AP NEWS

Opioid crisis, system shortfall hurts New Hampshire children

June 6, 2019

PORTSMOUTH, N.H. (AP) — A boyish touch to an otherwise characterless, simple room, a skateboard rests against a chalk-white wall. A quilt, lilac and baby blue, covers the bed, where at its head, an alarm clock, some books and papers are the only other belongings in sight.

Down the hall, a young boy plays video games while enveloped in a bean bag chair. The others are at school, but he is a new arrival.

Upstairs in a girl’s room down a long corridor, mismatched sheets and a fleece blanket with cartoon polar bears dress a twin bed, situated intentionally by the youth to catch morning light from a double window; perhaps a small reminder of home. A toothbrush and headband rest on a side table. Minimal clothing hangs in the closet behind the door.

One lived in a car infested with lice. Others were exploited by their parents, forced to engage in sexual intercourse with adults in exchange for drugs. Some arrived with scabies and hoarding habits from unclean living and severe food insecurity. All byproducts of New Hampshire’s opioid crisis, they’re the largely invisible victims, often raised in traumatic environments where adverse childhood experiences inflict irreversible harm.

Children who become tangled in the state system, their living situations deemed unsafe, may be sent to the Chase Home for Children in Portsmouth, one of four intermediate-level residential facilities in New Hampshire for at-risk youth, founded in 1877 as an orphanage.

“We are seeing an unfortunate trend of kids being referred to us more from the abuse and neglect side, because their parents are suffering from addiction and/or serious mental health issues, where they’re just not engaging in treatment,” said Executive Director Meme Wheeler. Youth at the Chase Home range from ages 11 to 19.

But the Chase Home, too, is overwhelmed by the very same crisis sending children to them, speaking to the larger issue the state faces in providing adequate services and funding for opioid addiction and its impacts. The Chase Home is paid a daily rate by the state of $188.54 per child for 24/7 residential care, but the true cost of support is $307 per day, said Wheeler. This results in a $45,000 deficit per child, per year, and the opioid crisis is prolonging children’s stays at the Chase Home.

“We have parents that just simply can’t get their act together,” Wheeler said. “They can’t clean up, they could be incarcerated, they could be missing or deceased, all from the opioid crisis. And those kids tend to sit here longer.”

Last year, the Chase Home served 65 children in its residential program, 60% of whom were referred from the abuse/neglect protection side of the Division for Children, Youth and Families, while 40% came for juvenile offenses. Until five years ago, 90% of the Chase Home’s residents were there for juvenile offenses.

“A key component is the amount of resources the Chase Home sucks up as a result of this opioid crisis,” said Craig Dennis, director of operations. “We get kids off the street who literally have the clothes on their backs. They come with nothing. The Chase Home absorbs a tremendous amount of costs there.”

Overloaded system

Compared to New Hampshire’s four intermediate-level children’s homes, there are 26 in Massachusetts, Wheeler said, juxtaposing resources.

And while the state has made strides in increasing access to addiction and mental health services, including Gov. Chris Sununu’s $45 million “hub and spoke” system of care, Wheeler said the Chase Home sees a significant backlog in parents still facing barriers. They’re either on waiting lists for treatment, don’t have appropriate insurance coverage, or could be homeless.

As a result, a child’s most basic needs often aren’t being met. Sometimes there’s seven family members sleeping in a one-bedroom apartment, Wheeler said, and the kids are chronically truant to school.

DCYF statistics show that in 2017, out of 688 instances of child removal from a home, 365 included allegations involving substances in the assessment.

In 2018, 12,341 assessments were accepted for further investigation. Of the total number of accepted assessments, 5,491 were determined to have substance abuse as a risk factor at the time of the referral, and 3,237 had at least one allegation involving substances.

“The system is really overloaded and at the same time that kids are coming in, there’s also an explosion of brain science on how all of these things impact kids,” said Moira O’Neill, director of the state’s Office of the Child Advocate, an independent body that oversees DCYF and the child welfare system. “We should be in a better position to mobilize and respond to their needs.”

