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.”

Lawsuit Against W.Va. Foster Care Gains Forward Momentum

The court found that the plaintiffs “demonstrated that DHHR maintains an inadequate array of placements to meet the needs of these foster children.”

Updated: 6:45 p.m. August 18, 2023.

A federal district court in West Virginia on Thursday certified the foster care case, Jonathan R. v. Justice, as a class action, allowing it to proceed on behalf of all of the children in foster care in the state.

According to the West Virginia Department of Health and Human Resources (DHHR) Child Welfare Dashboard, on August 18, 2023, there are 6,298 children in state care. 

Legislation passed earlier this year directed the DHHR to separate after years of turmoil within the agency. House Bill 2006 terminates the DHHR beginning Jan. 1, 2024 and creates three departments: the Department of Human Services, the Department of Health and the Department of Health Facilities. The bill was signed into law on March 4.

The DHHR oversees the state’s child welfare system, under the Department of Human Services and Bureau for Social Services.

The lawsuit against the DHHR was originally filed in September 2019. The original complaint against West Virginia officials alleged that they violated the rights of a dozen foster care children.

Marcia Robinson Lowry is the lead plaintiff for the class and executive director of A Better Childhood (“ABC”). ABC is counsel for the children, along with Shaffer & Shaffer, a West Virginia law firm and the non-profit organization Disability Rights of West Virginia.

“This is a careful, thoughtful decision, which will allow us to fully represent all these children

and finally prove that the state’s foster care system exposes children to the unreasonable risk of

serious harm, which the Constitution bars the state from inflicting on children,” Lowry said.

The group filed a complaint in federal court in October 2019, denouncing the Department of Health and Human Resource’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.

Lawyers from Shaffer and Shaffer, ABC and Disability Rights of West Virginia had to make an initial showing that they could prove their initial claims against the agency.

The court found that the plaintiffs “demonstrated that DHHR maintains an inadequate array of placements to meet the needs of these foster children.”

The court stated in its decision: “Plaintiffs paint a grim picture of a deeply flawed system that inflicts on vulnerable children much of the same abuse and neglect that it was designed to redress.”

The court also found that DHHR “contrary to its own stated policies fails to include families in the case planning process and engage in permanency planning for children.”

The court concluded that the plaintiffs had sufficient evidence of high caseloads and chronic understaffing and found that plaintiffs had shown these were long-standing problems.

“We will be moving forward to now present evidence of the state’s long-term neglect of these children, and how they have been seriously damaged by the state’s foster care system,” said Lowry. “The state is supposed to protect, not further harm, these vulnerable children. Instead, this system has ignored these children for far too long. It is time that the state is finally held accountable.”

Response from the West Virginia Department of Health and Human Resources

The West Virginia Department of Health and Human Resources (DHHR) is committed to improving 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, efficiently and effectively through home and community-based services including West Virginia Wraparound, Children’s Mobile Crisis Response and Stabilization, Stabilization and Treatment Homes, Behavioral Support Services, Assertive Community Treatment, and Mental Health Screening.

DHHR has implemented several initiatives including the Resource Rundown webinar to educate foster parents and the public about available services; 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; and ChildStat, an accountability tool used by senior leadership of DHHR’s Bureau for Social Services to monitor and track progress on key performance indicators.

DHHR also developed an informal Youth Advisory Council whereby senior leadership of the Bureau for Social Services meet regularly with children aging out of shelters to hear their concerns on how the child welfare system impacted their life and suggestions to improve it, implemented an email reporting system for mandated reporters in the education field to report suspected abuse and/or neglect, and launched the Children’s Crisis and Referral Line to connect families to services including Children’s Mobile Crisis Response and Stabilization teams, which de-escalate behavioral health crises by phone or in person, and West Virginia Wraparound, which includes the Children with Serious Emotional Disorder Waiver.

As of July 31, 2023, the vacancy rate for child protective services workers is 17 percent. DHHR recently published its semi-annual report outlining the expansion of children’s mental health system.

Disability Community Advocates At The Capitol

Wednesday was Jan Lilly-Stewart Disability Advocacy Day at the West Virginia Capitol, providing an opportunity for the disability community to come together and let their voices be heard.

Wednesday was Jan Lilly-Stewart Disability Advocacy Day at the West Virginia Capitol, providing an opportunity for the disability community to come together and let their voices be heard.

Paul Smith is the director of the Fair Shake Network, a grassroots organization of West Virginians dedicated to educating the public on issues that affect people with disabilities.

Smith said Wednesday was the culmination of a two day event to empower people with disabilities to advocate for themselves at the West Virginia Legislature, particularly around funding.

