In this study and many others, states assessed the nature of service needs using surveys of adoptive families, most often those receiving federal Adoption Assistance Program subsidies. The variation in service offerings and program structure among the five states described here is evidence that states tailor their programs to family needs and existing service delivery systems. However, other than acknowledging that not all desired services could be funded, state adoption program managers provided little explicit information as to how they had made these choices.
Comprehensive planning that encompasses subsidies and existing service resources, as well as PAS programs, could increase support for adoptive families.
Adoptive families needs could be addressed in several ways other than delivery through a PAS program: (1) by making services available through existing health, mental health, or social service systems; (2) providing resources directly to adoptive families so that they can purchase services; or (3) modifying existing service systems to reduce the need for the service among adoptive families. Although these three strategies are not interchangeable, alternative routes may exist for at least some services. States that are constrained in their ability to offer increased subsidies (because basic subsidies are capped at the states foster care rate) may be able to facilitate access to other services through Medicaid programs. Services such as case advocacy within schools might be addressed in the long run through systems changes that improve understanding of adoption issues among guidance counselors. Although case advocacy is necessary to respond to families immediate needs, changing school systems could improve school interactions for all adoptive families.
Adoptive parents often face a patchwork of services and supports, from which essential pieces may be missing. A comprehensive approach to serving adoptive families would encompass subsidies and existing service delivery systems, as well as PAS programs. Such a network would be challenging to develop, requiring coordination among agencies involved in health, mental health, education, and child welfare. However, comprehensive planning eventually could offer states more efficient use of their resources while improving the delivery of services to adoptive families.