Pubdate: Fri, 14 Jul 2017
Source: Florida Times-Union (FL)
Copyright: 2017 The Florida Times-Union
Author: Amanda Williamson



The blond toddler pounced from the floor without warning and reached
for a toy deep within Savannah Woods' entertainment center.

She remained on the plush, beige carpet, her eyes following the
toddler through the room. In attempt to rein in the child's energy,
Woods called him back to her side and asked him to name a smiling
woman in the picture she held.

"Momma," the two-year-old said. The photograph captured Woods and her
wife, Carly.

"In class, they teach you to let the child call you whatever they feel
comfortable with," Woods said. "It may be upsetting for the biological
parent, but the child has already been through so much."

The boy, who she was fostering until he could be reunited with his
parents, showed no delayed development, no abnormal behavior, and no
signs of opioid addiction.

For Woods, it isn't always like that.

At least one of the children she and her wife fostered over the last
year arrived to their Northwest Jacksonville home dependent on
opioids, medicine intended to relieve pain but instead was a remedy
that hurled the nation into crisis.

Opioids killed more than 33,000 people last year - and tens of
thousands more lived daily with the physical and mental side effects
of opioid addiction. Communities now battle with an increased number
of addicts, a lack of resources to treat them and the casualties
associated with both.

Public health officials say America is living through the worst drug
crisis in its history - and children across the country suffer the

More than ever, substance abuse is the driving factor behind the
removal of children from Duval County homes by the Florida Department
of Children and Families.

According to the department, 62 percent of the removals so far in 2017
came about as a result of substance abuse - a percentage that, only
four years ago, sat at 36 percent. As the numbers increase, the burden
placed on foster homes sees a parallel increase.

"If the epidemic keeps growing and more kids come into care and we
can't recruit enough foster homes to handle that, then those kids will
have to go into group care," said Family Support Services Chief
Financial Officer Bob Miller. "That's the danger. If this epidemic
continues, it will outstrip our capacity to take care of the kids."

In Florida, some counties already lack enough families to meet the

In Duval County, the situation remains under control at the moment,
but Miller attributes that success to the organization's proactive

Family Support Services of North Florida is the lead agency for foster
care, adoption and family preservation in Duval and Nassau counties.

Just last year, it launched a campaign to recruit more foster families
and attracted 75 new foster parents. This year, they are doing the
campaign again. They also established a post-reunification unit to
continue in-home help after the child returns to his or her parents.
The organization works each year to spend a large chunk of the budget
on prevention services.

The baby's curdling screams startled Woods the first night the infant
spent at her house.

Foster care officials didn't tell her much about the child - and even
less about her medical history. But, the symptoms seemed familiar,
something she'd read about or heard of before.

High-pitched screams, tense muscles, feeding struggles - Woods knew
exactly what she was seeing, even though her own child never displayed
such behavior. She turned to the Internet to confirm: opioid withdrawal.

Sure enough, when the child's court documents arrived, it was outlined
within the official texts. The child spent over a month in the
neonatal intensive care unit for opioid dependency, and now, Woods
would take over.

"You can't protect them from that," she said. "I feel for the parents.
It's not that they are choosing the drugs over their children. It's
that they have a disease."

More than three out of five overdose deaths now involve an opioid,
according to the Centers for Disease Control. The epidemic touches
every state in the country and shows no discrimination. Deaths, the
CDC reports, are up among men and women, of all ages and all races.

Last year, in Jacksonville, the fire and rescue department responded
to 3,411 overdose calls, more than triple the number from 2014. On top
of that, opioids accounted for 544 deaths. Even though opioid
prescriptions are down in the state of Florida, those found illegally
on the streets are more often than not being sliced with dangerous
additives, like fentanyl, Miller said.

"Once people get hooked on it, they will do anything to keep from
having to go through the withdrawal," he added. "When they get to that
point where they don't value anything other than the drug, it just
rips families apart. You can take away their children - and that still
doesn't get their attention."

That's where Family Support Services (FSS) steps in. The Florida
Department of Children and Families investigate possible instances of
child abuse or neglect, and then refer to FSS on an as needed basis
for fostering and adoption.

Recently, the foster-care organization has been getting more and more

This year, as of June 30, 217 children have been removed from Duval
County families due to drug or alcohol-related issues. In all 2016,
363 children were removed for substance abuse and a total of 658
children were removed.

In 2013, when DCF first created a database on substance abuse
removals, those numbers sat at 198 removals due to substances. That
was only 36 percent of the 550 children removed from their families.

Christine Cauffield, executive director of LSF Health Systems, said
she believes the almost 30 percent increase can be attributed to the
opioids. "Parents are dying," she said. "They are overdosing or
children are finding their parents unconscious with needles in their
arm. Even if the parents are revived, there's usually removal."

The average length of time a child must stay away from his or her home
now exceeds its historical average, Miller said. After children enter
the foster care system, they get placed with a relative, a foster care
family or a state residential agency.

A 12-month time frame then begins.

