Mississippi Appendectomy

I am happy to acknowledge LINK>Fannie Lou Hamer this Juneteenth. She rose from humble beginnings in the Mississippi Delta to become one of the most important, passionate, and powerful voices of the civil and voting rights movements and a leader in the efforts for greater economic opportunities for African Americans. She was a community organizer and vice-chair of the Freedom Democratic Party, which she represented at the 1964 Democratic National Convention. She went into the hospital to have a uterine tumor removed and was instead given a hysterectomy. The title of today’s blog comes from her having that experience. She died at only 59 years old.

I learned about her in a Time Magazine article by Alana Semuels LINK>How Women Get Pressured Into Long-Term Birth Control. In late 2020, news broke about an ACLU lawsuit related to LINK>Immigration Detention and Coerced Sterilization of Mexican woman. It was NOT the first time in US history that this happened. In 2021, the state of California compensated such women. Starting in the year 1909, women of Mexican descent were used as targets for the eugenics movement to reinforce population control and purity.

The Mirena IUD is mentioned. I once had an IUD during my adult journey into birth control but had to have it removed after a few months due to the pain it caused. Mine did not have the long lifespan of the new ones which came out in the 2000s. You can read the Time Magazine article at the link above.

Systemic racism and classism have a long history in US medicine. Even now, some doctors are pushing LARCs (Long Acting Reversible Contraceptives) on Black and Latina, as well as other lower-income women (especially those on Medicaid) coercing them into receiving these, sometimes even immediately after birthing a baby. According to Mieke Eeckhaut, a sociologist, “These ideas of who should and shouldn’t have children are still very much influencing our policies.”

Never Seems To Improve

The image is just for LOLs. The reality is poverty is not at all a laughing matter nor is it usually simply laziness on the part of the recipients.

This honest comment inspired this blog today – I’m a nurse but my primary experience is in the community with families, and case management. The issue with a lot of Social Services is that the income cut offs are way too low. Even if my husband and I were working minimum wage jobs, we would make too much to qualify for WIC, Food Stamps, Head Start, or daycare vouchers here in Florida. They need to be helping families before the are in total poverty with no way to claw themselves out. The working class needs support too. This was my situation growing up and it never improved because it couldn’t.

Another shares – We make very little over the cap for the childcare assistance so I could work to be able to afford more of our bills. It is extremely difficult trying to explain to people that if I worked a job we would lose money. Because if I worked a job that would make enough money to impact our financial status, my student loans would want $300 a month, my son would have to go to daycare which is $500 a week, and I can’t find a job that works with my schedule because my son has to see two specialists every week. And if I worked the opposite shift that my husband works, so that he could watch our son, but I would never see my kid.

Yet someone else notes – I got a small raise, I think it was 50 cents, that caused me to lose my food stamps. I’m in a better financial space now but I’ll never forget all the struggles I had to go through.

Another shares – There is about a 9 year wait to get HUD housing where I live. My retirement income is from a rental house. I chose a family who had a Section 8 voucher. Landlords need to consider – if the tenant loses their job, Section 8 will cover more. There are all kinds of rules for the tenant. The top amount of the voucher was actually more than I was asking for rent.

From someone else – Food stamps require you to be working some amount of hours (I think it’s 20hrs/week) and you cannot get away from that requirement, unless you are disabled and have special permissions granted by the DHS officer on your case. Medicaid is a tragedy in my region. Finding a doctor isn’t the worst thing, but good luck finding a dentist. Housing is a disaster. The only “landlords” who accept it are slumlords. No idea how long the waitlist is here.

If you don’t think the deck is stacked against the poor, you probably aren’t trying to stay alive through the system.

Investing in Families

Some thoughts from my all things adoption group today –

The state pays struggling families welfare benefits and the federal government also pays hundreds of billions in welfare and Medicaid benefits and subsidized housing and food stamps for poor families. The federal and state governments don’t enjoy financially supporting poor people’s children, they don’t find it to be a good investment. They think children raised on public funds grow up in large part to have more kids raised on public funds.

