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Officials say sweeping changes are needed to prevent institutionalization of West Virginians with disabilities; lawmakers are starting with pay raises

Editor’s note: This story was originally published by Mountain State Spotlight. Get stories like this delivered to your email inbox once a week; sign up for the free newsletter at mountainstatespotlight.org/newsletter

By Erin Beck, Mountain State Spotlight

Lawmakers will strongly consider increasing pay for workers who help West Virginians with intellectual disabilities live more independently, but a legislative study recommends a broader range of reforms also be implemented.

House Health and Human Resources Committee Chair Del. Amy Summers, R-Taylor, offered her support for the pay raises during interim meetings this week. She spoke in an interview after state health officials said the move would cost less than sending people to one of the state’s mental hospitals.

“It’s actually going to save money, because we’re going to be able to provide the services that we need to surround our vulnerable population with care outside of psychiatric hospitals and nursing homes,” Summers said. “We can care for people in homes or in smaller settings. We know that’s better for the person.”

Disability rights advocates have warned for at least two years that state-owned psychiatric hospitals were indefinitely confining people.

Between 2015 and 2021, the number of people with these disabilities admitted to William R. Sharpe Jr. Hospital in Weston and Mildred Mitchell-Bateman Hospital in Huntington nearly tripled, to 167. It remained over 100 in both 2022 and 2023.

During the last legislative session, lawmakers commissioned a study on whether to increase Medicaid pay rates for the care workers. Private companies employ in-home workers who care for these West Virginians, but the state reimburses those companies with state and federal money from the Medicaid program.

Since the state Department of Health and Human Resources is facing a projected $114 million Medicaid shortfall, Jeremiah Samples, a former health official who now works for the Legislature, had predicted tough decisions for lawmakers when considering measures like pay rate increases. 

State officials have said keeping people in hospitals costs around $800 per day.

Currently, care workers earn about $10-$12 an hour. The report recommends increasing that to a range closer to $15.50-$18.60, making pay in line with surrounding states. The report projected a $106 million increase in cost, most of which would be paid by the federal government.

That money could also go to expenses like overhead, so an increase in the pay rate would not necessarily result in an across the board hourly rate increase.

But disability rights advocates said that pay increases for those workers, who assist with tasks of daily living like laundry, hygiene and bill paying, would help workers feel more supported by their employers and providers would face less competition from other employers who pay more. Workers may also stay on the job longer and get to know their patients better over time, making them more able to identify easy-to-solve problems rather than turning to hospitalization.

In 2022, there were 135 people with intellectual and developmental disabilities admitted to the state-owned hospitals. Disability Rights of West Virginia, a group that monitors patient care at hospitals, estimated that if these people lived in homes instead, the state would have paid $10 million less that year.

In a separate report also commissioned last legislative session and released this week, state health officials outlined a multitude of policies that would be needed to end institutionalization.

They recommended that the state should build more health care facilities for the short-term care of people with disabilities who become aggressive, coordinate teams of workers who visit homes when they are in mental health crises and employ a state health official who would work with providers to keep them in homes or small-group residences.

Last year, Summers co-sponsored a bill to open a transitional facility for patients eligible for hospital release, but the measure did not pass. Disability rights advocates oppose that idea because they predict clients who stay there won’t transition back to residential living. 

But when state health officials presented their own recommendations this week, they opposed such a facility, saying West Virginia already has enough open beds at small-group homes.

That prompted Summers to back off, at least for now. 

“We’ll put that idea on hold,” Summers said.

While Summers said it was clear the problem won’t have a single solution, she said she would wait for further guidance from DHHR to decide what legislation and funding was needed. 

“They’re usually not shy about asking us for money if they identify something they need,” she said.

Reach reporter Erin Beck at erin@mountainstatespotlight.org

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