Each of the states in the case study contracted out its PAS program to providers who delivered services either statewide or regionally. Data from the ILSU survey suggest that most other states providing PAS contracted out some or all of the services. State adoption program managers identified several advantages to this model, including better protection against fluctuations in state agency budgets, the ability to standardize services throughout the state (especially in states where services are administered at the county level), and the avoidance of the stigma many adoptive parents feel in approaching the child welfare agency for PAS.
States developed a variety of structures by which they offered consumer-driven services and statewide coverage, but serving rural areas remained challenging.
Several of the case-study states consciously worked to make their PAS program consumer-driven, providing families with an array of services from which to choose. Adoptive parents did not specifically mention these consumer-driven efforts, but it was clear that they had taken advantage of the flexibility. Parents in focus groups cited using varying types of PAS.
Although PAS programs shared the goal of making services available statewide, each coordinator reported frustration in the programs ability to make services truly accessible in rural areas. Barriers included the scarcity of mental health services (adoption-competent or not), difficulty in gathering adequate participation for a training or support group, and increased travel time for program staff. Because online support groups appear to be effective with social workers (Meier, in press), PAS programs might want to consider new communication technologies for parent support and perhaps for training. The reported success of the online support group in Virginia lends credence to the potential effectiveness of using new technologies to support adoptive families. At least one state has attempted an online approach to training, although with limited success.
Support for adoptive families must be communicated by the child welfare system as well as PAS providers.
Although many states choose to contract out PAS services, focus groups with adoptive parents suggest that some level of post-adoption support should be maintained within public child welfare agencies. Most states expect adoption workers to be accessible to adoptive families for at least a limited time, and because of their association with the child, adoption workers are likely to be the ones that families in need of PAS will turn to as the first responders. However, families participating in focus groups reported that adoption workers often lacked interest in their ongoing welfare. Worse, the families reported encountering surprisingly negative attitudes from some adoption workers and intake workers when seeking residential care or other services. Some PAS programs in the case-study states were addressing this issue by offering training in adoption issues to public agency workers. If families are to feel confident about support from the system, system support must be consistently communicated to them at any point of entry to PAS, even if the content of the interaction consists only of a referral to the PAS program.