About Us Formed in 1979, the West Virginia Child Care Association is comprised of professional service agencies that operate a wide variety of behavioral health and child welfare programs throughout the state. Our role is to provide a voice for the most vulnerable and difficult children who have experienced abuse, neglect, emotional and behavior challenges, substance abuse and/or delinquency. We pledge to take a stand for our kids by championing quality behavioral health and child welfare programs found right here in West Virginia, supporting the dedicated providers who care for our children in need, and working together to provide care for our kids within our state’s borders.
2017 LEGISLATIVE PLATFORM RESPONSIVE BACKGROUND CHECKS Allow WVDHHR licensed child-caring and child-placing providers to be eligible to receive their own ORI number in order to apply for and receive their own CIB and FBI check results. LESSEN OVER–REGULATION Lessen over–regulation in the child serving system in order to increase the volume, quality and access to services for West Virginia's children and families. SUPPORT FOSTER CARE Strengthen support for West Virginia’s foster care providers by founding adoption service and recruitment funding, increasing the funding provisions for treatment foster care parents and revising ‘after midnight referral’ procedures. ASSISTING TRANSITION Transform & strengthen West Virginia’s system of care to improve outcomes for older youth transitioning to adulthood by developing a comprehensive, collaborative service model.
www.wvcca.org 304.340.3611 One United Way Square Charleston, WV 25301
RESPONSIVE BACKGROUND CHECKS
Timely background checks are critical to every child welfare, behavioral health and health care provider in West Virginia. Currently, WVDHHR processes all Criminal Identification Bureau (CIB) and FBI checks. West Virginia Child Care Providers, including child caring and child placing agencies, then receive a letter stating the department’s approval or rejection of the employment applicant or foster parent. Providers and applicants are not privy to the specific results of these background checks; despite being the responsible payee. Additionally, the provider is not informed if there is a conviction; therefore, providers are unable to evaluate if an applicant is a good match for an employment position or as a foster parent. Accessibility to background check locations, scheduling limitations, lengthy process times, unreadable scan requirements and WVDHHR staff turnover make the current procedure cumbersome for potential new employees and foster parents, ultimately causing them to abandon the process.
www.wvcca.org 304.340.3611 One United Way Square Charleston, WV 25301
The WVCCA recommends that WVDHHR licensed child–caring and child–placing providers are eligible to receive their own ORI number in order to apply for and receive their own CIB and FBI check results.
The West Virginia Child Care Association supports the following principles: 1. Results in 72 Hours. Results from both the state CIB and federal FBI check should be returned within 72 hours to the requesting organization.
2. Sufficient access to background check locations. Sufficient access requires the placement of scanning equipment in every West Virginia county that is operational five (5) days a week in larger counties and three days a week in smaller counties during regular business hours from 8 a.m. – 6 p.m.
3. One screen for CIB and FBI checks. Applicants should be able to have one scan completed electronically that is sufficient for both the state CIB and federal FBI checks. Multiple scans should not be necessary. The inadequacy of the current system is costly to the state and its citizens in immeasurable ways. It causes delays in employment, staffing problems, loss of income to potential workers, delayed adoptions, and loss of mentors for children. Perhaps most importantly, the current system affects the state’s ability to create sufficient services to serve its most vulnerable children. As qualified entities, providers would register with the CIB before submitting for screening. Each such request would be voluntary and conform to the requirements established by the National Child Protection Act of 1993, as amended. As part of the registration, the qualified entity would agree to comply with the state and federal law and would so indicate by signing an agreement approved by the CIB. CIB may periodically audit qualifies entities to ensure compliance with federal law of this section. In boarding states that have implemented this suggested process, providers receive background checks within 72 hours.
SUPPORT FOSTER CARE
All levels of Foster Care from Intensive Treatment Foster Care to Foster to Adopt are solely dependent on having families who are willing and able to provide services and homes for youth. These youths may be a single individual to large sibling groups of varying ages and intensity of needs. The struggles for agencies providing these services across the state include: no provider funding for recruitment of needed families, a lack of adequate funding for services and expertise, no funding for adoption services, and the growing need for middle of the night placements. Despite the increase in the cost of living each year, provider agencies have not received rate increases for services therefore forcing them to do even more with less.
Strengthen support for West Virginia’s treatment foster care and foster care providers by founding adoption service and recruitment funding, increasing the funding provisions for treatment foster care parents, and funding incentives for providers and their family that place you in foster homes after midnight.
The West Virginia Child Care Association supports the following recommendations: 1. Establish Adoption Service Funding Reimburse agencies for costs associated with adoption case facilitation, which manages documentation throughout the entire court process and individual proceedings in addition to the required foster care case management and/or treatment services provided to the children while in the foster to adopt home. There is no funding to the provider agency for, or associated with, adoption services they provide.
