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Foster youth health care funds debated

CHARLESTON — While delegates on both sides of the issue expressed concern about the well-being of foster children in West Virginia, they differ in how best to provide health care to nearly 6,200 children affected.

House Bill 4241 — legislation transitioning foster children into managed care — passed the House Finance Committee by a slim 12-9 vote Monday at the State Capitol. It heads to the House floor with the committee’s recommendation for passage.

Jeremiah Samples, deputy secretary of the W.Va. Department of Health and Human Resources, testified nearly 6,200 children are in state custody currently, and they would fall under the legislation. The number climbs to 17,000 when factoring in adopted children in the Mountain State.

Delegate Steve Westfall, R-Jackson, told the committee of his interest in a bringing West Virginia up to the standards of a similar program referred to as Georgia 360, which has been that state’s managed care program since 2014 for foster children, ones receiving adoption assistance and those involved in the juvenile justice system.

Samples acknowledged the merits of Georgia 360 and an effort for West Virginia to establish a similar program for its children.

“We’ve reached out to them and we’re looking at it, trying to find out more about what they’ve done,” he said.

Samples estimated about 300 children from West Virginia are receiving health care outside the state’s borders. His hope is to “bring them back home,” he said, though there are some barriers.

Several delegates had expressed concern, stating that the children may better served closer to home.

Samples said many times children go out of state because of “a lack of placement in West Virginia,” and specifically, “a lack of Psychiatric Residential Treatment Facilities.”

A lack of treatment centers for sexually abused children, especially girls, is an issue too, he said.

“It’s a major problem, not having these resources,” Samples continued. “We could be a lot more successful in terms of placement.”

Delegate Isaac Sponaugle, D-Pendleton, said in his prior experience as a young attorney he saw troublesome healthcare options for some disadvantaged children. Sponaugle is a managing partner in the law firm of Sponaugle and Sponaugle in Franklin.

“The court is going to look at the best treatment option for the child, not keeping him in the state,” Sponaugle said. “Bringing 300 kids back home sounds good, but it doesn’t necessarily work.”

“There are provider infrastructure shortfalls (in West Virginia) that even with a managed care system, we’ll still have to send children out of state,” Samples replied.

A savings of approximately $1.5 million to $1.7 million also could be realized by moving the children to a managed care program, Samples said, adding about 420,000 West Virginians are in managed care in the state’s 55 counties.

“The intent would be to reinvest any savings (House Bill 4241 might bring) back into the foster care system,” Samples said.

Delegate Ron Walters, R-Kanawha, asked Samples if concerns exist for children located in the most rural areas of the state, where travel and access may be an issue.

“One of the values of managed care is the responsibility falls on the MCO (Managed Care Organization) to make sure that children receive the appropriate care,” Samples answered. “If there is failure to do so, there are contractual consequences.”

Katrina Harmon, executive director of the West Virginia Child Care Association, testified her organization is concerned with the bill’s “timeliness … legislation not being required. The time frame puts stress on the healthcare providers.

“There’s a lack of thoroughness and planning,” she added. “We would really like to see this done with a pilot project to slowly introduce it, rather than put the whole system, the already fragile system, into such a (short) time frame.”

Sponaugle asked if Harmon is concerned with a possibility of fewer healthcare options dictated by insurance decision makers.

“That’s our concern,” she answered. “I would hope we would always put our children first.”

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