‘A change for the worse’ — Lawmakers troubled by DoHS treatment of WV foster care providers

by Amelia Ferrell Knisely, West Virginia Watch
December 10, 2025

State lawmakers are questioning how the Department of Human Services is trying to get a handle on the foster care crisis, raising concerns about delayed payments and a more than $300 million foster care technology platform that doesn’t fully work. 

Lawmakers are supposed to provide oversight of state agencies, and they’re trying to push for changes in the state’s troubled foster care system of nearly 6,000 children. 

On Tuesday, some members of the Legislative Oversight Commission on Health and Human Resources Accountability were particularly troubled to learn that DoHS is still struggling to pay foster care providers on time, including agencies that drive foster children to see their family members and run group homes. 

“Are you trying to put them out of business? Where would the department be if they can’t do business?” asked Del. Evan Worrell, R-Cabell, who chairs the committee. “It goes across every service line … I hear this all the time, I get phone calls all the time. What is the department going to do to change this? I’m trying to see a change for the better, and I feel like I’m seeing a change for the worse.”

The state doesn’t have enough foster homes for children — or some children need acute services in hospital-like settings — so residential treatment facilities are critical in West Virginia child welfare. 

Mia Johnson is CEO of Burlington United Methodist Family Services, which operates 82 residential beds for children, group foster homes and more. 

“Unfortunately, our ability to continue this work is at risk,” Johnson told lawmakers. “The greatest threat to our agency is the persistent failure of payment and reconciliation systems in our partnership with DoHS.”

Earlier this year, Johnson told lawmakers that some DoHS grants were seven months late. She said that, now, there are continued delays in grants that threaten programs for families and retaining staff. The payment delays are threatening the company’s cash reserves. 

The delay in payments, according to Johnson, was one of the reasons Burlington hasn’t been able to commit to taking on certain higher-need child populations, “such as sex offenders and sexually reactive children.”

“We can’t afford the insurance,” she said. 

There are 543 foster children in out-of-state group homes, typically older kids who need high levels of care for behavioral or mental health issues. 

DoHS Secretary Alex Mayer told lawmakers that DoHS is now looking for out-of-state providers to come into West Virginia to open beds for high-needs foster kids so they can bring children back in state. 

“I want to be clear that since arriving in West Virginia, I’ve been meeting with providers in groups and individually to discuss the opportunity to specialize in levels of care that are requiring us to send children out of state, and we have not received interest from any providers,” Mayer said. 

In response, Sen. Eric Tarr, R-Putnam, didn’t understand why the state would be looking out of state when they haven’t been properly paying their in-state providers.

“They’re testifying they’re about to be run out of business in West Virginia, so why in the world would we not shore up existing providers before we ask other providers to come in?”

Employees from Children First and Home Base, two socially necessary services providers in West Virginia, outlined multiple issues to lawmakers, including delayed state payments. Socially necessary services providers transport foster children to see their biological family members; providers have asked Gov. Patrick Morrisey to stop a new mileage documentation policy they said is excessive, redundant and “forcing some providers to discontinue services.”

“Our concerns reflect real challenges affecting real families and the real front line staff who serve them every day … We’re asking for solutions that allow us to spend time serving children, not compensating for broken administrative processes,” said Caroline McMillen, chief personnel officer for Home Base. 

Commissioner of the Bureau for Social Services Lori Bragg said that the department, in an effort to improve its finances, has conducted audits on residential providers and socially necessary services providers. 

One audit showed $5.4 million in over payment to residential providers, according to Bragg. Another audit showed over-billing for mileage from socially necessary service providers, she said. 

DoHS is now requiring additional verification from providers in an effort to prevent future overpayments, and some of those new steps have led to payment delays. Payments are still going out, she said, but noted there are sometimes one-week delays.

“We had to make sure we’re spending the money where we should be spending it,” Bragg said. “I do not believe we’re being unreasonable.”

Worrell wasn’t satisfied with the situation, saying, “I’ve got to ask this question, are you trying to bankrupt them?”

He continued, “Policies are being changed and enacted that are basically going to bankrupt providers and we’re not going to have any left in the state.”

Foster care providers’ issues tied to failing PATH system

Many of foster care providers’ issues with late payments were tied to the state’s PATH database system, a technology implementation under Gov. Jim Justice that was meant to more seamlessly manage child welfare cases, emergency food assistance applications and more.

The state contracted with Optum in 2017 for the more than $300 million development of a new Integrated Eligibility System to manage its programs, but the rollout has been a series of delays — some due to the COVID-19 pandemic — and problems. 

Johnson said that, in one case, a foster child couldn’t be found in the PATH database, so no payment was issued.

The state uses a separate company, Acentra, to do preauthorization for some foster care services like socially necessary services providers’ mileage.

“Since October of 2022, socially necessary services providers have experienced significant and ongoing operational disruptions with the PATH and Acentra systems. The issues begin with severe delays in reimbursement, jeopardizing the stability of agencies and the ability to pay staff,” McMillen said. 

Tarr said the PATH system was a disaster, telling DoHS leaders he wanted to know how it was being fixed.

“It’s a hundreds of millions of dollars debacle and we’re laying it on providers’ shoulders. We’re losing child care providers, we’re listing foster care providers, we’re losing behavioral health providers. Why do we continue to pay out hundreds of millions of dollars for this?” he asked. 

Mayer, who inherited the PATH contract, said he is working to pursue serious change to the system.

“It’s a failure,” Mayer told lawmakers. “We’re navigating the constraint of what we’re working within because of changes that were made to the contractual structure prior to me getting here. And that’s made it even more difficult for me to take action to hold feet to the fire to really create change.”

He continued, “I’m not content with where it’s at … I think we are headed towards a path of getting things better.”

DoHS secretary says foster care reform is underway 

Mayer outlined to lawmakers his plan for improving child welfare following a new federal audit show that the state’s CPS workers failed to properly investigate the bulk of child abuse and neglect referrals in a time period spanning from 2023 to 2024.

The state wasn’t in compliance with the federal Child Abuse Prevention and Treatment Act, which provides funds to states to improve Child Protective Services and child abuse prevention.

Mayer, who was appointed to lead DoHS after the audit was conducted, said he wasn’t surprised by the findings and had already began working to address long-standing issues with CPS and following up on child abuse referrals. 

“I want to begin with this: We take the (Office of Inspector General’s) findings seriously,” Mayer told lawmakers. “These are children’s lives, families’ futures, and the credibility of state government. What the audit did do was validate the steps we were already taking, the issues we identified, and the approaches to address what was outlined in the report. Simply, this was a deep, sustained, system-level reform that was needed, and we’ve already begun that work.”

He laid out eight pillars of foster care reform that included implementing a statewide practice model to ensure CPS decisions are consistent and trauma-informed. The department wants CPS workers to spend more time with families they’re serving.

Other initiatives include redesigning the state’s electronic child referral placement, and DoHS wants to support foster families and kinship caregivers through specialized training if they’re caring for children with high mental or behavioral health needs. 

A group of House and Senate Republicans are pushing for foster care reform to take precedent during the upcoming legislative session, which begins next month. This week, they unveiled 16 bills for foster care reform, including a measure that would mandate that CPS workers wear body cameras while conducting child abuse investigations.  

West Virginia Watch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. West Virginia Watch maintains editorial independence. Contact Editor Leann Ray for questions: info@westvirginiawatch.com.