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W.Va.'s certificate-of-need process drives providers away

Ever wonder why so many West Virginia health providers are leaving our state to locate in a border state?

The answer is that a restrictive medical certificate of need is required by West Virginia and not in our bordering states.

What is a certificate of need?

In 1974 a federal law required that all states have structures involving the submission of proposals and that all providers obtain approval from a state health planning agency before beginning any major expansion or ordering new high-tech devices.

Until 1986, the federal government required all states to have certificate-of-need programs to receive federal Medicaid funding. The certificate required a designated state agency's approval of the expansion of new medical facilities or equipment in excess of a certain dollar amount.

In West Virginia, this state agency is the Health Care Authority. The agency was originated in 1977. The stated purpose of the agency is to control health care costs, improve efficiency in the health care system, and develop health care delivery that will benefit all residents of the state.

No certificate is issued unless the state determines a public need for the project, service or equipment.

Many health care providers object to the restrictive nature of the certification process. It has become a fight between hospitals, which have the financial resources to comply with mandates of the Health Care Authority, and small health care providers that seek to meet these standards.

In 2007, the Legislature was involved in debate over whether or not to loosen the restrictive requirements. In the state Senate, the debate became one between a doctor with a small rural practice and a doctor who worked at the large Charleston Area Medical Center.

This debate resulted in little change in the requirements. In a more recent legislative session, House members were told that cumbersome requirements were contributing to a shortage of in-home personal care providers.

Evan Jenkins, a state senator and executive director of the state Medical Association, has said that West Virginia has one of the most restrictive CON laws in the country.

West Virginia is out of step because of our restrictive environment. We should become more like other states and do away with or reduce our CON oversight.

Movement of health care facilities and providers from West Virginia to Ohio has been a real boon to Belpre.

Belpre's mayor, Mike Lorentz, was quoted as saying "I have lived here all of my life and cannot remember something of such a large magnitude taking place."   

Frank Deem


Deem, owner of J. Frank Deem Oil & Gas in Parkersburg, served 30 years in the Legislature.



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