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National Rural Health Service Providers COVID-19 Resources Survey

National Rural Health Service Providers COVID-19 Resources Survey

Help us understand the resource needs of RHSPs

Cardea, Community Education Group, and TruEvolution are partnering to learn how COVID-19 is impacting Rural Health Services Providers (RHSPs) so they can better facilitate conversations with policymakers and advocate to expand access to resources to support client care.

RHSPs are a vital component of American public health infrastructure that often serve as entry points into care for populations that may not otherwise engage in health or social services. RHSPs provide healthcare-related services in rural counties, as designated by the Health Resources Services Administration (HRSA), or rural census tracts in urban counties. RHSP is a broadly defined term, and they can be:
  • Public or private
  • Non-profit or for-profit organizations and corporations
  • Faith-based or community-based
  • Located in rural, suburban, or urban areas
Despite the critical services they provide, they do not meet any existing federal designations designations set forth by the HRSA, the Centers for Medicare and Medicaid Services (CMS), and/or any other federal entity.

Do you operate an RHSP? Please consider participating in this 10-minute, voluntary, and confidential survey to share your experiences. Findings from this survey will be summarized in a brief report and will inform planning and policy conversations. This survey will close on September 7, 2020.

This survey will ask whether your organization has received several different types of resources to support COVID-19 response. The CARES Act created a couple of different pools of funds that health care providers might be able to access. For example, the CARES act Provider Relief Fund enables CMS to distribute federal funds to health providers in response to COVID-19. The Paycheck Protection Program (PPP), which has received wide media coverage, was also established by the CARES Act and provides small businesses with funds to pay up to 8 weeks of payroll costs including benefits. PPP funds can also be used to pay interest on mortgages, rent, and utilities. Several state and local governments as well as community foundations have also provided funding to service providers to respond to COVID-19.

If you would like to participate in this survey, please click the ‘Next’ button below.

It Takes a Village

Photo of Katrina Harmon, Executive Director, West Virginia Child Care Association
Katrina Harmon
Executive Director
West Virginia Child Care Association

Guest Blog By: Katrina Harmon, Executive Director, West Virginia Child Care Association

As the African proverb so wisely states, ‘It takes a village.’  In my role as Executive Director of the WV Child Care Association (WVCCA), I’ve repeatedly witnessed the truth in this statement as I represent a village of providers serving West Virginia’s foster care youth.

In addition to providing a wide continuum of care that includes therapeutic foster care placement, adoption services, behavioral health, family-based treatment, independent and transitional living support, positive behavior support, substance abuse prevention, treatment, recovery and many, many more services, this village of providers is a voice for children who have experienced abuse, neglect, emotional and behavioral challenges, substance abuse and/or delinquency.

WVCCA’s mission is to advocate for children and families by influencing public policy, sharing member knowledge and resources, and embracing partnerships.  To grow and nurture the proverbial village, the services and partnerships within our individual communities must continually be evaluated, modified and expanded based on the needs.

Known for our perseverance and resourcefulness, West Virginians are always willing to lend a hand to their neighbors and take care of ‘their own.’   So, in West Virginia, our “villagesseem to encompass so many more contributors, and for good reason.

While the roots of addiction issues have historically run deep in Appalachia, no one was prepared for the millions of prescription pills that flooded the state between 2008 to 2017 (Eyre, 2016). From there came a transition from opioids to heroin to fentanyl, and in some regions of the state, methamphetamine. Those drugs are stronger; more lethal. Unsurprisingly, deaths from overdoses rose higher in West Virginia than in any other state (West Virginia Department of Health and Human Resources, 2017).

No one was prepared for the myriad issues that came with the flood of drug use. The crisis has taken a toll on industry, education, and the overall family structure; it contributes to violence, crime, housing, and homelessness in every city and small community across the state. While each community has experienced the crisis slightly differently, none has been left unaffected.

In May 2018, the West Virginia Department of Health & Human Resources (DHHR) reportedthat West Virginia ranked as the state with the most child removals in the U.S. 83% of open child abuse/neglect cases involved drugs (Samples, 2018).  According to the State Inpatient Databases, rates for Neonatal Abstinence Syndrome (NAS) in WV increased 284% from 2009 to 2014.  Overall, 14.3% of all WV infants were born substance exposed and 5% were diagnosed with NAS (Samples).

