Katrina Harmon
Executive Director
West Virginia Child Care AssociationGuest 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 “villages” seem 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:
- improve the coordination of wrap around and other services for children and parents to mitigate number of children that need taken into state custody;
- improve clinical oversight in order to move children into most appropriate care in least restrictive setting;
- 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.
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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