House passes two certificate of need exemption bills
CHARLESTON — One day after rejecting several amendments aimed at stripping most of West Virginia’s certificate of need program from state code, the House of Delegates passed two bills Wednesday providing exemptions for two kinds of healthcare facilities.
The House passed House Bill 4607, removing opioid treatment programs from requiring a certificate of need, in a 61-38 vote. The House also passed House Bill 4643, exempting birthing centers from certificate of need, in an 86-11 vote.
Both bills will go to the state Senate.
HB 4607 would remove opioid medication-assisted treatment programs – such as methadone clinics — from a section of the certificate of need law that put a moratorium on such facilities.
“This moratorium has been in place … for decades,” said House Health and Human Resources Committee Chairman Matthew Rohrbach, R-Cabell.
“You can’t get a license to start a methadone clinic … all this bill seeks to do is put this medication at the same level as the other ones.”
According to the National Institutes of Health, methadone is a synthetic opioid used to help people addicted to opiates, such as heroin, wean themselves off the harder drugs. Only certain clinics, medical professionals, and pharmacists are allowed to access methadone and must be licensed by the Food and Drug Administration.
According Rohrbach, there are only nine methadone clinics in West Virginia, with seven of those clinics owned by Comprehensive Treatment Centers, a company with clinics all across the U.S.
“If you want to talk about special interests involved with this bill, there is a special interest against this bill and that would probably be the company that owns seven out of nine of the methadone clinics,” said Del. Mike Pushkin, D-Kanawha. “Because if this moratorium put in years ago before we were here, they’ve been given a license to make millions of dollars off of the misery of West Virginians”
Rohrback said the for-profit company earns as much as $10 million annually from its West Virginia clinics. Both West Virginia University and Marshall University wish to offer methadone programs, the moratorium prevents them from doing so.
“I’m not accusing anybody of having bad motives, but a lot of these treatment facilities that seem to be more successful have a non-profit model,” Rohrbach, a physician in Huntington, said. “We’ve set up a for-profit monopoly. Our universities have interest in using this medication, but they can’t do it. They are enjoined by what this Legislature has done. This bill seeks to get a treatment modality into the hands of our people that want to use it.”
Del. John Kelly, R-Wood, said he supported medically-assisted treatment facilities, but he raised concerns about taking them completely out of the CON process which could provide limits on where future facilities can locate.
“I don’t feel bad about putting a single treatment facility in the State of West Virginia. I think every one of them we have are needed,” Kelly said. “I think placement of those facilities are extremely more important than the number we have … I think certificate of need is the answer to that.”
Del. Ty Nestor, R-Randolph, opposed the bill, telling the story of his brother who attended a methadone clinic but still died from his addiction.
“This stuff is bad,” Nestor said. “You can’t fight West Virginia’s addiction to opiates with something just like heroin and just calling it something different … This is not the route to go about it.”
“I’m a huge proponent of abstinence-based recovery,” Pushkin said. “That, to me, is the gold standard and what we should be striving towards, but frankly, it doesn’t work for everyone. If the clinics would be shut down, you’d have a lot of accidental overdoses. It would be a huge disaster for this state.”
According to DHHR, there were approximately 932 drug overdose deaths in West Virginia in 2021, a number that is likely to increase once more data comes in. In 2020, the state saw 1,336 overdose deaths most due to fentanyl and heroin.
“We’re all tired of this drug epidemic … we didn’t get there overnight and we’re not going to get out of it overnight,” Rohrbach said.
The other CON exemption bill, HB 4643, would allow more birthing centers in the state without the need for a certificate of need. The state only has one birthing center – FamilyCare OB/GYN and Birth Center – located in Charleston.
Del. Jason Barrett, R-Berkeley, is the lead sponsor of the bill. Barrett’s wife is expecting their first child.
“This bill is necessary to ensure additional birthing centers will open in West Virginia,” Barrett said. “I believe the expectant mothers of our state deserve to have access to options in their healthcare. They deserve to have access to quality services. And they should not have to drive across our state borders to receive this care.”
A number of delegates – led by House Majority Leader Amy Summers, R-Taylor — tried to amend HB 4643 Tuesday to repeal CON or limit it. All those amendments failed. Summers was the lead sponsor of House Bill 4013 which would have also repealed CON, but that bill was rejected in committee in a 10-12 vote earlier this month.
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