Tag: Child Welfare

DHHR Shares $6.1 Billion Budget Proposal Focused On Child Welfare Reform, Family Issues

In its $6.1 billion budget request for the upcoming fiscal year, the West Virginia Department of Health and Human Resources has proposed increasing funds for child welfare programs, the recruitment and retention of staff, efforts to improve state-run hospitals and the elimination of a waitlist for the state IDD waiver program. 

DHHR Cabinet Secretary Bill Crouch told the House Finance Committee on Monday these requests fit into three priorities he has for the upcoming budget — substance use disorder treatment, child welfare and reforming state-run health facilities. 

The DHHR is largely funded by the federal government. This year, the department is requesting $1.1 billion in state dollars, $183 million less than the $1.3 billion allocated for the current fiscal year. 

Next year, Crouch said the department anticipates it will receive $4.1 billion in federal dollars. They also will have a $309 million funding surplus, which has been largely attributed to a decline in Medicaid enrollment.

The DHHR is requesting $60 million from that $309 million surplus to make improvements in 2021. That includes roughly $19.8 million to eliminate the IDD waiver waitlist, $15 million for social services, $10 million for state-run hospitals, $7.1 million to cover the state’s share of the Child Health Insurance Program and $4.4 million for staffing Child Protective Services.

The DHHR also is proposing $150 million from the projected $309 Medicaid surplus be put aside to create an emergency-use reserve fund for the governor’s proposed Families First Act described in Senate Bill 633. These dollars, if allocated, would cover things normal Medicaid streams would fall short on covering. 

The leftover portion of this Medicaid surplus would be used in another state department. The state budget office did not respond to a request for comment on Tuesday. 

Additionally, the department is requesting more money from the state to make some changes to its ongoing 2020 budget. That includes $10 million for its seven state-run hospitals, $714,368 for improvements to those facilities and $920,500 for the Office of Medical Cannabis. 

Staffing Increases, Addressing Shortfalls In CPS

Since 2017, Crouch reports the Bureau for Children and Families has added more than 60 CPS workers. Before this budget proposal, he said, the DHHR increased CPS salaries 20% and began offering a $1,500 sign-on bonus. 

These positions include two-year and five-year retention bonuses. Crouch said Monday this has helped reduce CPS worker turnover from percent from 41% to 24%. 

“Which is still high, but we are working hard to try to reduce the caseloads for these individuals,” Crouch said. 

According to data the Bureau for Children and Families provided to legislative auditors in 2019, since at least 2015 there has been a steady increase in the number of child abuse and neglect referrals CPS workers receive each fiscal year.

In 2018, CPS employees received 5,882 more referrals that year than the 20,988 it received three years earlier. The trend largely follows a surge in substance use disorders throughout the state. Since 2015, the legislative auditor’s office reported the number of substance-related referrals has increased by 79%.

State legislative auditors also reported CPS workers did not spend the legally required amount of time responding to half of the referrals the department received in 2018. 

Going into 2021, the DHHR has plans to hire 87 open positions in the Bureau for Children and Families, which employs CPS workers throughout the state. 

Throughout the entire agency — which covers everything from state-supported health care, nutritional assistance programs and laboratory testing — the DHHR has almost a 1,000 vacancies out of the 6,274 positions under the department umbrella. 

The Cost Of The Foster Care Crisis 

According to DHHR Deputy Secretary Jeremiah Samples, the DHHR works to keep families together or reconnect them whenever is safety to do so and possible. 

When it comes to children who have been removed from their homes now, the DHHR reports there are 2,800 kids who have not been connected to a foster home. Instead, they’re living in group residential facilities and emergency shelters. 

Samples reported the state is spending, on average, $209.51 daily per child in emergency shelters.

“We do believe that it’s critical to get those kids into a familial placement of family and have them in that family permanently to the extent that that’s possible,” Samples said. “So the more foster families that we have that are able to deal with children with acute needs, I do think it would mitigate the number of kids in these institutional settings.”

Hospitals and Laboratories In Poor Shape

Through several DHHR bureaus, the agency leads all seven state-run hospitals and three laboratories for testing. Samples said in his Monday presentation all of the buildings have their shortcomings, with some even being in a “state of disrepair.” 

The DHHR is requesting $10 million in 2020 for maintaining its hospitals and roughly $700,000 for capital costs, like equipment, fixing broken floors and HVAC issues. 

