COLUMBUS, Ohio - As they try to solve Ohio's opiate epidemic, the state's health, child-welfare and policy leaders are zeroing in on ways to help some of the most vulnerable addicts - infants.

Babies born to mothers who are addicted to opiates, including heroin and prescription painkillers, suffer from what is known as Neonatal Abstinence Syndrome. Registered nurse Elizabeth Tisdale at Mercy Health near Cincinnati said it means many complications for these little ones.

"These kids can be awake up to 32, 36 hours," she said. "They're just miserable. They have a high-pitched cry. They have an increased need to suck; they suck constantly to the point where some of them just overfeed themselves. And then, of course, you get the vomiting and diarrhea."

Mercy Health is among the hospitals working to address this issue through maternal drug use screenings, better parent education and communication with private pediatricians. In 2011, it's estimated that statewide, there were roughly five admissions a day for Neonatal Abstinence Syndrome, and treatment expenses topped $70 million.

To improve the odds of identifying drug addiction in children and their mothers, Tisdale said, her hospital instituted a universal drug screening process. She said their results show the problem has a much broader scope than they initially believed.

"There was a realization that it was across the board, it wasn't just your lower socioeconomic moms that were using," she said. "We were finding our little 'soccer moms' were having some difficulties, too."

Tim Dick, deputy director of Clermont County Children's Protective Services, said the opiate epidemic is complicating their efforts to strengthen families. Both babies and parents who are addicted must undergo lengthy and expensive treatment, he said, adding that the addiction often is so strong that many parents relapse and can't be reunited with their children.

"If after one year a parent is not working towards treatment, then we are required to file for permanent custody," he said, "which means that all parental rights would be severed and the child would be free for adoption."

Dick chairs the new Child Welfare Opiate Engagement Task Force, with the goals of improving outcomes for addicted parents and reducing the number of children removed from parental custody. It includes leaders in child welfare, medicine and the court system, and is examining best practices and policies for dealing with opiate addiction.


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Everybody loves to get something free and right now, kids aged 12-17 can get a fishing and hunting license at no cost from the Nevada Department of Wildlife.

The license is good for one year and normally sells for $15.

Bobby Jones, outdoor connection coordinator for the Nevada Department of Wildlife, said the free licenses are funded by donations to the Nevada Youth License Fund.

"This is actually the third year that the program's been active," Jones explained. "We keep it open as much as possible. We're just limited by the amount of donations that we have. Right now, we have almost 2,000 available and they go fast."

Youth can get a free license on the Nevada Department of Wildlife website or wherever the licenses are sold. Children under age 12 do not need a fishing license. The state said almost two-thirds of the kids who have taken advantage of the program in the past have never had a hunting or fishing license before.

Jones emphasized the program is designed to tempt kids to leave the digital world behind for a short time and enjoy some time outdoors. It could lead them to even consider a nature-based career like wildlife biology, forest management or outdoor education.

"Essentially what we're up against is a lot of kids are engaged in their phones and social media, TV," Jones pointed out. "They're constantly bombarded with things. We're trying to make it a little bit easier for them to enjoy the outdoors."

Some of the most popular fishing spots include Lahontan in the Fallon area, Wild Horse and South Fork in Eastern Nevada, and Lake Mead down south.


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The University of Nebraska is addressing a shortage of lawyers who represent the state's most vulnerable children, especially in rural areas.

The attorneys are being equipped to work with kids who have suffered through physical, emotional, or financial trauma - and are often living in poverty.

Of Nebraska's 5,500 licensed attorneys, only 7% of them practice in rural areas.

Michelle Paxton, director of the Nebraska Children's Justice and Legal Advocacy Center, said two thirds of child neglect and abuse cases originate outside the Lincoln and Omaha metro areas, in what she calls "rural legal deserts."

"We have twelve counties in Nebraska with zero attorneys living in those counties," said Paxton. "We have 22 with less than three."

Paxton said that there are too few qualified rural child justice attorneys, which means lawyers may drive hundreds of miles for juvenile cases, creating delays and court backlogs.

The University of Nebraska program will add lawyers trained to handle issues unique to children in low-income families.

Attorneys who work on juvenile court cases are getting the tailored knowledge they need, but Paxton added that the program is also creating an opportunity for those attorneys to network and get support from other lawyers in the field - who are often isolated.

"And so they don't often have another attorney doing this type of work that they can rely on for support and mentorship," said Paxton, "and our program provides that support and mentorship so that they are not only willing to continue working in juvenile court, increase their hours in juvenile court and increase their commitment. "

The advocacy center will also develop a case-tracking tool, enabling people to find an attorney online.

Support for this reporting was provided by Lumina Foundation.



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Statistics show one in five children in Texas struggles with hunger.

Approximately 10,000 students a day are getting a nutritious meal through the Summer Food Service Program offered by the Houston Food Bank. The meals are distributed across the food bank's 18-county region.

Jourdan Stansberry, senior manager of education programs for Houston Food Bank, said they partner with summer camps, churches and other nonprofit organizations to serve the students. She added anyone who is not near a meal site can take advantage of their non-congregate option.

"Sites that are considered rural by the Texas Department of Agriculture," Stansberry explained. "It's a grab-and-go model where families can pick up the meals, It's like a five-day bundle of frozen meals, breakfast and snacks, so 10 meals all together. They're able to pick it up and take it home."

Locations of the meal sites in the Houston area and across Texas are available at the Department of Agriculture's Summer Meal Site Map. The meals are available to anyone 18 years old or younger or students with a disability, up to 21 years old.

The meals are distributed at more than 250 sites around the Houston area. Students do not have to register to take advantage of the meals. Stansbury emphasized it is a great way to ensure kids have access to fresh fruits and vegetables during the summer. She added the menus consist of more than just a sandwich and chips.

"One thing that I know has been pretty popular is our orange chicken with rice, and we also have broccoli, vegetable-medley side that goes along with that. We saw also chicken tikka masala," Stansbury outlined. "We try to expose them to different meals, not only healthwise but also culturally."

The Houston Food Bank expects to distribute around 800,000 meals this summer. The meal program runs through Aug. 8.


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