The opioid epidemic is creating an increase in foster care enrollment in North Carolina, according to a report released this week by a child welfare nonprofit.
NC Child is advocating for a closure of the health insurance coverage gap in the state – a topic currently being discussed in the state legislature – in order to counteract these issues.
Whitney Tucker, research director at NC Child, said the organization was struck by the tragic nature of the opioid epidemic and wanted to assess its impact on North Carolina's children.
"We just thought, what does this mean for kids? And when we dug into it, we saw that it was unsurprisingly resulting in higher foster care stays," she said.
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In 39 percent of cases statewide of children admitted into foster care in 2016 and 2017, NC Child found that parental substance abuse was the lead contributing factor.
Eighteen percent of the children in Mecklenburg County's foster care system were placed there in 2016 and 2017 due to parental substance abuse, according to the report. More than half of the children in foster care in neighboring Iredell County were placed there due to parental substance abuse.
Tucker said the large disparity in figures across counties from the N.C. Department of Health and Human Services is likely due to the lack of a standardized system of records collection in regards to child's removal from a home.
Children in the foster care system whose parents suffer from substance abuse also have a higher likelihood of staying in the system longer than their peers, the report stated.
NC Child recommended increased access to healthcare, particularly for those who fall into a coverage gap that earn too much to qualify for Medicaid and not enough to afford health insurance, as a possible solution to the opioid crisis and its resulting effect on foster care enrollment in the state.
"Several different states have seen an increase in the number of Medicaid beneficiaries who are using mental health or substance abuse disorder treatment after they expanded enrollment," Tucker said.
A study from the Center on Budget and Policy Priorities last year found that Kentucky experienced a 700 percent increase in the usage of substance use treatment services from Medicaid beneficiaries after its expansion of Medicaid.
NC Child's recommendation section of its report mentioned House Bill 662, called Carolina Cares, which would provide a healthcare benefit package to those who don't qualify for Medicaid but whose incomes do not exceed 133 percent of the federal poverty level. That bill remains in committee.
Brian Balfour, executive vice president of the Civitas Institute, said healthcare coverage expansion such as the kind in House Bill 662 may create an issue of overcrowding within the healthcare system.
A 2012 study by the Urban Institute found that 78 percent of working-age adults in North Carolina newly eligible for Medicaid under expansion with incomes below 138 percent of the federal poverty level would be without children.
"There's concern that this new population of newly eligible enrollees would crowd out resources and divert resources away from more traditional, more needy Medicaid populations," he said.
He also stated that Medicaid coverage does not equal healthcare access automatically.
NC Child also has a critique of the bill: the nonprofit stated that its work requirement may jeopardize treatment access for individuals suffering from substance abuse that cannot work, have a criminal record or are in stages of substance abuse treatment.
"We think that, although it won't end the opioid crisis, that families are stronger when parents have the tools that they need to properly care for their children," Tucker said.