Randy Yohe Published

W.Va Disability Agency Leaders Say Foster Care Children Suffer From Poor State Discharge Planning

Children and teens in foster care are much more likely to be prescribed antipsychotic drugs.

Leaders with West Virginia’s disability agencies say the state is putting challenged teenagers at risk when they are discharged from the foster care system.

During the April interim sessions, lawmakers on the Legislative Joint Commission on Children and Families heard from several disability leaders.

Susan Given is the executive director for Disability Rights of West Virginia.

Her organization monitors state agencies and protects client rights. She said state agencies have poor discharge planning for children with mental disabilities who age out of the foster care system.

Someone with a developmental disability or a mental illness who has no place else to go ends up in a homeless shelter,” Given said. “That’s a recipe for disaster because they can be very easily taken advantage of.”

How does this happen? Given said the Department of Health and Human Services (DHHR) only offers one option for teens as they’re about to leave a foster home or facility. That is an IDD (intellectual and developmental disability) waiver. The waiver offers an encompassing program that continues to support teens with disabilities, even as they become adults, including services in their home.

But Given said many teens will not qualify for that program. These waivers usually go to seriously disabled children. Everyone else has to be waitlisted.

“Sometimes the DHHR, as the guardian of the child, will put all their eggs in one basket saying ‘I’m gonna apply for an IDD waiver’,” Given said. “Then, the child does not qualify and they turn 18.”

Oftentimes with no family at all, Given said if a child does not qualify and turns 18, the teenager ends up in a homeless shelter – or on the street.

She said these young adults end up losing their housing – and access to medications. She says they’re often unable to get their prescriptions filled within 30 days of leaving a facility.

“Oftentimes these are psychotropic meds, and without the needed medications their mental health declines rapidly,” Given said. “So there’s not enough planning to make sure that they have appointments once they leave a facility to see a psychologist or a psychiatrist.”

Given said issues relating to discharge problems stem, in part, from a lack of adequate funding for community based service – and an over-reliance on institutional care.

“The lack of adequate pay and disrespect for the profession cannot be discounted,” Given said. “We have seen firsthand the abuse and neglect of people with disabilities at the hands of poorly trained, inadequately paid direct care staff.”

Kelly Caseman is executive director of ‘Think Kids’, an organization that advocates for positive change.

One needed change Caseman explained to lawmakers was developing a public dashboard. The dashboard was part of the Foster Care bill proposal that did not make it through the 2022 general legislative session.

She said it’s an information center that would greatly help with discharge planning by offering families of children with disabilities recommendations for services closer to home, more care coordination, more people to talk to about their kids’ diagnosis and conditions.

“We need to create a centralized website of specialty care providers,” Caseman said. “A one stop site with all providers listed, so families can easily find what’s available to them. State hospitals only list their own programs and for some West Virginians it can be confusing and really hard to navigate. We’d like to see a website housed by DHHR that lists all providers with hyperlinks for more information.”

Del. Lisa Zukoff, D-Marshall, is a legislative commission member who listened to these disability agency leaders. She said there must be a better system for discharge planning when a child ages out of the system.

“We should be planning from the time that child gets into junior high school, what’s going to be the end game,” Zukoff said. “Let’s plan for this and be prepared so that the family and the child with disabilities can move forward and go on to a productive life where they’re safe.”

She said DHHR has started asking questions and meeting with folks to determine what needs to be on the public dashboard. She said that gives her hope.

Lawmakers hope the information provided in these sessions will help them enact needed changes next year.