Like most parents, foster caregivers are struggling with the strain of the pandemic.
To help, in April, May and July, Gov. Justice and the state Department of Health and Human Resources provided three separate payments — totaling about $100 per foster child — to foster families. The funding came from the CARES Act, which Congress passed in March. Some lower income families received additional support.
Marissa Sanders, who runs the Foster, Adoptive and Kinship Parents Network, said many families are worried about continuing to care for their foster children. “Families are faced with income challenges or child care and work challenges.”
Sanders said foster parents are also concerned about their family’s health. She says it isn’t clear if foster parents will be able to make the decision, for example, to do virtual school. “It takes a lot of the decision-making for in terms of my family’s safety out of [their] hands. So I worry that we’ll see people get frustrated with that. Or say ‘I have to work and I can’t get childcare.’”
A spokesperson with the DHHR said the agency is committed to getting foster families the support and resources they need. As a result of legislation passed earlier this year, the state increased rates for certified foster parents from $19.73 per day to $26 a day.
During the pandemic, there have been fewer referrals for investigations of child abuse or neglect, compared to 2019. Last year, from March-May, there were 11,499 referrals, according to data obtained by West Virginia Public Broadcasting from the DHHR. This year, during those same months, there were 6,991 referrals.
It’s not yet clear if cases of abuse are going underreported because children are out of school and not being seen by teachers, or how the return to school this fall may affect the state’s already overwhelmed foster care system.
I knew I would be a father someday. I just assumed it would happen the normal way. My wife Whitney had other ideas. She suggested that, instead of going the traditional biological route, we should become foster parents. After some long conversations, she had me onboard, too.
I wrote the following essay for the Father’s Day episode of Inside Appalachia.
Credit Zack Harold
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Zack Harold
Zack Harold takes a walk in the forest with his new daughter.
We began 10 weeks of classes, where we learned all the rules and got advice on how to deal with issues kids in foster care might experience. We started turning our home office into a kid’s room, too. This was tricky since we didn’t know how many kids we’d be getting, what their genders would be, or how old they would be, so we got a set of bunk beds, some gender-neutral bedding, a few toys — and figured we’d sort out the rest later.
After that, we had someone out to our house to do a home inspection. And just like that, the day after Easter 2019, our home was “open,” as they say in the foster care world. By that Wednesday, we got a call to see if we’d take a 5-year-old girl. By Friday night, Whitney and I were parents.
It was a strange thing to have a kid in the house at first. It’s a little bit like getting a roommate who can’t cook her own food, do her own laundry, or reliably groom herself without prompting.
Somehow we figured out how to take care of her and she seemed to enjoy living with us.
I felt a deep responsibility to take care of our little girl, and I liked spending time with her, but there was no spark.
For me, fatherly love came like a slow-rising tide. I was developing a bond; I just didn’t notice it as it was happening. Then I looked at her one day, I think I was following her up a trail in Kanawha State Forest, and realized I felt this brand-new kind of love in my heart — one that wasn’t ever going to go away.
Eventually it became clear our girl wasn’t going anywhere, either. It is a complicated thing, adopting a foster child. A lot of bonds have been broken in their lives for them to become eligible for adoption. The first priority of foster care is to reconnect kids with their biological families. If that fails, the goal is to find a safe, loving forever home for children. A few months after our little girl came to live with us, our foster care agency asked if we’d be willing to adopt her. This time, Whitney and I didn’t have to talk about it. The answer was, without hesitation: “Yes.”
So began months of paperwork and anxious waiting. Until you get your day in court, it feels like a trap door could open, and she could be gone. We’d had that experience before. About six months after welcoming our first foster daughter, a second little girl was placed in our home. Then one day Whitney called me at work. DHHR decided to move her to a biological family member, who would pick her up from school that day.
She lived with us for two weeks. I’d helped her with her homework. I’d fixed her breakfast. I’d hugged her goodnight. She was becoming part of her family. Now I wouldn’t get to say goodbye.
What if that had happened with this little girl, too? Luckily, I didn’t have to find out. Courtrooms are still closed because of the ongoing coronavirus pandemic. But last Thursday, we got our day in court via Skype.
As the hour approached, we all got dressed up. Whitney bought special dresses for the occasion. I put on a tie for the first time in three months. Then I propped my laptop on the coffee table and logged on. There was the judge, the court reporter, our lawyer, and the adoption specialist from Necco, our foster care agency.
The whole thing took about 15 minutes. Our lawyer asked us a few simple questions: Where we live, what is our wedding date, and whether we believed this adoption was in the best interest of our family. And then, it happened.
