Certificate of Need Story Archives - West Virginia Public Broadcasting

House Approves Bill To Arm W.Va. School Teachers

On this episode of The Legislature Today, there was contentious third reading debate in the House of Delegates over the much talked about bill to arm teachers as concealed carry protection officers.

Updated on Thursday, Feb. 22, 2024 at 10:14 a.m.

On this episode of The Legislature Today, there was contentious third reading debate in the House of Delegates over the much talked about bill to arm teachers as concealed carry protection officers. Randy Yohe has the latest on House Bill 4299.

In the Senate, the chamber had one of its busier days as official deadlines draw closer. Next Wednesday is Crossover Day, meaning that all bills have to be out of their chamber of origin to have a chance of becoming law. Briana Heaney has more.

Also, the Senate Government Organization Committee advanced a bill that would promote Randall Reid-Smith, the curator of the Department of Arts, Culture and History, to a cabinet secretary. The committee approved Senate Bill 865, which now goes to the full chamber. West Virginia Public Broadcasting is part of the Department of Arts, Culture and History.

A health facility would not need to obtain a certificate of need to operate in West Virginia if a certain House bill becomes law. Emily Rice has more.

Special education educators, students and their families gathered at the Capitol to advocate for more support in their classrooms. Chris Schulz has the story.

And, on History Day at the Capitol, the rotunda is sent back in time. It becomes a place of living history, where the lives and lessons from our state’s past become touchstones for the present and future. Randy Yohe has the story.

Finally, women’s health has been a popular topic in the Senate this year. Many bills and amendments have been introduced that focus on women’s health policy. Briana Heaney speaks with Sen. Patricia Rucker, R-Jefferson, and Del. Anitra Hamilton, D-Monongalia, about women’s health in the state and legislation that affects women.

Having trouble viewing the video below? Click here to watch it on YouTube.

The Legislature Today is West Virginia’s only television/radio simulcast devoted to covering the state’s 60-day regular legislative session.

Watch or listen to new episodes Monday through Friday at 6 p.m. on West Virginia Public Broadcasting.

House Committee Votes To Eliminate Healthcare Certificate Of Need

A health facility would not need to obtain a certificate of need to operate in West Virginia if a House bill becomes law.

Delegates debated certificates of need for health facilities Tuesday during the meeting of the House Health and Human Resources Committee. Proponents of eliminating the practice say it would open the state to more health care services, but health officials say it would put the existing health care system at risk.

A certificate of need (CON) is a legal documentation process in which a proposed healthcare facility must show the need for their facility at a certain location and financial feasibility, among other factors.

Currently in West Virginia, all health care providers, unless otherwise exempt, must obtain a CON before adding or expanding health care services, exceeding the capital expenditure threshold of $5,803,788, obtaining major medical equipment valued at $5,803,788 or more, or developing or acquiring new health care facilities.

House Bill 4909 would eliminate those requirements for all health facilities in West Virginia except hospice care homes.

Jim Kaufman, president of the West Virginia Hospital Association, testified before the House Health and Human Resources Committee on Tuesday. He said the association strongly opposes the repeal of CON.

“Our concern is if you eliminate CON, basically, you could have organizations from outside the state come in and cherry-pick services,” Kaufman said. “Usually what you’re going to see is they’re going to go after commercial pay patients, you’re paying patients and leave the institutions that are here with their Medicaid and uninsured population, and you’re gonna see the entire health care delivery system undermined.”

Kaufman testified that the average West Virginia hospital’s payer base is 75 percent Medicaid and Medicare. The national average is 40 percent.

“That’s why we feel it would undermine the health care delivery system in this state, leaving our existing hospitals, whether they’re a critical access hospital or midsize hospitals, with basically the lower paying patients,” Kaufman said.

Del. Heather Tully, R-Nicholas, questioned Heather Conley, an assistant attorney general embedded with the Health Care Authority. Tully asked if a facility’s certificate of need could be reconsidered if they’re not meeting a community’s needs.

“Once you have a CON, you have to do something pretty egregious, and someone has to bring it up before anything can happen to your CON,” Conley said.

Tully spoke in support of the bill, citing concerns about lack of oversight once a CON is granted.

“I think it’s concerning that we don’t look at the diversions and bed closures and changing of staffing levels,” Tully said. “So for that reason, I will be supporting this bill. And hopefully we will infuse some competition into health care and make it make everybody better.”

The bill passed with 13 yeas and nine nays.

