Access to records describes the inherent right of all adults to acquire and retain the vital records, including birth records, for which they are the subjects. Access to these records can be especially important, and historically denied, for individuals impacted by foster care, adoption and misattributed parentage.  Even when allowed for these individuals, practices regarding access, including how records are obtained and the ability for record amendments, are both inconsistent and inequitable.  For donor-conceived individuals, information regarding their biological origins may be retained in registries or medical facilities rather than vital records.

Why is this important?  Access to records provides persons impacted by foster care, adoption, misattributed parentage and/or donor conception with important social, genetic and medical histories. Research, knowledge and experience demonstrate that this access promotes psychological, social and biological health and can help facilitate important connections between family members separated by foster care, adoption and/or donor conception. A complete, accurate and factual representation of the record’s specified life event has important social impacts including citizenship, historical genealogy, and an individual’s recognition and identity.

What do we believe? 

• Adoption Network Cleveland (ANC) believes that all individuals should be provided the knowledge and means to identify the persons and circumstances surrounding their birth and/or adoption, including access to all original, unredacted vital records for which they are the subjects. 
• ANC supports complete and factual vital records that accurately reflect the circumstances of an individual’s genealogy, birth and, when applicable, adoption.  Subjects should have authority to request amendment/s to their records when necessary to accurately and factually reflect the specified life event.  Record amendments should be allowed in an equitable manner to all individuals, regardless of their connection to foster care, adoption, misattributed parentage and/or donor conception.
• ANC believes that adults who are not the subject of a particular vital record, even if they are listed on the record, should not have the authority to either approve or restrict the subject’s access to it. 
• ANC believes that anonymity in gamete donation results in harmful barriers for donor conceived individuals to discover their biological origins, updated health information and potential family relationships.

Action:

• ANC works within the legislative and adoption communities to secure unqualified and equitable access to records for adult adoptees, for adoptive parents while the adoptee is a minor, and birthparents of adoptees who are now adults. 
• ANC advocates for adult donor-conceived people to access identifying information regarding the gamete donation/s involved in their conception.
• ANC provides ongoing support and assistance for adults searching for family members separated by foster care, adoption and/or donor conception. 
• ANC plans and conducts community-based group meetings to offer social support and guidance on an as-needed basis to those considering or actively engaged in the search process. 
• ANC develops programs and marketing communications to educate the general public and adoption professionals on the merits of adoption searches and works directly with legislators to reduce or remove barriers to simplify the search process.

Revised 01/23/2025; Ratified by Board of Trustees on 02/27/2025

What is Openness in Adoption? Openness in adoption describes the opportunity for members of the adoption triad, the adoptive family, the adopted child, and the birth family to have contact after adoption. Openness in adoption can include a range of options in the amount of information exchanged and the degree of contact between triad members depending on the wishes and agreement of the parties involved. Fully open adoptions provide each member of the triad with the full name and contact information of the other triad members. Openness in adoption can be the result of a pre-adoption agreement, an understanding reached after adoption or arises organically by the circumstances surrounding the adoption.

Why is this Important? The voluntary exchange of information among the triad after adoption benefits all members of the triad. It allows birth parents, siblings and extended family to stay informed about the child’s well-being and growth, adoptees to have access to medical, genetic, and ancestral information and adoptive parents to provide their children a connection to an important part of their identity. Moreover, openness in adoption can help to ensure the long-term stability of the adoption process among each member of the triad. The opportunity for older youth adopted from foster care to maintain contact with their birth parents, siblings and extended family can allow for permanency while allowing youth to remain connected with their roots.

What Do We Believe? Adoption Network Cleveland (ANC) believes fully open adoptions are the preferred arrangement unless there are circumstances, like safety issues, that preclude it. ANC also believes that triad members should have the opportunity to create agreements that fit their individual situations.

Action: Through legislation, educational programming, and providing educational and advisory support to adoption agencies, families, and adoption professionals, ANC advocates for a range of openness options including changing Ohio law to allow for enforceable post-adoption agreements. Currently, under Ohio law post adoption contact agreements can be created but are not enforceable. In addition, ANC will educate adoption agencies, lawyers, and social workers in the field about the benefits of open adoption and encourage adoption practice to continue evolving toward openness.

