October 2021 | Vol. 22, No. 9
October 2021 | Vol. 22, No. 9
Written by Associate Commissioner Aysha E. Schomburg
I can't stop thinking about the children whose lives have been upended by Hurricane Ida. As I write this, I know that there are children in many parts of this country who should be getting ready for school tomorrow, but instead they are trying to figure out when or even if they will return to school. They may even be trying to figure out where they will sleep or where their family will live in the coming days. If they are in a shelter, they may wonder if that shelter will be safe for them and provide them with the resources they need. I can't stop thinking about the trauma their small brains are experiencing and whether they—or the adults around them—are even aware of it. The child victims of Ida are not unlike the child victims of Hurricanes Katrina, Sandy, or Maria. They are not unlike the child victims of the wildfires that have devastated the western states of this nation.
According to the 2015 National Report Card on Protecting Children in Disasters, after Katrina, more than 300,000 children were forced to enroll in new schools around the country. By some accounts, settling in new schools wasn't safe for evacuees; they were treated as outsiders and accused of soaking up resources that were designated for resident families. Superstorm Sandy ripped through the northeast and left children homeless or without heat and power. Many schools were practically destroyed, and students were required to squeeze into otherwise already overcrowded schools. According to one study regarding youth in Puerto Rico, 32 percent of youth experienced shortages of food and water in the aftermath of Maria. Natural disasters have left children without homes, without schools, without power, and without enough food and water. To make matters worse, I've read recently that long-term exposure to smoke from the wildfires is especially damaging to a child's lungs. That same article pointed out that "it matters whether your family can afford an air purifier." Recovery economics is an issue.
I'm worried about the children who survive the disaster but can't defeat the posttraumatic stress. Not surprisingly, those most impacted are children in underserved communities—Black and Brown children living in poverty with insecure housing. We rush to provide them with basic necessities during the first few weeks, then the news cycle moves on. I still wonder if they truly have access to all that they need. For so many children, after the temporary wind and the rain, what remains is the permanent tornado within. There is stifling trauma that suffocates their ability to succeed. When the water dries and debris removed from the streets, are we tending to the wounds left behind that only they can feel? Are we acutely aware of the lingering invisible injury? Are we fully invested in disaster recovery when the hurricane comes and stays? I'm not sure we are doing enough.
Issue Date:
October 2021
Section: Spotlight on National Substance Abuse Prevention Month
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5880
The National Council on Family Relations published a brief that explores the intersection of opioid use and child and family welfare in three states: Indiana, Massachusetts, and North Carolina. While these states face different needs, all are dealing with the changing landscape of the intersection of the opioid epidemic and child welfare. States can look at these case studies to see how they can apply to their own unique situation instead of relying only on national-level statistics and trends. The brief also covers relevant legislation these states have passed to stop the epidemic and enact potential policy responses.
Indiana had a 271-percent increase in opioid-related overdose deaths between 2010 and 2016. In 2017, its percentage of prenatally exposed infants exceeded the national average by 4 percentage points. Furthermore, more than half of all child removals in the state in 2017 were linked to parental substance use—again, far higher than the national average (35 percent). In response, Indiana passed legislation to limit opioid prescriptions and make opioid-specific treatment options more accessible.
In 2017, Massachusetts had an opioid-related overdose death rate that was nearly twice the national average. From 2014 to 2018, the percentage of families investigated for potential maltreatment was also consistently higher than the national average. In 2016 and 2018, the state passed two proactive prevention-focused bills to address the issue.
North Carolina experienced a 70-percent increase in opioid-related overdose deaths between 2015 and 2017, and prenatal opioid exposure increased over 20-fold between 2000 and 2013. In 2017, the state had a higher percentage of children involved with child welfare than the national average. The state overhauled its child welfare system and passed multiple pieces of legislation to reduce the supply of opioids and increase public awareness and prevention efforts.
