The Joint Committee on Health heard about childcare in West Virginia today during Interim Meetings. First, they received a brief overview of childcare regulations in the state. The regulation of childcare began in 1942. Childcare subsidiaries began in 1869. In the 1970’s there was a push to make sure childcare providers met specific education requirements.

Currently, the state has 16,777 families who are eligible to receive subsidized childcare. However, only 25 percent of these families are receiving care. It was stated that some families use private or at-home care, which is why such a low percentage receives subsidized childcare through the state.

The main source of funding for childcare is the Child Care and Development Fund. Funds received through this federal and state program must be expended each year. The program provides $54.3 million. Over 2200 families are served.

After COVID began, the state received $22 million of CARES funds for childcare services. An additional $240 was provided through the American Rescue Plan funding to help support to improving the affordability, availability, and quality of childcare. These funds helped stabilize the childcare market. The funds were used to expand services, especially in rural areas. The funds were used to provide more affordable care and more subsidies. Funds were also used to retain staff and provide more professional development. Funds were also used to educate the community about childcare. Once the ARP funds are used, other funds will need to be used for these services. These funds will have to come from grants or other means.

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On Sunday afternoon in Morgantown, state lawmakers got a preview of what nuclear power production in West Virginia might look like soon.

The Legislature paved the way for these possibilities during the 2022 Regular Session when they passed a bill that lifted the statewide ban on construction of nuclear power plants.

Mike Valore, Westinghouse Nuclear senior director for Advanced Reactor Commercialization, described their eVinci Micro-Reactor, currently in development at Waltz Mill outside Pittsburgh, to members of the Joint Standing Committee on Government Organization.

Valore emphasized that the eVinci has a smaller footprint and costs far less than a conventional nuclear plant. Micro-reactors, he said, generate less than 10 megawatts of power. The eVinci will put out just over 5 MW, plus 8 MW thermal energy at 350 degrees.

Valore also highlighted increased safety in several ways over traditional nuclear power. It’s not cooled by water but contains heat transfer tubes, so the U.S. Department of Energy says a meltdown is impossible. The fuel is not rods but TRISO “pebbles” about the size of pool table balls, containing uranium pellets surrounded by layers of protective material.

The eVinci is powered by those “pebbles” is hauled to site fully fueled, and will last about eight years. It’s then hauled off site, replaced by another micro-reactor, to Westinghouse which takes care of the spent fuel storage.

The eVinci contains no moving parts and takes only five people to operate, far less than other nuclear power options. Given the multiple units, it can also be scaled to suit specific power needs.

Valore mentioned that the intention with the eVinci is not to replace traditional power plants. Instead, he said it is ideal for power generation in very rural areas where grid power is very expensive. The hope is that power costs in those would drop significantly with the eVinci. He mentioned it will be great for heat production, noting that in terms of  zero-carbon, high-temperature heat, there are no options today other than nuclear.

For West Virginia, he said, Westinghouse envisions WVU serving as a research hub for the best ways to deploy this type of advanced reactor. Valore said WVU could have a unit on site by the end of 2028. That would give time to build the support infrastructure and supply chain.

Valore expects a first unit to cost in the $90 million to $120 million range, but as production increases the cost could come down to the $60 million range. Funding for a university unit would be arranged differently than funding for a power plant site in a remote area.

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The Joint Standing Committee on Education heard a presentation on mental health of students in higher education institutions. Students are disconnected and struggling. This is an issue across the nation, not just in West Virginia. Counselling Centers are seeing more and more students each year. Difficulties started long before pandemic. Many of the students received counselors in elementary or high school. They’ve been on medication before. More and more students are self-harming and attempting suicide Students are less resiliency and have less coping skills. WVU’s counselors see bout 500 counselling sessions in a week.

A survey of counselors at higher education institutes in WV found students need better access to psychiatric services, mental health services, long care therapy, more frequent appointments, more peer mentoring/wellness coaching and after-hours services. Staffing needs more counselors, more funding to recruited and keep counselors, and prevention opportunities.

Psychiatric care needs to start at a younger age. National data shows there’s been an increase in high school students who have feelings of hopelessness and sadness. They are beginning to have thoughts of self-harm and suicide at young ages.

The Legislative Oversight Committee on Regional Jail and Correctional Facility Authority met Sunday afternoon inside the Dean’s Suite at the Erickson Alumni Center in Morgantown.