2. Provide Recruitment Funding As families adopt, capacity has to be replenished. There is no funding allocated to child placing agencies responsible for replenishing as well as building additional foster home, Treatment Foster Care and Intensive Treatment Foster Care home capacity. Explore any existing recruitment funding efforts being allocated by WVDHHR to non-child placing entities to determine the amount of funding being allocated and the productivity/results being provided. Determine if efforts are being duplicated by the child placing entities for the purposes of replenishing foster care homes.
3. Funding Treatment Foster Care Parents
www.wvcca.org 304.340.3611 One United Way Square Charleston, WV 25301
Treatment and Intensive Treatment Foster Care requires Treatment Foster Care Training, targeted individualized training, smaller caseload sizes due to treatment needs, and additional services provided to families by child placing agencies through increased staff support, adaptive equipment and/or services, and staff expertise training. These are vital to providing treatment and follow National Best Practice standards to service youth in WV and in homes; unfortunately, this is simply underfunded.
The West Virginia Child Care Association supports the following recommendations: Impact of Lack of Funding to the items above means Foster Care reimbursement rates do not cover providers’ costs of doing business, therefore resulting directly in: •Higher caseloads •Less recruitment resources •Less specialized trainings resulting in less expertise •Foster parent reimbursement rates remain stagnate as the cost of living rises •Agency Administrative operational costs rise, salaries decrease or remain stagnant •Workforce becomes less competitive and child placing agencies are competing with private for-profit and other non-profit industries who have higher reimbursements and salary scales •Infrastructure costs are not met and continue to increase
4. Support ‘After Midnight Referral’ Fund efforts to increase and support the well-being of children, foster families and multiple child placing agencies’ staff who are awakened in the middle of the night to respond to the immediate needs of children/youth being removed from their homes. Issue: Many agency staff and families are awakened unnecessarily when often DHHR finds alternative placements. This results in foster parents who are less willing to accept emergency late-night placements due to the family’s routine being disrupted, does not result in placement, impacts daily schedule and functioning of staff and foster parents, and is taxing to resources due to schedule adjustments of staff and families. Recommendations include: • Create a financial incentive for agencies that make placement for the night, after midnight until 8am, to allow time for a home to be secured for placement. The provider will provide an incentive to the foster parents who accept midnight to 8am placements. • Determine the number of needed placements which came to the WVDHHR’s attention after midnight. • Exhaust and stop looking for kinship placement before decision is made to contact the private providers for that night. • Once a provider has successfully located a home for placement, immediately notify other providers that a home has been secured to allow families to get rest.
LESSEN OVER-REGULATION in the child serving system in order to increase the volume, quality and access to services for West Virginia’s children and families.
Currently the regulatory burden is vast and often duplicative, and, as a result, too costly to the state and its partners in the child serving system. Over the past several years, the necessary focus on how to provide the most access to the most essential services for children and families has been lost. The emphasis shifted into how West Virginia Department of Health and Human Resources (WVDHHR) could constrict the growth of the provider community, thus reducing access to and the volume of essential services for WV’s children and families. By increasing regulatory burdens, the WVDHHR’s focus increased growth of its upper bureaucratic staffing positions. The thrust by WVDHHR to eliminate or mitigate certain essential services came at a time when they dramatically increased the number of employees in Charleston and not in the field of service and operations. Thus, the WVCCA proposes that government assist providers in delivering a higher standard of care versus taking the role of a punitive disciplinarian.
www.wvcca.org 304.340.3611 One United Way Square Charleston, WV 25301
Who Benefits By removing unnecessary regulatory barriers, providers of services for children and families would have increased human and fiscal resources to devote directly to serving, treating and impacting those who are reliant upon those services. WVDHHR would be able to streamline its regulatory mission and processes, thus increasing budgetary savings and accountability throughout the whole system. Additionally, public officials in the state legislature, the executive branch as well as the state’s taxpaying citizenry would benefit.
Who Opposes It is clearly difficult to identify those would oppose lessening the regulatory burden in the child serving system of our state. However, it must be noted that despite the state’s decreasing population, the upper level of WVDDHR bureaucracy has increased dramatically during the past 20 years. Much of this personnel growth has been within WVDHHR areas that do not provide direct client services but rather to meet the duplicative regulatory and licensing burdens established by the WVDHHR.
The West Virginia Child Care Association supports the following recommendations:
The Issues Outlined here are issues that require direct intervention in the matter of an over-regulated environment which impacts workforce related matters. Established, unfortunately, in the current environment are duplicative and burdensome processes that hinder access and the rendering of essential services.
