Natalie Goodnow, a research fellow for the Wisconsin Institute for Law and Liberty and a visiting fellow at the Independent Women’s Forum, is the author of two important recent reports on foster care in the United States, one (“Flooding the System: A Study of Opioids and Out-of-Home Care in Wisconsin”) focusing on the devastating impact the opioid crisis has had on the system in Wisconsin, and another (“The Role of Faith-Based Agencies in Child Welfare”) for the Heritage Foundation on the importance of faith-based organizations as a solution to the orphan crisis nationally. She talks a bit about what she has learned and what we ought to be focusing on here.

Kathryn Jean Lopez: When we are talking about a flooded system, what are we talking about?

Natalie Goodnow: There has been a sharp uptick of children in the child-welfare system. More and more children are being removed from their homes and placed into care. Nationwide the number of children in foster care increased 10 percent from 2012 to 2016. Prior to 2012, that number had been in decline.

Since 2012, several states have seen an increase of over 50 percent in their foster-care population. For example, in New Hampshire, it rose by about 60 percent, Minnesota saw 65 percent growth, and in Montana and Indiana the number of kids in care grew by over 70 percent. Some counties are seeing even greater increases. Those are massive surges, particularly in such a short amount of time, and across the country they are overwhelming child-welfare systems that are not equipped for such a deluge — they need more staff, foster families, and resources to care for and support these vulnerable children adequately.

Lopez: What does foster care in America look like in 2018?

Goodnow: According to the most recently reported numbers from the Administration for Children and Families, in 2016 about 440,000 children were in care. To put that into perspective: That’s roughly the size of the population of Miami. By far the most common age for children to enter care is 0–1. In 2016, 18 percent — about 50,000 — of all entries into foster care were babies. We are seeing more babies entering care now than we have seen in decades. That’s a sobering thought.

While a little more than half of the children in foster care are reunited with their families, over a quarter of them are waiting for adoption. Almost half the states in America have seen an increase of 25 percent or more of children waiting to be adopted since 2012.

Lopez: What is it about the opioid crisis that has made things worse?

Goodnow: There has been a tragic spike in overdose deaths in the United States, with over 100 people dying each day from opioid overdoses.This represents a devastating loss in life — mothers, fathers, sons, and daughters. Drug abuse has also led to more kids in care. In the research my colleague Will Flanders and I did, we found a strong relationship between opioid abuse and the number of children in foster care. In 2016, a third of cases where children were removed from their homes and entered care involved caretaker drug abuse. Many mothers may delay getting important prenatal care because they are afraid of the stigma they will face and of the risk of losing their child.

Another consequence of the drug crisis is that opioid-involved cases can be more complicated and take longer to resolve, meaning that children may spend more time in foster care. This also means that more foster homes are kept full with these placements, preventing them from taking in other foster children. This strains foster-care capacity even more. Research from the Department of Health and Human Services also suggests that the opioid crisis has decreased the kinship opportunities for children in foster care. Child-welfare providers often rely on extended family to step up to care for children in foster care, rather than placing children in non-relative foster homes. However, multigenerational substance-abuse issues have reduced these kinship homes. So there is an increased need for non-relative foster homes.

Lopez: How crucial is it to help the situation with neonatal abstinence syndrome, and how can that be done most compassionately and effectively?

Goodnow: A little background: Neonatal abstinence syndrome (NAS) occurs when babies have been exposed to drugs or alcohol in the womb. (Note: Some instances of NAS occur because mothers are taking prescribed, medically necessary medication.) These little ones can go through terrible withdrawal at their birth. Nationally the rates of NAS have skyrocketed, increasing fivefold from just 2000 to 2012. That is heartbreaking. Our research in Wisconsin found that NAS rates are related to the share of children ages 0–1 in foster care. So as NAS rates rise, so does the number of infants in foster care.

Sadly, many mothers may delay getting important prenatal care because they are afraid of the stigma they will face and of the risk of losing their child. While appropriate measures need to be taken to ensure that these fragile children are safe and well taken care of, these mothers also need a great deal of care and compassion, not only during their pregnancy but also once their babies are born.

Lopez: Why is it so important to keep children from “aging out” of the foster-care system?

Goodnow: Research has shown that youth who age out of the foster-care system have much worse outcomes than do their peers, on average. Youth who age out were unable to be reunified with their parents and were not adopted while they were in care; they have left state care and are on their own. They are much more likely to experience homelessness, economic instability, and incarceration and are much less likely to attend or complete a two- or four-year college or even to complete high school.

