Adoption Assistance in America — Executive Summary
Purpose and Methodology
With its enactment of The Adoption Assistance and Child Welfare Act of 1980 (Public Law 96-272) nearly fifteen years ago, the United States Congress began to promote special needs adoption by providing federal reimbursement for adoption assistance payments made to families that adopt special needs children. Under 96-272, states must establish adoption assistance programs that provide monthly maintenance payments, Medicaid coverage, selected social services, and reimbursements for nonrecurring adoption costs to families adopting eligible children.
The North American Council on Adoptable Children (NACAC), through the support of the W.K. Kellogg Foundation, undertook this study to:
assess the general effectiveness of adoption assistance programs around the country
construct profiles of the children and families that receive assistance, as well as the types and sufficiency of benefits made available to them
analyze the impacts that various systemic policies and practices have on the distribution of these benefits
highlight dominant trends and areas of programmatic concern among assistance providers and recipients.
To address the objectives described above, NACAC solicited input from (1) state-level adoption administrators and policymakers, (2) front-line adoption workers, and (3) adoptive families in twenty states, including: Arizona, California, Colorado, the District of Columbia, Illinois, Indiana, Kansas, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Montana, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Texas, and Washington. In total, 27 (at least one per studied state) administrators and/or policymakers (i.e. state adoption supervisors, state legislators, and budget analysts), 140 workers (seven per state?five from public and two from private agencies), and 532 families (responsible for finalizing 753 domestic adoptive placements through licensed public or private agencies after 1990) provided information via telephone interview and written survey instrument.
In compiling stakeholder response, we learned that:
Stakeholders were virtually unanimous in their contention that adoption assistance programs are facilitating the permanent placement of children who might otherwise remain unadopted.
Special needs and/or subsidized adoptions are now the rule, rather than the exception, for most agencies across the country, particularly those in the public sector.
On average, 78% of the agency-facilitated adoptions finalized in the survey states in their most recent reporting year involved the provision of some form of adoption assistance.
Seventy-one percent of workers interviewed said that at least 75% (with many citing figures as high as 90-95%) of the adoptive placements they finalize are subsidized.
Assistance expenditures in most states have grown roughly 15?20% during the past year, 30?40% over the past three years, and 60?75% in the past five years.
Thirteen percent of the families in the sample population that adopted special needs children were never notified in any way of their state?s adoption assistance program.
Twenty percent of the children in the sample population with identifiable special needs (according to their respective states? individual special needs definitions) were placed without monthly maintenance payments, and 43% of the families that adopted them received no reimbursement for nonrecurring adoption costs.
Profiles of Adoption Assistance Recipients and Benefits Received
Children from the sample population who were placed with monthly adoption assistance (and the families that adopted them) exhibited the following characteristics:
Race of children placed with monthly subsidy:
African-American 30% (71% of all African-American adoptees received monthly subsidy)
Asian less than 1%
Hispanic 8% (78% of all Hispanic adoptees received monthly subsidy)
Native American 2%
mixed race 16% (63% of all mixed race adoptees received monthly subsidy)
white 44% (63% of all white adoptees received monthly subsidy)
Note: Total numbers of Asian and Native American adoptees were insufficient to derive meaningful percentages of each group receiving monthly subsidy.
Age (at time of placement) of children placed with monthly subsidy:
two years of age or less 24%
between three and five years of age 31%
between six and ten years of age 34%
11 years of age or older 11%
Average age (at time of placement) of all children placed with monthly subsidy: 5.6 years
Adoptive Parent/Family Profile:
Average parental age at time of placement: 40.9 years
Race of adoptive head(s) of household:
- African-American ? 20% (75% of all adoptive households headed by African-American parents received monthly subsidy)
- Asian ? less than 1%
- Hispanic ? 1%
- Native American ? less than 1%
- interracial ? 8% (68% of all adoptive households headed interracially received monthly subsidy)
- white ? 71% (57% of all adoptive households headed by white parents received monthly subsidy)
Note: Numbers of adoptive households headed by Asian, Hispanic, and Native American parents were insufficient to derive meaningful percentages of total households of each race/ethnicity receiving monthly subsidy.
