Consistent with President Trump’s Executive Order on Reducing Poverty in America by Promoting Opportunity and Economic Mobility, HHS’s Strategic Plan sets goals for HHS to encourage self-sufficiency and personal responsibility, and eliminate barriers to economic opportunity and to prepare children and youth for healthy, productive lives. This blog is part of the Self-Sufficiency Series: Solutions from the Field, which profiles local programs from across the country finding solutions to accomplish these goals.
For runaway and homeless youth with severe trauma, a weak or non-existent social support system, and other significant barriers, the personal responsibility of attaining self-sufficiency can be overwhelming. HHS’s Strategic Plan and the President’s Executive Order on Reducing Poverty in America recognize the value of eliminating barriers to economic opportunity. HHS invests in achieving this goal through the Family and Youth Services Bureau’s transitional living programs (TLP) which provide a safe and stable living environment, and a strong emotional support system, to help youth achieve self-sufficiency.
While many TLP staff provide employment resources, some programs are partnering with local job training and employment assistance organizations to provide targeted individualized support to youth in preparing them for meaningful jobs.
For example, the Family Services of Northeast Wisconsin, in Green Bay, has developed a creative approach to job training and developing employment skills, based on a youth’s career interests. The TLP, in coordination with a Workforce Innovation and Opportunity Act-funded Pathways to Employment program, provides specialized services, working to address employment barriers and challenge preconceived notions regarding readiness to work. The results are positive: Family Services of Northeast Wisconsin reports that 80 percent of the 15 youth enrolled in the program completed the Career Exploration curriculum, 73 percent gained employment, and one-third of the youth participants are enrolled in the Northeast Wisconsin Technical College preparing for careers in nursing and automotive.
This partnership seems to make a significant impact on youth. For example, after her referral by the TLP to the employment program, “Tamara Jankins” (not her real name), a 20-year-old mother of two, enrolled in the Youth Work Experience program and soon realized that auto mechanics was her passion. The program connected Tamara to an Auto Mechanics technical program at Northeast Wisconsin Technical College, where she is studying to be a Certified Auto Mechanic - an in-demand career field.
Being homeless, 21-year-old “Jacob Francisco” (not his real name) was struggling with continuing his education. After his referral to the Pathways to Employment program, he received individualized support and guidance with enrolling in the Northeast Wisconsin Technical College. The college and program partnered to offer him partial tuition, and he is now working toward completing his degree in electro-mechanical technology and has a promising future ahead.
Providing access to training and education as well as to affordable housing and supportive services relieves a major barrier for youth like Jacob to become self-sufficient and lead healthy, productive lives. Family Services of Northeast Wisconsin and other runaway and homeless youth programs across the country, funded by the Family and Youth Services Bureau, are developing creative strategies to eliminate barriers to economic opportunity in youth.
I wouldn’t be here today if not for this health center. I didn’t realize all the help they offer and how many people use them until I became a patient … The staff has always treated me with the utmost respect. I can never thank them enough. I’ll have a place in my heart for these folks for the rest of my life.”-Phillip, a patient at a health center in Virginia
For Phillip and more than 27 million other adults and children across the country, health centers provide affordable, high-quality and patient-centered primary healthcare that would otherwise be out of their reach.
Health centers use a holistic approach to patient care, treating the entire person by integrating mental health, oral health, substance use disorder and primary medical care services. The Health Resources and Services Administration (HRSA) funds nearly 1,400 health centers operating more than 11,000 service delivery sites in communities across the country.
Health centers improve their community’s health by focusing on access and quality. In 2017, 92 percent of health centers met or exceeded one or more of the nation’s Healthy People 2020 goals for their patients. Health centers exceeded national averages for patients with good control of their diabetes and for hypertensive patients with well-controlled blood pressure.
Health centers increasingly provide a gateway to integrated care for individuals with substance use disorder, mental health and primary care needs. HRSA support enhances access to substance use disorder services, including medication-assisted treatment (MAT) and pain management services. The number of health center clinicians providing MAT increased by 75 percent, from 1,700 in 2016 to nearly 3,000 in 2017. Additionally, 90 percent of health centers provide mental health services.