The federal government tasks states with promoting adoption of children whose parents get public assistance or whose parents qualify for public assistance. That means everything from fresh from the womb infants of uneducated unmarried girls who would qualify for welfare if they applied, to already born children of parents who are either on welfare or make so little as to be statistically likely to qualify for benefits at some point.

The federal government invests hundreds of millions of dollars in adoption incentives to save hundreds of billions on welfare benefits which also artificially sterilizes the poor by taking their children away and giving them to wealthier families who can afford to support them either totally on their own or with subsidies amounting to less than would have been paid to the parents on welfare.

The federal government requires states to hit a certain quota of adopting out special needs kids and pays $6,000 to $12,000 for every adoption of a child whose parents are on welfare or who qualify for welfare and states are mandated to increase the number of children on welfare adopted each year.

The state has zero incentive to return a child to a parent who has been meeting the state’s demands for return of their child, if that parent is on welfare. Returning the child to that parent literally costs the state money and so, there you go. Our judges work for the states that financially benefit from the adoption of welfare dependent children. There is a grave conflict of interest, when the arbiter is working for and paid by the state – who has a financial stake in the child being moved from the welfare dependent parent to a financially solvent adoptive home.

blogger’s note – The reality is that our society does not support struggling families well enough and is even a danger to many of them, causing the break-up of that family structure. It really is only about the money and our government would rather give it to the wealthy, who don’t need it but might donate to the politicians re-election campaigns, than help struggling families get on their feet and live dignified lives. Sadly, this is the reality.

Adoption, Foster Care or Guardianship

Came across some thoughts. Just passing them along.

To the thought that adoption equals indentured servitude, one adoptee said – It started as permanent indentured servitude and nothing has changed except the marketing. In answer to that, someone else said – Until the law changes, hopeful adopters can choose guardianship or (not quite as good) choose NOT to amend the birth certificate per this LINK>google doc on State Laws.

The perspective from an adoptive parent, who adopted from foster care, and who is also the sister of an adoptee – The problem with guardianship is it varies so much on what it provides and how it functions. Part of me wonders if that is by design – make it so onerous that it’s the less desirable option.

Washington state recently passed a law that forbids children to be removed from a placement – if that placement is willing to provide LINK>minor guardianship but not adoption. This was specifically done with kinship in mind – apparently children used to be removed from willing kin placements to be put up for adoption, if a grandmother didn’t want to make her grandchild, her child, on paper.

Under a guardianship, the youth loses the benefits they would keep if they had been adopted or remained in foster care, including medical benefits. Guardians can apply for cash support but it is SUCH a complex process and many people don’t qualify. Her perspective is that it makes guardianship only possible for a specific socioeconomic group – and less possible for kin. Like with adoption, a teen must consent. The system leaves many teens frightened that guardianship means no more stability than foster care – with less oversight.

This adoptive parent would love to see a streamlined guardianship process that is a federal/legal mechanism. One that conveys the same parental rights and responsibilities towards minors that adoption does, while simultaneously banning any birth certificate amendments, legal name changes and still preserves legal ties to all genetic family members.

From the daughter of an orphan and an anti-adoption activist – someone saying that “in guardianship the youth lose benefits that they would keep in foster care” – that is the whole point of guardianship and adoption – to transfer financial responsibility from the state to the guardian or adopter! The adopter or guardian puts the child on their medical plan, feeds them, clothes them etc. The government does provide adoption incentive payments and tax credits and sometimes Medicaid for children with complex medical needs because its still cheaper than having the kid remain in foster care. If guardians or adopters ever lose their jobs and can’t support the kids they took in, they can go on welfare, just like the families the kids were taken away from.

The federal government is betting that won’t happen. The federal government has started offering states Title IV funding for achieving ‘permanency’ through guardianship but it is a relatively new development. Title IV refers to federal student aid in which there is a demonstrable financial need to be able to attend public, private nonprofit and proprietary schools. Attendees of these colleges can receive student loans, grants or enter a work-study program.

