Special Children, Special Needs

To understand Harry and Karen Bither, you must first meet their kids. They have five at their home in the Shasta County farm belt, but we will focus for now on Alexa and Colette.

The girls are a handful, but not in the usual way. Their spinal cords were swept off course by some cruel genetic god, leaving them with legs that don’t work. Days are spent--and forever will be spent--in wheelchairs.

The medical problems don’t end there. Alexa, age 11, is incontinent and can’t sit up straight without support. A hole in her throat helps her breathe, but sometimes things go haywire and she turns blue from lack of air. At night, she lies tethered to a ventilator, its red light glowing from a shelf near her Barbie dolls.

Freckled Colette is tiny for a child of 5. Her backbone forgot to fuse with her pelvis, and her spindly legs are oddly bent. Solid foods do crazy things to her stomach, so she’ll need a feeding tube before long. She is as charming and headstrong as any first-grader, but tires more easily than most.

Alexa and Colette are not the Bithers’ children by blood, but they are by law. The girls’ birth parents decided they could not cope with kids so needy and frail. The Bithers decided they could and adopted the girls as their own.

The Bithers--who are in their mid-50s and have raised six biological kids--look not at what the girls can’t do but at how they have beaten the odds, defying grim predictions. True, they will never sprint across the lawn to catch a Frisbee. But Colette is a budding artist whose smile brightens a room. And Alexa, a Girl Scout, caught supper on the last family camping trip--a trout 14 inches long.

In California and nationwide, a vigorous search is underway for parents like the Bithers--people willing to adopt children with special needs. As part of a national mission to recruit loving families for such youngsters, both the federal and state governments have passed laws guaranteeing them aid.

But instead of help, many adoptive parents say they often face frustration. In California especially, families confront a wildly varying set of rules, differing from county to county--and often from social worker to social worker--that leaves them bewildered, bruised and even teetering on the brink of impoverishment.

“Sometimes it just gets overwhelming,” Karen Bither said. “These kids take so much emotion and energy. Parents don’t have time to fight the system too.”

There are 100,000 special needs kids looking for families to call their own, government officials estimate--22,500 in California alone. Some are like Alexa and Colette, surrendered by parents who cannot or will not deal with their disabilities. Many were poisoned in the womb by liquor or crack cocaine. Others were locked in closets, molested, burned with cigarettes or dumped by the side of a road.

They have one thing in common: They cannot return home.

The lucky ones get a fresh start through adoption. They bring delight to their new families, but such children are rarely easy to raise.

“Our kids are a joy, but the fact is, they all come with special problems, expensive problems,” said Garry Scherbert, whose household includes five adopted children with Down syndrome.

Indeed, families who adopt special needs children face a long menu of potential extras, everything from psychotherapy to tutoring, medication, vans with wheelchair lifts, and clothes to replace those torn by kids prone to violent fits.

“Unless you’re Bill Gates,” Scherbert said, “there’s no way to swing it without help.”

In theory, the government agrees with that. But in reality, many parents spend long, frustrating hours battling for funds and services to keep their families afloat. In some counties, social workers pick apart household budgets, suggesting, for example, that a family might cut utility costs by turning down the air conditioner.

At least every two years, parents must undergo “recertification” to prove that their children remain needy--even if they suffer congenital disabilities, like Down syndrome, that never go away. If a recertification form lacks certain documentation, or arrives late, aid may stop, leaving families in crisis.

And then there are the little defeats, blows that can drain the cheer from an adoptive parent’s day. The Bithers asked the government to help pay for a growth hormone that might enable tiny Colette to catch up in size. The government’s reply came swiftly; it was no.

Officials who oversee adoption aid acknowledge that their efforts often come up short. Los Angeles County recently overhauled its program to improve service to families, and statewide, the Wilson administration has created a task force that will study the failings of the adoption assistance system and propose ways to fix it.

Advocates for families say change is long overdue. “These parents ought to be treated as saviors--as the answer to one of society’s most terrible problems,” said Gail Johnson, executive director of Sierra Adoption Services, a private agency in Sacramento. “Instead, they have to fight for every penny and endure incredible anxiety and shame.”

‘We Had Room in Our Hearts,’ Says Parent of Nine

Michael Raibley spent his infancy living in a car, surviving on potato chips and chocolate milk. Social workers found him abandoned at a homeless camp--14 months old, struggling to breathe, covered with insects and scratched from head to toe.

