Opioid epidemic strains foster-care systems; states' initiatives to help could lose funding

Recovered opioid addict Raven Mosser credits her success in staying sober to Kentucky's START program. She moved to Ohio to become a recovery coach for other parents struggling with addiction. (Kaiser Health News photo by Sholten Singer)

One of the less-discussed effects of the opioid epidemic has been the strain it places on foster-care systems. Ohio, which has the nation's highest rate of heroin-overdose deaths, has been particularly hard hit. "Ohio's opioid epidemic is seen as the direct cause of an 11 percent increase in children in state custody over the past six years, according to the Public Children Services Association of Ohio," Dina Berliner reports for The Athens News.

Only 7,200 families are registered as foster parents in Ohio, but there are 15,000 children in the state's foster-care system, says state Attorney General Mike DeWine. And half of those kids are in foster care because one or both of their parents are opioid addicts, according to a 2016 survey by the Public Children Services Association.

It's a trend seen in other states. "Data from the U.S. Department of Health and Human Services show that from October 2012 to September 2015, as addiction surged, the number of kids entering the foster system rose 8 percent," Shefali Luthra reports for Kaiser Health News. That's because heroin use has surged among women and among people ages 18 to 25--and young mothers are at the intersection of those two demographics.

States are trying new approaches to reduce the impact of the crisis on state agencies. "Kentucky was a pioneer, starting in 2007, when opioid addiction first emerged as a public health concern. The program, called 'Sobriety Treatment and Recovery Teams' — or START — emphasizes a wraparound approach for at-risk parents that includes frequent home visits, vouchers for child care and transportation and mentorship from people in recovery," Luthra reports. "Under the Kentucky model, when child protection specialists learn a child is at risk, authorities specifically assess whether substance abuse could be a factor. If so, the parent is fast-tracked into treatment and assigned a 'recovery team,' which coordinates among agencies such as children’s aid, mental health, social services and recovery mentors."

Ohio's new plan is modeled explicitly on Kentucky's, and Indiana and North Carolina are launching initiatives too. But the funding for these programs might be in danger, since they're heavily financed by Medicaid. Senate Republicans haven't made public their budget resolutions for Fiscal Year 2018, but Budget Committee member Bernie Sanders (I-Vt.) published a five-page report saying GOP senators want to cut $1 trillion from Medicaid and $473 billion from Medicare over the next decade.

In rural areas, getting parents off drugs so they can keep custody of their kids can be difficult because of limited resources. Parents have to see an addiction specialist or go to rehab or a recovery group. "Those are all relative rarities in the small, rural areas where opioid addiction rates are relatively high," Luthra reports.