Foster reform back in House

March 9, 2019

CHARLESTON — One of the most significant pieces of legislation of the session passed the West Virginia Senate on Friday with only one vote against as senators swallowed heartburn over controversial provisions within the foster reform bill.

The floor debate swayed at least one senator, Glenn Jeffries, D-Putnam, who said he had intended to vote no. The extra reporting requirements of the managed care organization seemed to ease some of his concerns.

Sen. Richard Lindsay, D-Kanawha, was the only no vote.

Senate Health and Human Resources Chairman Mike Maroney, R-Marshall, said he believed the foster reform bill was the most important piece of legislation to go through the Senate this session.

The bill has nine components addressing different facets of child welfare.

The biggest is the transition to a managed care system of health care coordination, which is opposed by foster families and other advocates out of fear it will result in less services for children from the profit-driven organization. But as Maroney said on the floor, the Department of Health and Human Resources plans to contract with a managed care organization with or without the legislation, so passage of the bill allows

more legislative control over the transition.

The transition to a single managed care organization (MCO) will take place by Jan. 1, 2020. DHHR is currently bidding out the contract. The bill requires the department to ensure that the MCO program offers a seamless approach to servicing clients’ needs; delivers needed supports and services in the most integrated, appropriate and cost-effective way possible; offers a continuum of acute care services, which includes an array of home and community-based options; and includes a comprehensive quality approach across the entire continuum of care services.

The MCO must also organize an advisory group of foster, adoptive and kinship parents to discuss issues with the MCO and find solutions. This advisory group must meet quarterly in the first year and deliver a report to the Legislature.

The department must also provide a report to the Legislature, evaluating the MCO’s first year in terms of claims, the number of claims denied, the number of claims approved through appeals and other criteria.

The bill also creates an ombudsman in the Office of the Inspector General, who must have experience in child welfare, to advocate the rights of foster parents and investigate grievances against the MCO.

The bill now requires the MCO have 80 percent of its employees working in West Virginia and prohibits any employee who worked on the contract from being employed by the MCO within two years of the contract’s formation.

The second most controversial provision in the reform bill relates to residential treatment centers. The provision will require any center contracting with DHHR to accept a child placement provided the child meets the center’s criteria, as determined by DHHR, and the center is not at capacity. The center may not discharge the child without permission by the department, but the center may request a multidisciplinary team meeting to work toward an alternative placement for that child.

Directors of residential centers in the state have said they fear this will result in children being misplaced in their centers and thus receive the inadequate care.

Other provisions in the bill as it heads back to the House include:

• Requiring performance-based contracting with child placement agencies, such as NECCO. The department will need to evaluate contracts based on criteria like well-being outcomes of children, retention and retention of foster families, and capacity to meet service needs of the area.

• Requiring DHHR conduct a study and make recommendations on how to improve kinship foster care by October.

• Changing the foster home certification renewal to be every three years instead of annually. An annual home inspection will still take place.

• Adding language specifying that cosmetic home damage is not grounds for removal or not placing a child in a foster home; allowing designated sleeping spaces appropriate for the age and needs of the child; and requiring all foster home rules be evaluated considering normalcy and reasonable and prudent parenting standards.

• Allowing DHHR to set a reimbursement rate for socially necessary services as ordered by the court.

• Prohibiting courts from terminating parental rights based solely on a parent’s participation in medication-assisted treatment programs.

• Prohibiting the court from placing a child in an out-of-state facility unless the child is diagnosed with a health issue that no in-state facility or program serves, unless a placement out of state is in closer proximity to the child’s family for the necessary care, or the services are able to be provided more timely.

The House will need to accept the changes the Senate made before the bill heads to the governor. Saturday, March 9, is the final day of the regular session.

Follow reporter Taylor Stuck on Twitter and Facebook @TaylorStuckHD.