Steven, his brother by adoption, was born three months early to a mother who drank. He weighed just 1 1/2 pounds when he entered the world. A nurse said he had been “pickled”--steeped in amniotic fluid that smelled of gin.

The boys’ sister, Toiane, was picked up at a crack house, where her parents had gone to get high. Nearly 6 at the time, she had never lived in one place for more than 45 days. Foster families swore she was crazy, noting her tendency to eat glass and scream through the night.

Michael, Steven and Toiane are now savoring summer like kids should--riding bikes, swimming and frolicking with Molly and Streudel, the family dogs. They bear deep scars from a nightmarish start in life. But most of the time, they bear them well.

For that you can credit the children’s new parents, Dave Raibley, a pharmacist, and wife Mary, a nurse. Unable to create offspring the biological way, the Raibleys decided to adopt. They figured on two kids, but--in a pattern mirrored in many adoptive families--one thing led to another and yet another. Now they have nine children--white, black and Native American, ages 3 to 14. “We had room in our hearts,” Mary said, “and we just couldn’t resist.”

A recent morning began as most do--Dave in the kitchen, toasting bagels with one hand and distributing the kids’ medications with the other. On the counter lay the beginnings of lunch--18 slices of bread, which Dave swiped with peanut butter whenever he got the chance.

Nearby, Mary held Christina, who--in a ritual repeated four times a day--sucked medicine through an air compressor that soothes her damaged lungs. Michael, who also suffers from severe asthma, hovered nearby, next in line.

On the living room sofa, Toiane braided Ana’s hair as Jennie, the Raibleys’ eldest, outlined her plan to attend college in Oregon and become a pharmacist like her dad. At her feet sat Mark, whose cerebral palsy requires physical therapy with his mom twice a day.

As Mark struggled to pull on his shoes, hyperactive Steven hopped in circles around him, emitting a piercing squeal despite his mother’s repeated “Shhh.”

It is no small feat to raise the Raibley nine. Four were born addicted to drugs or alcohol, and nearly all were abused or neglected in their early years. Most have learning disabilities, three have attention deficit disorder and four are prone to seizures. Mark’s cognitive abilities are inexplicably going down instead of up. Because he tends to wander off, he needs close supervision around the clock.

Sara’s problems are harder to see. Sexually abused by her biological father, she was placed in foster care with the Raibleys at age 3. But a judge returned her home and she was molested again six months later--rescued only after she called police, telling them, “It’s not safe here.” Now her life resembles that of many 10-year-olds, except for the counseling that helps her deal with demons from the past.

Home base for the Raibleys is a tan A-frame in the rolling hills of Palo Cedro, 200 miles north of Sacramento. Before children, Dave and Mary owned a sports car, traveled and shopped at Nordstrom. Not any more. “We’ve done that,” Mary Raibley said one recent day. “This,” she added, gesturing with a smile at nine heads bent over lunchtime pizza, “is what matters now.”

But adopting special needs kids has left the Raibleys in financial distress. Although Dave is well paid--grossing about $77,000 per year--the Raibleys’ expenses are huge. Merely feeding a family of 11 means staggering bills; they go through two loaves of bread, four gallons of milk and 10 pounds of potatoes per day.

Utilities can run $1,300 a month. Then there are the mortgage, insurance, property taxes, preschool and a $450-a-month payment for the extra-large van. Household appliances work hard and die young. The washing machine churns out eight loads of laundry a day and conks out for good every two years.

The children’s medical needs create other costs. Dave’s insurance is adequate--and MediCal is also available for some of the children’s bills--but there are painful gaps. Every two months, the Raibleys must spend $700 to replace special shoe inserts that help Mark walk. A $3,900 bill for speech therapy also fell through the coverage cracks.

All told, the Raibleys figure that the kids add $4,055 to their monthly costs--just for the basics. Government help totals $945 a month.

To survive, the Raibleys have become clever cost reducers. They shop the sales and buy in bulk. In the winter, Dave chops wood to help heat the house. On family outings, the Raibleys do the free stuff--like flying kites. Occasionally they splurge and go out to eat, but McDonald’s is the destination and they drink water with their meals.

Living on the edge--with no savings, no buffer against an emergency--is stressful. Dave, 50, is blind in one eye and has had spells of temporary blindness in the other. What if he becomes disabled, unable to work?

