Monthly Archives: February 2017

Spotlight on Little Hearts Medical

February is American Heart Month, a month devoted to bringing awareness of heart related health issues. Parents who adopt from China often consider being open to a heart related special need because congenital heart disease (CHD) is the most common birth defect. 1 in 100 babies born will have congenital heart disease so there are many waiting children in China with some form of CHD. I wanted to make parents aware of Little Hearts Medical, a wonderful resource for those in the China adoption community. I contacted Andrea Olson, executive director of Little Hearts Medical, to get some information to share about the organization and about Andrea’s personal journey.


My husband, Eric, and I have six children. Five of our children were adopted from China; four were born with congenital heart disease. We’ve walked with our children through a great deal over the past seven years, and as we have become entrenched within the world of pediatric cardiology, working as Executive Director of Little Hearts Medical has been a great fit and has been a privilege and a joy!

Little Hearts Medical was founded in 2012 by adoptive parents, Mike and Tanya Lee, as a humanitarian organization. We are an all-volunteer group registered with the United States government as a 501c3. The primary mission of our organization is to partner U.S. pediatric cardiologists and surgeons with those in China, to share knowledge and expertise in order to better the lives of children born in China with heart disease.

The Lees have adopted three children with complex congenital heart disease, all of whom did not receive cardiac in China because the local hospitals and physicians were either not equipped or did not have the training necessary to intervene. To “teach a man to fish” was their inspiration and is our primary goal.

bayi-surgeons-with-loupesI came on board as Executive Director in August of 2014, and we have expanded our mission to include cardiac file assessments for orphanages, adoption agencies, and prospective adoptive parents at no charge. We have provided almost 300 file assessments since January of 2015. We also work with the CCCWA to bring cardiac care training to China’s orphanages. Our U.S. based pediatric cardiologists and surgeons continue to train those at our partner hospital in Beijing, BaYi Children’s. BaYi is a Tomorrow Plan hospital, and as such receives many CHD children from orphanages around China. Therefore, we feel it is critically important to assist the hospital with their pediatric cardiology program to the best of our ability.

Since November of 2015, we have outfitted BaYi’s cardiac surgeons with surgical loupes, thus enabling the junior surgeons to be able to be trained in advanced surgical techniques (you can’t repair a valve in an infant if you can’t see it!). A generous donation by Scanlan International of tens of thousands of dollars of new surgical instruments greatly assisted us in our endeavor, as well. Our Surgical Director, Dr. Stephen Langley, continues to make trips to China to train his partners, and our Medical Director, Dr. Laurie Armsby, is working towards building the cardiac catheterization program at the hospital. Our medical teams have made multiple trips to China since 2012 training our partners while providing cardiac catheterizations, surgeries, and assessments for orphan children and impoverished children residing with their biological families. Our team also provides ongoing consultation with cardiologists and surgeons in China caring for children residing in orphanages as well as at our partner medical foster home, Little Flowers Project Dew Drops.


I encourage all families considering the adoption of a child with congenital heart disease to first and foremost prepare themselves to be incredibly blessed by the strength and resiliency of these special children. CHD can be a tricky disease, and prospective families should be aware that heart disease might throw a lot of curve balls. Especially in the cases of more complex CHD, there is often not a clearly defined finish line and often, there is none at all. It’s a lifelong disease, and its twists and turns cannot be defined outright. Flexibility and an open heart and mind are good qualities to possess when considering the adoption of a CHD child.

Andrea has written many wonderful posts about her family’s journey into CHD adoption. One of my favorites is Andrea’s letter to her younger self. You can also read the story of how they brought home her daughter Rini, who received a heart transplant. There is an update here on Rini.

If you would like to learn more about what life is like parenting a child with CHD, please stop by the 28 Days of Hearts blog, which shares a different story from families who have adopted a child with CHD from China every day for the month of February. For a look at the transplant end of the CHD spectrum you can read this post on No Hands But Ours by Andrea and another mother, Emily.

If you would like to connect with Andrea and many other experienced CHD parents as you consider being open to heart related special needs, you can join the Special Needs Resources -China Adoption group on Facebook.

