W.Va. foster care bill is focus of packed public hearing

CHARLESTON — Over the course of an hour, West Virginia citizens debated whether a proposal to address West Virginia’s foster care crisis through managed care will help or hurt the situation.

The public hearing took place in the House of Delegates chamber. The bill  opening the foster care system to managed care is making its way through committee. The House Health and and Human Resources Committee was set to hear the bill this afternoon.

West Virginia’s ongoing opioid addiction epidemic has put more and more strain on the foster care system. The state Department of Health and Human Resources has reported there are about 7,000 children in foster care.

DHHR has said it needs help managing the system. The agency says managed care would provide a benefit of tracking foster children as they move through the system, including practical matters such as records of doctor’s visits.

Some social workers and family advocacy groups have expressed caution.

“This bill rushes headlong into uncharted waters,” said Sam Hickman, director of the National Association of Social Workers in West Virginia.

He advocated for other changes instead, including an independent ombudsman to provide oversight of the system.

Most speakers on Tuesday morning opposed the bill — or at least said it should be slowed down for more vigorous discussion.

“I ask you to slow down, I ask you to be very deliberate in this,” said Kristen O’Sullivan of Our Children, Our Future.

Those speakers expressed particular concern about the role of managed care organizations that would oversee healthcare for foster children.

The managed care organizations would be allowed to have overhead — administrative costs and profit — of about 10 percent.

That amounts to about $33 million a year — money that critics of the bill said could be used for direct help of children. Several speakers asked for a fiscal note to outline financial considerations.

“We do applaud the goals of this legislation, the intent behind it,” said Jim McKay, state coordinator of Prevent Child Abuse West Virginia.

“We owe it to ourselves not to take the shortcut and make things worse. We need to go with a deliberative approach that listens to the voices of parents, parents who are opening their homes. There is probably a role for managed care, but we don’t have those answers yet.”

Other speakers said the influence of a managed care organization would provide continuity for children who otherwise may be shuffled from home to home without anyone being fully aware of their medical history.

“They will come with no health records, no histories. They may not even know who the last doctor was that the child has seen,” said Chantal Fields, executive director of West Virginians for Affordable Healthcare.

“We believe an mco program could really help with this type of situation.”

Patricia Fast, vice president of government programs for the Health Plan, a nonprofit providing managed care services, said medical care and social care have been fragmented.

“We believe we can bring more coordination of that care,” Fast said. ”

“We don’t think an mco approach alone is a silver bullet. We think an mco approach that looks at collaborating with all of you. We need to develop the best collaborative holistic approach that meets the needs of the child and the family.”

The foster care bill actually has a triple reference. It passed out of the Senior, Children and Family Issues committee last week. It also would go to the House Judiciary Committee.

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