More than 220,000 hardworking, dedicated primary care providers, nurses, dentists, social workers, health educators and other staff provide quality healthcare for their patients regardless of their ability to pay.
We want to be the clinic that says, “We can help you.” Whatever the problem you come through the door with, my doctors, my nurses, my providers can say, “We can take care of that here today. We will not give up on you. We will work with you.” Whether it be substance abuse, diabetes, high blood pressure, cholesterol issues… all these aspects of care … we want to work with our patients and make sure any barriers to quality care are cut down. - Van Breeding, MD, a family physician at a health center in Kentucky
During this National Health Center Week, HRSA is proud to recognize health centers across our country and the important work they do every week to protect and promote the health of America. To the thousands of providers and staff like Dr. Breeding, who dedicate their lives to helping patients like Phillip, we thank you for making a difference in your communities. You are America’s healthcare heroes!
Consistent with President Trump’s Executive Order on Reducing Poverty in America by Promoting Opportunity and Economic Mobility, HHS’s Strategic Plan sets goals
for HHS to encourage self-sufficiency and personal responsibility, and eliminate barriers to economic opportunity, and to prepare children and youth for healthy, productive lives. This blog is part of the Self-Sufficiency Series: Solutions from the Field, which profiles local programs from across the country finding solutions to accomplish these goals.
Families living in poverty face a number of obstacles on the road to economic empowerment. Finding a steady job, saving for the future, and taking care of children can be especially daunting when facing financial and health challenges. The Temporary Assistance for Needy Families (TANF) program, operated by the Administration for Children and Families (ACF) in HHS, provides states with block grants to design and operate programs to help families in need achieve financial self-sufficiency and end dependence on government benefits. Approximately 1.41 million families (3.57 million individuals, 73% of whom are under the age of 18) receive TANF assistance each month, with an average monthly assistance of $398.
In addition to providing cash assistance, TANF programs also provide recipients with help in finding and keeping a job including job readiness and job search activities. HHS, along with the President’s Executive Order on Reducing Poverty in America, recognizes the value of helping individuals develop or expand their social support in order to achieve this goal. Some job readiness programs across the country are already demonstrating ways that this can be done. One such program is the Building Wealth and Health Network (The Network), run by the Center for Hunger-Free Communities, a nonprofit organization in Philadelphia, PA. The program focuses on building social as well as financial capital. The Network serves TANF customers, who are allowed to count participation towards their required work activities for TANF.
Social capital – or the connections, networks, and information flows among individuals, organizations, and communities – has a positive influence on individuals and communities’ well-being. Research has shown that individuals with high levels of social capital are happier, are healthier, find better jobs, and live longer.
Several aspects of the program aim to help increase families’ personal responsibility and reduce barriers they face to economic mobility, key priorities for HHS. For example, the Network provides a financial empowerment class for TANF recipients, with a cohort model and emphasis on group support. Over 16 sessions, with two classes each week, participants are taught about fundamental financial terms and resources, and use goal-setting strategies and other techniques to apply their newfound skills in their daily lives. The curriculum was developed especially for families that have been exposed to violence and adversity, and is regularly updated and adjusted based on their feedback. The program also helps participants to open a savings account with a credit union, as many recipients are unbanked, have poor or no credit history, and possess few or no assets. The Network also provides a one-to-one savings match for a year.
While the courses’ content works to build skills of economic self-sufficiency, the peer support model that builds social capital is essential in fostering self-sufficiency and sustainability. The Network uses a trauma-informed perspective to address the physical and mental health needs of parents experiencing poverty; this approach aims to buoy the whole family by helping the caregiver. By sharing their knowledge and experience with each other in a supportive space, parents build a sense of mastery, control, and connectedness – assets of social capital.
A study by Drexel University researchers found that this combination of financial and social capital empowerment has led to measurable success for participants. They quickly bond and say that they continue to come back because they’re attached to the people in their group. That randomized controlled trial found that, over the course of the program, parents in The Network reported fewer depressive symptoms, reduced economic hardship, and increased self-efficacy. They also reported higher earnings and were more likely to be employed compared to those not in the program.
