The Overlooked Challenges of Kinship Care and How States Can Respond

Blog

Published: September 9, 2025

Authors:

September marks Kinship Care Month, a time to honor relatives and family friends who step forward when children cannot safely remain with their parents. Kinship caregivers provide more than a home; they can offer stability, familiarity, and cultural continuity during a time of crisis. Research from Casey Family Programs shows that kinship care leads to greater placement stability, lower rates of abuse, better behavioral health, and a higher likelihood of permanency compared to those in non-kin foster care.

However, kinship caregivers often face significant and largely overlooked challenges. There can be the assumption that caring for a relative or fictive kin is easier than fostering a child with no prior relationship, but the reality is far more complex. These caregivers frequently step in with little notice, limited financial support, and minimal access to critical services. They will also be managing the complexity of emotions and relationships with the child’s caregiver of origin.

With the child’s best interest at the center, the stakes are high for everyone involved to get it right. This extends beyond the caregiver(s) and the child to others with responsibility for the child’s well-being, including healthcare providers, educators, local communities, and the state itself.

This Kinship Care Month, we explore the hidden struggles caregivers face and outline practical strategies states can adopt to strengthen kinship care to help meet the needs of children with complex challenges.

The Hidden Challenges Kinship Caregivers Face

When kinship caregivers step up to care for a child, the path is rarely smooth. Their struggles may go unnoticed because assumptions about family bonds obscure the need for structured support.

Financial Hardship

Many kinship caregivers are grandparents or older relatives on fixed incomes. Navigating eligibility for benefits often requires following lengthy and confusing processes at a time when individuals are already overwhelmed adjusting to their new caregiving role.

A kinship caregiver’s eligibility for such benefits can depend on whether their arrangement is formal or informal. Formal kinship care typically involves the child being in legal custody of the state, which then places the child with a kin caregiver. When a child protective agency is involved, it may be easier for the caregiver to access subsidies and financial support. On the other hand, informal kinship care may not involve the state or a court, and the caregiver of origin maintains legal custody of the child. This may make it more difficult for informal kinship caregivers to access financial and other supports offered through the child welfare system.

Limited Legal Authority

Informal kinship caregivers who do not have legal custody of the child may face barriers to enrolling them in school, authorizing medical care, or accessing necessary services. While most states have power of attorney laws^[1] that allow parents to give kin caregivers some temporary decision-making power regarding the child, these options may not be used if parents are unwilling, unable, or unaware of how to utilize them.

Navigating Multiple Systems

Kinship caregivers may interact with multiple systems such as child welfare, Medicaid, school systems, and the courts, yet these systems rarely communicate effectively. Without proper support, caregivers are left to piece together information, track down resources, and advocate for the child in their care without a roadmap.

Supporting Children with Complex Needs

Many children in kinship care have experienced trauma, disrupted attachments, or special health needs. Kinship caregivers often lack training in trauma-informed care or resources for mental health services, which could leave them to manage behaviors and crises with limited guidance.

Emotional and Relational Strain

Kinship placements can strain family relationships. Grandparents or other kin caregivers may feel caught between caring for a child and navigating relationships with the child’s parents. Guilt, grief, and burnout are common but rarely addressed.

How States Can Strengthen Kinship Care and Support Caregivers

Kinship care is a best practice in child welfare, but realizing its full potential requires more than encouraging relatives to step in. It requires intentional system design, integrated support, and equity for caregivers.

Here are four strategies states can adopt now:

Close the Financial Disparity Gap

Financial disparity between kinship caregivers and licensed foster parents is one of the biggest barriers to placement stability. According to the PEW Research Center, children whose primary caregiver is a grandparent are nearly twice as likely to be living below the poverty line.

What States Can Do:

Ensure kinship caregivers receive the same subsidies and reimbursements as non-relative foster parents: A 2023 Administration for Children and Families (ACF) rule allows state child welfare agencies to adopt separate licensing or approval standards for relative kinship foster family homes. States that take advantage of this new option can pay kin caregivers the same amount that would have been paid if the child was placed in a regulated non-related/non-kinship foster family home. Since August 2025, at least 12 states^[2] have received federal approval under this new pathway, and additional states have taken steps to increase parity between non-relative foster parents and kin caregivers.
Streamline Benefit Access: Create a single, “one-stop shop” online and through the phone for kinship caregivers to apply for benefits for which they might be eligible, such as TANF, childcare subsidies, and Medicaid.

Make It Easier for Relatives to Say “Yes”

Cumbersome approval processes and administrative hurdles can discourage relatives from stepping forward, even when they are willing and able to provide care. These barriers also delay access to financial and other resources that help stabilize placements.

Best Practices for States:

Build on Simplified Pathways: Many states already offer streamlined approval for kin; expanding these pathways and ensuring consistency across jurisdictions can make it easier for relatives to step in quickly.
Strengthen Pre-Approval Support: Provide immediate financial assistance and supportive services to kin caregivers while they complete any remaining steps in the approval process.
Leverage Technology: Use digital tools for background checks, training, and document submission to further reduce delays and paperwork burdens.

Build Integrated Support Systems

Kinship caregivers shouldn’t have to navigate multiple agencies on their own. Coordinated systems can make support accessible and improve placement stability.

What States Can Do:

Support Kinship Navigation Programs: Offer one-stop services, virtual or in-person, where caregivers can access legal aid, mental health resources, and benefits navigation.
Partner Across Systems: Foster collaboration between child welfare, health, and education agencies to share data and align services.
Invest in Caregiver Training and Peer Support: Provide on-demand, trauma-informed care training and facilitate peer support groups for emotional and practical guidance.

