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Opioid Epidemic Putting Thousands More in Foster Care

Throughout the Ohio Valley and West Virginia, thousands of children are in foster care — and the opioid epidemic is sending thousands more to join them. In fact, in just the past year, West Virginia’s foster care system alone saw an increase of 1,000 children entering care.

In 2016, West Virginia Public Broadcasting spoke with the Holbens, a former-foster family in Kearneysville, Jefferson County, to shed light on the struggles the opioid epidemic brings on foster care. We now check back in with that family and explore what lies ahead in combating this crisis.

Be sure to tune in for more on this subject during our nightly television program, The Legislature Today beginning January 11, 2018.

The Holben’s Experience

Stay-at-home mom and daycare provider Jen Holben lives in Kearneysville with her six kids. They’re like any other family – they joke with each other, share meals, laugh, play, and watch movies together. They love church and they’re actively involved at school and within the community.

But Jen is also a former-foster parent, who, for 14 years, along with her ex-husband, fostered 27 children ranging in age from infant to 18.

“I had heard adoption stories, and I really started to think I would like to adopt,” Jen said, “and when I started to research, I really didn’t know much about the foster care system at all, but when I would type in adoption, foster care would come up, and I educated myself, and I thought, that’s what I want to do, I want to help children.”

Jen also has two biological sons who are in high school. Of the 27 children she’s fostered, she adopted four – three of whom were exposed to drugs or alcohol in utero.

“My youngest was born addicted to three different drugs, and he was in the hospital for three weeks, and when he came home from the hospital, he screamed for four months straight until he really got off the drugs,” she remembered, “Right now, he’s on target. He’s really excelling and doing really well.”

The two other children impacted by drugs or alcohol are biologically related sisters.

The 9-year-old was born while her mother was addicted to heroin. Jen says she’s doing well, but will likely need ongoing help in school.

Jen’s other daughter, who’s 11-years-old, struggles a bit more.

“She’s probably on a second or third grade level and should be in the sixth grade, and she has fetal alcohol syndrome. She suffers from epilepsy from the fetal alcohol syndrome and is severely delayed.”

Both girls also have attention-deficit hyperactivity disorder, or ADHD, and take medication for it.

Jen says despite medical and academic struggles, she loves being a mom and watching her kids grow.

But there are other kids in the West Virginia foster care system who still need help. For Jen, the solution is making sure these kids are placed in a secure environment, early, and for the long term.

“We just need to get these kids in permanent homes as fast as we can, so that they can just heal,” she said, “I mean, if they’re drug addicted, then they need to overcome that. If they’ve been taken away because of neglect and abuse, then we need to get therapy, and let them do that, but they can’t do that if they’re jumping from placement to placement, or going home and coming back, I think we just really need to put the kids first.”

The Opioid Epidemic & Foster Care

But finding permanent homes is rarely easy.

The West Virginia Children’s Home Society, or CHS, is one of 10 agencies in the state that handle foster care referrals from the West Virginia Department of Health and Human Resources.

The organization works to find the best matchups for children who need temporary or permanent placements – whether that’s in traditional foster homes like Jen’s, or in other placements, such as with a relative or in emergency shelters.

Chief Executive Officer of CHS Steve Tuck notes that in just the last few years, there’s been a dramatic spike in the number of children coming into care – this has made it harder to ensure these kids find adequate home environments.

He also says the opioid epidemic has played a major role in that rise.

“The need has only gone up,” Tuck explained, “The number in care had gone up close to 6,000 from what it had stabilized for many years at around 4,000 kids, state kids in-care; it’s even in these last few months, it’s gone up almost 100 a month.”

DHHR reported in November 2017 that nearly 6,400 West Virginia children are in foster care. That’s about 1,000 more kids in care than the previous year.

Tuck says it’s hard to pinpoint just how many of those children are coming into care as a direct result of substance abuse.