Ratified by the Board of Directors on 4/21/2016

Triad members (adoptive parents, adoptees and birthparents) should be provided the knowledge and means to identify the persons and circumstances surrounding an adoptee's birth. ANC supports individuals seeking out family records and other triad members by conducting programs on how to perform an adoption search. ANC also plans and conducts community-based group meetings to offer social support and guidance on an "as needed basis" to those considering or actively engaged in the adoptive search process. ANC develops programs and marketing communications to educate the general public and adoption professionals on the merits of adoption searches and works directly with legislators to reduce or remove barriers to simplify the search process.

Revised 04/16/2002; Ratified by Board of Trustees on 5/9/2002

Definition: Adoption Subsidies are financial assistance programs for adoptive parents who adopt children meeting the federal definition of special needs. Ohio has four adoption subsidy programs. Two programs, Title IV-E Adoption Assistance and State Adoption Maintenance Subsidy, are restricted to children in the custody of a public or private agency at the time of the adoption. The other two programs, Nonrecurring Adoption Expenses and Post Adoption Special Service Subsidy, may also cover children who were not in the custody of a public or private agency at the time of the adoption.

Why are subsidies important? Adoption subsidies are critical to the adoption of children who are legally available for adoption in the public child welfare system. Subsidies enhance the opportunities for adoption for children by expanding the pool of prospective parents to those of all incomes. Subsidies also ensure that resources will be available to meet the ongoing needs of these children.

What do we believe? As a result, adoption subsidies increase the chances for a child to be adopted, provide resources for the child to receive needed services and decrease the possible financial apprehensions of the adoptive parents. It has also been documented that adoption subsidies are more cost effective for agencies than supporting a child in long-term foster care.

Action: Adoption Network Cleveland advocates for adoption subsidies on all governmental levels, educates prospective adoptive parents about subsidies, and creates avenues for our members to advocate and promote for the continued availability and quality of adoption subsidies.

Ratified by Board of Trustees on 3/10/2005

Definition: Child-centered recruitment emphasizes the importance of current and past relationships in a waiting child's life to identify people with whom the child can form life-long, permanent and meaningful relationships

Why is Child Centered Recruitment important? Child-centered recruitment is the best way to increase the opportunity for successful permanency within a family for those children and youth who have been waiting the longest for adoption.

What do we believe? Every child deserves a permanent family. Working toward adoption is the highest priority. Every effort should be made to keep siblings together, identify relatives first and keep children in their own communities.

Action: Through its Adopt Cuyahoga's Kids program, Adoption Network Cleveland promotes child-centered recruitment in working with children waiting for permanency.

Ratified by Board of Trustees on 3/10/2005

Definition: Children and youth who are either legally free for adoption or are in a long-term foster care situation with no permanent plan involving placement by age 18 with a specific family.

Why is this important? There are children and youth who are in the foster care system, unable to be reunited with their birth parents, and who have no identified 'second' family. They are typically in a legal status of either "permanent custody" (i.e., free for adoption) or "planned permanent living arrangement" (i.e., long term foster care.) Many of these children age out of the system every year without a permanent family, and the outcomes for such youth are very poor.

What do we believe? Regardless of age, adoption is the best option for children and youth who have no other permanent family. Long term foster care ("planned permanent living arrangement" under Ohio law) is not a positive option for those who are not returning home to their birth families. Independent Living services, while absolutely critical to older foster youth, do not represent a "permanent plan" for children or youth.

Action: Adoption Network Cleveland advocates on behalf of waiting children and youth, educates the community about their situation, positive qualities and needs, advocates for laws that support permanency within a family for all waiting children and youth and for those laws that remove barriers for such permanency to occur.

Ratified by the Board of Trustees on 3/10/2005

Adoption Network Cleveland believes that every child deserves a safe, nurturing, and permanent family.

Adoption Network Cleveland supports the belief that the permanency needs of Ohio's children are best met through effective recruitment, assessment, selection, and support of adoptive parents.

Adoption Network Cleveland supports the belief that no person should be excluded from adopting or fostering a child solely because of race, color, creed, age, marital status, gender identity or expression, or sexual orientation.

Adoption Network Cleveland is working to remove barriers to adoption through legislative advocacy, systemic change, and strategic program development.

Ratified by the Board of Trustees on 9/29/2005, revised 2/25/2021.

