With Ohio consistently near last in the nation in state funding for child-protective services, the number of children entering foster care has exploded — another financial and human cost of the opioid epidemic, according to a new report.

Ohio children are entering foster care at a rate never before seen, hitting 16,154 in 2018, an increase of 3,500 — or 28 percent — in five years, said the Public Children Services Association of Ohio, which released the report Thursday.

That’s creating a "tsunami effect" on foster-care placements, caseloads, agency budgets and "ultimately on the chances that these children will celebrate the holidays in a permanent home," the association said.

The strain on county agencies has been both financial and emotional: Employee turnover at county welfare agencies is six times the national average for the entire workforce, and one out of every four Ohio caseworkers quit in 2016 and 2017, the report says.

Even more shocking, a 2018 study found that more than half of Ohio’s children-services workers have high enough stress levels to meet the diagnostic threshold for post-traumatic stress disorder, according to the association.

"We need some bold leadership in this state," said Scott Britton, the Children Services Association’s assistant director. "We simply can’t continue the way we are."

With the state contributing only about 10 percent of the $621 million spent in 2016 on the cost of protecting Ohio children, and the federal government picking up 38 percent, the state’s 88 county-run child-welfare operations are on their own to find more than half the money to keep kids safe, the report says.

As a result, the child-welfare system "varies significantly by county," Britton said. "It really is all over the map," with some counties — including those in rural areas hit hardest by the opioid crisis — providing little to no local resources to protect their children, he said.

In Licking County in 2015, parental drug use was the reason for 71 percent of removals of children from their homes, and 43 percent of the children had a parent using opioids at the time of removal. In Franklin County, the numbers were 41 percent and 14 percent, respectively.

Yet Franklin County has generous local financial support, while Licking County "tells a very different story," Britton said. "They are in need of reform."

Absent state funding, family members are being called on to care for and financially support state foster children in increasing numbers. The number of children in county custody who were placed with relatives increased 92 percent in the past five years.

"These grandparents, extended family and close friends often struggle to pay child-care and other costs for the children in their home," association Executive Director Angela Sausser said in a written statement. "Because children’s long-term outcomes are better when they are placed with relatives instead of with strangers in foster care, Ohio cannot afford to neglect the needs of these caregivers."

County children-services agencies can’t afford to put these kids in foster care, either, the association said. The cost of placements in residential facilities totaled almost $370 million in 2018, up 35 percent in five years. That cost is projected to increase by at least $44 million by 2020. And that’s just the cost of room and board — not of providing any needed services.

"Because Ohio relies more heavily than any other state on local dollars, more than half of that increase will be borne by local resources, and counties are already underwater," Sausser said. "This year, we saw the biggest uptick in new and replacement children-services levies on the ballot in recent history, but the local tax base is already overburdened."