Department for Health and Human Resources Secretary Bill Crouch testifies in front of lawmakers during November interim sessions. Photo by Perry Bennett/WV Legislature.

BERKELEY SPRINGS — Inside a conference room in the rustic lodge at Cacapon State Park, Department of Health and Human Resources Secretary Bill Crouch sat with two cookies in one hand and a pepperoni roll in the other. He was in his last meeting of the legislative interim session, watching lawmakers grill his staff about data they had collected and, some felt, failed to properly compile and present.

It was a continuation of another contentious meeting, where lawmakers lambasted Crouch and his agency for failing to address issues in the department that are harming some of the most vulnerable West Virginians. Also included in lawmakers’ ire was a team of consultants, who had concluded splitting DHHR would not substantially improve the department’s issues or help the people who need the agency the most, including senior citizens, foster kids and people in recovery. Dividing the agency was the only solution lawmakers could agree on during the last legislative session, and now, after a $1 million report commissioned by Gov. Jim Justice rejected the idea, they were incensed by what they saw as an insufficient proposal to fix the department’s mounting problems. 

“We’ve gotten the same results over and over by doing exactly the same thing,” said Senate President Craig Blair, R-Berkeley. “From what I can interpret here, you’re saying throw more money, throw more time, but keep doing the same thing. That’s what I’ve gotten from your report. Frankly, it looks like this is a million dollar waste of our taxpayer dollars.”

But none of these problems are new, and neither Crouch nor lawmakers came to the meeting with any concrete ideas of how to address them. Now, while lawmakers say legislation either reorganizing DHHR or targeting specific health issues will be a priority during the upcoming legislative session, it’s unclear how lawmakers in a supermajority with a history of disagreement over health policies will move forward with either part of the two-pronged approach.

Fixing a problematic health department

During the last legislative session, lawmakers considered bills to address some of the Department of Health and Human Resources’ most glaring problems, including accountability in the foster care system and low wages for state-employed social workers. But despite bipartisan support, none made it over the finish line. The only bill that did — the  measure to cleave the agency into two — was vetoed by Justice. Meanwhile, West Virginia remains one of the most unhealthy states in the country, and lawmakers hear report after report alleging the abuse of some of the most vulnerable people in the agency’s care. 

Also in that time, disabled adults in the care of DHHR have died in state-run facilities, and the department has been unresponsive to lawmakers’ probing questions about how that happened and how to fix it.

While nearly all lawmakers agree that West Virginia’s numerous health issues need to be tackled, some in the majority caucus contend that in order to address these issues, problems in DHHR must be sorted first.

Sen. Jack Woodrum, R-Summers, said that the department is necessary to help legislators make decisions about health policy, but that required reports sometimes go incomplete. The issue hits close to home for him, as five children have died either in foster care or as a result of abuse or neglect in his district in the last few years. Last year, a bipartisan bill that aimed to improve reporting of child abuse in the foster care system was stalled by Sen. Eric Tarr, R-Putnam, the chair of the Senate finance committee, and ultimately didn’t pass. 

The poor information from the department, Woodrum said, “puts you in a position that you can’t make any informed decisions about what you need to be doing. That’s one of the things that’s bogging us down and, unfortunately, we have people that are dying because we don’t have information.”

Woodrum’s point was underscored in a Monday afternoon meeting about maternal mortality rates in West Virginia, which are higher than in most of the country, particular for non-white residents.

Woodrum raised concerns that required reports on the issue were not made available to lawmakers ahead of the meeting. A representative from DHHR said the agency had the data, but had not compiled it into a report yet.

Addressing health issues head-on

Fixing DHHR alone is not enough to reverse problems with social services and poor health trends in West Virginia. To be sure, a more responsive agency could provide better data illuminating potential solutions, and could keep some of the most vulnerable West Virginians in the care of the state out of danger. But it falls to lawmakers to create new policies to increase access to affordable and quality health care, and so far they’ve failed to get many meaningful measures across the finish line.

“Unfortunately, we see a lot of studies and we get a lot of recommendations, and often the Legislature fails to act or to address the root causes of our poor public health outcomes,” said Del. Mike Pushkin, D-Kanawha, who recently won reelection and is the chair of the state Democratic Party. “Many efforts never make it onto the agenda, or many bills that do pass don’t get funded.”

Last session alone, lawmakers failed to pass a bill aimed at holding accountable and improving the state’s foster care system, which a Mountain State Spotlight investigation found has sent kids in the state’s care to out-of-state homes with documented cases of abuse and neglect. The bill had bipartisan support, but was gutted in the Senate Finance Committee, and then died at the end of the session. Similarly, bills to decrease the cost of insulin and to provide raises for state-employed social workers, who DHHR has struggled to hire and retain, also failed in spite of bipartisan support.

Ultimately, state social workers got raises from Justice who unilaterally allocated funds dedicated to unfilled positions.

And even while West Virginia’s overdose and substance abuse rates remain high, lawmakers didn’t pass any substantive legislation to address the problem. Instead, in spite of years of state-commissioned reports indicating that harsher criminal sentences for drug offenders were not helping the state’s high rate of substance abuse disorders, lawmakers passed bills increasing penalties for people arrested for possession of fentanyl in multiple circumstances.

Lawmakers on both sides of the aisle, including leaders of the Republican supermajority, agree that changes need to be made and will likely be a priority this coming session. But so far, no concrete plan has been made public.

“I’ve only heard about legislation addressing DHHR,” said Del. Kayla Young, D-Kanawha, who noted that there are still nearly two months before the regular session. “Our foster care bill got gutted last year and we never really got anything substantive passed. Substance abuse is another problem we haven’t touched much the past few years. I’m hopeful those things happen, but I haven’t heard anyone talk about any of that yet.”

At this point in the year, lawmakers’ list of priorities is long and diverse, from taking up a stalled bill to increase access to contraceptives and help adoptive parents, to tackling substance abuse disorders to addressing maternal mortality rates. 

Over the next months, Republican legislative leaders will speak with their caucuses and identify priority policy proposals that have the potential to pass with a majority. And in January, they’ll present that to the public.

Ian Karbal is a Report for America corps member, and the state government watchdog reporter for Mountain State Spotlight.