Federal Monies Proposed To Address Opioid Crisis And Child Care Costs

The Biden-Harris administration is asking Congress for domestic supplemental funding to assist with the opioid crisis and child care costs — some of which would come to West Virginia.

The Biden-Harris administration is asking Congress for domestic supplemental funding to assist with the opioid crisis and child care costs — some of which would come to West Virginia.

If adopted, West Virginia would receive an estimated $39 million to counter fentanyl trafficking and strengthen addiction treatment, overdose prevention measures and recovery support services. 

Xavier Becerra, secretary of the U.S. Department of Health and Human Services, said in West Virginia, about 76 percent of the overdose deaths that occurred between May 2022 and May 2023 are due to synthetic opioids, primarily illicitly manufactured fentanyl.

“From this year to the previous year, West Virginia saw, I think, almost 1,500 deaths from overdose, most of those opioid overdoses, and the lion’s share today is driven by fentanyl,” Becerra said. “And so the $1.6 billion that the president is requesting in emergency funding for opioids would really help us target fentanyl. And let states try to make sure that they can catch someone before they overdose.”

According to provisional data from the Centers For Disease Control and Prevention, for a 12-month period ending in May 2023, 1,184 West Virginians died of an opioid overdose.

West Virginia also stands to gain $107 million for child care, if the domestic supplemental funding request is adopted by Congress. 

Becerra said pandemic-era child care stabilization increased the labor force participation for mothers with young children by an additional three percentage points.

“The president’s request is to help extend funding for many of those child care centers, over 61,000 children and their families in West Virginia benefited from those funds, and at least 1,600 childcare providers,” Becerra said. “I think the average cost of childcare in West Virginia is somewhere around $9,000. And we know that the stabilization funds end up saving families over $1,000 a year in their childcare expense per child.”

According to the Department of Health and Human Services, the price of child care for an infant in West Virginia is $8,736 per year. 

Facing West Virginia’s Child Care Cliff

On a national level, the end of pandemic-era benefits will affect child care costs and access. West Virginia hopes to avoid those shortfalls by relying on individual child care subsidies that date back to the 1960s.

The end of pandemic-era benefits will affect child care costs and access on a national level. West Virginia hopes to avoid those shortfalls by relying on individual child care subsidies that date back to the 1960s.

Sept. 30 marked the official end of federal pandemic-related stabilization money aimed at bolstering child care services in the U.S. Meaning, states had to have spent their allotted funds by that date.

In 2021, $40 billion in funding went to child care centers across the nation from the American Rescue Plan Act (ARPA).

According to the Administration for Children and Families, in West Virginia, 645 child care centers and 925 child care family homes received stabilization payments totaling more than $160 million.

The child care centers used the funds to pay for personnel costs and keep programs staffed. In some cases, child care centers used the funds to keep prices lower for parents struggling to pay for child care. Child care family homes mostly used the money to pay for personal protective equipment to ensure safe environments for children and staff.

Of that $160 million total, $101 million in ARPA funding was allocated to DHHR’s child care subsidy program in order to increase reimbursement rates. 

Kent Nowviskie, deputy commissioner for Programs and Policy at the Bureau for Family Assistance at the DHHR, said the funding allowed child care providers to be paid on the basis of enrollment in their programs rather than daily attendance.

“We switched to doing something that providers had been asking for for a long time, which was to pay them a monthly rate for each child enrolled in their setting instead of a daily rate that they had to calculate based on the attendance of the child,” Nowviskie said.

While the 2021 ARPA stabilization funds were a source of additional funding, West Virginia has had access to child care subsidies since the Appalachian Regional Development Act.

“We here at the West Virginia Department of Health and Human Resources, or even before it was the Department of Health and Human Resources, we’ve been doing that since 1969,” Nowviskie said. “That is an ongoing thing, it is not going away, those child care subsidies are not going away.”

Nowviskie said it is important to understand that in the child care industry, subsidies refer to the payments that are made to providers for services provided to specific children.

“So it’s an individual payment per child who’s being served in a child care setting,” he said.

Nowviskie said some ARPA funds had dedicated purposes, or places they had to be spent. One of these designations was subsidy payments, so the state increased the rates it paid for each child. 

The DHHR also expanded eligibility to everyone regardless of income who met the definition of essential worker, as outlined in the governor’s March 2020 executive order.

Julie Kashen is the director of women’s economic justice and a senior fellow at The Century Foundation, a progressive think tank in Washington D.C. She said the federal grant structure allowed families of more diverse incomes to qualify nationally.

“One of the differences between the stabilization grants and the supplemental grants is that the stabilization grants were able to reach a wider variety of families because they didn’t have that same income restriction,” Kashen said. “There was much more of a combination of the poorest families, lower income families, middle class families, were able to benefit from that.”

Nowviskie said the DHHR has taken steps to mitigate the loss of ARPA funds but in October 2022, the DHHR restored income eligibility requirements for child care subsidies.

“When we saw that those monies were dwindling, we circled the wagons here to try to figure out what we could do to stretch those out as long as we could,” Nowviskie said. “And we put an income limit back on.”

When this ARPA funding allocated for subsidy assistance was exhausted in May 2023, the DHHR set aside $24 million of Temporary Assistance for Needy Families (TANF) funding to allow providers to continue being paid by enrollment for services rendered through August 2024.

“So until September of next year, services provided through August of next year, then we’ll be able to keep the pay by enrollment going as well as those increased rates,” Nowviskie said.

Nowviskie and other experts agree a long term solution would be the best case scenario.

“We don’t anticipate readjusting rates downward,” Nowviskie said. “But absent an influx of additional funding, we may have to go back to a pay by attendance model, which is not ideal. Child care providers nationally are advocating and trying to move toward the pay by enrollment model. In fact, I think Congress is looking at the issue. So we hope they have some additional funding that will come along with that.”

