A Report to Congress on Interjurisdictional Adoption of Children in Foster Care

Administration for Children and Families

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IV. Study 1: Barriers Study: Staff Perspectives

A. Methods

To obtain additional perspectives on barriers to adoption, the research team distributed surveys to participating public and private agencies for completion by administrative staff, recruitment staff, adoption exchange staff, adoption subsidy staff, and family and child workers. A goal of 360 completed staff surveys was set. The 29 items on the survey included questions assessing agency and system barriers, family and child barriers, solutions to overcome barriers, and child's preparation for adoption. The survey was available to agencies in either electronic or hard copy form. Electronic copies were sent to agency liaisons via e-mail attachments and liaisons were asked to forward the survey to all available adoption-related staff for completion. Hard copies were mailed in individual packets to agency liaisons and individual packets were provided to all available adoption-related staff. Both versions of the survey were sent with a cover letter, which contained instructions for completing and returning the survey. Hard copy surveys were also distributed at national, regional, and local conferences and trainings by the Principal Investigator or AdoptUsKids Trainers.

Approximately 1,659 surveys were sent to staff in 34 States and Washington, D.C. A total of 382 (23 percent) surveys were returned. Surveys were returned from staff located in 29 States and the District of Columbia.¹⁷

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B. Staff Demographics

Of the 382 respondents, 323 (85 percent) were female, 39 (10 percent) were male, and 20 (five percent) did not provide information about their gender. On average, staff respondents had worked at their current agency 10.3 years. Two hundred sixty-nine staff (70 percent) worked in a State agency, and 113 (30 percent) worked in a private agency.

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C. Results

From a list of agency, family, and child factors, staff respondents were asked to rate on a scale of one to five the extent to which they believed these factors were barriers to the adoption process, with "one" indicating "not a barrier at all" and "five" indicating a "major barrier." For purposes of analysis, ratings of two and three were combined to indicate "somewhat a barrier" and responses four and five were combined to indicate "major barrier." The top five agency, family, and child factors rated by staff as "major barriers" are described below. Additional analyses were conducted on the seven States with public and private agency representation (59 private agency staff and 78 public agency staff) to determine whether statistically significant differences existed between public and private agency staff members' perceptions of major agency, family, and child barriers, using a significance level of .05. Unless otherwise noted, statistically significant differences were not found between public and private agency staff perceptions of major barriers.

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1. Agency Barriers

Inadequate pool of families appropriate for adoption of children with special needs/Inadequate pool of prospective adoptive families (in general).
Of the 382 staff respondents, 67 percent (n = 255) rated "inadequate pool of families appropriate for adoption of children with special needs" as a major barrier (rated a four or five on the rating scale). Fifty percent also rated "inadequate pool of prospective adoptive families (in general)" as a major barrier.

After rating each factor listed on the survey on a scale from one to five, survey respondents were given an opportunity to identify strategies for overcoming the factors they rated as "major barriers." For example, to overcome the problem of having an inadequate pool of prospective adoptive families, the majority of respondents stated that agencies should increase their efforts at family recruitment. More specifically, staff noted that "recruitment of minority families" and "families willing to adopt older children and sibling groups" were needed. Other solutions to this barrier included: 1) hiring workers whose sole responsibility is recruitment; 2) improving and increasing marketing and community awareness; and 3) dedicating State funds to Statewide recruitment. One respondent also added that agencies should "utilize our families to get the word out about adopting," as [adoptive] families are "a major resource we have yet to use."

There was a statistically significant difference in how public and private agency adoption staff perceived barriers related to inadequate pools of families, in general and for children with special needs. Analyses revealed that 60 percent of adoption staff working in private agencies rated "the lack of families appropriate for adoption of special needs children" as a major barrier, whereas 80 percent of adoption staff in public agencies rated it as a major barrier.
Jurisdictional issues related to termination of parental rights (publication, litigation, full dockets, etc.)
Forty-eight percent (n = 183) of survey respondents rated "jurisdictional issues related to termination of parental rights (TPR)" as a major barrier. Full dockets, paperwork delays, too few judges and court personnel, appeals by birthparents, and judges giving birthparents "too many chances" were all cited as reasons for delays in the termination process. Over half (59 percent) of respondents who rated this a major barrier believed that hiring more judges and attorneys and training and educating judges and attorneys, specifically about the Child Protective Service system and termination of parental rights, would begin to address this barrier. Other solutions offered by respondents included changing current laws and policies to speed up the process, prioritizing TPR cases, increasing communication and cooperation within the jurisdictions, and reducing caseloads or hiring more staff to address the problem of paperwork delays.
Interstate Compact on the Placement of Children (ICPC)
Of 382 staff respondents, 46 percent (n = 176) believed that there were barriers in relation to the Interstate Compact on the Placement of Children (ICPC). Poor communication and coordination between States, failure to adhere to timelines, and disagreement between States regarding responsibility for services were all cited as problematic aspects of the ICPC process. One respondent characterized the ICPC process as a "large barrier for out-of-State adoptions... Once a family is selected in another State and the ICPC application has been processed, the child CANNOT visit the selected family. Time to bond must be put on hold; often the process takes six to nine months to get approval in the receiving State."