The brief provides the following suggestions for future policy changes:
Issue Date:
October 2021
Section: Spotlight on National Substance Abuse Prevention Month
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5881
Understanding the relationship between the opioid epidemic and child welfare—particularly how children are indirectly affected by the increase in opioid misuse—continues to be a priority. An article published in Contemporary Economic Policy found that increases in opioid-related mortality and emergency-department visits were associated with increased foster care entry, but there was no significant relationship between legal opioid distribution quantities and home removals. The article, "What About the Children? How Opioid Use Affects Child Well-Being," explores the relationships between opioid use and child well-being and between opioid-related public policies and child welfare outcomes.
Results of the study show that there is a strong need for policies that mitigate the harmful—and sometimes indirect—effects the opioid epidemic has on children. It also notes that policies should focus less on reducing the amount of legal opioids available and instead focus on improving how we can predict prescription abuse risk and reduce illicit opioid use. Findings also suggest that reducing the impact of the opioid epidemic on children can lead to a substantial amount of public savings.
To learn more, read "What About the Children? How Opioid Use Affects Child Well-Being."
Issue Date:
October 2021
Section: Spotlight on National Substance Abuse Prevention Month
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5882
A 2020 article in Children and Youth Services Review explores the potential correlation between opioid overdose events and child maltreatment. The authors posited that conducting research that encompasses broader aspects of the opioid epidemic and child maltreatment can lead to a better understanding of the link between the two and better inform policy and practice decisions that improve child outcomes. Opioid overdose mortality rates have increased nearly six times since 1999, and there have also been significant increases in the number of children born with neonatal abstinence syndrome (NAS) and the percentage of home removals attributed to parental drug use. Many researchers have prioritized better understanding the specific impact of the opioid crisis on the child welfare system.
This study examined the link between county-level opioid overdose event rates and child maltreatment indicators (e.g., intake, substantiation, placement rates). The study also included additional county-level variables and characteristics. Data were obtained from 39 Washington state counties from 2005 through 2017 to model predictors of child protective services (CPS) outcomes over time.
The study did not identify any significant trends for CPS indicators as counties experienced increased opioid overdose events, which contrasts with previous findings of positive relationships between the epidemic and NAS. The data revealed the relationship to be more complex and requires the incorporation of macro-level contextual factors to better understand the link.
To learn more, read "Opioid Overdose Events and Child Maltreatment Indicators: Differential County-Level Associations."
Issue Date:
October 2021
Section: Spotlight on National Substance Abuse Prevention Month
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5883
The Office of the Assistant Secretary for Planning and Evaluation (ASPE) within the U.S. Department of Health and Human Services published a brief that identifies, summarizes, and provides possible solutions for key challenges rural communities face in regards to the intersection of parental substance use and child welfare. The research team conducted a literature review, interviewed subject-matter experts (SMEs) from relevant fields, and reviewed relevant gray literature and articles recommended by SMEs and ASPE staff.
Rural communities have a significantly higher per capita opioid overdose rate than urban areas as well as higher rates of methamphetamine use. Rural communities also have less capacity to treat substance use disorders, and treatment is further complicated by the increased rate of polysubstance use. Rates of poverty and unemployment are widespread in many rural areas, which increases the risk for both substance use and child maltreatment and further exacerbates the complexity and issues in providing successful treatment.
This brief highlights the differences between rural and urban areas, key issues communities face, and potential strategies agencies can employ to improve their services to parents and families affected by substance use disorders. Some of the challenges included the following:
The brief emphasizes the need for better access to services and provides the following potential solutions to offset the barriers rural communities face:
A forthcoming brief will feature promising models for addressing the needs of parents with substance use issues who are engaged in the child welfare system and live in rural communities.
To learn more, read Challenges in Providing Substance Use Disorder Treatment to Child Welfare Clients in Rural Communities.
Issue Date:
October 2021
Section: Spotlight on National Substance Abuse Prevention Month
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5884
Over 5 million children in the United States have parents who are jailed or incarcerated, and a disproportionate number of these children are Black or Latino. Parental incarceration has a profound effect on family well-being and is a key risk factor for poor outcomes for children, which can lead to involvement with the child welfare system. A literature review from the Office of Planning, Research, and Evaluation within the Administration for Children and Families (ACF) of the U.S. Department of Health and Human Services presents studies about family-strengthening programs that seek to maintain relationships between children and their incarcerated parents.