Policy: Adoption Network Cleveland’s sibling policy is to support and promote healthy, bonded sibling relationships for children in out-of-home care and in adoptive homes. Adoption Network Cleveland believes every effort should be made to place siblings together unless living with siblings is not in the child’s best interest, to reunite siblings who have been separated, and to facilitate visitation between siblings both in foster care and adoptive homes.

We also believe that every child has the right to remain with members of his or her sibling family unit.
Siblings are children and youth who have at least one biological parent in common, or who have been adopted by the same parent. Siblings can have connections through blood or adoption.

Why is this important? There are children in the foster care system or who are adopted who currently do not live with their siblings, and do not have frequent contact and face to face visits with siblings. Children in foster care or who have been adopted might not be aware when younger siblings enter the foster care system, or have been adopted. The National Study of Child and Adolescent Well Being (2007) states that sibling and visitation placement results in a significantly lower level of internalized problems (e.g. depression, self-blame, anger and aggression). The Hegar and Rosenthal study (2009) states that siblings are significantly more likely than others to feel emotionally supported, to feel close to a primary caregiver, and to like living with the people in the home than siblings who have been separated. Premature disruption of foster home placement (an indicator of serious problems with placement adaptation) has been found to occur less often among children placed with siblings than among siblings who have been separated (Leather, 2005).

What do we believe? Every child deserves the opportunity to know and be connected to his or her siblings throughout their childhood. Adult siblings deserve full access to information about one another.

Every child has the right to be placed with his or her siblings.

If living with siblings is not in the child’s best interest, that child has the right to visit and have frequent contact with his or her siblings.

Action: Adoption Network Cleveland advocates on behalf of children and youth touched by foster care and adoption to protect their rights to know and be connected to their siblings. In instances where this has not taken place, we advocate for full information disclosure to adult siblings about one another.

For more information see:
• National Survey of Child and Adolescent Well-Being (NSCAW) Research Brief No. 16: Summary of Findings (2007)
• Hegar, R. L. & Rosenthal, J. A. (2009) Kinship care and sibling placement: Child behavior, family relationships, and school outcomes. Child and Youth Services Review 31 (2009) 670-679
• Leather, S. J. (2005) Separation from siblings: Associations with placement adaption and outcomes among adolescents in long-term foster care. Children and Youth Services Review 27 (2005) 793-819

Ratified by the Board of Directors on 5/26/2011

All children in foster care deserve appropriate medical care that, where necessary, includes a comprehensive, individualized mental health treatment plan. Such plans should consider a variety of appropriate treatments beyond just medicating children, and no child deserves to be over-medicated on psychotropic drugs.

Why is this important?

Mental and behavioral health is the largest unmet health need for children and teens in foster care, and is impacted by trauma experiences, ongoing separation, losses and caregiver transitions.  Challenges with consent, health insurance barriers, fragmented healthcare and lack of appropriately experienced and trained pediatric mental health care providers compound this problem.

As a result, children in foster care often end up accumulating mental health diagnoses and experiencing overmedication with psychotropic drugs and, in many instances, multiple psychotropic drugs.  Children in foster care are more likely than other children with Medicaid to receive psychotropic medication without accompanying psychotherapy or behavioral interventions.  Taking too much or too many medications carries serious risks for children’s physical and psychological health.

The Tufts Multi-State Study on Psychotropic Medication Oversight in Foster Care (2010) found an increasing trend in the use of antipsychotics, antidepressants, and ADHD medications among youth in foster care; the use of multiple such medications at the same time; the use of these medications among particularly young children; and an increasing reliance on blanket authorizations to administer medications as needed. In some instances, the use of these medications is not consistent with currently accepted medical practice, has not been FDA-approved, and the benefits and risks to the child have not been documented.

What do we believe? Every child deserves appropriate mental health care.

Action:

• Adoption Network Cleveland (ANC) advocates for a comprehensive oversight system that screens for mental and behavioral health issues using a standardized evaluation within a reasonable period of time following a child’s entry into foster care. 
• ANC advocates for a holistic and coordinated approach to the use of psychotropic or mood-altering medications in children and youth impacted by foster care or adoption.
• ANC advocates for the development of medication guidelines within the foster care system that describe acceptable practices for prescribing psychotropic medications.  These guidelines should include:
  • An evaluation by a pediatric mental health professional when possible, or other appropriate health practitioner including primary care provider, prior to the start of psychotropic medications
  • Mental health diagnoses that are supported by the child’s history and symptoms
  • Mental health treatment plans that include evidence-based psychosocial interventions such as therapy, education and support for the child and their caregiver/s
  • Consideration of psychotropic medication use only if non-pharmacologic treatments are under-effective and started at the lowest effective dose
  • Frequent monitoring for psychotropic medication efficacy, side effects and need for continued use
  • When appropriate, involvement of biological parents and siblings and/or the child in mental healthcare decision-making processes 
  • Mental healthcare oversight should involve a collaboration among professionals in child welfare, Medicaid, mental healthcare and the children’s family/caregiving units including foster or kinship parent/s when applicable

