CHARLESTON, W.Va. -- Few states are as hard-pressed as West Virginia when it comes to finding space in treatment centers for people addicted to drugs or alcohol. While offering coverage to more of these people, the federal health care overhaul may also stretch those meager resources even further, according to an Associated Press analysis of government data.
More than 11,200 uninsured West Virginians with substance abuse problems will be able to shop for private policies through the federal law starting in January, the analysis estimates. While Gov. Earl Ray Tomblin has yet to decide whether to expand Medicaid as called for by the law, taking that step would cover an additional 33,677 people struggling with addiction, the data suggests.
But with only 558 treatment center beds, West Virginia already has a higher occupancy rate than every other state except Idaho and New Hampshire. The federal figures estimate that 119,000 West Virginians need substance abuse treatment, or 1 out of every 13 people statewide, but that just 13,000 are currently getting such care.
At 26 beds, The Healing Place of Huntington has a waiting list with about 68 names on it, Executive Director Walter "Skip" Ewing said Tuesday. While another $100,000 a year in annual funding would nearly double its capacity, Ewing questions where the money would come from.
"My board won't let me proceed until I get more operational funds," said Ewing, whose goal is a 100-bed facility. "It takes nine months to go through my program. There's no quick answer when it comes to addiction... It's very structured, very regimented. If you know anything about addiction, you know that's what they need."
The dearth of resources is particularly hard on women with substance abuse problems, Ewing said; his center is male-only. The Healing Place relies on state and federal grants as well as foundations and fundraising efforts. Ewing believes the government, state and federal, must do more than expand insurance access.
"They've got to come to the party, so to speak, and be part of the solution," Ewing said. "Right now, they're standing in the background wondering what to do."
Crime fueled by substance abuse has become a major issue at the Legislature. A measure enacted last year targeted meth labs and doctors who negligently hand out pain pill prescriptions. Just last week, lawmakers pledged $25 million over five years for such community-based services as addiction treatment. But that funding is part of Tomblin's proposal tackling the state's inmate crowding crisis, and so those resources will only go to people accused or convicted of crimes.
"This year, we have not invested any new money in resources for people who are not adjudicated," said House Health and Human Resources Chairman Don Perdue. "We have not created a situation where we can have more long-term beds. We have not invested in those thousands and thousands of people (not in the criminal justice system) who require treatment and recovery."
A Wayne County Democrat, Perdue was part of the House-Senate committee that reached a compromise Tuesday on a new 2013-2014 state budget. With general tax revenues faltering amid weak coal prices in mining-heavy West Virginia, and Medicaid costs rising even without the federal overhaul's provisions, lawmakers did mostly cutting this year.
"Right now our budget's very tight, and we're certainly aware of that," Perdue said. "There are also a lot of concerns about what's going on in health care right now, and that's creating a situation where people are reluctant to take the big stride."
Perdue believes expanding the health coverage rolls would prove of some benefit to people who abuse drugs or alcohol: by helping them get care for ailments that often accompany addiction, such as liver or kidney disease. But improving treatment resources will likely require reliable state funding, Perdue said. Without success, he's long proposed hiking taxes on beer, which he said hasn't changed in 55 years, and on liquor and cigarettes.
"The big stride I'm taking about would have to be creating a funding stream for substance abuse," Perdue said. "We may have the ability to nibble around the edges, but we don't have the appetite to take a big bite. Yet. We need to develop that appetite."