With a record number of children in the West Virginia foster care system, and with three managed care organization recently submitting bids to take over management, the state of the system is undoubtedly in crisis. How did we get here?
Just last week it was reported by WV Public Broadcasting that we are facing record numbers of children in the foster care system in West Virginia and that the number has nearly doubled since 2015, largely due to the opioid crisis.
In late August, UniCare, The Health Plan and Aetna, submitted bids to run WV’s foster care system. Below we will look at the history of the system, as well as how we got to this point.
19th Century Social Reform
Okay, I bet you didn’t think that the history would entail going back as far as 1896, well it doesn’t exactly, but it does mark the start of foster care and one, still prominent, West Virginia nonprofit.
According to an article by Susan Johnson, “Children’s Home Society has roots in 19th century social reform,” posted on Charleston-Gazette Mail, in the 1850s, childhomlessness became a very prominent issue. With the westward expansion, many farms needed more labor and thus the The Orphan Train Movement was created.
One retired minister, Rev. D.W. Comstock, brought the movement to WV and started the Children’s Home Society, according to the CHS website. This provided many children with homes and families.
The Early 2000’s
In 2005, there was 4,331 children in the foster care system in West Virginia according to the Adoption and Foster Care Analysis and Reporting System (AFCARS) and more than 52% of the children leaving the system in 2005 were reunited with their birth parents, as reported by the Child Welfare League of America.
As we can see, these numbers were gradually increasing from what they were in the nineties, mimicking the growth of NAS, or neonatal opioid withdrawal syndrome (NOW) incident rates and opioid overdose death rates in WV during 2005, from data provided National Institute on Drug Abuse.
2015: The Opioid Crisis in West Virginia
According to a paper by R. Merino “The Opioid Epidemic in West Virginia“:
“The epicenter has been West Virginia with the highest rates of overdoses accounting for 41.5 deaths per 100,000 people among the 33,091 deaths in 2015.”
2015 really marks the point for when the crisis was really becoming prominent to the region and nation. The following year, 4,581 children were placed into foster care in WV, according to the American Academy of Pediatrics.
2018: WV’s DHHR, and Other Non-Profits Brace for Federal Lawsuit
By 2018, there were nearly 7,000 children in the foster care system, according to , that’s a big leap in just three years from 4,500 in 2015. The system was then declared in a state of crisis, as there was only about 1,500 foster homes, according to the Mission West Virginia’s Frameworks program.
Due to this crisis, the DHHR, along with other non-profit agencies in WV, braced for a federal lawsuit. Here is a snippet from Caity Coyne’s article “WV DHHR, others brace for federal lawsuit over foster care” from the Charleston Gazette:
“The Department of Justice believes West Virginia is removing too many children from homes, without ample support for them once they are removed,”
Winter 2019: Major Revisions to HB 2010
With HB 2010 passed in March, some major provisions were made, the most prominent being the Department of Human Relations and Resources being required to contract out specialized care for the young in WV’s foster care. This new change will impact the 7,000 children that are currently in the system.
Some community members were not happy about the proposed bill, as one petition was started by Betty Rivard in partnership with Our Children, Our Future; the WV Citizens Action Group to Veto HB 2010.
The petition was due to the DHHR’s MCO proposal not requiring an assigned care manager to every child, or for the care manager to meet with the child and family in person. There was also no language requiring the MCO to work with already established community based programs.
August 2019: Bids for MCO Takeover
Unicare, Atnea and the Health Plan recently submitted bids to run West Virginia’s foster care system.
The chosen company won’t “take over” the foster care system, not to say it won’t provide more than just managed care services, but it will roll more foster services/CPS under their charge. This is was made the concept controversial, according to Kelli Casemen, Director of Children’s Health at WVAHC, where they focus on healthcare policy that impacts children.
The transition to an MCO is set to happen on Jan. 01, 2020.
What Now?
Due to some of the controversial decisions being made over the last year regarding the foster care system in WV, it’s critical that right now community members open up a conversation with policy makers to determine what has and hasn’t been working.
Right now, the Children’s Home Society of West Virginia, as mentioned above, is trying hard to initiate that conversation. Over the month of September, they have held multiple sessions throughout the state in hopes to gather input and policy suggestions from communities to take to the next legislative session.
Some of the concerns mentioned at the meeting were the tedious requirements to babysit foster care children, six month long waits for home inspections and the huge amounts of paperwork, according to WV Public Broadcasting.
From here, open dialogue across the multiple platforms working hard to improve the foster care system, even in the mist of a MCO transition, is the most important.
Foster Care in Appalachia 