Evaluating Agency Fee Schedules



**Please skip to the revised version of this blog post which has information from twice as many agencies.**

Although I have already written about evaluating the amount of fees a potential agency charges, I have recently run into a few situations that made me think I should take a closer look at the aspect of *when* the fees are charged. Here some situations I have discussed with people within the past few weeks:

  • A family which had paid all of the agency fees before their homestudy was completed. The agency was barred from international adoptions and the family has lost the money they paid.
  • A family which applied to a particular agency because the agency was going to receive the file of a child they wanted to adopt. The agency was upfront about the fact that the family was not guaranteed to receive the child’s file. Another family ended up with that child’s referral, but because the first family had already paid several thousand dollars in fees, they ended up staying with the agency.
  • A family which used the same agency they had used for previous adoptions. This agency requires several thousand dollars upfront. After realizing that wait times for matching had increased significantly since their previous adoptions, the family would have preferred to switch agencies but now felt tied to the agency because of financial commitment.
  • A family found a child profile they were interested in on the “shared list” section of an agency advocacy site. The agency informed them that if they applied to the agency, they would help them find the file. The file was with another agency which refused to transfer, but now that the family had committed to the first agency by paying fees they didn’t have the freedom to switch to the agency which actually held the file.

The common theme here is that adoption is expensive. Families are prepared to pay the cost of the adoption, but they usually don’t have the funds to lose $3000-$6000 if they start over with another agency. The timing of WHEN you pay the fees can give you flexibility if the first agency you work with does not turn out to be the best fit for whatever reason. I looked up the fee schedules (or tried to) for 16 different adoption agencies with China programs. Let’s look at what I learned so you can make an informed decision when choosing an agency.

IMG_0179Fee Schedules– When I gave agency red flags, not posting a fee schedule on the agency website was one of the items I listed. It was no surprise to me that 3 agencies I consider unethical did not have fee schedules listed on their websites. Two additional agencies only gave a general estimate for the costs of the China program without listing individual fees. The other 11 agencies had at least a general breakdown of fees and when to expect to pay them. I’m sticking with my suggestion that if you don’t find a fee schedule on an agency website, don’t use them.

Application fees– Application fees ranged from $200 to $800. Application fees are not refundable. If you are considering an agency because of a waiting child, very few agencies will require an application fee to view a file. Most agencies can and will locate specific files for you free of charge because they hope to gain you as a client.

Homestudy– It came as a surprise to me to find that some agencies are expecting fee payment before the homestudy is complete. Remember that the purpose of a homestudy is to determine that you are eligible to adopt. Certainly most families pass the homestudy, but I would be hesitant to work with an agency which expects payment before you have been determined eligible to adopt.

Application approval/Contract signing– Of the agencies which had a payment that could be due before the homestudy was approved, most had the first payment tied to when the application was accepted or when the agency contract was signed. This fee was around $3000 with most of the agencies.  If this is the case with the agency you want to work with, consider not formally applying or signing the contract until after your homestudy is complete. The agency can review the homestudy and make changes once they have accepted you into the program. This is probably not going to work if the placing agency is also doing your homestudy, but it would give you the freedom to switch if you find a child at a different agency during the homestudy process.

Number of agency fees– Agencies had between 1 and 3 agency fees.

  • Two agencies had a single fee which was due after homestudy completion.
  • Five agencies had two fees. Three had the first fee due at contract/application and the other two did not have a clear timeline on their website.
  • Four agencies had a three fee structure. The first fee was due at contract/application with two agencies while the other two charged the first fee at homestudy completion.
  • Besides homestudy completion, the most common times agency fees were due were at dossier submission and/or at child match.
  • Some agencies indicated that payments were flexible, so you could continue to make payments throughout the process. It is a good idea to ask a potential agency if the fee payment dates are times that payment is required in full or if you can make payments on it.

Conclusion– If you are not looking at an agency because you are pursuing a particular waiting child, it is beneficial to look closely at the fee schedule of potential agencies. Especially if you are anticipating submitting your dossier first to be matched with a LID child, choosing an agency which has multiple fees spaced out throughout the process will give you maximum flexibility if you end up switching agencies later. It is very common for families to begin the process intending to adopt a LID child but to find a waiting child through an advocacy group or site during the process. You might feel sure you will stay with an agency, but giving yourself flexibility is still a good idea.