Hopefully, guardianship would help stop the bullying of people into adoption. Some persons make guardianship sound like it is not as good as adoption for money related reasons. It is outrageous that ‘the system’ is manipulating teens into believing that adoption offers them more stability and oversight than foster care. Foster care meets their needs until they reach the age of 18. They have a right to facilitated visitation with their family. They can’t be moved out of the county where their family resides. They can’t be homeschooled or forced to participate in their caregiver’s religion. They don’t have to call their caregivers “mom” or “dad” and their care givers are not legally allowed to refer to them as their son or daughter. Their caregivers have to take them to mainstream doctors and dentists. They are assigned a caseworker to monitor the safety and appropriateness of the placement. If they are abused in a foster home, they can sue the state and be awarded damages. They always have the right to be returned to live with their family – if it ever becomes safe and however possible – even after their parents rights have been terminated – ONLY if they have NOT been adopted.

Child Protective Services pushes for adoption in order to meet quotas. They receive bounty payments when the meet federal government requirements for completing placements into adoptions. When kids age out of foster care, they age out with their rights intact and there are many programs and scholarships available to them as former foster youth. These would not be available to them, if they are adopted or obtain a guardian. With both guardianship and adoption, the child loses the oversight of the state. The state is freed from the liability related to what happens to the person in the adoptive home or at the hands of the guardian, if any abuse occurs.

At least with guardianship, the youth remains a member of their family with all kinship rights intact – permanently. The guardian has to do the job of a parent without the title. Legally a child is entitled to the same level of care and support from a guardian that they would receive from an adoptive parent, only they won’t lose their kinship in their family and they can return to their parents, if the situation improves. The guardian does not have a right to keep the person permanently. A guardian also is not allowed to exploit a child in their care, the way an adopter can (such as putting them on Youtube and profiting off filming their every move, as so many adopters and parents do these days). Adopting without changing the birth certificate is not as good as guardianship but it is vastly better than adopting and changing the birth certificate for those who are forced to adopt their kin, rather than serve as guardians.

Autism and Foster Care

Children with autism are more likely to end up in the foster care system. Long- and short-term outcomes for children in foster care are not good: Children who spend any amount of time in foster homes are less likely than their peers to graduate from high school and more likely to end up homeless, in the criminal justice system or in long-term residential care. Foster care may be an even less desirable place for children with autism, given their special needs. Although foster parents may receive some specialized training, it is generally not nearly enough to help them adequately care for these children.

7.3 percent of Medicaid-enrolled children with autism were in foster care in a 2008 study. This is well above twice the proportion of all Medicaid-enrolled children in foster care. The prevalence of children with autism in foster care started out at 7.5 percent in 2001. It climbed to 10.5 percent in 2005 and then declined to 9.1 percent in 2007. Children with autism were 2.4 times more likely to enter foster care than a typical child.

Raising a child with autism is stressful for families, as the condition is unusually difficult to manage effectively. Some parents may simply not have the skills and resources to do so. This may result in neglect or abuse — and placement in foster care. Alternatively, families may voluntarily place children with autism in foster care because they can’t handle the children’s behavioral problems. Third, parents may relinquish custody so that their children can obtain Medicaid-funded or residential care that they otherwise cannot afford.

I will always be for family preservation. To lower the chances that a child with autism will land in foster care, clinicians working with these families should talk openly about the stresses of raising a child on the spectrum. They should ask how that stress is manifesting in the family, and assist the family members in getting the support they need. All US states should offer home visits from professionals or short-term breaks for parents of children with autism. (Only a handful currently do.) Home visits and respite services have been shown to lower the chances of psychiatric hospitalization among children with autism, and also may reduce the risk of foster care placement.

Foster care arrangements can cost between $30,000 and $50,000 in taxpayer funds per child per year. That money could be more wisely spent supporting the needs of these families. Society has an ethical obligation to help families care for their children with autism. We can and must do better to help these most vulnerable children and their families.

Thanks to David Mandell and his essay in LINK> Spectrum News for today’s blog. I started with an interest in how neurodivergent issues relate to foster care and a google search ended up with that essay.

