From the Well | May 23, 2024

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86th West Virginia Legislature

Special Session

May Interim Meetings

State Capitol

May 22, 2024

West Virginia News Headlines

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LOCHHRA QUESTIONS: The Legislative Oversight Committee on Health and Human Resources Accountability (LOCHHRA) questioned state officials about Hopemont Hospital.

RADIOLOGY PROGRAM: The Legislature’s Joint Standing Committee on Health heard an overview about the state’s radiological health program.

TECHNOLOGY AND INFRASTRUCTURE: The House Technology and Infrastructure Committee heard an update about broadband expansion and road maintenance.

BUDGET REVIEW: Legislators heard state officials’ review of the FY25 budget.

DEVELOPMENT UPDATE: The Joint Standing Committee on Economic Development and Tourism heard presentations from the state Secretary of the Department of Economic Development on the state’s strong economic performance and ongoing development projects.

CORRECTIONS: The Legislative Oversight Committee on Regional Jail and Correctional Facility Authority heard two presentations this week — one on behavioral health and another on staffing.

COLLEGE HELP: West Virginia students trying to figure out how to pay for college after the botched rollout of a new federal student aid application could get help under a bill the Legislature passed and sent to the Governor.

Governor Jim Justice called the special session after expressing frustration that the regular legislative session concluded with funding levels for human services programs far less than adequate. The Legislature already was scheduled to meet in Charleston for its May interim meetings.

WV MetroNews said the special session allocation provided a little more than $5 million to the state Department of Health and $183.4 million to the Department of Human Services in new reserve funds that agency secretaries can access when or if the money is needed.

Click here for more news coverage from WVMetroNews.

Jessica Whitmore, General Counsel for the Office of Inspector General, provided information, limited by federal regulations, about a report each Committee member received on Hopemont State Hospital in Preston County.

Delegate Bob Fehrenbacher of Wood County said, “The report provided has some telling failures at multiple levels. Disappointing to read.” He added there appears to be systemic failures. The report referred to by members of the Committee is a 2567 form that is generated by the Office of Health Facility Licensure & Certification within the Office of the Inspector General.

Ms. Whitmore replied, “Federal regulations don’t allow us to testify about specific reports. There are further investigations currently being completed.”

Delegate Fehrenbacher asked whether the investigators’ role involved looking for patterns. Ms. Whitmore replied, “It is not one of our stated roles. We may but it is not required.”

Delegate Matthew Rohrbach of Cabell County asked questions about facilities but concluded by saying, “It appears we’re not going to get any answers today to much of anything.”

Senator Vince Deeds of Greenbrier County had several questions about administrative guidelines and processes for an investigation. Ms. Whitmore explained that “immediate jeopardy” requires an investigation within three business days as governed by the Centers for Medicare and Medicaid Services (CMS).

“Our scope is limited to what is in that complaint,” added Ms. Whitmore, further saying the office completes a statement of deficiencies after the investigation, presents it to the facility, and then the facility provides a correction plan.

Asked by Senator Deeds whether the 2567 form is public record, Ms. Whitmore replied that the content of the complaint and the complainant is confidential by federal regulation, 45 CSR, part 2 that requires the agency from discussing complaints.

She said the 2567 report is compiled with several surveys completed by a team and is released only to the public when finalized. The turnaround time depends on the scope and severity of the complaint but any immediate jeopardy must be fixed immediately. External complaints can be made through a phone call or online form.

Delegate Rohrbach, a medical doctor, expressed the apparent frustration of the Committee, saying, “We as a Legislature have no idea what happened to one of our patients. As part of a report, we can’t find out what happened to patient number 19.”

Delegate Heather Tully of Nicholas County, serving as Chair, asked Ms. Whitmore whether anyone asked her to limit her testimony. She responded, “No.” Chair Tully then asked who the Committee could contact on the federal level to answer questions. Ms. Whitmore said it would be Region 3 in Philadelphia.

Michael Caruso, Secretary of the West Virginia Department of Health Facilities, provided a long-term sustainability report on seven facilities.

“I’m very pleased with all the work we’ve done,” Secretary Caruso said. He provided the Department’s four main strategies:

·     stand alone restructuring;

·     management agreements;

·     divestiture of facilities; and

·     affiliation with other health care systems.

The four components of those strategies include quality of care as the key element, followed by preservation of jobs, addressing facility structures, and making sure funds are used appropriately.

Secretary Caruso discussed accomplishments, including progress on confidentiality and non-disclosure agreements, focus on finances, and completion of the benchmark studies. He announced that 80 employees have been added in the past four months, decreasing the vacancy rate from 43% to 33%. He also commended Welch Community Hospital.