Solutions that were suggested by staff to overcome barriers related to ICPC included streamlining the entire process, holding States accountable for ICPC timelines and service provision, and promoting cooperation among workers while also emphasizing worker persistence. One staff member specifically suggested that "bureaucratic barriers" to the ICPC process be reduced by "hold[ing] States accountable for delays in completing home studies or approving placement, [and] eliminating discrepancies between IV-E Medical Assistance and non-IV-E Medical Assistance for kids moving across State lines."¹⁸

There was a statistically significant difference in how public and private agency adoption staff perceived ICPC barriers. Analyses revealed that 34 percent of adoption staff in private agencies rated ICPC as a major barrier, whereas 64 percent of adoption staff in public agencies rated it as a major barrier.
Size of workers' caseloads
Forty-five percent (n = 172) of survey respondents rated "size of workers' caseloads" as a major barrier to the successful completion of the adoption process. For many caseworkers, this not only included the number of cases carried but also a number and range of responsibilities in areas other than adoption, such as child protection. Both were thought to create delays in the adoption process.

Of the respondents who listed caseload size as a major barrier, 62 percent said the solution to this problem was to reduce caseloads by hiring more staff. In addition, respondents believed that worker responsibilities needed to be reorganized or reduced in order to increase their focus on adoption cases. They believed that hiring more workers might also help to relieve some of the additional responsibilities that they have. Respondents suggested that in order to hire and retain competent and committed staff, agencies should increase pay as well as provide compensatory and overtime pay.

There was a statistically significant difference in how public and private agency adoption staff perceived caseload barriers. Analyses revealed that 42 percent of adoption staff in private agencies rated caseload size as a major barrier, whereas 63 percent of adoption staff in public agencies rated it as a major barrier.
Availability of post-adoption services after finalization/Lack of respite care
Forty-two percent (n = 160) of survey respondents believed that the lack of availability of post-adoption services after finalization was a major barrier in the adoption process. Services seemed to be particularly scarce in rural areas. One respondent noted the "limited availability of services for children with serious special needs, especially in the area of mental health and sexual abuse." Forty percent also rated the lack of respite care services as a major barrier.

More than half (56 percent) of respondents who rated lack of post-adoption services as a major barrier believed that funding was the best solution to this problem. While some respondents noted that existing services should be improved, most concluded that existing services could be expanded and improved through funding, and that new services could be offered if more funding was available. One respondent proposed that prospective adoptive families provide respite for families who have adopted, which would provide a needed service for adoptive families, and serve the purpose of providing the hands-on training that respondents believed to be critical in several areas of family training and education.

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2. Family Barriers

Prospective adoptive parents' specificity in type of child desired (i.e., parent wants young child with minimal special needs).
Sixty-seven percent (n = 256) of agency staff survey respondents rated the adoptive parents' specificity in the type of child they desired to adopt as a major barrier to the adoption process. Survey responses indicated that prospective adoptive parents may have unrealistic expectations about the type of children available for adoption or unrealistic behavioral expectations of children with special needs. Furthermore, responses seemed to indicate that many prospective adoptive parents want to adopt a young, Caucasian child with minimal special needs.

Of the respondents who rated this as a major barrier, 49 percent believed that the barrier could be overcome through training and education of prospective adoptive parents, as well as hands-on experience with children who have been in foster care. Related to the idea of hands-on experience, one staff member added that "nurturing the relationship between the adoptive parent and former foster parent can be very helpful in helping adoptive families broaden their perspectives on the needs of the child and how community resources can be very helpful." Additional suggestions to overcome this barrier included recruiting families who are open to adopting older children, sibling groups, and children of color, and improving the screening process of prospective adoptive parents. Respondents recommended that agency staff members screen families more rigorously and get more information from prospective parents in the screening process, suggesting that careful and thorough screening early on may reveal prospective parents' desires and expectations and areas in which training and education were needed. Beyond better screening, survey respondents believed that workers have a responsibility to give prospective adoptive families accurate, honest, and thorough information about the type of children who are available for adoption.
Prospective adoptive parents' criminal background (major offenses, such as crimes against a person or substance abuse convictions).
Fifty-one percent (n = 195) of survey respondents rated the criminal background of prospective adoptive parents as a major barrier to families being approved for adoption and completing the adoption process. Specifically, offenses such as crimes against a person and substance abuse convictions tended to keep many families from being approved for adoption.