Just in case, Mary, 42, has returned to school to become a nurse practitioner--a profession with higher salaries and more family-friendly hours than nursing. “We’re doing everything we can to provide financial security for our kids,” Dave said. “But right now, it’s a struggle just to pay the utility bill on time.”

Despite the money crunch, there are some things the Raibleys won’t give up.

“The social worker tells us, ‘You really don’t need to have these kids in music lessons or gymnastics,’ ” Mary said as Jennie performed a near-perfect “Moonlight Sonata” on the piano.

“But my feeling is, ‘Look, my children had such tough starts. They have overcome so much. Should I really deny them those things?’ ”

As Thousands Wait for Homes, Governments Try to Help

Denial defines the lives of most kids adrift in America’s child welfare system. Deprived of their birth parents, they tote their teddy bears from foster home to foster home as their childhood ebbs away. They have no roots, no stability and fading hopes. They have no family to call their own.

Last year, about 20,000 kids in America’s foster care system were adopted--one-fifth the number waiting for homes, government figures show. Aiming to reverse this shameful trend, both President Clinton and Gov. Pete Wilson are pushing initiatives to rescue more special needs children from limbo and find them permanent, loving homes.

Congress had the same goal in 1980 when it established the Adoption Assistance Program. Beyond brightening the lives of children, lawmakers hoped to protect big-hearted families from the sort of struggle the Raibleys now face.

Former Sen. Alan Cranston, who sponsored the enacting legislation, saw it this way: A family’s standard of living should not drop, he said, because it takes in a child with special needs. The state Legislature funds a parallel program for Californians who are not eligible for federal aid.

To qualify for help, kids must fall into one of several categories distinguishing them as “hard to place”--including those with physical or mental disabilities and those who were abused or neglected, before or after birth.

“Many of these children have experienced severe hardship and are behind socially, academically and emotionally,” said Richard Barth, a professor and adoption researcher at UC Berkeley’s School of Social Welfare. “It’s not enough to just plug them in. They need extra help.”

Many parents manage to obtain aid for their children--or at least some of what they are entitled to by law. Statewide, there are 25,600 youngsters who have been adopted and whose families are receiving help through California’s Adoption Assistance Program. They get an average of $448 a month.

Nationally, California’s rates rank in the middle--well below generous Connecticut but above miserly Alabama.

Rates, however, do not tell the whole story. Minnesota, for example, pays less in monthly assistance than California but offers parents a bounty of other help not provided here--from free child care to fully subsidized remodeling to make a home accessible to wheelchairs.

Moreover, because California has turned its system over to individual counties, the process in the state is “a real patchwork, with some counties doing a great job and others really forcing parents to struggle,” said Jeanette Wiedemeier Bower of the North American Council on Adoptable Children, which runs a resource center and hotline for families.

While some states have rate charts that govern adoption assistance awards, California’s system lacks uniformity by design, said Jim Brown, adoptions chief in the state Department of Social Services.

“Critics say our approach is not equitable,” Brown said. “But I think it would be terrible to go to a one-size-fits-all model. Because it’s like Army clothes--one size doesn’t fit all.” The state’s system allows social workers to tailor payments to individual needs, he said.

Many parents and adoption experts, however, call the current system maddening, capricious and needlessly adversarial. Among their complaints:

* Although the law declares that adoption assistance grants will be decided “by agreement” between parents and their social worker, the process in many counties is far more unilateral. The worker settles on a number and if the family doesn’t like it, the only hope is to appeal to an administrative law judge--assuming the family knows it has that right.

In the meantime, the state Department of Social Services may issue a “notice of action” declaring that all benefits are terminated.

* The amount of grants vary widely from county to county. That might make sense if the differences related to the county in which the family resides--reflecting, for example, the much higher cost of living in urban areas. Instead, support payments are the responsibility of the county from which a family adopted a child.

So a rural, cash-strapped county like Modoc or Plumas might award no funds to a crack baby with a seizure disorder and asthma, while a similar child living across the street might receive $835 a month from San Francisco County.

* Many counties require detailed receipts for the routine expenses of child-rearing--everything from sneakers to vitamins and gasoline for trips to the therapist. The requirement poses a burden that is not only laborious, but makes parents feel like welfare cheats.