My data– I am sharing my fee schedule tally below without agency names.

  1. 3 fees, 1st with application approval
  2. 3 fees, 1st with application approval and second due within 45 days (I had to submit personal information to download the fee schedule)
  3. 3 fees, 1st at homestudy approval
  4. 3 fees, 1st at homestudy approval
  5. 2 fees, time of 1st fee is unclear
  6. 2 fees, 1st at agency contract but only needs to be paid by dossier submission
  7. 2 fees, 1st at agency contract
  8. 2 fees, timeline unclear
  9. 2 fees, 1st at application acceptance and 2nd at homestudy acceptance
  10. 1 fee, timing unclear but probably at homestudy acceptance
  11. 1 fee, after homestudy acceptance
  12. Only total amount estimate for China adoption listed
  13. Only total amount estimate for China adoption listed
  14. No fee schedule
  15. No fee schedule
  16. No fee schedule

If you are just beginning your adoption journey and found this post helpful, you might consider buying my book which has all of this information and more, including several chapters on travel.

August One Year Home



I did not do a nine months home post for August as I did for Leo because we were very busy at that time. It also didn’t feel that much had changed from six months, although we were on the verge of several big changes.

I mentioned in the six months home post that we were considering getting some counseling to help August learn some better ways of coping with his emotions. Right around that time, August had a big verbal growth spurt. August is a guy with big feelings. Being able to express them in more than one or two words almost immediately decreased his tantrums and screaming. Now he regularly shouts things like:

  • I very MAD at you!
  • NO, dat MINE! You not take dat!
  • No, don’t go! Come back!

screen-shot-2017-02-03-at-3-23-26-pmWe also felt that August had overcome his separation anxiety enough to be enrolled in the same special needs preschool that Leo attends. It is only 3 hours a day for 4 days a week. After extensive testing, he was determined to be low average in all areas but social/emotional development. That’s great for having been home only 9 months at the time of testing! We all think he will catch up quickly. At school he interacts with other children his age who are typically developing. He also receiving a little occupational therapy. They are planning to give physical therapy as well after the surgical intervention on his leg is complete. August was hesitant only a day or two. He absolutely loves going to school now. I think his favorite part is riding the bus.

August was only at school for a few weeks before he had a break to have his leg surgery. After consulting with a doctor about 5 hours away, and one 2 hours away, we ended up going with a doctor at our local hospital. They recently recruited one of the top orthopedists in the country, but it took a few months for him to move here. We were very happy with him after our initial appointment so we scheduled the surgery for the end of November. August currently has an external fixator, a metal frame mounted into his leg bones, on his left leg. He will wear it for about three months total. Currently, we are planning to have it removed around the end of February. He will wear a leg brace after that.

screen-shot-2017-02-03-at-3-23-11-pmLeo had cleft surgery about 2 months home. We hadn’t planned to wait nearly a year for August’s surgery, it just worked out that way. I know many families struggle with the best timing for major surgeries after an adoption, so I plan to share more about our two experiences in a future post. For now I will say that it worked out very well for us. I was able to explain to August what was happening. It was wonderful to have him wake up at the hospital and be able to say “Leg really hurts!” or after the pain medicine kicked in, “Feel better now. I go to school today?” After one trip to the orthopedist where some parts had to be switched out on the fixator, he spent the entire trip home ranting to me. “I not like that doctor! He so mean! I very angry at him! I not like him! We go home, we not go see that doctor!” Having him so verbal by surgery time made a huge difference.

Aside from the major surgery, August continues to be happy and healthy. He loves playing with Vincent and Leo, but also happily plays independently with his collection of cars. August misses being able to walk, but really enjoys running over people with his wheelchair (watch out!). We thought winter would be a good time to have the surgery because he couldn’t play out on the playground then anyway, and Christmas would be a good distraction. Having your first Christmas as a 3 year old is an amazing experience. August thought everything was magical, and opening presents on Christmas day was the best day of his life! At one point he opened a simple remote control police car. When he pushed the button and the siren went off, he said “Oh, I love you! I love you!” to the police car. He makes us laugh every day. We’re so happy to have his larger than life self in our family!