“Grandma Needs Help” Examining Social Supports for Kinship Caregivers

Date

Desdamona Rios PhD, Edna Herrera, Aundrea Enrique, Lluvia Larios, Stephanie Zepeda, Victoria Palacios DeLeon, Althea Lacewell MSW, and Valerie D Jackson PhD

INTRODUCTION

          Kinship caregivers, those who have a familial relationship with a child, compose 40% of the Texas foster care system today. With the passing of the Family First Prevention Services (FFPS) Act in February 2018, kinship care has gained popularity, recognized as a primary resource for children in foster care because of the positive long-term outcomes (Font, 2014). This more humane practice evolved from a long and shameful history of removing children from their families and placing children with private families that began in the mid-19th century. Typically, placements were informal apprenticeships, in which children were exploited as workers for their new guardians, who did so legally. Any laws that existed around this subject, were there to protect adults. By 1875, Charles Loring Brace, founder of The Children’s Aid Society, was exporting 4,000 orphans a year by trains that went across the nation. By 1912, the Children’s Bureau was formally created with a mandate to protect children, rather than protecting their adult caregivers. Nevertheless, orphan trains continued until 1930, when criticism of the lack of oversight to protect children finally stopped them. In response, in 1931 the division of child welfare was established under the State Board of Control as the children’s agency for the State of Texas. And by 1935, the federal government took over the foster care system.

 

          The practice of separating children from their families was informed by research that suggested “punitive conditions and isolation from family made possible by institutionalization would coerce children into obedient labor market behavior. The functions of children’s institutions were to train and rehabilitate young people and to provide a model for the moral reform of society”(Downs,1983). This family separation practice within the child welfare system was prominently enforced upon Black and Indigenous families, and continued through the foster care system until 1980, when the US Congress passed the Federal Adoption Assistance and Child Welfare Act (FAACWA). It is worth noting, however, that the same practice has emerged again along the borders of Texas and Mexico.

 

          The FAACWA resulted from the work of advocates of child welfare, and the research that indicated the need for stability and constancy to support the positive development of children. Therefore, child development experts began advocating for the support of families to avoid removal of the children; or if removal was necessary, to help families prepare for eventual reunification. Consequently, familial caregivers became eligible for the financial and social support services that were previously only available to non-kinship foster and adoption families. Nevertheless, many families continue to struggle to provide the stability that their children need. And it is important to note that there are different causes for this difficulty. Therefore, this manuscript examines how kinship caregivers are defining social supports, and whether and to what degree they feel that those supports are available to them. In essence, we ask, what do kinship caregivers consider enacted social support?

RELATIVE CAREGIVERS AND SOCIAL SUPPORT

          Relative caregivers social support comes from sources that they identify as reliable. The general definition of social support is the perception and actuality that one is cared for and has assistance available from a supportive social network. It is important for relative caregivers to be able to identify their social support network as it can be a detrimental factor for reaching the goal of permanency (Kondrat et al., n.d.). Kinship families without a secure social support network are at risk for social isolation that can influence the stability of the family (Inchaurrondo et al., 2015). Inchaurrondo at al. (2015) further discusses that psychological and legal assistance can be seen as both formal (school, social services, economic assistance, etc.) and informal (family, friends, community) types of social support and it is important for kinship families to be able to identify and appreciate their support.

          Cavanaugh et al. (2020), explained the importance of well-being and meaning making in the face of adversity; the article mentions the risk and resilience theory, which is just a person’s ability to achieve success or failure based on risk factors and resilience factors. One of the resilience factors mentioned was the social support from an individual’s peers amongst other factors such as financial resources, coping skills, and positive role-models. These factors help kinship caregivers achieve a state of well-being and may even help in ensuring that caregivers reach permanency.

          Based on the Inchaurrondo et al. (2015) and the Cavanaugh et al. (2020) articles, we see that an underlining factor in an individuals’ and families overcoming adversity is through the social support of their peers. The support provided by their peers can be vastly different based on the needs of the kinship caregivers or the person that is giving their support. For example, there may be one friend to the kinship caregiver that gives advice and is able to support in that way because they have kids and may have been in a similar position to the kinship caregiver. While another friend may only be able to help with small tasks such as picking up the kids or buying a meal for everyone.

