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As Workforce Woes Hit Behavioral Health Centers, Advocate Calls For More Funding

The West Virginia Developmental Disabilities Council says strengthening jobs and funding for behavioral health centers and state health programs would help folks with disabilities live independently and find jobs.

West Virginia is home to 13 publicly funded behavioral health centers, run through the West Virginia Department of Human Services. Located across the state, these facilities provide things like at-home care, counseling and crisis support to residents with disabilities.

But the United States is currently facing a shortage in its health care workforce, and West Virginia is no exception. Nursing jobs in the state had a vacancy rate of nearly 20% last year, and a majority of the state’s 55 counties are medically underserved, according to a 2024 report from West Virginia University.

Tina Wiseman is executive director of the West Virginia Developmental Disabilities Council (WVDDC). She said the shortage has spelled trouble for the state’s behavioral health centers, which play an important role in providing long-term support to folks with disabilities.

“Everywhere there [are] workforce issues. But those programs would really benefit from increasing wages, more standardized training, more oversight by middle management,” she said. “Making sure that people with developmental disabilities aren’t institutionalized and lose their rights.”

The WVDDC is federally funded, and every U.S. state and territory has its own version of the council, as required by the federal Developmental Disabilities Act.

“Our main goal is to advocate for people with developmental disabilities, to make sure their rights are protected, to provide education and technical support to policymakers and lawmakers about what the big issues for people with developmental disabilities [are],” Wiseman said.

Wiseman acknowledged that state spending might be constrained by a projected budget shortfall this year. In January, Gov. Patrick Morrisey estimated that the state would face a budgetary deficit of $400 million this coming fiscal year, and said he expects it to grow in the years ahead.

Still, Wiseman said investing in behavioral resource centers, and programs that support residents with disabilities broadly, should not be looked at as a simple expense. She said these services also help residents with disabilities live independently, uplift their communities and rely less on state services, reducing costs to the state.

“It’s a needed investment, and they have payoff,” Wiseman said. “It is, on average, cheaper than any institutional facility if you invest in people with disabilities living in their communities, invest in supporting them to get jobs.”

Wiseman visited the State Capitol Wednesday as part of Disability Advocacy Week, an annual awareness campaign where advocates from across West Virginia come to Charleston to speak with residents, lawmakers and lobbyists about the needs of residents with disabilities.

On Tuesday, advocates raised awareness about West Virginia’s state use program, which helps residents with disabilities find employment by prioritizing them in the hiring process for certain state-requested jobs, like janitorial work and mail processing.

Wiseman said a better behavioral network for the state could spill over into improving other areas of policy concern. During this year’s legislative session, state lawmakers have expressed concern over reports of violence against school teachers from some students, and difficulties enforcing student discipline policies in local school systems.

The causes of school discipline issues run the gamut. But for students with mental health issues or developmental disabilities, Wiseman said more robust behavioral health care could turn a disciplinary problem into a chance for a child or teen to get the health support they need.

“Sometimes, kids just need someone that can maybe take them out of that classroom environment, maybe take them on a walk,” she said. “Just do some talking to them. It gives everyone in the classroom a little bit of a break to kind of reset. It gives the teacher time to reset. And it gives that student time to just calm down, refocus and then go back into the classroom.”

Wiseman feels that providing students support can be more effective than punitive responses to discipline violations.

“A lot of those things are things that really should be dealt with in that manner, as opposed to in-school or out-of-school suspension,” she said.

While investing in mental and behavioral health resources comes with a price tag, Wiseman said it also cuts costs in other areas. She believes that pays off in the long run, especially when it means helping residents find jobs that make them feel both fulfilled and financially independent.

“It all comes around full circle, supporting that community. The more people we can get in the workforce, the better,” she said. “I mean, it’s a win-win.”

PEIA Getting More Expensive, Agency Execs Say Pharmaceuticals Are Driving Up Costs

Nearly every day since the West Virginia legislative session began, each of the chamber’s finance committees has been hosting hearings from different agencies, organizations, and branches of government. Wednesday the House Finance committee held a hearing on the Public Employees Insurance Agency.

The agency’s five-year plan asks for about a $100-million bump in funding from the legislature.