These results show the power of communities: when people come together, they have the opportunity to help themselves and others. The Network shows one example of how individuals can use this power to support each other in moving toward self-sufficiency. Efforts like these and others by HHS-funded TANF agencies help promote progress toward HHS’ goal of eliminating barriers to economic mobility.
Consistent with President Trump’s Executive Order on Reducing Poverty in America by Promoting Opportunity and Economic Mobility, HHS’ Strategic Plan sets goals for HHS to encourage self-sufficiency and personal responsibility, and eliminate barriers to economic opportunity and to prepare children and youth for healthy, productive lives. This blog is part of the Self-Sufficiency Series: Solutions from the Field, which profiles local programs from across the country finding solutions to accomplish these goals.
The negative impact of poverty on a child’s education and future career is quite substantial. Youth raised in poverty often miss significant opportunities for long-term economic mobility, healthy lives, and being community assets – goals that are important to HHS. An Adolescent Pregnancy Prevention (APP) program grantee funded by the Family and Youth Services Bureau in Hurricane, West Virginia is one example of a program that aims to help youth reach their greatest potential by supporting organizations and communities that guide youth along the path of school, work, marriage, and then children – referred to by the American Enterprise Institute and others as the millennial success sequence.
West Virginia has one of the highest teen birth rates in the country. Through APP’s sexual risk avoidance education program, youth in West Virginia obtain knowledge and skills to form healthy relationships and set goals that help them postpone pregnancy until they are better equipped to support a baby financially and emotionally.
Teaching Health Instead of Nagging Kids (T.H.I.N.K.), overseen by Mission West Virginia Inc., provides evidence-based instruction to high-risk youth and young adults from 12 to 24 years old in a variety of settings, such as middle and high schools, juvenile detention facilities, group homes, residential treatment facilities, and youth emergency shelters in seven counties. The program leverages statistics and messaging that demonstrate how following the success sequence can help them avoid poverty and lay the foundation for success in the future.
During one exercise, youth visualize how to be an ideal parent from a child’s perspective. Through classroom discussion, they explore whether they are capable of being a successful parent as a high school student and, if not, what they can do to avoid becoming a parent until they are financially and emotionally prepared. After taking the final class on fatherhood, one student said, “[T]oday’s lesson really made me think. You know, about my Dad and stuff and where I’m going. It really touched me.”
One special feature of T.H.I.N.K. is that the educators take great care to avoid shaming or alienating youth who may already be parents when discussing the success sequence. Educators emphasize the importance of being the best parent they can be and encourage them to postpone a second pregnancy until they have completed the success sequence.
By integrating efforts to promote both healthy relationships and the success sequence, Mission West Virginia’s T.H.I.N.K. program is working to equip youth with the tools to successfully transition into adulthood and to become self-sufficient. HHS believes it is important to help young people achieve healthy, productive lives, and T.H.I.N.K. is one example of the many organizations that operate programs funded by the Family and Youth Services Bureau every day to help achieve that goal.
As a pediatrician, public health advocate, father, and grandfather of a young infant, it is one of my greatest sorrows to know that even one child died from a disease that is preventable.
Thanks to vaccines, we can protect young infants against whooping cough by making sure everyone is up to date with their vaccines. Pregnant women can pass on protection to their newborns by getting vaccinated during their third trimester every pregnancy. Family members and caregivers can strengthen that protection by getting up-to-date on the whooping cough vaccine, which helps prevent the spread of this life-threatening disease to infants and their mothers.
Whooping cough is just one of several vaccine-preventable diseases that threaten Americans. Outbreaks continue to occur, and many vaccine-preventable diseases remain common. Consider pneumococcal disease, which affects nearly 4 million Americans each year and can cause pneumonia or infections of the ears, blood and brain. Or that 1 in 3 Americans each year will develop shingles, which can lead to debilitating pain that lasts for weeks, months and, in rare cases, years.
Vaccines are safe, effective and the best protection against these diseases—from infancy to early adulthood and into old age. By getting vaccinated, we not only protect ourselves, we help stop the spread of disease to our children, families and communities. But, for vaccines to be most effective, vaccination rates must remain high.
