Government Story Archives - Page 1195 of 1196 - West Virginia Public Broadcasting

Health care exchange begins enrollment in W.Va.

West Virginia’s Department of Health and Human Resources has been working for months to organize their federal-state partnered health insurance exchange beginning enrollment on October 1.

Likened to the travel website Expedia, the exchange will allow consumers to go online, compare plans from private insurance providers and choose the one that’s best for them, but the site will also determine your eligibility for coverage on state programs like Medicaid.
For the state of West Virginia, the passage of the federal Affordable Care Act meant new requirements, like establishing a health care exchange, but for consumers, Assistant Secretary for the state Department of Health and Human Resources Jeremiah Samples said the ACA means options. Options for insurance coverage and providers.

Those options, however, aren’t as abundant here as in many other states.

As West Virginians begin to navigate the healthcare exchange looking for insurance to cover themselves and their families, the plans they have to choose from will all come from one provider: Highmark Blue Cross Blue Shield.

“Private insurance companies made the decision to not proceed with offering coverage on the exchange and there’s a number of reasons for that. Our market is not very large so it’s not as attractive to many insurance companies, and there’s also challenges to the paradigm shift from the health insurance laws,” Samples said.

“That exposes insurance companies to risks that they’ve never had to deal with before and so there are a lot of challenges there that many insurance companies felt they were not in a position to precede.”

Samples said even though there is only one private insurance provider, Blue Cross Blue Shield will still provide a variety of plan options at different cost levels.

But some West Virginians will take a different path to coverage. Samples estimated more than 130,000 West Virginians will find through the exchange they are eligible for Medicaid.

The DHHR sent out eligibility letters to more than 118,00 of those West Virginians to allow them to enroll by simply checking a box to agree to the program and then mailing the form back in to the state.

“We already have about 45,000 folks that have sent those letters in,” Samples said. “That’s 45,000 people that didn’t have insurance before, 45,000 people that will not be coming in to the county office bogging down the systems using our resources. It will also be the most streamlined process by which that consumer can go through to have their eligibility determined.”

Those individuals became eligible for coverage when Governor Tomblin announced Medicaid’s expansion in May, covering individuals earning between 17 and 138 percent of the federal poverty level. Many of those are SNAP, more commonly known as food stamp, participants and parents whose children were already covered through the state.

But if you’re still not sure where you fall, whether you are eligible for Medicaid, or want to find an insurance plan to fit your budget, Samples said the process starts online at healthcare.gov, with a phone call to the federal call center, through a private insurance agent, or at your local DHHR county office.

“Each DHHR office will have an in-person assistor embedded into it. An in-person assistor will be trained on how to provide consumers information about private health insurance,” Samples said. “So, for example, if a consumer wants to know, what is a co-pay? What is co-insurance? What do these terms mean to me? Than that in-person assistor will be able to provide them with some support as they go through the exchange.”

Open enrollment through the health care exchange begins October 1 and ends March 31. Health insurance bought through the exchange goes into effect January 1.

The website to enroll is www.healthcare.gov.

Will West Virginia Legalize Medical Marijuana?

After three failed attempts to get a bill passed that would make marijuana available to those who would benefit from its medicinal properties, Del. Mike Manypenny (D-Taylor) continues to press on. With three republicans cosponsoring his bill this past session, a public hearing on the issue late in the Regular Session, and a successful resolution to study the issue sponsored by House Health Committee Chair Don Perdue (D-Wayne), Manypenny and other advocates appear to be gaining some traction on the issue.

Members of both legislative houses met Wednesday for a hearing with the Joint Committee on Health to learn more.

The committee began with a presentation via Skype from Karmen Hanson in Denver of the National Conference of State Legislatures. Hanson pointed out that 20 states and the District of Columbia currently permit the use of marijuana for medicinal purposes.

However, the drug remains outlawed on the federal level and is classified as a Schedule I controlled substance by the Drug Enforcement Agency and the Food & Drug Administration, which means it’s seen as having a high potential for abuse with no medical purpose.

The floor was then turned over to Marijuana Policy Project Legislative Analyst, Matt Simon, a Parkersburg native who holds a master’s degree from WVU currently living in New Hampshire.

