ARI SHAPIRO, HOST:
Let's take a closer look now at an effort in Missouri to help parents with drug addiction. It allows them to get treatment and keep their kids out of foster care. As St. Louis Public Radio's Jason Rosenbaum reports, it's getting results when it's used.
JASON ROSENBAUM, BYLINE: Elisha Griffith's daughters were placed in foster care eight years ago as she struggled with substance use disorder. She eventually regained custody of them, but earlier this year, she relapsed.
ELISHA GRIFFITH: Kind of gave up, felt like a failure as a parent, didn't know what I was doing, and it just led to a lot of stress, and then that led me to another relapse.
ROSENBAUM: Instead of sending her kids to foster care again, Missouri's Children's Division gave her another option. It's called a Temporary Alternative Placement Agreement, where a parent struggling with drug addiction can have their children stay with a relative while they get rehabilitation services. After getting full custody of her kids earlier this month, she says the program was a godsend.
GRIFFITH: And I was so excited about the resources, seriously, so excited about that part. And it's helping. I'm not seeing changes overnight, but I'm seeing results little by little.
ROSENBAUM: The program was Missouri's response to what child welfare advocates call hidden foster care, where kids stayed with family or friends without an official agreement. This program tries to bring informal arrangements out of the shadows and have both court officials and Children's Division personnel involved. Jaidan Adams, the director of behavioral health at an anti-drug-abuse agency called PreventEd, says this program can be less traumatic for children and their families.
JAIDAN ADAMS: We know that trauma is the No. 1 risk factor for future mental health disorders, behavioral health disorders, substance use disorders. So I feel like anything that can be in place that can reduce that trauma - definitely a great tool to have.
ROSENBAUM: But the number of children dying of accidental fentanyl overdoses in Missouri is rising. And a review of cases from 2022 is bringing into question whether the rehabilitation program is used aggressively enough to get children out of homes where there's fentanyl use. Jessica Seitz, a child welfare advocate who looked into the rising number of deaths, found that Children's Division personnel often failed to offer the alternative program to parents and missed warning signs that they were using fentanyl.
JESSICA SEITZ: There were cases where there were clear drug problems, including at birth, where mom and/or child tested positive at the hospital.
ROSENBAUM: The fentanyl report also found that the arrangements were used unevenly throughout the state. For instance, they were offered 84 times in St. Louis from fall 2021 through spring 2024, but around 800 times in southwest Missouri during that same time period. Children's Division officials attribute the disparity to staffing shortages, and they said they've hired more people, but that momentum could be at long-term risk. Workers make far more money across state lines in Illinois or the private sector. And lawmakers like Democratic State Representative Maggie Nurrenbern have been unable to change that.
MAGGIE NURRENBERN: And when we're choosing to do things like build a new arena at the state fair, instead of using that same amount of money - $30,000,000 - to actually make meaningful change to the Children's Division, I think it says a lot about who's in power here.
ROSENBAUM: It will be up to Missouri's governor and the state's lawmakers to decide if keeping the Children's Division staffed - and giving families more options for drug rehabilitation - should be a priority.
For NPR News, I'm Jason Rosenbaum, in St. Louis.
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