The same adopted child in Colorado could get $1,000 of monthly subsidies, or none. The deciding factor? Where they live.

Expenses were not top of mind in 2018, when Tracy and Allen Alexander decided to foster three brothers, ages 3, 5 and 10. But after the boys arrived, followed by two trash bags containing their belongings, the costs quickly started to add up. 

Tracy, a teacher, had owned a small sedan. Now she was leasing a van. The couple had gone to Costco once every three months. Now, they were spending $800 to $1,000 a month to feed growing boys. The oldest brother was behind in school. They spent $6,000 for a year on tutoring. There was $10,000 to turn an unfinished basement into a bedroom for one boy. Another $8,000 insurance deductible when he flooded the basement. 

At one point, a Larimer County official told the Alexanders that the costs were theirs to bear. 

“‘When you adopt foster kids, you are taking them in as if they’re your own,’” the official said, Allen recalled. 

The comment surprised the couple. 

If we birthed these boys, the parents thought, they wouldn’t have been hit as kids. Tracy wouldn’t have consumed alcohol while pregnant. The boys wouldn’t have “trauma.” 

“This is not a normal situation,” Allen said. 

In Colorado, adopted families get a subsidy to help manage the expense of parenting children who may have intense psychological needs. The federal and state governments cover most of the cost, with the county kicking in 10%. 

But negotiations happen at the county level. The Alexanders didn’t know it, but they were in one of the stingiest counties in the state: Larimer County. 

Colorado is among just a handful of states where adoption assistance rates are set entirely by counties. There have historically been vast disparities in how much counties pay, if they pay anything at all, according to a 2017 report from the state’s Child Protection Ombudsman. As recently as this year, the rates ranged from $180.29 in Baca County to $1,015.05 a month in Dolores County. Across counties, federally subsidized adoptions in Colorado each received about $4,095 last fiscal year — among the lowest rates nationwide, according to federal data. 

Families who get adoption subsidies are three times more likely to disrupt, with the adoptive child going back to foster care, than those who don’t, according to a study conducted through a partnership between Colorado State University, the Colorado Department of Human Services and 11 Colorado counties’ human service departments. That may be because families and children with greater needs are more likely to get subsidies in the first place.

Colorado overhauled its rules on adoption assistance after the 2017 report came out and is working to standardize the process statewide. 

But there’s no new money available for adoption assistance. And some parents say the more intractable problem — lack of mental health services — still exists. The need for those services is particularly acute in the 73% of the state that are considered rural or frontier counties. In a report comparing mental health demand with available service across the country, Colorado ranked last for adults and 13th for kids. 

“Because of their diagnoses, because of what they’ve been through, because of their age or because usually a combination of all of these, these are children who present a barrier to adoption,” said Timothy Eirich, a lawyer whose Denver-based firm specializes in adoptions. 

“Some of these kids have such needs that it really impacts every aspect of family lives — to the point where something as simple as getting a kid dressed and out the door becomes a couple-hour affair.”

In Phillips County, Samantha Jacobs adopted two boys after their sibling died of head injuries inflicted in their mother’s care. Their mother pleaded guilty to child abuse and was sentenced to 25 years in prison. 

Jacobs’ older boy struggled. He threatened to kill his brother and adoptive parents. The family and sometimes their caseworker drove him and his brother 150 miles to Greeley to see a therapist. After he was placed in a residential treatment facility, they drove nearly three hours to visit him for family therapy. Jacobs and her husband later adopted another set of siblings in Montrose County who also went to therapy. Years after the oldest boy moved out of the house, the other children are still spooked when they hear someone yelling.

“The subsidy money — it just disappears because you have so many services you need for the kids,” Jacobs said. “Of course, I love my children, and I love what we’ve come through in the end. But I do not recommend it to people. I just don’t. I can’t. It is not something that ordinary people can even understand.”

The federal government began subsidizing adoption assistance payments in 1980, aiming to prevent children from languishing in foster care. The monthly rates must be less than those paid to foster parents, and should be based on a negotiation that considers both the child’s needs and the adoptive family’s circumstances. 