With regard to financial statements, Secretary Caruso said, “We are not there yet,” referring to the implementation of an industry-standard reporting system.

Delegate Amy Summers of Taylor County asked Mr. Caruso about the Hopemont facility, which was the subject of the first presenter.

He responded, “I have been instructed to say that it is still under investigation.” He added, “We had a very unfortunate situation. We addressed the issue. We solved the problem,” noting that Hopemont is rated a four-star facility.

“The radiological health program is part of the newly formed Department of Health,” Frame began. “It resides within the Bureau for Public Health.

Click here to read a story from the West Virginia Press Association.

According to Frame, the primary function of the radiological health program is to register radiation-producing machinery facilities within the state. The practice has been in place for decades and includes facilities such as dental and medical offices, hospitals, and industrial facilities, Mr. Frame added.

“It’s a huge variety of machines across the state that vary vastly in their power output,” Mr. Frame noted. “There are about 2,300 machines within our registration at this point.”

The registration and inspection of mammography facilities, Mr. Frame further explained, is another component of the radiological health program. Currently, 66 such facilities are within West Virginia and regulated by the FDA. The radiological health program works in partnership with the FDA for staff accreditation; facility inspections are performed annually.

At the conclusion of Tuesday’s meeting, House Technology and Infrastructure Committee Co-Chair Daniel Linville of Cabell County posed that question to Kelly Workman, Director of the state Department of Economic Development’s Office of Broadband.

Kelly replied that she was “not prepared to ask for any regulatory actions.”

Delegate Linville’s line of question apparently was based on the Committee’s May agenda, which states:

·     “Update with total new homes and businesses served relating to previously awarded (broadband) grants; and,

·     “Requests for legislative modifications to the regulatory structure regarding utility pole attachments.”

“Will you commit to doing this for us?” he asked Ms. Workman at August legislative interim meetings.

She said yes, but the presentation might be best in “cooperation with utility pole owners” who have a prominent role in broadband project completion.

Delegate Linville, noting that 2,000 Broadband connections have been finalized in since 2022, wondered whether it would take 53 years to complete the remaining projects based on the completion rate during this two-year period.

Ms. Workman said the 53,000 figure for Broadband connectivity is to be completed by “2026” and that the pace for project completion will “accelerate to ensure that objective is met.”

Delegate Linville prefaced his questions by saying a potential 25 years for broadband connectivity is “not acceptable.”

Ms. Workman’s presentation included statistics relating to broadband connectivity for homes and businesses in 42 counties.

She said West Virginia has one of the highest broadband connectivity rates, citing use of federal moneys while noting the state’s terrain and other factors, such as the National Radio Quiet Zone, affect connectivity, resulting in about 168,000 sites that that are affected mostly in areas of sparse population or less habitable regions of the state.

Project completion is to occur by 2029, she said, given new federal funding streams.

Delegate Jim Bulter of Jackson County asked about public utilities’ cooperation with broadband connectivity.

Ms. Workman reiterated the goal is to minimize completion delay. She said utilities have committed assurance in terms of “pole-pulling,” which includes scheduling and training.

She noted other factors include weather, other commitments utilities have made, and problems that broadband vendors face.

She said newer broadband projects include loan guarantees, as well as reimbursement after some project work has occurred, but that the state has few additional regulatory considerations.

Panel hears about road maintenance funding

In another Committee presentation Tuesday, Tim Moran, an acting Department of Highways official, discussed road maintenance funding.

Mr. Moran reviewed allocations for two state accounts relating to road maintenance, which he said were funded, in large part, by revenues derived from Department of Motor Vehicles account, such as vehicle taxes, registrations, and licensure.

He cited DOH “Fund 237,” which provides moneys for paving while also supporting DOH priorities at the state and district levels, including use of DOH 237.01 to “do projects as they may pop up.”

Mr. Moran reiterated that DOH also derives funds from federal Highways reimbursements, mentioning the Department often provides outlays of money to vendors to trigger federal reimbursements.

Mr. Moran said DOH funding streams include both $283.3 million in fixed costs and variable costs of $80 million to align with counties’ climates, terrain, and vehicle needs.

In response to a question from Senator Chandler Swope of Mercer County, Mr. Moran said “weighted factors” help ensure projects are not overly dominated by subjective considerations. He acknowledged projects are carefully considered because there is no “inherent warranties” in place with contractors.

“Once we finalize the project, there’s no recourse after that … . The work was completed from specifics.”

