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Foster care reform passes the House

February 1, 2019

CHARLESTON — The West Virginia House of Delegates on Thursday passed legislation to reform the foster care system in the state, including a controversial provision to transition to a managed care system.

Both sides of the debate admitted the bill, HB 2010, is not perfect, but those in favor said something has to change to address the crisis situation child welfare is facing.

“That dome light should be on right now because there are 7,000 kids that need someone to be a voice for them,” said Del. Kayla Kessinger, R-Fayette, the bill’s lead sponsor.

The bill makes several changes to the foster care system, but the sticking point for those in opposition was the transition to managed care.

The Department of Health and Human Resources is working on bidding out a contract to a managed care organization to take over coordination of health care services for foster children. The goal is to provide more coordinated care for children, reducing duplication in health services and keeping better track of medical records. Foster families often report their children don’t have proper medical records, and Kessinger described events such as a child receiving duplicate vaccinations because medical records were missing.

The contract with a managed care organization stipulates the MCO must meet with multidisciplinary teams to determine what is in the best interest of the child and must follow court mandates. The contract is expected to be about $22 million, with 10 percent going to the MCO’s administrative costs and 1 percent for profit. The contract will be reviewed yearly.

Del. Barbara Fleischauer, D-Monongalia, said she had only received one email in support of managed care organizations.

“They don’t understand why we would be giving away something the state has been doing since the ’30s to a company that would make profit,” she said. “We shouldn’t make profits off our most vulnerable children.”

Other delegates said similar things, while some, such as Del. Amanda Estep-Burton, D-Kanawha, said they could not vote for the bill because no foster parents were consulted.

But Kessinger said she spoke with dozens of foster families, children, judges and other stakeholders in the year she spent developing the bill. DHHR Deputy Secretary Jeremiah Samples said last week the department also has spoken with foster families as they work on the MCO contract, and the contract is in its third public comment period where anyone can submit concerns.

DHHR plans to continue transitioning to managed care regardless of the outcome of the legislation.

Along with the managed care provision, the bill makes several more changes to the foster care system.

Provisions of the bill include:

n Requiring DHHR to hire an independent ombudsman to investigate foster family complaints against the MCO;

n Requiring DHHR to study kinship care;

n Require children to be placed in in-state facilities unless there are no in-state facilities that can provide the level of care needed or an out-of-state facility is closer to the child’s family than an in-state one;

n Implementing performance-based contracts for child placement agencies. The new contracts will require that agencies use evidence-based practices;

n Mandating that a parent undergoing medication-assisted treatment for substance use disorder cannot be the sole reason for terminating parental rights;

n Changes re-certification of foster homes from every year to every three years. Home inspections will still occur annually;

n Requires DHHR to evaluate rules for foster families in regard to reasonable and prudent parent standards, the national standard that gives foster parents the authority to make day-to-day decisions affecting children in their care;

n Prohibits the removal of a child from a home or prevention of placement of a child in the home due to cosmetic damages to the home and allows for dedicated sleeping spaces that are appropriate for age, the child’s needs and similar to other household members.

The bill passed 67-32. It now moves to the Senate for consideration.

Follow reporter Taylor Stuck @TaylorStuckHD on Twitter and Facebook.

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