Accreditation of Intercountry Adoption Service Providers

The process of accreditation includes four core features: self-assessment, on-site review by peers, decision, and ongoing monitoring.⁴

The process begins with a self-assessment during which organizations read and understand the standards, assess their own compliance, and take steps to improve practice where they have not met standards. The next phase is the on-site review for which most accrediting entities rely on peers, professionals from other accredited organizations, to conduct the evaluation. Because these peer reviewers are experienced, highly credentialed, and have been involved in accreditation at their own organizations, they bring a deep knowledge of current practice and standards, and can draw from experience applying and evaluating the standards. Common monitoring and oversight activities include periodic and event-based reporting and review of complaints.

The Hague Convention on Intercountry Adoption

In the early 1990s with a steady growth of intercountry adoptions, an emerging specialized profession, and scandals causing significant international concern, world leaders looked to enhance collaboration and coordination of intercountry adoption services. In January 1988, the Hague Conference on Private International Law (Hague Conference) began to draft a new Convention on intercountry adoption.⁵ An extensive report on intercountry adoptions described serious concerns regarding intercountry adoption practices, and identified areas for building in safeguards and protections for children and families.⁶

The Hague Convention on Protection of Children and Cooperation in Respect of Intercountry Adoption (the Convention) establishes administrative processes to coordinate the delivery of services and obliges countries to take special precautions to prevent the abduction, sale, and trafficking of children.⁷ The Convention requires each country to designate a Central Authority.⁸ During the deliberations, serious concerns were raised about continuing to allow the involvement of private entities in international adoption, as was common in the United States, so a compromise was reached allowing accredited, nonprofit agencies and approved persons to provide certain adoption services.⁹ The final draft of the Convention was approved and signed on May 29, 1993.

U.S. Law and Regulations Governing Accreditation

In October 2000, the U.S. implementing legislation, the Intercountry Adoption Act (IAA), was enacted, designating the Department of State (the Department) as the U.S. Central Authority and setting basic provisions for the accreditation process and standards. The Department went on to issue proposed regulations in September 2003.¹⁰ Despite having received comments on an earlier draft and numerous community engagement activities, the Department continued to receive significant and conflicting opinions about the proposed regulations. The Department spent two years reviewing over 1,500 comments on the proposed rule and revising the regulations.¹¹ Many of the conflicting comments either sought stronger protections for children and families or sought to eliminate standards thought to be unnecessarily burdensome.

The final rule was published in the Federal Register on February 15, 2006, and includes an extensive set of responses to the comments received, providing detailed attention to key controversial areas of the standards such as supervised providers, professional liability insurance, personnel qualifications, and waivers of liability. These responses provide the best source of interpretive guidance on the regulations, shedding light on the intent and scope of many of the standards and process requirements. The final rule also sets forth an accreditation process that combines elements of accreditation and state licensure. Like accreditation systems, the standards go well beyond what is typical of licensing, the process does not include annual on-site reviews, and achievement of accreditation requires substantial, not full, compliance. Like state licensing, the standards are codified in regulations written by government officials, not by the field itself, and provisions for oversight and adverse actions are more closely aligned with the typical compliance approach used by regulators.

Designation of Accrediting Entities

Just after the draft rule was published, the Department issued a Request for Statements of Interest from accrediting entities. The Department received 12 applications and entered discussions with six of the applicants.¹² In July 2006, the Department authorized two accrediting entities, the Council on Accreditation (COA) and the Colorado Department of Human Services (CDHS). The designations of both a private accrediting entity and a state licensing authority provided an opportune foundation for establishing an accreditation system that is essentially a hybrid of accreditation and licensure. While the Department ensured the accreditation processes between COA and CDHS were similar, there were some key differences. COA utilized volunteer peer reviewers and CDHS used licensing staff to conduct reviews, and the fees charged by CDHS were substantially lower. Having multiple accrediting entities gives adoption service providers a choice in accrediting bodies, creating incentives to drive up quality, and provides an essential backup should one accrediting entity discontinue its services.

The agreements with the Department included special tasks for the initial application period and required CDHS and COA to expend their own funds for preparations needed to launch the accreditation system.¹³ Preparatory tasks were extensive and included the development of operational procedures and tools, fee schedules, explanatory guidance on the standards, training for evaluators, and the Substantial Compliance System (SCS) to be used for evaluating applicants. Over the years, the Department sought to engage additional accrediting entities but no others were authorized until Intercountry Adoption Accreditation and Maintenance Entity (IAAME) was designated in 2017.¹⁴

Initial Accreditation Applications and Ratification of the Convention

The accreditation process formally kicked off in October 2006, when applications for accreditation were made available.¹⁵ By December of that year, over 325 adoption service providers had filed initial applications for accreditation, far exceeding early projections of 200 applicants. COA and CDHS worked very closely with the Department over the next year and a half to train staff, evaluators, and adoption service providers, conduct the accreditation reviews, and make decisions on the initial applications. While many of the initial applicants achieved accreditation, a large number did not complete the process as the scope of the requirements became more apparent and the exceptions to the accreditation requirement became clearer. In the first round of accreditation reviews, 12 adoption service providers were denied accreditation.¹⁶ By April 1, 2008, when the Convention took effect over 220 adoption service providers had achieved accreditation, temporary accreditation, or approval.

Two-Tier System and the Universal Accreditation Act (UAA)

Within a few years of the accreditation requirements being in effect, it became increasingly clear that because the requirements only applied to adoptions involving other countries who had implemented the Convention, a two-tier system of adoption services had emerged: one for Convention adoptions and another for non-Convention adoptions. This was primarily evident with incoming adoptions because the number of outgoing adoptions (U.S. citizen children leaving the U.S. for adoption) was small and the countries receiving the children were all Convention countries. Given the dual standards, the intercountry adoption community sought to provide more uniformity in their practices and establish the same safeguards for children and families that existed within the Hague Convention’s framework by calling for accreditation of all adoption service providers providing intercountry adoption services. In response, the Universal Accreditation Act (UAA) was passed in 2013 which applied the accreditation requirements to incoming international adoptions from all countries.¹⁷

While this has significantly improved the oversight of adoptions from non-Convention countries, it remains a challenge to achieve or expect full compliance with all standards. Non-Convention countries have not agreed to the Convention, may not have the necessary resources to coordinate adoption activities, and may have laws, policies, or practices that are not consistent with the Convention. In its role as the Central Authority, the Department of State can coordinate resolution of questions on conflicting laws or policies through bilateral engagements with its foreign counterparts.

Substantial, Not Full, Compliance Is Required

According to the Intercountry Adoption Act and the regulations, accreditation can be granted when an agency is found to be in “substantial compliance” with the standards. In 2007 COA and CDHS collaborated with the Department to develop the rating system including weighting of the standards and the criteria for achieving “substantial compliance.”¹⁸ The substantial compliance system (SCS) developed by CDHS and COA specified a four-point rating system describing levels of compliance ranging from full compliance to non-compliance.