CHARLESTON, W.Va. (WCHS) — On Monday, West Virginia Department of Human Services Cabinet Secretary Cynthia Persily went before the Joint Finance Committee to discuss Medicaid funding, but ended up fielding questions on the other pressing issue facing her office – childcare.
During August interims, she assured legislators that the “funding cliff” is not an immediate crisis when it comes to childcare providers in the state.
Now under a federal mandate to provide enrollment based childcare subsidy reimbursements instead of attendance based, the state is responsible for funding it.
It was previously said in an April interim meeting that DoHS would need $23 million before Sept. 1 to make that happen, which created concern and confusion as the date approached among providers.
Persily said they are good for now moving money around but will need help in the future to keep this going.
“Lots of things coming, but there is not an immediate crisis, but we need to be planning, and we are,” she said.
Persily told lawmakers the agency is funding enrollment-based reimbursements through surplus funds from Temporary Assistance for Needy Families money. She said this is just temporary and will run out.
“The cost for childcare changes every month because it costs more for babies and less for school-aged children, so if we have more babies, we have more costs,” Persily said. “TANF funds we may use them for some other initiative. We have leftover funds there so we’re moving them over to childcare. It’s hard to predict when those funds are going to run out.”
Providers have continued to express the need for enrollment-based reimbursements as Persily said it is a better business model for them. They are still preparing meals and hiring staff and using utilities even when a child does not show up.
Right now, Persily said there are 1,425 providers which she said is more than the state had three years ago. The secretary also said there are also slightly higher numbers than previous years of centers that have closed.
During Sunday’s child care rally, it was said 60 centers have closed in 2024.
Sen. Eric Tarr, R-Putnam, said he would like to see a more cautious approach. He noted that the state’s annual expenses for childcare has gone up $64 million a year over the past four years.
“I think we need to look at all the answers for childcare,” Tarr said. “Just throwing money at it doesn’t seem to be the answer because apparently we still have a childcare shortage if you hear from the people who are actually providing that care.”
Tarr believes there is time to work on the issue and develop solutions for the next regular legislative session instead of being rushed in a potential special one.
“I think in order to be able to provide the services to the people that the state is obligated provide services to – think of that TANF population, think of the foster care children – to have those dollars available on a limited tax base we have to be really smart on looking at things that can really blow a budget up, and this is one of those things that can blow a budget up,” Tarr said.
Persily said providers would get a 60-day heads up if any funding changes are made.
Persily also discussed the latest updates in waiver programs. Recently, her office announced they would be doing a 15% increase in provider rates for people on waiver programssuch as the Intellectual and Developmental Disabilities and Age and Disabled Waiver.
Because of this, the plan is to take an additional 50 people off the I/DD waiver waitlist later in the fall.
“We need to look carefully at any higher numbers because we do think it will stress the system, but the governor has asked that we evaluate removing everyone from the waitlist, so we will do that carefully,” Persily said.
Persily said the wait list has 763 people on it, all awaiting to receive home health options or reimbursements for family care. Persily said the alternatives to not being on the program is institutionalization.
Persily was questioned why DoHS has not taken out any of the $183 million in reserve funding that was appropriated in the May special session for them. She said it is still early on in the budgeting process, but the department does not anticipate using it until the fourth quarter.
She was then asked if she was aware the funds would expire in March of next year. Persily said she was but that she believed that was a “flaw in the system.”
Rate increases go into effect Oct. 1.