1. Eliminate the presence of burdensome regulations that strain providers' ability to hire staff so as to meet the treatment needs of children and families. For example, providers were previously able to train and certify their staff to provide certain services. Several years ago, the WVDHHR mandated that only specified staff can provide certain supportive services as prescribed by the WVDHHR thereby creating a negative impact in an industry and a state with a severe labor shortage. These changes were not driven by federal agencies but rather by an over interpretation. This overreach by the WVDHHR hinders innovation and service provision across West Virginia. It is exacerbated by the lack of knowledge, awareness and understanding by the WVDHHR on what is actually required to provide the essential services to children and families. 2. Promote and allow the use of existing technology to improve access to treatment services in order to circumvent socioeconomic and academic challenges for children and families as well as transcend West Virginia’s geographic barriers. 3. Write rules and regulations clearly and objectively that will eliminate the use of interpretive guidelines. Thus, a rule is strictly a rule not subject to bias or agenda. 4. Develop an inter-rater reliability process to ensure an accountable, easily understood and unambiguous regulatory review. The enforcement of rules and regulations should vary as little as possible from one regulatory staff to another, therefore eliminating misinterpretation and enforcement of a regulation and/or rule and abolishing contradictory messages from the WVDHHR. 5. Examine the feasibility of Council on Accreditation, Joint Commission, and CARF accreditation being used in lieu of state licensing reviews to minimize the cost and resources associated with duplicative reviews. New legislation would be required to allow Office of Health Facilities Licensure and Certification (OHFLAC) and the Bureau of Children and Families (BCF) to deem a license based upon accreditation by these national organizations. 6. Establish accountability by eliminating the silo approach to regulatory oversight, thus confirming that regulatory bodies work seamlessly and connectively to ensure the safety and wellbeing, as well as the provision of treatment services, for West Virginia’s children and families. The streamlining and/ or reorganizing of these silos and processes would eliminate contradictory messages, interpretations, guidance and directives often emanating from the WVDHHR. This requires the leadership and vision of those currently in charge of these silos. 7. Establish, where it does not exist, a formal appeal process to ensure the integrity of the inter-reliability process remains intact and to serve as an efficacious stop gap device for the process.
ASSISTING TRANSITION
Transform & Strengthen West Virginia’s system of care to improve outcomes for older youth transitioning to adulthood by developing a comprehensive, collaborative service model.
For the hundreds of older youth transitioning into adulthood from West Virginia’s System of Care, the pathway is often challenging, the odds great, and the reality sometimes frightening. Many have been diagnosed with serious mental illness, have substance addictions, and have experienced multiple traumatic events during their lifetime. Often, as they age out of the system, these youths find themselves homeless and jobless. Historically, they are provided services based on their chronological age versus traumainformed, flexible support and services appropriate for their developmental age. To best serve our youth, developmental stages, trauma impact, intellectual disability, mental health needs, as well as the impact of disabilities or handicapping conditions and childhood experiences should be carefully considered. Support and housing must take into consideration the impact of trauma, developmental versus chronological age and the full transition to adulthood continuum must be trauma informed.
Recommendations for Older Youth Transitioning to Adulthood Service Model Development: • Transition to Independence services and programs be provided by licensed agencies with the proven ability, experience, training and well-being standards that provide quality programming for transitional living supports, services, housing and treatment provisions and connections. • Follow a developed set of unified standards for all providers. By establishing clearly defined standards, the model will be easy for youth and young adults to understand, navigate and access, regardless of the provider they choose. • Utilization, monitoring and oversight of Chafee Funds be thoroughly reevaluated to support a model that maximizes funding and encourages value-based outcomes. The model should include evidenced-based best practices of crisis services, social support, life skills training and in-vivo experiences, transition facilitation, financial literacy, job coaching and support, and developmentally appropriate accountability. • Include the following components: Crisis Prevention and Support, Education, Employment and Training Support, Financial Literacy, Housing Support, Life Skills Training & Support, and Medical & Mental Health Support. • Provide Transition Coaching and Life Coaching, regardless of custody or FC-18 agreement, for all youth that have been in an out-of-home-care setting at any time within two years of turning 18, up to the age of 22. Access should be available with any Transitional Living provider in addition to BCF staff. • Implement Future/Transition Plan development, including Life Skills Assessment and Training, by approved Transitional Living Transition and Life Coaches, via contract, for all youth age 14 and up in designated catchment areas. • Ensure youth are discharged from care with safe and stable housing options available to them.
www.wvcca.org 304.340.3611 One United Way Square Charleston, WV 25301
• Designate a specified time period for Transition and Life Coaches to follow-up with all aging out youth in contractually designated catchment areas in order to further coach, maintain connections, and link to available services, housing and supports, as well as collect National Youth in Transition Database information for WV DHHR BCF. • Fund providers with a reliable reimbursement methodology that allows flexible and stable funding that will provide secure, safe, and affordable housing for youth transitioning into their first apartment/home.