For more information see:

• American Academy of Child and Adolescent Psychiatry (AACAP), Recommendations about the Use of Psychotropic Medications for Children and Adolescents Involved in Child-Serving Systems (2015)
• American Academy of Pediatrics (AAP), Mental and Behavioral Health Needs of Children in Foster Care (2021)
• Bellonici, M.D., Christopher, Prescription Psychotropic Drug Use Among Children in Foster Care, Hearing before the Subcommittee on Income Security and Family Support of the House Committee on Ways and Means, 110th Congress (May 8, 2008)
• Multi-State Study on Psychotropic Medication Oversight in Foster Care, Tufts Clinical and Translational Science Institute (2010)
• Psychotropic Medication Utilization Parameters for Foster Children, Texas Department of Family and Protective Services and The University of Texas at Austin College of Pharmacy (Dec. 2010)
• Psychotropic Meds for Georgia Youth in Foster Care: Who Decides?, Georgia Supreme Court Committee on Justice for children (Jan. 5, 2011)
• Steele, Julie s. and Buchi, Karen F., Medical and Mental Health of Children Entering the Utah Foster Care System, Pediatrics, Vol. 122, No. 3, e703 (September 2008)

Revised 02/03/2025; Ratified by Board of Trustees on 02/27/2025

Policy: Adoption Network Cleveland’s policy regarding normalizing the foster care experience is that youth in foster care should have the opportunity to participate in normal age-appropriate activities that do not take place under the roof of their caregivers (including, for example, birthday party sleepovers or prom), and therefore require the permission of the public children services agency, private child placement agency, or private noncustodial agency that serve as their custodians or supervisors of their foster parent(s). At this time the process and requirements for approval vary by county, and in some instances are so lengthy that permission only comes after the activity has already happened. Adoption Network Cleveland believes that every effort should be made to revise those processes and requirements to ensure that permission is granted before the activity occurs.

We also believe that codifying limitations of liability for the agencies and foster parents approving these normal age-appropriate activities will allow agencies and foster parents to make better, more timely decisions regarding these activities.

Why this is important: Being in foster care can be a stigmatizing experience for youth. This stigma increases when children are unable to participate in normal age-appropriate activities either because they cannot obtain permission from all of the necessary parties or because the approval process takes too long and the permission comes too late.

What we believe: We believe that youth in foster care deserve the opportunity to participate in normal age-appropriate activities such as sleepovers and school dances.

Action: The Foster Care Advisory Group convened by the Ohio Attorney General has identified fear of liability as a major barrier to public children services agencies, private child placement agencies, and private noncustodial agencies allowing youth in foster care to experience normal activities. While Adoption Network Cleveland recognizes the need to keep youth in foster care safe, it advocates for a statewide, codified limitation of agency liability for normal age-appropriate activities in order to remove this barrier. Once this codification of agency liability is in place, agencies throughout the state should review their policies to determine which are truly essential for the safety of youth in foster care, and eliminate those which are not essential. These agencies should also seek to streamline and shorten their approval processes for youth seeking to participate in these activities so that permission is granted before the activity occurs.

For more information see:
• http://www.ohiochannel.org/medialibrary/Media.aspx?fileId=137558 at 33:40 to 37:15
• http://www.ohioattorneygeneral.gov/OhioAttorneyGeneral/files/40/4062f373-0495-4b8d-a5e4-45d3767e801c.pdf at 11:00

Ratified by the Board of Directors on 6/4/2014.

Adoption Network Cleveland is committed to providing and promoting post-adoption support for adoptive families. In the wake of a Reuter’s expose that brought visibility to adoption disruptions, specifically “rehoming,” we want to reinforce our commitment to post-adoption support and education. Adoption can be challenging and stressful and it’s imperative that we arm adoptive parents with resources and life-long strategies for success that will actively prevent disruption. In the event disruption occurs, Adoption Network Cleveland advocates for the timely involvement of child welfare professionals, and the enforcement of existing laws surrounding rehoming.