          Barrera (1986) categorized these types of social supports into three main types of support that are specific enough to ensure common usage across the study, but still broad enough to include all identifiable support. This streamlined definition supports future studies. The three types of social support identified are: Social Embeddedness, Perceived Support, and Enacted Support.

          Social Embeddedness is a “concept that refers to the connections that individuals have to the significant other in their social environments” (Barrera, 1986). This support type can be found in churches, family ties, and even in the workplace. It addresses feelings of nonalienation or isolation. Perceived Support, which is the measure of “perceived availability and adequacy of supportive ties” (Barrera, 1986, is the confidence a person has in specific individuals within their community if ever in need of support from those individuals. It is based on the trust a kinship caregiver has in those people to rely on during difficult times. An individual may experience this type of support with a friend, family member, or other peers. Enacted Support, the “actions that others perform when they render assistance to a focal person” (Barrera, 1986), is the most impactful support.

          Enacted family support is identified as reliable sources of support that is action based through the offering of goods and services (paid and unpaid). Based on family interviews and data, these positive supportive offerings are viewed by kinship families as helpful and gracious, creating a sense of family cohesion, empowerment, warmth, and security. Reliable family sources help kinship families feel support and address their needs for higher levels of quality of life and family functioning. Kinship caregiver’s appraisal of enacted support includes bonding time, instructional, accountability, financial, gifting, phone calls, advice, and child supervision, among many others. The more tangible the supports received by kinship families, the more they feel supported in reliability, peacefulness, happiness, calmness, encouragement, and appreciation. These positive helps of enaction create structure, sustainability, traditions, and routines that create a healthy nurturing family household.

          These support mechanisms can help relieve stress from people in crisis. Kinship caregivers face similar crises to other families, but often with additional challenges due to the trauma the child may have endured during pregnancy, childhood, home removal, and/or home placement changes. The benefits of a substantiable support system cannot be overstated.

OVERVIEW OF STUDY CONTRIBUTIONS AND BROADER IMPACT

          The stability of kin and non-kin placements has been studied often in recent years. Research found that children in non-kin placements experienced increased risk for placement moves when first placed out of the home, and overall, experienced more placement moves than those in
kinship care (Webster et al., 2000). Kinship foster care is often more stable than non-kin foster care despite socioeconomic disadvantages (Winokur, Holtan, & Batchelder, 2014). In contrast, Testa found that the increased level of placement stability for those initially placed with kin dissipates for children in care for longer than one year (Testa, 2008). This finding would suggest that permanency (adoption or guardianship) with a relative is the best option.   

          We conducted our own qualitative research to augment the data above. We found that although many social supports, both financial and non-financial, are offered to kinship family placements, many families continue to struggle with creating stability. We began by considering
how the family caregiver defines social support. Our findings indicated that perceived social support can be approval of life decisions (i.e., adoption of relative) from others, feelings that family and friends would “do anything” for them, as well as their spouse being their main support. The interviewees indicated that in the category of social embeddedness their network system is their family, friends, and extrafamilial others. The subcategories of support include husbands, coworkers, and professional relationships. This network of support provides trust, reliability, dependability, and advice. Some of the interviewees stated that people within their social network are role models. Examples provided by the interviewees on enacted social supports were phone calls, financial assistance, and gifting.

          In the cases where we found that kinship caregivers were refusing supportive services, we found various reasons. Among those are federal policies and funding allocations that impact the types of supports child placing agencies can provide to kinship families. A large portion of federal funds are Title IV-E, designated for the support of licensed foster care, and only a fraction of federal dollars can be spent to support unlicensed kinship placements. The Title IV-E funds operate as open-ended entitlements for eligible children. States can receive unlimited reimbursements for every eligible claim submitted for foster care administrative and placement costs. The licensing rules and regulations are different for every State. These requirements can discourage relatives from becoming licensed, thus limiting the services and supports they are eligible to receive. This is unfortunate since most relative caregiver’s report that daily stressors, such as “making ends meet” from one pay period to the next; having sufficient income to provide for basic household needs, including food, utilities, and rent; and transportation challenges take a toll on their mental and physical health (Blair & Taylor, 2006).

