Children could be endangered and some state facilities forced to close if the state Department of Health and Human Resources changes how it pays to place juveniles in residential treatment facilities when ordered to do so by judges, speakers told the Juvenile Justice Commission during a six-hour hearing Wednesday.
"I'm just very concerned for the safety of children," said Charles Johnson, a Charleston attorney representing seven residential treatment facilities. "We're no longer placing kids in places that can best serve their needs."
The treatment facilities are seeking an injunction in Kanawha Circuit Court to delay implementation of the new DHHR system for reimbursing those providers.
The Juvenile Justice Commission, created by the state Supreme Court to oversee juvenile justice issues, spent much of the day Wednesday listening to concerns about the pending reimbursement changes, including a 180-day limit on juveniles' stays at the facilities.
"Each child is an individual, and there's nothing about a 180-day deadline that's clinically indicated," Kari Sisson, executive director of the Association of Children's Residential Centers, told the commission.
"If they said, gee, you've got cancer, and we're only going to treat you for 180 days ... everyone would think that's ludicrous," Sisson said.
The pending DHHR contract would also replace bundled rates of $250 a day for residential placements to a standard rate of $178 a day for room, board and supervision, while requiring residential care facilities to bill separately for other services provided to each child on a fee-for-service basis.
That change, along with the elimination of three levels of classification of children based on treatment needs, could cause severe financial issues for residential centers that provide more intensive treatment options, commissioners were told.
Donald Cookman, a former state senator, circuit judge and prosecuting attorney, said the center where he serves on the board of directors - Davis Stuart in Lewisburg - stands to lose $900,000 a year under the new DHHR contract.
"Will that close the doors? I don't think so, but it certainly will cause problems with the services they render there," he said, adding that other facilities may not be able to absorb the cuts.
"I'm concerned what's going on here is going to close the doors of some of these facilities, and that's very disturbing to me," said Cookman, who said he became involved with Davis Stuart after seeing positive outcomes for the children he sent there as a judge.
Wednesday's hearing filled the Senate Judiciary Committee room in the Capitol, requiring some in the room to stand, while others spilled out into the west wing hallway, where the hearing was broadcast was video-streamed to a TV monitor.
Conspicuously absent was anyone from DHHR - a point not lost on Delegate Don Perdue, D-Wayne, a former House Health and Human Resources Committee chairman.
"I'm disturbed and deeply frustrated that no one from DHHR is here," Perdue said. "That is not the way to be collaborative."
Perdue added that he believes the DHHR changes are strictly aimed at budget cutting.
"What is driving this bus is the same thing that drives every bus - the totals - what is it going to cost us?" he said.
After the hearing, DHHR communications director Allison Adler said there were two reasons why DHHR wasn't represented at the hearing.
"DHHR has a circuit court hearing tomorrow, and it wasn't appropriate for Secretary [Karen] Bowling or any member of the DHHR team to attend this public forum to argue DHHR's case," Adler said. "These are contracts between the state and providers, and we could not jeopardize those ongoing discussions."
Adler said the DHHR has a duty to ensure that every child is placed in a safe and least restrictive environment. "It is critical that all appropriate behavioral health services are provided, and the new contracts ensure that takes place," she said.
Putnam Circuit Judge Phillip Stowers, commission chairman, said the commissioners called the hearing because they've had difficulty getting answers about what sort of services will be available for judges placing juveniles in residential centers.
"We're dismantling years of work," Stowers said.
Reach Phil Kabler at philk@wvgazettemail.com, 304 348-1220, or follow @PhilKabler on Twitter.