Gov. Jim Justice’s latest plan for spending millions of dollars of federal pandemic aid would set up a program that aims to train new nurses, but provide no immediate help for West Virginia nurses who — stressed and exhausted — await another winter onslaught of COVID-19 cases expected to flood the state’s hospitals over the next few months.
A year ago, the West Virginia Nurses Association began asking Justice to allocate a small amount of the $1.25 billion the state received in federal CARES Act money to meet nurses’ urgent needs: compensation if paid leave ran out while they were off work because they contracted COVID-19 on the job, and help to cover financial hardships from being sick. They only wanted $200,000. They were told all the CARES Act money was already allocated, and continued to lobby for help from other state sources.
“Our issue is not the fact that we need to continue to [train] nurses and create programs to create nurses,” said Julie Huron, the group’s executive director. “We need to do something to show nurses we have their back right now.”
But with just over a week before the federal deadline to allot the more than $120 million the state had remaining in CARES Act money, Justice instead announced he would earmark a large chunk for a nursing program that officials say won’t have an impact for years to come.
West Virginia public health leaders know this winter is likely to be a difficult one, as health care systems face a potential one-two punch of the Omicron and Delta variants.
“We’re worried really about No. 1, people’s lives and well-being, but No. 2, and a very close No. 2, is our hospital systems’ maintenance of their capacity and capability because those two things go hand in glove,” state coronavirus czar Dr. Clay Marsh said in a recent interview.
The West Virginia Hospital Association said in a statement this week that the state’s medical system is nearing a breaking point, with health care workers mentally, emotionally and physically exhausted.
Emergency medical services are in a similar boat: dealing with crushing workloads ferrying patients to hospitals around and out of the state, while low-paid employees quit under the stresses of the job.
In Boone County, the director of the county’s ambulance service has also been pushing for aid to help through the COVID-19 surges
“EMS in the state has asked and asked and asked [for help] and we’re still waiting,” said Bryan Justice, director of the Boone County EMS.
He said another one of his paramedics quit Tuesday.
“Our employees and our providers in the whole state of West Virginia are very, very tired and they’re very, very stressed,” Bryan Justice said. “They’re trying to help as much as they can, but their patience is wearing thin, and they’re not wanting to do this job anymore. They’re not wanting to come out here and bust their butts for 24 hours and get no sleep for $13 or $14 an hour.”
But instead of the immediate relief Huron and Justice have been asking for, the governor unveiled the new nursing program, which has a goal of producing more than 2,000 additional state nurses over the next four years.
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Justice’s initiative would, as announced, create a joint nursing program at Glenville State College with Marshall University, open a program at Concord University and expand BridgeValley Community and Technical College programs.
This will fix a long-term problem the state has attracting and retaining qualified nurses, said Jim Kaufman, president of the West Virginia Hospital Association.
“[This is] not going to address today’s crisis, but it’s going to address the crisis that we knew has been coming, which is the retirement of health care professionals and the sheer need of health care professionals in West Virginia and around the country,” he said.
“Our hospitals are overrun and understaffed,” Gov. Justice said, later adding that 1,700 West Virginia nurses didn’t renew their licenses last year, with the main reason being because they “were tired.”
“We’re going to flood West Virginia with quality, great nurses that don’t get tired, that just do the great work they do every day,” he said.
Huron said that nurses are “tired” is an understatement.
“They’re more than tired, they’re exhausted, and they’re scarred,” she said. “They feel overlooked, quite frankly.”
Huron said the nurses’ association hasn’t been invited to the table on CARES Act discussions. And, despite representing the state’s nurses, she didn’t know about this most recent allocation before Justice made the announcement.
But while West Virginia’s nursing shortage has been an ongoing problem, the state will likely need more medical capacity long before Justice’s program expansion begins producing nurses.
The nursing program represents the latest of Justice’s spending practices that has been criticized for not addressing the urgent needs of West Virginians suffering from the COVID-19 pandemic. A lot of money has instead gone toward things like loading the unemployment trust fund, road repairs and multiple rounds of an unsuccessful vaccination lottery.
“[The state doesn’t] acknowledge what we’re saying: the severity of the problems, the severity of the poverty, the severity of the struggles,” said Pam Garrison of the West Virginia Poor People’s Campaign.
Justice has continued to defend his CARES Act expenditures.
“Along the way, there were a lot of naysayers that said, ‘governor, you should do this and this and this with the monies and everything,’ and along the way what did we do?” said Justice, who has sole control of the funds. “We spent the money wisely. We made the right choices. And now we have a few bucks that are left over from that and absolutely we want to commit that in this direction right here.”
But Justice is doing so under an extreme time crunch of his own making — he received the money in April 2020. Originally, it had to all be spent by the end of December, but the federal guidance, updated last week, has now clarified that instead it just has to be obligated by the end of the month — meaning that an order has been placed or a contract made. States have to spend that obligated money by the end of September 2022.
Ed Lazere, a senior fellow at the national Center on Budget and Policy Priorities, said his issue isn’t with funding the nursing program itself — it’s that the money wasn’t spent earlier, and the governor put himself in a position where he had to quickly decide what to do with the funds before the deadline.
“The real frustration is that federal money is being made available, and it’s not being thoughtfully planned and used with public input, and not being used in a timely way,” he said.
While $48 million of the remaining CARES Act money is now set to go to the nursing program, that still leaves more than $75 million unaccounted for.
With a little more than a week to go, Justice on Tuesday still did not provide details of how he plans to spend the rest of the money. A spokesman for the governor did not respond to emailed questions.
There’s still hope for more immediate help for West Virginia’s nurses and emergency services agencies, with $1.35 billion in American Rescue Plan funds and multiple years to spend it. Unlike with the CARES Act money, the Legislature has most of the control of those funds, which are meant for both short- and long-term projects.
“There’s still a lot of federal money available, and this state has a chance to do it right,” Lazere said.
Though, he added that seeing the governor make last-minute plans with the CARES Act money makes him nervous.
“Will we see the governor and the Legislature sit on that money, or will we see them actually put it to good use?” he said.