          Kinship care provides an environment often just as effective as foster care—if not more effective in the case of family—for promoting a sense of belonging. (Alison Hassall1 et al. 2021). Feeling safe and supported is the foundation for the wellbeing of mind and body. A sense of belonging in interpersonal relationships and to broader groups is a fundamental need of humankind (Perry, 2012). Thus, someone with increased financial resources, stronger social support, and higher levels of meaning-making will likely exhibit greater resilience than an impoverished, socially isolated person with the same level of meaning-making (Cavanaugh et al, 2020). Kinship care has demonstrated enhanced family connection for children in these placements as caregivers have a pre-existing relationship with the child (e.g. a relative or family friend), and may be more invested in their caregiving role through familial or cultural ties (Farmer, 2010; Hassall, van Rensburg, Trew, Hawes, & Pasalich, 2021).

LIMITATIONS OF EXISTING RESEARCH

          Despite the growing population of kinship caregivers, little research has examined therapeutic programs for families in kinship care. This lack of knowledge is a concerning trend, considering the complex vulnerabilities and limited resources of the families.

          Our qualitative research worked with a small sample size to initiate this research—a sample size of n=8. Given the size, consideration is warranted in generalizing the findings beyond the participants responses. Also, the sample comes from a single child placing agency as opposed to a random sample from various agencies in Texas. Therefore, we cannot assume that the selected participants from the one child placement agency represent the views of all kinship caregivers.

          Additionally, grandmothers consist of more than half of the population of kinship caregivers. However, in this study they comprised only 20% of the caregivers interviewed. In the future, more grandmother participation is needed.

          Finally, more follow-up questions regarding social support systems are needed—for example, how often families access that support, when they typically utilize these resources, and for what reasons.

METHODS

BACKGROUND:

          The current study was conducted in Houston, Texas with caretakers who were currently working with Monarch Family Services (MFS), a child placement agency in region 6, consisting of twelve counties. MFS is a contract service provider of the Texas Department of Family and Protective Services, and it provides various services to relative caregivers. This research is observing the most frequent types of social support reported by kinship caregivers.

DATA COLLECTION PROCEDURES

          For this study relative caregivers were recruited from Monarch Family Services to participate in a 1–3-hour semi-structured interview. Open ended questions were asked to encourage participants to describe their experiences in their own words (Reinhartz, 1992). Purposive criterion sampling was used to ensure participant criteria were met. In purposive sampling, the researcher draws from their expertise to choose participants from a particular population (Palys, 2008). Participants were recruited through relationships developed between MFS staff and relative caregivers. Participants did not receive any compensation for their time. All interviews were conducted with two of the authors (Rios and Herrera). To accommodate relative caregiver’s schedules and adherence to social distancing protocol during the COVID pandemic, all interviews were conducted over Zoom.

          All participants were asked basic demographic questions about age and racial/ethnic identity as well as questions about how the child(ren) came to live with them, their relationship with the child(ren)’s biological parents, their own family history, and social support network. All interviews were recorded on Zoom and transcribed using the software Sonix (see www.sonix.ai). All identifiers related to current or past places of residences, and names of personal and professional relationships were removed from the interview transcripts. The project met standards and was approved for studies involving human subjects as delineated by Behavioral Sciences Institutional Review Board. Our approach was informed by grounded theory (Charmaz, 2000) because of our interest in honoring participants’ narratives as an insight into their experiences. In line with using grounded theory as an analytic method, we developed questions, themes, and theories throughout the analytic process by increasing familiarity with the data. As we became more familiar with the data, we identified patterns across the eight interviews, including three types of social support: Enacted, Perceived, and Social Embeddedness. The interviews were observed by three research assistants to determine the levels of social support that was endorsed by the families. The findings were rated and analyzed by the researchers using interrater reliability. Interrater reliability is the extent used to demonstrate two or more raters agreeing on the designated quotes used throughout the eight interviews. Interrater reliability across the coding of the eight interviews was .88 calculated in terms of percent agreement based on the coded theme, which is above the acceptable reliable coding of .80.

SAMPLE

          There were eight (8) kinship caregivers interviewed for this study. Seven (7) identified as female and one (1) as male. The age range was 34 – 66 years old. When asked the caregivers ethnicity, four (4) stated they were African American/Black, three (3) were Hispanic/Latino, and one (1) was White/Caucasian. The marital status of the caregivers was observed, and four (4) reported they were single and four (4) stated they were married. The annual income of the caregivers ranged from $29,000 – 90,000. The relationship to the child(ren) in care were documented as follows: three (3) fictive kinship caregivers, two (2) grandmothers, two (2) aunts, and one (1) cousin.