O’Neill expressed frustration that a rate increase for community-based providers, such as the Chase Home, isn’t included in the Senate Finance Committee’s biennial budget plan. Instead, she said, they’re investing in buildings rather than services, like a new secure psychiatric unit on the New Hampshire Hospital grounds. “It’s like we’re working against ourselves on a policy level,” she said.

The committee did, however, add approximately $9 million for new child protection workers, supervisors and specialists reflecting the passage of Senate Bill 6, and nearly $20 million reflecting the passage of Senate Bill 14, which increases mental and behavior health services for children.

In October, the federal Family First Prevention Services Act goes into effect, which will allow states to take federal dollars used for foster and residential care and divert them upstream for prevention purposes, such as substance abuse care for parents, and parenting and home visit programs. O’Neill called it a “beautiful shift of funding,” as residential care should be the “last resort” for children.

“Public health prevention programs could be paid for to keep kids out of residential care,” O’Neill said. However, she noted, New Hampshire isn’t yet ready for that model, and will need to delay implementation of the act.

“Gov. Sununu has put a lot of attention into getting people the treatment they need,” O’Neill said. “But I would say the children who have parents who are struggling with substance abuse have really been forgotten in this conversation.”

‘They are survivors’

The Chase Home takes children from all over the state. Wheeler rattled off Manchester, Nashua, Hampton, Seabrook and Keene as some recent cities and towns they’ve seen. Every child at the Chase Home is court-ordered to be there, having made their way through the family court system where a parent or guardian was found neglectful or abusive. On the juvenile justice side, the child could have been convicted of shoplifting or marijuana use.

No one wants to go to the Chase Home, Wheeler said. Every child who arrives, and their family, is in crisis.

Wheeler shared the story of a girl who stayed with them for two years, and had been living in her mom’s car in Laconia. “She came to us with a head full of lice, completely neglected, food insecure,” she said. “Mom was MIA, in and out of jail. We had to pay for this high-end service in Portland for lice removal.”

Highlighting a more recent case, Wheeler said two teenage siblings, who looked more like 8 and 10 years old, arrived at the Chase Home at night “in pajamas and crying.” The parent was missing all teeth, was very thin, and “clearly addicted.”

“Generally, the goal really on whatever trauma they’re coming to us from is stability right out of the gate,” Dennis said. “It’s very traumatic to be placed here in itself.”

Many children are operating at the age level their trauma occurred, so while they may be 15 or 16 years old, they could function with the competency of a 10-year-old.

The more structured the children’s days, the better, Wheeler said. The Chase Home is big on bike riding and recreational activities, considering its 26 acres is the largest residential plot in Portsmouth. The kids hike, go fishing and take beach trips, while also receiving free passes to the YMCA. On site, there are outdoor gardens, planted by Gather food pantry, where the kids spend the summer growing their own food.

Most kids attend Portsmouth schools while living at the Chase Home, but they have the option to be bused to their home district if close by, like Rochester, Somersworth or Dover. Relocation often results in a lack of relationships, Dennis said, and the Chase Home is forced to confiscate cellphones for safety reasons.

“The bottom line is it is in the best interest of everyone if we can ultimately get that child home,” Wheeler said. “And I would say 90% do go home.” The outlying 10%, often with no home to return to, are usually admitted to college or a technical school, or begin working, straight out of the Chase Home. The nonprofit also has a home-based program, which provides support to youth transitioning from the residential program to reintegrate with their families.

In a statement, Kathy Remillard, public information officer for the state’s Department of Health and Human Services, said DCYF has expanded its use of licensed alcohol and drug counselors in district offices to help guide caseworkers with these challenges, and to connect families impacted by substance use to services. With the Bureaus of Drug and Alcohol Services and Children’s Behavioral Health, DCYF has contracted with Granite Pathways and the Family Resource Center of Gorham to establish “Strength to Succeed,” which provides peer support, access to treatment for parents and caregivers struggling with substance use, and support to other family caregivers who may be caring for children.

“Through this integrated approach to services and programs, DCYF is working to address the impact of the opioid crisis on children, the state’s most vulnerable residents,” she said.

“That’s one fascinating thing about every one of these kids,” Dennis said. “They are survivors. Very resilient.”

Online: https://bit.ly/2MykVMa

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Information from: Portsmouth Herald, http://www.seacoastonline.com

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