“To be clear, what patients are asking for with a state-level medical marijuana law is, really, two things,” said Simon. “They want to be protected from arrest if their doctors have recommended that they use this substance and they want to have a way to access it safely and legally.”

Simon pointed to states like California and Montana where limited regulations allow for too much access and create as many problems as they solve. He said Maine’s laws might provide a better model worth consideration.

Amongst other criticisms, Simon attempted to quell concerns that the passing of a medical marijuana law might increase use of the drug among young people. He said 15 states can provide before and after research on medical marijuana legislation where use by young people has remained the same or even dropped.

He also talked about another sticking point that often gums up legislation: the potential state revenue marijuana sales could garner.

“Some state medical marijuana programs do bring in significant revenue,” said Simon. “Others are revenue neutral. Many are written to be revenue neutral; fees are set to cover the cost of administering the program so that taxpayers will not bear the burden.

“And a few states were primarily concerned with patients and were not concerned with revenue at all, so they actually operate at a loss to those programs.”

Simon also pointed to a Pew Research study from March that shows an upswing in Americans that favor full on legalization of the drug. In fact, the study suggests that 52% of Americans are in support of legalization. He attributes these results to an increase in states with medical marijuana laws and U.S. Attorney General Eric Holder’s announcement of a change in the policy of enforcing marijuana related crimes.

Regarding the new change in policy with the Department of Justice, Joint Committee on Health Minority Chair Del. Ellington (R-Mercer) asked whether a a change Administrations on the federal level might change the DOJ’s approach to enforcing related laws.

Hanson responded with: “No one can predict the future.”

The committee finished the hearing by watching an excerpt of a video released in August from CNN and Dr. Sanjay Gupta titled Weed that details the benefits an epileptic child received from the drug as well as research being conducted in Israel.

Perdue, who also chairs the Joint Committee on Health, called Gupta’s report and some of the information provided during the meeting “compelling” but said major hurdles remain in dealing with medical marijuana legislation.

“How do you get away from the fact that—and I do believe that—marijuana is a gateway drug? Well, so are a lot of other medicinals,” said Perdue. “So, again, if you view it only for its medicinal value that’s not a hurdle you should have to overcome. Yet it’s going to be back there. That’s the thought process.

“That’s kind of the synchronization of the people who oppose marijuana. I understand that. But, in the understanding that, the discussion has to be framed in terms of medicinal value. Not in terms of recreational use or what might or what could happen.”

As for Manypenny, he’s working now on building provisions into a new version of this past session’s bill.

“One of the things that is proposed in my bill is that the taxes generated, after the cost of regulating the industry, would go to treating substance abuse in the community and drug prevention programs in the schools,” he said.

“If there’s enough money generated, then, a percentage of that will go to build a veteran’s nursing home in the southern part of the state,” Manypenny added.

Despite past and planned efforts on the issue, no specific legislation that would allow the medicinal use of the drug in West Virginia was discussed during the hearing. Manypenny hopes to firm up potential legislation during interims in December and have it ready for introduction at the beginning of the 2014 Regular Session.

State falling short in revenue collections for FY 2014

Newly appointed Secretary of Revenue Bob Kiss and members of his department presented an overview of last year’s budget to lawmakers. Legislators…

Newly appointed Secretary of Revenue Bob Kiss and members of his department presented an overview of last year’s budget to lawmakers. Legislators scrutinized the governor’s last minute decision to cut almost $18 million from Medicaid to balance the budget at the end of the last fiscal year, but they were also given some crucial insight into the revenue numbers for this year.
To fulfill his Constitutional duties in balancing the state budget, Governor Tomblin cut the state’s Medicaid program by nearly $18 million at the end of the Fiscal Year 2013.

But where that money went is still in question by some lawmakers, including House Minority Whip Daryl Cowles. He questioned Secretary Kiss during a Joint Committee on Finance.

“What was that money spent on? If we appropriated it to Medicaid, what was that money spent on?” Cowles asked.

“It wasn’t spent on anything. It didn’t exist so to speak. So, the budget had to be cut to make sure you finished the year with a balanced budget,” Kiss responded. “That $17 million didn’t go any place.”

So, it wasn’t spent. Kiss explained the governor made the total Medicaid budget smaller than what the legislature had appropriated for that year in order to keep West Virginia out of the red.

