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State pulls plug on grant to expand treatment for pregnant moms who abuse drugs

  • Jennifer Payson sits in her room where her children visit at the Cynthia Day Family Center at Keystone Hall in Nashua on May 2. ELIZABETH FRANTZ / Monitor staff

  • A medical exam room in the Harbor Care Health and Wellness Center at Keystone Hall is seen in Nashua on May 2, 2016. (ELIZABETH FRANTZ / Monitor staff)

  • Jennifer Payson talks about her experiences at the Cynthia Day Family Center at Keystone Hall in Nashua on May 2, 2016. (ELIZABETH FRANTZ / Monitor staff)

  • High chairs are seen in the dining room of the Cynthia Day Family Center at Keystone Hall in Nashua on May 2, 2016. (ELIZABETH FRANTZ / Monitor staff)

  • A play area in the Cynthia Day Family Center at Keystone Hall in Nashua on May 2. ELIZABETH FRANTZ / Monitor staff



Monitor staff
Wednesday, May 18, 2016

Jennifer Payson gave birth to her daughter in Manchester’s Valley Street jail. The 31-year-old mother of three has used painkillers and heroin on and off since she was a teen, but landed behind bars in 2014 on a drug-related charge that was later dismissed.

Payson is now receiving substance abuse treatment at one of the few centers in New Hampshire that let moms and their children live together.

“This is the real world,” said Payson, of Derry, who has lived at the Cynthia Day Family Center since March taking parenting classes and receiving counseling. “You are taking care of your children day-in and day-out, while dealing with addiction.”

The path to recovery is especially difficult for women like Payson. On top of the lack of services, many women are reluctant to seek help because they fear the state will take away their children if they admit to abusing drugs.

Recognizing a need to boost services, the state proposed a grant last year to fund more treatment options for low-income pregnant women or parenting moms who abuse drugs and are at risk of becoming homeless.

But the Department of Health and Human Services never awarded any money this spring because the grant proposals “did not meet the criteria.”

“We don’t know what’s going on,” said Colene Arnold, a physician and co-founder of Hope on Haven Hill, which applied for the funds. “To have the rug just pulled out from under us . . . is very frustrating.”

The Cynthia Day Family Center in Nashua applied for the grant money, as did Hope on Haven Hill, which is planning to open an eight-bed treatment center for pregnant women and their young children in Rochester.

Officials from both centers said they received word in April, two months after applications were due, that the grant was on hold, but have gotten few other details.

HHS spokesman Jake Leon said the department is now “reassessing what we need to do to provide additional housing supports for mothers and pregnant women in recovery from substance misuse.” He didn’t provide a timeline or any information about whether the state will launch a new grant.

“We recognize there are many new organizations and others who have not qualified for state funding before in the area of substance misuse and other areas,” he said in a statement. “DHHS is considering ways to provide educational resources about the RFP process in general.”

Hope on Haven Hill had hoped to get $450,000 to house six women from Strafford County who face homelessness, Arnold said.

The center plans to open in the next year and offer substance abuse treatment and parenting skills to pregnant women. State officials, including the director of the Bureau of Drug and Alcohol Services, are visiting the location today, Arnold said.

“We’re hopeful we can work something out to secure funding,” she said.

Cynthia Day applied for the grant in conjunction with the Greater Nashua Regional Public Health Network and had planned to use the money to expand transitional housing for women and their children, according to Keystone Hall Vice President Annette Escalante.

Cynthia Day provides a family-centered treatment approach and can accommodate 24 women at a time, or 20 women with their children. Each client is allowed to live there up to six months, and get prenatal care, substance abuse treatment, mental health services, child care and parenting classes.

“They live here,” Escalante said. “The goal of this program is to remove barriers to treatment.”

The state’s 69-page request for grant applications gave the department the right to reject “any and all proposals,” and allowed the department to cancel its request at any time.

A spokesman for Democratic Gov. Maggie Hassan said the state has been in contact with grant applicants and is “working to improve education efforts about the RFP process in general.”

A family problem

HHS doesn’t specifically track how many women with children, or who are pregnant, are abusing or are addicted to drugs in New Hampshire.

