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W.Va. could get more federal black lung money

By Dave Boucher, Capitol Bureau Chief

While state lawmakers have lamented a type of funding cap for federal black lung grants, the state could actually receive more money for the clinics next year.

That’s because, for the first time, the state submitted two applications for federal grant funding.

In a March 19 letter, U.S. Sens. Jay Rockefeller and Joe Manchin, along with Rep. Nick Rahall, all D-W.Va., wrote to the head of the Health Resources and Services Administration criticizing changes to its black lung funding program.

Individual grant applications could apply for no more than $900,000 this year, the first time there’s been any such cap. Dr. Letitia Tierney, state health officer and head of the Bureau for Public Health, said the cap came “without warning” and affected only West Virginia, because it was the only state to receive more than $900,000 in the last round of funding.

In addition to Tierney, Rockefeller, Manchin and Rahall, Rep. Shelley Moore Capito, R-W.Va., and Gov. Earl Ray Tomblin also wrote letters expressing their frustration at the funding cap. Capito called it “illogical.” Tomblin said West Virginia would be the only state to suffer.

Capito sent her letter March 21, and Tomblin voiced similar concerns in a March 31 letter,

But by the time Tomblin sent his letter, the state had already submitted two applications for black lung grants. In fact, the bureau “realized” it could submit two plans “around” March 20, state Department of Health and Human Resources spokeswoman Allison Adler said.

Each of the applications, both for $900,000, were submitted March 28, the filing deadline. The state applied for one grant, and the West Virginia Primary Care Association applied for the other.

“The state would be a subgrantee to the Primary Care Association, and would then, with the funds that we will hopefully receive from our grant, would be able to continue to fund all clinical sites throughout the state,” Tierney said in a submitted statement.

The change is supposed to help distribute funding more evenly to address black lung issues across the country, said a DHHS representative.

There’s about $6.7 million available per year, with the current funding system in place for three years, according to a Health Resources and Services Administration application document.

In response to the letter from Rahall, Manchin and Rockefeller, the head of the Health Resources and Services Administration suggested submitting more than one application. Administrator Mary Wakefield also said the program changes were announced in September of 2012, with implementation scheduled for 2014, and the administration sought comment from states and organizations that received grants in the past.

“Representatives from the state of West Virginia, as well as community-based organizations in the state, also provided input into the process,” Wakefield wrote.

Last year West Virginia received $1.4 million in federal grants for its 18 clinics, which provided services to about 8,500 coal miners, Tierney said.

While the $1.8 million potentially available from both applications is an increase, a two-grant system brings new challenges.

“Also, having this new system of grants, means that more money is going be to spent on administering grants, rather than being spent on the health care of those who most need it,” Tierney said in her statement.

Rahall, Manchin and Rockefeller echoed those statements in their own letter.

They acknowledged the federal administration’s suggestion of submitting two grants, and thanked them for trying to consider different funding options under the new system, but said two grants presents and “unnecessary and insurmountable administrative burden on our clinics.”

“It also creates the possibility that applications submitted on behalf of some clinics will be approved while others are rejected, leaving some clinics in our state without any funding at all,” he said in the letter.

The state referenced each clinic in both applications, Adler said. That way, if one of the applications is rejected it wouldn’t necessarily mean a certain clinic would go without funding. But it could also mean less funding for all clinics.

Adler said there wasn’t a breakdown of how much funding each clinic would receive. However, the clinics are not funded on an equal basis.

Black lung has affected coal miners in the state at higher rates than anywhere else in the country.

The federal change in funding came as a result of an increase in black lung diagnoses nationwide starting in 2000, the DHHS representative said, adding diagnoses went down nationally from 1970 to 1999.

West Virginia had the most cases during that time period, and its coal miners remain in the region that continues to lead the nation in black lung diagnoses, the lawmakers state, citing a health surveillance program from the National Institute for Occupational Safety and Health.

Citing the same study, Capito said the cap places a burden on the region that needs the money most.

“The fact that (the program’s administration) does not know the geographic areas where additional resources for black lung clinics may be needed is all the more reason not to apply an arbitrary cap to grant awards,” she wrote.

All of the West Virginia officials asked for the cap to be removed, and Tierney said she was “cautiously optimistic” it could be waived.

Adler said in the past the DHHR has typically learned how much funding it will receive in June.

Contact writer Dave Boucher at 304-348-4843 or david.boucher@dailymailwv.com. Follow him at www.Twitter.com/Dave_Boucher1.


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