When comparing 2014 with 2017, there was a 46% increase in the number of youths in the custody of the state (Samples).  During that same time period, the State reported a 22% increase in accepted abuse/neglect referrals and a 34% increase in open CPS cases (Samples).  63% of the children entering care were aged 10 and younger, and 43% of the children were placed in kinship/relative placements.

Simultaneously, the State averaged a 23% vacancy rate for Child Protection Service (CPS) positions and adoptions had increased 113% since 2006 – the highest in the nation (Samples).  Growth nationally for adoptions was trending at only 6% with PA, OH, and MD seeing declines ranging from 5-28% (Children’s Bureau, n.d.).

With record numbers of children and families requiring CPS interventions due to the drug crises, and the resulting skyrocket of expenditures, the State Department began to form strategic initiatives that included efforts to:

  1. improve the coordination of wrap around and other services for children and parents to mitigate number of children that need taken into state custody;
  2. improve clinical oversight in order to move children into most appropriate care in least restrictive setting;
  3. ensure that medical records follow a child wherever they receive services.

Additionally, in 2019, the WV State Legislature further enacted the procurement of a dedicated Managed Care Organization (MCO) in an effort to better coordinate the health care needs of the State’s foster care population (Relating to Foster Care, 2019). 

In November 2019, Aetna Better Health of West Virginia was selected to achieve the goals of streamlining the administration of health services, tailoring services to meet the needs of enrolled populations, coordinating care for members, and working to transition members from out-of-state care to community-based treatment in West Virginia. 

Simultaneously, on the federal level, West Virginia plans to become one of the first states in the country to adopt the Family First Prevention Services Act (FFPSA), as part of the Bipartisan Budget Act of 2018.

FFPSA redirects federal funds to provide services to keep children safely with their families and out of foster care, and when foster care is needed allows federal reimbursement for care in family-based settings and certain residential treatment programs for children with emotional and behavioral disturbance requiring special treatment.  Covered services will include mental health and substance abuse prevention and treatment, in-home parent skill-based programs, parent education, individual and family counseling in the home.

FFPSA further allows federal Title IV-E funds to be utilized for residential programs that serve parents with Substance Use Disorders (SUDs), their children, and allows additional investments to keep children safely with families (and kin) that lead to permanency and/or reunification, such as Kinship Navigator programs.

The Family First Prevention Act will change the way child welfare agencies work with families.  No longer will the federal government incentivize out-of-home placements by paying Title IV-E only after children are removed. The prevention services act will allow states to claim funds for providing in-home services parenting education, mental health and substance abuse services to at risk families in an effort to keep families together.

If states continue to remove children at the current rates, there will never be enough residential or foster care beds to meet the need.  Through serving more families at home, before crisis states are reached, the hope is to reduce the trauma to families and children that removal causes (Family First Act, n.d.).

During the 2020 WV Legislative Session, well-intentioned legislators once again worked to fix systems that have been broken by the drug crises, and the state’s child welfare system was once again in their focus.  The passage of the “Foster Parent Bill of Rights,” promised an additional $16.9 million to increase reimbursement rates for foster families and, for the first time, raise those rates for kinship families to be an equivalent amount.  The broad-ranging bill enumerated certain rights for foster families and foster children while also providing greater detail for the duties of guardians ad litem, who officially speak on behalf of children (HB 4092, 2020).

There’s been a lot of work done in a very short period.  Service providers, bureaucrats, legislators and many, many other stakeholders have stepped up to make change and care for one of West Virginia’s most vulnerable population – our kids.  But just fixing state systems won’t get us out of these scary times; we need to work on fixing communities and fixing the individual families within our communities. 

While the crisis continues to reveal itself in very real, tangible ways, our neighborhoods continue to develop real, tangible solutions, and they are impactful.  Local churches are initiating foster care open houses, backpack programs are springing up for food insecure students; local businesses are sponsoring after-school tutoring; local United Way programs are allocating funds towards after-school programs so kids have a safe place to hang out; teachers are opening their homes to students who need emergency placement; police officers are volunteering at summer camps for at-risk kids, because they see the needs of these kids when answering emergency calls at their homes; grandparents on limited, fixed incomes are trying to determine how to keep their grandchildren fed while learning the new technologies required for the children in their care to academically succeed; and countless parents are offering up spare bedrooms or couches to their children’s friends who have been displaced.

It really ‘takes a village.’ 

As government funding is released and disseminated, it is imperative that we ensure our front-line community stakeholders and providers get the resources they need to meaningfully respond to the specific challenges and opportunities within their area.  While successful programs can be replicated, it’s important to remember no two communities are molded exactly the same. Research shows that the people most directly affected by systemic barriers and inequities are the best positioned to drive change in their own neighborhoods.