House Lifts Certificate Of Need, Extends Corrections Staffing Emergency

The House passed House Concurrent Resolution 78, indefinitely extending Gov. Jim Justice’s state of emergency over correction facilities staffing levels. The concerns continue to focus on safety, security and maintaining National Guard support.

On Thursday, the House of Delegates lifted the requirement that medical facilities must show a service is needed and extended a State of Emergency for the state’s corrections system.

House Bill 613 passed with a 75-20 vote. The bill lifts certificate of need requirements for birthing centers and medical facilities on a hospital campus and allows facilities other than hospitals to perform MRI’s. Previously, medical facilities had to get state approval before offering new services.

Del. Mike Pushkin, D-Kanawha, opposed the bill, concerned the measure would hurt more people than it helped.

“When you allow these private practices to offer these types of procedures that are really what they can bill a whole lot more with, the hospitals also will bill a whole lot more,” Pushkin said. “When they can cherry pick, and they can say, well, we’re not going to take PEIA, we’re not going to take Medicaid, we’re not going to take Medicare, we’re only gonna take private payers. The hospitals, they have to take everybody and rightfully so. Then you can run into a dangerous situation, and who will it hurt? The people who need the services because they can’t afford it.”

Del. Heather Tully, R-Nicholas, supported the bill. She said it would help her constituents with enhanced medical options.

“I live in Summersville. As you all well know, it’s about an hour commute either to Beckley, an hour and a half to Charleston, an hour and a half to Clarksburg or some of our patients even go to Elkins to get obstetrical care,” Tully said. “My hospital in my community also is interested in expanding some cancer treatment services and so that would also eliminate the travel times for patients in my area that may need cancer treatment services if those are to be implemented.

HB 613 is effective from passage and now goes to the governor for his signature.

Del. David Kelly, R-Tyler, chair of the House Jails and Prisons Committee, spoke of the continued dangerously low corrections employment rate.

“We expect to spend anywhere from $17 to $20 million this year, just to cover the cost of our National Guard. Additionally, we’re looking at $22-plus million dollars last year in overtime. And we can only expect that that number will increase this year, because we’re losing our officers almost on a daily basis,” Kelly said. “Our officers are saying I can’t do this anymore. And so I just want to share just a few things with you, if I may. As of March 2, we have 1,042 overall vacancies in DCR, that’s 27 percent. Now when we narrow that down, what we’ve got are 751 officer vacancies. That’s unconscionable. That’s 33 percent vacancies in our jails and prisons.”

The House also completed legislation on House Bill 2002, providing support for families by increasing an adoption tax credit, establishing the eligibility of adopted children of West Virginia residents for early intervention services and creating the West Virginia Mothers and Babies Pregnancy Support Program.

And they passed Senate Bill 273, which allocates child protective service workers in counties according to a county’s average caseload and population based on the 2020 Census.

The bill requires the Department of Human Services to report those changes to the legislature and have a backup system in the event of a centralized intake outage. The bill also orders the development of a merit-based system for specified employees.

Both HB 2002 and SB 273 now go to the governor for his signature.

Medicaid Buy In, Other Health Legislation Advances During Saturday Session

Legislation focused on West Virginia health issues was a topic of debate and lawmaking during Saturday’s legislative session with many bills being passed through both chambers.

HB 3274 – Affordable Medicaid Buy-In Program Passed the House

Affordable Medicaid Buy-In Programs were a topic for debate in the House of Delegates.

House Bill 3274 would create the Affordable Medicaid Buy-in Program to help alleviate financial strain on recipients of Medicaid who start a job that disqualifies them from receiving their benefits.

Medicaid buy-in programs soften the “cliff effect” for recipients who lose their coverage when starting a new job that pays too much for Medicaid eligibility, until they can earn enough to afford other health insurance plans.

According to 2023 data from the U.S. Department of Health and Human Services, an individual would lose their Medicaid benefits in West Virginia when they earn more than $20,120 annually. The Affordable Medicaid Buy-in Program would allow that threshold to rise to 200 percent, or $29,160 annually.

Del. Evan Worrell, R-Cabell, explained the bill on the house floor.

“The idea behind this legislation is an attempt to mitigate the cliff effect for those individuals on Medicaid,” Worrell said. “The cliff effect occurs when wages from a new employment opportunity do not make up for a family’s loss of state benefits, putting the family in a worse financial situation.”

