Many challenges, but hope for state’s foster care system

Simon F. Haeder

Recently, I had the pleasure of hosting a roundtable that was part of a series of four hosted by West Virginians for Affordable Health Care and was co-hosted by the West Virginia Chapter of the American Academy of Pediatrics.

The roundtable was focused on a population of children referred to as transient or displaced. You may have heard them called “opioid orphans.” These children have parents or guardians who are occasionally present—they may suffer from substance use disorder, or are incarcerated. These children may become “wards of the state,” as they were often referred to years ago, and may become institutionalized, or placed in residential living temporarily. They may officially wind up in kinship care, or foster care, they may live temporarily with a number of family members, and they may, as we have come to call it, become “couch surfers.” Often, these children can wind up homeless or in a juvenile detention facility.

Often exposed to abuse, violence, and crimes, transient children are more likely to suffer from physical and mental health care conditions and require more frequent monitoring of their health status. Virtually all of them suffer from neglect. Yet these children often lack a guardian who can provide consent for treatment, inadequate resources and access to appropriate care. They pose tremendous challenges for school system and communities, which often lack the additional resources for these children.

The situation in the State of West Virginia is rather dire. Just recently, Bill Crouch, the Secretary of the Department of Health and Human Resources, reported to the legislature that West Virginia is experiencing nothing short of a child welfare crisis: We lead the nation in children removed from the home, and we are 48th in the nation when it comes to congregate care. To make things worse, children in the system are becoming younger and more traumatized. Not surprisingly, West Virginia falls short when it comes to foster care families, adoption options, child protective service staff and other resources.

The ubiquitous opioid epidemic ravaging the state has only made the situation more dire. Indeed, 80 percent of children are removed from home with substance abuse. The numbers have skyrocketed from 970 children in 2006 to 2,171 in 2016.

Yet, as the roundtable showed, the situation is not without hope. The roundtable brought together a diverse set of stakeholders including medical providers, schools, local and state government officials, foster parents, non-profits, and researchers. Most importantly, during the conversation it became more than apparent that everyone involved is immensely dedicated to these children and their families. Often at a tremendous cost to themselves and their families.

Participants offered some relatively simple solutions to improve the situation quickly. We need to train and prepare our foster parents better. We need to provide them with resources and support systems. We need to improve care coordination for children with often complex physiological and psychological conditions. We need to actively include and support schools, often the only source of stability for these children. We need to bring all stakeholders together to find synergies and take advantage of our existing resources.

However, truly improving the situation unquestionably will require private and public resources, as participants pointed out, as well. We have to invest in our schools, in our local and state employees, including CPS and DHHR, our non-profits, and our communities. We have improve access to medical providers, including specialists, through the expansion of telemedicine services and by extending the scope of care. We need to preserve funding sources like Medicaid and the Children’s Health Insurance Program for children and their parents.

And of course, we have to make a dent in the opioid epidemic by helping those currently engulfed in it, and by preventing more of our fellow West Virginians to get caught up in the maelstrom. All of this will require resources in a time of scarcity.

Yet, if we fail to address the issue now, we are at risk of losing our state’s future. These children deserve better.

Simon F. Haeder is a political science

professor in the John D. Rockefeller IV

School of Policy & Politics at WVU.