Counties can also offer case services — or reimbursements for items like tutoring or child care — and money to cover lawyers, new birth certificates or other costs directly tied to adopting. Adoptive children are eligible for Medicaid, government-sponsored health insurance, until age 18 or 21. 

The Alexanders received between $3,500 and $4,000 a month for the three boys while they were in foster care. As they took steps to adopt them, Larimer County made its first offer for adoption assistance. 

It included Medicaid, and up to $2,000 per child for adoption expenses. But there was no money for case services, and no monthly subsidy.

Chapter Two: “What I’m asking for is a drop in the bucket” 

Negotiations over adoption assistance can be fraught. Adoptive parents may feel uncomfortable haggling over money when they are anxious to finalize an adoption. Perceptions that foster and adoptive parents are taking in children for money can add a stigma to asking for more financial help. County officials can contribute to that feeling of guilt. 

Eirich, the lawyer, once represented a mother who submitted a budget that accounted for healthy food for an adopted teenager, who among a number of issues, struggled with her weight.

“I remember distinctly the woman we were negotiating with … was just saying offensive things like, ‘I don’t spend that kind of money on food. I don’t buy that high-quality food,’” Eirich recounted. “‘My client was like, ‘I’m not doing this for the money. What I’m asking for is a drop in the bucket of what I pay out of pocket.’” 

The conversations have become less “offensive” in the past 10 years, Eirich said. But differences between counties remain. Compared with urban counties that handle many adoptions, some rural regions might have one case worker who goes out on domestic violence calls, helps find subsidized housing and takes on the occasional adoption. 

Experiences can vary from one family to the next even in similarly sized counties.

Larimer County, for example, starts each negotiation with the same adoption assistance offer: Medicaid and no monthly subsidy. Since fiscal year 2001, the county has led the state in not providing subsidies to adoptive parents, limiting them to Medicaid-only contracts at a rate higher than at least 55 Colorado counties. (Data for the remaining counties could not be determined due to how few adoptions they handle.) Nearly 460 of the county’s agreements have been Medicaid-only, compared with 482 with subsidies, according to state data. 

By contrast, of 1,306 adoption assistance agreements in Mesa County over the past two decades, 35 have been Medicaid-only, according to data provided by the state. 

Abigale Aster Stafford remembers Larimer County officials threatened to find another family to adopt the children she had been fostering, when she negotiated for adoption assistance around 2019. The kids — a nonverbal 3-year-old whose case worker said he was deaf, and a 9-month-old who had spent most of her life in a car seat — were first placed with Stafford and her husband in 2015. Stafford wanted to foster and “help kids in hard situations” because she was abused as a child and “wanted to be the adult” she didn’t have growing up. 

The county agreed to reimburse the family up to $11,000 a year for the two children. Stafford tracks receipts each month and sends them to the county for reimbursement. The requirements and formatting for submitting expenses has changed about a half-dozen times in three years, and it can take two to three months to be reimbursed, she said. 

When she asked the county for more assistance and for it to come as a monthly subsidy rather than case services, a Larimer County adoption specialist said her supervisor was conflicted. 

“He does not agree that changing the case services to a monthly payment is justified just to relieve the administrative burden of the reimbursement process,” the official told Stafford in a recent email.

The county last week agreed to the family’s request, after more than 4 months of negotiations.

There are differences in the county’s negotiation process meant to accommodate families, said Jill Maasch, a spokesperson for Larimer County’s human services department. If a family wants more assistance than Medicaid, they are asked to complete a questionnaire and may be asked follow-up questions about their request. 

“We will make an amended offer as needed. This process usually takes on average a week to two weeks depending on many factors in the process,” Maasch said in an email. The county often offers case services, sometimes lasting until the adoptive child is 18 or 21 years old. 

“Adoption assistance is intended to support the unique needs of the children, not to provide financial incentive to adopt a child,” she said. 

Chapter Three: Some families get more than they expected

While some families walk away from adoption subsidy negotiations with far less than they hoped for, others receive more than they expected. 