RESULTS

          This research observed connection between kinship caregivers and the people who are supporting them. In accordance with existing research, we also found that a strong social support system can be a protective factor for resiliency and stress management. And the lack of social support exacerbates parenting stress and negatively impacts psychological well-being. However, our research also indicates that it is therefore not only important that support is available and accessible at times when the caregivers need it the most, but it is also crucial that such supports are identified by caregivers themselves.

THEME OF PERCEIVED SOCIAL SUPPORT

          Perceived social support refers to how caregivers interpret the availability of friends, family members, and others as sources to provide material, psychological, and overall support during times of need. Research respondents identified this type of support accordingly: Ms. A. described her support network as “Everybody…” She continued with an explanation of how she interpreted their support: “…none of my friends, nobody was against it. They kind of know it’s me, and it wasn’t something that was so out of character.” Ms. A. feels supported emotionally from indirect approval and non-judgment from her family and friends and perceives that support as confirmation that she’s doing the right thing, which leads her to continue with the adoption process. Ms. E. describes her relationship with her friends by recounting how she can fully rely on them. In this narration she indicates her gratitude and confidence toward her friendships. Mr. B. indicates that he’s willing to do anything for his family, and they would do the same for him, no matter the situation, assuming legality. Mr. B’s account indicates reciprocal relationship of responsibility and trust. Ms. A. highlights the lack of judgement from her family about the decisions she makes in her life as an important form of support.

          Regarding crucial relationships, most caregivers named their spouses as the main person in their support system. Spouses were described as, their backbone—someone they can rely on, for example, in areas that the main caregiver may demonstrate a weakness. Multiple caregivers acknowledged the balance in their routine and the support of their spouses. Some who named their spouses also mentioned other family members as part of their support network. Ms. E. discussed the confidence and trust she has in her family and friends to care for the children if she ever needed someone to watch over them for a while: “It’s like if they tell me that if I need someone to take care of them on the weekend, or something that I can confidently leave them there.” She indicated that she has not taken advantage of this opportunity but feels confident the children would be safe should she do so. Among all respondents, there was an understanding of an unconditional support expected from families no matter what is required, because the caregiver would reciprocate the support. It appeared to be an unspoken aspect within their relationship. That aspect was a key difference among caregivers that named friends as part of their support system. The same amount of reliability and trust was present, but without the unspoken, unconditional reciprocation that appears with family.

          There was only one caregiver who stipulated that God was the key relationship within their support network. When asked who supports the caregiver, Ms. A. responded: “God. It must be.” Her response demonstrates the level of her faith and her belief in the unconditional support she feels from God. Among other respondents, there was no direct mention of God as a part of the support network. At most, caregivers mentioned the church they attended, as well as, how prayer created bonds within their family. We therefore found that a higher power or metaphysical being can provide caregivers with a feeling of support.

THEME OF SOCIAL EMBEDDEDNESS

          Social embeddedness defines the reachability and reliability of individuals who support the  caregiver through role modeling, caring, and providing stability in the child’s environment. This  category of support reflects on the social network system of the caregiver and provides an  understanding of “who” may support the caregiver. Our interviews showed three main categories  of individuals who support the caregiver: family, friends, and extrafamilial others such as  coworkers and professional relationships. There is a sense of unity in most of the quotes that  described the network of the caregiver that provides trust, reliability, care, and dependability. 

          Amongst the quotes, cultural or traditional values were highlighted as key elements  embedded in the social networks of caregivers. For example, Ms. E. indicated that she and her  husband set an example for the children by: “pray[ing] to God for the whole family.” 

          Additionally, role models provided opportunities for caregivers and for children to learn from.  For example, Ms. I. describe her husband as a “good male figure,” from whom the children can  observe how they are supposed to treat women. Ms. I. also explained how her friends served as  “role models on how to raise the children.”  

          Employers also ranked high among the supporters of caregivers. Ms. E. reported that her  supervisor and co-workers were amicable and lenient towards her if a situation occurred with the  children, or if she needed her paycheck early to meet their needs.

