The case-study states were fairly consistent in offering a core set of services (information and referral, education and training, support groups, respite, and counseling). Within this core, the variety with which states addressed these core services reflects considerable creativity in program design and commitment to adapting service delivery to local conditions. It also suggests the potential usefulness of systematic program evaluation in shedding light on which service delivery approaches work best under various circumstances.
Respite care was highly valued by families but difficult to provide.
Respite care appears to be a particularly challenging need to address. Families consistently reported it as a need: in the literature, in state needs assessments, and in these focus groups; and states have tried a variety of approaches in providing respite. Two states offered respite in congregate settings, through camps and weekend outings. In addition to offering parents a break, this model provided beneficial opportunities for adopted children to interact with one another. However, adoptive parents noted that this model did not meet the needs of very young children, those with attachment issues, and those with the most severe behavioral difficultiesin other words, the children whose parents were most in need of respite. In-home respite models might help to provide younger children with a more familiar setting, which would be less likely to raise concerns about being placed again. Such models have been tried successfully with adoptive families (Owens and Barth, 1999). Other models might be needed for families with adolescents.
The two states that assisted parents in finding and paying for family-specific respite care struggled with the challenges of finding or training providers acceptable to parents and funding agencies. Restrictions on using family members as respite providers, even though these may have been most acceptable to the child and parents, suggest a concern with the appearance of misuse of funds or providing babysitting rather than professional services. For the most part, limitations on funding meant that only a very limited level of relief was available for parents who were dealing with extremely challenging children.
Both PAS providers and focus group participants reported that PAS is more often used during times of crisis than as a preventive measure. Moreover, while state and provider interviewees mentioned sending information on PAS to families receiving adoption subsidies, they also noted a lack of coordination between adoption workers and PAS providers. A better understanding of the type of need and extent of need for both preventive and crisis services could improve service planning and provide impetus for better coordination and referral systems between adoption workers and PAS providers.
Expanding eligibility to all adoptive and pre-adoptive families could substantially extend the impact of PAS programs.
None of the case-study states offered eligibility to families in which children had been placed from the state child welfare system but whose adoptions were not yet finalized. Outreach to these families by PAS providers was limited to discussing PAS at adoptive parent classes. However, providers in several of the states expressed a strong interest in providing some of their core PAS to these families, whom they felt were facing some of the same challenges as families with finalized adoptions. Because many PAS providers also were child-placing agencies, they might have been already serving these pre-finalization families. As just described, adoptive parents also felt that greater pre-finalization assistance beyond required adoption classes and home visits were warranted. States using Title IV-B, Subpart 2 funds were not precluded from using the funds to serve these families; however, there did not appear to be any state-initiated movement in that direction.