W.Va. Health Centers To Receive $6 Million In Federal Funds

The United States Department of Health and Human Services has allocated more than $6 million to health services in West Virginia, including health centers in Greenbrier, Hancock and Webster counties.

The United States Department of Health and Human Services has allocated $6,448,505 to health services in West Virginia.

The new slate of funding will go toward health care centers in Hancock, Greenbrier and Webster counties, as well as the West Virginia Department of Health and Human Resources.

The funds aim to bolster public health infrastructure in West Virginia. Nationally, rural health care centers face an increased likelihood of closure, often because of funding issues tied to lower patient volumes.

This can leave rural residents at risk of reduced health care access. But the new funding aims to reinforce services already in place.

Sen. Joe Manchin, D-W.Va., shared news of the new investment in a press release Wednesday.

Manchin said the new funding’s impact will extend beyond the health care centers themselves, directly supporting the residents of West Virginia.

“The awards announced today will support public health infrastructure statewide,” he said.

The following health care resources were selected for funding:

  • West Virginia Department of Health and Human Resources: $3,025,950
  • Change, Inc., Hancock County: $1,196,097
  • Rainelle Medical Center, Greenbrier County: $1,184,522
  • Camden on Gauley Medical Center, Webster County: $1,067,886

State Recovers Nearly $1 Million From Check Fraud Scheme

State officials report that more than $1 million was stolen from the Department of Health and Human Resources in a check fraud scheme. Roughly 85% of the stolen funds have been recovered so far.

State officials recovered more than $966,000 from a fraud scheme involving paper checks and a state agency, according to state Auditor JB McCuskey during a Friday press conference.

After the Department of Health and Human Resources (DHHR) sent more than $1 million in checks to a Texas vendor, it was soon intercepted as part of a fraud scheme.

Fraudsters now under investigation used a chemical agent to remove the vendor’s name from the DHHR’s checks and redirect the funds to their own accounts.

Details on the incident — like the individuals responsible, and a timeline on when the fraud and investigation occurred — remain scarce, because McCuskey said the investigation remains ongoing.

So far, approximately 85 percent of the stolen funds have been recovered by McCuskey’s office, alongside investigators with the state treasurer’s office, the U.S. attorney’s office, the governor’s office, the West Virginia State Police and Truist Bank.

Agencies involved in the investigation described the recovery of stolen funds as a success story, but one that points to deeper concerns.

“Unfortunately, in the world we live in, there are a lot of fraudsters. They are very creative,” said Truist Regional President Patrick O’Malley. “It continues to be the number one risk in the banking industry.”

McCuskey said that particular risk to the state comes from the use of paper checks to transfer large amounts of money. These can be more easily redirected by outside parties, he said.

Since taking office in 2017, McCuskey said he has made a concerted effort to reduce the number of paper checks sent by state agencies. On Friday, he urged current state officials to consider opting for electronic forms of payment instead.

“If you haven’t signed up for electronic funds transfer, please do so,” he said. “You’re actually doing yourself a favor. But more than that, you’re doing the taxpayers of West Virginia a favor because it makes our jobs in finding fraud much, much easier.”

United States Attorney for the Southern District of West Virginia Will Thompson said that instances of check fraud have been growing nationwide.

“It’s happening with obviously the state of West Virginia, but it’s also happening in private industry and private individuals,” he said. “I want to make people aware of it.”

Thompson said his office will continue to pursue a criminal investigation into the perpetrators of the fraud. He has not yet provided a timeline for the investigation or said what charges will be filed.

Attorneys Seek Sanctions In Delayed Lawsuit Against DHHR

Recently, a class action lawsuit against the Department of Health and Human Resources for children’s rights related to the foster care system has taken a turn as attorneys battle for sanctions against the agency.

Attorneys say they have new evidence that shows the now split West Virginia Department of Health and Human Resources (DHHR) purposely deleted emails related to a class action lawsuit.

Plaintiffs in the suit, A Better Childhood, a New York-based nonprofit, along with Shafer and Shafer and Disability Rights West Virginia, recently asked for sanctions in the case due to lack of evidence retention from the defendants.

The lawsuit alleges the DHHR failed to properly care for thousands of foster kids, putting some in dangerous and unsafe situations.