We must be persistent in raising awareness about immunizations and encouraging timely vaccination. Every August is dedicated to National Immunization Awareness Month (NIAM). NIAM is an annual observance designed to highlight the importance of immunizations. Each week of the month underscores the benefits of vaccination for people of all ages—including infants, children, teens, pregnant women and adults.
As NIAM kicks-off, we are announcing the release of a new video series focused on vaccinations across the lifespan. Each video is designed to inform parents, caregivers and adults of the importance of getting vaccinated. The series includes videos on pneumococcal disease, whooping cough and shingles.
Over my career at HHS, I’ve assisted communities across America in recovering from more than 30 different disasters. So I’m often asked, which was the worst disaster you worked on?
I can’t answer that. If you’re the person whose home, business or school was destroyed, it’s the worst hurricane, earthquake, tornado, flood, or incident ever. You simply cannot compare disasters. Every disaster is different; every community is different. Instead, what matters is to peel back the layers of the onion and see how a community has been affected by the disaster. Whether that is a Hurricane Harvey or the creek that floods out one house, all are devastatingly difficult for the people affected.
I lead disaster recovery for HHS within the Office of the Assistant Secretary for Preparedness and Response, or ASPR. Recovery is the stage after the life-saving activities have concluded in the disaster response, and it can last for years. We work with partners across the federal government and localities to deal with the health and social service needs that communities have.
When I’m not in the field, I’m meeting with our partners across the country or I’m in the Secretary’s Operations Center, the SOC, our information hub for disaster response and recovery. The 2017 hurricane season was intense, with one massive storm after another in different parts of the country. Each time, HHS and other partners were on hand to bring medical help, supplies and hope. In fact, ASPR teams are still supporting those missions today. We still have nearly 50 people in Puerto Rico; eight in Texas; about 10 in the U.S. Virgin Islands; and while our onsite support in Florida has concluded, we continue to support the Floridians who are still working on their recovery.
In support of the recovery missions following hurricanes Harvey, Irma and Maria, we’re focused on rebuilding community capacity and working with our state and local partners to deal with issues that happen after the disaster to put them in the best position to lead their recovery in the months and years to come. It’s their recovery, not ours. Our job is to help close the distance between the community in need and the resources available. Whether the needed resource is information, knowledge or rebuilding funding, we work with the community to try to make the process more efficient and more effective.
The 30-some major disaster recovery missions I’ve participated in include Hurricane Katrina, Hurricane Sandy, national-level drought, floods in Alaska, and powerful tornadoes across Arkansas, Missouri, Alabama and Oklahoma. At ASPR, we are continually working with states and communities to be ready to respond to and recover from the next disaster, whether it’s a natural disaster, technological disaster, act of terrorism, or biological incident.
Public service is where I feel I can make the most difference. Last year, lots of people from agencies throughout HHS joined hurricane response and recovery teams and deployed for their first time. Sometimes it can be very intimidating when you first arrive after a major disaster; you show up in an area that has debris piles that can go as high as a house, and then you look at that debris pile and you realize that was someone’s house. Everything a person worked their entire lives for could be piled up on the side of the road. It can be overwhelming. Despite that, HHS staff who supported the recovery efforts often said afterward that they want to do it again!
These communities that experience disasters, they didn’t ask for it. Nature is not discriminating. It’s the great equalizer. It is an honor and a great mission to be able to assist when people’s lives are upended in a single moment. Individuals, families and community leaders find themselves standing in the aftermath of the incident wondering, “What’s next?” And then we arrive. We’re not there to undo the damage, but to help them take those next steps.
I'm Josh Barnes. I help rebuild communities after disasters, and I am HHS.
Josh is one of more than 79,000 people who make HHS run every day. You can share his story and see others on Twitter and Facebook using #IAmHHS.
Consistent with President Trump’s Executive Order on Reducing Poverty in America by Promoting Opportunity and Economic Mobility, HHS’ Strategic Plan sets goals for HHS to encourage self-sufficiency and personal responsibility, and eliminate barriers to economic opportunity and to reduce the impact of mental and substance use disorders through prevention, early intervention, treatment, and recovery support. This blog is part of the Self-Sufficiency Series: Solutions from the Field, which profiles local programs from across the country finding solutions to accomplish these goals.
