Executive Summary
The state of Texas has prioritized investments in its child welfare system to promote the adoption of children. Over the ten-year period between fiscal years 2010 and 2019, a total of 53,412 children have been legally adopted (i.e., consummated) from the Texas child welfare system. The annual number of adoptions consummated increased 27.2 percent, from 4,802 in fiscal year 2010 to 6,107 in fiscal year 2019. Data from the Texas Department of Family and Protective Services (DFPS) reflect the growing acuity and complexity in the physical, behavioral, and mental health needs of children in foster care, especially for children who remain in the child welfare system for longer periods of time. Significant resources have been invested to help all children in foster care, including children with complex needs, find their forever homes.
Concerns
The amount of funding appropriated by the Texas Legislature to DFPS for post-adoption services has not kept pace with demand for these services. The lack of appropriate funding results in the provision of limited services to a small number of adoptive families who are mostly already in crisis. Children and youth whose needs are not met post adoption may return to care. State contracted post-adoption service providers must adhere to budget approval requirements when transferring funds to meet client needs. These requirements create administrative challenges and limit provider ability to meet family needs in a timely manner.
Many families who could benefit from early linkage with support post adoption are not receiving the services that could help to strengthen and stabilize their families. Most families adopting children through the Texas child welfare system do not receive state contracted post-adoption services during the same fiscal year that their adoption was consummated. Barriers to engagement include process gaps related to how and when adoptive families receive information about post-adoption services as well as fear and distrust among adoptive families about engaging DFPS-funded services.
Recommendations
Recommendation 1: Appropriate an additional $2.0 million in General Revenue funds ($8.0 million in All Funds) to DFPS for the FY2022–23 biennium to increase funding for post-adoption services and include a rider directing DFPS to use an updated funding allocation methodology for post-adoption services that is based on the current number of adoption consummations, historical demand for post-adoption services, and an updated average service cost. To ensure accountability, the rider should also require DFPS to improve oversight of post-adoption services, including monitoring utilization and spending data, and submit a report to the Texas Legislature that details how additional funding was spent. This funding would provide for a 10 percent growth in caseload over estimated FY2020 levels (estimated that a total of 3,000 families to be served each year) with a $1,000 increase in the average amount spent per family to allow for the provision of services in addition to case management.
Recommendation 2:Include a rider in the FY2022–23 General Appropriations Act directing DFPS to provide state contracted post-adoption providers with a single funding allocation per region to be budgeted across services by the provider. Providers should be required to submit an annual budget for approval by DFPS but be permitted to make transfers between services within a region, with a requirement only to notify DFPS after the transfer is complete. Providers should be required to obtain approval from DFPS to make transfers between regions, but the updated funding allocation methodology in Recommendation 1 should help ensure that the regional budget more accurately meets family needs, reducing the need to request transfers across regions.
Objectives, Scope, and Methodology
Objectives: The purpose of this review was to identify strategies to improve the current system for delivering and funding services offered by organizations contracted by the state to provide post-adoption services in Texas, based on the assumption that improvements to the provision of post-adoption services could help to prevent adoption dissolutions.
Scope: This report focuses on the supports and services offered by state contracted post-adoption providers in Texas and provided to adoptive families after adoptions are legally finalized (i.e., consummation). Adoptions are defined to include the adoption of children from the Texas child welfare system administered by the Department of Family and Protective Services (DFPS). Adoptions from the child welfare system include “foster to adopt” families, kinship adoptions, and “match” adoptions whereby families are matched with a child with whom they did not previously foster.
While the report does briefly discuss findings related to preparing and serving adoptive families prior to consummation, an in-depth review of these issues was beyond the scope of this report. We do, however, recommend that additional action be taken to more fully understand and address key areas prior to adoption. Services provided to children who are permanently living with a relative, including cases where the relative has permanent managing conservatorship, but have not been adopted are not included in the scope of this report. DFPS also contracts for the provision of post-permanency services (funded out of the same strategy as post-adoption services, B.2.5., Post-Adoption/Post-Permanency Purchased Services). While there are some similarities between the services available, those programs are not included in the scope of this report, though some of the recommendations may be applicable. Methodology:
The Importance of Post-Adoption Services in Texas
The state of Texas has taken steps to promote the adoption of children from the state’s child welfare system. Over the last six years, in response to the Texas Sunset Advisory Commission’s 2014 legislative report, a 2014 Operational Review performed by The Stephen Group, legislative direction, and agency initiative, DFPS has implemented numerous strategies to reduce the time to positive permanency and reduce the number of individuals who have been in the state’s care for longer than two years, including through relative and nonrelative adoption.
Children and Trauma in the Foster Care System
Many families struggle to address the complexity of behaviors that result from the trauma and loss their children have experienced prior to being adopted from the Texas child welfare system. A report by the national Evan B. Donaldson Adoption Institute synthesized existing knowledge in the field of post-adoption services, including the challenges faced by these families, the research on adoption outcomes, and the range of service needs for adoptive families. The report found that most adopted children, because they suffered early deprivation or maltreatment, come to their new families with elevated risks for developmental, physical, psychological, emotional, or behavioral challenges. Among the factors linked with these higher risks are prenatal malnutrition and low birth weight; prenatal exposure to toxic substances; older age at adoption; early deprivation, abuse or neglect; multiple placements; and emotional conflicts related to loss and identity issues. The use of clinical services by adoptive families is about triple the rate reported by birth families partly due to a greater need for assistance. Adopted children also are more likely than their non-adopted peers to score in the clinical range on standardized behavior problem measures.
