The five case-study states offered substantial flexibility in their subsidy programs. All permitted establishment of deferred subsidies, which allowed families who did not require a subsidy at the time of adoption to request one at a later date if circumstances changed. In addition, all five states noted that subsidies could be renegotiated as family circumstances changed. Among the case-study states, Oregon appeared to be the most proactive in this way, sending an annual letter to all families receiving a subsidy to remind them to contact the state office if their circumstances have changed such that they require more (or less) support.
Adoptive parents lacked necessary information on subsidies.
Flexibility in policy is of limited value unless adoptive families understand what resources may be available to them and how they can be accessed. In four of the five states, adoptive parents participating in focus groups expressed considerable frustration and confusion related to subsidies. They described themselves as confused as to how subsidy levels were set and the extent to which parents can influence their provision.
Parents in one group believed that subsidy levels were set by the state and were not negotiable. This confusion is notable because parents participating in these focus groups all were involved to some extent with the states PAS program. Thus they could be expected to be better informed, and more able to resolve questions of this sort, than other adoptive parents. One parent suggested that parents receive a bill of rights during the home study period that explains what they can ask for and do to obtain subsidies that meet their needs. The Oregon Adoption Assistance Handbook provides an example of such a document, including definitions of eligibility criteria, Title IV-E eligibility, the application process, Medicaid eligibility, and provisions for appeals.
For states to garner federal participation in a subsidy award, the award must be no higher than the states foster care rate. Some states have low foster care rates, and others have state laws that limit subsidies to the basic foster care rate rather than a higher rate paid for special-needs children or children in treatment foster care or group care. States that are constrained from offering generous subsidies could compensate by offering strong PAS programs. Or states that have flexibility around the amount of subsidies paid might allow families to use subsidies to purchase services in the marketplace.
The case-study states offered generous adoption support in addition to strong PAS programs.
Data on state adoption support policies compiled by the North American Council on Adoptable Children (NACAC) suggest that in the five case-study states, strong PAS programs are accompanied by relatively generous subsidies and other supports. However, case study data did not reveal any suggestion of a planned effort to coordinate the various forms of support to which families have access. Although strong advocates for adoptive families are likely to find a variety of ways to pursue their goals, their efforts may be moderated by the organizational and political complexity of programs, agencies, and funding streams involved.
|Provisions of special needs definitions that met or improved upon federal definition||Medical condition or handicap||Ethnicity or minority race, age, medical condition or handicap, high disability risk||Ethnicity or minority race, medical condition or handicap, need for placement with foster parents||Ethnicity or minority race, medical condition or handicap||Ethnicity or minority race, age, medical condition or handicap, need for placement with foster parents, sibling group, high disability risk|
|Basic AAP subsidy amount:|
|Specialized AAP (SAAP) as a percentage of specialized foster care rate||100%||Not available||100%||State does not pay SAAP||State does not pay SAAP|
|Medicaid eligibility for state-subsidized children||Under certain conditions||Yes||Yes||Yes||Under certain conditions|
|Nonrecurring adoption expense amount||$2,000||$400||$2,000||$1,500||$2,000|
|Availability of Title XX services for children receiving AAP subsidies||IV-E AAP recipients only||No||Yes||Yes||Yes|
|Special service subsidies availability||When funds available, public agency children only||Yes||Yes||Yes||Yes|
|Respite care funded or reimbursed||Yes||No||Yes||Yes||Yes|
|Residential treatment paid for||Yes||No||Yes||Yes||Yes|
|Deferred AAP agreements offered||Yes||Yes||Yes||Yes||Yes|
|Subsidized guardianships possible||No||Yes||Yes||No||No|
|Similar treatment for public and private agency adoptions||Yes||If IV-E eligible||Yes||No||Yes|
|AAP subsidies for children over 18 years||Yes||Yes||No||Yes||Yes|
|AAP administration||County||Statewide||Statewide||Statewide||Local offices|
|AAP = Adoption Assistance Program
Source: Bower and Laws, 2002.