Annual funding for PAS in 2001 varied widely across states, ranging from $500,000 in Oregon to between $8 million and $9 million in Georgia (Exhibit 5-3). In Texas it grew from $1.3 million in the early 1990s to $3.9 million. Given the variations in population size and program eligibility among the five states, it is difficult to compare funding levels across states; however, funding levels clearly varied with the provision of higher cost services such as crisis intervention (in Georgia) and residential care (in Texas). Adoption program managers across the states reported that PAS funding had been relatively stable in recent years with some midyear fluctuations. Although they believed that more funds were needed for their PAS programs, significant increases were not anticipated, especially in light of state budget crises and slowing economies.
Annual funding (in millions of dollars)
Among services providers, concern was widespread regarding the current levels of funding, and a range of measures had been taken in response to funding concerns. Although no states reported waiting lists for PAS services, some had to restrict availability of higher cost services. In Georgia, a provider of crisis intervention services noted that her agency had reduced the service period from six months to 90 days. Georgias adoption program manager also noted that the state was planning to change how respite rates were determined. The state planned to pay caregivers a flat rate ($9.00/hour), instead of deciding on a case-by-case basis.
|States and PAS providers noted fairly stable levels of funding, but providers expressed concern over the high cost of respite services, crisis intervention, counseling, and residential treatment.|
A regional PAS provider in Texas said his agency was developing a strategy for securing private grant funds to supplement state funds for respite because the agency perceived the need for respite as greater than the current state funding level allowed. His counterparts in Massachusetts noted that they had had the same budget for five years while serving an increasing number of clients. The lead PAS provider said that available funds were inadequate to cover families respite needs across the state and that low salaries had increased staff turnover in some regions. Massachusetts had not limited service availability, however, but recently eased limitations on the number of counseling appointments.
The Texas programs budget was particularly vulnerable to the influence of residential care. PAS providers expressed concern that residential treatment costs were limiting their ability to provide other services. One noted that residential treatment drives the budget, often requiring shifting of funds to cover it, and that the flat reimbursement rates reduced flexibility in responding to families particular needs. Faced with funding shortages, PAS providers in Texas met in the mid-1990s and mutually agreed to limit the coverage of residential treatment only to the highest level of care and to not cover therapeutic foster care for adoptive children. They also reduced the coverage of camp stays from two weeks per year to one week per year.
Adoption program managers and other officials in several states expressed concern that the dramatic increase in adoption in the past several years will increase future needs for PAS and require additional funds to support it. A budget official in Oregon noted that as adoption assistance under Title IV-E increases, the funding available for PAS through Title IV-B, Subpart 2 will not increase accordingly. The state expanded its Social Services Block Grant (SSBG) plan to include PAS and independent living services so that future SSBG funds can be allocated to supplement Title IV-B, Subpart 2 funds, if necessary. A PAS provider in Texas expressed fear that increases in adoptions will create enormous pressures for service delivery, especially for residential treatment. With increases in the number of adoptions in the past 5 years and the increasing average age of adoptive children, there will be a crisis in residential care due to the critical mass and flat [reimbursement] rates.
Midyear fluctuations in funding also can affect providers ability to plan and deliver services. Providers in Massachusetts and Virginia reported that midyear increases in respite funding had allowed them to fund additional camp stays for children; however, this led to dissatisfaction among parents in subsequent years when those funds were unavailable. In Texas, one PAS provider reported being concerned that the annual budgets were shrinking over time and that midyear budget cuts occurred. [We] do not have a guarantee of how much money is available.