Some child-welfare workers unfortunately have the idea that these older children in care are unadoptable and so, when they reach 14 or 15, cease trying to find adoptive families for them. Many of these teenagers are also reluctant to be adopted, perhaps because they fear being rejected, or because they experience tremendous guilt and worry that they would be betraying their biological family.

Fortunately there are also fierce advocates who believe each and every one of these youth is adoptable. They work through the youths’ fears and help them find forever families. Having a stable, loving, permanent support system is incredibly important for these children — as it is for all children. Even if legal guardianship is not possible for some of these youth, ensuring that they still have that emotional support system is critical — whether it’s a neighbor, teacher, or family friend who will pledge to stay a part of their life even after they leave care.

Lopez: With more children entering care, are there enough foster homes to take them in? If not, what can be done to recruit more foster families?

Goodnow: While the data on foster parents are lacking, research has found that at least half the states have seen their foster-care capacity diminish over the last few years. This is because either the number of foster beds and homes is decreasing, or the number of foster beds and homes is staying the same or not increasing as fast as the number of children in foster care. I would say that recruiting, training, and maintaining foster homes are very important issues for many communities right now.

Over the last several years, programs have emerged to tackle this precise task. Faith-based initiatives have had some great successes on this front. Just one example is the faith-based organization The CALL, which was started in 2007 and has recruited almost half the foster homes in Arkansas. It was able to bring in many people who wouldn’t have otherwise considered fostering or adopting. That said, I don’t think we have fully tapped into the potential in faith communities; there are opportunities for more churches to mobilize on this issue, for states to strengthen their partnerships with faith-based organizations, and for networks to recruit more good foster families.

This touches on another issue facing recruitment efforts — communication. Many families who might be willing to foster and adopt don’t realize the need that exists in their cities. Unless you know someone who is involved with the child-welfare system or have been involved yourself, foster care probably does not cross your radar often, if ever. It’s not a very visible issue. This is why it is important for states to work with many different organizations to help inform people about the need in their communities and for faith leaders to speak out on this issue.

Lopez: We hear about foster-care and adoption in relation to clashes involving religious freedom and discrimination. What’s the bigger picture people need to know? Besides the fundamental-fairness questions, can children afford to have faith-based providers of adoption- and foster-care placement removed from the picture?

Goodnow: At the end of the day the children are what matter most, and we should all want as many good providers and homes as possible, to ensure that these children are getting the care and attention they need. It doesn’t make sense to decrease the number of good child-welfare partners for states, particularly in a time of high need.

I think there are two things to bear in mind when discussing this issue: capacity and diversity. Many communities are strapped for resources as more and more children enter foster care, and there is a high need for foster parents in many states. There are many examples of faith-based child-welfare providers and faith-based networks exceling at recruiting, training, and retaining foster and adoptive parents, as I mentioned earlier. Research has also found that practicing Christians may be more than twice as likely to adopt, compared with the general population, 50 percent more likely to become foster parents, and almost three times as likely to consider becoming a foster parent. Faith communities and providers are useful partners in building states’ foster-care capacity and in ensuring that every child who needs a loving home has one.

Also, in an incredibly diverse nation, having a diversity of agencies represented is important. While states have a set of standards that all providers need to abide by to make certain that children are receiving appropriate care, the child-welfare system is made up of a wide variety of public, private, secular, and faith-based child-welfare providers. They all provide significant and valuable services. It doesn’t make sense to decrease the number of good child-welfare partners for states, particularly in a time of high need. We should focus on maximizing the resources for the growing number of vulnerable children in care.

Lopez: Who are the heroes of this current crisis? Of foster care in Americatoday? What are some of the best resources?

Goodnow: There are heroes everywhere in this type of work. Whether it’s loving foster parents or extended family who take these children into their homes, the people who work with parents to help them get their lives together — doctors, therapists, policy advocates, dedicated social workers — or legislators who champion child-welfare reforms. Many of these are unseen heroes. They rarely if ever make the news, and they work tirelessly to help these children and families. I have tremendous respect for the many people who daily pour their hearts into this.

I think the best resources tend to be at the local level — churches that partner with child-welfare agencies and support foster and adoptive families in their congregations, on-the-ground nonprofits, such as Safe Families for Children, that work with struggling families before they get involved in the child-welfare system, court-appointed special advocates (CASAs) who speak up for the needs of foster children, and many others.