RESPONDENT: Teresa Strom, Child Welfare Policy Consultant, Division of Social Services North Carolina Department of Health and Human Services
I. General information (background on state service system)
County-based vs. statewide system
The Division of Social Services is a county-based child welfare system administered through 100 counties in 11 regions of the state.
Uniformity of services across the state
There is considerable variation in services across counties.
Children on subsidy as of June 2013
Approximately 15,204 children and 9,500 families.
Are public child welfare adoption workers expected to provide post-adoption services?
The policy manual states that post-adoption services are to be provided, including responding to questions, maintaining a list of mental health providers, Medicaid providers and respite care services and providing financial assistance information or other information. Each county determines how this is implemented. For most counties, child welfare workers offer information and referral services to families who are having problems, and adoptees searching for bio-families are referred to the confidential intermediary program.
II. Post-Adoption Services Funded by the State for Adoptive Families
North Carolina budgets $2 million annually for post-adoption services, which is divided equally among the 11 regions, yielding $181, 818 per region. (This allocation increased over the past decade to the current funding level established in 2011.) Through a Request for Application process, private agencies are invited to apply for grants to provide post-adoption services to one or more regions. Currently there are four agencies providing these services; one private agency serves six regions. There is an array of post-adoption services included in the contract, but agencies are not limited to these services. (The respondent is the monitor for these post-adoption contracts.) In FY 2011-12, 283 adoptive families received services through these contracted programs.
Information and Referral
Post-adoption services contractors provide this service, assessing the families’ situations and referring them to services as needed, including those provided directly by the private agency.
Educational Programs or Materials
Post-adoption providers provide trainings for adoptive parents – most have two trainings each year, and some have as many as six trainings. These range from half-day trainings to a day-long conference with multiple workshops. All of the providers operate lending libraries for adoptive families.
Support Programs
Post-adoption contracted agencies have struggled somewhat with getting support groups established. Three of the four providers have succeeded with getting groups running, but the other has not been successful. The provider in the eastern part of the state had a support group run by adoptive parents prior to receiving the post-adoption contract, and it has continued to be a strong resource to parents. One provider’s website lists support groups in eight cities, which include foster and adoptive parents.
North Carolina
Therapeutic Interventions
All of the four post-adoption programs offer some type of therapeutic counseling services. Two of them provide intensive family preservation services. The largest provider works with a statewide learning collaborative related to trauma-informed treatment and provides TF-CBT.
Advocacy
Post-adoption providers assist families with advocacy as needed, particularly in relation to helping parents navigate the educational system and find residential treatment when needed.
Respite
Post-adoption providers all offer respite services. Some use child care workers from their agencies to provide the respite; others have adoptive parents find their own providers.
Residential Treatment
Does the state pay for residential treatment for children adopted from foster care? What is the process for obtaining this?
The need for residential treatment is a mental health issue that is typically handled through a managed care organization. An adopted child would not come back into foster care unless the adoptive parents are strongly insisting on this, and it is deemed to be necessary.
Does the child have to re-enter state custody?
The child welfare system would not pay for residential care unless the child re-entered state custody.
III. Qualifications for Post-Adoption Services
A. What are the eligibility criteria for receiving services?
Just that the child is adopted; the existing programs do not deny post-adoption services to other types of adoptive families.
B. Under what circumstances, if any, are these services provided to children who were not adopted through North Carolina’s Division of Social Services?
See above. Having a finalized adoption is the only criteria for eligibility.
IV. Support for Post-Adoption Services
A. What is the total annual budget for post-adoption services (excluding Adoption Assistance)?
$2 million
B. What are the primary sources of funding for post-adoption services? (Please order from 1=top funding source to the source that the lowest amount of funds is used.)
Title IV-B, Part 1, Child Welfare Services 1
Title IV-B, Part 2, Promoting Safe and Stable Families for “Adoption Support & Promotion"
Title IV-B, Part 2, Promoting Safe and Stable Families from categories other than adoption
Adoption Incentive Funds
Early Periodic Screening and Diagnostic Testing Title XX, Social Services Block Grant (SSBG)
North Carolina
Donaldson Adoption Institute 159
Title IV-A, TANFF
Federal grants such as Adoption Opportunities
Other federal funds-specify: ________________________________________ State child welfare funds
Other state funds-specify: __________________________________________
C. Which, if any, of these services is legally stipulated in state law? If any post-adoption services are included in state law, please describe:
None.
D. Have there been significant cutbacks in post-adoption services or adoption subsidies in the state in the past 10 years? If so, please describe:
No. Budget for post-adoption services has increased.
V. In your state, are there noteworthy practice models or research reports related to adoption support and preservation that you could share with us?
A. Please describe practice models:
Aspects of the programs are exemplary, such as their trauma focus, emphasis on strengthening protective factors, and the practice of completing a functional assessment of the child and family at the beginning of services.
B. Significant findings of program evaluations or other post-adoption studies conducted in the State in the past 10 years:
None.
VI. Please share any strategies that you have used to successfully advocate for post-adoption services in your state.
The state Department of Health and Human Services recently succeeded in resolving barriers to Medicaid coverage for mental health therapists seeing adopted children by changing the state’s Medicaid policy. A 2011 state law created regional mental health agencies that managed their own patient-care networks and state, local and federal funds that pay for services. It stipulated that the counties where children originally went into DSS custody is where their Medicaid was based, and there were many barriers when home county MCOs had to contract with providers in another county. Now children’s Medicaid can be transferred from one county to another. A group within the state Department of Health and Human Services met for about a year to help come up with the policy change, and adoptive parents assisted in advocating for this.