In the original court filing, the Plaintiffs allege, “Children in West Virginia’s foster care system have been abused and neglected, put in inadequate and dangerous placements, institutionalized and segregated from the outside world, left without necessary services, and forced to unnecessarily languish in foster care for years.”

The group filed a complaint in federal court in October 2019, denouncing the DHHR’s “over-reliance” on shelter care, shortages in case workers and a “failure to appropriately plan for the children in its custody.”

The following year, a motion for class action status was filed but left undecided when the case was dismissed in 2021. In 2022, that decision was reversed by the Fourth Circuit Court of Appeals and the class action motion was renewed in May 2023.

According to the DHHR Child Welfare Dashboard, on Jan. 16, 2024, there are 6,087 

children in state care.

The Missing Emails

Recently, the case has taken a turn as attorneys battle for sanctions against the DHHR for failing to preserve emails from former top officials that were relevant to the case.

In an email, Wetzel said the DHHR instructed the West Virginia Office of Technology (WVOT) to preserve all emails relevant to the case.

“Unfortunately, a litigation hold was not placed by WVOT on certain email accounts, resulting in some emails not being preserved,” Wetzel said in an email. “Subsequently, Gov. Jim Justice has directed WVOT to develop an updated form and process for legal hold requests.”

Wetzel also said in an email that all emails of current employees, including all emails between current employees and former employees have been preserved.

“Therefore, the majority of relevant emails involving dozens of employees are available to be produced to plaintiffs in this case, as requested,” Wetzel said in an email. “Over the last four years, DoHS (West Virginia Department of Human Services) and its predecessor agency have preserved and produced to plaintiffs more than 1.2 million pages of documents, including hundreds of thousands of emails and attachments.”

The DHHR said the Office of Technology was responsible for the statewide policy of deleting the emails of people who left the state’s employment within 30 days.

However, relevant emails had a litigation hold placed on them, according to court documents.

In November, defendants in the case filed an opposition to the plaintiffs’ motion for sanctions, apologizing to the court and the plaintiffs for the lost electronically stored information.

In the midst of an ongoing class action lawsuit and possible sanctions for lack of record keeping, the state health department’s top attorney retired at the beginning of 2024.

DHHR General Counsel April Robertson retired effective Jan. 2, 2024, said Jessica Holstein, a spokesperson for the DHHR, in an email.

The news of Robertson’s retirement comes after attorneys who brought the class action lawsuit announced in October that they were filing for sanctions, because the DHHR had failed to preserve about three years of requested emails.

Robertson gave a deposition on Nov. 21, 2023, stating that she had been General Counsel at the DHHR since May of 2019, the duration of the pendency of the class action litigation.

The lawyer questioning Robertson, J. Alexander Meade of Shaffer & Shaffer PLC, asked her if the General Counsel’s office had followed up with the Office of Technology to ensure that the electronically stored information of the named defendants or individuals within the matter was being preserved. 

She responded that she did not follow up, and when asked why, she said, “I had no reason to assume that there would be any problem.” She later testified she had never needed to follow up on a litigation hold with the Office of Technology.

Robertson testified that she submitted the litigation hold in December 2019 via email. She said she received signed acknowledgments from the individuals who were subject to the litigation hold, but not from the Office of Technology.

“I can’t speak to what they may read or not read in their inboxes,” Robertson said in her deposition.

Meade asked Robertson about the purpose of the acknowledgment form if no signed acknowledgment was received from the Office of Technology.

“The purpose in my mind is primarily to make sure our DHHR folks are seeing it and making sure that they understand,” Robertson said.

Robertson also testified that, before September 2023, she was not aware of the Office of Technology’s policy regarding the deletion or purging of electronically stored information about staff who had separated from state employment.

“What we have learned is it seems that there’s a great deal of either incredible carelessness or willful destruction of documents,” said Marcia Robinson Lowry, the lead plaintiff for the class and executive director of A Better Childhood (ABC).. “It’s very unclear what’s happening.”

In an affidavit, Michael Folio, legal director of Disability Rights of West Virginia (DRWV) and a previous attorney at the DHHR, testified that officials at the agency, namely Robertson and previous DHHR Secretary Bill Crouch, knew about policies surrounding preserving documents.