Bill Franko is an associate professor of political science and director of graduate studies at the WVU Eberly College of Arts and Sciences. He worries that child care settings will struggle to pay their staff at the same rate they have since 2021.

“What’s going to happen is the centers are not going to have the money to pay living wages to the child center workers,” Franko said. “You’re gonna have fewer people who are going to want to enter that industry or stay in that industry. It’s going to be much more temporary, like it was prior to the 2021 influx of the child care stabilization funds.”

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

Child Care Centers To Receive Final Pandemic-Era Payment

A final pandemic era payment will be issued to child care centers across the state, according to Gov. Jim Justice.

Starting Sept. 30, states will lose access to federal pandemic-related stabilization money aimed at bolstering child care services in the U.S. but Gov. Jim Justice said Friday that there is enough leftover pandemic-related stabilization money to distribute a final payment for October.

In 2021, $40 billion in funding went to child care centers across the nation from the American Rescue Plan Act

With this funding set to expire, a bill in Congress to extend child care funding has gone nowhere.

According to the Administration for Children and Families, in West Virginia, 645 child care centers and 925 child care family homes received stabilization payments totaling more than $160 million.

The child care centers used the funds to pay for personnel costs and keep programs staffed. In some cases, child care centers used the funds to keep prices lower for parents struggling to pay for child care that now costs an average of $15,000 a year for one child, according to a Care.com study.

Child care family homes used the money to pay for personal protective equipment (PPE) to ensure safe environments for children and staff.

“It will be slightly lower than the normal monthly payment,” Justice said. “However, again, you got to realize this is just an extra payment that nobody really expected.”

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

Experts: W.Va. Child Care System Needs More Public/Private Partnerships

West Virginia Child Care providers hope a high-profile partnership convinces more in-state businesses to help subsidize a struggling system.

West Virginia Child Care providers hope a high-profile partnership convinces more in-state businesses to help subsidize a struggling system.

Directors with the state Bureau for Family Assistance say they help provide child care for nearly 17,000 children a month. About two thirds of the children subsidized by the state child care system are six years old or younger.

During legislative interim meetings, Child Care Program Manager Deidre Craythorne told members of the Joint Committee on Health about 1,300 child care facilities statewide, including homes, established day and evening care centers, and head start centers, are not enough.

She said the Bureau for Family Assistance budget runs at about $60 Million a year. The bureau will lose more than $340 million in combined federal COVID-19 relief funding by fall of 2023. That money has been used to recruit and retain employees, maintain facilities and subsidize client families.

Craythorne said it’s often a challenge for child care centers to remain viable – with enough steady clients to get the bills paid, staff retained and fulfill commitmments of services offered. She hopes more businesses will aspire to the public/private partnership child care model now being forged between the state and steel producing giant Nucor.

“That will help expand things,” Craythorne said. “If we can get more businesses in West Virginia to really understand and appreciate the impact the lack of child care has on their workforce.”

Craythorne had no answer when asked why only about a quarter of potentially eligible West Virginia families take advantage of child care subsidies. About a third of families in the system are at or below the poverty level.

W.Va. CPS Employees Raises Set, Child Welfare Dashboard Nears Activation

Gov. Jim Justice has approved the promised 15 percent raises for direct service employees with the Department of Health and Human Resources (DHHR).

Gov. Jim Justice has approved the promised 15 percent raises for direct service employees with the Department of Health and Human Resources (DHHR).

During Justice’s regular briefing, DHHR Secretary Bill Crouch said he faced major challenges in collapsing and reorganizing 600 agency positions to find the money for the raises without jeopardizing essential services. Justice said Crouch’s effort was completed without any funding coming from the state budget.

Mounting Child Protective Service (CPS) employee vacancies have overwhelmed many county case workloads. With West Virginia CPS wages less than neighboring states, the hope is the raises will aid in worker recruiting and retention.

The governor also said the state will publish a child welfare dashboard. The dashboard was proposed during the legislative session.

A public information data dashboard to benefit foster care families was a key provision of House Bill 4434. The foster care legislation died in the last hours of the 2022 regular legislative session.

DHHR Secretary Bill Crouch said the dashboard will let people see what’s going on with child protective services programs.

“We’re going to be showing referrals, we’re going to be showing CPS placements,” Crouch said. “We’re going to give staffing and workload information, we have a long list of things that we’re interested in looking at.”

Crouch said this will be a visual, living dashboard with constant content updates, without confusing spreadsheets and always subject to change. He said it will be up on the DHHR website June 1st.

Foster Care Worker Raises To Come Before July 1

West Virginia’s sweeping foster care bill, HB 4344, died in the Legislature, but there is a plan to deliver on the raises promised to front line case workers.

West Virginia’s sweeping foster care bill, HB 4344, died in the Legislature, but there is a plan to deliver on the raises promised to front line case workers.

With Child Protective Service worker vacancies ranging from 25 percent statewide, to 70 percent in some counties, some of West Virginia’s most vulnerable children may not be getting the attention they need. Just before the bill died, Gov. Jim Justice said he would honor the 15 percent raise request meant to recruit and retain protective service workers.

DHHR Secretary Bill Crouch said the state will come up with the money for the raises by collapsing many long time vacancies all across the Department of Health and Human Resources.

He says the 15 percent raises for both Child and Adult Protective Service workers, along with critical staff, will be in addition to the five percent raise the legislature approved for all state workers. Crouch said those raises will come sooner than later.

“We’re pushing to have this done before July first of this year,” Crouch said. “So that those raises go into effect prior to the statewide July first raises.”

Crouch said the job reorganization is being done methodically, while maintaining the positions needed to provide essential services.

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