In the wake of the opioid crisis, kinship and foster care systems in Kentucky have been stretched to the limit, with the number of children in the homes of relatives or close family friends rising by over 50 percent. It is not clear how elderly kin will afford to care for these children.

Over the past two years, Norma Hatfield has collected stories: One grandmother, living on a $700 per month disability check, who woke up to the state delivering six kids to her doorstep in the middle of the night. Another single grandmother who found out the night of her grandson’s birth that she would be parenting the infant, born with neonatal abstinence syndrome. She had to quit her job. She closed off every room in her house but one, because she could not afford to heat them.

Hatfield is a kinship caregiver. She has permanent custody of her granddaughter and another unrelated child. She took them in after the adults in the mother’s house were arrested for drug use. Looking for assistance, Hatfield went to support groups for kinship caregivers. There, she met a grandmother who was selling her own clothes on Facebook to try to raise money to buy school clothes for her 8-year-old granddaughter, whom she was caring for. 

“She had to quit her job to care for all five children; she went from a two-income home with two people to a one-income home with seven people,” Hatfield said in an interview with Rewire.News. “That’s when I started paying attention to what was going on around me.”

To support other kin caregivers like herself, Hatfield has become an organizer and advocate, lobbying the legislature and the governor in her home state, Kentucky, over the past two years. A reporter dubbed her statewide organizing the “Grandma Underground.” The name stuck.

In the wake of the opioid crisis, kinship and foster care systems in Kentucky have been stressed to their limits. Between 2013 and 2017, the number of Kentucky children in kinship care, children who live with and are cared for by relatives or close family friends instead of their parents, rose by over 50 percent.

According to the Annie E. Casey Foundation’s Kids Count data center, 8 percent of children in Kentucky, more than 80,000 kids, are in some form of kinship care—the highest percentage in the United States; neighboring Appalachian states West Virginia and Ohio each have 5% of children in kin care. At least 12,000 Kentucky children are in kin care because the state removed them from their homes due to abuse, neglect, or parental incarceration. Despite the increasing prevalence of this kind of care, Kentucky lacks the resources to meet the needs of kin caregivers.

Families Foot the Bill

Placing children with relatives instead of foster parents who are strangers to them is often the least traumatic option for children who end up in custody of the state; it gives children a semblance of familiarity. In an interview with Rewire.News, Wendy Welch, who conducted dozens of interviews with former foster kids, foster parents, and social workers across Central Appalachia for her book Fall or Fly: The Strangely Hopeful Story of Adoption and Foster Care in Appalachia, explained kinship care’s role in lessening the trauma for children whose parents get arrested: “Harm reduction would be calling grandma as soon as the [police] raid is over and saying, ‘We have your grandchildren in the backseat of a police car. We would very much like to bring them to your house instead of the foster care system.’”

While better for children’s well-being, immediately placing them in relatives’ homes, rather than processing them through the foster system first, is one of the ways the state denies funds to caregivers.

This past July, a comprehensive foster and adoption reform law went into effect in Kentucky. Thanks partly to advocacy efforts by Hatfield and others, the legislature added $4.9 million to the budget over two years to a fund called kinship care, designed to support relatives caring for children who have been removed from their homes.

There are two separate programs for caregivers who take in children related to them: kinship guardianship assistance and relative foster care payments. Kentucky has neglected both during the last four years of the state’s meteoric rise in child placements with relatives. Now, there is money in the new kinship care fund—but state officials announced yesterday that only kin fostering children on a temporary basis will receive it.

Kinship guardianship assistance was formerly a $300 per child per month payment to low-income caregivers who had gained permanent custody—adoption or assumption of legal guardianship—of related children. But in April 2013, the state ended enrollment in that program and removed recipients whose eligibility temporarily lapsed, due to such issues as late filing of renewals. 

After that, “it was next to impossible for the elderly to care for kids on their fixed incomes,” wrote Anna Houston, director of the Family Resource Center for the Danville, Kentucky, Independent School District, in an email to Rewire.News.

