In private kinship care arrangements, as well as agency-involved public care, birth parents typically retain custody of their children, often affording kinship caregivers more limited decision-making authority than non-kin foster parents. Without legal custody, kin lack the authority to take important actions such as enrolling a child in school, signing permission slips for field trips or other school activities, authorizing emergency medical care, or enrolling the child in their health insurance policy. In addition, many kinship caregivers are retired and on Medicare, so the only health insurance option they have is to buy an individual policy for the child, which can be prohibitively expensive. As noted in Chapter 1, private kinship caregivers are unable to get foster care payments, and although they may be eligible to receive some welfare benefits, the amount is significantly lower. Moreover, studies have shown that welfare workers have often incorrectly denied benefits to kinship caregivers because they did not understand eligibility rules (Chalfie, 1994; Hornby et al., 1995). Private kinship caregivers may also be denied access to public housing or other public benefits that impose strict family definitions on recipients.