The review aimed to answer the following research questions:
Issue Date:
October 2021
Section: News From the Children's Bureau
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5885
The Children's Bureau website hosts information on child welfare programs, funding, monitoring, training and technical assistance, laws, statistics, research, federal reporting, and much more.
Recent additions to the site include the following:
Issue Date:
October 2021
Section: News From the Children's Bureau
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5886
Child Welfare Information Gateway released a factsheet that provides caseworkers with information about how to apply the Indian Child Welfare Act (ICWA) to their practice. The factsheet, The Indian Child Welfare Act: A Primer for Child Welfare Professionals, includes a brief overview of the history of child welfare practice with tribes, including factors affecting tribal-state relations and federal legislation affecting child welfare practice with tribes. In addition, the factsheet provides a brief discussion of the practice implications of ICWA, such as determining whether ICWA is applicable to a child welfare case and what to do if a child is determined be American Indian/Alaska Native (AI/AN), transferring jurisdiction to the appropriate tribal authority, implementing active efforts to maintain or reunite a child with their family, removing a child from the home and terminating parental rights, and placing an AI/AN child in out-of-home care.
The factsheet also includes a list of cultural considerations to keep in mind when working with AI/AN families:
Issue Date:
October 2021
Section: Training and Technical Assistance Updates
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5887
The Children's Bureau funds several technical assistance centers to provide professionals with tools to better serve children, youth, and families.
Visit the Child Welfare Information Gateway website for more.
Visit the FRIENDS National Resource Center website for more.
Visit the CBC website for more.
Visit the CBLCC website for more.
Visit the AdoptUSKids website for more.
Visit the NDACAN website for more.
Visit the NCWWI website for more.
Visit the QIC-WD website for more.
Visit the QIC-AG website for more.
Issue Date:
October 2021
Section: Training and Technical Assistance Updates
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5889
Improving outcomes for children and families and preventing child maltreatment requires transformation across the entire human services system. A recent policy brief from Chapin Hall at the University of Chicago explores how various human services agencies can provide concrete and economic supports to ensure families have what they need to keep children safe and healthy.
According to the brief, economic need and disparity is the root cause of child maltreatment, particularly neglect, for many families. The brief outlines key steps to understanding the relationship between economic risk and well-being outcomes and increasing the use of economic and concrete supports. The following are the four areas for system transformation outlined in the brief, as well as their core strategies:
Issue Date:
October 2021
Section: Child Welfare Research
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5890
A study that examined the effectiveness of the Families Actively Improving Relationships (FAIR) program found that program participation resulted in significant reductions in parental opioid and methamphetamine use, mental health symptoms, and parenting risk.
The FAIR program was developed to address the needs of families with parental opioid and methamphetamine use who are involved in the child welfare system. FAIR is an intensive, community outpatient program that involves four major treatment components: substance use treatment, mental health treatment, parent management training, and resource building and services receipt.
A key component of the program is the FAIR store. Parents are awarded "FAIR bucks" for positive treatment gains, such as negative drug tests and the use of positive parenting strategies, that they can spend on items to support their individual and parenting goals. The donated store items range from clothing, games, and toiletries to passes for swimming lessons and scholarships for camps. FAIR bucks are awarded liberally to positively reinforce incremental gains.
The study recruited 99 parents. Of the 86 participants who engaged in services, 72 percent completed their treatment. The average length of treatment was 8.7 months, with a 24-month follow-up period. Outcomes showed statistically and clinically significant reductions in parental substance use, mental health symptoms, and parenting risk, as well as improvements in stability. Many participants maintained improvements in their substance use, mental health symptoms, and parenting risk throughout the follow-up period. The researchers concluded that there is a need for policies that support funding intensive, family-based programs.
For more information, read "Meeting the Needs of Families Involved in the Child Welfare System for Parental Substance Abuse: Outcomes From an Effectiveness Trial of the Families Actively Improving Relationships Program."
Issue Date:
October 2021
Section: Child Welfare Research
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5891
The National Center on Substance Abuse and Child Welfare (NCSACW) developed a new technical assistance tool to provide information to child welfare professionals, substance use treatment providers, health-care professionals, and other child-serving community agencies about working with adolescents who are at risk of misusing or abusing substances.