It also raises premiums, co-pays, and deductibles. Users can expect premiums to rise by 14% to 16%, deductibles to rise around 40%, and co-pays by as much as 150%.

Jason Haught, Chief Financial Officer, presented the plan to delegates.

“We will be increasing premiums at an estimated 29.9 million for the non-state fund,” Haught said.

“The next row is deductible and out-of-pocket. So we made some benefit changes this year to the plan substantially, the value estimated for the state fund deductible and out-of-pocket,” Haught said.

Spousal surcharges, for those who have access to health insurance through their workplace, are also going up – which, according to Haught, will mean less users.

“This was a big move. This was a big impact on the plan, and it’s about to get bigger, because after analysis of the first year we did increase the spousal surcharge substantially. It’s going to be going up to 250 dollars,” Haught said.

He said this increase will help the state save on the program through increased revenues from the increased spousal charge and the assumed cost reduction of those who leave the plan.

Haught told legislators the major cost driving down the bottom line across the healthcare industry as a whole is pharmaceuticals.

“When I first started with the plan, drugs made up about 10 % of our overall plans, possibly 15%,” Haught said.

Now Haught said pharmaceuticals account for 25 to 30 percent of the budget, around a ten percent increase, which Haught said equals hundreds of millions of dollars.

“Healthcare trend the last few years has been startling in all sectors, retiree and active. So you know 10% of 1 billion is 100 million dollars. So that kind of puts into perspective, when you talk about a percent,like talk about 5% talk about 10%, we’re not talking about a $500,000 line item. We’re talking about a $1 billion line item,” Haught said.

Del. Mathew Rohrbach, a Republican from Cabell County, is also a practicing doctor. He said the key to relieving the financial obligations of the state to PEIA, and the cost to users, is to get pharmaceuticals costs down.

“The biggest driver of our cost is increased pharmaceutical cost, and anything we can do in that regard through better discounting, better utilization, better pharmacy benefit manager arrangements, that’s really where we’re focused,” Rohrbach said.

But he said the state can only do so much on this, and it’s going to take an act of Congress to achieve.

“Most of the relief that’s going to be had on pharmaceutical costs is going to be from the federal level, and that does appear to be one of the few things there’s actually very bipartisan support in Congress, is I think the whole country is tired of these just massive increases in pharmaceutical costs,” Rohrback said.

Correction: The Article was changed from Spousal surcharges, for those who don’t have access, to spousal surcharges that DO have access.

House Bill To Repeal CON Law Fails By One Vote

One of the most debated and discussed bills of the 2025 legislative session failed to pass its committee by one vote Monday afternoon.

House Bill 2007 bill failed to leave the committee on a roll call vote 12 to 13.

A similar bill, Senate Bill 453, is being considered by the Senate’s Health and Human Resources committee. The bill was introduced and referred to the health committee on Feb. 13 but has yet to be placed on an agenda.

In past sessions, lawmakers have introduced bill after bill in an attempt to repeal a regulatory process required to expand health care services called certificate of need (CON).

CON is a regulatory process, overseen by the West Virginia Health Care Authority (WVHCA), that requires providers who want to create or expand healthcare services to obtain legal documentation proving those new services fit an unmet need in the area.

This session’s version is House Bill 2007, which aimed to repeal the CON process and terminate the WVHCA, leaving those decisions to the incoming secretary of the Department of Health, Dr. Arvin Singh and Attorney General John “JB” McCuskey.

Both Singh and McCuskey are new to their positions. McCuskey was elected to his position, and Singh was appointed by Gov. Patrick Morrisey after he was elected the state’s 37th governor in November 2024.

The repeal of CON is a major priority for Morrisey, as he outlined in his State of the State address Feb. 12., with the stated purpose being to restrict duplicative services.

“It’s essentially a permission slip, it’s given out by the government, that you need to open up a new hospital or healthcare facility,” Morrisey said. “It hands over power to unelected bureaucrats and major healthcare providers who decide which committee communities need new or expanded healthcare services. This is big government activism at its worst.”