To all those involved in making change, your acts of kindness don’t just give kids hope, they keep the spirit of your ‘village’ alive. Maybe one day, rather than telling the state’s story of the drug crisis through death rates and dying communities, we will finally be able to tell it through the acts of good people who, despite all the odds and negative statistics and stories, saved their neighborhoods with each and every small act working together to raise ‘the village.’

You can learn more about the West Virginia Child Care Association by visiting their website by clicking on their logo, below, or by Liking their Facebook page by clicking the icon below the logo.

Logo for the West Virginia Child Care Association

References

Children’s Bureau. (n.d.). Adoption Data. Washington, DC: United States Department of Health and Human Services: Administration for Children & Families: Children’s Bureau: Child Welfare Outcomes Report Data. Retrieved from: https://cwoutcomes.acf.hhs.gov/cwodatasite/adopted/index

Eyre, E. (2016a, December 17). Drug firms poured 780M painkillers into WV amid rise of overdoses. Charleston, WV: Charleston Gazette-Mail. Retrieved from: http://www.wvgazettemail.com/news-health/20161217/drug-firms-poured-780m-painkillers-into-wv-amid-rise-of-overdoses

Family First Act. (n.d.). Family First Prevention Services Act. Family First Act: About the Law. Retrieved from: https://familyfirstact.org/about-law

House Bill 4092. (2019). https://legiscan.com/WV/text/HB4092/id/2171356/West_Virginia-2020-HB4092-Enrolled.html

Relating to Foster Care, WV Code, Chapter 44. (2019). https://legiscan.com/WV/text/HB2010/id/1958217/West_Virginia-2019-HB2010-Enrolled.html

Samples, J. (2018, May). West Virginia’s Child Welfare Crisis A Path Forward. Charleston, WV: West Virginia Department of Health and Human Resources: Bureau for Public Health. Retrieved from: http://wvahc.org/wp-content/uploads/Prez-on-Child-Welfare-1.pdf

West Virginia Department of Health and Human Resources. (2017, August 17). WEST VIRGINIA DRUG OVERDOSE DEATHS HISTORICAL OVERVIEW 2001-2015. Charleston, WV: West Virginia Department of Health and Human Resources: Bureau for Public Health: Office of Epidemiology and Prevention: Outbreaks. Retrieved from: https://dhhr.wv.gov/oeps/disease/ob/documents/opioid/wv-drug-overdoses-2001_2015.pdf

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Disclaimer: Blog posts on CEG’s Community Perspectives blog do not necessarily reflect the views of the Community Education Group, its grantors, its corporate sponsors, or its organizational partners, but rather they provide a neutral platform whereby each author serves to promote open, honest discussion about issues specific to their personal expertise, lived experience, and perspective. Please note that some of the content on Community Perspectives may be graphic due to the nature of the issues being addressed by the author.

People Worth Knowing: Katrina Harmon

Katrina Harmon, Executive Director
West Virginia Child Care Association

This week’s #PeopleWorthKnowing interview feature’s Katrina Harmon, Executive Director of the West Virginia Child Care Association (WVCCA).

Katrina Harmon was appointed Executive Director of the WVCCA in March 2017 after serving 2 years as Associate Director.

With years of experience in the non-profit sector, Katrina works with 15 member agencies to provide a voice for the most vulnerable children in West Virginia who have experienced abuse, neglect, emotional and behavioral challenges, substance abuse and/or delinquency.

WVCCA advocates for children and families by sharing member knowledge and resources, embracing partnerships and influencing public policy.

Prior to joining WVCCA, Katrina’s career roles included serving as a non-profit marketing consultant; nearly 10 years as Marketing Manager & Director at the state’s largest cultural arts facility and children’s museum; VP of Sales & Marketing for a construction firm specializing in community revitalization and development; and Account Executive for the Charleston, WV Convention & Visitors Bureau.

She received her Bachelor’s degree in Public Relations from West Virginia University and was one of the first graduates of WVU’s cutting-edge Integrated Marketing Communications Master’s degree program in 2005.

Katrina volunteers her time with the Winfield Baptist Church Awana program, and local United Way and 4-H youth programs. She enjoys practicing martial arts with her husband and son.

You can learn more about the West Virginia Child Care Association by visiting their website by clicking on their logo, below, or by Liking their Facebook page by clicking the icon below the logo.

Logo for the West Virginia Child Care Association