New Research Shows Impact of Opioid Epidemic on Child Welfare Services

After more than a decade of sustained declines in the national foster care caseload, beginning in 2012, the number of children entering foster care began to rise. Between 2012 and 2016, the number of children in foster care nationally rose by 10 percent, from 397,600 to 437,500. The experience of individual states varied, though more than two-thirds (36 states) experienced caseload increases. Hardest hit have been six states whose foster care populations rose by more than 50 percent over this four year period.

While many believe parental substance use – including prescription drugs, illicit drugs and alcohol, but especially opioids – has been the primary cause of the increase in foster care placements, thus far there has been little evidence to support this assertion. To better understand how select indicators associated with substance use relate to the changing trend in child welfare caseloads, the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) carried out a research study that included both quantitative analysis and qualitative data collection. The first two research briefs from this study were released in March 2018. Top-level findings are as follows:

• Caseloads: Nationally, rates of drug overdose deaths and drug-related hospitalizations have a positive relationship with child welfare caseloads (that is, rates of child protective services reports, substantiated reports, and foster care placements). Generally, counties with higher overdose death and drug hospitalization rates have higher caseload rates. In addition, these substance use indicators correlate with rates of more complex and severe child welfare cases.
• Availability and use of substance use treatment: Several major challenges affect how child welfare agencies and families interact with substance use treatment options, including medication-assisted treatment for opioid use disorder. Family-friendly treatment options are limited, and caseworkers, courts, and other providers often misunderstand how treatment works and lack guidelines on how to incorporate it into child welfare practice.
• System response: Child welfare agencies and their community partners are struggling to meet families’ needs. Haphazard substance use assessment practices, barriers to collaboration with substance use treatment providers and other stakeholders, and shortages of foster homes and trained staff undermine the effectiveness of agencies’ responses to families.

The research briefs are available at the ASPE website.