But that last minute cut wasn’t the only time Medicaid had been shorted in Fiscal Year 2013.

The fiscal year ended before a funding bill passed by the legislature for the program could take effect. That bill would have taken $67 million out of excess lottery funds and put them toward Medicaid.

Regular lottery funds were down last year as well. Of the $50 million dollars from that fund that is dedicated to Medicaid, only $29 million actually came in, adding another $21 million to the program’s deficit.

In total, Medicaid was shorted about $109 million in Fiscal Year 2013.

Director of the State Budget Office Mike McKown said for now, the program is financially stable.

“Medicaid’s cash flow is pretty good right now, but by the middle of probably March if we don’t appropriate some money to Medicaid, there’s going to be some cash flow problems,” McKowan said.

“On the last day of the fiscal year we didn’t really have many options to balance the budget. If we had not cut them the last day, nothing would have gotten re-appropriated which would have caused some major problems for some of the agencies and we felt that the cash flow was strong in the Medicaid program for a few months so that was the reasoning behind that.”

Secretary Kiss reassured the committee the emergency $18 million cut to the program’s funding is not a permanent one. The legislature will be able to restore those funds and the $67 million dollars appropriated from lottery funds is still in the state accounts to be put toward the program.

But Medicaid isn’t the only state funded program feeling financial woes. A letter in early August from Kiss and Tomblin asked state agencies to prepare its budgets as if it were taking a 7.5 percent cut. For the second year in a row.

Tomblin stressed this was a precautionary measure, but three months into the Fiscal Year, McKown said revenues are already below estimates.

“At the end of August, after two months into this fiscal year, we were down $32 million for estimate,” he told the committee. “So, this year started off not strong, but we’re keeping a close eye on that.”

McKown did bring some good news to the committee. He said budget cuts have been made without having to furlough or lay off any workers, the state has kept up with retirement contributions and the bond rating is still very good because of a strong Rainy Day Fund, ranked one of the top five in the nation.

Currently holding about $907 million, McKown added that fund, however, is not enough to fall back on. If the state lost all sources of revenue, the Rainy Day Fund could only sustain state spending for an additional two and a half months.

Legislative audit shows state purchasing laws not followed

Legislative auditors told an interim legislative committee the state's $38 million expansion of a statewide microwave communications network ignored West…

Legislative auditors told an interim legislative committee the state’s $38 million expansion of a statewide microwave communications network ignored West Virginia purchasing laws. Legislative leaders say they’re committed to reviewing the purchase process to prevent future misconduct.

The audit says the state grant implementation team didn’t seek competitive bids for the tower project. Instead, they used a Lewis County Commission contract to authorize Premier Construction to build the new towers.

The statewide plan includes building 12 towers and refurbishing five others to fill a gap in the microwave communication system for law enforcement and other first responders.

Lewis County had hired Premier in 2009 to build one microwave tower as a part of that plan in Roanoke.
State rules allow purchases from contracts issued by other public bodies, but the audit says state Purchasing Director David Tincher wasn’t asked to approve using Lewis County’s contract for the state project.

According to the audit, Tincher advised state officials to stop the towers’ construction, but his request wasn’t followed.

Senate President Jeff Kessler and House Speaker Tim Miley said in a release they have already begun a thorough review of the state’s purchasing laws and will to determine if there is the need for new legislation.

A representative of the governor’s office said Governor Tomlin will embrace the audit’s suggestions and plans to ask lawmakers to consider implementing legislation based on the report’s findings.

DHHR Secretary stays focused on filling 600+ vacancies

In her first appearance before legislators, Department of Health and Human Resources Secretary Karen Bowling said the department is not yet prepared to release a detailed response to a performance review completed earlier this year. Instead, she shared some generalizations about major issues the department is trying to address. The biggest of those issues is hiring and retaining the necessary personnel to run the state’s largest agency.

Called a fragmented department with duplicative programs seeing little results and a lack of a strategic goal-setting vision, the performance review released in April of the Department of Health and Human Resources was less than positive.

Completed by Pennsylvania-based consulting firm Public Works, the report is still in review by the DHHR and its new secretary, Karen Bowling.

On the job since July 1, Bowling admitted she’s still trying to digest the 116 pages, but was called on by the Legislative Oversight Committee on Health and Human Resources Accountability for an update during interim meetings at the Capitol.

