The Justice administration lit a red light in the Capitol dome in 2017 to symbolize emergency conditions in state healthcare funding.

CHARLESTON, W.Va. — West Virginia still has an uphill battle in treating addiction problems and the steadily-increasing number of children in state care.

Leaders of the state Department of Health and Human Resources underscored those points during their budget presentation to the Senate Finance Committee.

“Let me talk about the real crisis facing this state,” DHHR Secretary Bill Crouch told senators. “According to the Substance Abuse and Mental Health Services Administration, West Virginia has about 154,000 people with a substance abuse disorder.

“That is a tremendous number of people, and yet I believe that number is low.”

MORE: DHHR secretary tells lawmakers time to ‘pivot’ opioid treatment

Crouch and his staff then went on to describe a series of related challenges facing the state, using a set of slides to illustrate.

DHHR’s total budget is $6.3 billion. More than $4 billion of that is federal money, mostly through Medicaid.

The agency is asking the state for $57.7 million more than last year.

The agency has fewer financial resources than it used to have. West Virginia’s state budget problems led to cuts over the past several years.

Big cuts to DHHR budget over the past few years pic.twitter.com/EgCGsWfxgD — Brad McElhinny (@BradMcElhinny) January 23, 2019

DHHR also noted possible strains on federal Medicaid funding.

List of frightening Medicaid things pic.twitter.com/P9dm6pY83R — Brad McElhinny (@BradMcElhinny) January 23, 2019

DHHR has 1,200 positions vacant. Of those, 213 are in the child welfare system.

Crouch said the agency hopes to change the classifications of many of those workers, leading to more competitive pay.

West Virginia has a steadily rising number of children in state care, up about 3,000 from five years ago.

Steady rise in number of children in #WVgov care. Another alarming chart pic.twitter.com/XhWZ5iUNOO — Brad McElhinny (@BradMcElhinny) January 23, 2019

Forty-three percent of children entering foster care are 5 years old or younger. Another 28 percent are between 13 and 17 years old.

About 17 percent of the children entering the care of the state wind up institutionalized. The national average is 11 percent.

“We’ve seen tremendous increases in children in state custody,” DHHR Deputy Director Jeremiah Samples said.

When children leave foster care, about 58 percent are reunited with parents. About 27 percent are adopted.

“It’s important if we can save those parents that we do so,” Samples said.

“I’ve said this too many times now, but even bad parents are loved by their kids. If you remove a child from bad parents, that’s still a trauma for that child.”

Samples noted alarming statistics for children who grow up in foster care.

Thirty-nine percent have had a mental health diagnosis in the past year.

Forty-four percent have had substance abuse or dependence.

Less than half attain a high school diploma.

Less than half are employed.

Sixty-eight percent of males and 40.5 percent of females have been arrested since leaving foster care.

“We are trying our best to deal with this, but this is bigger than just DHHR,” Samples said.

Crouch said improvements to the foster care system could come through the federal Family First program as well as a serious emotional disturbance waiver through the Medicaid program.

“All of these efforts are aimed at improving the child welfare program,’ Crouch said.

Both Crouch and Samples advocated for a managed care organization to handle the healthcare needs of foster children.

“We need to have a managed care system for our foster care children,” Crouch said. “We’ve been working on that for some months. We are excited about making that change.”

DHHR has already prepared a contract reflecting that change, but there is also legislation under consideration in the House of Delegates.

“Foster care, I think it’s probably going to be the most important thing we do in the Health committee this year,” said Senator Mike Maroney, R-Marshall, who leads the Senate Health Committee.

West Virginia also has experienced an increase in the number of children being sent out of state for care. One of the stated goals of the foster care bill is to find more ways to treat children in-state.

Youth sent out of state. Big bump pic.twitter.com/jectxnTyap — Brad McElhinny (@BradMcElhinny) January 23, 2019

The trends show increasing costs to the state over the next few years, growing to almost a half-billion dollars within five years.

Exploding costs to state pic.twitter.com/Zm16jHCzmE — Brad McElhinny (@BradMcElhinny) January 23, 2019

After the presentation, Senator Ron Stollings, a doctor, commented on its bleak nature. “I think we all need a healthy dose of Prozac or something,” said Stollings, D-Boone.

Senator Eric Tarr, R-Putnam, agreed.

“It has been a very somber day. A lot of harsh realities hitting us,” he said.