“Well, I had conversations with each of April Robertson and Bill Crouch, that arose as a result of an employee’s emails not having been preserved who was going to be a witness in a pending civil action,” Folio said. “And I raised the issue at that time about the spoilation of evidence. And this was wholly unrelated to the foster care lawsuits.”

Lowry said in a lawsuit similar to this one, she has to show that not only were the children’s constitutional rights violated, but that it was done with deliberate indifference to the children’s rights.

“The way you usually do it is by getting emails from the key players,” Lowry said. “And showing that there’s a pattern of saying that they knew about it, they knew about the harm being put on children, etc. Because people don’t admit it.”

However, in this case, the emails and the evidence they contained have not been turned over to the Plaintiffs.

Lowry said the loss of that information brought her to ask the judge for sanctions against the DHHR.

“There seems to be some sort of a pattern here with the state, not just not keeping information that’s necessary to prove your case,” Lowry said. “And the rule is that if they have done it willfully, then there are influences that can be made in the plaintiff’s favor.”

Lowry called the case highly unusual and said defendants know that when they are being sued, or even about to be sued, they have to maintain documentation.

“Whether they didn’t do it because they were incompetent or willful or just happened, we don’t know,” Lowry said. “But we do think it’s a very serious issue, and it’s never happened in another case that I’ve been involved in.”

Lowry said settlement discussions were had years ago, at the beginning of the lawsuit in 2019, but that they were “not fruitful conversations,” so she decided to proceed to a trial. She said one of the best things about settlement is being able to discuss with defendants the best ways of fixing the system.

“We’re still fighting about whether the system violates the Constitution, and we think it clearly is, it’s got to be one of the very worst systems in the country,” Lowry said.

When asked whether the division of the original DHHR into three separate departments would have an impact on the case, Lowry said only if the new secretaries presented concrete plans for improvement.

“If they were to say that, we would be very, very happy to talk to them,” Lowry said. “But that’s not happened, and that doesn’t mean it won’t happen.”

Folio said the splitting of the DHHR into three agencies is a bold and symbolic gesture.

“To me, the split is not just coming up with a new organizational chart,” Folio said. “The split requires a cultural change. It requires a change of individuals in leadership who manage the day-to-day affairs, and admittedly, there are three new secretaries, but the people under them, by and large, are still the same individuals who were there that resulted in the criticism by the legislature that resulted in the split of DHHR into the three agencies.”

The trial date has recently been moved from June to September because the defendants have not produced the information the plaintiffs are seeking. The court has ordered them to give the plaintiff’s more information by the end of January.

“They haven’t given it to us yet,” Lowry said. “It’s not due till the end of this month. It is a real system in total disarray and children, but the bottom line here is his lives are being damaged by how poorly the system is run.”

All parties will go before a magistrate judge who will hear arguments on sanctions on Jan. 17, 2024.

Abuse And Neglect

Plaintiffs cite federal data and reports in claims that in 2017, the rate of child deaths related to abuse and neglect per 100,000 children in West Virginia was more than double the national average and allege the rate of child victims of maltreatment was double the national average.

Nationally, during the Federal Fiscal Year (FFY) 2017, an estimated 1,720 children died due to abuse or neglect. The overall rate of child fatalities was 2.32 deaths per 100,000 children in the national population.

This claim appears to be verified by a 2019 Bureau for Children and Families Critical Incident Report, citing the annual Child Maltreatment Report produced by the U.S. Department of Health and Human Services, Administration for Children and Families (ACF), in which West Virginia has a higher recorded rate of deaths per 100,000 children than the national average for eight of the 12 years studied.

That same audit found that information on child fatalities in West Virginia is “not well documented, hindering the ability to determine the state’s needs for training, policy or field improvements that could reduce future child fatalities and near fatalities.”

Plaintiffs also allege the rate of child abuse and neglect investigations or assessments was more than triple the national average and near fatalities of children known to DHHR due to abuse or neglect rose by more than 20 percent per year between 2014 and 2018.

According to the same report from the Bureau for Children and Families, in FFY 2015, seven children were seriously injured due to abuse and neglect known to the bureau. This is an increase of two children from FFY 2014 to FFY 2015. 

In FFY 2016, nine children were seriously injured due to abuse and or neglect known to the bureau. FFY 2017 saw the first and only recent decrease in critical incidents with two children seriously injured due to abuse and neglect known to the bureau.