Delegate Rick Hillenbrand of Hampshire County praised DOH’s Safety With Action Today (SWAT) hotline, which was designed for citizens to contact the Department with concerns about roads in their communities, although Moran said use of a chain of command, contacting local officials first, may be the best approach. The SWAT program is set up to track complaints and ensure that citizens receive timely responses to their questions.

Delegate Hillenbrand said the SWAT hotline must “wired to someone’s seat.” He gave kudos to the DOH effort.

In terms of a final question from Senator Swope, Mr. Moran said state unfunded highways project needs might total $35 billion.

The presentation, chock full of statistics about state-level finances, was well received by the Committee. Acting Secretary Pack thanked legislators for their leadership and said West Virginia corporations are making money and paying taxes and growing as the result of their hard work.

Acting Secretary Pack said the state April quarterly fiscal calculations show the state projected to end the fiscal year with a $750 million surplus, noting the last quarterly surplus was $114 million ahead of estimates as the result of heightened tax collections at the state and local levels.

Deputy Secretary Muchow said corporate net income tax was $133.7 million above estimates and that sales and other collections from other taxes grew as well.

“These are overall pretty good numbers for General Revenue (funds),” he said.

In response to a question from Delegate Gary Howell of Mineral County, Deputy Secretary Muchow said tax revenues from natural gas were up, while coal-based tax revenues were down and that “liquid” oil and gas revenues were stationary.

Deputy Secretary Muchow, responding to a question from Senator Mike Oliverio of Monongalia County, said the two state rainy day funds, noting Rainy Day Fund B, initially funded from federal tobacco settlement funds, has not received legislative appropriations since 2007. Rainy Day Fund A, which Senator Oliverio characterized as the “more liquid” of the two funds, asked about heightening investments revenue by seeking to invest all rainy day funds to secure higher yields rather than varying investment strategies. Deputy

Secretary Muchow responded, saying that was a “policy” question for the Legislature to determine.

Most of the remaining questions dealt with a possible 10% personal income tax reduction.

As The State Journal reported, Deputy Secretary Muchow responded to Delegate Larry Rowe of Kanawha County, saying: “It’s a little more complicated than what I’m going to make it out to be, but let’s just say that we end up at $2.2 billion for PIT collections for all funds that are collected,” he said, “10% of $2.2 billion would be $220 million.”

Click here to read more from The State Journal.

A personal income tax reduction of around 2% would see about $44 million returned, Deputy Secretary Muchow said.

State Senator President Craig Blair of Berkeley County, during a March interview with WV News, said he would like to see lawmakers take action during the upcoming special session to delay the trigger by one year.

“How we set that trigger up was a mistake,” President Blair said. “It needs to be adjusted so it’s one year out. Not so that it saves the state any money — that’s not it. It’s being able to have long-term budgets.”

Governor Justice has said he is opposed to delaying the trigger and that he supports a swift elimination of the state’s personal income tax altogether.

“Let’s do it again,” Governor Justice said in April. “I mean, let’s just keep doing it. The more money we put in the hands of our people — it’s their money in the first place — but the more money that we put in the hands of our people, the better things happen.”

The Governor recently signed House Bill 4880 into law. The bill will begin the process of phasing out state income tax collections on Social Security benefits over the course of three years. It will go into effect June 7.

In addition, the Committee heard an update from Jeffrey Lusk, Executive Director of the Hatfield McCoy Regional Recreation Authority.

Secretary Carmichael highlighted West Virginia’s strong economic growth in recent years, with billions in new investments, job additions, rising incomes, and its outperforming other states. He emphasized West Virginia’s central location, low costs, skilled workforce, and other competitive advantages that have attracted major employers.

Secretary Carmichael referenced a recent magazine article praising West Virginia’s economic transformation from its former reputation as a struggling “Rust Belt” state. He said large companies have found West Virginia to be a receptive environment as the result of its policies.

Secretary Carmichael reviewed West Virginia’s strong economic performance in recent years. From 2017 to 2021, the state saw $6 billion in investments. From 2022-23 nearly, the state attracted $10 billion in investments.

West Virginia’s job growth of more than 125,000 jobs in the past 38 months was the fastest in state history, he said.

Secretary Carmichael said Federal Reserve data showed West Virginia’s GDP grew 5.1% in 2023, the highest in the Eastern U.S. Personal income growth also outpaced the national average, unlike in the past. Average wages are up along with retail sales. The state has recorded more than 300,000 new broadband connections since 2020.

Graphical data from the Federal Reserve Bank further illustrated West Virginia’s economic performance. It was second in the nation for nominal GDP growth from 2020-21 and led other states. GDP and wage growth have consistently exceeded the national rates, said Secretary Carmichael, who also highlighted the state’s location within 500 miles of half the U.S. population as an advantage. Low costs of business operations are also a major competitive strength, thanks to supportive policies involving workers’ compensation rates, taxes, and regulatory reform.