The House’s Health and Human Resources Committee discussed the original version of the bill at length in a hearing on Feb. 20 where lawmakers heard differing opinions from several presenters.

Singh was the first presenter called to speak to the committee on Thursday afternoon.

“By putting CON decisions in the hands of bureaucrats, we are artificially inflating costs and determining winners or losers, leading to negative impacts to patient care,” Singh said. “This must change, and that starts with the repeal of CON laws and the Health Care Authority.”

Singh argued that repealing West Virginia’s CON laws would allow for new providers to offer more services without government regulation, which he and other proponents of repealing the law say would allow for competition in the healthcare industry, possibly leading to innovation.

Throughout the five-hour-long discussion, delegates from some of the state’s more rural regions expressed concern that competition, if it does occur, will be focused on the state’s more densely populated areas, worsening their regions’ lack of access to adequate care.

Del. Jeffrey Stephens, R-Marshall, asked about the possibility of further hindering rural area’s access to quality health care if CON is repealed.

“West Virginia, being a rural state, you know, some of us are from more populous areas like myself that, I mean, I can go to a lot of places, I can be within three hospitals within 10 minutes,” Stephens said. “I think if you’re going to be a business person, the surgical center or the hospital or anything like that, I’m going to go to where the population is.”

Del. Mike Pushkin, D-Kanawha, and minority chair of the committee expressed concerns about viewing the healthcare industry as a business during Singh’s testimony.

“You said, like any other business, it’s up to that,” Pushkin said. “That’s what you said.”

“I don’t think health care is like any other business,” Singh answered. “It deals with people’s lives. It’s a very, very important industry.”

Delegates heard from 13 speakers in total at the Feb. 20 hearing. Witnesses ranged in representation from hospitals like West Virginia University Medicine, Memorial Health System, Valley Health and Mon Health, all of whom hold differing views on CON repeal. There were also representatives from research institutes across the country offering their expertise.

Del. Jonathan Pinson, R-Mason, expressed some frustration with all the contradictory testimony the committee heard.

“I think myself and several other members of the committee are kind of left in the same spot in that we have half of this discussion telling us that competition is going to destroy the market, that it’s going to destroy the healthcare industry in the state of West Virginia if we repeal CON,” Pinson said. “And then we have the other half (of) the discussion telling us the only way to improve the health outcomes, the health industry in the state of West Virginia is to improve the market by repealing CON.” We’re left right here in the middle trying to figure out everybody’s facts and which facts are actually facts, and which facts are conjecture.”

Monday’s Roll Call Vote

On Monday, lawmakers voted on a committee substitute for House Bill 2007 that would have continued the state’s moratorium on certain services, such as nursing homes, intermediate care facilities, methadone beds, substance abuse treatment beds and hospice care.

The number of beds allowed in those types of facilities would also remain regulated under House Bill 2007. For example, West Virginia’s limitation of 250 licensed substance abuse treatment beds is maintained in the legislation.

Pushkin asked legislative counsel to clarify the moratorium and its relation to CON regulations.

“Certificate of need still exists, Delegate, but the Secretary is prohibited from issuing a certificate for the development of these services,” Legislative Counsel explained.

Pushkin asked counsel if a facility that provides any of the services under the moratorium closed, would another be able to take its place?

“I’m still kind of hung up on this moratorium thing, of this way of dealing with carve-outs, of just creating these new moratoriums,” he said. “If a hospice wasn’t doing so well, then another agency purchased them, would that be allowed under this law?”

Counsel explained that under this legislation, it would take legislative action to allow for a new facility to open.

Pinson expressed similar concerns.

“If West Virginia’s population were to increase, and we realized that there was a greater need for some of these services, the legislature would have to go in and increase the number?”

Counsel confirmed legislative action would be required to replace a facility that falls under the moratorium laid out in the committee substitute for House Bill 2007.

Pushkin moved to amend the bill to remove West Virginia’s moratorium on the opening of additional methadone clinics, which was passed into law in 2007.

There are currently nine methadone clinics allowed to operate in the state by law. Pushkin said that seven of those facilities are owned by an out-of-state company, which he argued proved the moratorium put in place almost 20 years ago did not stir competition but created a monopoly.