“There’s this suspicion, like we can’t be trusted to spend what’s appropriate to meet our children’s needs,” said Anne Fitzpatrick, a mother of three adopted kids in east San Diego County.

* Then there is the notorious world of “recertification.” The biennial review is designed to give parents the chance to highlight changes in their children’s condition, often leading to a higher award, said Brown of the state Department of Social Services.

That’s a sound principle, but in many counties, recertification almost always means cuts in assistance, said Graham Wright, president of the California Adoption Agency Assn.

Which counties make such cuts--and how often and in what amounts--is a mystery, because the state does not track such trends.

The Raibleys adopted their children from Shasta County, and their experience typifies the problems families face. Although all but one of their kids appear to qualify for adoption assistance, only four receive it--in sums ranging from $150 to $345 a month.

The Raibleys declined aid for their two eldest, Greg and Jennie. Despite difficult beginnings, the kids are thriving, so Dave and Mary finance their care on their own.

But the youngest two, biological siblings Christina and Michael, have fragile health and came with a promise of assistance when first placed with the Raibleys as foster children, Mary said. Once their adoption was finalized, however, Shasta County changed course, declaring that the family’s income was too high for them to receive aid.

Federal law specifically forbids the use of a “means test” to disqualify families from aid, but many counties appear to employ them anyway, parents and their advocates say.

“It just doesn’t make sense,” said Mary, who has appealed the rejection. “Why do we get assistance for one child, but for others, they decide we make too much money? There is no rhyme or reason to anything they say.”

Shasta County officials declined to discuss the Raibleys’ case. Pat Stanley, the adoptions supervisor, said to do so would violate the family’s right to confidentiality--even though the Raibleys agreed to waive their rights and permit The Times access to their files.

“It wouldn’t be appropriate,” Stanley said. She added that Shasta County applies the rules “evenly and fairly” to all.

Critics would not use the words “even” and “fair” to describe the adoption assistance program. Instead, they say, it is plagued by inconsistency and unpredictability.

Because California has no statewide guidelines for assessing what a child’s special needs are worth, that determination is left to each county--and, beyond that, to each social worker evaluating a given case. Thus, subjectivity rules.

“If you get a friendly worker, things can go smoothly,” said Harven Ng, who has adopted three special needs kids--two from Los Angeles--and works as a volunteer advocate for adoptive parents in the Bay Area. “But if you get a worker who doesn’t know the law and who thinks the whole thing is a boondoggle, you have to beg and fight the whole way.”

The fighting at times gets worse as the child ages and new, often unanticipated, needs and expenses surface, experts say.

“Usually, the initial [adoption assistance] grant is not too contentious--the family wants the child, the county wants the child placed, and everything is hunky-dory,” Wright said. “But two years down the road, the picture changes. Counties are routinely cutting grants, often without any valid reason. It can be very frightening for families.”

Along With the Personal Struggles, Having to Fight the System

Judy Thompson is among the frightened. During the last recertification for her son Tyler, 6, who has Down syndrome and was adopted through Los Angeles County, Thompson’s assistance checks inexplicably stopped.

Turned out, a doctor’s report on Tyler arrived after the county’s deadline.

“It took seven months for L.A. to start sending the checks again,” said Thompson, a widow with three other adopted and seriously disabled kids who lives in Redding. “My bills didn’t stop for seven months. . . . Who can live that way?”

Thompson can’t. Fearful of future interruptions, she has put her house up for sale and plans to move to less expensive quarters.

Officials insist such glitches are not widespread. “I have heard examples of all of these problems,” said Brown, the state adoptions chief, “but I would not say that they characterize the system.”

Advocates for parents say the troubles are more routine than rare. But regardless of who is correct, the stories have consequences that echo far beyond the security of adoptive families. Some experts believe they are preventing needy children from finding permanent homes.

Among foster families--the source for 80% of the special needs adoptions in California--there is “a sense that adoption assistance is just not a stable program,” said Carole Shauffer, executive director of the Youth Law Center, a San Francisco-based group that specializes in child welfare issues.

That feeling was exacerbated in 1992, when the Legislature cut adoption assistance funding in an 11th-hour budget deal. After an outcry, the program was restored the next year, but benefits were tightened and the saga left an enduring impression among foster parents--that adoption assistance is vulnerable.

“Because they’re insecure about it, many are not taking that step from foster parent to adoptive parent,” Shauffer said. “What a terrible tragedy for kids.”