Of the 51 percent who rated criminal background problems as major barriers, 28 percent of survey respondents reported that the barrier should not be overcome or the barrier could not be overcome. Staff also recommended that prospective adoptive parents should be better screened and that criminal and background checks should be thorough and conducted as early as possible.
Prospective adoptive parents' inability or unwillingness to accept certain characteristics in a child's history or background.
Forty-five percent (n = 172) of staff survey respondents rated prospective adoptive parents' inability or unwillingness to accept certain characteristics of a child's history or background as a major barrier. Some staff members perceive that parents' unwillingness to accept a child's background is due to a lack of education and misunderstanding that "love will solve the problem." Other survey respondents reported that some parents expect children to adapt to their home environment, rather than parents and children adapting and changing together.

Almost two-thirds (64 percent) of respondents who rated this factor as a major barrier suggested that prospective adoptive families should be offered training and education which "stretches" families' perceptions of what types of children and behaviors they can handle. Related to training and education, respondents suggested that training in the form of hands-on experience with children who have lived in foster care would be beneficial. Agency support and family therapy were also offered as ideas for increasing families' acceptance of children's backgrounds and histories.

There was a statistically significant difference in how public and private agency adoption staff perceived barriers related to prospective parents' inability or unwillingness to accept certain child background and history characteristics. Analyses revealed that 41 percent of adoption staff in private agencies rated this as a major barrier, whereas 61 percent of adoption staff in public agencies rated it as a major barrier.
Prospective adoptive parents' unwillingness to access services or community resources.
Forty-four percent (n = 168) of staff survey respondents rated prospective adoptive parents' unwillingness to access services or community resources as a major barrier to the completion of the adoption process.

Of the 44 percent who rated this factor as a major barrier, 45 percent believed that family training and education were needed to overcome this barrier. Specifically, families needed to be educated on services and resources available in the community, and they needed to be trained on how to access these services and resources. One survey respondent added the following:

"It should be known that our children need safe, stable, loving parents and environments; needing parents who are assertive and who can get the child's needs met if/as they arise. They need parents who are mentally and physically healthy so there is a probability of longer term permanence for the child."

Some adoption staff believed that in addition to training and educating families, more services and resources were needed in the community. In addition, the existing services and resources available in the community should be improved and better funded, namely in the areas of agency support services and family therapy.
Prospective adoptive parents' lack of experience with special needs children.
Forty-one (n = 157) percent of staff survey respondents perceived prospective parents' lack of experience with special needs children to be a major barrier to the adoption process. Over half (53 percent) of these respondents recommended training and education to overcome this barrier. Twenty-one percent also recommended that family training include hands-on experience with children who have lived in foster care or that families be matched with an adoptive family that can serve as a "mentor" for the prospective family. Adoption staff believed that close supervision and support by the agency would be helpful, as would therapy for the family and adopted child.

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3. Child Barriers

Child's age
A large majority of survey respondents reported that a child's age (11 years old or older) was a major barrier to the adoption process. Eighty-four percent (n = 321) rated "14 or older" as a major barrier, and 54 percent (n = 206) rated "11 - 13 years old" as a major barrier. One respondent expressed the following sentiment: "We leave kids in inadequate foster homes for too long and let kids get too old in the system. We have no budget for special needs adoption recruitment, even though we know we have hundreds of waiting kids."

When asked to suggest ideas for overcoming barriers related to age, just over half (51 percent) of respondents who rated these to be major barriers thought that recruitment was the solution to age barriers. Respondents reported that recruitment efforts should be targeted and focused on families who are willing to adopt older children. Staff members recognized that the agency's role in overcoming age barriers not only involved recruitment but also increasing community awareness and use of media campaigns. Furthermore, some respondents believed additional family training and education about older children in the system might result in more families considering adoption of an older child. One respondent suggested that agencies and workers "increase the push for parents to adopt teens—end this cycle within systems that says teenagers are unadoptable and don't need families." Another added that agencies should "provide child-specific recruitment efforts to adolescents to locate resources who had an established connection with youth (birth family member, previous foster parent, mentor, coach, teacher, etc.)."
Child is currently engaging in sexual perpetrating behaviors/Child has a history of sexual perpetration
The majority of adoption staff who responded to the survey rated "child's current sexual perpetrating behaviors" and "child's history of sexual perpetration" as major barriers to the adoption process (n = 309, 81 percent and n = 294, 77 percent respectively). Workers noted that a lack of adequate therapeutic services to address sexual perpetration issues further compounded this barrier, as did prospective adoptive parents' fears that adopting a child with sexual perpetration issues would harm or negatively impact other children living in their homes.

