Editor’s Note: Daniel Heimpel is an award-winning journalist, child welfare expert and educator. As the founder and president of Fostering Media Connections, Heimpel serves as publisher of the non-profit journalism organization’s two publications: The Imprint and Fostering Families Today magazine. The views expressed here are his own. For more on this story, watch “This Is Life with Lisa Ling” Sunday at 9 p.m. ET/PT.
It is February 12. Ebony Clancy’s tight townhome in Dayton, Ohio, is crowded with a film crew, “This Is Life” host Lisa Ling and myself, all there to understand the damage the opioid crisis has inflicted upon American families.
As we visited her home, Clancy shared what she wanted above all else: to be reunited with her three-month-old baby girl Merceades. To do that, she would have to stop using heroin, a drug that had killed her brother and mother, and led Clancy to relinquish custody of her first two daughters at age 19.
“I deserve to have Merceades. Merceades deserves to have me, but not this me,” Clancy told us, teary-eyed and curled up on a chair in her small living room. I noticed that the walls were covered with pictures of the infant, despite Merceades never entering her mother’s home.
The next day, Clancy would check herself into rehab. But the evening of our visit would turn into a mad all-nighter, replete with syringes and clouds of meth.
“She’s had this me her whole existence, even before she came into this world,” Clancy said. “I’m ready to stop this me.”
Before the pandemic, an epidemic
In the time before Covid-19, America was consumed with another public health crisis: A relentless drug epidemic that has left tens of thousands dead and countless children separated from their parents.
Of the 423,000 children in foster care in America, more than one third of those who entered care last year are there because of drug use, according to the most recent federal data available. And if you were to draw a heat map of the opioid inferno at its height, the whole of Ohio would burn red – the county of Montgomery, and its seat, Dayton, the bright embers at its heart.
In Ohio, as much as half the state’s foster children enter the system because of substance use – in large part opioids. From 2010 to 2020, the total number of children in state care surged from nearly 12,000 to more than 16,500.
Toward the end of 2019, Clancy’s daughter Merceades was poised to be one of them.
Clancy and I met at a Dayton, Ohio nursery for babies exposed to opioids. I was there working on an episode of “This Is Life” about the opioid crisis and the foster care system. Over the next several months, Clancy and I would remain in touch even after filming wrapped. Along the way, I’ve come to know a mother dedicated to her daughter, but also haunted and hunted by addiction.
In one of our many conversations, Clancy told me she was still using the day she went into labor. She was drug-tested after giving birth, which triggered an investigation by child protective services. This easily could have led to an all-too-common tragedy: The permanent separation of mother from child.
But something unique happened. Montgomery County’s child welfare system, along with a clutch of non-profit agencies, formed a continuum of care for the baby and her mother. Clancy was able to retain custody of Merceades as she desperately fought heroin’s grasp, affording her precious time to get sober without losing her child.
Montgomery County’s strategy to keep families together, built on trust and support, could very well serve as a national model in the fight against the wreckage brought by addiction and substance misuse. The question is whether the recovery offered there can endure the devastation of Covid-19.
Keeping families together
In Montgomery County, there are two paths for parents who might otherwise lose their children to foster care. One is for parents who are found to have maltreated their children, either through abuse or more often neglect. In many such cases, the local Children Services agency and the child welfare court offer “family treatment court,” where parents are given specialized social workers and are encouraged through recovery.
Another path is the one Clancy has embarked on, wherein the system allowed her to maintain legal custody of Merceades if she lived separately from the baby while getting clean.
After spending her first two weeks of life in the hospital, Merceades was moved to Brigid’s Path, a newborn recovery nursery for babies struggling with neonatal abstinence syndrome, or withdrawal from the drugs a baby was exposed to in the womb.
There, babies are often given decreasing doses of morphine or methadone, pharmaceuticals aimed at weaning users – even days-old infants – off heroin and other opioids. In 2018, Sen. Sherrod Brown led an effort to amend Medicaid, making “residential pediatric recovery facilities” like Brigid’s Path eligible for federal funds, opening the door to replication in other communities.
Under the terms of Montgomery County’s program, Merceades would stay at Brigid’s Path for 90 days. Clancy was able to visit, even while high, to ensure that the two built a tight bond – something critical in the days to come.
When Merceades’ 90 days at Brigid’s Path were up in late January, Clancy was still using. She didn’t take Merceades home immediately, rather allowing her to be placed with a volunteer “host family” organized by a national non-profit called Safe Families. Merceades would spend two weeks with a young couple in a Dayton suburb while Clancy entered a rehabilitation clinic, a juvenile hall that had been converted into a women’s rehab facility dubbed “the Hill.”
By March, after Clancy completed what she said was “the worst detox I ever did in my life,” she and Merceades were reunited.
Sitting in a rocking chair in one of the Hill’s stark rooms with Merceades in her arms, Clancy described her state of mind to Ling, who had come back to Ohio to witness this important milestone in Clancy’s recovery.
“I gotta do it for me, to do it for her,” Clancy said. “Babies can get us into treatment, but they can’t keep us clean.”
“You do have an opportunity to break the cycle with her,” Ling responded. “And I know you can do it if you want to do it.”
“I want to. I do. She’s worth it. I’m worth it,” Clancy responded. “I just want to be a good mom.”
A new challenge silently loomed. That same month, Ohio joined states across the country in ordering its residents to shelter in place to reduce the spread of a novel coronavirus.
A break of light
Clancy, a self-avowed “social butterfly,” said that in the beginning, “the pandemic was a blessing because it gave me solidarity with my child.”
