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McCabe: DHHR should consider privatizing behavioral health hospitals

CHARLESTON, W.Va. -- A state senator Wednesday urged the Department of Health and Human Resources to look at the feasibility of privatizing state-operated behavioral health hospitals, saying soaring costs could be difficult for the state to bear.

"I think we in the Legislature are headed for a train wreck going forward in trying to find money for DHHR," Sen. Brooks McCabe, D-Kanawha, said during the department's budget hearing before the Senate Finance Committee.

In the proposed 2014-15 budget, behavioral health accounts for about $187.8 million of the department's $1.07 billion in state funding, an amount McCabe believes will increase dramatically as demand and cost for services increase.

Additionally, he said, many of the state facilities, including Lakin, Mitchell-Bateman and Sharpe Hospitals, are in older buildings with rapidly increasing maintenance and operating costs.

"I wonder if, as a state, we'll have the dollars to adequately deal with that," McCabe said.

He said DHHR should begin studying the possibility of privatizing those hospitals, allowing not-for-profit hospital corporations to operate them.

DHHR Secretary Karen Bowling agreed that DHHR should at least study privatization.

"We recognize ourselves the facilities are reaching the end of their useful lives," she said.

In her first budget presentation as DHHR secretary, Bowling went over the department's proposed $4.9 billion budget, $3.36 billion of which is federal funding, primarily for Medicaid health coverage.

She said 87 percent of DHHR's budget is exempt from the governor's 7.5 percent budget cuts -- which makes the cuts more difficult for the remaining 13 percent.

Bowling said the budget attempts to improve efficiencies in DHHR agencies by eliminating duplication of services.

"They're all good programs, but what is a duplicative service and what is not?" she told the committee.

Also Wednesday, Bowling said:

During the recent chemical leak incident, the state Bureau of Public Health served as a conduit for U.S. Centers for Disease Control's water quality assessments, because the bureau does not have experts to independently make such assessments.

"They're the experts. That's what they do. At some point, you have to rely on scientists," Bowling said.

The CDC was criticized for issuing a letter to the DHHR last Wednesday advising that pregnant women should not drink West Virginia American Water so long as any level of Crude MCHM was detectable, two days after indicating that water sampling at below 1 part per million of MCHM was safe to drink.

"It was out of an abundance of caution, because that's what was relayed to us," she said, adding, "We have to rely on the national center."

Sen. Erik Wells, D-Kanawha, was critical said calls from the Tomblin administration to officials in the nine affected counties were "one-way dialogues."

"That does not instill confidence," he said.

DHHR has cancelled a statewide contract for a broker to coordinate all non-emergency medical transportation for Medicaid recipients after none of the bids received produced significant cost savings.

Bowling said the request for proposals is being modified, with the intent of rebidding the proposed contract next week.

She said DHHR believes having a statewide broker is the only way the state can comply with federal Center for Medical Services' requirements for reimbursing nonemergency transports.

It will cost DHHR about $11.1 million this budget year to administer expansion of Medicaid benefits to about 76,000 West Virginians, and that administrative costs will increase to about $17 million in 2015-16.

Reach Phil Kabler at philk@wvgazette.com or 304-348-1220.


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