Respite Care Services for Families Who Adopt Children With Special Needs, Page 3

A Synthesis of Demonstration Program Final Reports (4/02)

Challenges and Lessons Learned

Every program noted challenges. In reviewing these reports, it appears that many of the challenges may have been avoided if pre-program needs assessments had been conducted (only two programs noted that they had conducted needs assessments). Needs assessments can reveal the characteristics of targeted families that must be addressed as well as their needs for type, duration, and location of services. Needs assessments might also examine and identify previously successful or unsuccessful strategies to recruit and train providers and families. This information can help to ensure that a new program is designed to meet the needs of its target population and that its intended strategies are based on knowledge of "what works and doesn't work."

In addition, many programs experienced challenges in conducting rigorous evaluations that could produce useful data about a program's effectiveness. These challenges affected the programs' abilities to state their accomplishments with certainty.

A summary of the programs' identified challenges and lessons learned is presented below.

Provider Recruitment, Training, and Licensure
Two programs noted difficulties in these areas. One program was not as successful as they had hoped to be in recruiting prospective adoptive parents as respite providers. They believe prospective parents were more focused on identifying a child they might adopt than they were in providing temporary care for children from other families. A difficulty in scheduling training sessions to accommodate natural helpers was noted. One program acknowledged that the lengthy, stringent licensing process they utilized may have resulted in fewer providers, but they believe that it also resulted in higher quality providers. One multi-state program noted challenges in complying with various State licensing requirements and adopted strategies to address this. These strategies included recruiting existing foster and adoptive parents who were already licensed; structuring the duration and type of services such that they did not require use of licensed providers; having adoptive parents choose, hire, and pay their own providers; and getting legal advice for the agency regarding liability issues in training respite care providers.

Recruitment of Families
Five programs noted challenges in this area. In almost all cases, challenges included families' reluctance to use services. Common reasons included not understanding what respite is, not being comfortable with providers they did not know, not wanting to seem inadequate, and doubt about others' ability to handle their child. Some adoptive parents had confidentiality concerns; some did not want the type of services offered by the program; and some wanted to stay with their natural helpers. In many cases, families' concerns were based upon their belief that respite care is a service provided only in emergencies and that their use of the service might reflect poorly on their ability to parent their child with special needs. Programs noted that these concerns need to be addressed early and often, and that it can take up to a year to build trust between the families and program staff. Some programs strengthened efforts to educate families about respite, emphasizing that it is a supportive service rather than a service reserved solely for crises. Some programs worked through trusted community agencies to build a relationship with families.

Service Provision
Two programs noted difficulties with services being offered that did not meet families' needs. Both reported that they offered in-home hourly services and families wanted longer periods of service. One program also noted that the location of out-of-home services at a camp was not convenient for families.

Program Management/Administration
Two programs noted challenges with this aspect. One developed a system that was run by parent groups, which, while successful in some areas, posed challenges to accomplishing tasks such as provider recruitment and training, licensing and liability, and referrals and matching. Some parent groups partnered with an agency to address these challenges. Another program had difficulty establishing a contract with a provider agency and had to spend considerable time identifying and negotiating a contract with a new vendor.

Evaluation Activities
Four of the programs that attempted to survey families about their experiences with the program noted low response rates from families. This resulted in findings that could not be deemed statistically reliable. Follow up phone calls helped improve response rates in one program. Another program discussed difficulties of matching pre- and post-test surveys due to attrition of families from the program. Another program noted that administration of the surveys by project staff was inconsistent.

Accomplishments

Each project noted its significant accomplishments in various areas. While all projects were successful in completing their identified tasks, some were particularly successful expanding or enhancing services in their area, establishing an infrastructure within which to operate, producing replicable training models, or influencing State policy. These accomplishments are summarized here.

Service Provision
Most projects documented the number of families and/or children served, number of providers recruited, and number of hours of service provided. Of the projects that documented these accomplishments, the number of families served ranged from fewer than 20 to more than 80, the number of providers trained ranged from fewer than 20 to more than 130, and the number of respite hours provided ranged from 7,000 to more than 41,000. (The project that provided more than 41,000 hours was using an existing foster care respite care agency as its lead agency.)

Target Population
One program noted that by serving foster-adopt families who had not yet finalized their adoptions, they were serving a group that was otherwise not eligible for any other respite services under existing funding guidelines. (They were not eligible for foster care funds because they were considered to be in the adoption system, but were not eligible for adoption funds because the adoptions were not finalized.)

Satisfaction
Four programs assessed families' satisfaction with the program. Although not statistically reliable, families in general were satisfied with the providers' and children's interactions.

Impact of Services on the Family
Five programs assessed the impact of the services on the families served. Although not statistically reliable, results indicated that many families felt some relief from child care responsibilities, that the services had helped to improve family relationships, and that their family's stress level had been reduced. Families that participated in a tutorial-based program said the services helped improve their children's behavior and academic work. Some families indicated that the respite services had prevented adoption disruptions.

Program Management/Administration
One program noted that it had successfully developed a parent-run system with a high degree of parent ownership. Another program attributed some of its successes to the collaboration with a neighborhood faith-based organization.

Information Dissemination
One program successfully developed and disseminated a training manual for providers and families. The manual, now in its second printing, is entitled "The AFIRM Project Respite Training Manual."

Policy
One program testified before the State legislature and helped to pass the Oregon Lifetime Respite Care bill, which established an infrastructure to coordinate respite services through the State. Another program helped establish a statewide workgroup that was developing state policy to entitle all adoption subsidy children to 12 paid days of respite per year.

Credits: Child Welfare Information Gateway (http://www.childwelfare.gov)

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