“Of course funding, the last three years the governor’s budget has been a flat budget, and we love that things don’t get cut,” he said. “But in reality, with inflation and such, it’s really a cut, especially over a three year period.”

Smith said it’s a constant fight for people with disabilities to make sure their rights don’t get cut or shortened, and it’s important to keep their issues at the forefront of legislators’ minds.

Christy Black is the advocacy specialist at the West Virginia Developmental Disabilities Council.

She said advocacy days are important to give legislators perspective.

“I’m also a parent of a child with developmental disabilities,” Black said. “Unless you live it, it’s sometimes hard to understand the challenges that people face, or things that we need or how some things may affect people with developmental disabilities differently than someone that doesn’t have a disability.”

Both Smith and Black said they will be following House Bill 2505 closely. The bill would introduce the option for West Virginians with developmental disabilities to make their own decisions with help from trusted individuals as an additional option to guardianships.

The Senate approved Resolution 9, designating Jan. 18, 2023 as Jan Lilly-Stewart Disability Advocacy Day.

Advocate Brings Transparency Concerns About Treatment Of People With Disabilities To Lawmakers

The state health department is attempting to conceal information about the treatment of people with disabilities who are in state care, according to an attorney with Disability Rights West Virginia.

The state health department is attempting to conceal information about the treatment of people with disabilities who are in state care, according to an attorney with Disability Rights West Virginia (DRWV).

Mike Folio, attorney for DRWV, told state lawmakers Tuesday that this year his organization made 80 visits to William R. Sharpe Hospital, a state-run psychiatric facility in Weston. Under federal law, DRWV monitors the treatment of West Virginians with disabilities in facilities run by the West Virginia Department of Health and Human Resources (DHHR).

“Last Tuesday, two of my advocates and I … met with Sharpe Hospital employees, who I would call our informants. They shared with us disconcerting information that they were told by (DHHR) leadership not to talk to DRWV,” Folio told lawmakers in the Joint Health Committee.

“As we dig into this, we see a pattern, a practice, a habit, a custom of concealing information,” he continued. “That violates federal law.”

Folio said what’s going on at Sharpe Hospital is “an abysmal failure.” In contrast, he noted that DHHR is doing well with patients at the state-run Mildred Mitchell Bateman psychiatric hospital in Huntington.

DHHR Cabinet Secretary Bill Crouch was given the opportunity to rebut Folio’s comments in front of lawmakers. He called for an investigation of his agency and into DRWV’s practices and said DHHR does its own investigations of its state-run hospitals. The state Office of Health Facility Licensure and Certification, which is under DHHR, also conducts facility investigations.

“The implication that we’re covering things up … it is wrong. We take good care of folks,” Crouch said. “We don’t sweep things under the rug. We tell the truth.”

The presentation to lawmakers added to the growing list of issues that have come to light about DHHR’s treatment of people with disabilities who are in their care.

In October, Senate President Craig Blair, R-Berkeley, sent the governor a list of what the lawmaker called abuse under DHHR’s care and issues at Sharpe, and his letter included concerns about DHHR’s transparency about issues. And last month, the U.S. Department of Health and Human Services launched an investigation into DHHR’s alleged discrimination against patients with disabilities by allowing them to be unnecessarily institutionalized. Lawmakers have heard concerns about treatment of patients with disabilities in previous legislative sessions.

Much of Folio’s presentation focused on what he referred to as “patient dumping” or “warehousing patients” by allowing them to remain unnecessarily institutionalized. He said the agency has spent $20.3 million to institutionalize 29 patients this year, which is more than $700,000 a patient.

Crouch has maintained the state does not have enough community placements for people with disabilities.

“We certainly want these people in the right level of care. There’s no intent to keep people in psychiatric care,” he told lawmakers.

Folio is a former attorney for DHHR, and Crouch, in response to the presentation, said that Folio has made DRWV’s investigation a “personal attack” on the agency.

“Mr. Folio says that (DRWV) is not adversarial with DHHR … then he goes on to criticize every aspect of DHHR. Then, he gets personal with our CEO and myself,” Crouch said.

Folio told lawmakers, “We are not here as an adversary of DHHR. We are here as an ally of the disabled persons who have no voice.”

DHHR has currently instated a hiring freeze as it is undergoing an internal restructuring in an effort to improve agency outcomes. The changes following the $1 million review from the McChrystal Group, which said the agency was in need of “bold changes.” Lawmakers have criticized the report for its lack of substance amid the state’s poor health outcomes.