For example, if a child is pulled from a home because of some form of neglect, the role substance abuse played isn’t always clearly noted. Likewise, when children are born with drug related issues, there’s no consistent methods for determining the extent of parental substance abuse.

Tuck says to improve these situations, there needs to be more communication.

“We all need to get together from the medical, especially the hospitals serving those situations, and the ones that might need to take custody for children,” he noted.

Despite the difficulties, Tuck argues the general consensus regarding the number of children coming into care due to substance abuse is at least 50 percent.

“And I’ve seen numbers as high as 90 [percent], but that’s really probably people’s more anecdotal, you know, who’ve worked in this work a long-time, acknowledgement that it almost affects every placement of children coming into care.” – Steve Tuck

Tuck says one way to help limit the number of children needing to enter care is to start with the families.

CHS, Marshall University, DHHR, and the behavioral health and addiction treatment center Prestera are all working together on a pilot project to help addicted mothers get the care and therapy they need to get off drugs and keep their children.

The pilot project has been launched in Cabell, Lincoln, and Wayne counties first, but Tuck hopes if it’s successful, it will expand to all 55 counties.

Tuck asks state lawmakers to keep the foster care system in mind during the 2018 state Legislative session.

“My encouragement to them is really just to acknowledge that there’s a lot higher cost to taking care of these kids,” he said, “and they are our West Virginia children that we all are responsible for, so they really have to look at that one when most of the discussions are around budget cuts and reduced funding and things like that.”

Back at the Holben’s, Jen encourages more West Virginia families to think about becoming foster parents.

“You hear all this stuff, and it can scare you away, but is the most rewarding; every kid I’ve had has been a blessing to me, but definitely educate yourself, so you’re prepared for what you might deal with, and just always remember that a kid that comes to your house through foster care, through adoption, through anything; their story goes beyond the day you bring them home,” Jen explained, “And whether you bring them home as a baby, they still have biological parents that, it’s part of them, and it’s part of their story; their story isn’t just being in your home.”

Still, Jen’s biggest concern is ensuring the children who end up in West Virginia’s foster care system are placed in permanent homes as soon as possible.

According to the West Virginia DHHR, of the nearly 6,400 children in foster care, 51 are available for adoption.

Lawmakers Consider Ways to Combat Opioid Epidemic in 2018 Session

The start of the 2018 state Legislative session is only one month away. Lawmakers in the Eastern Panhandle met in Martinsburg for a Legislative Outlook Breakfast hosted by the Berkeley County Chamber of Commerce to discuss several issues they hope to tackle at the statehouse this year.

One focus is creating more ways to combat West Virginia’s opioid epidemic — particularly how the crisis affects those in the state’s foster care system.

The state Department of Health and Human Resources reported in November that nearly 6,400 children are in some type of foster care – whether that’s in traditional foster homes or in other placements like emergency shelters. The West Virginia Children’s Home Society says at least 50 percent of kids in foster care are there due to drug related issues.

Senate Finance Chairman Craig Blair, a Republican from Berkeley County, suggested one way to tackle the problem would be to offer long term, reversible birth control to mothers who are addicted to drugs.

Blair said by providing easy access to things like IUDs, or intrauterine devices – would be more cost effective for the state than spending the hundreds of thousands of dollars spent on special care for children born with drug related issues.

“You get this contraception out there,” Blair said, “You will see a significant reduction in the amount of children being born [with drug related issues] and the money that we have to spend weaning them off whatever their mother was addicted to.”

Blair says he’s pro-life but states he’s pro-contraception as well. He argues this option would be another way to combat the opioid epidemic and help keep more children from being born with drug related ailments.

The 2018 state Legislative session will begin on January 10.

Advocates Question Plan for College for Foster Care Youth

Some child advocates say a plan by a nonprofit group to convert a southern West Virginia campus into a college specifically for children transitioning out of the foster care system is not a good idea.