Throughout the Skype call, our girl had been motionless and expressionless. I worried what was going through her mind, but once it was over, she said she didn’t want to speak up because she didn’t know any of the people on the screen. Fair enough, kid. I think it was a strange experience for all of us.
The rest of the day was a party. The grandparents all came over — and stayed six feet apart, of course. But we ate hotdogs, hamburgers, and sheet cake. Our girl devoured about two dozen chocolate covered strawberries one of Whitney’s aunts made. And while we usually try to watch her sweets intake, we told her all bets were off that day.
After all, we missed out on five years of her life. We’ve got a lot of celebrating to catch up on.
Only eight months after launching West Virginia’s first family treatment court, Boone County Judge William Thompson said the coronavirus pandemic caused some drastic changes to the program.
Family treatment court is a “problem solving court.” Instead of punishing parents in the abuse and neglect system for their addiction, it connects them to treatment options and resources to improve their parenting.
The goal, Thompson said, is to help parents reach recovery and get their kids back. As parents progress through the program, which consists of weekly meetings with himself and daily contact with a county case coordinator, they get more visits with their kids, until they’re ready for reunification.
Boone County had reunited its first family and was almost ready to reunite others, when COVID-19 hit West Virginia, causing the state to end most in-person court hearings and visitations for families with children in foster care.
“We had one young mother today who’s doing wonderful in the program and is at the point to be considered for reunification,” Thompson recalled from one of his weekly meetings, which he now conducts over phone and video conferencing. “And probably, but for the coronavirus, she would have had her child back with her at this point.”
In one meeting, the mother talked about learning her child had crawled for the first time.
“You could tell that for the mother, it was great that the baby crawled,” Thompson said, “but you could also tell it was breaking her heart that she didn’t get to see it.”
Hearing From The First Court
Thompson’s court was the first of five to launch family treatment court in West Virginia.
Advocates for the program say it could reduce the number of children in the state’s overwhelmed foster care system, who often are removed from their homes due to issues related to substance use disorder.
The programs were showing promising results, but now that the coronavirus crisis has restricted in-person gatherings, these five courts and their participants have been forced to adapt quickly. Inpatient treatment options are limited, and most outpatient appointments have moved to telehealth.
“While not perfect, and not ideal, we are doing the best we can in these circumstances,” said Thompson.
Credit Emily Allen / West Virginia Public Broadcasting
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West Virginia Public Broadcasting
West Virginia Public Broadcasting visited the Boone County Courthouse in August, before the first family treatment court in the state was launched.
On March 20, the state Department of Health and Human Resources began advising virtual visits instead of physical visits, for families involved with Child Protective Services. Many parents with children in foster care haven’t been able to see their kids since then.
Some families whose children are in kinship placement, either with a family member or family friend, have been allowed some visits with the court’s permission.
The West Virginia Supreme Court of Appeals issued an order on March 22 declaring a judicial emergency, which halted all nonessential, in-person hearings until May 15. The supreme court issued another order on Wednesday, allowing in-person hearings to resume on or after Monday, May 18.
Parents, Kids Face Digital Divide
In normal circumstances, family treatment court functions best when parents can maintain regular visits with their kids. According to Chautle Haught, who leads family treatment courts for the state supreme court, the strength of this program hinges on developing healthier, more nurturing relationships.
“We require these participants to be involved,” Haught said. “We want them at every doctor’s appointment, every school function. We want them present in their childrens’ lives, as much as they can, as long as there’s no safety concerns.”
She compared family treatment court to other problem-solving programs, like the adult and juvenile drug courts that already are active in West Virginia, helping people avoid incarceration for addiction-related crimes.
“The difference with us is that our courts are involved in the civil proceedings, not the criminal proceedings that your adult drug courts and juvenile drug courts are,” Haught said. Instead of jail or prison time, she said, parents in family treatment court risk losing custody of their children.
Even in a pandemic, Haught said parents have made excellent progress in their recovery from addiction.
With school events and appointments on hold, courts are increasing the number of video visits parents have with kids.
“We’re doing lots of telephone visits, we’ve got some of our foster parents equipped with the same type of technology for Zoom and Skype platforms,” said Judge Thompson in Boone County. “But that’s been by far the most difficult part. I have a participant who’s doing everything they’re supposed to be doing. And I can’t get them the in-person physical visits that they deserve.”
Roane County Judge Anita Harold Ashley, who launched her family treatment court in January, agreed her four participating families struggle the most with not seeing their kids — especially since many Roane County residents have a hard time regularly tuning into video calls, due to unreliable broadband access.
