CHARLESTON, W.Va. — Privatization in some form for the Mountain State’s seven state hospitals is among the recommendations from the Public Policy Foundation of West Virginia ahead of the Wednesday start of the 2019 Regular Legislative Session.
Billed as a “reality check,” the report found the bureaucratic model currently being used to run the facilities has been keeping down staffing levels, delaying building improvements, driving up costs and affecting patient care availability.
“The rule-driven, top-down control, compliance-based model that governs our state hospitals has proven to not only be ineffective and inefficient in a highly-competitive health care market, but has created a situation in which state hospitals are underutilized,” the report said.
“We think there are better, smarter ways to do this,” said Dr. Terry Wallace, senior scholar at the Public Policy Foundation.
He co-authored the report with Rob Capehart, a senior resident scholar, and Raymond Keener, also a senior scholar, after site visits, interviews with key leaders and information reviews.
Staffing and structural needs were reviewed at the following locations:
– Hopemont Hospital, a long-term care facility in Terra Alta;
– Jackie Withrow Hospital, a nursing home in Beckley;
– John Manchin, Sr. Health Care Center, a long-term care facility in Fairmont;
– Lakin Hospital, a long-term care facility in Pt. Pleasant;
– Mildred Mitchell-Bateman Hospital, a psychiatric hospital in Huntington;
– Welch Community Hospital, an acute care hospital;
– William R. Sharpe, Jr. Hospital, an acute care psychiatric facility in Weston.
Though there were individual differences, all of the facilities were found to be underfunded, understaffed with critical shortages and rampant turnover in health care providers and underutilized due to staffing issues blamed on lack of flexibility from the state.
At Hopemont, for example, 48 of 98 beds were being used with 50 people on a waiting list because of a shortage of essential personnel, 107 of the authorized 178.
A rigid state salary structure is at fault, the researchers found.
“Not everybody may want the state salary system,” Wallace said. “Some of the younger people may not want all the benefit programs. They’d really rather take that in direct salary, but there’s no flexibility to do that.”
Hiring takes too long, he said, and even the process for simple purchases is lengthy.
In several cases, contract staff have been routinely used to maintain services.
“For the most part, these are services that are one-of-a-kind and have to be there and we’re paying more now probably to operate these things than we should if we had the most effective and efficient system in place,” Wallace said on Monday’s MetroNews “Talkline.”
“As we looked at and toured all seven of these hospitals, what we found were people who were committed to what they’re doing, who know how to do the right thing, but they’re very limited.”
Included in the report was a proposal for the creation of a Hospital Facilities Authority, or HFA, to examine the potential for privatization of each facility.
Cited as a model to follow was the privatization of West Virginia’s workers’ compensation insurance system in the early 2000s.
As envisioned, a nine-member appointed Board of Managers would study the feasibility of privatization and have the authority for a set period of 30 months to “undertake any sale, lease, contractual relationship or restructuring necessary to effectuate the approved plan.”
Wallace was involved with a similar transition in Ohio.
“Ohio moved away from state operation to kind of a hybrid array of administrative structures that allowed them to provide services that met individual needs rather than living with an old-time bureaucratic model and most other states have done that,” Wallace said.
“West Virginia is a little bit behind the times.”