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Opioids driving up county costs

In a two-week period, Chautauqua County saw 10 babies test positive for opioids in a two-week span in mid-September.

The statistic came up as part of a discussion of new and ongoing child and maternal health programs in Chautauqua County. A new program, paid for with a federal grant through the Child Abuse Prevention and Treatment Act, places a public health nurse with Child Protective Services caseworkers. County officials have said they are happy with the program’s results in the first several weeks.

“The goal really was to have a public health approach to child welfare,” said Christine Schuyler, county public health coordinator. “Now we’re really seeing this when you’re pairing up the Child Protective Services caseworker and a public health nurse and you’re going in together on these families.”

Both Schuyler and members of the Chautauqua County Board of Health said at a recent meeting that there is a cost associated with treating the opioid epidemic, particularly when it affects children.

Schuyler said the Health Department was budgeting an increase in several areas that are expected to increase when a county is dealing with childhood development issues caused by both increasing levels of opioid abuse and high levels of lead in homes.

Dr. Richard Berke, former county health commissioner and current Board of Health member, noted that 20 years ago, Buffalo Children’s Hospital was seeing 15% of its babies born with positive toxicity screenings, a troubling number considering Children’s Hospital typically delivered babies born to suburban mothers. Inner city hospitals were seeing 30% of babies born with a positive toxicity screening.

“Now we’re seeing it here,” Berke said. “We’ve not exactly kept our eye on the ball here because we never thought it would come here.”

In the 2020 Chautauqua County budget that will be approved this month, the projected cost of the county’s coroner program will nearly double from 2018 levels, due in part to an increased number of autopsies needed due to opioid overdoses. Early intervention costs are projected to increase roughly $57,000 from 2018 levels and environmental health costs are expected to increase about $200,000 from 2018.

“Since the opioid epidemic has come to light with our positive (toxicity) babies, since 2014-15 we’ve been dealing with this,” Schuyler said. “Every year I’ve said at budget time you’re going to see trickle down effects from this. You’re going to see an increased cost in child welfare, maternal and child health, early intervention, preschool special education, because this is what we’re going to have as impacts. Now here we are because those are the areas to our budget that we have seen increases. Temporary assistance is down. Safety net is down. That’s all great. That means our economy is doing good and we have fewer people on public assistance. But right where we figured we would be seeing the issues, that’s where we’re seeing them.”

In addition to opioids, lead in homes is a problem in Chautauqua County. State officials have recently lowered the amount of lead in a child’s blood to be considered poisoned by lead from 10 micrograms per deciliter to 5 micrograms per deciliter. There were 268 cases of children having an elevated blood level of 5 micrograms per deciliter in 2018. Lead poisoning impacts the development of the brain of children from newborn to 5 years old. She said lead poisoning has a permanent impact that can reduce intelligence, cause attention deficient disorder, memory problems and impulse control that later in life can possibly lead to more criminal behavior. Eight out of every 10 homes in the county has lead paint, while one out of every three children are not being tested.

“The other side of that is what’s happening in school with those kids,” Berke said. “Their cost is going up for counseling and kids that are hyperactive and kids with special needs because of subtle changes in their development because of lead toxicity, even at low levels. It’s pervasive. If you don’t address it at the level of prevention you pay for it 100 times over.”

Dr. Lillian Vitanza Ney, a former Jamestown City Council member and current Board of Health member, said the county Board of Health may need to become more involved in the lead paint issue in the county to help decrease the number of children affected.

“The other side of lead is substandard housing in the county,” Ney said. “In a way I think we need to bring it up at our Board of Health meetings in the future about what it is we can make recommendations for or amend the sanitary code or enforce certain aspects of it to help. We don’t have the budget really to do what I think is needed in terms of getting out there and making a connection between the lead toxicity in children, which is high in our county, and the substandard housing issues that are not being addressed by other groups. So that will come at another time. I think our work is going to get more complex.”

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