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Since May, the Department of Health and Human Resources has been working with advocates to address “heinous” mistreatment and malpractice of West Virginians in care facilities.

“I don’t use the word ‘heinous’ lightly,” said Department of Health and Human Resources Deputy Secretary Jeremiah Samples to the Joint Committee on Health and Human Resources Accountability on Tuesday.

In May, the department’s Office of Health Facility Licensure and Certification provided a report to the committee that detailed complaints within the past two to three years.

Behavioral health centers in the state provide a continuum of services for the treatment of individuals at-risk of or suffering from mental, behavioral or addictive disorders. There three kinds of behavioral health providers: group homes, which includes intermediate care facilities for individuals with intellectual disabilities (ICF/IID), and residential units; outpatient services, including day programs; and substance use disorder facilities providing behavioral health services.

There are 611 licensed behavioral health sites in West Virginia, not including IDD waiver homes with three or fewer individuals. Of those, 228 are residential group homes.

Top complaints from all behavioral health centers in 2020 were abuse and neglect by staff, violation of rights and safety concerns.

The list of incidents does not differentiate between the facilities, indicating that the issues are pervasive throughout the system. In several instances, neglect by staff led to deaths.

Samples said one more person has died in a licensed center since May. The person was severely emaciated.

“We need advocates meeting with these people to make sure they are safe,” Samples said. “Frankly, to make sure they aren’t being starved.”

The department worked with a group of advocates and stakeholders to come up with 12 recommendations for improving the system. Many of the problems, as with many of the issues with state services, tie back to the workforce shortage West Virginia, but also the nation, is facing — particularly in health care.

The Department of Health and Human Resources is looking at how it can work with its budget to modify the reimbursement model and rate increase and increase training and support for workers. The American Rescue Plan Act for the pandemic provides some funding the department can leverage to address labor shortages.

Other recommendations include requiring monthly visits with wards of the state from case workers and advocates, and also enhancing the role of the new mental health ombudsman.

Similar to the foster care ombudsman, the mental health ombudsman can investigate complaints and promotes the safety, wellbeing and rights of consumers. The ombudsman office was created just this year following the dismissal of a nearly 40-year-old lawsuit originally filed to address patients’ rights to humane conditions and therapeutic treatment. The office needs more funding to enhance staffing and to promote its development.

The department has also worked to close facilities where the horrible acts took place, while other closed voluntarily. The department is bidding out new contracts to replace those lost beds.

Samples said the department is passionate about fixing the issue, but it will take continued attention. He said regulators have seen improvements, but still report deplorable conditions, which is a concern given the reaction to the report in May.

“We don’t know if any of this will work,” Samples said. “We hope it does but we have to maintain constant vigilance because no one speaks for these people.”

He said they are committed to working with the good providers and advocates.

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