David Price, County Commissioner from Preston County, spoke to the committee about the unique challenges his county faces as it relates to regional jail costs.

The current per diem rate, the cost of incarcerating one person for one day in regional jail, has been artificially capped at $48.25 since 2018. The legislature passed a bill in the 2022 regular session to keep that rate intact through June 30, 2023. The actual cost to incarcerate one person for one day in one of the state’s 10 regional jails is currently $54.13 according to calculations by the State Budget Office.

Price said Preston County, with a yearly operating budget of $9 million, faces costs that are not factored into the per diem rate, such as transport costs to regional jails from a rural county and the wear and tear that those vehicles consistently incur.

Price believes more widely available drug treatment facilities are needed in his area, citing that the drug problem is a leading driver of incarceration. He also noted that while clearing dilapidated homes is needed, the inhabitants of those structures often end up in the regional jail system, adding to costs.

Price said home confinement has helped ease some costs in Preston County and believes that could be an option to help counties throughout the state.

Brad Douglas, Chief of Staff of the Division of Corrections and Rehabilitation was on hand Sunday afternoon but did not give prepared remarks. He informed the committee that he was more than willing to provide members with whatever information they needed to deal with the cost issue.

Members discussed the intention to form a working group with all stakeholders over the summer in an attempt to come up with solutions for regional jail costs. They hope to offer a report of their findings and suggestions to the full legislature by September.

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The Joint Committee on Volunteer Fire Department and EMS met today for interim meetings in Morgantown. The committee heard from Monongalia County EMS. It was stated to the best care system, we need to think outside of county lines and collaborate to provide the best assistance in emergencies. Increasing funding for PEIA to reimburse EMS in helpful.

It’s important to remember EMS only gets reimbursed if they take someone somewhere. Frequently, EMS responds to call that don’t require a hospital transport. Some call EMS responds to include drug overdoses and mental health needs. During the presentation, it was stated that more training is coming from hospital and being used in field. This training could help determine whether EMS should transport to hospital, emergent care, or a mental health facility.

The Committee also received a presentation on House Concurrent­­ Resolution 109. The resolution requests the Joint Committee on Education and the Joint Committee on health to cause and possible solution of issues relating to the current supply and future demand of EMS personnel in West Virginia. There is currently a workforce shortage, and the committee wants to determine the best way to meet the demand.

One way to combat the shortage is through the cares funding that has been received to help provide training for EMS. The Governor allocated $10 million EMS for Training. Monongalia County Technical Education Center will begin its first of two free training sessions in June. Of the 100 applicants, 50 were accepted into the training. Six career and technical schools to offer EMS programs. The funding also went to new vehicles for crews with training. There will also be a two-year course offered in high school that students can complete and receive an EMS certification along with high school diploma.

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Brad Douglas, Chief of Staff for the State Division of Corrections and Rehabilitation (DCR), told the committee on Tuesday that job vacancy rates in the state’s regional jails are nearing a crisis point.

Douglas informed the committee that there were 887 correctional officer vacancies in West Virginia at the end of March. He noted that the most dire need is in the Eastern Panhandle, where regional jail facilities have 50 and 60 percent officer vacancy rates. Douglas is also seeing similar troubling vacancy trends across other regions of the state.

Douglas said his agency was making progress with vacancies as recently as 2019, after three consecutive years of targeted pay raises for corrections officers, along with the average 5 percent pay raises all other state employees received. However, when the pandemic hit, progress halted, and the aftermath has drastically changed traditional hiring processes.

He informed lawmakers that while the $30,000 starting salary for corrections officers is a welcome change from the $22,000 number five years ago, it still hasn’t moved the needle because of Covid-19 and other jobs raising salaries recently in response to the pandemic. Douglas noted that correctional starting salaries break down to $14.75 an hour. He pointed out that post-pandemic starting pay at places like Sheetz is $15 an hour and more at grocery stores like Kroger and Aldi.

Douglas said the Division is handling the vacancies by taking correctional officers from other regions of the state and moving them to the Eastern Panhandle where they stay in hotels for a week and work in the regional jails. He noted this is a costly and unsustainable method of handling the issue.

Vacancies in other areas of the state are handled with correctional officers working plenty of overtime. Some regions of the state are even collaborating with Division of Natural Resources Officers to cover shifts.

Douglas also highlighted the need to address deferred maintenance costs in the regional jails. He noted the cost has grown to $277 million. He said one of the greatest needs is in the area of jail and prison security doors, most of which are 25 to 30 years old, some of which have been damaged and compromised.