This is a decrease from all previous years of the critical incident review for near-fatal incidents.  

In FFY 2018, there were five children who were seriously injured due to abuse and neglect known to the bureau. In FFY 2019, there were eight children who were seriously injured due to abuse and neglect known to the agency. 

According to findings from the Child Welfare League of America, in 2020 West Virginia had 37,695 total referrals for child abuse and neglect. Of those, 26,572 were referred for investigation.

According to the U.S. Department of Health and Human Services, there were 6,116 child victims of abuse or neglect in West Virginia in 2020, at a rate of 17 children per 1,000.

Influx Of Children Entering The System

According to the plaintiffs, the number of youth entering the West Virginia foster care system has skyrocketed in recent years. They say in court filings that, “Between 2013 and 2017, the foster care population swelled by 67 percent — substantially higher than the national average increase of 11 percent during the same three years. A variety of factors played a role in causing this spike. For one, the opioid crisis disproportionately affected West Virginia, the 47th poorest state in the nation.”

West Virginia suffers from the highest age-adjusted rate of drug overdose deaths involving opioids in the nation. Plaintiffs claim caregiver addiction and deaths stemming from substance use disorder have driven more children into the system.

As of 2017, West Virginia had the highest rate of foster care entries for youth ages 14 to 17, at 14.2 per 1,000 children, as compared to the national average of 2.8 per 1,000 children.

The plaintiffs argue that the defendants fail to maintain an adequate number of appropriate placements for youth entering foster care in West Virginia. They allege that, as a result, the DHHR placed children in homes that have not been sufficiently vetted, supported or monitored to ensure children’s safety and well-being while in those homes, or institutionalizing them.

Plaintiffs argue that the DHHR increased their reliance upon kinship caregivers by more than 30 percentage points over the last five years. 

They also argue that in West Virginia, a disproportionate number of adolescents in foster care are sent to residential facilities, citing that 71 percent of youth between the ages of 12 and 17 are institutionalized in West Virginia, and in out-of-state facilities. 

Court filings claim that “as of June 2019, DHHR placed 327 foster children in out-of-state institutions. In-state, DHHR placed 588 youth in residential care and 83 in psychiatric facilities.”

In September 2023, there were 6,298 children in West Virginia state care and 31.79 percent of those children were between the ages of 13 and 17 years old. That means slightly more than 2,000 of them are teens.

According to West Virginia’s Child Welfare Dashboard, there are currently 488 West Virginia children in state-group residential care and 256 in out-of-state group residential care.

In an email response, Whitney Wetzel, a spokesperson for the West Virginia Department of Human Services (DoHS), formerly a part of the DHHR, said that DoHS continues to expand West Virginia’s children’s mental health system, “to ensure that children can receive appropriate mental health and social services in their homes, schools and communities through home and community-based services including West Virginia Wraparound and Children’s Mobile Crisis Response and Stabilization.”

“DoHS has implemented several initiatives including the Resource Rundown webinar to educate parents and caregivers about the Pathway to Children’s Mental Health Services (Assessment Pathway) to streamline access to mental and behavioral health services for children and families while quickly connecting them with a Wraparound Facilitator to help children and families navigate the process,” Wetzel said in an email.

Recently, DoHS published its semi-annual report outlining the expansion of children’s mental health system.

Staffing Shortages

Plaintiffs argue that West Virginia’s child welfare system is fraught with significant administrative problems that hinder its ability to operate effectively.

During the 2023 West Virginia Legislative Session, state lawmakers voted to divide the DHHR into three separate departments to increase transparency and improve outcomes in foster care. The new departments went into effect on Jan. 1.

There is now a Department of Human Services for programs like Child Protective Services, a Department of Health (DoH) and a Department of Health Facilities for facilities like state-run hospitals. Each agency has its own secretary to lead each agency.

In August 2023, Commissioner of the Bureau for Social Services Jeffrey Pack provided updates on hiring and retention initiatives in the department.

He said the bureau’s vacancy rate has been reduced from 31 percent in January to 19 percent as of June 2023.

Pack credits this reduction with pay increases for those who work multiple years of service in the department.

Another retention tool the department is using is trauma response for Child Protective Service (CPS) workers.