Jackie Brochu, a long-time foster parent through the Colorado Springs agency Kids Crossing, received a $3,000-per-month subsidy for a 16-year-old girl she adopted from Denver County this year. Brochu, 60, said she didn’t even have to argue. The Denver Human Services worker knew the girl’s family history and offered her whatever she needed.

“Everything. Right down to the child getting her hair done because she’s African American,” Brochu said. “Sports. Food. Clothes. If I needed anything extra medically. Honestly, it was like everything.”

In Adams County, Leon Wittner said human service officials were understanding when his wife of 37 years got cancer. She died in 2021. The county agreed to cover some of the costs for a nanny for his five adopted children, all of whom are siblings, though he ended up not needing to hire one.

That kind of assistance and flexibility allowed Wittner and his wife to parent their adoptive children.

“Had we not had some sort of assistance, we couldn’t afford to do it,” said Wittner, 61.

He’d been warned not to negotiate with the county without lawyers present, saying he’d been told “all they’re going to do is give you Medicaid and then you’re going to be on your own.” 

“It was just the farthest thing from the truth,” Wittner said. 

We hear all the time — and we hate it — Oh, you’re such saints. You’ve changed these kids’ lives. We just wanted to be parents and this was the way it happened for us.

— Tracy Alexander, who adopted three boys with her husband

State officials say recent reforms are meant to ensure consistency in the process statewide. The aim isn’t to increase subsidies across the board or to eliminate variance between counties entirely. 

A Grand Junction family that must routinely visit a children’s hospital, for example, would spend far more time driving to appointments than a family in Aurora next to a pediatric hospital, said Korey Elger, child protection administrator for the Colorado Department of Human Services.   

“Your assistance is going to look different because you’re going to have to travel for hours — maybe, once, twice, three times a month — to that specific service,” she said. “That’s going to look really different than if you live in Aurora and it’s a five minute commute to that service that you can do very easily.”

“It’s supposed to be a conversation,” Elger added. “It’s not supposed to be ‘You get this for this.’”

The expectation is that while some families get more money using the tool created by the state reforms, others will get less. 

But families who have already tested the tool out received considerably more adoption assistance, raising questions about whether overall costs to the states and counties will increase. 

An internal state memorandum found that if every child in Colorado received half the maximum adoption assistance package, it would cost an additional $2.8 million to $5.7 million over two years, a 68% to 139% increase. 

Colorado had 777 adoption assistance agreements begin last fiscal year, and the program overall cost $46 million. Thirty-six percent of those agreements did not include a monthly subsidy. 

Already, Larimer County has seen increased requests for assistance, including funding for homework help, transportation assistance and in-home therapy, Maasch, the county spokeswoman, said in an email. Some of the funds come out of the same budget as other child protection and family services expenses.

“​​Counties are trying to provide as much assistance as possible to all families when there is a justified need, while balancing our appropriated funding for all child welfare services and fiscal responsibility to our taxpayers,” she said. 

State and county officials expect counties will be required to use the tool starting next spring. They will test it out for about a year and make any needed adjustments. 

Mike Arnett’s son puts on shoes in his backyard in Dacono. Mike Arnett and his wife adopted him in 2009 when he was eight months old. (Olivia Sun, The Colorado Sun via Report for America)

Chapter Four: Potential for increased costs

Michael Arnett received about $400 a month from Mesa County to care for the 8-month-old he adopted in 2009. The boy suffered abuse as an infant that left him with permanent brain damage. Doctors thought he would never be able to chew food, talk or stand up.  

Arnett, an engineer, took a 50% pay cut so he would have enough flexibility to drive the child to medical appointments. He and his wife divorced, in part from the stress of raising the child. They live far apart now, but still co-parent the boy. 

Now 13, the boy loves music, loves to dance around and loves to swim — but, because he has seizures, he mainly plays on splash pads instead of in pools. He is incontinent, tends to destroy clothing and household items, and has specialized orthotic shoes that are expensive. It’s hard for Arnett to go out with the teen because he is sensitive to loud noises and crowds. It’s also hard to find a caretaker trained to handle the boy, especially now that he’s grown. They have ended up in the emergency room because the boy hurt himself or Arnett. At home, he’s attached to Arnett’s hip 24-7.

