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House panel presents foster reforms

January 19, 2019
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Del. Chad Lovejoy, D-Cabell, listens as a bill to reform the child welfare system is unveiled in the House of Delegates' Senior, Children and Family Issues Committee on Thursday in Charleston.

CHARLESTON — A bill to reform the child welfare system in West Virginia was unveiled Thursday in the House of Delegates’ Senior, Children and Family Issues Committee.

House Bill 2010 changes facets of the system, from provisions aimed at making it easier to be a foster parent to moving to a managed care system.

The bill requires the Department of Health and Human Resources to create a three-year certification period for a foster home, something experts told a joint committee earlier this month would ease the burden on foster families. The certification period would coincide with background checks.

A yearly home inspection would still be required. That would bring West Virginia in line with neighboring states.

It also 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, something foster parent advocate Marissa Sanders told the joint committee was happening. It also allows for dedicated sleeping spaces that are appropriate for age, the child’s needs and similar to other household members.

DHHR must also review legislative rules 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. These would be such matters as extracurricular activities or going to a friend’s house to stay the night. The goal is to ensure normalcy for foster children, giving them the same life as a child not in the care of the state.

The bill also transitions the foster care system from a fee-for-service system to managed care. DHHR is in the process of bidding out a contract with a managed care organization, and Jeremiah Samples, deputy secretary for DHHR, said it has been one of the most extensive bidding processes the department has undertaken. The contract is in its third public comment period.

The transition must be complete by July 1.

Managed care, as defined by Medicaid.gov, is a health care delivery system organized to manage cost, utilization and quality. Medicaid managed care provides for the delivery of Medicaid health benefits and additional services through contracted arrangements between state Medicaid agencies and managed care organizations (MCOs).

Samples said more than 40 states have transitioned to managed care for their foster systems. The idea is to better coordinate care for foster children through MCO case managers. A common problem is the lack of medical records following foster children through the system, and Samples said this could help address that.

A bill to transition to managed care made it to the House floor last session but didn’t make it out. Several delegates on both sides of the aisle had questions and concerns about transitioning, but Samples assured them DHHR and the Bureau for Children and Families felt this was in the best interest of the most vulnerable population they serve — foster children.

Samples also eased the minds of delegates concerned that the ease in the recertification timeline could potentially harm a child.

“I don’t think anything would compromise the safety of the children,” Samples said. “There has to be a balance of overburdening the foster families and ensuring safety. Safety is always our No. 1 goal. If we felt any of the provisions in this placed children in harm’s way, we would convey that to you all.”

Other provisions in the bill include:

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

• Clarifying how much DHHR will pay for court-ordered services. If a service is provided by Medicaid, the court cannot order the agency to pay more than the Medicaid price. If it is not covered by Medicaid, such as drug tests, DHHR will set a rule on how much can be charged.

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

• Requiring a child not be placed in an out-of-state facility unless the child is diagnosed with a health issue that no in-state facility or program serves. There are 403 children placed out of state currently, according to the most recent legislative report.

The bill was passed by the committee and next will go to the House Health and Human Resources Committee and then the Judiciary Committee.

Follow reporter Taylor Stuck on Twitter and Facebook @TaylorStuckHD.

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