Adoption program undergoes changes
By Cynthia Dailard, Senior Public Policy Associate
The Alan Guttmacher Institute,
Washington, DC
In late September 2004, the Department of Health and Human Services (HHS) announced a new round of national and regional grantees for the infant adoption awareness-training program. Given the dubious track record of this program during its first three years of operation, many family planning providers are hopeful that this will bring much-needed changes to the national training curriculum — one that has the potential to result in a positive and meaningful collaboration between family planning counselors and adoption experts.
The Infant Adoption Awareness Act (IAAA) of 2000 supports the training of certain federally funded health care providers, including Title X family planning providers, on how to provide adoption information and referral on par with other options in nondirective pregnancy options counseling. Federal regulations for the Title X family planning program require pregnancy counselors to "offer pregnant women the opportunity to be provided information and counseling regarding each of the following options: prenatal care and delivery; infant care, foster care, or adoption; and pregnancy termination." If such information and counseling is requested, counselors must "provide neutral, factual information and nondirective counseling on each of the options, and referral upon request, except with respect to any option(s) about which the pregnant woman indicates she does not wish to receive such information and counseling."
Former Rep. Tom Bliley (R-VA), a staunch family planning opponent who for many years sought to prevent Title X providers from discussing abortion with women facing an unintended pregnancy and to require Title X providers to actively promote adoption instead, authored the IAAA.
Funding for this program was first released in October 2001 to four adoption organizations to the tune of $8.6 million. The lion’s share of the funding ($6.1 million) went to the National Council for Adoption (NCFA), an organization that takes credit for having played a key role in developing the IAAA and whose leaders share many of Bliley’s views. Under its grant, NCFA was charged with developing a national curriculum and implementing a training program based on that curriculum.
Review the history
Interviews conducted by the Alan Guttmacher Institute between September 2003 and July 2004 with more than 20 family planning providers in 15 states about their IAAA training experience reflect decidedly mixed experiences. Many reported an overall positive experience or praised their trainers for their "evenhanded approach" in discussing all the options available to pregnant women. Others found valuable specific components of the training (most notably a session with an adoption attorney who discussed the legal aspects of adoption) or the opportunity it presented to build relationships with other service providers in their community, particularly local adoption program directors.
However, most family planning providers interviewed reported a far more negative training experience. Collectively, these dissatisfactions raised significant concerns about the implementation of the infant adoption awareness-training program by NCFA.
A fundamental complaint raised by a number of participants was the directive nature of the training. In January 2004, Charles Marquardt, the program coordinator and lead trainer for the Title X training program at the California Family Health Council (the largest Title X grantee in the nation), highlighted his concerns about his training experience in a seven-page letter to his federal regional health administrators. He wrote: "The trainer promoted tactics and techniques for attempting to persuade the client to choose adoption by 1) discouraging abortion as a viable option; 2) overly promoting adoption; 3) highlighting the difficulties [the] child will encounter if [a woman] should choose to raise it herself; and 4) encouraging counselor opinions in scenarios by having the counselor choose for the client the best option." Others echoed these complaints and said they were given tips and techniques for promoting adoption that bordered on coercion, in clear violation of Title X guidelines and principles of medical ethics.
Other key criticisms included that the trainers promoted a negative view of clients (portraying them as deluded, ignorant, and unable to make good choices for themselves); a hostile training environment due to the presence of trainers and trainees from crisis pregnancy centers and other antiabortion organizations; and the religious overtones of the training (which some participants noted included prayer and emphasized the importance of placing children in "good Christian homes").
The new national grantee, as announced by HHS in October, is Spaulding for Children, based in Southfield, MI. More regional training projects will be run by Harmony Adoptions of Maryville, TN; Arizona Children’s Association in Tucson; Lutheran Social Services of South Dakota in Sioux Falls; Independent Adoption Center in Pleasant Hill, CA (serving Northern California); and Latina Family Institute of West Covina, CA (serving six counties in the Los Angeles area).
Whether this new round of grants will result in the development of training programs that are responsive to the criticisms of those family planning providers who attended past training remains to be seen. Many family planning providers, however, are hopeful that for the first time under this program; it presents a real opportunity for a productive and mutually satisfying collaboration between adoption educators and pregnancy counselors.
In late September 2004, the Department of Health and Human Services announced a new round of national and regional grantees for the infant adoption awareness-training program. Given the dubious track record of this program during its first three years of operation, many family planning providers are hopeful that this will bring much-needed changes to the national training curriculum.
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