Next year, Samples said, the DHHR is requesting $10 million for maintenance and $1.5 million for capital costs.

Nothing in the DHHR’s budget addressed state laboratories and their building’s needs. 

“All three of those facilities are dated,” Samples said in an interview after the budget presentation. “Within the next few years, the state’s going to have to strategize on how to either repair those facilities or build out a new facility for those functions.”

Crouch said he plans to address these needs in this next budget cycle. 

“We have some buildings out there that are very, very old and take a lot of maintenance, very difficult upkeep,” Crouch said. … I think it’s something next year I’m going to try to tackle, in terms of what are some alternatives or solutions to these situations.”

Emily Allen is a Report for America corps member.

Correction: The DHHR is requesting $150 million in Medicaid surplus go toward the Families First Act, proposed in Senate Bill 633 from the governor’s proposal. An earlier version of this article stated that the DHHR was requesting $150 million for the Families First Prevention Services Act, a different program established to help families at risk of separation. 

W.Va. Senate Forms Committee Dedicated To Child Welfare Issues

A committee has been formed in the West Virginia Senate to focus on upcoming legislation related to child welfare.

The Senate Select Committee on Children and Families, whose formation was announced Wednesday, will be led by Kanawha County Republican and Senate Majority Leader Tom Takubo.

The committee will focus on issues related to the state’s ongoing foster care crisis and substance abuse epidemic, the Senate said in a news release.

The state’s foster ranks have swelled to about 7,000 children as the state grapples with the opioid crisis. West Virginia leads the nation by far in the rate of drug overdose deaths.

The statement cited a recent legislative audit that found the Department of Health and Human Resources’ Child Protective Services did not meet a required time frame for investigating child abuse and neglect allegations in 50 percent of cases in fiscal year 2018.

In addition, Child Protective Services continues to experience high turnover, while the drug epidemic has increased CPS worker caseloads by 79 percent since 2015.

The committee was formed because legislation on child welfare issues otherwise would have had to compete with dozens of other bills if they had been channeled through other committees.

“Our children are our state’s most precious resource, and it’s clear that despite our best efforts, we are falling way short in adequately providing for the needs of the ones who need us the most,” Senate President Carmichael said. “My hope with this new Select Committee is that the members take a deep dive on these issues and work toward the kinds of solutions that will ensure no child in the state of West Virginia gets lost in a bureaucracy that does not put them on the best path to stability, comfort, and self-worth.”

The GOP-controlled legislature began its regular session Wednesday.

Takubo and fellow committee member Ron Stollings, D-Boone, are physicians. The nine-member committee also includes Senate education chairwoman Patricia Rucker, R-Jefferson, and Democrat Paul Hardesty, a former board of education chairman in Logan County.

“It brings everything to the forefront,” Takubo said in an interview before the Senate convened Wednesday. “Politics will kind of divide Senate members or House members, but the one thing we’ve always been (in the) loop on is families and children. We’re trying to bring in the resources of the Senate members to look at this as a whole.”

The state also faces a federal class-action lawsuit alleging the foster care system has failed to protect children. The state is seeking to dismiss the suit, brought by nonprofit advocacy groups and a law firm on behalf of a dozen children.

Department of Health and Human Resources Secretary Bill Crouch continues to make substantive changes to its system.

The lawsuit describes stories of alleged neglect and harm done to foster children in DHHR’s care. Marcia Lowry, executive director of the nonprofit A Better Childhood, has said the state isn’t doing enough to deal with problems in its foster system.

Federal Legislation Prompts DHHR to Move Youth in Residential Treatment Programs Back in State

West Virginia youth who need intensive non-family residential treatment have traditionally been served out of state. Now, the West Virginia Bureau for Children and Families will try and move some of those kids back in state to comply with new federal regulations.

In February, President Donald Trump signed the Family First Prevention Services Act, which included major reforms for child welfare. The legislation is essentially designed to help keep kids with their families or in a family-like setting.

Under the new legislation, states must take steps to reduce the use of group homes and other group care facilities. When children need residential services for “behavioral, intellectual, developmental and/or emotional” disorders, those must be provided in a child-care institution with no more than 25 children. The legislation lists a number of options the state must provide in order to qualify for federal funds including establishing Qualified Residential Treatment Programs.

According to a press release from the WV DHHR, the agency is seeking to establish these treatment programs for youth ages 12-21 by converting beds in existing residential treatment programs.   