“What you have right now with the methadone clinics is one company from, I believe, from Ohio, that makes a lot of money off of West Virginian’s misery and sends all that money to Ohio,” he said. “I think that while we’re dealing with this would be a good time to correct that mistake that was made years ago and created this monopoly in this state, really not very well regulated monopoly at that where patients are treated, not so much like patients, but more like cattle.”

Lawmakers rejected Pushkin’s amendment via voice vote.

Pushkin moved to table the bill, calling it “flawed” and “not well thought out,” and said he thinks it needs more work. The motion was rejected.

‘I’ve Got Nothing Here’, Advocates For Homeless Folks Grapple With Limited Resources In Southern Coalfields

In a little church, nestled in the middle of the town of Logan sits Nighbert Methodist Church. Inside residents who are experiencing homelessness or food insecurity line up for a free meal, and a care package full of groceries.

The church hosts these events multiple days a week.

Outside the rain is picking up. The event organizers let folks know about a flood warning. Floods can be deadly for people sleeping along the creeks and rivers that scribble through the county.

“Listen, listen, we are going to start getting flood warnings. Don’t fall asleep in the flood zone,” said Marty Dolin, one of the organizers.

Violet, whose name was changed to protect her identity, is one of the attendees who will need to heed this warning. She lives, for the most part, outside.

“I stay wherever I can. I’ve stayed in abandoned buildings, under bridges, in the open night air,” Violet said.

She said she experienced a divorce and unemployment.

“Just things happen, I couldn’t maintain everything,” Violet said.

She also struggled with addiction. Logan County was part of the nation’s epicenter for the opioid epidemic.

“I’ve had a long line of history with, you know, substance abuse and such things,” Violet said.

In Logan, Violet and others say it’s hard to shake the stigma. She said, in a small town, it’s hard to get past being once a criminal, or a once addict.

“I’ll never be more than that, no matter what I do, I’ll never be more than that,” she said.

Aside from the churches and a few nonprofits there isn’t a lot of help in breaking the cycle.

Last summer’s U.S. Supreme Court decision allowed for camping bans aimed at homeless communities. Those bans are going into effect across the state, and a statewide ban has been introduced.

There isn’t a homeless shelter within an hour’s drive of Logan. This is the case for nearly all of southern West Virginia, where most communities are a couple hours from a shelter.

And the City of Logan recently passed a camping ban, that prohibits camping on public property.

Ben Hannah and Kristy Preece, outreach workers with the Coalition to End Homelessness said people with nowhere to go, really have nowhere to go now.

“Your quickest way for a warm bed if you’re homeless,” Hannah said.

“— is rehab,” said Preece.

“— Or jail. That’s the only way around here,” Hannah said.

Working in rural southern West Virginia also leaves him with very limited resources. He often provides transportation to people and gives people rides to available shelter throughout the region.

“’I’ve taken people to a shelter in Pike while I’ve taken people to a shelter in Beckley. I’m taking people to a shelter in Huntington, Charleston. I’ve even met people from Parkersburg and did a hand off with them to get them up there,” Hannah said. “ I have nothing here, nothing.”

Kristy Preece helps the mother of four fill out housing forms.
*Briana Heaney/West Virginia Public Broadcasting*

Affordable housing is in short supply here too. Especially units with living standards that qualify them for housing vouchers. Rent can be expensive. The average yearly income here is $28,762 per year. Rent for a one-bedroom can be upwards of $800 per month.

Some families seek temporary shelter in hotel rooms.

At a hotel in Chapmanville, Hannah and Preece are checking in with clients, a family of six.

The coalition is paying for their hotel room until they can get the family into more stable housing.

Hannah gave the couple an update on their prospects.

“The affordable housing that we have around here is just basically non-existent. Yeah, there’s only so many places you can go, and we’ve almost exhausted all of them. But, I mean, I have faith that we’ll find one for you guys,” Hannah said.

Hannah said there’s one extra problem for the family.

“But then we got the issue. We’ve got four daughters and two parents, so it has to be a bigger unit. Yeah,” Hannah said.

The couple has never had an eviction, nor do they have a criminal record. Hannah said those qualifications should make it easier for the family to get into a place if they can find one.

