TOPEKA, Kansas — Keandra Hoskins had a thing for cannabis and MDMA, or ecstasy.
She also had a son. And some denial about her dependence on drugs, how she’d take a hit of something to deal with the stress about her grandmother catching COVID-19, the fact that she was homelessness or that child welfare officials had an open case on whether she was a fit mother.
She ultimately realized she needed to get into a serious, residential drug rehab center.
But what to do with her son while she worked through her problems? She was one of the lucky ones who found treatment that made room for the children of patients.
“It’s just helped me become better at everything,” Hoskins said, “give you the life tools that you need so you can continue living your life.”
Addiction treatment taught her how to budget and to avoid things that could trigger a relapse.
The place she went, CKF Addiction Treatment, allowed her to bring her son to live with her. If she had to pick between treatment and motherhood, well, she would have picked motherhood.
Parents across Kansas struggle to find ways to battle addiction while tending to the 24/7 job of looking after their children.
One Kansas mother, who is now in prison on drug charges, said finding child care while in treatment is one “huge obstacle that a single mother could never possibly overcome.”
Inability to pay or finding housing is also an issue, but treatment providers say they lack enough child-friendly options.
Consequently, those who can’t get child care are less likely to get help for their addictions.
“If everyone who needed care showed up for care, our system would not be able to serve the need,” said Shane Hudson, president and CEO of CKF Addiction Treatment in Salina.
And if those parents don’t tend to their drug problems, they could die from drug use, could face criminal charges or child maltreatment investigations from the foster care system.
Hudson estimates about 10% of people who need help seek care. He has seen parents try to go through addiction treatment while finding child care on the side. Some may be a few weeks into treatment with a few weeks left, then life gets in the way.
“We’ve had people (in treatment) say … ‘I just need to get home. There’s things going on with my kid and I need to be with them,’” he said. “Some (come back), but some don’t. And some don’t even come to treatment in the first place.”
‘It can be complicated’
Treatment providers say they need more child-friendly rehabilitation programs.
But to create those programs requires mental health services for children, coordinating schooling and finding community partnerships to maintain a range of other services kids might need.
Then come difficulties from running facilities that have both adults and children. That means more space, extra staffing and additional programming. Treatment facilities might not be reimbursed for housing children, even though those children are taking up resources.
“It can be complicated,” Hudson said.
Treatment providers, like CKF, offer programs that do not require overnight stays. That alleviates some child care concerns, but that could still mean five to nine hours of child care a week because children aren’t allowed at those sessions. And some parents need more intensive programming only a residential stay could offer.
Hudson said that children old enough to understand what is going on could end up in rooms listening to people recount sensitive and private moments in their lives — very adult conversations. If the child is too young to understand what is happening, then they could be a distraction.
Telehealth programs, which have expanded since the pandemic, offer one possible solution. Or scheduling appointments while the child is at school. But parents who find themselves with an evening appointment and nowhere to take their children will need to leave them at home.
“Once you bring a child into the same setting as everyone, it’s not as simple as muting your mic when your child has needs going on,” Hudson said. “(The child) could actually disrupt the group process that’s happening.”
Finding slots
Treatment program Mirror Inc. used to have a designated women’s program in Newton, Kansas. That facility shut down partly because of staffing shortages and the cost of running it, staffers told the Kansas News Service.
Cynthia Breitenbach worked for Mirror. She is retired now but has plenty of experience with women’s programs. She started the first one in Kansas in the 1980s. She said those models of care are expensive and people sometimes shy away from the program because they don’t want to be seen as bad parents.
Using drugs could mean losing your kid to the foster care system and entering treatment means telling people you do use.
“(They think) ‘I’m a female. I’m an addict. So, therefore I am a bad mother,’ which is not the case,” Breitenbach said.
Addressing substance use for one person is complex and involves dealing with past trauma. Programs that take in kids now have another patient to deal with: the child.
Breitenbach said children need as much care as their mothers when entering treatment. That means facilities likely need to call in specialists who help kids. That could be everything from a child therapist to qualified day care workers.
Getting licensed child care at drug treatment is difficult and grants for drug treatment programs typically can’t be used for day care. Centers could try to cut costs by taking those children to a day care center in the community, but those can be hard to find.
Plus, day care is expensive. In Kansas, full-time daycare for a 4-year-old in a child care center is $800 a month. For an infant, that is $1,250 a month. And prices are headed up. For some Kansans, the cost of child care for their family is more than a mortgage payment.
Finding temporary day care can be trickier than a long-term set-up. Day care providers usually prefer taking a child who will stay longer so they don’t need to fill an open slot in a few weeks.
“We did try to access care in the community,” Breitenbach said. “Sometimes we were successful, sometimes we were not.”
Finding money
Navigating grant funding is yet another barrier to operating these programs.
A $200,000 federal grant given to foster care agency KVC Kansas will help expand an existing program in the state. The previous program was also offering family-based addiction treatment, but the requirements of the grant meant only Native American families could access it. Now the program will take more people.
Without the new grant, KVC Kansas wouldn’t be able to operate the program. Even with the grant, KVC has one year to prove the program is worth funding or it could risk losing the money.
“Sustainability is always a source of anxiety when you have a grant like this and you really believe in the program,” said Megan Hosterman, director of permanency services for Johnson and Douglas Counties for KVC.
The federal money that funds women’s programs doesn’t exist for men. For a facility to create a space for single fathers would mean funding that construction with fewer grants available. That’s financially risky for businesses that might already be struggling with tight budgets.
Despite grant-fueled anxiety, Hosterman is confident she can show the success of treatment.
The money will help hire workers, pay for space and pay for child care. The program is a 14-week long course. It starts with family meals so parents and children can spend time together. Then they break off for separate child and parent therapy sessions.
Hosterman said her agency has always wanted to focus more on the prevention side of substance use treatment. More investment in these systems could prevent kids from entering foster care in the first place.
All told, parent or child substance abuse was the reason a child was put into foster care 13% of the time. The most common reasons for removal was physical abuse — 18% of the time — and lack of supervision led to 15% of foster cases.
Hoskins, the mother who is now in recovery, said she isn’t sure she would still have custody of her child if not for addiction treatment. She not might have her house or even be in school.
The operators of programs that include children say they serve a very specific need and can help families who have few other options. Hoskins didn’t have family in the area. And while she had friends, there wasn’t anyone she trusted enough to care for her child.
Day care could have been an option, but her child had unique medical needs and she was worried that could overwhelm day care staff or friends. That means keeping the child with her was best for the mother and her baby. “I could see myself not going down the right path. Even with the child, I probably still would have (gone) down the wrong path,” she said. “And now, after treatment, I shocked myself. I’m a completely different person. I never thought that I would be working again. I never thought I would have my own place.”
Blaise Mesa reports on criminal justice and social services for the Kansas News Service in Topeka. You can follow him on Twitter @Blaise_Mesa or email him at blaise@kcur.org.
The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy.
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