New Federal Investigation Targets DHHR’s Treatment Of People With Disabilities

The federal government has launched a civil rights investigation into the West Virginia Department of Human Resources’ treatment of persons with disabilities who are in the state agency’s care.

The federal government has launched a civil rights investigation into the West Virginia Department of Human Resources’ treatment of persons with disabilities who are in the state agency’s care.

In a Nov. 14 letter, the U.S. Department of Health and Human Resources Office for Civil Rights said the investigation was based on a complaint filed by Disability Rights West Virginia (DRWV). Under federal law, the organization monitors the treatment of people with disabilities in the state’s facilities.

The investigation centers on DRWV’s complaint that DHHR allegedly unlawfully discriminated against people with intellectual and developmental disabilities by not providing appropriate services that could have prevented institutionalization.

“In the complaint, (DRWV) alleges that DHHR fails to administer services, programs and activities in the most integrated setting appropriate to meet the needs of qualified individuals with disabilities,” the letter stated.

The Office for Civil Rights said patients are “now needlessly segregated in state- operated hospitals.”

Under state law, DHHR is responsible for persons with disabilities who are in state-run facilities.

DHHR Cabinet Secretary Bill Crouch said Monday during the governor’s virtual briefing that the agency is cooperating with the investigation. He said the state struggles to have “adequate placements” for people with disabilities in community settings.

“I’ve talked for several years now about trying to make sure we have adequate placements for individuals in our psychiatric hospitals,” Crouch said. “I’ve said numerous times on this call and before the legislature that no one should live in a psychiatric hospital that shouldn’t have to. We’re looking at making sure we can move folks to an appropriate level of care.”

In response to the federal probe, DHHR spokeswoman Allison Adler said in an email, “The DHHR does not tolerate discrimination of any kind, and works diligently to prevent discrimination from occurring in any service, program or activity which is administered by the agency.”

West Virginia Public Broadcasting reported last month that Senate President Craig Blair, R-Berkeley, had asked Gov. Jim Justice to launch an independent investigation into DHHR’s treatment of people with disabilities.

Blair’s letter cited multiple examples of what he called abuse under DHHR’s watch, including people with disabilities being strangled, being forced to use the bathroom outside and dying from inappropriate nutrition. Blair included concerns about DHHR’s transparency about its oversight of persons with disabilities, as well.

Blair’s letter also cited concerns about DHHR’s oversight of Sharpe Hospital, a psychiatric facility in Weston, and DRWV is currently investigating DHHR’s oversight of Sharpe Hospital. After the WVPB story published, Crouch defended his agency, saying, “We don’t have any tolerance with regard to patient abuse.”

Crouch told lawmakers in November that the investigation and emails by DRWV attorney Mike Folio, a former DHHR attorney, into DHHR’s practices was “bordering on harassment.”

DHHR, which operates with a $7.5 billion budget, is currently undergoing an internal restructuring in an effort to improve its communication and overall outcomes. The agency also instituted a hiring freeze.

The changes follow a $1 million outside review of the agency, which said it needed to improve its communication as the state is performing poorly in many health outcomes. Lawmakers criticized the review, performed by the McChrystal Group, for its lack of substance.

Reports Show People With Disabilities Are Abused In State Care

In a letter to Gov. Jim Justice, Senate leaders outlined abuse suffered by people with disabilities who are under the care of the West Virginia Department of Health and Human Resources.

People with disabilities are being abused in state-run facilities, and lawmakers want answers from the state health department.

In a letter to Gov. Jim Justice, Senate leaders outlined abuse suffered by people with disabilities who are by law under the care of the West Virginia Department of Health and Human Resources. There were reports of people with disabilities being strangled, being forced to use the bathroom outside and dying from inappropriate nutrition. Even worse, they said there were efforts to cover it up.

The lawmakers, led by Senate President Craig Blair, said there is probable cause to believe DHHR is aware of patient mistreatment and abuse, and that the department is also aware of ongoing critical staffing issues and patient mistreatment at a state-run psychiatric facility.

The letter, dated Oct. 14, included examples of what lawmakers said was abuse under DHHR’s watch: In 2018, an Ohio County man with an intellectual disability died after three staff responsible for his care refused to provide CPR; in 2020, a woman from Cabell County with a disability died after being fed an improper diet then staff attempted to cover up their role in the death; and last year, a group home for people with disabilities had broken plumbing and staff forced them to use the bathroom in the backyard for months.

DHHR did not provide an interview for this story, but in an email, DHHR spokeswoman Allison Adler said there were significant inaccuracies and errors in the information but did not respond to the letter’s content. She pointed to the fact that the hospital is still certified to serve Medicare patients.