Houston has run a support group for relative caregivers since 2010. Newer members in Houston’s support group who have sought financial help from the kinship guardianship assistance program since passage of the legislative reforms have been either rejected or deferred. Currently, only around 5,000 families receive these kinship guardianship payments, down from more than 11,000 in 2013, according Shannon Moody, policy director of Kentucky Youth Advocates, in an interview with Rewire.News.

Hatfield recalled a woman who was the guardian of two grandchildren; when social workers called about a third, the child had to be sent to foster care because the grandmother could not afford to care for all three children herself. “If she had received that additional per diem of kinship [guardianship assistance] … all those children would be in her home.”

Relative foster caregivers are in a different position. When children are taken in by the state, social workers try to find relatives to care for them instead of sending them to nonrelative foster care. Until an October 2017 federal court decision, Kentucky did not provide these relatives with the support payments nonrelative foster caregivers receive.

In 2014, Richard Dawahare, an attorney in Kentucky, sued the state of Kentucky for refusing to grant foster care maintenance payments, around $750 per month per child, to relatives who take in children on a non-permanent basis. In October 2017, the U.S. Court of Appeals for the Sixth Circuit agreed with Dawahare’s argument. After the U.S. Supreme Court refused to hear an appeal by the state, some caregivers began getting payments, but many still aren’t, Dawahare says. Dawahare filed another lawsuit three months ago to challenge this practice.

The state is now obligated under court order to reimburse relative foster caregivers. Kentucky’s Department of Community Based Services had already warned that the bulk of the $4.9 million put into kinship care could go to the court-ordered payments for these short-term, relative foster parents. Funds will not be available for guardianship assistance anytime soon for the low-income, elderly relatives who have already established permanent custody of children.

Hatfield, organizer of the Grandma Underground, is frustrated by this decision by the state, which speaks to the dearth of resources to deal with the influx of children who need care—and caregivers who need help. “This lawsuit was already in the works for a few years. The Cabinet should have been prepared for this … Even the money that they allocated to kinship care wasn’t a lot.”

Relatives who take in children do become eligible for the federal Temporary Assistance for Needy Families program (TANF), but that only amounts to $186 per month, said Moody, policy director of Kentucky Youth Advocates. They also become eligible for child care assistance for 12 months, and a one-time $350 per child placement support benefit—but many kin caregivers do not receive it because they are not made aware of it in time.

“Aside from that,” Moody said, “there’s not a whole lot else out there for relative caregivers right now.”

Confronting stereotypes

Many foster parents and kin caregivers in Appalachia feel uncomfortable talking about needing more resources. They feel keenly the stigma of caring for the children of relatives or friends involved with drugs, and the stereotype that caregivers abuse the system for personal financial gain.

Welch, the author of Fall or Fly, pointed out the implicit judgment many people make about low-income foster and kin caregivers: “Grandmothers who give their children back [to the state] because they can’t afford to keep but one of them are the subjects of [people’s] judgment, not the system that says you can only have this much money,” she said. “The public doesn’t go after the system; they go after the grandma.”

“People who have to have the money to foster or provide kin care aren’t necessarily in it for the money,” Welch said. “What the public doesn’t know are the thousands of points of light that some of these people are.” Kin caregivers and foster parents clothe, feed, house, educate, and provide emotional support to children who have been through extreme trauma.

W (who asked that a full name not be used for privacy reasons), a single foster parent in eastern Kentucky who works full time, wrote in a statement to Rewire.News that their stipend has been critical to covering their child’s essential needs like diapers and child care. “There’s a disconnect in our society when we talk about taking care of young ones and how we talk about assistance. I myself am happy to pay taxes if it means they’re going to help keep a young child safe in a loving home,” W wrote.

Hatfield said, “It’s very easy for people to say, ‘Why would you pay a relative to take care of their own kin?’ [But] that money is for the child. This is about neglected and abused kids.”

She noted that when she started collecting stories from kin caregivers, many relatives “were afraid to say much publicly,” to avoid association with drugs or with being in dire need. In the past two years, as the opioid crisis has increased the need for kin care even more, caregivers have started opening up. At Kentucky’s legislative session, Hatfield hand delivered a petition of over 6,000 stories and names of kinship caregivers to every state senator. “We united here in Kentucky for the children,” she wrote.

This story was originally published by Rewire.News.