At Least This

I was born in New Mexico, so I chose to highlight the blog with this image. With the potential of the Supreme Court overturning Roe v Wade soon to kick off – 26 of these United States, just over half, will completely ban all abortions for any reason and the forced birthing of women who find themselves pregnant will be the result. Some states – Arizona, Florida, Tennessee and Texas have all extended health benefits for low-income mothers in recent months, and Alabama and Georgia have both moved to implement such extensions. There is an important distinction to make here – all of these states listed here plan to impose severe abortion restrictions or bans.

New Mexico will NOT be banning abortion – they are expanding Medicaid coverage for the RIGHT reason and not as cover for their war on women’s equal rights. Abortion is legal at all stages of pregnancy in New Mexico. There was a law in New Mexico that banned abortions except in cases of rape, incest, or if it was necessary to save a woman’s life. That law was put on NM’s books in 1969. In Feb 2021, Gov Michelle Lujan Grisham signed a bill that struck that old law from the books. She said, “This is about women who deserve the right, particularly when there are untenable circumstances, to have a relationship with their provider and control over their own bodies and we know when that occurs, frankly, we are saving lives.”

Colorado took it even a step further than New Mexico in April 2022. Gov Jared Polis signed the Reproductive Health Equity Act into law. The legislation makes it a right for people to make reproductive health care decisions without government interference.

I have long argued that we do not support mothers and children, or families for that matter, seriously enough as a society. So this expansion of Medicaid benefits is certainly welcomed. However, the bans that will go into place if the Supreme Court rules as currently expected, will also result in a worsening of the current maternal mortality rate. That rate has risen overall in 2020. There were almost 24 deaths per 100,000 births, or 861 deaths total. This number reflects mothers who died during pregnancy, childbirth or the year after. The rate was 20 per 100,000 in 2019. Among Black women the rate has long been much worse. There were 55 maternal deaths per 100,000 births. That is almost triple the rate for white people.

“If they [Republican lawmakers] really cared about maternal mortality they’d reduce the causes of maternal mortality – and it goes way beyond Medicaid expansion,” according to Loretta Ross, an associate professor at Smith College in Georgia and a reproductive justice activist.

The truth is that there have been changes to Medicaid, thanks to a provision of federal pandemic aid, which streamlined postpartum benefit changes. Missouri has long refused to expand Medicaid. The most dramatic effect of a post-partum extension would be felt in those Republican-led states, where lawmakers have long refused to expand the program to more low-income people.

In Texas, 25% of women of reproductive age lack health insurance, the highest rate in the nation. Texas is also among the 10 worst states for maternal mortality. Lawmakers in Texas recently expanded Medicaid to pregnant patients for six months after giving birth, instead of only the two they were given previously.

Back to my previous argument that we don’t support mothers, their children or the families enough – a single mother in Texas supporting two children cannot earn more than $2,760 a year and qualify for Medicaid – unless they are pregnant, in which case they can earn up to $45,600 a year and qualify. The previous exemption lasted only 60 days after birth – which it should be noted is also the federal minimum. After that, most become uninsured once again. so, the expansion to six months is welcome but still insufficient.

In Tennessee, the Republican governor, Bill Lee, directly connected the state’s postpartum Medicaid expansion and abortion. At a press conference in May, he spoke about Tennessee’s “trigger” ban, a law that will allow the state to immediately ban abortion, if the supreme court ends federal protections. He said, this is for “The lives of unborn children (and that) it’s very important that we protect their lives. It’s also important that we recognize that women in crisis need support and assistance through this process. For example, that’s why we’ve expanded our postpartum coverage for women in TennCare.”

It is all a brilliant smoke and mirrors strategy to pretend they care but I sincerely doubt they do. Want to bet that these women’s poverty related need for Medicaid will be used against them to take the children away and give them to wealthier people wanting to adopt ?

Statistics and details are thanks to The Guardian and KOB4 in Albuquerque NM.