For people who experience mental health issues and substance use disorders, problems such as poverty and homelessness can hurt their progress toward recovery. Many evidence-based treatment approaches account for these challenges and provide services that promote recovery and self-sufficiency, which align with the goals of President Trump’s Executive Order and of the HHS Strategic Plan. Avivo, a treatment provider in Minneapolis, is an example of a local facility trying to reduce the impact of mental and substance use disorders and to increase economic mobility and self-sufficiency.
Every day, Avivo participants face barriers to economic opportunity, contending with adversity such as poverty, racism, substance abuse, mental health difficulties, poor work skills, and low educational attainment. Avivo first opened its doors in the 1960s as a vocational rehabilitation center and now offers treatment for mental and substance use disorders paired with employment services, providing a range of services that aim to help their patients thrive long after they graduate from residential treatment.
HHS is interested in facilitating personal responsibility and economic opportunity, and Avivo’s approach shows one strategy for doing so. The staff at Avivo assesses each individual to determine their unique strengths, needs, and desires. The diverse treatment team specializes in assisting unemployed people discover purpose and meaning in their lives by finding and maintaining employment. Employment offers stability and helps to build self-esteem in individuals who formerly only knew the chaos associated with substance abuse.
In addition to treating mental health and substance use disorders, Avivo, which receives support from the U.S. Department of Health and Human Services, also addresses economic mobility. It operates a licensed, accredited career school that offers credentialed training in eight career paths: accounting, office support, medical office support, information technology , manufacturing, maintenance, mechatronics (which teaches skills and knowledge needed for a wide range of manufacturing and warehouse jobs), and warehouse operations. Individuals in Avivo’s treatment programs have access to a full array of credentialed training and several of the training programs conduct training on-site at Avivo’s intensive outpatient treatment program. Avivo has also made it easier to access these economic opportunity supports by signing agreements with three Minnesota state colleges and universities and by providing scholarships to participants in its recovery programs who are interested in Avivo’s school. These agreements furnish a pathway where Avivo participants may choose to advance their education, which helps them move toward self-sufficiency.
Formerly incarcerated individuals are among those HHS aims to help obtain and maintain employment, and Tonique is an example of how Avivo is putting this goal into action. She was released from prison with only the clothes on her back and estranged from her family. At Avivo, Tonique got treatment for her drug abuse, therapeutic services, career education, and vocational training. With Avivo’s help, she learned how to write a cover letter, build a resume and properly interview for a job. Tonique, who has been reunited with her family, now works in the community by helping women overcome sexual exploitation.
According to Avivo Vice President Boyd Brown, over 80 percent of alumni of Avivo’s treatment programs are now gainfully employed.
Avivo is thus another example of a private organization that shares the HHS priority of encouraging self-sufficiency by helping people like Tonique leverage their own strengths and talents to achieve self-sufficiency and a renewed sense of purpose.
Consistent with President Trump’s Executive Order on Reducing Poverty in America by Promoting Opportunity and Economic Mobility, HHS’s Strategic Plan sets goals for HHS to encourage self-sufficiency and personal responsibility, eliminate barriers to economic opportunity, and to prepare children and youth for healthy, productive lives. This blog is part of the Self-Sufficiency Series: Solutions from the Field, which profiles local programs from across the country finding solutions to accomplish these goals.
Helping families achieve self-sufficiency and economic success is one of the goals of both President Trump’s Executive Order on Reducing Poverty and HHS’s Strategic Plan. Family-centered approaches, which work with both parents and their children, hold great promise because they not only empower parents to attain economic independence but also invest in the future by providing children with a strong foundation for a lifetime of achievement. HHS invests in these approaches through programs such as Head Start, the Child Care and Development Fund and others.