Tina Faber is based at West Virginia University in Morgantown and runs a state program called Mentoring with Oversight for Developing Independence with Foster Youth, or MODIFY.

She told the Charleston Gazette-Mail that it’s very important for children in foster care to live a normal life and to be with peers who aren’t foster children.

Faber said many of the children she’s worked with likely wouldn’t choose to attend this type of college.

“They do not want to be known as foster kids,” Faber said. “They really shy away from that identity, and I think it goes back to they just want to be normal. They want to be seen as any other kid, any other young adult, and they want to experience going to college and all of those other things you get to experience. They crave that normalcy.”

Earlier this month, Olathe, Kansas-based KVC Health Systems announced a plan to give foster children a chance to earn two-year degrees at no cost to them.

KVC, which specializes in behavioral health care and child welfare, will take over several buildings at the West Virginia University Institute of Technology in Montgomery. West Virginia University is moving WVU Tech’s operations about 40 miles south to Beckley by this fall.

KVC initially wants to target children from West Virginia and have 200 students while eventually opening up the college to out-of-state students. The students would have access to behavioral specialists and mentoring programs.

American Association of Community Colleges spokeswoman Martha Parham had said it’s the first time she’s heard of a college being created solely for foster children.

Tommy Bailey, a legislative lobbyist in West Virginia for KVC, had said a traditional college environment isn’t always the right fit for foster youth because of the support network they require.

But Director Vicki Pleasant of the Charleston-based crisis intervention nonprofit organization Daymark said it would be easier to help foster youth attend an existing two- or four-year college.

“I have always felt that keeping youth in their communities, and wrapping services around them, is more productive than any other option available,” Pleasant said. “That means you utilize the services already available in your community.”

Pleasant said her group sponsored a house on the West Virginia State University campus in Institute in the late 1990s for students transitioning out of the foster care system. The students would live in the house before moving into one of the school’s residence halls or out on their own.

“We were able to focus on the youth and give them the time and the energy and the resources they need,” she said. “It really helped the youth in the program.”

Children’s Home Society of West Virginia chief executive officer Steve Tuck said he doesn’t see KVC’s plan as a viable option.

“We know and we work very hard in our shelters and foster care system to partner with local resources,” Tuck said. “My premise would be, among the nine community and technical colleges and the six or so smaller four-year colleges, the youth in this target population could be served far better in a community-based and decentralized approach to their individual circumstances.”

Foster care benefits are terminated at age 21 in most states, including West Virginia. Because foster students typically have no support system or homes to return to during summer vacation or the holidays, those in Montgomery will live on campus full time, Bailey said.

Drug Epidemic Takes Toll on Foster Care System

The drug epidemic in West Virginia affects more than just the work force, or the number of people in a prison cell or treatment center. It’s also had a major impact on the state’s foster children. West Virginia Public Broadcasting introduces the Holben family who has seen the impacts of the drug epidemic first-hand.

Meet the Holbens

Alyssa Holben is 8-years-old and in second grade. She came to live with the Holbens as an infant; first as a foster child and was later adopted.

Alyssa’s older and biological sister, Aaliyah, was also adopted by the Holbens, at 2-years-old. She’s now 10, in the fourth grade, and is shyer than her little sister.

Both girls love church, gymnastics, Disney movies and their 2-year-old brother, Brayden.

You would never know, but all three kids were exposed to drugs or alcohol in utero.

Alyssa was born addicted to heroin. Her older sister, Aaliyah, was born with fetal alcohol syndrome. And their little brother, Brayden, who’s not biologically related to the girls, was born addicted to three different kinds of drugs.

Jen and Jamie Holben, the children’s parents, live in Kearneysville, Jefferson County, with their six kids, four of whom were adopted through the state’s foster care system. The Holbens have been foster parents for nearly 13 years and have fostered almost 30 children during that time – ranging in age from infant to 18.