Douglas plans to get a list of the top-priority deferred maintenance projects to lawmakers by the end of May.

The Legislative Oversight Committee on Health and Human Resources Accountability met during the April Interim Meetings.

The focus of the meeting was the organization of the Department of Heath and Human Resources. Chief Counsel from the House Committee on Health and Human Resources, Charles Roskovensky, gave a brief history of the organization of DHHR. Several years were noted during this presentation. In 2012, a performance review of DHHR recommended the agency be split in two. In 2018, legislature was proposed to split the agency into three structures. The focus of this legislation was the Office of Inspector General and the creation of the Health Facilities Department. This legislation did not make it through the session. In 2019, changes were made within DHHR. In 2021 the Bureau of Families and Children split into two bureaus: the Bureau of Families and the Bureau of Social Services. In 2022, legislation was passed to separate the DHHR into two agencies: the Department of Health and the Department of Human Resources. This legislation was vetoed by the Governor.

The DHHR Secretary Crouch gave an overview of the current DHHR Organization. Noted were the six bureaus which provide core services: the Bureau of Families, the Bureau of Social Services, the Bureau of Child Support, Bureau of Public Health, Bureau of Medical Services, and Bureau of Family Assistance. The Secretary also noted the DHHR has over 800 vacancies.

Former Chairman of the House Committee on Health and Human Resources Don Perdue provided his thoughts on the reorganization of DHHR. He stated that DHHR has always been a top-heavy organization. He also noted the 2012 performance review, which recommended the split of DHHR.

Garrett Jacobs, the Commissioner of the Bureau for Child Support Enforcement, provided an update on Child Support Enforcement. He stated the main organization of the bureau is in field offices and the central office. There are 35 counties with full-time offices. The other counties are served part-time by those county offices. The agency has 487 full-time positions with 120 vacancies. The BCSE usually have a 10-20% vacancy rate and are attributing the increase to pandemic. He stated that the agency lost some new staff during this time, and it is believed that frustrations with uncertainty and difficulties training may have caused departures. The BCSE’s budget has remained static the past several years. The BCSE is the only state agency responsible for establishing paternity and child support collection and enforcement. The Bureau uses Online Support Collections and Reporting (OSCAR) to manage 91,334 cases. The system maintains case balances and tracks collections and distributions, generates legal documents, and works with the internal DHHR interfaces. PATH will replace OSCAR. The BCSE’s personnel, financial, communications, MIS, legal, customers services are provided by the Office of the Secretary.

State Veterans Assistance Secretary Ted Diaz warned lawmakers on Monday about the U.S. Department of Veterans Affairs’ recommendations that he believes would negatively impact healthcare for West Virginia’s veterans.

Diaz’s testimony came roughly a month after the federal agency released its Asset and Infrastructure Review with recommendations to “modernize facilities and realign priorities” as a result of Congress passing the VA Mission Act in 2018.

If these recommendations are implemented, West Virginia would see a significant reduction in services. Some facilities will stop offering health care and instead attempt to utilize relationships with health care partners for care. The medical centers in Huntington, Beckley and Clarksburg would reduce health care options. Federal officials recommend replacing the Beckley VA Medical Center with a facility that only provides primary care, outpatient mental health and non-surgical outpatient services.

Diaz noted that inpatient mental health care, inpatient and outpatient surgeries, and emergency room care will be eliminated. Community-based outpatient clinics in Parsons and Franklin also face closure under the recommendations.

These services, for about 71,000 state veterans enrolled in the VA health care system, would be divided among other health care providers in the community at a time when rural hospitals are already struggling. Diaz noted that wait times at community facilities can be weeks or months compared to the VA system’s one to two weeks. Diaz also emphasized his concerns of the ability of non-VA facilities to address veterans’ unique needs, trauma that is often both physical and mental in nature.

Diaz told lawmakers that the best recommendation he can give state lawmakers, one that he has already shared with the state’s Congressional delegation, is to do everything possible to eliminate this plan now.

The federal agency has until Jan. 31, 2023 to hold public hearings and submit a report to the Biden administration on the proposed changes. Diaz is attempting to get out ahead of this deadline so West Virginia leaders can lobby the Biden administration to eliminate this plan.

Lawmakers concluded Monday’s meeting by voting to draft a resolution to show opposition to these federally recommended cutbacks. The resolution is likely to be presented at the Legislature’s next Special Session later this year.