|What services are being offered by PAS programs?|
What we know: Although the field has proposed an optimal continuum of care for adoptive families (Howard and Smith, 1997), the provision of post-adoption services can best be described as patchy rather than comprehensive. Services offered range from information and referral networks to support for residential treatment. Yet there is little uniformity in provision of services across, and sometimes within, states.
Although each of the states responding to the ILSU interviews reported providing a range of PAS, open-ended descriptions of these services revealed that many states relied on adoption subsidy workers to provide limited information and referral services and/or had one-time grants or time-limited programs designed to provide various PAS. Some states considered adoption subsidies to be a PAS, since families can use these funds to purchase needed services.
Our case studies and available written descriptions of state-level programs suggest that information and referral, parent and professional training, advocacy, and support groups are the most commonly offered post-adoption services. Adoption-sensitive counselors were frequently offered as well. Although respite care was commonly mentioned by families as a significant service need, funding for, or provision of, respite care was relatively uncommon.
Many sites do not offer one or more of these basic elements, and available services are often not linked to each other. In a few places (e.g., Minnesota, Oregon, Massachusetts), we did find statewide information and referral resource interfaces that identify adoption support groups that operated in local communities. In some places, training of clinicians about adoption was paired with information mechanisms to inform adoptive families about which professionals were trained, but this pairing was more the exception than the rule.
Moving forward: At a basic level, we can identify effective strategies for putting families in touch with the resources that exist in local communities. Web-based resources may be of value, including interactive systems that enable parents to search for adoption-competent therapists and websites with information on services provided, eligibility, support group locations, and links to other resources.
PAS program developers have to date drawn on a patchwork of professional recommendations, state-level needs assessment and practice wisdom to design their service menu. Absent from this mix is systematic compilation of the experience of states that have developed programs, at a level of detail that could offer practical guidance for other states, particularly those at earlier stages of program development. Useful information would answer the following questions:
- What services are offered, either locally or statewide?
- How have other states resolved questions of which services to offer through PAS programs rather than through existing service delivery and payment systems?
- Which services have been used by most families, including those with less severe needs?
- Which have been used by families in crisis, and are there preventive services that might have averted the crisis?
- What are the relative costs involved in providing different services?