Chicago Tribune - January 6, 2002
Bonnie Miller Rubin, Tribune staff reporter

After the infant drains the bag of milk, Flores disconnects the tube and tenderly swabs around the opening in the child's stomach before twisting a "cap" back into place.

This feeding regimen is not something Flores was forced to learn, but something she has sought out. Flores is serving as foster mother to the little girl, who was born addicted to heroin a year ago.

In another time, such babies would not have survived. Today, medical technology and know-how have increased their odds dramatically. Doctors can perform heroic feats with infants born prematurely--the major risk factor of prenatal drug exposure--saving 95 percent of infants born as early as 26 weeks and weighing a pound and a half.

They can mend gaping holes in hearts, unknot twisted bowels and stave off HIV with medications unheard of just five years ago. But science can only do so much. The other--and frequently most difficult--half of the equation is how to nurture babies who not only require intensive medical care but also are born into home lives so chaotic they wind up in state custody.

`They're like gold'

With such babies living longer and the number of foster homes shrinking, child welfare agencies are desperate for more people like Flores, who has provided the baby with the only home she has ever known.

"Finding qualified foster parents is the biggest challenge we face," said Elizabeth Monk, an administrator for the Illinois Department of Children and Family Services. "It's definitely not for everybody, but when you find a parent who has the talent, skill, love and temperament ... well, they're like gold."

Of the 28,000 children in state custody, approximately 10 percent are designated "medically fragile," Monk estimates. All require special care.

Before arriving in Flores' cheerful Humboldt Park living room, the girl lived at Children's Memorial Hospital. She was tethered to a ventilator that pushed oxygen in and out of her tiny lungs, a complication from ingesting solid wastes in utero. A tracheostomy was inserted to protect her airway, and a tube still delivers nourishment directly to her stomach.

Foster parents to such children must be willing to administer medications, learn medical procedures and maintain a never-ending calendar of doctor's appointments.

As kids age, the list of needs grows longer: widened doorways, wheelchair ramps. Learning and social problems--on top of the usual adolescent issues--are a given.

"It's really more like a calling," Monk said.

Sometimes, the needs are extraordinary, even by DCFS standards. Currently, a 15-month-old boy in Chicago awaits a rare liver transplant at Children's Hospital in Pittsburgh. The foster parent must relocate while the child goes through surgery and recovery. Without the right situation, he may be ineligible for the life-saving procedure.

The increased need for foster parents comes at a time when the number of foster homes in the U.S. has declined by about 20 percent, according to the National Foster Parent Association. One of the unintended consequences of a national push from substitute care to permanent placement that began in 1997 is that it has compressed the pool of available homes.

"There are only so many apples in the basket," said Donald Morey, an administrator with Illinois Mentor Network, a Schaumburg-based social service agency that specializes in the placement of children with medical problems. "Once someone adopts one or two kids, they're done."

Flores, a 30-year-old nurse, has not only endured but embraced the responsibilities of foster motherhood.

After caring for the addicted baby at the hospital's neonatal unit since her birth in January, Flores was so impressed by her tenacity that she was determined to take her home.

"She was such a little fighter. ... I thought together we could really accomplish something. We could make up for lost time," said Flores.

After the baby defied the odds in the intensive-care unit, Flores wasn't going to let her go to just anyone. "I saw some of the foster parents that would come by and, frankly, I didn't think anyone was worthy of her."

With the blessing of her husband Joaquin, a locksmith, and 4-year-old son Joaquin Rey, she started the two-month process of becoming a licensed foster parent through the Illinois Mentor Network.

A tough sell

More often, attracting and retaining foster parents depends on word of mouth and church fairs, said Renee Haas of the Illinois Mentor Network. Foster parents to medically fragile children get a larger payment that those who have healthy fosterkids--$1,100 a month, compared with $357--but even so, it's a tough sell.

"No one does this for the money," said Haas, intake coordinator for the network's medically fragile program.

No matter how desperate the need, she asks tough questions when screening new prospects. Are there siblings? Two parents? A support network? "Burnout," she says, "is a big problem." Is there one parent who doesn't work outside the home? These babies are often too sick to go to day care.

At night, nurses can give foster parents a reprieve for children who require 24-hour care--but even that can be a headache. "Not everyone is comfortable having strangers in their home," said Haas.

Ultimately, however, the size of the home is less important than the size of the heart. When these kids get people who focus on them, the turnaround can be amazing, Monk said.

As proof, one need look no further than the Flores living room.

"Come on, honey. You can do it, you can get up," Flores coaxes as the girl struggles mightily to get on her hands and knees and then rocks rhythmically. She flashes her foster mother a megawatt smile. "Oooh ... did you see how close we're getting? She'll be crawling in no time."

Hopes of adoption

It is that slender wisp of potential that has Flores ferrying the child six times a week to the occupational therapist, nutritionist, physical therapist and pediatrician.

"But the first time she rolled over, it didn't happen with a therapist, it happened here, while she was playing with Joaquin Rey," Flores said. "You are who you hang with--and as long as she's hanging with us, she's going to be OK."

The Flores family would like to adopt the girl--they've even started her college fund--but they also know that there's a chance she could be reunited with her birth family. Once a week, Flores must hand the baby over to her birth mother for a visit.

"It's hard for me to look at her," Flores said, "because I know what she did to her child."

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