Acuity and Complexity of Children in Care
Data from DFPS reflect the growing acuity and complexity in the physical, behavioral, and mental health needs of children in foster care, especially for children who remain in the child welfare system for longer periods of time. Significant resources have been invested to help all children in foster care, including children with complex needs, find their forever homes. Some examples include the creation of therapeutic foster care.
Given the traumatic life experiences that children in care have often endured, a substantial proportion of them will continue to have ongoing developmental and behavioral needs, some of which may intensify as they age. In some cases, adoptions breakdown and result in disruption (before consummation) or dissolution (after consummation). When adoptions dissolve, the economic and social costs are considerable, and the toll on the children and families involved is even greater. Each year in Texas, a small but significant percentage of adoption dissolutions occur. At the time of this study, DFPS could not provide data on the number of children who are re-entering DFPS conservatorship following an adoption. However, national studies report that between 1 and 5 percent of consummated adoptions dissolve. Based on these percentages, it is estimated that between 534 and 2,670 of the adoptions from the Texas child welfare system that occurred during the ten-year period between fiscal years 2010 and 2019 may have resulted in dissolution.
Overview and the Current Structure of Funding
The Texas Family Code allows children and their adoptive families who received services from DFPS prior to adoption to receive post-adoption services either directly from DFPS or through contract. These services are part of a package of services Texas makes available to adopted children and families including:
• Monthly Title IV-E and state-paid adoption subsidies – This financial assistance supports initial placement expenses, childcare, educational needs, maintaining sibling/other family contact, and routine maintenance (e.g., housing, food);
• One-time payments up to $1,200 for non-recurring adoption-related expenses (e.g., attorney costs); and,
• Health insurance coverage through the state’s Medicaid program – Adopted children can receive medical, behavioral health, and dental services up to age 18.
Post-adoption services compliment these services but are not duplicative. They are the only state services available to adoptive families focused on preserving the adoption, helping the child and parents adjust and form a healthy attachment, and assisting the family in meeting the child’s needs in light of past trauma and maltreatment. While adoption subsidies do provide financial support to the family, they are meant to address basic needs, and while Medicaid benefits provide for services the child may need (e.g., therapy), they do not provide for family services (e.g., family counseling, respite, residential treatment). Post-adoption services are intended to be the payer of last resort.
Adoptive Family Eligibility for Post-Adoption Services
Contractors must serve all eligible adoptive families who present and meet all four of the following criteria:
1. When the child was placed for adoption, either:
• DFPS served as the child’s managing conservator and placed the child for adoption, or
• A licensed child-placing agency (CPA) in Texas served as the child’s managing conservator and placed the child for adoption, and DFPS is currently providing Title IV-E adoption assistance to the child;
2. The adoption is consummated;
3. The adoptive parents have requested post-adoption services; and
4. The child is younger than 18. When necessary, services may continue for up to 90 days past the child’s 18th birthday to ensure an orderly termination of services.
Post-Adoption Service Array
Post-adoption services are provided either directly by the contractor, through subcontractors, or through community resources and services supplied by providers identified by the contractor. The services available through contracts with post-adoption service providers must include casework or service planning.
Contractors must be available to provide crisis intervention services twenty-four (24) hours a day, seven (7) days a week. Contractors must provide children and their adoptive families with post-adoption services based on the results of a written intake assessment. Casework services cannot be subcontracted. Each family must have a current Service Plan that is developed using information collected with the family in a face-to-face visit. CPS may approve exceptions to the face-to-face visit.
Spending and Utilization of Post-Adopt Services
As shown in Figure 3, the four contracted providers in Texas together reported spending $3.9 million statewide in state contract funds on post-adoption services for 2,153 families in fiscal year 2019. The statewide average spending per family in fiscal year 2019 was $1,834, which declined 15.6 percent from $2,172 in fiscal year 2017. Spending by the Centers for Children and Families, which covers seven regions, represented almost half (49.8 percent) of total statewide spending in fiscal year 2019.
Between fiscal years 2017 and 2018 (which cross two state appropriations biennia), state spending on post-adoption services provided by organizations contracted by the state declined 8.4 percent, from $4.3 million to $3.9 million. There was a slight increase of $29,695, or 0.8 percent, between fiscal years 2018 and 2019. Meanwhile, the total number of families who received post-adoption services from the four state-contracted providers increased 9.3 percent during this time period, from 1,969 in fiscal year 2017 to 2,153 in fiscal year 2019. Most of the increase in the number of families served occurred between fiscal years 2017 and 2018, which corresponds to the 8.4 percent reduction in state spending on post-adoption services between those years.
Improve the Delivery and Funding of Post-Adoption Services in Texas
Services and supports that are trauma-informed and designed to assist the entire family after adoption consummation are an essential part of the adoption process. These types of post-adoption services are a cost effective strategy to prevent the return to care for at-risk children. Supporting adoptive families after adoption helps to preserve and stabilize at-risk placements and offers children and families the best opportunity for success. A continuum of post-adoption services that is trauma-informed is vital to an adoptive family’s success in integrating and effectively parenting a child with experiences of maltreatment and loss. The cost of funding post-adoption services is far less than the cost of caring for children in foster care. States with high utilization of post-adoption services report exceptionally low rates of children returned to the care of the state (i.e., less than 1 percent). By stabilizing families and providing permanency for children, the promotion of health and well-being of children and families is long-term and the benefits to society are long-lasting.
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