Four years after Arnett and his wife divorced, he asked Mesa County if the subsidy could be increased as he was now raising the child on a single income. He had been running up hundreds of dollars in credit card debt each month trying to care for the boy. 

“They told me under no uncertain terms,” Arnett recalled, “the maximum we can give you is $5 (more) a day.”

He later contacted Deborah Cave, an adoptive parent and head of the nonprofit Colorado Coalition of Adoptive Families. She told him the state had been working on an adoption assistance tool and encouraged him to fill it out as a test-run. Arnett’s monthly subsidy rate doubled to a little over $1,000, he said.

He began to pay back the debt, and is trying to create a savings account for the boy, so he has a financial cushion after Arnett dies. 

County officials were kind and professional to deal with. But there was initially “no discussion of ‘Oh you can get between $1 and $500,’” he recalled. “They’re like ‘This is the rate. This is what we give.’ You’re like ‘OK.’ You don’t know any better.”

Cave said county officials were supportive of the renegotiation. She wished there was an independent advocacy group that could take over her volunteer job helping adoptive families. 

“I think the fact that there is a need for this level of advocacy indicates that the prior protocols weren’t appropriate,” she said. 

Mesa County officials did not respond to questions seeking comment. 

The Alexanders this summer tested out the same tool in Larimer County, at Cave’s suggestion. Allen went through line by line by trying to quantify how much the couple’s financial situation had changed in the nearly five years since they began fostering the boys. They expect to finalize the adoption Nov. 18. 

The three boys had arrived thin and sallow-skinned. 

The oldest had been a student in Tracy’s third grade class, a scrawny boy who looked like he “had a hard life,” she recalled. He was hungry all the time. One day, he came to class with his sweatshirt hood up, crying because he had been given an unflattering buzzcut. Another time, he was despondent when a winter coat he’d been given by the school ripped. 

Tracy stocked a drawer of snacks for him. She sewed his winter coat and — soon — a few of his other clothes. She trimmed his hair. When the boy and his younger brothers were removed from their biological family’s custody, Tracy and Allen went out to a bar, drank a stiff drink, and decided to foster then adopt the three boys. 

The middle brother arrived first. That night, he asked Tracy if he could have some of the cheese she had set out to make pizzas for dinner. The 5-year-old tilted the bowl to his face, eating the cheese in mouthfuls. She still has a photo of him from that night, the cheese shreds stuck on his eyelashes. 

Parenting them has been all-consuming, the Alexanders said. 

They must keep their eye on the middle brother at all times. The boy — who as a child held up a kitchen knife and threatened to kill his grandparents — will eat so fast he’ll throw up.

The youngest still has poor muscle tone from spending the first three years of his life in a bed or being held. Now 8, he will have accidents if the Alexanders don’t remind him to use the bathroom. 

Allen said their home — filled with family photos of the boys on vacation, signs celebrating family and integrity, and charts listing their chores — can feel like a “haunted house” because of the boys’ mood swings.  

“You never know when something’s going to jump out at you or (someone’s going to) throw a fit,” he said.  

In February, Larimer County made a second offer for adoption assistance. The county would reimburse up to $3,200 a year in services for the youngest; $9,600 for the middle; and $2,300 for the oldest, the Alexanders said. 

Allen re-negotiated using the new state tool. With it, the family was offered $3,878 a month for the three boys — about $35,000 more a year than previously offered. Two of the boys will each get an additional $2,000 a year for tutoring and sports.

Chapter Five: “Everyone went broke”

Families say more adoption assistance can be critical. But several counties said they had few adoptions fall apart despite the relatively low amounts they give out in monthly subsidies.  

Larimer County has the second fewest number of disrupted and dissolved adoptions among 11 metro counties, the county said, which officials there attribute in part to their investment in prevention programs.

Broomfield County did not have any adoptions dissolve between 2001 and the end of 2021, and had fewer than 12 disrupted adoptions during that time of 93 total adoptions. The county has provided among the lowest monthly subsidy rates, on average, compared to similarly sized counties in the last six years.