“With the fact that there’s really poor internet service, and most folks have bad cell service, it just breaks my heart if they’re not seeing their kids,” Ashley said.
An Inconvenient Time For A Global Pandemic
These challenges come just as family treatment courts were starting to show some promising results. The supreme court reports there are 50 adults involved in Boone, Nicholas, Ohio, Randolph and Roane counties, with roughly 100 to 150 children between them.
Boone County has 16 adult participants and roughly 25 children involved.
Other, newer courts have said they hope to have the same success. Like Nicholas County, which was the fifth in the state to launch a family treatment court in late February.
Stephanie Smith is the Nicholas County family treatment court case coordinator. Like Boone and Roane counties, she said the Nicholas County program is different now than the one they planned for earlier this year.
“We’ll be excited when we can safely get back to doing things like normal,” Smith said. “But until then, we’re just chugging along and everybody’s hanging in there, making it work right now.”
Smith still conducts home visits with adult participants every week. Sometimes, she brings others from the family treatment court team with her.
“I talk to them [the participants] every day, multiple times a day, phone calls, text, whatever,” Smith said of the parents. “When I went out there, I mean, you could just tell that they really enjoyed that face to face contact … It really made a difference.”
Recovery ‘Difficult Enough’ In Normal Time, Challenging During COVID-19
Most of the resources parents are connected to — namely, those for addiction treatment and parenting skills — have moved online or become remote. Sweat patches that last two weeks have replaced regular drug testing, for example.
When the patches need to be changed in Nicholas County, the participants can visit the local Day Report center, which is still open to those in family treatment court and the criminal justice system, dealing with addiction.
“It’s difficult enough when it’s a normal time, trying to keep people sober and making sure they don’t OD [overdose] or anything like that,” said Nicholas County Day Report Center Director Gary Jarrell.
Individuals reporting to the center who are involved with the criminal justice system check in on Monday, Wednesday and Friday, Jarrell said.
For them and family treatment court participants, the center has a recovery specialist on staff, who holds video meetings every week.
For those who need intensive inpatient care, Haught at the state supreme court said she’s in touch with probation services and their connections throughout the state.
The situation isn’t perfect, but there’s still evidence that families are benefiting from this program, according to Ohio County Family Treatment Court Coordinator Erin Jordan.
“There are some things that may not quite be able to happen,” Jordan said. “But they’re still going through their milestones. Some people have still advanced during all of this.”
Credit Emily Allen / West Virginia Public Broadcasting
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West Virginia Public Broadcasting
Judge William Thompson sits behind his desk in August.
In Boone County, Thompson noted parents are opening up more, and supporting each other in their weekly calls.
“They have sort of formed their own support system where they’ll depend on one another,” Thompson said. “It’s a stressful time, but they understand each other.”
Ohio County has even found a way to make family calls work, Jordan said, using money from grants that went to the five pilot counties, to support participants and provide incentives for their recoveries.
“We’ve ordered books, one for the child, one for the parent,” she said. “That way, with a video chat, the parents can read the book and the child can have the same book in their hands, looking at the pictures at the same time.”
For many children in West Virginia, school is a respite; it’s a place where they get two meals a day and where teachers and counselors keep watchful eyes over them. But schools have been closed for a month and will remain closed for at least another two weeks due to the coronavirus pandemic. The situation has child welfare workers concerned that children in vulnerable situations may be going unnoticed.
Teachers and school counselors are mandatory reporters of suspected child abuse or neglect. Referrals to the state’s Child Protective Services are down. According to the West Virginia Department of Health and Human Resources, referrals were at least 49 percent lower between March 13 and April 13 than during any month over the past year.
Even though the number of referrals has dropped, child advocates are worried that instances of abuse and neglect have not. Rather, with children at home, there are fewer eyes on them. Teachers, school counselors and social workers are getting creative with ways to reach children they used to see regularly.
Cindy Rubenstein is an elementary school counselor in Taylor County. During a normal school week, she would talk to kids going through all sorts of situations from academic struggles to parents getting divorced.
“Not seeing the kids face-to-face, not having access to them all the time, has been a challenge,” said Rubenstein.
Rubenstein has delivered meals to students’ doorsteps on behalf of the school system, and she’s been checking on students over the phone.
“There have been a few that I haven’t been able to get in touch with, which is worrisome,” she said.
After following-up with Child Protective Services, she learned all are OK.