Prioritize Mental Health for Caregivers

Many kinship caregivers find themselves unprepared to take on the seemingly endless responsibilities of full-time caregiving. Often, caregivers prioritize the needs of their family at the expense of themselves, which can lead to emotional exhaustion and burnout. By providing accessible mental health services, states can help increase the resilience and mental health of kinship caregivers.

What States Can Do:

Expand Telehealth Access: Ensure kin caregivers in rural and underserved areas have access to virtual counseling and psychiatric care.
Integrate Care Coordination: Embed mental health services into kinship support programs.
Fund Respite Care: Offer short-term and therapeutic respite options to reduce caregiver burden and prevent placement disruptions.

A Call to Action

Kinship care is not a fallback option; it’s a best practice that keeps children connected to family, culture, and community. Despite the benefits for children and families, adequate support for kinship caregivers is not always prioritized.

States have the unique opportunity to change this reality. By closing financial gaps, streamlining licensing, integrating systems, and addressing behavioral health needs, states can strengthen kinship care as a cornerstone of child welfare.

This Kinship Care Month, let’s commit to moving beyond recognition and toward effective solutions that honor the caregivers who keep families together, and the children who deserve stability and love.

[1]Alabama , Alaska, Arizona, Arkansas, Colorado, the District of Columbia, Georgia, Hawaii, Idaho, Kentucky, Maine, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Tennessee, Utah, and Washington from: Grandfamilies.org

[2] Colorado, Kansas, Kentucky, Louisiana, Michigan, Nebraska, Nevada, North Dakota, Oregon, South Dakota, Tennessee, and Washington; from: ACF.gov

Contact our Experts

Expertise: Child and Family Well-being, Medicaid Long-Term Services and Supports
Markets: Medicaid Managed Care Plans, State, County and Other Governmental Agencies

Katie Renner Olse

Katie Renner Olse’s impactful leadership in child and family well-being for both the public and private sector has left an indelible mark on communities across the country. Before joining Sellers Dorsey, Katie served as the CEO of the Texas Alliance of Child and Family Services (TACFS) where she supported the work of community organizations serving children and families in the child welfare system. There, she spearheaded critical initiatives and championed system reform efforts including oversight of the nation’s largest state network of child, youth, and family-serving provider organizations. Under her leadership, she launched the Texas Center of Child and Family Studies (TCCFS), which has become a model for supporting private child and youth-serving providers in other states and has grown to support hundreds of providers within the mental health, juvenile justice, and child welfare arena.

Katie also served as the President of the National Organization of State Associations for Children (NOSAC) where she worked with top leaders in state child welfare, juvenile justice, and mental health associations. Prior to her experience at NOSAC, Katie served as Deputy Commissioner for the Texas Department of Family and Protective Services (DFPS), a state-based agency with over 12,000 employees responsible for protecting Texas children from abuse, neglect, and exploitation. DFPS operates five major programs including Child and Adult Protective Services, Child Protective Investigations, Prevention and Early Intervention, and Statewide Intake.

Additionally, Katie was the Chief of Staff for the Texas Health and Human Services Commission (THHSC), an agency within the Texas Health and Human Services System that has hundreds of programs helping more than 7.5 million Texans each month live healthier lives. THHSC provides a wide range of services to Texans including assistance with aging, finances, food, mental health, substance use, and more. Before her tenure at THHSC, Katie was the Senior Policy Advisor to the Executive Commissioner for DFPS, and the former Department of Assistive and Rehabilitative Services.

Current Responsibility

Katie serves as Senior Director within the Firm’s National Consulting Practice. Katie utilizes her leadership experience across the full continuum of child and family well-being to offer innovative solutions to clients and increase impact on children and families nationwide. Her expertise resides at the intersection of child welfare and healthcare as she provides a wide range of insights to support clients including drivers of child protection involvement, community-based services and approaches to serving families, key state and federal child and family well-being initiatives, implementation of complex, cross-system initiatives, and more. She has a strong track record of forging, maintaining, and strengthening relationships with critical child welfare stakeholders including legislatures, providers, state associations, advocates, and public sector professionals. Her critical connections in this space help open doors for clients and support them in fulfilling their unique missions.

Education

- Indiana University Bloomington

Brittany Dawn McAllister

Brittany is an accomplished health and human services policy and government affairs professional with extensive experience advancing Medicaid and other health and human services public policy initiatives.

Before joining Sellers Dorsey, Brittany served as Senior Government Affairs Manager for The National Service Office for Nurse-Family Partnership and Child First. There, she helped states create continuums of care-- from prevention to positive permanency—to support families in or at risk of involvement with the child welfare system.

Brittany has experience designing Medicaid reimbursement structures to support clinicians delivering home visiting, nutrition, and nursing services. She possesses expertise in developing coalitions and partnerships to promote systems change across early childhood services, maternal and child health, child welfare, and more.

She has worked in most states across the country, bringing a national perspective to her work and a deep understanding of the diverse policy landscapes that shape health and human services. Brittany has also led federal and state Legislative and Regulatory Affairs for the American Nutrition Association, worked in state policy at The American Association of Nurse Practitioners, and conducted Medicaid policy research at The George Washington University.

Brittany is passionate about promoting family stability and healthy child development. She has lived experience in kinship care and adoption and as a Medicaid recipient.

At Sellers Dorsey, Brittany helps child and family wellbeing clients navigate challenges and opportunities related to public funding and partnerships. She translates policy changes and funding mechanisms into actionable strategies that drive sustainable impact.