Del. Riley Keaton, R-Roane, asked Worrell questions and spoke in opposition to the bill on the House floor.

“So, we’re actually going to see is the public payer mix of patients grow pretty substantially for our health care providers,” Keaton said. “And then we’ll be faced with politically complicated decisions about how to make that program make sense.”

Jordan Maynor, R-Raleigh, spoke in support of the bill.

“I think my friend from the 15th (Keaton) brings up a great point. And it did get me thinking, but I think the intent of the bill is to move people off of Medicaid, keep a job, keep climbing that ladder of economic success, if they get off Medicaid completely eventually,” Maynor said. “And right now, it seems to be if we don’t do this, we’re incentivizing them to not keep their job, not take that pay raise and just be on Medicaid completely, which means no buy in from the patient.”

The bill passed the House with a vote of 73 yays, 19 nays and 8 absent, or not voting. The Senate will decide whether or not the bill makes it to the governor’s desk for his signature.

House Bill 2993 – Rural Emergency Hospital Legislation Passed Unanimously

House Bill 2993 would create a new hospital designation called “Rural Emergency Hospital.”

During discussion of the bill in the Senate Health and Human Resources Committee Feb. 21, it was stated that the new designation was intended to allow access to critical outpatient hospital services in communities that might not be able to support or sustain a traditional critical access hospital.

The bill passed the Senate unanimously on Feb. 25 and was sent to the House with a request to concur.

Senate Bill 613 – Certificate of Need was laid over

In recent years, “Certificate of Need” has been a topic of interest in the West Virginia legislature.

Since 1977, most West Virginia health care providers that want to open or expand facilities must obtain a Certificate of Need. The process is overseen by the state’s Health Care Authority. To acquire a Certificate of Need, facilities must prove that their community needs the proposed service.

The purpose is to regulate the healthcare market to discourage unnecessary duplication of services. However, some lawmakers and advocates have asserted in recent years that the process — which can cost providers tens of thousands of dollars — actually creates more barriers to care. They claim it protects existing providers from competition more than it protects patients.

Senate Bill 613 aims to amend state code relating to a certificate of need. Two sections relate to birthing centers which are healthcare facilities, staffed by nurse midwives, midwives and/or obstetricians, for mothers in labor, who may be assisted by doulas and coaches.

This discussion comes just weeks after the Senate passed House Bill 2789 removing the requirement that a birthing center obtain a certificate of need; and exempting birthing centers from obtaining a certificate of need, to the committee on Health and Human Resources on Feb. 8.

Senate Bill 613 would remove birthing centers from the list of reviewable services, providing that birthing centers are exempt from certificate of need review; and removing an exemption for hospital based birthing centers.Other code changes include, providing physician office practice meeting specified criteria may acquire and utilize one magnetic resonance imaging scanner and providing for data verification.

The bill was laid over on 3rd reading with the right to amend.

HB 3341 – Allowing for Cigar Bars

House Bill 3341 would permit cigar bars and cigar lounges to operate in West Virginia resorts. It passed through the House of Delegates.

The bill was discussed in the House of Delegates with lawmakers arguing for personal freedoms, while others argued the bill would be a step in the wrong direction for tobacco cessation in West Virginia.

Del. Moore Capito, R-Kanawha, explained the bill on the House floor.

“The purpose of this bill is to permit cigar bars or cigar lounges, meaning an indoor area designated specifically for the smoking of tobacco products at a resort,” Capito said. “The bill defines what a resort is and puts forth a framework under which these lounges or bars are to operate.”

Some legislators argued that the definition of resort was not clear while others stood to share personal stories of tobacco use hurting them and their loved ones, arguing against exposing employees of resorts to secondhand smoke.

Del. Adam Burkhammer, R-Lewis, said he felt the bill would push West Virginia in the wrong direction.

“I believe that in recent years, we’ve even created a Tobacco Prevention Task Force. And now I’m not real quick on the budget, but I believe we give that about $3 million a year. I’m sure someone can probably correct me in that, but we’re moving in the wrong direction for things that we have said we did not want in public places anymore,” Burkhammer said. “And I will agree, and I support freedom, but I will tell you that you can take your freedom and smoke outside.”

After a half hour of debate on the House floor, House Bill 3341 passed to the Senate for their consideration with a vote of 57 yays, 33 nays and 10 absent, or not voting.

Lawmakers Agree W.Va. 'Certificate of Need' Laws Need Reform

Multiple proposals that would have either repealed or significantly scaled back the “Certificate of Need” requirement for health care services in West Virginia were voted down Tuesday during an hourslong debate on the House floor.

