Facing a mental heath care shortage, new ‘rapid access’ initiative aims to help WV kids

The program also aims to reduce the number of foster kids that the state has to send out of state for care. West Virginia is under a federal mandate to address the issue following a federal investigation.

By: - August 23, 2023 6:00 am

Kathy Szafran, executive director of Mountain Health Promise with Aetna Better Health of West Virginia, speaks about The initiative is known as the “Critical Access to Pediatric Psychiatry Program,” or CAPP WV, on Tuesday, Aug. 22, 2023. (Orion Strategies | Courtesy photo)

A lack of child and adolescent psychiatrists in West Virginia has led to “alarmingly high wait times for mental health assessments and subsequent treatments,” according to state health leaders. 

The lack of mental health access has pushed more kids nationwide to emergency rooms for care, which aren’t always equipped to help children in psychiatric distress.

Additionally, West Virginia is facing a shortage of residential treatment beds for children as the state grapples with the fastest rate of kids coming into foster care. 

In response to the need, Aetna Better Health of West Virginia, CVS Health and Community Care of West Virginia announced Tuesday a new initiative with the goal of providing rapid access to specialized child psychiatry services for at-risk populations throughout West Virginia. 

The new service aims to provide better and faster care for kids and, ultimately, reduce the number of kids West Virginia has to send out of state for care. The state health department is under a federal mandate to address the issue following a Department of Justice investigation. There are more than 300 kids in out-of-state group residential care and psychiatric facilities, according to state health department data, and at times, state investigators found that kids were sent to unsafe facilities

The initiative is known as the “Critical Access to Pediatric Psychiatry Program,” or CAPP WV.

“The goal is to get children assessed, level of care identified, and appropriate services coordinated as soon as possible,” said Kathy Szafran, executive director of Mountain Health Promise with Aetna Better Health of West Virginia. “Our current outcomes are promising, keeping children with family and with the services needed.” 

Aetna Better Health of West Virginia, which provides care for children in foster care and kinship care, provided $1.5 million to support the program, according to a news release

The new initiative will offer a virtual pediatric psychiatric evaluation anywhere in West Virginia usually within 24 hours to kids.

Additionally, when on-site psychiatric care isn’t available, CAPP WV will expedite psychiatric evaluations within 24 hours, ensuring urgent interventions for children facing emergent mental health crises.

“By providing swift access to specialized care and creating a crisis response unit, CAPP WV aims to reduce the burden of extended wait times, limit foster care transitions, and minimize out-of-state placements, ultimately paving the way for healthier and more resilient communities,” the press release said. 

The state is trying to address the growing number of foster kids in residential care, despite a federal mandate to reduce the number of children in facilities both in- and out-of-state. A 2014 Department of Justice investigation found the state relied too heavily on it, particularly for children with disabilities. The investigation, which was completed in 2019, required the state to increase access to community- and schools-based support services. 

The West Virginia Department of Health and Human Resources, which oversees foster care, has been working toward the goal. Earlier this month, department leaders told lawmakers about a proposed plan to divert more kids away from group care and connect them with community-based services. The state can’t force in-state private residential providers to change their services, but they’ll ask some to provide a higher level of care so kids don’t have to go out of state for services. Providers have raised concerns about the plan that could restructure how they provide and bill for care.

The new CAPP WV initiative will also help kids on waitlists who have medication needs. They’ll facilitate bridging appointments to long-term established behavioral health providers to provide continuous care during the waiting period. CAPP WV will collaborate closely with pediatricians and primary care physicians to provide expert behavioral health recommendations for kids enrolled in the state’s Aetna program. 

The new program will offer support to the state’s rural emergency rooms helping kids who are experiencing a mental health crisis.

During the COVID-19 pandemic, more kids in the United States ended up in emergency rooms in need of immediate mental health care. West Virginia University hospitals said that more than 3,000 kids went to their emergency rooms for mental health care from November 2021 through October 2022.

American Academy of Pediatrics, the American College of Emergency Physicians and the Emergency Nurses Association released a joint statement last week calling for local communities to increase access to mental health services for children before emergency care. They said emergency departments across the country are overwhelmed. 

“We believe CAPP WV will make a significant positive impact on the lives of West Virginia’s most vulnerable children and adolescents,” said Trish Collett, deputy CEO of Community Care of West Virginia. 


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Amelia Ferrell Knisely
Amelia Ferrell Knisely

Amelia is an investigative reporter for West Virginia Watch. Her coverage regularly focuses on poverty, child welfare, social services and government.