A study by a West Virginia think tank points out a series of problems with the seven state hospitals* and offers a practical solution. The report by the Public Policy Foundation finds that facilities, although they have different missions, suffer from similar challenges of underfunding, critical staff shortages and high turnover and underutilization because of the staffing shortages.
For example, the report says that Hopemont, the long-term care facility in Terra Alta, Preston County, is “currently utilizing only 48 of its 98 beds, yet maintains a waiting list of 50 people.” The Mildred Mitchell-Bateman Hospital in Huntington has “a severe shortage in critical nursing personnel,” and in some cases it can take up to two years to fill a vacancy.
Dr. Terry Wallace, a senior scholar at the Public Policy Foundation and one of the authors of the report, attributes the challenges to the restrictive personnel and purchasing policies administered by the state Department of Administration.
“Hospital officials told us that when they asked for the authority to offer nurses $3 to $4 an hour more, the Division of Personnel denied their request saying, ‘If you paid them more, we would have to pay the other nurses more’,” Wallace said.
Additionally, the hospitals have many physical plant needs. A 2012 report by the West Virginia Department of Health and Human Resources said it would cost $70 million to make the recommended improvements to the facilities. Today that number could be as high as $100 million.
The result is, according to the report, “extreme duress, often bordering on emergency and crisis” at the facilities. “The top down, bureaucratic model imposed on these facilities has produced a set of common problems that has a critical impact on the availability of health care to West Virginia’s most vulnerable population.”
Wallace believes the answer is the creation of a new Hospital Facilities Authority (HFA), which would have the power to privatize all or part of the seven state hospitals. “The mission of the HFA would be to align each hospital with a privatization model that would best suit their own unique circumstances,” Wallace said.
Any attempt to privatize will stir critics who believe a for-profit facility would be more oriented to the bottom line while patient care suffers. However, the report quotes a 2014 study by the American Medical Association which concluded that, “Hospital conversion to for-profit status in the 2000s was associated with improvements in financial margins but not associated with differences in the measured quality of care provided.”
West Virginia Legislators interested in addressing the problems with the state hospitals should read the report and consider the findings. The government does not have to solve every problem on its own. The answer to the challenges at the state-run hospitals may be found in expertise and efficiencies of the private sector.
*(The seven state hospitals are: Hopemont Hospital long-term care facility, Jackie Withrow Hospital nursing home, John Manchin, Sr. Health Care Center long-term care facility, Lakin Hospital long-term care facility, Mildred Mitchell-Bateman psychiatric hospital, Welch Community Hospital, William R. Sharpe, Jr. acute care psychiatric facility.)