Lawmakers were split on removing the requirement, with around 60% voting consistently against the proposals and 40% in favor. But delegates on both sides said that the decades-old system is in need of reform.

“There are some uncertainties, but one thing that is certain is that the system we have is not working,” said Republican Del. Dana Ferrell, who spoke in favor of repealing some Certificate of Need requirements.

Since 1977, most West Virginia health care providers that want to open or expand facilities must obtain a “Certificate of Need.” The process is overseen by the state’s Health Care Authority. To acquire a Certificate of Need, facilities must prove that their community needs the proposed service.

The purpose is to regulate the health care market to discourage unnecessary duplication of services. However, some lawmakers and advocates have asserted in recent years that the process — which can cost providers tens of thousands of dollars — actually creates more barriers to care. They claim it protects existing providers from competition more than it protects patients.

Republican Del. Heather Tully called the Certificate of Need “a competitor’s veto.”

“It is heavily influenced by political relationships, providers’ clout, organization size, overall wealth and resources, rather than sound policies, objectives and concern for patients,” she said.

Republican Del. Joe Jeffries agreed, saying that it limits consumer choice and stifles innovation in the health care field.

“I don’t think there’s one member on this floor that hasn’t heard from constituents about not having decent health care options in this state,” he said. “We need to bring the competition to the state.”

A bill that would have repealed the Certificate of Need requirement failed earlier this month in the House Health and Human Resources Committee after five hours of discussion and debate.

The proposals being discussed Tuesday that would have repealed some requirements were amendments to a different bill. Among the amendments was one that would have repealed the Certificate of Need requirements except for nursing homes, intermediate care facility beds, hospice, home health, and personal services. Another would have excluded a Certificate of Need process from birthing centers and all existing hospitals.

Republican Del. Matthew Rohrbach, chair of the House Health and Human Resources Committee, spoke against Tuesday’s proposals, but he said the system is “antiquated and ”has to change” and be updated.

“Yes, the Certificate of Need needs change, there’s no question about that — that came across loud and clear,” he said. “Will we do that with a sledgehammer and just blow it up today and see where the pieces fall? … I would challenge there is a better way, a more thoughtful way.”

Republican Del. Ken Reed agreed. He said the Legislature should be having serious conversations about updating the requirements, but that it’s a process that requires more time and discussion.

“We’re trying to push something through that’s going to cause a ripple effect in the marketplace going forward and just with the pandemic going on, I just don’t think that’s a wise thing to do at this point,” he said. “I just do not think this is the right time to push that boulder over a cliff because you just don’t know where it’s going to land.”

House Pushes to Keep 'Certificate of Need' in W.Va.

A legislative audit released earlier this year encouraged lawmaker to get rid of the state’s certificate of need process. A Certificate of Need is essentially approval from the state to open a new hospital, clinic or health related facility. Senators have introduced bills to get rid of the process, but delegates are trying to save it.

More than 30 states have a Certificate of Need process like West Virginia. It’s meant to prevent the inflation of health care costs by limiting the services provided in a geographic area based on need.

Two bills have been introduced into the Senate this session to completely remove the certificate of need process, eliminating the West Virginia Health Care Authority, but in the House members are attempting to clean up the certificate process through House Bill 2459.

Delegate Matthew Rohrbach, a Republican from Cabell County, is a sponsor of the bill. As a doctor, Rohrbach says he understands that getting rid of the process might increase competition in the healthcare system in West Virginia.

“Some states have done away with CON that are bordering us,” Rohrbach said, “and unfortunately that’s created an unfair advantage for some of our border states against our local hospitals that are providing care to our patients and they’re employing our citizens.”

Rohrbach says, though, other states that have gotten rid of the approval process have faced challenges too.

“In Pennsylvania in particular, they’ve had a lot of problems when they’ve dropped their CON, with the expansion of services, volume has went down, and they’ve had some quality problems.”

Both of the Senate bills to repeal the certificate of need process are sponsored by Senate Majority Leader Ryan Ferns, a physical therapist and business owner from the northern panhandle. While neither of the Senate bills have been considered by the Senate’s Health and Human Resources Committee yet, Del. Rohrbach calls the House bill a fair compromise that balances healthcare access for rural communities with the quality of service provided.

House bill 2459 passed 98 to 1 Monday and moves on to the Senate.