Definition: Adoption is meant to be permanent. Disruption is the term given to the end of an adoptive relationship. Although rare and an unfortunate circumstance, many disruptions are handled through the appropriate child welfare officials. Rehoming is the term used for adoptive parents who permanently place their adopted child in another home without involvement of child welfare agencies, often through the use of internet forums.

Why important? Adoption disruptions are filled with grief and loss for all parties involved but when necessary and handled through the appropriate channels can be in the best interest of everyone involved. However, as a recent Reuters exposé brought to light, sending children to a home without investigation and oversight by child welfare officials can expose children to abuse and exploitation. In addition to the possibility for abuse, these informal transfers of custody do not allow child welfare systems to continue to search for permanency for these youth. This phenomenon is a particularly egregious symptom of the lack of supports parents face after adoption, especially when the adoptee is from a foreign country.

What do we believe? Adoption disruptions can be prevented with appropriate supports for the family and children. There should be more post-adoption emotional and financial support for adoptive families, and temporary placement options that protect the safety of the adopted children and all members of the adoptive family. When disruptions do occur, involving child welfare professionals in all placements is preferable to sending a child to live with an unscreened family. The child welfare system uses official background checks, professionals trained in child development, and ongoing monitoring to ensure safety and promote permanency for children.

Action: Adoption Network Cleveland encourages state and local officials to implement supports for adoptive families to ensure the safety of children and families and encourage permanency, enforce current laws which prohibit the abuse and neglect of children against parents who rehome their children, and educate law enforcement to identify and prevent rehoming. Adoption Network Cleveland will continue to provide and promote post-adoption supports for adoption families.

For more information see:
• Twohey, Megan, The Child Exchange: Inside America’s underground market for adopted children, http://www.reuters.com/investigates/adoption/
• Coalition of Oregon Adoption Agencies, Disruption Statement, https://sites.google.com/site/coaaonline/position-statement
Ratified by the Board of Directors on 10/2/2014.

What is Fertility Fraud? Fertility fraud occurs when a patient seeks assistance from a physician to perform an assisted reproductive technology procedure. The patient consents to the procedure, however the patient consents based on false or fraudulent information given by the physician. The physician knowingly uses or implants reproductive material for purposes other than those to which the patient has consented. In a typical case of fertility fraud, a physician represents to the patient that they are using reproductive material from a sperm bank, an anonymous donor, or the patient’s spouse, but instead substitutes their own reproductive material without the patient’s consent. Fertility fraud has become more visible due to the increased use of direct-to-consumer DNA testing.

Why is the Issue of Fertility Fraud Important? When the physician makes false representations to a patient, the physician is violating the moral, ethical, and legal duties to the patient. The fraudulent behavior perpetrated by the physician not only affects the patient, but also the children conceived from the physician’s insemination. Adoption Network Cleveland (ANC) believes that all people should have access to social, genetic, and medical histories whether adopted or conceived through assisted reproductive technology. In instances of fertility fraud, impacted families believe that they have this information and may make decisions based on erroneous information. Inaccurate information may have consequences for medical decisions. Further, once fertility fraud is discovered, cases are often settled out of court and include gag orders. These orders prevent families from discovering other half-siblings and from investigating further medical/genetic issues. 

What Do We Believe? ANC believes Fertility Fraud is unethical and should be illegal, physicians should be held accountable for their actions, and those affected should be able to seek remedies against those physicians. Part of the remedy should include consequences for the physician. Victims of fertility fraud should never be prevented from putting their DNA profile on personal genomics sites and should not be prevented from finding half-siblings. Out-of-court settlements should be prohibited from containing provisions that would remove this information or access. The victims deserve truth, honesty and offspring should have access to their genetic identity.

Action: At this time California, Indiana, Texas, Colorado, and Florida have enacted legislation imposing civil and criminal penalties against physicians who have committed fertility fraud. Unlike those states, there is currently no law in Ohio holding physicians accountable for their actions or preventing physicians from committing fertility fraud. Through education and support, ANC brings awareness to the issue of fertility fraud, provides assistance for those impacted, and advocates for Ohio law to create laws to deter and address fertility fraud.