THEME OF ENACTED SOCIAL SUPPORT

Enacted social support emphasizes specific supportive actions offered to others. Based on the respondents of this research, the most enacted supports (unpaid/paid goods and act of service)  were the following: 

  • Check-in (calls) /follow-up 
  • Child supervision (babysitting) 
  • Family Bonding time (sporting events, going out to eat, social gatherings) in person  contact 
  • Instructional Support (advice, tips, reminders, affirming words of expression from  others) 
  • Financial Assistance (like child support from bio parents) 
  • Gifting (gift cards etc.) 
  • Hands on (changing diapers, driving lesson, homework, feeding time, cooking) Overall, our findings indicated kinship caregivers need direct support and guidance with  accessing services to be able to provide children quality care.

DISCUSSION

          Today, grandparents represent the fastest-growing segment of the population raising children  (U.S. Census Bureau, 2011). Relative caregivers’ average age is between 40 – 60. Despite this  growing trend, grandparents receive the least amount of supports in the foster care system. As well, we know little about the type of supports this population needs. In a quarter of grandparent led homes, the majority are at or below the poverty line and more than half fall below 200% of  the Federal Poverty Level (FPL). Poverty is one of the major social concerns and barriers that  prevent stability in kinship households. Therefore, in line with the Family First Prevention  Services Act (FFPS) of 2018, we propose that grandma and grandpa need supportive lines to  help care for their grandchildren. 

          Nationwide, approximately 30% of children in conservatorship live with people  considered relatives (Parolini, 2018). In Texas, the percentage of formal relative caregivers  correlates with the national numbers. In Harris County, 33% of children in conservatorship with  Department of Family and Protective Services (DFPS) were placed with relatives oppose to non relatives (TACFS, 2021). In Fiscal Year 2021, Harris County had 44 percent of children exited  out of care to family members either through custody to a relative (31%) or adoption by a  relative (13%). The highest rate of relative caregivers is in the South and Southwestern states,  with Black American families overrepresented compared to the general population of Black  Americans. In this paper we propose a standardized model for supporting kinship care families,  in particular grandparent-led-households, that addresses the unique barriers that prevent these families from developing stable and safe homes. 

THE APPLE DOESN’T FALL FAR FROM THE TREE

          The discriminatory practices of child welfare services were embedded in its very beginning.  And today, the foster care system continues to illuminate disproportionality and disparities based  on race. African American children are 15% of the United States population but represents 33%  of children that reside in foster care. Many Black families are impacted by the intersection of  child welfare and systemic issues of poverty, parental incarceration, and substance use. There is  a lack of preventative and community-based services for families and communities of color that impact the demographic disparity within the foster care system. For years, the federal  government did not favor relative placement, likely because of the adage that “an apple does not  fall far from the tree.” The prevailing view was that because the parents demonstrated abusive or  neglectful behaviors, the children couldn’t possibly be safe, nor could they break old habits of  family dysfunction; therefore, rehabilitation was likened to the adage of the apple falling from  the tree. And of course, the added tragedy here is that families were likened to fruit. 

          Children are removed from their parents due to imminent and ongoing abuse and neglect, which is typically a primary source of trauma. However, the separation of children from their  parents is an additional trauma related experience. According to the Casey Foundation (2019)  report on kinship care, there are many benefits in placing children with relatives. In doing so, we  reduce the trauma of children being placed with strangers, reinforce, and strengthen the child  cultural identity, and maintain family and community connections, while recognizing that  relative placement offers stability, safety, predictability, and improved well-being. 

          Research states that kinship care reduced trauma after removal by providing familiarity,  continuity, and retention of familial ties (Epstein 2017; Ehrle & Geen 2002), as well as improved  mental health outcomes (Epstein 2017; Messing 2006; Winokur, et al. 2018). Comparatively, youth in foster care reportedly have lower self-esteem, less happiness, and less satisfaction with  life than the general population. Research have indicated that, without familial ties, 40% of foster  children will be homeless, incarcerated, or die within three years of aging out of the foster care  system. 

          Placement stability is linked to several positive outcomes for children, including fewer  school transitions, decreased stress, and few behavioral, mental health, and academic  achievement problems associated with changing placement (Carnochan et al. 2013, p. 235). For  children in unrelated foster care, the number of changes of placement are high. Kinship family  placement allows children to remain connected to their culture, religion, and family traditions.  Also, they have continued contact with other family members, and greater familiarity with  caregiver surroundings. There is a higher likelihood of placement stability and permanency  outcomes (Carnochan et al. 2013, p. 23). 

