A near doubling of drug-exposed babies is overloading Orange County's emergency shelter system and forcing hospitals to board the infants, authorities say.
Beside the potential social devastation of drug-damaged children, the dollar cost to the taxpayers in 1989 was more than $258,000. The figure is significant because for the first time, "we can now put a dollar amount on the problem," said Bob Theemling, director of Orangewood Children's Home. "We knew this was a social problem. Now we can say, look, this is costing all of us money."
A report released last week by the U.S. Health and Human Services Department estimated that it will cost $500,000 a year to provide hospital and foster care for 8,974 cocaine-exposed babies reported in eight cities--Los Angeles, Miami, Phoenix, Chicago, New York, San Francisco, Tacoma and Ft. Wayne. The report estimated that a total 100,000 cocaine-exposed babies are born each year in the United States.
In the last three months of 1989, Orange County identified an average of 27 drug babies a month, up from 16 in 1987, the first year statistics were collected, said Mary Harris, a program analyst with the Orange County Social Services Agency. Most tested positive for a combination of drugs--primarily cocaine and others such as methamphetamines.
About 30% of the infants, those with parents in drug treatment programs, were sent home. But authorities placed the remainder in protective custody.
Some of the infants went to the county's emergency shelter, Orangewood Children's Home. But because of the increase, Orangewood is often full, so hospitals are forced to board the children temporarily until shelter or foster homes can be found, said Bill Steiner, executive director of the Orangewood Children's Foundation.
The so-called "boarder babies"--common in drug-plagued cities such as New York and Washington--are a new phenomenon in Orange County, Steiner said. "Five years ago we did not have this kind of an issue," he said. "All these are drug babies."
During the past year, the number of boarder babies rose from 60 to 78 at hospitals in Orange County, according to a survey undertaken last month by the Orangewood Foundation.
One infant remained at a hospital in the county 50 days at a cost to county taxpayers of $19,431. Last year, the cost of their extended stays rose from $161,543 to $258,542. The county picks up the bill because Medi-Cal coverage ends when a patient can be released medically.
At Martin Luther Hospital in Anaheim, the total number of days the boarder babies stayed increased from 41 days in 1988 to 116 in 1989, creating what President George Mack called a major capacity and staffing problem.
In addition, the babies occupy beds needed by other newborns, said Vicki Lombardi, administrative director of women's and children's services. Packing 15 into a room meant for 12 also increases the risk of passing infections, she said.
While cocaine babies do not suffer the typical "withdrawal" of heroin babies, they are irritable, difficult to feed, have a piercing cry and become overstimulated easily, hospital workers said. It may also be hard on nurses who must watch the newborns thrash and cry without being able to help them, Lombardi said.
"You try to cuddle them, they still scream. You try to feed them, they throw up."
Some authorities worry about the psychological damage to children whose first home is a hospital.
"They don't get the emotional and visual stimulation they should," Lombardi said. "Under the constant glare of nursery lights and change of nurses, they don't learn day and night cycles or to relate to one person," she said.
Nurses use swings and wagons to carry them around, "but it's not the same," she said. "It's tough for those babies' development."
"They should be bonding with families and not be in a hospital setting," Steiner said. "But if there are no alternatives, that's what we're up against.
"The phenomenon is causing increasing concern to everyone working with these children."
Eventually, the boarder babies are placed in foster homes, with relatives, or at Orangewood or other shelters when there is room available, Theemling said.
But with a dwindling pool of foster homes, ideal placements are difficult for nearly all children in custody and even worse for drug babies who need special care.
Both the county Social Services Agency and UCI Medical Center offer training programs for prospective foster parents and caretakers of drug babies.
Meanwhile, authorities are seeking longer range solutions.
The Social Services Agency and the Health Care Agency are developing an outreach program for drug-using pregnant women so that they can obtain treatment "without being concerned about legal implications," Harris said. "Hopefully, they would avoid the need to have the baby come into custody."
NEWBORNS WITH DRUG EXPOSURE
Monthly number of hospital holds on drug babies in Orange County: 1990: 28 Source: County of Orange