The tool, Working With Adolescents: Practice Tips and Resource Guide, provides information on adolescent development, as well as tips and best practices professionals can utilize when working with at-risk youth. Topics discussed include the five Cs of positive youth development (competence, confidence, connections, character, and caring); the role of parents and caregivers in adolescent development; and the co-occurrence of trauma, abuse, neglect, and substance use in adolescents. Many children and youth involved with child welfare have experienced trauma, increasing their risk for substance use.
In addition to providing tips for practice, the guide links to additional resources for professionals on substance use prevention, intervention, treatment, and recovery.
Issue Date:
October 2021
Section: Strategies and Tools for Practice
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5892
The Office of the California Surgeon General published a report detailing how adverse childhood experiences (ACEs) and toxic stress are threats to public health that can be mitigated. The report, Roadmap for Resilience: The California Surgeon General's Report on Adverse Childhood Experiences, Toxic Stress, and Health, provides a framework for a cross-sector response to these challenges.
The report is intended for a wide audience, including professionals, families, community organizations, researchers, and advocates. It proposes enhanced coordination in addressing ACEs and toxic stress from various human services sectors, including health care, public health, social services, early childhood, education, and justice. Children and youth involved with child welfare often have ACEs and deal with the stress and trauma related to those experiences. This report can help child welfare professionals understand how ACEs and toxic stress have affected the families they serve and provide ways they can take a collaborative approach to easing this strain on families' well-being and improving outcomes.
The roadmap outlined in the report is split into four parts:
Issue Date:
October 2021
Section: Strategies and Tools for Practice
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5893
Written by the Capacity Building Center for States
Integrating disaster planning into regular agency strategic planning, reporting, and continuous quality improvement (CQI) efforts is critically important in helping ensure that agency services for children and families can continue during a disaster. While we don't know exactly when and where the next flood, fire, shooting, or health crisis will occur, integration ensures that disaster planning remains a visible agency priority and that sufficient resources and staff are allocated to allow agencies to advance their plans for achieving desired outcomes, even during a disaster.
Although disaster planning is already part of the Child and Family Services Plan (CFSP) and Annual Progress and Services Report (APSR) process, in practice it often is not closely linked with other agency work. By better integrating disaster planning with other processes, such as strategic planning, reporting, and CQI tasks, agencies can do the following (Capacity Building Center for States, 2021):
Issue Date:
October 2021
Section: Strategies and Tools for Practice
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5894
A blog post from AdoptUSKids discusses why spending time on the internet can be a dangerous pastime for children, particularly those in foster care; the associated risks; and considerations and strategies for parents and caregivers to keep kids safe online.
Excessive online screen time, a problem compounded by COVID-19, can threaten personal safety; lead to deteriorating mental health, including feelings of social isolation, depression, and low self-esteem; and open the door to unauthorized or unhealthy connections with their birth family and others.
The following tips are some of the ways parents can limit screen time and mitigate safety concerns:
Issue Date:
October 2021
Section: Resources
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5895
The National Council for Adoption (NCFA) has provided an updated guide to understanding the adoption tax credit (ATC). The guide includes sections discussing the following:
Issue Date:
October 2021
Section: Resources
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5896
Children and Family Futures released a new 2021 FTC Practice Academy training series to support family treatment court (FTC), child welfare, substance use disorder treatment, and dependency court professionals, as well as other stakeholders, as they build their collaborative capacity to help families dealing with substance use.
The 2021 training series aims to help trainees learn how to implement best practices and improve equity outcomes, create action plans that show what works best for families dealing with substance use disorders, and share innovations and inspiration between FTCs.
The series comprises three standalone courses that include videos, team discussions, virtual live conversations between participants and subject-matter experts, Take Action tools to help trainees shape their own action plans, and resources to encourage and support additional discussion.
The following are the 2021 FTC courses:
For more information and to participate in the courses, visit the FTC Practice Academy website.
Issue Date:
October 2021
Section: Training and Conferences
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5897
Upcoming conferences and events on child welfare and adoption include the following:
Issue Date:
October 2021
Section: Training and Conferences
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=230&articleid=5898
Contact us at cb_express@childwelfare.gov.