"The clock starts ticking," Miller said. "Lots of times, even though
we try to keep them bonded to the child, these parents say, 'Oh, this
is great. Now I don't need to pay attention to anybody. I can just go
on my merry drug way.'"

FSS provides parents with a case plan and services in hopes they will
change any behavior that contributed to a child's removal.

"If you look at classic addiction treatment, they don't treat people
until they are ready to be treated," Miller said. "Then, eight months
goes by, nine months goes by, 10 months, and they haven't even engaged
in trying to get their children back. They are still using. That's why
these drugs being so powerful compound the issue."

It stretches the whole process out, he added.

If parents don't actively engage in recovery, the child can stay in a
foster home until a court determines the child should leave. That can
mean the termination of parental rights, Miller said. If a parent
decides to pursue treatment, the process starts anew.

"At Family Support Services, we have this belief: every child that can
safely remain in their home should do so," Miller said. "As good as
foster parents are, and they are fantastic about taking kids in and
loving them, in order to cure trauma, those kids need a forever bond."

As Duval County fire and rescue units stock medication to counteract
overdoses, as morgues overflow with the opioid casualties, children of
drug users watch these scenarios unfold.

Often, women who engage in high-risk behaviors such as opioid use have
a higher chance of becoming pregnant, experts say. As their child
ages, if he or she isn't removed, then the child must deal with an
addicted parent.

A large portion of the children pulled from home dues to substance
abuse are under 5 years old.

"Those children are the most vulnerable. They are non-verbal. They
can't care for themselves," Miller said. "So, if the mother is using,
you have no idea how to make that child safe. Say the mother passes
out. If she is passed out for long periods of time, no one is taking
care of the child."

Evidence shows parents - at a much higher rate - are using drugs
around their children. It could be at home or in a vehicle or at a
friend's house. Regardless, if the parent dies or becomes unconscious,
no one is around to care for the child.

Placing those in the under 5 group tends to be easier for FSS than
placing teens.

"By the time a child enters the foster-care system, they've already
seen an great amount of trauma," said Angela Mann, a professor in
child psychology. "Not only are we going to see an increase in the
number of children coming into the foster care, which will strain the
system, but they are also coming with quite a bit of need."

That creates a generation of children who will be at risk for
mental-health issues, behavioral issues and even physical health concerns.

What happens, Mann asked, when the children go to school? They might
have trouble controlling their behavior. They might fall behind. They
will struggle to make friends, to stay motivated.

"To think about those numbers growing, it is unclear to me how we are
going to meet the need," Mann said.

For many, treatment may ultimately be found only in prison, she added.
When mental health issues are not addressed, the cycle starts again.

Miller agreed. When something happens to a young girl or boy that
isn't treated, they grow up vulnerable. They may start using to
self-medicate, he said. Then, they have children and they can't parent
because they were never taught how to. So, their children get raised
in the same unhealthy environment.

"That's where we are really trying to break the chain," he added.
"It's not what's wrong with them. It's what happened to them. They
aren't programmed like they would be mentally if they'd been in a
supportive family from the beginning."

Because of that mindset, FSS spends more on prevention than any other
foster-care agency in the state, Miller said. According to FSS staff,
it spends approximately 15 to 20 percent on prevention and family
preservation services.

Those prevention services result in FSS maintaining the third lowest
rate of removal in the state. Much of this, said Miller, can be traced
to the organization's FAST program. The program grew from the
recognition that pulling children from their families increases
trauma. So, FSS focuses on implementing services in the home to
protect and treat the child, while empowering parents.

"We had 1,000 children in our FAST program last year," Miller added.
"If not for FAST, those children would have come into foster care."

The opioid epidemic may shake up that program - as it's harder to care
in-home when parents are unconscious or overdosing.

In situations where removal is unavoidable, foster parents can access
services to improve the quality of a child's care. FSS offers several
different training opportunities, including therapeutic and medical

Currently, in its pilot phase, a post-reunification unit works to
ensure a smooth transition for the child and parent after time in the
foster-care system. That program, launched in March, provides a
secondary caseworker for the family for six months.

Though the program is under evaluation, Miller said, it was created as
a result of the opioid epidemic. "We are doing that because substance
abuse is so difficult, it's recalcitrant. It's hard to overcome," he

Enter Bethany Moore, a 27-year-old teacher who has been a foster
parent for over a year.

Because she sees the need daily in her classrooms, Moore plans to
pursue certification to increase the number of children she can foster
at one time. For her, the classes provided by FSS were like
foster-care bootcamp.

The information, she said, was vital. Knowing the current situation,
Moore pursued classes specifically to help her understand children
born with drugs in their system.

For over a year, Moore fostered a little boy who came to her just
after turning 1 year old. The child was born early due to his mother's
drug use.

She sees the signs even now. She constantly works with him on his
speech, on his walking. She takes him to counseling.

"He is making so much progress because of the home he is in," Moore
said. "Two months after being a foster mom, I knew I could be his
mom.... If I can do this, anybody can."

Moore plans to adopt her foster son this month.
- ---
MAP posted-by: Matt