Of survey respondents who rated sexual perpetration issues as major barriers, 46 percent believed that funding for therapy and support group services for the child and for families was critically needed during pre- and post-adoption. Some workers stated that these services already existed, but that the services would be improved by having therapists who were specifically trained to work with children and families and who could address problems and issues that are unique to adopted children and adoptive families. In addition, adoption staff believed that prospective adoptive parents could benefit from additional training and education, specifically on sexual perpetration issues and handling associated behavioral issues. Five percent of workers believed that children who have histories of being sexual perpetrators or who continue to be sexual perpetrators should not be placed in homes with other children.
Child is currently engaging in sexually acting out behaviors/Child has a history of sexual acting out (i.e. public masturbation, provocative, etc.)
Children currently engaging in sexually acting out behaviors or children with histories of sexual acting out were both rated by survey respondents to be major barriers (n = 298, 78 percent and n = 283, 74 percent respectively). Similar to barriers related to sexual perpetration, workers noted that the lack of services, funding for services, and adequate therapeutic services made these barriers even more problematic.

Suggestions for overcoming these barriers were similar to those suggested to address sexual perpetration issues, with the exception of placement with no other children. Again, survey respondents reported a need for funding to create new services for children and families, as well as a need to improve existing services. Family training and education on special needs and behavioral issues of children were also provided as ideas to address sexual acting out issues.
Need for siblings to be placed together (group of three or more)
Fifty-six percent (n = 213) of survey respondents reported that sibling groups of three or more needing to be placed together was a major barrier to placement, due to the overall inadequate pool of prospective adoptive families and because of some prospective adoptive families' unwillingness or inability to adopt a sibling group of this size.

Respondents who rated this as a barrier stated that the problem may be overcome by recruiting families who wish or are willing to adopt a sibling group of this size. It also may be addressed by educating current families on the importance of keeping sibling groups together, so that families may broaden their conceptions of what types of children, and how many children, they wish to adopt or can handle.
Child has behavior problems in the home
Fifty percent of staff survey respondents reported that children's behavior problems in the home were major barriers in the adoption process. Among the problems mentioned by staff were oppositional defiant behavior, verbal and physical aggression, manipulation, and lying.

Of the 50 percent who rated behavioral problems in the home as a major barrier, 33 percent believed that support and therapy for both the child and the family was necessary to overcome this barrier. Beyond availability of therapy, staff members believed that the quality of the therapeutic services was equally if not more important. One staff member elaborated by saying children should be enrolled in "...positive counseling, not just someone who the kids can bowl over with their stories of abuse and neglect, someone who will get in there and work with the children." Other ideas for overcoming this barrier included training and education for families, particularly in the area of behavioral issues and special needs. Staff members also believed that improved parenting in the form of increased supervision, consistency, and discipline, may be helpful in reducing behavior problems in the home.

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4. Differences Between Public and Private Agency Staff Perspectives

Differences were noted in perspectives between public and private agency respondents. Adoption staff working in private agencies and public agencies identified agency or administrative, family, and child factors that they perceived to be major barriers to the successful completion of the adoption process. Statistically significant differences existed between public and private agency staffs' perceptions of major agency and family barriers. Although public and private agency staff agreed that the lack of families available and appropriate to adopt children with special needs was a major barrier, public agency staff believed this to be a greater barrier than did private agency staff. Public and private agency staff also differed in how they perceived ICPC and caseload size as major barriers, with public agency staff rating these as greater barriers than private agency staff. In the rating of family barriers, more public agency staff rated the prospective adoptive parents' inability or unwillingness to accept a child's background and history as a major barrier than did staff working in private agencies.

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¹⁷ Findings must be interpreted with caution, as samples in each State are not representative and may not include responses from both public and private agency staff. Of the 29 States and the District of Columbia, there were seven States from which both public and private agency surveys were received. These States include Arizona, California, Colorado, Illinois, Minnesota, Mississippi, and Texas. Of these seven, three are among the States with the highest numbers of available children waiting for adoption: Texas with 10,147 waiting children, California with 4,903 waiting children, and Illinois with 3,621 waiting children. back
¹⁸ The Interstate Compact on Adoption and Medical Assistance (ICAMA) of 1986 was enacted to coordinate the provision of adoption subsidies, medical assistance, and post-adoption services to children placed for adoption across State lines (Rycus, Freundlich, Hughes, Keefer, & Oakes, 2006). ICAMA ensures that children placed for adoption across State lines who are eligible for Title IV-E assistance are able to receive medical services. However, ICAMA does not guarantee medical coverage for children who are not Title IV-E eligible. Eligibility for medical coverage for a child who does not qualify for Title IV-E assistance must be negotiated between the sending and receiving State and/or county child welfare systems. Typically, the sending State agrees to pay for the child's medical expenses until the adoption is finalized and the child becomes a legal resident of the receiving State (Smith, 2005). back