Assessing the Field of Post-Adoption Services: Family Needs, Program Models, and Evaluation Issues. Analysis of Secondary Data. 3.3.4 Reasons for Payment Changes

11/01/2002

When an AAP payment is started, restored, recertified, or changed, the reasons for the AAP payment change must be submitted. Multiple choices are allowed at any time. Reasons for AAP changes were recoded into four categories of rate changes: (1) basic care, (2)basic and special care, (3) special care, and (4) residential care, which account for 98 percent of all rate changes. The remainder were excluded from the analyses. We examined reasons for each payment change. The major reasons for payment changes were basic care changes (70 percent) or basic and special care changes (23 percent). The percentage of AAP recipients needing special care and residential care changes consistently increased from the first payment change to the fifth payment change. For instance, the portion (2 percent) of AAP recipients seeking residential care increased from 2 percent at the first payment change to 16 percent by the fifth payment change (see Exhibits 24 and 25 ).

Exhibit 24.
Reasons for AAP with Each Average Amount ($) of Payment Change
Payment changes Basic care Basic + special Special care Residential care Average of total
payment changes
1st payment change
Row %
$34
(n = 470)
(75%)
$149
(n = 125)
(20%)
$30
(n = 20)
(3%)
$2,964
(n = 11)
(2%)
$108
(n = 626)
(100%)
2nd payment change
Row %
$20
(n = 321)
(71%)
$52
(n = 100)
(22%)
$208
(n = 13)
(3%)
$1,410
(n = 18)
(4%)
$88
(n = 452)
(100%)
3rd payment change
Row %
$31
(n = 156)
(65%)
$145
(n = 61)
(26%)
$-164
(n = 7)
(3%)
$1,385
(n = 15)
(6%)
$139
(n = 239)
(100%)
4th payment change
Row %
$-124
(n = 63)
(55%)
$-291
(n = 37)
(32%)
$81
(n = 5)
(4%)
$1,805
(n = 10)
(9%)
$-1
(n = 115)
(100%)
5th payment change
Row %
$-430
(n = 28)
(46%)
$53
(n = 20)
(33%)
$233
(n = 3)
(5%)
$1,193
(n = 10)
(16%)
$27
(n = 61)
(100%)
Cost of payment changes by reasons 
no. of cases of payment changes X
average amount of payment changes
$7,384
(n = 1038)
$22,963
(n = 343)
$3,260
(n = 48)
$108,739
(n = 64)
$142,137
(n = 1493)
* Percentage may not total to 100 due to rounding.

Exhibit 25.
Percentage of Reasons for Payment Changes

Exhibit 25. Percentage of Reasons for Payment Changes

Transition to residential care is often preceded by multiple subsidy increases.

These data show a pattern of usage that may indicate that it is unusual for children to have high payment changes ($500 or more) as their first payment change. Among all the first payment changes, only 20 of 642 (3 percent) were greater than $500; by the fourth and fifth payment changes, however, this percentage had increased to 7 percent and 11 percent, respectively. This is confirmed by the pattern of residential expenditures. Most children who are entering residential care do so after several payment changes requested by families to help them provide services to their children (n's not shown in table). So, among those families that obtain residential care for their children during the fifth payment change, they have already become users of substantial subsidies  this is why the fifth payment change related to residential care ($1,193) is only one-third the earlier changes. Knowing that many families have already had increases in their subsidy rates makes the provision of residential care seem somewhat less costly than it would be if this were a common first payment change.

View full report

Preview
Download

"report.pdf" (pdf, 1.44Mb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"apa.pdf" (pdf, 663.96Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®