Jeremiah Samples, Senior Advisor to the Joint Committee on Government and Finance, worked with Blair on the letter. He was second in command over DHHR from 2017 until earlier this year when Samples lost his job over what he said was a difference in opinions among leadership about how to fix the agency’s major problems.

“DHHR is not being transparent with them about what’s occurring in these facilities,” Samples said. “As the Senate President said in his letter, this raises the importance of an independent investigation to find out what’s going on here. And, why do these issues – where disabled West Virginians are abused – why do these issues continue to come up year after year?”

Last year, lawmakers were notified of treatment of people in state-run psychiatric facilities through a DHHR report.

Lawmakers who signed the October letter called on Justice to launch the investigation. The governor has not responded to their letter and his administration did not return our request for an interview.

Disability Rights West Virginia (DRWV) told lawmakers about the ongoing mistreatment of persons with disabilities who are under the state’s care. Under federal law, Disability Rights WV monitors the state’s facilities and schools.

“The manner to which the legislature has been alerted to these issues is very troubling, especially given the immensity and gravity of the information shared by DRWV,” Blair wrote in the letter.

DRWV’s legal director, Mike Folio, said the lack of transparency at DHHR has been an ongoing issue.

Since I started here, I learned that DRWV has sent letters to (DHHR) Secretary Crouch and his general counsel, April Robertson, back in 2020, and to date have not received a response. There is a pattern of unresponsiveness, non-responsiveness by DHHR,” Folio said.

Adler refuted this claim.

“We are unaware of any emails that were not responded to or that are not currently in the process of having responses prepared,” she said.

Folio added that a DHHR employee contacted them confidentially and said they were instructed to not provide information to the organization.

“That’s against the law,” Folio said.

Adler acknowledged the statement happened and she said its purpose was not to withhold information but rather to ensure that communication was accurate before being sent to DRWV.

Ongoing issues at state-run psychiatric hospital 

DRWV is currently investigating DHHR’s oversight of William R. Sharpe Hospital, a psychiatric facility in Weston run by DHHR.

The facility has a troubled past. In 2017, the federal Centers for Medicare and Medicaid Services found the hospital had been providing inadequate treatment to patients, and CMS ultimately revoked the hospital’s ability to bill Medicaid or Medicare for services. It was reinstated in 2019.

Last year, a health service worker at the hospital was charged with strangling a patient. Four more workers were fired over allegations that they participated in patient abuse or watched it happen. DHHR recorded the abuse in its own inspection, and its records indicated broader abuse at the facility.

Folio sent a letter in October to Sharpe Hospital’s CEO saying an overload of patients created an unsafe environment for patients and staff. This led to patient abuse and neglect, Folio said, which violated federal laws that protect individuals with mental illness.

“We have received information from informants at Sharpe where patients have been abused …that there has been retaliation taken by certain members of Sharpe membership toward patients, and these have all occurred after August,” Folio said. “We are continuing to investigate.”

Adler in an email pointed to federal and state regulations that require hospitals ensure patients the right to receive care in a safe setting and their right to be free from all forms of abuse or harassment in response to our inquiry if patients Sharpe were being abused or mistreated.

Sharpe Hospital CEO Patrick Ryan did not respond to a request for an interview.

In July, lawmakers focused on Sharpe Hospital during a meeting of the Legislative Oversight Committee on Health and Human Resources Accountability. They questioned why DHHR and Sharpe leaders were failing to comply with state laws regarding patient treatment and documentation.

Lawmakers asked DHHR Cabinet Secretary Bill Crouch how involved he was with the hospital.

“We have biweekly meetings where we talk with all of the hospital administrators in terms of their functioning,” Crouch replied to lawmakers. “I’m involved with regard to the activities of Sharpe and what happens at Sharpe.”

Folio stressed there are staff members at Sharpe and at DHHR caring for patients, and they are raising the alarm that they’re concerned about a lack of training and accountability.

“We’ve had a couple individuals who I’ll call our informants who are fearful of retaliation – that if they report issues that need to be addressed because it’s in the best interest of the patient, they’re fearful they’ll be retaliated against by leadership,” Folio said. “That’s not how this system is supposed to work.”

If you are a family member or legal guardian of a person with a disability who has been under DHHR care or at Shape Hospital, or if you are a person with a disability who is able to share your experience under DHHR care, we would like to hear from you about your experience for our reporting. Email reporter Amelia Knisely at aknisely@wvpublic.org.

Exit mobile version