No new beds are to be created. Instead 100 beds – 25 in each of the bureaus four regions – are to be converted with the help of start-up funds from the state.

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

Changing the Child Welfare System with Safe at Home West Virginia

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

House Bills Move to Next Stage Without a Hitch

A number of bills were on the floor Tuesday from child welfare to the election of judges to the qualifications of the labor commissioner; all of them passed to their next stages without much of a hitch.

Eight bills were on the House Floor, and only House Bill 2200 was on third reading. This bill is to revise, rearrange, consolidate, and recodify the laws of the state relating to child welfare and juvenile disposition.

Judiciary chairman, Delegate John Shott, is the lead sponsor. He described the bill to be more user-friendly for those who have to deal with this area of law.

“There have been complaints for many years over how difficult it is to work in this area and how it can lead to misinterpretations, misunderstandings,” Shott noted, “and this is an effort that this bill, it’s got bipartisan support, it’s got widespread support among those who need to be able to navigate these complicated provisions of law, and Mr. Speaker I urge passage.”

House Bill 2200 passed 98 to 0.

The next five bills were on second reading; the amendment stage. First up was Senate Bill 13, which has to do with the liability of a possessor of real property for injuries caused by open and obvious hazards.

Delegate Shott proposed an amendment.

“The amendment that has been passed in the judiciary committee to modify the senate version, Senate Bill 13, basically recognizes a very limited exception to the open and obvious doctrine,” said Shott, “and that is where the danger on the landowner’s property is a violation of a law intended for the public safety, and that violation caused the injury, then in that narrow situation, the landowner is still responsible.”

Shott’s amendment passed and the bill progressed to third reading.

House Bill 2010 was up next. This bill relates to electoral reforms requiring the election of justices of the Supreme Court of Appeals, circuit court judges, family court judges, and magistrates to be on a nonpartisan basis.

Delegate Tim Manchin proposed an amendment that would extend public campaign financing to circuit court judges. It’s already in place for candidates for the Supreme Court.

“That program has worked. As a matter of fact, we have a current Supreme Court justice now who sits in the chamber upstairs because of this bill. It was a private project at the time, which is now been made permanent for Supreme Court judges,” Manchin explained, “The reason that I’ve offered this bill [amendment] is because, quite frankly, the only real reason to have nonpartisan judges, or the only stated reasons, are two; number one, so that there not beholden to anybody and they don’t appear to have partiality after they’ve been elected. Number two is to cut down on the cost of election, however if we miss this opportunity to extend the public campaign financing to those circuit court judges, we will leave in probably the greatest threat to the appearance of impartiality that there is, and that’s direct campaign contributions.”

Delegate Shott stood to oppose the amendment but in good faith.

“This is a good idea, and it’s an idea that it’s time may come, just not today,” Shott said, “I’m going to speak against this amendment not because I don’t think it’s a good idea, I think it’s where we want to be at some point, but I’m concerned that it complicates a bill whose focus is to take the first step, and that is to make these judicial elections nonpartisan.”

Delegate Manchin stood again to encourage the amendment be adopted.

“We have an opportunity right here to do something good right now and not wait until later, until all other kinds of people weigh in,” Manchin said, “and tell us all other reasons why the system won’t work, when in fact it already has.”

Delegate Manchin’s amendment was rejected 67 to 31, and House Bill 2010 moved on to third reading.

Also up for passage Wednesday will be House Bill 2217, relating to the qualifications of the Commissioner of Labor. The bill removes the term “labor interests of the state” and inserts language to require the commissioner to have knowledge and experience in employee issues and interests including employee-employer relations.

Child Advocates Still Seek Funding Restoration

  Child advocates throughout the state are stepping up their campaign to convince Governor Tomblin to restore the budget cuts he made to social services.  

Members of the Our Children, Our Future Campaign have asked to meet with the governor multiple times. Jamie Gudiel who volunteers at a family resource center in Morgantown would like to know why the governor vetoed the funding in the first place.

“That’s why we’re asking for a face to face meeting with him.  We’ve asked several times.  Five times over and gotten no response. I would like to hear from his mouth.  I can only speculate,” Gudiel said. 

Advocates did meet with Revenue Secretary Bob Kiss and Health and Human Resources Secretary Karen Bowling.  As a result, the governor restored some funding to in-home family education,  child abuse prevention and domestic violence programs earlier this month. 

But social service workers say that’s not enough. They hope the governor will put a bill to restore the funding on a call for a special legislative session later this month.

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