion and additional insights and resources from families who have been in their shoes.
One of the biggest adjustments that adoptive families of children with disabilities face is the change, and often loss, of the services the child was receiving as a child in foster care. California does provide medical, financial, and educational services for children in foster care post-adoption, but sources agree that, unfortunately, many resource and adoptive families aren’t adequately prepared for the transition and what resources are available to them after adoption. As Mandolfo mentioned earlier, adoptive parents may receive lower rates than they did pre-adoption, or they may need to have new assessments done to re-establish resources external from CDSS, such as the Regional Center. It can also come down to a child’s needs changing in the time it took to finalize the adoption, and that the child will no longer work with the same foster parent and court-appointed attorney that they had while in foster care.
“Post-adoption, you’ll have a [case] worker, and then every year or two years, you have to fill out a form that says, ‘Yes, we still need this [service],” says Iacobacci. “Say your child that has a disability has acquired, say, a co-occurring condition or something additional, and you’re finding, as a parent, that an increase for services would be helpful. You will have to obtain [documentation] from providers, like your pediatrician [or] mental health providers, to show that there’s actually a need.”
This process can be lengthy and often opaque, so parents should prepare to advocate to their local FFA or county agency. Social workers will determine whether the child’s needs warrant an increase in financial assistance, but often resource families don’t know that they can negotiate. “Whatever you do, just ask questions. Don’t assume anything,” adds Iacobacci, “because you don’t know unless you ask. A lot of times, there’s stuff that’s just sitting there waiting to be utilized, and no one asks. So I would say to families, ask — the worst they could tell you is no, right? ‘Nope, we don’t cover that.’ Okay, can you help me in this [area]?”
Adoption Assistance Program
The needs of children with disabilities adopted from foster care do not disappear with the finalization of the adoption, but how the child and adoptive family receive assistance from the state changes. A child is still eligible for Medi-Cal and can continue to receive care from the providers already familiar to them. Financially, families can receive assistance through the Adoption Assistance Program (AAP). Adoptive families can, for example, put AAP funds toward wraparound services for their child or use it for out-of-pocket expenses for assessments that are not covered by Medi-Cal. The funds are the families’ to use as they see fit, but the understanding is that the monthly AAP payment will be used for the child’s needs, whatever they may be.
In this clip, Iacobacci details how the needs for a child with disabilities can change post-adoption as that child ages, and how to ensure that the child’s AAP rates reflect their needs.
Per Disability Rights California, a child adopted from foster care is eligible for AAP if:
A child’s AAP funds are determined using similar metrics to the Level of Care assessments for children in foster care, called the AAP LOC Matrix. This matrix takes into account the child’s previous case files, the services they were receiving before adoption, direct observation of their needs, and any and all information the prospective parents can provide, including medical records and interviews about the child’s day-to-day needs. For children with disabilities, this means documenting and emphasizing the out-of-pocket costs of appointments, service providers, and school placement.
Adoptive parents must apply for AAP assistance before the adoption has been finalized, and Sherwood stresses that negotiating the appropriate rate for a child with disabilities can drastically extend the adoption process. Sherwood encourages resource families to review all the potential resources their child will need for their disability in the long term and to discuss the transition with the child’s case manager and health care providers before they begin AAP negotiations with the county agency. As is the case with LOC assessments, children with disabilities almost always receive scores indicating higher levels of care are needed.
“AAP is a recognition that kids who are adopted out of foster care have more and greater needs than kids who are adopted privately, and AAP is supposed to pay for those special needs,” says Sherwood. “How much AAP is going to be appropriate to cover the anticipated expenses of that? Counties want to say, ‘Not much.’ Adoptive parents who are in the know say, ‘Therapy costs this much, and [occupational therapy] costs this much, and [physical therapy] costs this much.’ It can be renegotiated later, but the initial AAP amount has to be set.”
Special Needs Network (SNN)
The Special Needs Network (SNN) is a Los Angeles-based nonprofit that has worked with the Department of Developmental Services since 2017 through the Service Access and Equity Grant Program. Their work has helped improve access to services for youth in foster care and their families within the Regional Center system in Los Angeles County, in addition to providing access to therapeutic services for families and specialized trainings. Their Foster Care Pediatric Hub and Stepping Stones program help provide services such as behavioral, physical, and occupational therapy to youth in foster care with disabilities, ensuring they get supports that may be delayed due to placement matching, adoption proceedings, or lack of resources.
For resource parents who feel undersupported or overwhelmed, they also host regular Parent Advocacy Mentor programs to help both resource and adoptive parents understand their rights, identify their child’s disability needs, navigate eligibility for Regional Center services, and start (if rights permit) the process for starting or amending an IEP. They partner with a wide range of local agencies, institutions, and community organizations to address the multifaceted needs of children with disabilities, and especially those coming from foster care.
The truth of adopting a child from foster care is that none of the joy comes without a degree of loss and grief for everyone involved. No experience will be perfect or go according to the resource and adoptive parents’ ideal plan, but there are a myriad of resources that resource parents can access to prepare them for life after adoption and to best serve the needs of their child.
“[There] is this dominant narrative of adoption and also fostering in our society, which is lots of lovely rainbows and sunshine . . . and it’s just not true,” says Devine. “Adoption does not exist without loss. There is loss for the adoptee no matter how wonderful those [adoptive] parents are. There is loss for siblings that they no longer live with. There is loss for the birth parents, and oftentimes there’s loss with the adoptive or resource parents, because the reality of parenting this child who’s very complex and needs a lot is not what they expected.”
One of the best things that resource families can do for both themselves and their child is to approach their training and learning as a lifelong endeavor. Reading books — such as Devine’s recommendation, Raising Kids with Big, Baffling Behaviors — that pertain to their child’s needs and experience can be helpful. Engaging with other families in their area can also help resource and adoptive parents better understand their rights and manage their expectations. And of course, parents can also research the organizations and trainings provided by our sources. “Seek out support groups, nonprofits,” says Mandolfo.
“That’s certainly California Alliance of Caregivers. That’s what we were created to do, to support caregivers of all kinds in whatever stage. We do our own support group, we do trainings, we go to county events that reach out to families,” she continues. “Don’t lose our number. We can answer questions for you. We can walk you through something. We can just listen and help you know that you’re not alone in your frustrations or your advocacy.”
Some organizations and services that sources recommend for resource and adoptive families are:
As Devine tells us, “As an adoptive parent of a child who’s really complex, your learning never ends. And so anytime that you feel like, ‘I’ve got this, I don’t need any more,’ check yourself on that, because we all need reminders. We all need to be coming back to this information and making sense of it for what it means at the child’s current age and their current developmental stage.”
Next, head to our follow-up article Supporting a Child with Disabilities In Foster Care.
Save your favorite resources and access a custom Roadmap.
Get Started