However, the 2019 lawsuit alleges that West Virginia fails to employ and retain a sufficient number of appropriately trained caseworkers and fills vacancies with unqualified applicants.

In an email response, Wetzel said the DoHS is committed to improving West Virginia’s child welfare system and children’s mental health system. 

“Last year, with the assistance of the governor, DoHS markedly increased the salaries for all child welfare workers and provided additional positions to help support child welfare workers,” Wetzel said in an email. “DoHS’s Bureau for Social Services (BSS) implemented ChildStat, an accountability tool used by senior leadership to monitor and track progress on key performance indicators of child welfare.”

DHHR Officially Split Into Three Departments

The West Virginia Department of Health and Human Resources has been split into three separate departments following the passage of a bill to split the agency passed last year.

The West Virginia Department of Health and Human Resources has been split into three separate departments following the passage of a bill to split the agency last year. 

The DHHR has long been troubled but has come under fire in recent years for staffing shortages and other problems, compromising the care provided to children in the foster care system or those living in state hospitals.

Following an investigation and the filing of a class action lawsuit, in 2023, the Legislature decided to split up the agency. House Bill 2006 was signed into law by Gov. Jim Justice on March 6, 2023.

These departments are the Department of Human Services, run by Secretary Cynthia Persily, the Department of Health, run by Secretary Dr. Sherri Young, and the Department of Health Facilities, run by Secretary Michael Caruso.

Gov. Jim Justice congratulated the new secretaries and expressed hope for positive change in the agencies.

“Now, it is three differences in three different secretaries, three different departments,” Justice said. “With all that being said, we want to, we want to welcome the change, we want to hope, like crazy that this makes things better.”

Justice also noted how much money flows through the agency, more than twice the amount of the entire state’s annual budget. 

“There’s so much money that’s flowing in and out of DHHR,” Justice said. “It’s unbelievable. And therefore, maybe this will just make us better.”

For fiscal year 2024, the DHHR presented a budget of more than $7.5 billion, with 75 percent of that being federal funding.

The legislature attempted to split the agency up in 2022, but that bill was vetoed by Justice.

The bill takes effect in May, but the new departments were required to be in place by Jan. 1, 2024.

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

W.Va. Democrats Ask For Investigation Of CPS

In response to the DHHR’s inability to produce Child Protective Service travel records, the West Virginia Democratic Party has asked for an investigation into the department.

On Tuesday, the West Virginia Democratic Party (WVDP) Chair Mike Pushkin, D-Kanawha issued a letter to Gov. Jim Justice, urging him to launch an immediate and thorough investigation into the West Virginia Department of Health and Human Resources (DHHR) handling of a particular child neglect case.

Earlier reporting by Eyewitness News revealed two children were found living in “devastating conditions” in a shed, with minimal facilities and inadequate care, leading to felony child neglect charges against Donald Ray Lantz and Jeanne Kay Whitefeather.

A recent Freedom of Information Act request by West Virginia Watch indicates that no travel records exist from Child Protective Service (CPS) workers confirming that they never visited the home despite multiple complaints from neighbors about the well-being of the children.

“The neighbors in this close-knit community out in Sissonville, the neighbors had been repeatedly calling CPS and at least we don’t see any kind of evidence that CPS responded to that,” Pushkin said. “To me, that’s very troubling and that warrants an investigation.”

In the letter, the WVDP states that they believe this CPS case is not an isolated incident but a symptom of a larger systematic issue within the state’s child welfare system.

“They can’t produce any documents to show that they actually responded, which would lead us to believe that they did not respond to these calls,” Pushkin said. “Is this an isolated incident? Or is this more part of just a culture of complacency or competency over there? And if so, is it possibly due to staffing shortages?”

Pushkin noted Justice’s “flat budget” as a possible reason behind CPS understaffing and shortcomings.

“Now the legislature and the governor can pat each other on the back for passing flat budgets and creating these artificial surpluses over the years,” Pushkin said. “But what does that really mean? It very well could possibly mean that we aren’t meeting essential services that need to be provided to the state, very least of which, would be taking care of children in the state’s custody. If we can’t do that, what can the state government do?”

Ongoing Litigation

DHHR employees and Justice are defendants in an ongoing class action lawsuit, originally filed in 2019, that alleged the state had violated the constitutional rights of more than 6,000 kids in the state foster system. 