Meanwhile, life goes on for the 7,233 children who are in the state’s foster care system. Agencies that oversee children once they enter the system are trying to help kids cope in new ways. Siblings sent to different placements have been connected through video chats.
“That just brought me to tears, when they were able to see each other over some type of video chat, they were just in tears,” said Michelle Vaughan, director of shelter services for the Children’s Home Society of West Virginia, describing a reunion of sorts between two siblings at different emergency shelters.
Visitations with biological parents are happening over video conferencing, too. Where the technology isn’t available, foster parents are sending photos through the mail.
At an emergency shelter operated by the Children’s Home Society of West Virginia, Delvin Johnson’s responsibilities have grown. He manages the shelter that has 10 beds for children ages 12 and older. All the beds are taken currently, as they usually are, a result of the state’s ongoing battle with the opioid epidemic.
Credit Brittany Patterson / WVPB
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WVPB
Johnson’s days are spent helping kids do school work and trying to keep them active while not being allowed to leave the shelter’s grounds.
“These kids are resilient. They are brave. They’re helping staff. They know what’s going on in the world,” Johnson said.
While referrals to Child Protective Services are down and movement in the foster care system has slowed, there is increased interest in foster parenting. Agencies have moved trainings online and seen enrollment grow. And child welfare workers, who are considered essential workers during the pandemic, continue to help children and families.
Angie Hamilton Thomas is an executive director with Pressley Ridge, which offers youth education, treatment and foster care programs. She’s worried about the stress some already fragile families may be under.
“You know if you think about kids and families being more shut-in, more isolated in a lot of areas, some of the mental health issues and problems that children and families face can be escalated,” Thomas said.
Pressley Ridge is also using video chats and checking-in with clients more frequently than when visits were in-person. They’re looking for signs of distress that would prompt an in-person visit, even during a stay-at-home order and social distancing.
“We would practice the safety precautions, we will practice the CDC guidelines,” Thomas said. “But we would still have an obligation to be responsive to those families.”
04/20/20 9:20 a.m.: This story was modified to better reflect current information on adoptions.
The West Virginia Legislature recently passed a major foster care bill, which provides more resources for foster care parents among other provisions.
This bill is part of ongoing reforms to the state’s overwhelmed child welfare system, as officials work to manage the futures of nearly 7,000 children in state custody. Last year the West Virginia Department of Health and Human Resources announced it had selected Aetna Better Health to help manage health services for foster children.
A managed care model is essentially privatized government services. In most states, including West Virginia, Medicaid is managed through similar private care models.
This shift to a managed care model is a result of House Bill 2010, which was sponsored by Republicans and passed into law last year.
Roxy Todd sat down with two of the managers of Aetna’s new managed care system, Todd White and Kathy Szafran.
***Editor’s Note: The following has been edited for clarity and length.
Todd:There are some concerns that a for-profit companies, such as Aetna, have profits in mind over the welfare of people and children. Here in West Virginia, you know, there’s no denying we have a broken foster care system. How will this shift help address that?
White: Sure. So we’ve been here for over 23 years. What we’re looking to do is not take money from the system and ship it to a for-profit company. In a managed care model, the goal is to shift the care from like an emergency room setting, from an inpatient setting, to more of the preventive services. So you see those utilization numbers go up, with the hope that the emergency room utilization will drop. And so our job is to make the state’s program as efficient as possible, while driving all the healthcare outcomes.
Szafran: And when you look at it from the perspective of where do we start intervening our current foster care system, we’re intervening in a very reactive way. We’re the ones who aren’t getting involved when, you know, children have experienced a lot of adversity. Families are totally falling apart. And the services that many of these kids end up needing tend to be very high-end, expensive services, because of the amount of complications they’ve experienced.
Todd:As you know, there’s current litigation here against the state of West Virginia on behalf of foster care children who allege the DHHR has rampant issues with institutionalization for children, inadequate mental health services, and overextended caseworkers. And meanwhile, we see that in Texas, there’s also been a similar lawsuit. And that state has been embroiled in this litigation for years. And Texas moved to a managed care model in the 1990s, I believe. So how is the shift going to improve the underlying issues that are really affecting our foster care crisis here in the state?
White: So I’ve thought about this a good bit. And so a lot of the issues that we see on the general Medicaid side over the last several years, it’s not an issue with the services that are available, you know, through the benefit structure, it’s really the resources from the provider side and where do we expect to come in and be able to help the program is to take some of the load off of the CPS workers. We’ll have a care coordinator working with the family as well. We’re really hoping to kind of go in and take some of the load off these folks that’s been doing this by themselves for quite some time.
