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WV Legislative Interims: Health Committee looks at use of opioid lawsuit settlements

By Autumn Shelton, WV Press Association

CHARLESTON, W.Va. – With over $867 million coming to the state from opioid lawsuit settlements, an ever-increasing need for effective statewide substance abuse recovery facilities, continual mental health support for residents, and strong medical cannabis permit guidelines, the Legislative Joint Committee on Health had much to discuss during their Tuesday morning interim meeting. 

First, the committee heard from Steven Travis, general counsel for the Office of the Attorney General, as he discussed the opioid lawsuit settlements, the status of the West Virginia First Memorandum of Understanding (MOU), and the purpose of the WV First Foundation. 

“Settlements to date total more than $867 million,” Travis told committee members. “As of last week, $340 million has been received in payments from defendants.” 

That money is currently placed in a secure account, he continued, adding that 24.5% of all settlement monies received will be distributed to local governments “based upon an agreed to percentage” as explained in the MOU, which can be found on the attorney general’s website. 

Then, the WV First Foundation will receive 72.5% to be held in a private 501c3 foundation. 

The state will hold the remaining 3% to “ensure there are not unforeseen costs that need to be accounted for as it relates to the litigations,” Travis continued. If the money is not used, after a certain number of years, it will be redistributed to local governments and the foundation. 

All of the settlement money must be used for the “abatement of the opioid crisis,” Travis added. 

SB 674, signed into law in March, sets forth how a board of directors will be selected for the WV First Foundation, according to Travis. Of the 11 board members, five will be selected by the governor. The remaining board members will be selected from one of six statewide regions. 

The Attorney General’s office is currently working on drafts of the Articles of Incorporation for the WV First Foundation. 

“I am happy to report those drafts are in, what we believe, near final form,” Travis stated, noting that when finalized, it will detail how board members are selected from each region and place a board approved executive director. 

Travis concluded his presentation by announcing that the last major opioid settlement case, against Kroger, is set for trial June 5, 2023. 

The next presenters, Dr. Kevin Blankenship and Ed Boyle, discussed Lauren’s Wish – a Morgantown-based organization designed to help those struggling with substance abuse disorder. 

According to Boyle, he and Blankenship are two of the six directors of Lauren’s Wish, all of whom have been “deeply affected by this drug overdose and addiction epidemic,” including the loss of family members to overdoses and watching as loved ones enter recovery. 

After studying how society is failing those who struggle with addiction, especially when a person is released from an emergency room following an overdose, Boyle said he and the others decided to start the 28-bed Lauren’s Wish Addiction Triage Center as a possible solution. 

“Unless they have the family support system, or the financial wherewithal to take the next step in the recovery process, they’re going right back into the environment that led to the overdose in the beginning,” Boyle said of those upon ER release. “We termed it, ‘Treat and street.’” 

Blankenship, who also founded Jacob’s Ladder, a long-term addiction treatment community in Preston County, added that Lauren’s Wish is a place where people can go directly following an ER release to await bed availability at a sober-living facility. 

“We take them – a warm hand-off from the emergency department, transfer right over to us – we can get them stabilized on suboxone if necessary, and we can keep them safe and keep them healthy and get them transported then to their ultimate goal,” Blankenship said. 

He added that his experiences have taught him that the typical 28 to 30-day treatment program is not working, and often people will return to substance abuse. Instead, he suggested that legislators consider funding longer-term recovery facilities and addiction triage centers, like Lauren’s Wish. 

“There is something to be said about time when you are talking about healing the brain, and that’s what addiction is – it’s a brain disorder that can be healed with time and the appropriate treatment,” Blankenship stated. 

Committee members next heard from Crystal Lowe, interim director of the DHHR Office of Medical Cannabis (OMC). 

According to Lowe, the OMC works with seven medical cannabis growers, nine processors and 48 dispensaries – with total sales of over $40 million. There are 131 registered physicians and 17 telemedicine companies participating in the state’s medical cannabis program. 

“Physicians do not prescribe medical cannabis,” Lowe explained. “The physician certifies that a patient has one of the serious medical conditions listed in the Medical Cannabis Act that allows the patient to obtain an ID card that allows them to purchase products at a dispensary.” 

Since the OMC started accepting patient applications for dispensary permits in Feb. 2021, they have processed close to 25,000 applications, Lowe continued. 

In order to qualify for a medical cannabis permit, a patient must have been diagnosed with cancer, HIV, ALS, Parkinson’s disease, MS, nerve damage to the spinal cord, epilepsy, neuropathy, Huntington’s disease, Crohn’s disease, PTSD, intractable seizures, sickle-cell anemia, severe chronic pain, or a terminal illness, Lowe added, noting that chronic pain is the most common diagnosis for most patients. 

She said that health insurance companies do not financially assist patients with the purchase of medical cannabis, although dispensaries may determine if a patient should be offered a “compassion” discount if they qualify as low-income. 

The last presenter of the day was Dawn Cottingham-Frohna, commissioner of the DHHR Bureau for Behavioral Health (BBH). She was appointed to her position on March 27. 

Cottingham-Frohna stated that in the short time since accepting her position, she has found that “one of the most significant challenges” faced in West Virginia is substance abuse. 

“Since the beginning of the pandemic, we have seen a drastic increase in substance use and overdose deaths,” Cottingham-Frohna stated, adding that has been a nationwide trend. 

As a result, the BBH has implemented a statewide naloxone distribution program. 

“When administered timely, naloxone has shown effectively to reverse the effects of opioids thereby avoiding a potential overdose,” she said. “With naloxone recently being made available without a prescription, we are working closely with our community partners to ensure that it is available to everyone in every corner of the state.” 

In 2021, she said over 93,000 naloxone doses were distributed. 

Additionally, she said that West Virginia is ranked 42nd in the nation for mental illness, and 10th for suicide deaths. 

As for childhood mental illness, there has been a “69% increase in the number of adverse childhood events,” such as violence, abuse and neglect, Cottingham-Frohna noted, adding that the most recent data from 2019 shows that 20% of the state’s youth considered suicide. 

Unfortunately, she said that hospital data shows that many children in crisis are “boarding in our emergency rooms for days, or even weeks, waiting for access to appropriate placement options including impatient crisis care.” 

“We need to collaborate closely with our healthcare providers to begin to do a deeper dive into trends over the past several years, and identify key contributors that impact why a child is unable to be discharged from the ED.”