But they still haven’t been able to find housing for the family. Hannah said with the recent floods, it’s going to be even harder.

A Legislative District In Turmoil, Flood Recovery And Substance Abuse Prevention, This West Virginia Week

On this West Virginia Week, we’ll learn more from two experts about Certificate of Need and why state lawmakers want to change it.

We’ll hear from the state’s new director of substance abuse prevention and recovery. We’ll also visit a legislative district that’s been thrown into chaos.

We’ll get an update on the flood recovery in southern West Virginia. We’ll also hear about beekeepers, a preservation district and a surface mine.

Curtis Tate is our host this week. Our theme music is by Matt Jackfert.

West Virginia Week is a web-only podcast that explores the week’s biggest news in the Mountain State. It’s produced with help from Bill Lynch, Briana Heaney, Chris Schulz, Curtis Tate, Emily Rice, Eric Douglas, Jack Walker, Maria Young and Randy Yohe.

Learn more about West Virginia Week.

Senate Passes Bill Broadening Vaccine Exemptions

The West Virginia Senate passed a bill Friday that would allow for broad exemptions to vaccination requirements for children.

Last year, the West Virginia Legislature passed House Bill 5105, which would have broadened student vaccine exemptions and granted non-public schools authority to set their own vaccine requirements. But former Gov. Jim Justice vetoed the bill, citing concern from the medical community.

But this year, Gov. Patrick Morrisey has expressed support for wider vaccine exemptions. Senate Bill 460 would expand upon those outlined by the legislature last year.

The bill requires public and private schools to accept children who have received a religious or philosophical vaccine exemption. The bill modifies an original proposal from the governor, removing mandated reporting requirements for students receiving vaccine exemptions.

Using an annotated map to make her point on the Senate floor Friday, Sen. Laura Chapman, R-Ohio, said the law will bring West Virginia in line with other surrounding states.

“This law is not something crazy that anti-vaxxers want,” Chapman said. “This is bringing us up with 45 other states that realize that religious beliefs need to be respected, and they find that it’s safe and effective for public health to allow these children to have a religious or philosophical exemption.”

Many legislators spoke against the bill.

Sen. Tom Takubo, R-Kanawha, said the bill’s passage undermines medical advice from nearly 30 West Virginia institutions.

In a 16-minute floor speech, Takubo said that most constituents he has talked to don’t want this. Chief among them are private schools that would be required to accept unvaccinated students despite their own policies, he said.

“The question for me (is) who wants this bill? It’s not religious schools. I mean, the vast majority are begging us, ‘Let us decide on our own,’” Takubo said. “It’s not parents. People of West Virginia have overwhelmingly spoken on this issue. It’s not the medical community.”

Aaron Siri, a civil lawyer who specializes in vaccine law, addressed the Senate Health Committee over video call last week, and spoke for an hour in support of the bill.

“In Senate Health, the only proponent was a trial attorney from L.A. that makes his living — hundreds of thousands of dollars, his entire law firm — on suing on vaccine issues,” Takubo said. “Are we doing this for trial attorneys?”

Dr. Steven Eshenaur, the public health officer for the Kanawha-Charleston Health Department, says West Virginia children are especially at risk due to low vaccination rates for babies and toddlers.

“West Virginia is different. We have one of the lowest immunization rates up through 24 months of age in the entire country,” Eshenaur said. “If those children are not immunized, we may see much, much, much lower immunization rates going into school than other states.”

Eshenaur added that the state could witness outbreaks in diseases like polio, which were nearly eradicated.

“Unfortunately, we may have to learn the hard way through seeing the reintroduction of childhood diseases that spurred our predecessors, our grandfathers, our fathers, to pass laws to protect their children,” Eshenaur said.

Sen. Patricia Rucker, R-Jefferson, said current vaccine laws prohibit unvaccinated children from attending school and participating in extracurriculars.

“Compulsory immunization forces those West Virginians to choose between their religious belief and their children’s fundamental right to an education,” Rucker said.

Senate Bill 460 passed by a vote of 20 to 12. It now heads to the West Virginia House of Delegates for further consideration.