It is also bad news for taxpayers. Studies show--and experts agree--that adoption assistance is a great investment, particularly compared to the leading alternative--maintaining a child in long-term foster care.

Supporting a child in long-term foster care costs $14,000 a year; to support that same child with adoption assistance runs $5,400--a savings of $8,600. For a child adopted at age 3, that’s a savings of $129,000 by the time he or she turns 18. (After age 18, aid to the parents stops in the great majority of cases, but adults with severe disabilities may be eligible for other forms of government help.)

Beyond calculations of the payback to taxpayers are other costs of sentencing children to the transient life of foster care--costs that are harder to tally, but compelling nonetheless. Studies show that former foster children are more likely than others to become homeless. Many unadopted foster children--robbed of love, stability and maternal bonding early on--cannot feel empathy and fail to develop a conscience, researchers say. Often, they grow into adults who wind up behind bars, claiming victims along the way.

“The way I see it, you can build prisons or you can help families help these kids,” Karen Bither said. “It’s as simple as that.”

One Family’s Battles Highlight Problems, Hopes

Over the years, Garry and Nancy Scherbert have become experts in the ins and outs of the adoption assistance rules. They’ve had to.

Three times they have gone to administrative hearings, appealing grants they said were insufficient to cover their adopted children’s needs. Take J.J., for example, a Down syndrome child like all four of his siblings.

Jeremiah--J.J. for short--is 3 but functions at the level of a 1-year-old. He has no verbal skills and is fretful and sickly. He is prone to biting, and in tunnels, elevators and parking garages--or whenever his routine is upset--he panics and screams. J.J. is also a danger to himself, requiring a constantly watchful eye.

A diagnostic assessment concluded that it would cost the state $1,022 a month to house the boy in an institution. But Los Angeles County offered the Scherberts just $345 in adoption assistance. When the family balked, the county announced that their benefits for the boy would be cut off.

After researching the law, the Scherberts appealed their case. The judge ordered the county to double the grant, awarding the Scherberts $670 a month.

By contrast, the Scherberts have had no trouble with San Francisco County, where they adopted Timothy. “It’s so easy, so respectful with them, and you feel like the children’s needs really come first,” said Nancy, 45. “In L.A., they’re not family friendly at all.”

Peter Digre, Los Angeles County director of the Department of Children and Family Services, groans when he hears such complaints, because he has heard them many times before. The county has by far the largest number of adoptions in the state. A recent overhaul of the county’s adoption assistance program will better ensure that families get what they need, he vowed.

For starters, the county simplified forms and dropped its requirement that parents document expenses with receipts. And in a dramatic policy change, the county in April announced that there will be no cut in assistance when a child moves from foster care to adoption.

Previously, a child who was receiving $600 a month in foster care might have had his or her grant slashed to zero upon adoption, a quirk that made many foster parents reluctant to adopt.

“When people adopt, they make a commitment to a child for life,” Digre said. “We’re saying, ‘We’re committed to help you make it work.’ We just weren’t saying that loudly enough before.”

The Scherberts hope that Digre means what he says--and that other counties will take his words to heart. The payoff for children, they say, would be great.

“There are families out there willing to adopt even the most difficult kids,” Garry said. “But they just can’t do it alone.”

The Scherberts live in Butte County, where services for disabled children are thin but the cost of living is low. Economics forced them from the Bay Area to Oroville, where $105,000 bought four bedrooms and a big backyard for the kids.

The house is modest, but its color--egg yolk yellow--stands out. The neighbors aren’t crazy about the vibrant hue, but it was picked for a reason: If one of the Scherberts’ kids should wander off, he can say “yellow house” and few will fail to get the picture.

When you have children with Down syndrome, you think about these things. Indeed, for the Scherberts, safety is a full-time preoccupation.

The garbage pail sits atop the kitchen table beyond the reach of ever-exploring hands. At night the chairs live in the garage, locked away in case a kid gets an impulse to climb. Latches keep cupboards secure and all the doors squeak on purpose--an informal alarm system to detect would-be escapees.

“You know that expression ‘no fear?’ That’s our kids,” Garry said. “They’ll walk in front of a car or right up to a vicious dog. You’ve always got to be on alert.”