Number of other adopted children in the home at the time of subsidized placement:
- no other adopted children ? 45%
- one other adopted child ? 28%
- two other adopted children ? 13%
- three or more other adopted children ? 14%
Total annual household income:
- less than $15,000 5%
- between $15,000 and $35,000 36%
- between $35,000 and $50,000 32%
- between $50,000 and $75,000 20%
- more than $75,000 7%
In terms of other benefits received, respondents provided the following information:
On average, 70% of the children in subsidized placements in the studied states were Title IV-E eligible, with several of the most highly populated states reporting rates as high as 95% and 97%, respectively.
Seventy-five percent of the special needs adoptees were placed with Medicaid cards.
Fifty-seven percent of the special needs adoptees (and/or their adoptive families) received "concrete" services.
Opinions on Specific Programmatic Provisions and Operating
Policies governing the following programmatic provisions were viewed as impacting?both positively and negatively?adoption assistance benefit distribution across the country: (1) "special needs" definitions; (2) "reasonable efforts" to place without adoption assistance; (3) individualized assistance negotiations; (4) income and resource consideration; (5) maintenance payment determination and sufficiency; (6) annual reviews; (7) agreement modification procedures; (8) fair hearing/appeal processes; and (9) the general programmatic ineligibility of international and "independent" adoptees.
Despite significant state-by-state differentiation in systems operation, respondents identified six problems that plague adoption assistance programs across jurisdictional boundaries:
Administrative interviewees viewed the current linkage between IV-E eligibility and AFDC eligibility as the single greatest impediment to comprehensive and equitable adoption assistance offerings nationwide.
Forty-one percent of front-line workers interviewed had never received formal adoption assistance training of any type.
Only 46% of all front-line interviewees felt "completely familiar and comfortable" with the workings of their home state?s adoption assistance program.
Workers? knowledge deficits detrimentally impact special needs children and the families adopting them. Of the parents adopting special needs children who were notified of their state?s adoption assistance program, only 65% said they received information in a "clear and understandable" manner.
Fifty-eight percent of administrators, 61% of workers, and 36% of special needs adopters said that services provided through or in conjunction with their state?s adoption assistance program are insufficient to meet the needs of special needs children. The most commonly cited service needs were counseling and mental health services, respite care, tutoring/educational services, day care, and residential treatment services.
Forty percent of administrative interviewees and 33% of front-line staff said that children and families served by private agencies in their state have less access to adoption assistance benefits than those served by public (state and county) agencies.
Eighty-five percent of the families that adopted special needs children through public agencies received monthly maintenance payments, compared to 65% of the special needs adopters that worked with private agencies.
Forty-five percent of interviewed administrators and 64% of surveyed front-line workers claimed that interstate placements are "particularly problematic" within the adoption assistance framework.
Operational, attitudinal, and fiscal differences between counties and regions, as well as the staff and administrators working within them, often lead to inequities and inconsistencies in benefit distribution and service delivery.
Future Trends, Hot Topics, and Unresolved Issues
In addition to identifying a set of universal problems, administrators, workers, and families highlighted and discussed a group of core issues, trends, and ideas central to the future of special needs and subsidized adoption in America, including:
Respondents gravitated to two basic schools of thought when discussing "proper" programmatic purpose and objectives: (1) adoption assistance as a promotional tool or "enticement" to adopt; and (2) adoption assistance as reimbursement for, and coverage of, specific, identifiable payments and services only.
In attempting to control program expenditures, some administrators and front-line workers around the country have begun to question the validity of certain special needs eligibility criteria, most notably those tied to the racial or ethnic status of children in substitute care.
Several states have begun testing P.L. 96-272?s statutory limits by openly pressing for routine, standardized consideration of family resources when determining adoption assistance eligibility within their jurisdictional borders.
Interviewees reported growing usage of "deferred" subsidy agreements (formalized, signed agreements which initially establish monthly maintenance payment rates of $0 until a specific need for assistance arises at some future date) by adoption assistance practitioners around the country.
Post-finalization requests (requests for adoption assistance after adoptive placements are finalized) now make up a significant proportion of all assistance requests processed in many jurisdictions.
Respondents identified kinship adoption in general, and its relationship to adoption assistance in particular, as areas requiring further analysis and greater understanding.