“We wanted to help out in some way, I mean, because I think we’re all here to make a difference,” Jamie said, “and we were very driven, whether it’s from our past hurts from us growing up as kids, or just seeing this world be cruel to people, you know, just wanting to make a difference.”

Jamie is a police officer who works in nearby Loudoun County, Va., and Jen is a stay-at-home mom.

The Holbens say one of the biggest struggles they’ve found raising their three kids who were born addicted to drugs and alcohol is the medical and academic problems that come with it.

“The three children we have in this house that have been affected by drugs and alcohol are totally different,” Jen noted, “They all have their own different disabilities and struggles. Brayden has three holes in his heart; Alyssa had a heart murmur when she was little, and academically, both girls struggle in different places.”

Alyssa and Aaliyah see their doctor every six months. Both girls take medication for attention-deficit hyperactivity disorder (ADHD). Alyssa also takes medicine to help her fall asleep at night. And Aaliyah takes one for epilepsy.

While Jen said Brayden seems to be developing in line with other children his age, she and her husband, Jamie, wonder how the kids’ individual struggles will affect them when they’re older.

“I think one of our biggest battles is, is there gonna be a plateau? Are they gonna reach a certain limit, and then, that’s it?” Jamie said. “We don’t know, and there’s no doctor that can give you that answer, there’s no psychologist, psychiatrist that can give you that answer, just because they don’t know.”

Effects on the Foster Care System in West Virginia

At the end of August, the West Virginia Department of Health and Human Resources had 5,068 children in foster care, 274 of whom are in out-of-state placements.

Only about 1,500 of those children are available for adoption, according to the West Virginia Supreme Court. Justice Brent Benjamin said that’s because some are placed in foster care temporarily.

“In many cases, they’re in temporary situations because maybe mom or dad are going through an improvement period,” Benjamin said, “because there’s been an abuse-neglect issue, or there could be any number of issues there, but they’re in foster care on a temporary basis as opposed to something that is more long term.”

But just how many of those children are in foster care because of their parents’ problems with drugs or alcohol?

Linda Watts, Deputy Commissioner for the Bureau for Children and Families at DHHR, said that number is difficult to track.

“Sometimes the reason that you’re removing a child for abuse-neglect is not necessarily the primary reason is substance abuse; it could be for another issue say physical abuse; it could be neglect, it could be some other related issue and then as you continue to do your investigation, it may then surface that it was substance use and abuse,” Watts said.

“What we’re seeing is that drugs may not be the primary issue in the abuse-neglect case, but it is certainly a driving issue in over 95 percent of those cases, so it’s a profound driving force in issues related to the welfare of children.” – Justice Brent Benjamin

Abigayle Koller is a clinical coordinator with the West Virginia National Youth Advocate Program, which is one of 10 specialized foster care agencies in West Virginia.

Koller said it can also be difficult to provide foster parents with the information they need to deal with the possible medical or developmental issues associated with substance abuse, because sometimes children’s birth or medical records are never provided to the agency and can’t be tracked down.

“So we often treat what we see,” Koller said, “which doesn’t do justice when a lot of the needs are underlying, and we have to dig, and we have to start with what we see in order to uncover what we don’t see.”

Being a Foster Parent

Jen Holben said she and her husband knew when they adopted Alyssa, Aaliyah and Brayden, that drugs or alcohol had been in their systems before birth, but she said that doesn’t always make addressing their needs any easier. While the demand for foster families in West Virginia is growing, Jen said it takes special people to do it.

“If you’re gonna go pick up a baby from a hospital, know that baby can scream for four months, because he’s addicted to drugs,” she said, “or know that, that child might have developmental delays, and be okay in accepting. You’ve got to be accepting of not just the children, but be accepting of their biological parents, and you have to support what that biological parent is doing to get their kid back.”

Jen and Jamie say they never expected to be where they are today, but they’re grateful for each of their kids — adopted and fostered. They hope the state can make the overall foster system better, especially for the kids who slip through the cracks.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.