DHHR’s challenges include covid, child welfare, addiction and its own staffing

West Virginia’s Health and Human Resources Secretary told legislators today the agency continues to cope with the effects of the covid-19 pandemic, including people’s struggles with mental health.

“It’s difficult to imagine we’re entering the third year of this pandemic. We certainly didn’t think three years ago we’d be in the position we are right now,” Secretary Bill Crouch told the House Finance Committee during a budget hearing this morning.

“We have employees who put in extremely long hours over two years and we still do not have an end in sight here.”

On the basic issue of finance that the committee was there to explore, Crouch said the agency’s budget proposal is essentially flat. DHHR always represents one of the biggest areas of the state’s general fund, with funding coming from both state and federal sources.

But Crouch described a broad range of challenges, from the covid-19 pandemic to child welfare to addiction to mental health — and all the ways those issues overlap.

“The covid pandemic, of course, is our main priority,” Crouch said.

He noted that the pandemic has not only caused widespread health effects because of illness but also has contributed to mental health challenges for many state residents.

“This pandemic has been devastating for folks. The isolation out there, the inability to communicate many times with your support group. That’s for everybody, children on up,” Crouch said, noting an increased suicide rate.

“If you have any mental health problems at all, it’s just exacerbated by the loneliness and the inability to be with your friends.”

Crouch described an emphasis on support services to help people with mental health challenges.

The secretary addressed West Virginia’s longstanding addiction crisis, providing some statistics that offer hope. Seventy-five percent of people with addiction may recover over the long term if they are presented with opportunities for support, he said.

“Most people recover if we can keep them alive long enough,” he said. “If we do that, get them into long term recovery, we can get them back into society contributing to our workforce and our economy. We should not give up on these individuals.”

But he said deaths from overdoses are still too high. “This is not necessarily due to more people using drugs. This may be due to the transition to the market for more deadly substances like fentanyl,” he said.

The state, again, is trying to alleviate those problems through preventative programs as well as through distribution of naloxone kits that can help revive people who have overdosed. “That’s how we’ve saved lives with this addiction problem is to get naloxone out into communities,” he said.

West Virginia continues to have challenges with the numbers in the child welfare system. Although many people have stepped up to provide support for the foster care system, Crouch said it’s never enough. So he said the agency is focusing on more wraparound services to try to help keep children in their homes when possible.

State officials have taken many steps to hire and retain child protective services workers, but staffing remains a problem. Efforts have included pay raises, signing bonuses, a clear career ladder for staff and two- and five-year retention pay.

“We have a crisis situation in DHHR with child protective services workers. It’s still a crisis over several years, and it’s not because we haven’t focused on it,” Crouch said.

“We’re trying to do everything we can to try to make this a better and more stable position for folks who have a difficult job and need the support. Even after all that, our retention rates are low.”

The agency is challenged to keep workers in many other areas as well, including physicians, nursing, epidemiologists and more.

“I’ve been concerned for some time about our ability to recruit to DHHR. Our workforce is getting smaller, and our workforce is aging. I’m very concerned that we need to have  a way to bring more people and keep young people in DHHR,” Crouch said.

Dianna Graves

Delegate Dianna Graves, R-Kanawha, said the staffing numbers appear alarming.

“When I look at the numbers, I’m worried that the ship is going down,” Graves told Crouch.

“I’m worried about the fact that we don’t’ have enough people to get the work done, and I’m worried about the people who are still with you. They’re with you because they care so much about the children and the people they’re trying to help that they’re probably working themselves to death.”

She asked Crouch to provide more insight about what level of pay might help the agency retain workers. “If the ship is going down, it’s incumbent upon the Legislature in some way to help you right the ship,” she said.

Crouch agreed that his is deeply concerned below his calm. “We are struggling, and I’m worried. I’m calm about it, but I’m worried.”

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