Skewing The Narrative

It is a fact that many adoptees will actually say they wish their natural, genetic, biological mother had aborted them. It is also a fact that the government does NOT fund abortions, contrary to the messaging that comes out of evangelical, pro-Life and conservative interests with the hidden agenda of triggering people’s emotions in order to get their vote. It is also true that the government is already funding some adoptions through a huge tax credit for the single adoptive person or couple. The government also funds adoptions from foster care paying court expenses. Many of these adoptions also receive an adoption subsidy, Medicaid and free tuition for the child.

And finally, I do speak from experience on this issue. I am grateful for access to a safe, legal abortion back in the early 1970s. That is a blessing that is increasingly hard to get access to. This planet actually already has enough people and truth be told, more than is sustainable.

I do believe in letting nature take it’s course. I believe that purging events such as the COVID 19 pandemic is an activity of this Earth. I believe that predators cull out the weak. Not that I wish to be a victim of either. I believe in the kind of God that always knows what each of that God’s individual expressions will do in any given situation. I believe in a life that is meant to teach our soul important lessons, make us more empathetic and give us a more tolerant perspective on human behavior. I also believe there is never anything wrong going on, even if we are unable to truly comprehend what we are seeing. And I do believe that humanity evolves and progresses and that includes what medical science advances including safe abortions and reproductive assistance. Finally, I believe that death is only an experience in our human lives but personally, I believe in eternal souls living more than one incarnation. We cannot kill a soul though we can kill the body that the soul moves about the planet with.

An image like the one above is offensive. Abortion and adoption have nothing to do with each other. Speaking of government funding – why not help families stay together, fund the help that struggling families actually need and support them through a financial crisis ? What if government funded birth control ? What if society supported struggling mothers ? What if society held fathers to higher standards ?

While I’m at it – what about free health care ? Mental health intervention ? How about the government starts caring about drug addicts and puts more funding into rehabs and counseling ?

Some of these people who think like the image above should have to spend at least 9 months forced to serve as a walking incubator for someone they’ll never be allowed to meet again, and then have all proof that they gave birth to a child erased by changed birth certificates and sealed adoption records. Yes, think about all of those mothers who have had that very experience. One can get over a conception and abortion quickly. One lives with the pain of having been separated from their child for a lifetime.

Plan B

It may seem strange to write about this but unplanned pregnancies are a leading cause of adoption. Adoption results in often unconscious and definitely life-long trauma for the adoptee and for their mother from whom they are removed. Ridding one’s self of the possibility quickly, results in less guilt and shame than an abortion, even when done by 3 mos gestation. If definitely prevents the surrender of a baby to some stranger.

An interesting fact about this method is that it often fails obese women. Weight matters in this regard. This is an important consideration in the United States, where over 35% of adults are obese because obese women (with a body mass index, or BMI, of 30 or greater) became pregnant over 3 times more often than non-obese women when trying this method.

While the commercially marketed brand names are expensive and often kept in anti-theft cabinets, it is possible to obtain a generic. I have read that with a coupon code from GoodRx the cost of a generic could be as low as $14.

Plan B is meant to delay or prevent ovulation. It does not “end the pregnancy”. Plan B is not an abortion pill. It’s a heightened dose of birth control to prevent implantation. It’s not misoprostol or mifepristone. So there is no danger of harming the fetus’s development, if a pregnancy develops after trying this. Using this does slightly increase the risk of an ectopic pregnancy. If you’re already pregnant, it won’t work; but it will basically force you to have a period, if you’re not pregnant.

If you’re on Medicaid, they have an online site and will mail it and birth control to your home for free monthly. And at pharmacies, it is often found on the shelf right next to the pregnancy tests and near the condoms! Don’t be in denial about unprotected sex. Believing “Oh it won’t happen to me, I’m invincible” could prove to be wrong and then it is too late for the easy precautions. Girls under 18, be aware that many states require a prescription to buy it at a pharmacy, making it much less accessible but you can actually buy it on Amazon, of course.

Beware though if you live in a conservative, religious right state like my state of Missouri – you may get a judgmental/religious pharmacist. There are tons of stories of women being blocked by pharmacists from getting it – either lied to or just told no. And parents in these conservatively religious regions often don’t believe in sex education and tell their children to just say “no” with predictable results.