But other indicators help shed light on the scope of the problem.

Nearly 10 percent of children up to age 11 in the Granite State have lived with someone who had a “problem with alcohol or drugs,” according to the 2011/2012 National Survey of Children’s Health. Seventeen percent of kids here between the ages of 12 and 17 years old report they have lived with someone who had an alcohol or drug problem, higher than the national average of 14.7 percent.

Children can be affected by drug use even before they are born. Pregnant women who abuse opioids can give birth to babies with their own symptoms of withdrawal. The state’s Division for Children, Youth and Families has seen a more than 50 percent increase in the number of referrals for children born exposed to drugs, from 285 in 2013 to 430 in 2015.

Payson began using prescription painkillers after she had a shoulder operation at age 16. The doctor never warned her the drugs were addictive, she said. Whenever she called, the prescription was refilled.

In her 20s, after a few more surgeries, Payson turned to heroin, a cheaper alternative that was much easier to find.

Despite several efforts to stop, the death of Payson’s brother and other traumatic events drove her back to drug use. Still, Payson was trying to be the best mother she could to her kids, bringing them to storytime at the local library and to the beach over the summer, she said.

“I was an at-home mom who was addicted to painkillers, and switched to heroin,” she said.

Breaking the cycle

Many providers say the state needs to improve its addiction services for low-income pregnant women and mothers. Twelve of the state’s 55 substance abuse treatment facilities offer programs specifically for pregnant or postpartum women, according to a 2013 National Survey of Substance Abuse Treatment Services.

All substance abuse treatment centers that contract with the state are supposed to bump pregnant women to the top of their wait lists. Still, lines persist. Cynthia Day, for example, is typically full, Escalante said.

Treatment is key, she said, because getting a mother into recovery can help break the cycle of addiction within a family. “It’s really important because we’re dealing with first, second or third generations,” Escalante said.

But getting mothers in the door can be particularly challenging.

Women often don’t seek substance abuse treatment because they are the primary caregivers for their children, Escalante said. It’s difficult for moms – who want to enter a residential 28-day program, or even seek daily counseling services – to find child care or transportation.

Only three of the substance abuse treatment centers in New Hampshire offer child care for their clients’ kids, according to the 2013 survey. They include Families in Transition in Manchester and Families First on the Seacoast, Leon said. Cynthia Day is the only program in the state that lets women stay with their children while they seek treatment, Arnold said. Hope on Haven Hill would be the second.

The stigma around drug abuse can also be a deterrent, especially for parents, who worry about judgment.

“We have to as a culture start talking about addiction as a disease and not as a bad behavior,” said Jacqui Abikoff, executive director of Horizons Counseling Center. “You don’t become a drug addict by choice.”

Mothers are often fearful that their children will be taken away if they seek help for addiction.

That concern is only growing, Payson said, as the Legislature mulls a bill that would let the state initiate child neglect investigations of parents who abuse drugs, but who aren’t in treatment.

“It’s horrible,” said Payson, whose oldest son lives in Florida with her parents. Her youngest children, who are 3 and 2 years old, are not currently in her care, but visit her at Cynthia Day.

“Not enough time is being spent on helping the parent, and helping the family,” she said. “Women are afraid. We’re afraid to say I need help because we don’t want to lose our kids.”

Payson’s gray-walled room at Cynthia Day shows signs of her family. Dozens of photos of her sons and daughter are posted on the walls, and a red Elmo doll and stuffed zebra toy lie on a child-sized bed next to Payson’s.

Cynthia Day helps Payson juggle recovery with becoming a better parent, she said. Payson loves to read – her wardrobe is stuffed with books – and after Payson leaves the Nashua facility, she plans to finish her associates degree in criminal justice. Cynthia Day, where Payson is getting substance abuse treatment, taking self help and parenting classes and learning to cope and avoid relapse, has made it all possible.

“It gives you a safe place to become the best mother and best person that you can be,” she said. “It lets you get back what you lost, and that’s amazing.”

(Allie Morris can be reached at 369-3307 or at amorris@cmonitor.com.)