As noted in the Executive Order, government is just one part of the solution, and we must also empower the private sector and local communities. Jeremiah Program, for example, is a nonprofit organization that aims to put families on a positive trajectory toward self-sufficiency and reduce generational dependence on public assistance. Jeremiah helps low-income single mothers complete their education while providing access to high-quality early childhood education that readies their children for a successful future. The program is primarily funded through private donations, although participants may be eligible for federal and local child care and housing subsidies. According to a 2013 evaluation by Wilder Research, private funders invested about $63,000 per family during participants’ nearly 30 months of stay in the program. This investment generated $185,486 in benefits and savings, or a return of $3.93 for every private dollar invested. Separately, the evaluator found savings from decreased dependence on government assistance, as well as second-generation benefits such as savings from costs associated with crime and special education.
Mothers in the program are provided a range of supports, including individualized coaching and life skills training. The program makes quality child care readily accessible to mothers, often in the same building where the families live, which allows the mothers to focus on their own education and career development. Mothers pursue a two- or four-year college degree and choose a career track. The program also provides safe and affordable housing to the family and parent coaching to enhance the mothers’ ability to improve their child’s development.Within this safe environment, Jeremiah works to build a supportive community that fosters personal growth and self-confidence through positive relationships.
This two-generation approach to providing high-quality child care in addition to parent support seems to be working: Jeremiah Program reports that 81 percent of children who attended a Jeremiah child development center are performing at or above grade level in elementary or middle school. In addition to positive child outcomes, parents who graduate from Jeremiah increase their earnings by 68 percent while in the program.
One mother’s work with Jeremiah led her to apply to North Dakota State University, and today, she is pursuing a degree in human development and family science/elementary education. “I can’t wait to become the teacher I have always wanted to be and just have a better life and opportunities for my daughter,” she said. Another mother participated in program because she found that “the organization is built on supporting the child’s education, as well as the mother’s. I wanted to be a part of a community that cared about me and my child.”
The combination of educational support, career coaching, and quality early childhood education can help families achieve self-sufficiency today and ensure that prosperity continues across generations. Jeremiah is one exciting example of a promising strategy communities are using to promote opportunity and economic mobility, two generations at a time – a goal they share with HHS.
In the past week, two of the world’s largest pharmaceutical companies announced that they will postpone the kind of broad, steep price increases that have characterized America’s market for prescription drugs for far too long. It is hard to imagine, in light of this news, that some in the media are still claiming that the Trump Administration’s plan for reforming drug pricing isn’t delivering.
Yet that’s the tired story many are sticking to, and they’re leaving out crucial facts in the process.
Since President Trump announced his comprehensive proposal to put patients first in May, HHS has responded, implementing changes and reforming regulatory pathways to lower the price of prescription drugs.
The president’s American Patients First blueprint outlined a series of proposals to change how Americans pay for prescription drugs. It sought public comment on them, with the window closing on Monday at midnight. Stakeholder input was necessary because of the dramatic changes we’re contemplating for our country’s pharmaceutical system, but it hasn’t stopped us from taking action.
HHS has already been implementing changes, using our administrative powers and sending legislative text to Congress to act where necessary.
Just last week, HHS proposed new Medicare Part B rules that will save seniors and taxpayers money on some new drugs. Medicare has overpaid for drugs in this space for years, and under President Trump, that’s finally going to stop. Whether the media chooses to notice or not, senior citizens who use these drugs are going to notice the savings in their medical bills.
Yesterday, FDA Commissioner Scott Gottlieb released new guidance on how companies can give consumers easier access to a broader selection of non-prescription drugs, which can often be more convenient and potentially cheaper.
This afternoon, the FDA is announcing an eleven-point action plan to encourage a competitive market for biosimilars. These are like generic drugs, but for complicated treatments called biologics, such as drugs to treat cancer and anemia. Unfortunately, branded drug companies have abused the rules in this space to hold up competition, costing American consumers billions. The Trump Administration is finally going to bring real competition to this market, which represents fully 40 percent of American drug spending, and deliver on efforts begun by Congress years ago.
Another key area of action is working with states to help them get better prices on drugs in the Medicaid program. The President, Secretary Azar, and CMS Administrator Seema Verma are eager to help states engage in tougher negotiation with pharmaceutical companies. The President’s budget proposed giving states the opportunity to participate in pilot negotiation programs like the one recently proposed by Massachusetts. We have provided legislative text to Congress to make this happen.