Szafran: Yeah. And I can’t emphasize enough the importance of care managers in the communities, knowing the communities and knowing the families. That’s another very positive part of how I approach this. It will allow the continued development of community resources as the care managers work with the CPS staff, to best serve children, where they’re at, and assisting families. Also, looking at this with a trauma-informed lens, and really understanding the ramifications of trauma and how it affects children and families, short term and long term. I think that is very significant for a managed care organization to adopt this cutting-edge science approach to well-being. I think it’s very critical, and I think that the outcome will be positive for West Virginia.
Todd: You mentioned trauma-informed care. Here in West Virginia we have a shortage of mental health providers that specialize in taking care of children who have a background in trauma. So how do we address this shortage?
Szafran: Oh, that’s the fun part of the job. Part of the training collaborative is going to be connecting and training throughout the state. And one of the beauties of being trauma-informed is more and more people are coming to the table and wanting to learn. There’s a variety of trainings that we can utilize. school systems now are coming and saying we want to become trauma-informed schools, and different health providers. It’s something I’m very, very proud to say that I’ve been part of. It is critical to all of our children and to our families that this is how we see the world, and it’s much more than a training. It’s much more a paradigm shift into how we evaluate, how we work with, and how we deal with each other. So when you said, mental health professionals, trauma-informed care is the bus driver, right? Good trauma-informed care is the lady who works in the cafeteria. Everyone can be trained on how to be sensitive to trauma in the lives of others, so that you don’t have to be a licensed mental health professional. You can be an incredible teacher, you can be an awesome foster parent, and still be very cognizant of what that means to be trauma-informed. So whoever the caregiver is for the child can impact that child and help them heal. If they understand that the behavior that they see is more of a way a child is trying to explain what’s happening, not just a behavioral disruption. So I think that’s really critical that we continue educating and training throughout the state.
West Virginia senators passed a bill from the House of Delegates on Friday, in an attempt to reform various aspects of the state’s overwhelmed foster care system.
House Bill 4092, as voted on by the Senate, sends roughly $16.9 million to the state Department of Health and Human Resources to implement a tiered system of direct payments to foster families and child-placing agencies.
The legislation also formally adds “kinship caregivers” to state code, referring to adults with an established connection to the child they’re fostering. It includes a list of more than 20 rights for foster children and their caregivers, and it increases accountability related to guardians ad litem, or the attorneys who represent foster children in the judicial system.
“It addresses the crisis that we’re currently in, of being woefully short on foster families,” Del. Jeffrey Pack, R-Raleigh, said of the $16.9 million request on Thursday. “The idea behind increasing the imbursement rate was to help recruit more certified foster families in our system.”
Senate Finance Chair Craig Blair, R-Berkeley, told his chamber on Friday that lawmakers received a “revenue adjustment letter” on Thursday for $20 million.
“It gave us the flexibility for what we had in our budget, to be able to do that,” Blair said.
The House version of the bill increased monthly payments to foster families from $600 to $900, per all children, regardless of need and age.
The Senate version of the bill that passed Friday creates a tiered system to “provide higher payments for foster parents providing care to, and child placing agencies providing services to, foster children who have severe emotional, behavioral or intellectual problems or disabilities.”
In committee testimony, the state Department of Health and Human Resources has said the agency would favor a tiered system, because having different tiers would allow them flexibility to better serve older foster children and children with greater needs, who are often harder to place with families and end up in expensive group facilities, out of state or in some instances juvenile detention.
“For some reason, the department has a much easier time placing infants, very young children, than they do placing teenagers,” Judiciary Chair Charles Trump, R-Morgan, said on the Senate floor Friday. “Children who have problems, or special needs, are especially hard to find homes for. So, as a consequence of that, what we’ve got in West Virginia right now is we have a lot of them in institutional environments … and that’s wrong. Any child that could be put in a home and is put in congregate care in some institution, is not being served in the child’s best interest.”
Marissa Sanders, a member of the West Virginia Foster, Adoptive and Kinship Parents Network, said Friday after the Senate’s vote she was pleased with the body’s decision.
“It’s just amazing to see people who have felt like they had no voice, and no real involvement in the process, step up and begin to share their truths,” Sanders said of foster families. “The feeling of being heard by legislators is just absolutely incredible. To look at that bill and see that these things are here because foster families said, “this is what we need,” and they heard us, that’s incredible.”
The bill is going back to the House, where 96 delegates passed an earlier version of the legislation in February. Should the House agree with the Senate’s amendments, the bill goes to Gov. Jim Justice for final approval.
