Drug office losing leaders, experience
CHARLESTON — In a very quick and quiet move, a senior official with the West Virginia Department of Health and Human Resources was granted approval to begin looking for another job, leaving an oversight position for a state agency charged with the state’s drug response leaderless.
On Thursday, the State Ethics Commission voted to grant an employment exemption to Anne Williams, deputy commissioner for health improvement at DHHR. State employees are required by law to seek an employment exemption with the Ethics Commission if seeking jobs with companies the agency regulates.
Williams has more than 27 years of experience at DHHR, starting in 1991 as the director of the family planning program with the Office of Maternal, Child and Family Health. In 2006, Williams became director of the Division of Perinatal and Women’s Health in the same office. In 2010, she was promoted to director of the entire office.
In 2013, Williams was named the deputy commissioner of health improvement in the Bureau of Public Health. As a deputy commissioner, Williams was responsible for hiring a director for the Office of Drug Control Policy. The office, created with the passage of House Bill 2620 on April 8, 2017, was placed under the Bureau of Public Health.
The office is charged with developing a state drug control policy and a strategic plan, coordinating funding and data sharing between state agencies, being a repository for information on drug and alcohol abuse, and making policy recommendations to the Governor’s Office and the Legislature.
As part of the legislation, the office was mandated to submit its strategic plan by July 1 to reduce drug, alcohol and tobacco abuse by 10 percent. That plan was never submitted.
The issues at the Office of Drug Control Policy are causing concern among lawmakers. State Sen. Mike Woelfel represents Cabell County and Huntington, which has received attention at the national level for the number of opioid overdoses.
“It is disheartening, to say the least, that the Office of Drug Control Policy has failed to meet the deadlines set by the Legislature to create strategic plans to address the drug crisis in West Virginia, while at the same time news reports last week noted there were more than 1,000 fatal drug overdoses in West Virginia last year,” Woelfel said in a statement. “These plans are a critical part of the Office of Drug Control Policy’s mission and its failure to complete them raises questions.”
When asked about the issue during a press conference Tuesday, Gov. Jim Justice said he was unaware of any issues and directed any further questions back to DHHR Secretary Bill Crouch.
“I don’t. I really don’t know all the details to that whatsoever and I wish Bill Crouch were here who could answer that better,” Justice said.
The office became official on July 7, 2017, with DHHR seeking a director for the office on June 27, 2017, through the state Division of Personnel. Williams was the point of contact for director applicants.
Jim Johnson, who had only been retired for a week as former director of the City of Huntington’s Office of Drug Control Policy, was hired in September 2017 as the first director of the new state office. He barely made it five months before retiring on Jan. 22.
“I am hopeful that my tenure at DHHR has been impactful and that many of the projects we have initiated will help combat this horrible epidemic,” Johnson said in a statement. “I have decided that after 45 years, it really is time to enjoy retirement, although I am still excited and appreciative for the opportunity to continue some of those efforts to combat this terrible disease.”
During this time, Williams, Johnson and other DHHR staff oversaw the creation of a report, titled the “2016 West Virginia Overdose Fatality Analysis: Healthcare Systems Utilization, Risk Factors, and Opportunities for Intervention.” The report was put together independently by the Bureau of Public Health and not the Office of Drug Control Policy, according to DHHR.
The report found that males were twice as likely to die of drug overdoses than women, but women were 80 percent more likely to seek some sort of medical help 12 months prior to death. Women were 7 percent more likely than men to have more than one drug in their system at the time of death and 18 percent more likely to have three or more drugs in their system. Those who died of drug abuse between the ages of 15 and 44 were more likely to die from fentanyl or heroin.
The state also released a proposed “Opioid Response Plan for the State of West Virginia” in January for public comment. That plan listed several recommendations, including: giving authority to public health professionals to stop inappropriate prescribing of pain medications, expanding access to substance abuse treatment in hospitals and the criminal justice system, requiring first responders to carry naloxone to revive those having an overdose, and to expand programs to expecting mothers and contraceptive services to drug users.
The next director, Dr. Michael Brumage, was appointed on Feb. 5. Brumage was the former executive director of the Kanawha-Charleston Health Department and an assistant dean for Public Health Practice and Service at West Virginia University’s School of Public Health. Nearly two months later, Brumage resigned effective March 23.
That resignation came after criticism of a needle exchange program he created at the Kanawha-Charleston Health Department in 2015. Created to limit the spread of hepatitis A among heroin users, an audit issued in May found that the health department didn’t properly collect data on the program, allowed multiple users to get needles using the same identification number, and had no plans to address community concerns over needle litter. DHHR recommended the program be suspended.
“I am committed to the health and well-being of all West Virginians and can do so best through my work with the West Virginia University School of Public Health, away from the distractions of recent events,” Brumage said. “I hope people will recognize the hard work, talent, and professionalism of all of the people at the Department of Health and Human Resources.”
Susie Mullens, the former program director for the office, has twice served as interim director between the resignations of Johnson and Brumage. She has since resigned to take a new job in Preston County. She was replaced as interim director by Nancy Sullivan, assistant to Crouch.
“Since its inception, the Office of Drug Control Policy has had two directors and at least two interim directors; and despite the law requiring the Office to operate under the supervision of the State Health Officer, it has apparently been co-opted by the Secretary’s Office,” Woelfel said. “Quite simply, the Legislature charged DHHR with addressing the drug crisis in West Virginia and it appears to be negligent in its responsibilities.”
Allison Adler, communications director for DHHR, downplayed Williams’ role with the office, despite Williams being a deputy commissioner and at one point helping hire the office’s director.
“Anne Williams has no role in the Office of Drug Control Policy,” Adler said. “She is a deputy commissioner of Health Improvement serving under Dr. Rahul Gupta, commissioner and state health officer, DHHR’s Bureau for Public Health.”
An organization chart supplied by Adler and dated for Oct. 20, 2017, doesn’t show the Office of Drug Control Policy. Adler said that all agencies underneath DHHR are working hard to fight the opioid epidemic, including spending $1 million on quick response teams to help get overdose victims into rehab within 24 to 72 hours of an overdose.
“In reality, the efforts to combat the drug epidemic are a departmental wide effort that involve a large number of staff from the Bureau of Public Health, Bureau of Medical Services, the Bureau of Behavioral Health and the Bureau of Children and Families, as well as several programs and offices in DHHR,” Adler said. “These various Bureaus and programs are working extremely well together and utilize funds from a variety of federal and state programs to impact this problem.”
An incident in Huntington involved a person overdosing behind the wheel of a car and driving through a playground.
“Most West Virginians agree we are in a crisis right now with respect to drugs and addiction,” Woelfel said. “I am committed to collaborate with interested parties to create legislation so that the punishment for that type of conduct fits the crime. It is my intention to introduce legislation on the first day of the session in January to elevate this form of wanton endangerment to a felony status.”