Sunday, September 21, 2014

Our Experience As Middle Class Foster Parents Navigating Low Income Systems

As I've mentioned before, sometimes being a foster parent puts us in weird situations.  One of those is the experience of dealing with systems and agencies that exist to serve the poor, even though we ourselves are a middle class couple who would not otherwise find ourselves in these situations but for our foster parent status.  I'll preface the reviews below with the statement that this is just our experience and others' experience may differ.  I also want to say that my comments about these programs and services do not stem from an arrogant, middle class, I-deserve-better-than-this attitude, but rather an overarching humans-deserve-better-than-this sadness.  Oof.  So here goes...

WIC: Where Inefficiency Reigns and Dignity Goes To Die
I hate the WIC office.  I do not throw around hate casually, but this place is like the 6th circle of hell.  Or whatever circle of hell makes you sit in a crowded waiting room in excess of two hours with small children who are bursting at the seams with boredom, hunger, tiredness, or all of the above, and therefore start tussling with other children in the room who are suffering from similar afflictions.

Here is what must be accomplished during a WIC certification or re-certification appointment, in order to receive your food benefits for your child:

-Five minutes with a WIC representative to fill out a few paperwork items
-Five minutes with a nutritionist to weigh and measure your child and prick their finger for an iron test
-Three minutes with the nutritionist again to go over the results and ask any questions
-Two minutes with the paperwork person again for wrap up and to get your updated WIC cards

How many minutes does that add up to?  Yeah, not many.  Remember I said above that this process takes over two hours.  Your "appointment" will be set for either 10:00 am or 1:00 pm on a certain day.  You show up and sign in, along with many other families, then go sit in the waiting room.  Twenty or thirty minutes passes in between each of the steps listed above and families are called in for each in no apparent order.  So, though I was among the first to show up a few weeks ago for Sister's "re-cert", I was literally the last to leave, over two hours later.  Each time a WIC employee comes to the waiting room door, you pray to the high heavens that they call your name, then sink back in your seat when they inevitably don't.  Oh, but when they do, it's like Christmas, until you remember you have a billion steps left in the grueling process.

So, why, you may ask, doesn't the WIC office simply schedule 15 minute actual appointment slots?  They run about 8 or 9 families through there in the terrible two hour span.  You do the math.  That works out to about 15 minutes each.  Well, perhaps they tried that at one point and realized that many low income folks don't keep appointments well, so they went to this current approach of "show up mid morning and we'll run you all through at some point before lunch in no logical order whatsoever."  Lucky for me, the only white woman in the waiting room, wearing lovely business casual clothing, I have a professional job with three weeks of vacation, two weeks of comp time and one week of sick time available to me each year, all of which I intentionally saved up for the express purpose of caring for these children.   But if I were actually a minimum wage earning individual that WIC mostly serves?  I would have just lost about a tenth of my pay for the week...

By the end of each of the two WIC appointments we have had, one with the whole family and one with just me and Sister after she turned one, I have left the building feeling utterly and completely defeated.  I was physically tired from wrestling a toddler for hours.  I was angry at the system for being so inefficient.  I was grasping at any shred of dignity I could find left at the moment after being crammed in a waiting room for so long with no regard given for my time, my obligations, or my child, whose day was very disrupted.  I found myself weighing the benefits we get from WIC against the crummy appointments necessary to obtain them.  My conclusion is that it is no longer worth it.  When Sister got seven cans of formula a month, that saved us over $100.  But now that she does not get (or need) formula since she turned one, her benefits match Brother's (milk, cheese, juice, cereal, fruit, veggies, eggs) and both their benefits combined save us about $30 per month.  Considering we're actually comfy middle class folks who find ourselves in some of these programs via our foster care status, and not from actual need...$30 per month is not worth it.  Not worth our time, our sanity or our dignity.  So when this hard earned round of benefits is up, we'll let them lapse.

But for the folks to whom $30 a month is huge...they have no choice.  They're stuck.

Medicaid: Accept Rejection
When the kids came to us, they were very sick, so we called up a random clinic the next day that the initial social worker mentioned takes Medicaid.   We got in right away but quickly realized the doctor we landed on was terrible.  Probably why we got in right away.  I'm not sure how this person keeps many patients for long.  After several weeks and many terrible appointments (the kids continued to get sick repeatedly in the beginning), Trent and I asked our own doctor if he could care for our kids.  "Sort of," he said. "I can see them for sick visits but cannot provide their well child checkups or their shots."  Kinda weird, but that's how his clinic was set up with foster kids' Medicaid status. Our first Medicaid hurdle.  At the time, we went for it.  Our kids kept getting sick and we needed to get away from the initial terrible doctor, stat.  Then our kids' birthdays came around and the need for checkups and some shots.  We realized that, as much as we love our doctor, we needed to settle in some place that could provide all we need.

So I began making calls to various clinics and doctors.  And with each call I wanted more and more to reach through the phone and punch someone...

"We do not accept Medicaid."

"We're not taking Medicaid patients at this time."

"We're not taking foster children at this time." (Ouch.)

So, after many calls and many dead ends, I decided to just call the Family Health Center, whose main purpose is to serve folks with Medicaid.

"We're not accepting new patients at this location."

For the love!!!  Can a foster kid get a doctor around here??  Thankfully, I had recently met a lovely woman at an adoptive/foster moms gathering who is a doctor at the FHC and my personal connection with her allowed us to bypass the clinic's current state of "sorry, bye bye" and get an appointment.  Finally!

Note: In case you are wondering, the kids must remain on Medicaid.  We cannot put them on our personal insurance in order to bypass these issues.  Until legally adopted, children in foster care are served by a certain division of Medicaid designated for them.

Making Appointments: Oh, You Have A Life?
My experience with making appointments in these systems has been...interesting...   You'd think the process of scheduling an upcoming appointment of any sort would naturally begin with a question such as "What day of the week would be good for you?" or "Would morning or afternoon work best?"  On the contrary, in these systems, the process of scheduling an upcoming appointment begins with "Your next appointment is on this date at this time."  WIC is especially bad at this.  At least the FHC followed the above statement with "Is that alright?"

This caught me majorly off guard at first.  I wasn't given time to consult my calendar. I was just handed my next time to show up.   I guess they assume low income people have no life, all they do is work...or not it doesn't make much difference when you tell them to come in.  Even so, at least give a person the dignity of being asked...

In Conclusion...
You have probably heard the phrase "If you build it, they will come."  I'd like to offer an alternate phrase: "If you crush them, they cannot rise."


  1. So true so true. Sometimes they ways these systems treat the folks they are supposed to be helping is appalling. You think getting an appointment with Medicaid is hard, you should try actually getting the Medicaid in the first place. Not efficient, not easy, and apparently often depends on the whim of whoever happens to handle your application. At least that part is bypassed for foster parents.
    As a social worker I've had a lot of experience helping families access these services, which I hope will serve me when we actually get a foster placement.
    One secret: You can say - that won't work what else is available to a particular appointment. They pretty much expect people to reschedule. And always bring your calendar to your appointment and go ahead and schedule the next one rather than have them call you or mail you an appointment if possible.;)

  2. I was not prepared for the Medicaid rejection!! WOW. You should have heard the indignation coming from my mouth as we were rejected time and time again. Whew.