Down syndrome kids have one too many chromosomes, a condition that leads to mental retardation and a constellation of other problems. Four of the Scherbert children have defective hearts and one can’t swallow liquids, taking his milk through a feeding tube three times a day. All are prone to choking and have limited verbal skills.

Samuel, the eldest at 6, is an impish, cuddly boy known as Sam the Ham. Peter, 2, is an inquisitive sort, while Timothy, 5, is a loner who likes to flush toys down the toilet. (Last time, it took an $80 service call to clear the thing out.)

Baby Esther is a rosy-cheeked infant who giggles when Nancy helps her roll back and forth on the rug. Esther’s biological parents--horrified by their daughter’s condition--relinquished her at birth, six months ago. Nancy was delighted: “It’s a girl!” she yelled when a social worker called, inviting the Scherberts to adopt.

Esther has improved the household gender balance and revived thoughts of Bethany, an adopted daughter who died of a malformed heart. The Scherberts’ van bears license plates in memory of the girl; REMBETH, they read.

Bethany was the Scherberts’ first adopted child, the one they took in to fill the empty nest created when their two biological kids were grown. Giving her a home appealed for other reasons as well: The Scherberts oppose abortion, but don’t believe in “screaming about it on street corners,” Garry said. Adoption is their way of expressing a belief.

Garry, 46, retired from the Navy as a chief petty officer in 1989. He was at sea much of the time when his two biological kids were growing up. He’s not missing a moment of Round 2.

A jovial, bear-sized man, Garry doesn’t hesitate to drop to his knees and scrape macaroni off the kitchen floor after lunch. He savors T-ball and summer swim lessons with Sam and never runs off when there’s a diaper to change. For the Scherberts, parenting is a joint venture all the way.

In the beginning they--like many adoptive parents--felt squeamish about accepting government help. It seemed inappropriate, somehow, to take money for a child you love and have legally made your own.

But now they are well acquainted with the emotional strain--and bills--such children can create. Now they understand why adoption assistance is there.

What they don’t understand is why a bureaucracy that encourages them to adopt will not do more to help newly formed families stay intact. Somewhere in the adoption process, they say, there is a shift in the posture toward parents, from appreciation to institutional mistrust.

But do not assume that the Scherberts--or others who adopt special needs children--are ready to quit. Battling makes things harder, yes. But would they give the kids back?

Not on your life.

“These kids are the light of our lives,” Garry said. “We don’t have a single regret.”

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

Help With Special Needs of Adopted Children

The federal and state governments provide aid to adopted children who were abused or neglected or have physical, emotional or mental disabilities. In California, aid comes in two pieces--a “basic care” grant for normal child-rearing costs and a “special needs” grant for extraordinary expenses. Parents whose earnings exceed the median family income may not qualify for the basic care grant. California ranks 19th among states in the maximum basic care rate for 2-year-olds.

Far Above Average

Alaska

Connecticut

Hawaii

Maryland

New Hampshire

Texas

Vermont

*

Above Average

Kansas

Michigan

New York

West Virginia

Wyoming

*

About Average

Arizona

California (Ranked 19)

Delaware

Iowa

Maine

Montana

New Mexico

North Carolina

Oregon

Rhode Island

Tennessee

Utah

*

Below Average

Arkansas

Colorado

Florida

Illinois

Indiana

Kentucky

Massachusetts

Minnesota

Nevada

New Jersey

North Dakota

Ohio

Oklahoma

South Dakota

Virginia

Washington

Wisconsin

*

Far Below Average

Alabama

Georgia

Idaho

Louisiana

Missouri

Mississippi

Nebraska

South Carolina

****

A LOOK AT THE COUNTIES

There are 25,600 children receiving an average of $448 a month through California’s Adoption Assistance Program. Aid varies according to a county’s policies and the needs of each child as determined by social workers. In 1996, Orange was the only county in Southern California with monthly assistance awards above the statewide average.

*--*

Children Total 1996 Average Monthly (Average per Month) Expenditures Payment Los Angeles 5,589 $32,145,860 $400.30 Orange 1,004 $8,260,778 $521.49 Riverside 776 $4,172,184 $448.23 San Bernardino 494 $2,406,978 $406.45 San Diego 2,788 $15,017,989 $448.97 Ventura 420 $2,211,890 $438.43

*--*

Note: Pennsylvania has a different rate in each county, so no average is provided.

Source: North American Council on Adoptable Children