“Although subsidies assist in adoption stability, money is not the only thing that can ensure successful adoptions,” said Tiffany Ramos, manager of Child, Adult, and Family Services in the county’s human services department. She said the array of services provided to families before and after adoption helped.

Increasing adoption assistance rates can also raise the specter of budget shortfalls in cash-strapped counties or for the state.

Federal dollars spent on adoption assistance payments nationwide went from $400,000 in the early 1980s to $1.3 billion 20 years later. Monthly adoption subsidies increased nearly 600 percent in Colorado between 1992 and 2001, and the number of children receiving subsidies grew from just over 900 to more than 4,000 over the same period. 

By the early 2000s, cost concerns led several states to curtail adoption assistance payments. In Colorado, a 2002 state audit called on its child welfare division to “encourage use of low-cost subsidies,” and favorably drew attention to one county that placed about 95% of its adoptive children with no subsidy beyond Medicaid. 

Denver County, where human services officials aimed to give families whatever they needed to help adoptions succeed, eventually tried to reduce the amount promised in subsidies. A similar pattern played out in El Paso County, where officials had pushed to get kids out of foster care.

Connie Vigil, Denver County’s adoption supervisor until 2005, said she would look at kids and “feel like we need to give them everything that we possibly can.”  Vigil later spent several years as adoption program administrator of the state human services department and helped develop the new adoption assistance tool.

“Being a social worker rather than an accountant, it didn’t matter to me how much it cost,” she said. It “became clear that my philosophy was not conducive to balancing the budget.” 

In the early 2000s, subsidies were running $2.4 million over budget in Denver County, according to appeals from an adoptive family whose monthly subsidy was being cut in half. 

“Certainly we are not going to deny that at issue is money,” a lawyer representing Denver’s human services department said in 2003.

A 2005 letter an advocate group sent to the state human services department said families were being pressured in phone calls and “renegotiation meetings” to agree to decrease their existing subsidies. The calls were intimidating and sometimes lasted more than an hour, the letter said. In-person meetings would have five to seven county employees present. Some families were told their subsidies would be decreased to $25 a month if they couldn’t provide certain documentation. Others were told they might not be able to adopt if they didn’t agree to a decrease. 

One woman was told by Jefferson County officials that if she did not accept an adoption assistance rate of $349 per month she would not be allowed to move forward with the adoption. 

By the time the state’s Child Protection Ombudsman began looking at adoption assistance rates around 2016, about half of the state’s counties had set caps on how much adoptive families could receive.

Logan County limited adoption assistance payments to $900 a month. Grand and Jackson counties had a $250-a-month maximum, according to documents from the time.

A family adopting a special needs child in Denver might receive up to $500 a month. Across the county line in Arapahoe County, they would get up to $361. Vigil heard about siblings, then age 2 and 3, who were adopted in neighboring counties on the Eastern Plains. One received $700 a month in adoption subsidies. The other: nothing but Medicaid. 

Being a social worker rather than an accountant, it didn’t matter to me how much it cost … (it) became clear that my philosophy was not conducive to balancing the budget.

— Connie Vigil, adoption program administrator of the state human services department

Families in some counties were provided little or inaccurate information about what subsidy they could receive. Many didn’t understand how the subsidy amount was determined or why there were such wide differences among counties. 

One family in Otero County negotiated their subsidy in court, during the adoption proceeding — instead of in an in-office meeting where such things are typically discussed. The case worker helping the couple, Suzanne Ruzich and Bryon Downing, was supportive, but said there was virtually “no support” they could offer the adopted girl, who had experienced neglect and sexual abuse. The couple was paid $9.89 a day for about two months, according to county records.

In many cases, the subsidy rates were set so low that there was no negotiation. Families would qualify for the maximum amount before all their needs were considered.

Lawmakers in 2018 agreed to increase the state’s contribution to adoption assistance, in an effort to ease the strain on counties. Counties now cover 10% of the costs, down from 20%. 

Some counties have also overhauled their adoption assistance processes in recent years and take efforts to guide adoptive families to available resources.  