Morally and Ethically Wrong

An adoptive parent disclosed that she receives $4,000 per month in adoption subsidies for 3 children. These children do not have any physical or intellectual disabilities. They do not have any known medical conditions.

The fact is that states can pay not only foster parents but adoptive parents as much as $4,000 per month for 3 children. Homeless parents are often working one or more jobs and still can’t find affordable, income-based housing. How is this fair ?

Often adoptive parents are the first ones to say that the natural parents need to be able to provide for their kids “on their own”.

How can people not see why and how this is problematic and how morally and ethically wrong this is. Some even justify this as a fair situation. Something is terribly wrong in our society that we do not give full support to struggling families but instead take their children away from them and pay complete strangers to care for them.

I didn’t even know adoption subsidies were a thing.

And to be clear, not EVERY adoption qualifies and it varies by state law. Often, there does have to be some kind of ‘special needs’, though that is a broad category that includes sibling groups, children over 6 years, minorities as well as physical or mental disabilities.

Sadly, many of the original parents who surrender children for adoption do so because they believe not having enough money defines them as not being good enough to parent a child.

Here is one story to highlight the unfairness –

There was a couple who adopted a sibling group. This family makes a 6 figure income. The couple was childless for 14 years. All of the adopted children received Medicaid, the family received a substantial subsidy, and all of the children were eligible to attend a public university of their choosing free for 4 years.

The kids never had to do “without” the basics growing up (though they did not have their biological mom which is always a significant loss). All of the children are now adults.

The husband does very very well in his profession. The couple never actually “needed” a dime of assistance nor did they ever have to pay for healthcare for the children. To their credit, the couple did make trusts for the children.

It is just hard to understand why a sibling group is automatically considered “special needs” . Why is this kind of financial support not “income based”, like every natural parent would be faced with ?

And this is basically political. Universal health care, living wage, other so-called “socialist” policies would address all these issues struggling families face. Hard core capitalist each have their own version of America. No one would ever need to remove children from parents simply for poverty. Not doing this creates an insanely expensive, ineffective child welfare system, and a lot of suffering. And again, this is a voting issue.

Aging Out

This is inevitable and it happens to every child who is in foster care until they are 18. Today’s story of a girl aging out goes this way –

My son’s girlfriend is living with us. She is just aging out of foster care and I would like some help finding supports to put in place. Her mother is deceased and her father is incarcerated (I hate to give too much info but I don’t know if that changes her eligibility). She needs health insurance and is trying to go to college. They are planning to move cross country in a few weeks so I am trying to help her as quickly as possible. Any info on where I can turn for help for her is appreciated. She is a sweet kid.

Sharing some answers that may help someone else with similar circumstances.

For the health insurance, simply aging out of foster care could make her eligible for Medicaid. This does vary by state.

One recommendation was actually to enlist in the Army – this can be full time, reserves, or National Guard. They offer many college incentives plus a good bonus, stable income, and health care. Many (including the person suggesting this) that joined the military found it was a great opportunity for them.

It was mentioned that she may qualify for SSI due to the death of her mom. Depending on why she went into foster care she may qualify for VOCA (is that The Victims of Crime Act ? – the state may have filed an application or she may not even know that it’s available to her).

This does NOT seem generally known but someone said – If she is under 21 most states offer foster care until 21. It’s not nearly as invasive as it is for kids under 18. She can get a monthly stipend to put towards housing, Medicaid, and other help as long as she meets the requirements – typically in school or working at least part time.

There is a Preparation for Adult Living program that is part of Child Protective Services agencies that exists to help teens aging out of foster care. So contacting the coordinator of that program to inquire about benefits could be helpful.

There is The Free Application for Federal Student Aid which may give special consideration to youth aging out of foster care. There may be other scholarships available – this organization may be able to help Foster Care to Success. A student like her should qualify for a full Pell grant. Depending on the state, she might be eligible for reduced or free state college because she was in foster care.

Finally, one more link. iFoster has programs to assist Transition Age Foster Youth.