That bond, and Clancy’s recovery, made a positive impression on her county social worker, Regina Howell. During a home visit over the summer that Clancy recorded on her phone, she and Howell had a long conversation, intermittently cooing over Merceades while Clancy boasted on her “genius, protégé child.”
“When we first started, I had very little hope for you,” Howell told her. “Now I like everything I see; I really do. I like the change. You look healthy. … You can be upset with what’s going on, but you aren’t throwing back crap … That’s huge.”
“I know,” Clancy replied. Merceades made a noise on the recording. “What boogie?” Clancy said. “See, she’s scooting all over the place.”
In July, the child welfare court dismissed Clancy’s case, meaning that Children Services’ oversight would end.
“She worked so hard for that,” Clancy’s attorney, Julie Kolber, said at the time. “I can’t imagine getting through this with the drug history she had. That this baby was there was to show her the light. She worked the program, and she is so good at taking care of that baby.”
But as the pandemic stretched on, increasing need and economic uncertainty would stress the family preservation strategies that Montgomery County had worked so hard to implement. Judge Anthony Capizzi, who presides over the county’s juvenile court, told me he’s worried about the worsening state of his already vulnerable clients. “The disease didn’t create the problem,” he said. “It’s [the] effect of the disease on [the parents’] ecosystem and the social system.”
‘Killing us for years’
In August, a stunning loss would imperil the future with Merceades that Clancy had spent the better part of 2020 trying to secure.
Overall, heroin has dealt the Clancy family incredible sorrow. In 2016, Clancy’s younger brother, Jeff, overdosed and died, followed by her mother two years later. Then, the drug claimed another Clancy, baby sister Mary Kate.
Mary Kate was released from jail in late August. Clancy said she promptly went to the home of an older sister, where Mary Kate shot heroin and overdosed.
By the time Clancy arrived at the hospital, she was already thinking about using. When another sister told her she had the same bag of heroin that Mary Kate had overdosed on, Clancy said she asked for a “point,” went to her car and got high.
“You just know,” she told me of her relapse. “It’s like you know you plummeted all your responsibilities all over the edge. You have done all this work, all this build up, for this moment where you tell yourself, ‘I don’t want to live in this moment.’ Then you don’t want to stop. But you know you have to.”
Within 36 hours, Clancy said, the doctors took Mary Kate off life support. Dead at 23, she left young twin girls behind.
“What about this pandemic?” Clancy asked me, crying hard, plain angry. “What about this pandemic that has been killing us for years. Where is the stimulus for that?”
Where two public health crises meet
The fallout of Covid-19 – isolation, lost jobs and mounting economic hardship – has already coalesced with a marked spike in substance use across the country. In late October, the American Medical Association issued a brief based on national media reports showing that 40 states had seen an increase in deaths related to drug use. And a letter published in JAMA Psychiatry just this month noted that “overdose-related cardiac arrests rose sharply during April 2020,” with the weekly average rate up nearly 50% as compared to 2018 and 2019.
In May, at least 532 people died of drug overdoses across Ohio, the state’s deadliest overdose month in at least 14 years. In Montgomery County, total accidental overdose deaths are on track to eclipse those of the past two years.
“It’s clear that the addiction epidemic hasn’t gone anywhere,” said Scott Britton, the assistant director of the Public Children Services Association of Ohio, which represents county level child welfare agencies. “The epidemic is, unfortunately, still very healthy.”
Until September, Jewell Good served as the director of Montgomery County’s Children Services agency. In the early days of the pandemic, with schools shut and fewer mandated reporters with eyes on children, allegations of maltreatment coming into the hotline dropped, Good said. But in the summer, she continued, the numbers of child abuse investigations started to surge.
“People are so unstable because of Covid,” Good said. “That isolation. To me that is one of the worst things Covid has done. It has totally cut off those pro social connections that keep people healthy and stable.”
The summer surge in referrals coincided with a severe shortfall in caseworkers, who were either out sick or had quit because of the stress of it all, Good said. By the fall, Good was tapped out and left the agency. “I think Covid just threw me over the edge.”
As frontline workers reel from the convergence of these two public health crises, Ohio appears committed to its children and families. On Nov. 20, Gov. Mike DeWine held a press conference to announce the release of a slate of recommendations to improve child welfare in the state. Despite the impact of the economic downturn, DeWine was emphatic that the state wouldn’t recede from its financial support for county child welfare agencies, like Montgomery’s.
Having covered child welfare systems as a journalist for more than a decade, I know that Montgomery County’s strategy to keep families like Clancy’s together is promising. From Merceades’ birth in October 2019 until just about the start of the pandemic, the county expended incredible effort to ensure that Clancy had a chance to get sober and keep her daughter.
That strategy worked. But as the months ground on and the pandemic worsened, Clancy was ultimately left alone; a single mother fighting an addiction she calls “a real winner”; one “that knocks people down.”
That’s where our child welfare system still has work to do, in finding ways to get parents like Clancy past those first few rounds – to help them win the fight.
As I write this, Clancy is struggling.
Merceades, Clancy told me, has been staying with her attorney, Julie Kolber. With Mary Kate’s death and her own relapse, Clancy wants to keep her now one-year-old baby girl shielded from the “chaos” in her life.
But Clancy has a plan. She is going to check herself back into that rehab center they call the Hill.
“I suck at both sides of this,” Clancy told me. “I am really bad at being sober, and I am really bad at being high. But I still keep trying. You never ever stop. I will never stop trying to get clean.”
“This Is Life with Lisa Ling” airs Sunday at 9 p.m. ET/PT.