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West Virginia Legislative Oversight Committee on Health and Human Resources Accountability updated on spending, funding

By Matt Young, WV Press Association

CHARLESTON, W.Va. – The Legislative Oversight Committee on Health and Human Resources Accountability (LOCHHRA) met for nearly three hours on Tuesday to hear testimony from both the Office of the Inspector General, and representatives of the West Virginia Department of Health and Human Resources.

Only state senators were present during Tuesday’s meeting, as members of the House of Delegates were convened in Special Session. Christina Mullins, commissioner of the Bureau for Behavioral Health (BBH) was the first to present. 

“From 2017 until 2020, BBH was awarded nearly $201 million,” Mullins began. “We expended over $166 million, and returned $34 million – that’s in federal funds.”

Mullins then explained how the majority of those federal funds are “related to two primary grants programs – the State Targeted Response Program, and the State Opioid Response Program.”

While all federal funding has not yet been spent, Mullins stated, the money has been “critical in the state’s substance abuse disorder response.”

“We are constantly working to balance the need to quickly deploy financial resources, while assuring the funds are appropriately managed,” Mullins added. 

Mullins also noted that delays in disbursement of the funds were largely unavoidable. 

“While BBH experienced better than a 1,200% increase in discretionary funds, West Virginia lacked the infrastructure to quickly expand this level of funding,” Mullins said, before adding that significant progress has nonetheless been made. 

“The $34 million that was returned to the federal government, why was that returned?” Sen. Amy Grady, R-Mason, asked at the conclusion of Mullins’ presentation.

Mullins explained that the funds were returned primarily due to infrastructure and administrative challenges faced while trying to allocate them within the scope of acceptable usage. 

Next to present before the committee was Tisa Wiseman from the Office of the Inspector General (OIG). 

“One of the big questions you had (during the June committee meeting) was OIG salaries – you wanted to know if DHHR had input into that process,” Wiseman stated. “The answer is a whole lot of people have input. The Inspector General, the program manager, whoever is hiring that person – they make a salary recommendation.”

According to Wiseman, the Inspector General has “the final say” on OIG salaries. However, all OIG salaries do require final approval from the governor. 

Sen. Jack David Woodrum, R-Summers, inquired as to which department is responsible for setting the OIG budget, and was advised by Wiseman that the OIG is tasked with setting the budget for themselves. Much as with salaries, the OIG budget requires the governor’s final approval.

Third to speak was Dr. Ayne Amjad, commissioner of the Bureau for Public Health (BPH), who provided the committee with an overview of the Bureau’s hierarchy, including specific responsibilities and current departmental-vacancies.

“Is there a strategy to improve our population’s health?” Woodrum asked plainly at the conclusion of Amjad’s presentation. “We’re ranking very low with the health of our citizens.”

“We know that West Virginia ranks highest in obesity, hypertension, diabetes,” Amjad replied. “Some of the grants – these are used to try and target those highest-risk morbidities, and those are the ones we try to focus on as far as strategies go.”

“Are you seeing any success?” Woodrum continued. “Do you have any data to indicate these programs are working the way you want them to work?”

“I think it’s hard to measure success with that, especially when we’re always in the top three worst states,” Amjad said. “As of now, I don’t see anything that says it’s working or not working.”

Next before the committee was Shevonna Lusk, COO of the Office of Health Facilities (OHF) and Dr. Colleen Lillard, Statewide Forensics Clinical Director, who provided a similar overview of the OHF operational-purview. 

“From 2014 through 2022, we’ve had an increase – basically 66% – in forensic patients,” Lusk advised the committee. “Forensic placement, (in the same period) we’ve had an increase in community placement. This is exactly what we want to see – an increase of 31%.”

“I’ll provide a brief overview of some of our successes, and some of our weaknesses,” Lillard said, before reminding the committee that SB 702 – enacted in 2021 – “modernized West Virginia’s forensic laws.”

“I think the largest success for us has been the creation and implementation of the Dangerousness Assessment Advisory Board,” Lillard noted. “We have had one referral from the courts to date.”

Lillard cited staffing concerns as the department’s primary weakness at this time. 

Tuesday’s final presenter was Mark Drennan, executive director of W.Va. Behavioral Healthcare Providers Association (WVBHPA), to provide testimony relating to medical clearance.

“What we’re talking about is the involuntary commitment process,” Drennan began. “Our members at the (WVBHPA), they’re the gatekeepers of the mental hygiene process.”

“There is a simple flow to the process,” Drennan explained. “A loved one, or someone with knowledge of the person files an application stating that ‘this person is a danger to themselves or others.’ If the court clerk accepts the petition, a pick-up order is initiated.”

At this point in the process, the county sheriff’s department is tasked with picking up the individual, and transporting them to the designated facility for a mental hygiene evaluation. 

“That’s where our folks come in,” Drennen added. “If the individual is determined to be a danger, then they move forward to a mental hygiene hearing. If the court determines them to be a danger, they are transported to a hospital where they receive treatment.”

“With regard to the mental hygiene examination, what are the qualifications of an examiner?” Sen. Ron Stollings, D-Boone, asked Drennan.

Drennan stated that examinations are performed by licensed practitioners with advanced medical and psychological training, before adding that “I think substance abuse is related to about 80% of the issues we’ve got right now.”

LOCHHRA will reconvene during the next Interim Legislative Session, scheduled to begin Sept. 11. 

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