West Virginia’s opioid crisis has contributed to a dramatic increase in the number of children who have to be removed from homes and placed in the state’s foster care system.

State Department of Health and Human Resources Secretary Bill Crouch told the Senate Finance Committee this week that the number of children in state care has shot up from 4,300 in 2013 to 7,200 last year. That’s an increase of 67 percent.

As a result, the state’s foster care program is overwhelmed. Because of the crisis, the legislature is considering a comprehensive bill aimed at improving the system.

Some provisions are common sense changes aimed at easing bureaucratic burdens on foster parents. However, the biggest proposed change is the most controversial—hiring a managed care company to oversee the healthcare of foster children.

Child welfare costs are exploding. The state spent $246 million in 2017, but this year the budget will reach $337 million and DHHR estimates that by 2024 the state will be spending over $400 million.

DHHR Deputy Secretary Jeremiah Samples said the agency needs help, particularly in the area of coordinating and tracking the healthcare of the children. “We’re not taking money from anywhere in the department to pay for this,” he said. “It’s to help manage it through its own efficiencies by eliminating duplicative assessments.”

Some are raising warning flags about managed care. Several lawmakers question whether children will get all the medical and psychological services they need. Still other opponents see managed care as a boogie man because the company makes a profit.

DHHR officials are trying to assure the critics that their agency and judges who are overseeing the child welfare cases will continue to have final say. Additionally, a private company with expertise in child welfare can provide badly needed efficiencies.

Other critics accuse DHHR of moving too fast. Well, the crisis is now and getting worse by the day. Also, anyone who accuses the legislature of moving at a breakneck pace must have a different concept of time.

Children in foster care typically have more frequent and more serious health issues including medical problems, mental health issues, and developmental disabilities. According to the American Academy of Pediatrics, “It is common for such problems to have gone undiagnosed and untreated before these children enter foster care. Up to 80 percent of children and adolescents enter with a significant mental health need.”

As Samples told lawmakers, “We do not have the staff to manage the number of children that are in care today. A lot of these children also have significant medical issues These are very vulnerable children. We need another set of eyes to assist the department in managing this system.”

That’s well said by someone intimately familiar with the challenges of the foster care program. The legislature should pass the bill to help DHHR do its job better. More than 7,000 children are waiting.



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