RESPONDENTS: Rebecca Sharp, Manager
Adoptions and Intensive Foster Care and Clinical Services Program Thomas Robertson, Adoption Subsidy Coordinator
Cheryl Herring, Program Coordinator: AAP, IV-E John Shackelford, Finance
South Carolina Department of Social Services
I. General Information (Background on State Service System)
County-based vs. statewide system
The state is in the process of widespread change and system improvement. It is a regional system and, as such, adoption services are not available in every county. The state is divided into five regions (four prior to November), and adoption managers are being appointed for each.
Uniformity of services across the state, etc.
Early intervention adoption workers, also known as concurrent workers, work with birth families with an eye to permanency from the first entry to care. A worker may cover more than one county in rural areas. Other workers are strictly on adoption, and do home study, pre-service training, and placement.
Until two years ago, there were very limited post-adoption services, primarily information and referral. Because adoption finalizations increased dramatically (from 400+ to 800 annually), there was a real challenge to meet the children’s post-adoption needs. The increase also reflected a shift in the demographics of the children being adopted and included older children, medically fragile children, and children with substantial special needs.
Previously intensive foster care and clinical services (residential placements, intensive case management) were regionally based and served only those children still in state care. With the number of new adoptive families needing intensive support, this clinical unit began doing the post- adoption support and service work, beginning prior to finalization. Services are now available on a voluntary basis for 90 days after finalization.
Families who come back years later with teenagers can also access intensive case-management services. Prior to this, only residential programs could be paid for and children would have to re- enter care. Funds have been diverted from supporting residential placements to provide intervention and in-home services prior to the need for out-of-home care, and include wrap- around, school supports, crisis intervention and more.
Medicaid in the last year has moved to a managed care system as a result of South Carolina’s Governor’s leadership; this has had a negative impact on the system’s ability to meet the needs of the children and their families. Authorizations for many services have been more difficult. Agency administration recognizes the need for the services and is working to move the government to recognize and respond to this challenge.
Children on subsidy as of June 2013
South Carolina
Are public child welfare adoption workers expected to provide post-adoption services?
Yes, those regional workers described above. The state also contracts with private agencies to provide post-adoption services.
II. Post-Adoption Services Funded by the State for Adoptive Families
Post-adoption services are available through the Department of Social Services (DSS), private agencies and family organizations. Post-adoption services include services in the categories described below.
South Carolina has an Adoption Preservation (AP) program. AP services primarily consist of linking families to existing resources, case management, support services and counseling. According to the website (http://www.state.sc.us/dss/adoption/album/preserve.htm), “the purpose of these family-centered services is to support families while they identify their own problems and how they want to deal with them.”
Information and Referral
Families seeking services call their former worker for information and referral. All adoptive families are told at the point of finalization that this is the first place to go. All families are offered case management services as they finalize.
Educational Programs or Materials
Adoptive families are welcome to attend FPA training and DSS training, but many do not attend. A monthly calendar of training opportunities is provided.
South Carolina has one of the strongest foster parent associations in the nation – the state contracts with the association to do training and education in all counties. The association also does the screening of interested potential resource families.
Support Programs
Families can contact the regional offices to find out about support groups that may exist in their area. The South Carolina Council on Adoptable Children used to provide support services and an annual conference for parents and others involved in adoption. However, after the death of the leader, the Council is no longer active.
Therapeutic Interventions
Adoption Preservation staff refer families to providers in their communities. Also public mental health services for children in South Carolina are administered by the Department of Mental Health (DMH), Division of Children, Adolescents and Their Families (DCAF) and include the following examples: assessment, case management services, day treatment, out-patient treatment (counseling/therapy), in- patient hospitalization, wraparound services, residential treatment services (in-patient general psychiatric and substance abuse units), school-based services, Youthful Sexual Offenders Program, and Intensive Family Services and Multi-Systemic Therapy (MST) Initiatives. Services are largely provided through the DMH’s network of 17 local community mental health centers. DMH seeks to provide services in as natural and comfortable a setting for the family and child as possible, such as in the school or home. DMH’s vision is to develop a statewide system of services that is child-centered, family-focused, community-based, and culturally competent.
South Carolina is also making progress in their efforts to infuse trauma-informed clinical work with the mental health providers and child welfare staff.
South Carolina
Donaldson Adoption Institute 183
Advocacy
Parents Reaching Out to Parents (PRO-Parents) is a group that provides advocacy for families working with the school systems to meet the needs of their adoptive child. A state agency known as South Carolina Protection and Advocacy also helps adoptive families manage system issues. DSS local county offices locator and state contacts link: http://www.state.sc.us/dss/counties.html.
Respite
There is no formal program offered at this time, but the state would like this to be a spin-off of the support groups. Families can access respite funds on a case-by-case basis through the supplemental benefit for assistance (see below under other services). Each child can receive up to $500 for respite care annually; the family arranges the respite provision and providers.
Residential Treatment
Families are required to work to meet children’s needs in the home first. If it is determined that residential care is a necessity, the family is required to participate in treatment with a view to return home.
Does the state pay for residential treatment for children adopted from foster care? What is the process for obtaining this?
Case management must determine that this is therapeutically necessary. The family is required to work with providers to keep the child safe at home and to access intensive case management prior to looking at a residential placement. After this, the team will approve a 30-day stabilization placement. If longer stays are necessary, they require further authorization.
If yes, what is required to obtain this?
(See above)
Does the child have to re-enter state custody?
No.
Other Services
The Supplemental Benefit for Medical Assistance (SBMA) Program is available to children adopted from the foster care system and funded entirely with state dollars. It is commonly referred to as Medical Subsidy. This is available to a parent for as long as the child is eligible for the monthly subsidy. The SBMA exists for the purpose of supplementing already existing resources, such as insurance, Medicaid, and other resources. It is to be used to assist the family in providing medical treatment or medically necessary equipment for specific needs, which are listed in the child's Adoption Assistance Agreement. The annual amount of SBMA funds available to the family for a child is determined by adoption staff on a case-by-case basis. Respite care is funded through SBMA funds.
III. Qualifications for Post-Adoption Services
A. What are the eligibility criteria for receiving services?
The child has to have been adopted out of the South Carolina foster care system.
B. Under what circumstances, if any, are these services provided to children who were not adopted through South Carolina’s Department of Social Services?
This is very unusual, but has been done in cases of family preservation.
IV. Support for Post-Adoption Services
A. What is the total annual budget for post-adoption services (excluding Adoption Assistance)?
South Carolina
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.)
Pooled from a variety of sources
X Title IV-B, Part 1, Child Welfare Services
X Title IV-B, Part 2, Promoting Safe and Stable Families for “Adoption Support & Promotion"
X Title IV-B, Part 2, Promoting Safe and Stable Families from categories other than adoption
X Adoption Incentive Funds
Early Periodic Screening and Diagnostic Testing X Title XX, Social Services Block Grant (SSBG)
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 are earmarked or legislated.
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:
None noted.
V. In your state, are there noteworthy practice models or research reports related to adoption support and preservation that you could share with us?
No information.
VI. Please share any strategies that you have used to successfully advocate for post-adoption services in your state.
The state agency has responded to the emerging need for post-adoption support services and has shifted existing funds from residential and foster care to provide services to adoptive families and their children. The number of children in foster care has dropped from 5,000-6,000 to approximately 3,000. This, combined with fewer children entering residential care, has allowed for the state to meet many of the needs.