          Legislation such as Miller v. Younakim, which ruled that relatives to the child could not  be excluded from providing foster care (Chang and Liles, 2007), has advanced the notion of  relatives as the preferred resource for children who must be removed from their birth parents.  According to the Kids Count Data Center (2022), there were a total of 2,682,000 children in  kinship care from the year 2018 to 2020 in the United States. The Annie E. Casey Foundation  reported in 2020, that one in 11 children go into a kinship family before the age of 18, and one in  five Black children are in a kinship family care situation. In the past decade children living with  relatives have increased by 9%. The growth of kinship care can be explained by seven  interrelated factors: poverty, lack of access to services, parental ill health and death, immigration  policies, disasters and conflict, cultural beliefs, and the child protection policy response (Phagan Hansel, K., 2017).  

          Given the enormity of this population, and the expected growth over the next decade, it’s  important to provide kinship caregivers the support and resources they need to sustain a stable  environment (Chang and Liles, 2007), and to create a secure relationship with the children who  are under their care. These resources support the caregiver with confidence and a foundation  toward parenting the child.  

THE KINSHIP CARE PILOT PROGAM

          The first kinship care program in Texas began in Bexar County in 1997 through the support of a  three-year federal grant known as the Comprehensive Relative Enhancement Support and  Training Project (CREST), the program funded paid caregiver assistance. CREST was  established specifically to address the needs of relatives and therefore strengthen these  placements. The program goal of CREST was to “support and promote safety, permanency, and  the well-being of children through care by relatives.” 

          CREST was implemented through three support modalities for the caregivers: formal  group training, individualized case management, and limited financial assistance. The formal  group trainings consisted of two 10-week curriculums, one for the relative caregivers and one for  the children in the home. The kin curriculum included such topics as stress management, self esteem, drug addiction, sexual abuse, community resources, discipline and CPS processes. Free  childcare was available during the training sessions. CREST not only supported caregivers  directly with necessary services to develop stable homes, but it also contributed to the  development of communal support for minority communities who are kinship families (Hawkins  and Bland, 2002).  

          This program confirmed that kinship care works. Kinship caregivers have a diverse and  important role in the lives of the children in their care. They train the child on social skills,  values, and traditions. The relationship that is established between the caregiver and child  initiates the beginning of characteristics for family connectedness amongst the kinship  household. Overall, children raised by relatives, as adults have reported better well-being than  children in foster care (Winokur et al., 2014).

FUTURE IMPLICATIONS

          The findings of this research indicate that kinship caregivers have various types of support needs  that will stabilize their home environment for possible permanent placement of the child relative  in their care. Therefore, as the federal government works to create more policies that support  maintaining these family connections, it is important that advocates continually highlight that African American and Indigenous children are disproportionately represented in the United  States child welfare system (Fallon et al., 2013); and that grandmothers are the fastest growing  population of kinship caregivers.  

Research indicates that 57% of grandmothers raising grandchildren live in poverty,  compared to 14% of two grandparents raising grandchildren together. The grandparent caregiver is more prevalent in African American (6.0%) and American Indian/Alaskan Native  communities (5.8%), than in Hispanic (4.1%) or White communities (1.3%) (Fuller-Thomson &  Minkler, 2005). The stressors of caring for a relative’s child can be particularly acute for elderly  caregivers who are confronted with health and financial problems of their own (Burton, 1992).  

          Considering this information, only 6% of eligible relative caregivers complete the home  licensing process in Texas, including the Foster to Adopt, Foster to Permanency Managing  Conservatorship with Permanency Care Assistance, and Adoption (DFPS Data Book, 2021). Doing so, would position them to receive financial and other support benefits for the child and  family. Future research should explore the reasons these families do not take advantage of these  support mechanisms despite their eligibility. And given the historical practice of family  separation among African Americans (e.g., slavery and mass incarceration), immigrants (e.g.,  separation at the border), and indigenous communities (e.g., American Indian Residential Schools), a comparative analysis should be conducted between BIPOC and non-BIPOC relative  caregivers regarding accessing government supports. 

*Reference section is available upon request.

Make A Donation

Monarch Family Services is a 501(c)(3) non-profit organization. All donations are tax-deductible.