“I’m not sure that we would ever have enough hours to present 78 recommendations, but I think just the idea of just some of the most important points in that Public Works report,” Bowling said Monday, “I wanted to make sure I emphasized those and talked about those so everyone could understand the direction in which we were going.”

But moving any direction is proving to be a slow process for the state’s largest agency.

With more than 630 vacancies, Bowling said one of the department’s top priorities is trying to fill those positions. Public Works accounted those vacancies to an “unstable work environment,” which lead to a turnover rate of 30 percent and an additional $7 million in mandatory overtime pay last year.

“Part of the turnover rate and part of the vacancy rate and part of the overtime issues are not being able to fill the jobs quick enough. Part of it is getting qualified people into the jobs fast enough and getting them oriented and ready to go,” Bowling said.

“We, the DHHR, will have to work with other areas to make sure that we change the process to the extent that we can so we can move quicker on filling vacancies.”

So to address the problem, Bowling said the DHHR is beginning to work with the Department of Personnel and the Department of Administration to try to streamline the hiring process.

Senator Ron Stollings, the committee co-chair, said that high turnover rate comes down to those on the front lines—social workers in child protective services or other areas—being overworked and under paid.

“Unfortunately, we probably don’t pay these front line workers competitive salaries and we haven’t hired,” Stollings said. “There are so many vacancies so the ones that are working are working so hard and I’d say there’s a very early burn out. So when there’s something better that comes along in a private arena they leave.”

Aside from streamlining the hiring process, Bowling said they’re looking at other factors like mentor systems and managerial training to create a better work environment and reduce the turnover rate.

On other issues, however, Bowling responded with broader answers. She said the department isn’t prepared to talk specifics for many of the areas of the complex review until they complete an internal self-study.

That answer seemed to be acceptable for the committee and Bowling will return in December to present more concrete, specific examples of how the department is making changes.

There was one question, however, Bowling was prepared to take a stance on. A position brought up by Delegate Don Perdue, who serves as co-chair of the committee, to break the DHHR into separate entities, one dealing with human services, the other with Medicaid.

“That was one of two suggestions that have been made periodically over the last 16 years that I know of. Each time, each time the Department has said, no, we don’t want to cut it a part into health and human resources, we don’t want to take out Medicaid, we don’t want to do anything like that,” Perdue said during the meeting, “and yet, Madame Secretary, our statistics are not changing. They’re getting worse.”

“I am really concerned that if we continue to gather all these chicks into one nest, they are going to be some that suffer and that’s what’s happening now in my belief. I hope you can prove me wrong.”

Bowling said she believes she can. She stood behind her predecessors, but said the DHHR can be more successful than it is today under her leadership in the future. The Secretary said she can help the department achieve the outcomes Perdue wants to see.

“My belief is that actually further integration and breaking down silos. You know, bureaus can get stuck in silos and I think breaking those down will actually improve efficiencies and will give us a greater opportunity to make positive change in the state,” she said.

“My job will be to show statistically that I can make that happen through leadership and maybe through some changes in organizational structure and management and then maybe Chairman Perdue will see that change in years to come and agree with me.”

Most of those changes Bowling believes can be made internally without much legislative action needed, but Stollings said he stands firmly behind the department and is prepared to support any legislative action that may be necessary to help turn the DHHR around.

Tabled report: How many high school seniors feel college bound?

Lawmakers delayed hearing a report from the West Virginia Higher Education Policy Commission Monday that showed only half of the state’s graduating seniors felt academically prepared to go on to college.

Chancellor Paul Hill was scheduled to present the report to the Legislative Oversight Committee on Education Accountability Monday, but the item was pushed until next month’s legislative interims because of time.

Legislators, however, were still provided with a copy of the report compiled from a survey of more than four thousand graduating seniors at 51 high schools across the state. It is intended to give lawmakers more insight as to why more students aren’t getting a college education.

According to the opinion survey, only 50 percent of graduating seniors in 2012 felt “very prepared” or “prepared” to go on to a 2- or 4-year degree program. The report also says 57 percent of students overestimated the cost of tuition at a four-year, in-state, public college or university. Those students also said the cost of attending was an obstacle. Socio-economic status and being a first-generation college student were also hindrances listed in the report.