Intro
There is a significant global concern with parental substance use and abuse which ultimately has major negative consequences for the children (Barnard & McKeganey, 2004). The opioid epidemic has caused widespread concerns around the globe and has introduced a ripple effect of poor outcomes, particularly for the children and families. Increasing awareness pertaining to this public health concern is extremely necessary. Advocating for the children in foster care and foster parents is the responsibility of the public and government representatives. Therefore, writing letters to government and state politicians, speaking with representatives of root organizations about the specific concerns and needs of child protection services are important starting points to improve this domineering health concern.
Public Health Concern
“Parental substance use is particularly relevant to child welfare as children whose parents misuse or abuse substances are disproportionately the victims of neglect or abuse, which may lead to placement in a foster home” (Gifford, Eldred, Vernerey, & Sloan,2014). “The crisis is especially prevalent in rural and economically disadvantaged communities where poverty is associated with poor physical and mental well-being, health access is limited, opioid prescription rates are higher, and treatment programs are few” (Treating the Opioid Epidemic as a Children’s Health Crisis, 2018). In fact, due to the lack of access to health care and treatment centers in the areas of poverty, this cycle will continue as well as child neglect and removal from their homes and their parents. Other statistics show that “child protective services nationwide have seen a surge in children removed from parents since 2012, around the time of the heroin epidemic was first recognized” (DeMio, 2018). Under those circumstances, “foster care placements are at a record high and the number of drug exposed newborns in Ohio has jumped over 200 % in the past decade” (Mealer, 2017). These are only a few reports of the countless data out there explaining the health disparity placed upon the helpless children and hopeless families is extremely distressing to say the least.
Resources and Support
The admirable individuals making the decision to become a foster parent and or respite care provider are initially required by the state to go through extensive training and background checks before obtaining a fostering parent license. Resources and support are provided from the beginning and throughout the time of fostering, but, are the resources from the agencies sufficient for the persons stepping up to provide a safe home for these kids? After speaking with those on the front-lines of children protection services; social workers, foster and adoption agency staff and foster parents, similar feedback was given.
Support from the agency begins at time of orientation. Per a conversation with the foster parent licensing coordinator at Beech Acres Foster and Adoption Center, “organized monthly training sessions are provided ranging from basic child development to recognizing the effects trauma has on child development and behavior and learning different styles of approach verses the traditional care approach”(personal communication).
Another model of support is a new clinic at Cincinnati Children’s Hospital Medical Center (CCHMC), known as CHECK -- Comprehensive Health Evaluations for Cincinnati Kids. This clinic is designed to improve care for foster children and equip foster parents with adequate support to health and development of the child in their care (DiMio, 2018). The team of clinicians evaluate the child’s medical and dental needs and the social workers complete a comprehensive mental health assessment.
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One other support system based out of Louisville Kentucky is, Commission for Children with Special Health Care Needs (CCSHCN) Nurse Consultant Foster Care Support Program. This program offers nurse consultant support to social workers and foster families on medical issues. The nurse is available to interpret medical reports, enhance care coordination including prevention and wellness programs (Foster Care Support Program, n.d.).
Foster Parents Perspectives
Individuals who offer themselves to provide another parent’s child a home, who also raise their own biological children, are true blessings for the children who are involuntarily removed from the only environments and family they have ever known.
A portion of my practicum experience consisted of conversations with foster parents who are currently fostering children from homes with substance abuse issues. The foster parents interviewed have experience in Ohio, Kentucky and New York. One of these parents have fostered a total of 278 children over a 30 year period. Overall, the feedback from all three parents were comparable and positive.
One foster parent was very knowledgeable and passionate about the multiple resources available to the fostering community here in Ohio. She described a non-profit organization called HOPE’s Closet; a volunteer supported organization which was founded by foster parents who believed there was a need for additional support and resources. One of the many resources of this ministry is a boutique where children and their fostering parents can shop for clothing, backpacks and school supplies, baby gear and equipment and other items twice a year at no cost. Many children come into the foster system with only the cloths on their back, so this is a wonderful resource for foster parent.
All three foster parents professed having great relationships with their case workers and felt comfortable calling them at any point of the day with concerns, questions or specific needs.
There was only one negative comment about an area that was in need of improvement and that was the county and state level of support.
Local Foster Agencies Hopes
The primary goals for all child welfare organizations is safe placement and ultimately reunification for the children. With elections drawing near, Hamilton Country Children’s Services is hoping for a significant increase in funding during the 2018 elections to assist on numerous levels. Passing the vote on Issue #9 would sanction a county levy to increase funding for foster care and children services (Hamilton County, Ohio, Issue 9, Children's Services Tax Levy, 2019). During a conversation with Jessica Thompson (personal communication, November 1, 2018), the director at Beech Acres Foster Care and Adoption Center, the levy would help fund child placement costs, kinship care needs, behavioral health needs not covered by Medicaid, and additional specialized parent mentoring and substance use disorder assessment and treatment, to name a few.
Personal Practicum Activities
The practicum opportunities I participated in over the course of the semester allowed me to develop a new understanding of public health care policy in addition, how to proactively take political action to advocate for public health concerns. In a sense, I also found the involvement to be empowering. This experience put me in a position to advocate for notable organizations and selfless individuals. I wrote a letter and sent to Ohio Senator Rob Portman explaining my position as a pediatric home care nurse, observing an increase in infants affected by substance use and being cared for by foster parents. I also pointed out the fact that foster care placements are at a record high and the number of drug exposed newborns in Ohio has jumped over 200 % in the past decade (Mealer, 2017). I also had the pleasure of speaking with three compassionate foster parents who all had biological children of their own.
Conclusion
During the research and practicum hours spent throughout this semester reflecting on the public health topic; the impact opiates has on the child welfare system, the reality became clear; there is no easy fix. Until the drug issue is controlled, the statistics of children entering the foster system will continue to rise. In the meantime federal resources are needed to support state and local foster care systems, children and families in need of protection
References
- American University School of Public Affairs BJA Drug court technical assistance/clearinghouse project summary of drug court activity by state and county juvenile/family drug courts. 2012 Nov 30; Retrieved from http://www.american.edu.
- Barnard M, McKeganey N. The impact of parental problem drug use on children: what is the problem and what can be done to help? Addiction. 2004;99:552–559.
- DeMio, T. (2018, September 27). Heroin children, removed: Children of the opioid epidemic face neglect, trauma. Retrieved from https://www.cincinnati.com/story/news/2018/09/26/children-removed-heroin-addicted-parents-face-trauma-neglect/1203721002
- Foster Care Support Program. (n.d.). Retrieved from https://chfs.ky.gov/agencies/ccshcn/Pages/foster-care.aspx
- Gifford, E. J., Eldred, L. M., Vernerey, A., & Sloan, F. A. (2014). How does family drug treatment court participation affect child welfare outcomes?. Child abuse & neglect, 38(10), 1659-70.
- Hamilton County, Ohio, Issue 9, Children's Services Tax Levy (November 2018). (n.d.). Retrieved from https://ballotpedia.org/Hamilton_County,_Ohio,_Issue_9,_Children’s_Services_Tax_Levy_(November_2018)
- Mealer, B. (2017, May 17). 'It's just horrific': Caseworkers break their silence to reveal toll of addiction on children. Retrieved from https://www.theguardian.com/us-news/2017/may/17/ohio-drugs-child-protection-workers
- Treating the Opioid Epidemic as a Children's Health Crisis. (2018). Retrieved from https://www.nichq.org/insight/treating-opioid-epidemic-childrens-health-crisis
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