Allegations include the state failing to protect children, overburdened CPS workers, and leaving kids to languish in the system without any permanency plan.

Plaintiffs in the suit, A Better Childhood, a New York-based nonprofit, along with Shafer and Shafer and Disability Rights West Virginia, recently asked for sanctions in the case due to lack of evidence retention from the defendants.

The motion accuses the DHHR of “deliberate indifference” to due process claims brought by the attorneys representing foster children against DHHR.

Justice’s chief of staff, Brian Abraham, said in October, that the emails were deleted because of the Office of Technology’s protocol to delete the emails of employees who’d left their positions with the state.

“This administration was unaware that there was a policy in place at the Office of Technology to delete the emails of employees who left employment with the state of West Virginia,” Abraham said. “So there’s no basis whatsoever for any allegation that emails were intentionally deleted from any agency.”

Abraham added that the administration was not sure when the policy began or who enacted it, but said they are investigating this state-wide policy.

Marcia Robinson Lowry,the lead plaintiff in the case, said the defendants knew the emails she sought were evidence in the case.

“We don’t know whether anybody destroyed them willfully, or whether it was just more questions of competence and thoroughness on the part of the state, the state runs right now a very, very dysfunctional child welfare system,” Lowry said.

Dividing the DHHR

During the 2023 Legislative Session state lawmakers voted to divide the DHHR into three separate departments to increase transparency and improve outcomes in foster care. The new departments go into effect on Jan. 1.

There will now be a Department of Human Services for programs like Child Protective Services, a Department of Health and a Department of Health Facilities for facilities like state-run hospitals. Each agency will also have its own secretary to lead the agency.

The new secretaries are Dr. Sherri Young, incoming secretary of the Department of Health, Dr. Cynthia Persily, incoming secretary of the Department of Human Services and Michael Caruso, incoming secretary of the Department of Health Facilities.

Pushkin voted in favor of splitting the department but has voiced concerns about the efficacy of the split in improving health outcomes for West Virginia.

“Well, you know why I voted to split up the DHHR to three separate departments have often said, unless we really address the culture there,” Pushkin said. “Instead of having just one large dysfunctional department, we’re going to wind up with quite possibly three, slightly smaller, dysfunctional departments, until we really start prioritizing what’s important.”

More Than Half Of DHHR’s Workforce Eligible For Retirement By 2029

A health committee Sunday heard reports from state officials that more than half of the Department of Health and Human Resources workforce will be eligible for retirement by 2029.

A health committee Sunday heard reports from state officials that more than half of the Department of Health and Human Resources workforce will be eligible for retirement by 2029. 

Dr. Sherri Young, interim secretary of Health and Human Resources, and incoming secretary of the Department of Health presented an update on the transition of the Department to the Legislative Oversight Commission on Health and Human Resources Accountability.

She said while hiring initiatives have taken place and vacancies have been filled, more than 50 percent of the DHHR’s workforce will be eligible for retirement by 2029.

“Imagine five years from now 53 percent of those people retiring and going home,” Young told the committee. “You’re going to lose the institutional knowledge of the folks or nurses that have been there for 40 years. You’re going to lose that institutional knowledge of programs and how to make things work.” 

She said it is important to build efficient systems during the restructuring of the department to avoid delays when that workforce retires.

“So we owe it to our citizens of West Virginia to make sure that we get the most efficient programs, but then we are backfilling and making sure that we are getting young folks and West Virginia folks in there to serve these programs now, because we have that additional vulnerability later on,” Young said.

Del. Bob Fehrenbacher, R-Wood, asked Young to survey the workforce to find out who will retire when they are eligible and who will stay on past retirement age.

“In my experience yes, there’s a day with experience and age that happened, but then workers may stay around longer,” Ferenbacher said. “And so to kind of understand when they’re eligible versus when they currently leave, I think would be interesting to kind of incorporate that into your you will attrition and planning and higher up in that regard.”

Young replied that while that survey could be useful, the retirement eligibility of the workforce is still a weakness in the system, one she hopes to remedy with planning.

“It’s not a bad question to go ahead and ask folks upon retirement eligibility, ‘Do you plan to stay?’ It’s our goal to make that a place where people want to stay,” Young said.

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