Changing the Child Welfare System with Safe at Home West Virginia

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Children in the West Virginia welfare system are nearly three times as likely as those in other states to be placed in group-care facilities. But a new program, called Safe at Home West Virginia, is beginning to change this pattern.

A little background: based on 2013 data from the Department of Health and Human Resources, 7 out of 10 children in West Virginia’s welfare system were placed in either a group home, residential treatment facility, psychiatric institution or emergency shelter. These could be either in or out of state.

Karen Bowling is the Health and Human Resources cabinet secretary. She says the old welfare system was flawed.

“There’s a pretty significant recognition on our part that we weren’t necessarily doing the evidence-based practices to impact the 12-17 age group and their families,” she says.

The new program allows West Virginia to use federal money traditionally allotted to pay for out-of-home care and repurpose it toward support services designed to help children either return to or stay in their home community. This could be help in the form of counseling services or parent education.

“What child welfare leaders across the country are doing is advocating for total change in the way the federal government funds child welfare services to ensure that they’re not just funding out-of-home care, but also funding or allowing states to have the flexibility to fund community-based services as well,” says Bowling.

Bowling says part of the issue is that West Virginia doesn’t have a lot of money. The federal funds available for state foster care just pay for a child’s room, board and supervision – not community-based support services.  But child welfare organizations, such as the national Children’s Bureau, agree that children “are best served in a family setting.”

Nancy Exline is the commissioner for the Bureau of Children and Families under the Health and Human Resources department. She says in the past, the state has “engaged the kid, not the family. Not the dynamics around the family. Not all the dynamics around the child. So it’s looking at all that and not looking just at behaviors of the child. How does the child’s behavior interact with their parent or siblings or whatever and making sure all that is in place?”

The bureau does this by providing regional facilitators who make sure children and families have access to whatever services they need to be successful.

I asked if I could talk to a child or family that the program affects. Health and Human Resources declined my request, citing privacy for families still involved in open child protective services cases, but sent me to Mindy Thornton, the Children’s Program Director and Children’s Outreach Liaison for the Prestera Center in Huntington. She agreed to talk about a patient story in ways that would not identify him.

“One of our first cases that we received – he was placed out-of-state in Ohio. We got the chance to go to Ohio and visit him at his treatment facility in Ohio,” she begins.

Thornton was quick to point out traveling to out-of-state treatment facilities was not something providers usually do, but that it gave her an opportunity to assess the situation.

“The one thing that stuck out in my mind the most about that visit is that he told us that he was going to be there through high school,” she says. “And this young man was in middle school.”

She told me the boy had mental and behavioral health challenges, but wouldn’t give specifics beyond “aggressiveness” that had caused his parents to seek outside help.   

“That was in October,” she says. “And he came home mid-February to his home, not to a foster home, not to an in-state residential, but to his home. He came home. He completed his treatment program. We did a lot of things with him while he was there.”

While still in Ohio, he began to have weekly contact with the new Safe at Home facilitator in his region. Meanwhile Safe at Home provided training to the family on how to deal with his disorder.

“The stepmom was new to the situation and she was worried she wouldn’t be able to handle his behaviors in the evening before his dad got home,” she says. “And so what we did in that [situation] is we just found staff to be there when he got home from school to be with her to encourage her to be the parent we knew she could be.”

In less than a week, the stepmom decided she was fine on her own and the extra staff stopped coming.

“Now he is doing well in school – he’s in a special class, you know, he’s not in the general population all the time – ­but he’s in his school in his home community and he’s doing really well.”

West Virginia’s plan for Safe at Home was approved in 2014. In October of 2015 staffers began implementing the pilot program in 11 counties. By March 2016, they had referred more than 100 youth to the program and were soliciting applications from new counties. In May, data will be published from a third party evaluator to assess how successful Safe at Home has been thus far. The program is currently set to be funded through 2019.

“West Virginia has one of the highest rates of congregate care in the country,” says commissioner Exline. “If WV is successful at this, and as that data starts to come in, it really builds the case for child welfare leaders to say ‘this works. Children have better outcomes if you allow states to use their funds more flexibly and not just for out-of-home care.’”

Exline says this program may make a real difference in the lives of West Virginia’s children and maybe even children in states across the country. If the program proves to be successful, other states might say, ‘If they can do it there, then we can replicate here.’

Appalachia Helth News

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.