Counties officials have a vested interest in seeing adoptions succeed, said Roxanne Sabin, a human services program manager for Jefferson County, one of the departments that has made changes. 

“These are kids who we have seen on their absolute worst days — usually when they’re being traumatized by removal from their families,” she said. “We don’t want kids to be re-traumatized by a later disruption of their adoption.”

Chapter Six: Lack of services a problem

Families and officials say there are additional problems that will not be fixed by the new template used by both the Mesa County father and the Alexanders in Larimer County. Chief among them is a lack of health care services.

Carla Bennett and her husband, Frank, who worked in the public mental health system, adopted two children in Denver in the 1970s and 1980s. The younger boy had difficulty bonding with others and when Bennett called his subsidy worker to ask what resources were available, she remembers being struck by the response: “She didn’t know any therapists that she could refer us to.” 

“That was a real shock,” recalled Bennett, who later advocated for child welfare issues and adoption reform in Colorado. “It brought home to me that, ‘Hmm, if they’re going to be placing these children with families, it would be good to have some idea of what’s available out there in the community in terms of help for them.’” The couple received about $200 a month in subsidy payments for one boy and no subsidy for the other. 

Three decades later, Jacobs, the woman who adopted two sets of siblings, faced similar issues. Cave helped her negotiate subsidies of $600 and $400 for the first boys she adopted, and she received $600 for each of the two siblings she adopted later — rates she heard were generous for each county. But officials in neither county had “any concept of who’s out there who can actually help,” Jacobs recalled. 

On the Western Slope, her children saw a therapist who accepted Medicaid in Telluride, a 45-minute drive away, until that therapist retired. One son with reactive attachment disorder — a condition in which children struggle to form emotional bonds with their caregivers, often due to past neglect — cycled through therapists who were “no help at all.” 

Jacobs was working as a teacher. Her husband, working part-time as a school bus driver, nearly every day was driving the children to appointments and to separate visits with their biological parents, an hour and a half drive away. 

“It would definitely help if they had a list of resources for you like, ‘Oh, do you need extra food? Get the food here,’” Jacobs said. “Even if they’re out-of-county services, that’s fine.” 

She was recently looking again for a therapist after the most recent provider one daughter used decided to stop seeing the child. She found a mother-daughter therapy class that does not take Medicaid, which means the family is now paying about $140 per visit, four times a month.

“It would really be nice if I could go to the county and say, ‘Hey, we don’t have a therapist for her. We really need one. Can you help us find one?’” 

Alternatively, Jacobs would appreciate it if the county would agree to increase the child’s subsidy, in recognition of the out-of-pocket therapists costs. 

“If you think about it, to see this therapist, it’s $400 a month out of pocket. Well, her subsidy is $600 and her braces are $200 a month,” she said. “Right there, the money is gone.” 

Access to health care providers is a “huge problem, in rural areas especially,” said Stephanie Holsinger, Montrose County’s adult and child protective services program manager. The west end of the county has few services. 

If payment rates for Medicaid providers were higher, “we would be able to entice people to come to the area,” she said.

Chapter Seven: “Unjust” some families get more

For the Alexanders, the subsidy means less stress about making ends meet and maintaining a decent standard of living for the boys. 

“We hear all the time — and we hate it — Oh, you’re such saints. You’ve changed these kids’ lives. We just wanted to be parents and this was the way it happened for us,” Tracy said. “What we do is hard work and there’s not a day that goes by when we’re not battling with some form of their baggage or trauma that they came to us with.”

The family has made strides.

The couple taught the oldest how to use an escalator at age 10. He and his middle brother graduated off individualized learning plans after the Alexanders spent nights helping them with school work. If they failed a test at school, they’d retake it at home. 

The family has a Friday tradition of roasting hot dogs outside and playing yard games. Two of the children take kung fu — more than $1,000 each year per kid — to know “no one can ever hurt them again,” Tracy said. 

The couple said they would have found a way to make the adoption work, no matter what happened with the subsidies. But they wanted to fight for other families who don’t have the financial wherewithal or knowledge to ask for more. 

It’s “unjust that some families are going to get more due to (their) tenacity,” Tracy said.