Unfortunately, as mentioned in a recent New York Times editorial, Massachusetts came forward with a proposal that CMS was not prepared to approve. The state asked for new negotiation powers, but wanted to continue receiving the full amount of their rebates from manufacturers called for under federal law. CMS had to turn down this idea not because we don’t support state negotiation, but because it would have resulted in an imbalance in negotiating power.
This week, we will see more action to reform drug pricing in America than we have seen in a number of years. As someone who has worked in various parts of the drug market for decades, I have never seen a time of change like this.
President Trump has a strategic, comprehensive approach to driving the changes needed, and the results will keep coming. The weeks and months to come will be a wakeup call for anyone who still doubts President Trump’s ability to fix a broken system and get better deals for the American people.
Note: This is one of a series of stories by people whose lives have been affected by the use of opioids. Fighting the nation’s opioid crisis is one of HHS’s main priorities.
The drug test came back positive for opioids and the needle puncture sites in the young, pregnant woman’s arms were infected. At just 92 pounds, neither she nor her unborn child were benefiting from any nutritional intake. She returned to her OB/GYN six weeks later, keeping few prenatal appointments in total. When she returned, she was prepared; she had another person’s urine in her purse. But she fooled no one, and her physician offered to help her find treatment and recommended a facility where she could receive medication-assisted treatment (MAT) and medical care. She denied her drug use and rejected the referral.
Baby Asa was born just a few weeks later and a few months early, weighing only three pounds and dependent on heroin. His life began in rehab. He was a tiny, unhappy, uncomfortable, failure-to-thrive newborn still in the throes of Neonatal Abstinence Syndrome (NAS). He was one of thousands of babies born with NAS in 2014 and one of thousands who entered the foster care system as a result. NAS is a group of medical problems that occur in newborns who were exposed to drugs while in the mother's womb.
Robin holds Asa in a hospital room during one of his hospitalizations at a year old.
When Asa was discharged from the NICU, he came to live with me as a kinship foster care placement. His given name was Leland and he was a grandson of my first cousin. Today, he is 3 years old and is a thriving, energetic, smart, preschooler with a sweet disposition and a strong will. My husband and I have adopted Asa. He is our son, and we will do everything we can to shelter him from the storm of heroin. We will try to choose the right words when the right time comes to tell him his story.
We will tell him that his biological parents couldn’t recover from their disease without the treatment they needed. We will tell him that they loved him very, very much, but the court system determined he would not be safe if he returned to his birth parents. When he is old enough, we will focus on the positive. We won’t tell him about the multiple overdoses, multiple arrests, and, God willing, we will never have to tell him about their deaths.
Raising Asa isn’t easy; loving him unconditionally is. Not sleeping for more than 15 minutes at a time for his first year of life took a toll. Five therapy appointments per week for three years were difficult to schedule and manage. Hospitalizations and multiple trips to specialists proved to be nerve-wracking and worrisome. Managing feelings of anger toward his birth mom zapped my emotional strength and challenged my maturity in ways I hadn’t imagined. Every time she used a dirty needle, she risked his life. Every time she lost consciousness and her pulse slowed, so did his. Every time she went without oxygen, so did he. Yet, he survived her battles, and now I will move mountains to make it up to him.
Robin's husband, Sean, and Asa play with a football.
My son is inspiring me to find ways to help other babies like him.
I will not keep his story a secret from him or from our community. There is too much to be done to fight the opioid epidemic and stigma that prevents people from getting the treatment they and their babies need. Increasing access to evidence-based treatment like MAT; creating awareness about babies born dependent on opioids; and supporting more research on the impact of opioids in utero and throughout childhood and the best interventions to care for these newborns are all foundational building blocks for the smallest, youngest and most vulnerable victims of America’s opioid crisis.
Securing treatment cribs is also just as important as expanding capacity for more treatment beds. I want my work –and the love I’ve gained – to honor Asa’s life and his early struggles as a victim of the nation’s opioid crisis.
For information about opioids and what the Department of Health and Human Services is doing to combat the opioid overdose epidemic, see HHS.gov/opioids.