The Hatfield McCoy Regional Recreation Authority’s Jeffery Lusk provided background on the Hatfield McCoy Regional Recreation Authority, which the Legislature created in 1996 to build, maintain, and manage off-road trails in southern West Virginia. The goal was to diversify the economy and add tourism through ATV/UTV trails. He reported the trails now cover more than 1,100 miles across 10 counties. More than 70 new lodging businesses, such as cabins, resorts, and campgrounds, have opened to accommodate visitors, he said.

The trails have transformed many struggling coal towns into “trail towns” that welcome riders. Mr. Lusk emphasized the trails have been a huge economic success, generating $4 million annually in permit sales.

More than 14,000 West Virginia and 78,000 out-of-state permits are sold each year, he continued, adding that 93% of visitors are overnight guests spending on average over $150 per trip. The activity, he said, has created businesses and jobs.

He said visitor numbers have grown each year, and the trails now attract riders from 50 states and more than 20 countries. He said the biggest challenge is now lodging capacity to accommodate further growth.

Mr. Lusk thanked the Legislature for its long-time support and vision in creating the trails project. The potential for continued growth is high, he said, if more lodging infrastructure can be developed to meet rising demand.

Dr. Merideth Smith, PSIMED, Director of Clinical Services, discussed medication- assisted treatment in the facilities. Dr. Smith is a psychologist and works with Wexford to oversee mental and behavioral health care. She described interventions that are best practices, including medications used for opioid-use disorder.

Dr. Smith said medications such as Naloxone and Subaxone are commonly used to prevent full withdrawal, reduce cravings, and get good results for reducing opioid use and mortality rates. She also noted that methadone, one of the oldest medications, is usually not used in prisons but is effective in reducing cravings and overdose deaths. She added that the first two weeks after release from incarceration present the most risk of overdose.

Dr. Smith said Narcan is an immediate withdrawal medication and is lifesaving but is not a maintenance treatment.

The behavioral health treatment the facilities provide is needed to keep patients continuing in treatment, especially when transitioning back to the community. It also helps with real-life barriers, such as transportation and housing.

Relapse prevention targets specific risk factors but doesn’t address cravings. Dr. Smith said it helps patients with their motivation, social skills, improve quality of life, and maintain sobriety when they’re back in the community.

They also treat mental health disorders, such as anxiety, depression, and trauma that are co-occurring with opioid-use disorder. Dr. Smith said the treatment can help with stresses that come with recovery and can address the risk of suicide.

Dr. Smith said Wexford got the contract in June 2022 for mental health care, and the program “kicked into high gear.” In the current iteration, Wexford is addressing the needs of the facilities, patients, and communities with the goal to expand access to the medications and treatment.

William Marshall, Commissioner of the Division of Corrections and Rehabilitation, announced to the Committee that he has hired a new deputy commissioner, chief of staff, and general counsel. He also announced that, as of May 10, the National Guard is no longer working in any of their facilities. He thanked Guard members for their professional service.

Commissioner Marshall said that as of January the Division has 238 new corrections officers, and vacancies are down to 12%. Non-uniform position vacancies are down to 20%. He attributed the changes to the effectiveness of the recruiting teams and on-the-job training. He said on-the-job training has been effective as opposed to the pre-service academy.

“The superintendent can observe OJT to see if the candidate can do the job, and the candidate can see if the job is for him.,” Commissioner Marshall said.

Marshall said there is new crisis management protocol to respond to critical incidents and some innovative programs. The South Central Regional Jail held a successful job fair for inmates that the Division will try to replicate throughout the state.

Traditional cell doors have been replaced, and he passed around a photo of the new type of door, saying the doors no longer look like jail cell doors from the “Andy Griffith Show.” The Division is working with DMV to get official identification to inmates quickly when they are released. At the Western Regional Jail, an RV was parked on the parking lot as a pilot project to provide a place where those being released could get the assistance they need, including help with clothing, housing, and official documents.

Commissioner Marshall concluded his presentation by inviting Committee members to visit their facilities.

“I think you’ll be impressed with the work we’re doing now,” he said.

State lawmakers approved $83 million for higher education — including $51 million for grants to help students pay tuition — during the special session that ended Tuesday.

State colleges and universities have seen a 26% reduction in applications, which Republican Senate Majority Leader Tom Takubo called “dramatic and devastating.”

Click here to read more coverage from the AP.

·     September 8-10 (Parkersburg)

·     October 6-8

·     November 10-12

·     December 8-10