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Stollings: Legislature will address Medicaid, chronic disease

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Four health issues could be big in the Legislature this session — Medicaid, substance abuse, chronic disease and oral health.

Sen. Ron Stollings, D-Boone and chairman of the health interim committee, said committee members studied different issues in the interim session and wanted to keep a focus this year on chronic disease management and better coordination with care.

"This session isn't going to be a health session," he added. "It's going to be an education session."

Stollings said the Legislature should look at high-risk populations on Medicaid, while keeping cost-savings measures in mind.

"Unfortunately, there's going to be a $170 million hole to have to fill with Medicaid," Stollings said, explaining the federal match of 4-1 has gone down to 3-1.

Under that same topic, Stollings said there has been discussion about taking Medicaid out of the Department of Health and Human Resources and housing it under state insurance.  .

"There is a feeling that the DHHR is so big and unwieldy that it's hard to get your arms around," he said noting that the DHHR would instead focus more on public health issues such as chronic disease management, children, families and oral health.

The state also may look at Medicaid expansion, which the U.S. Supreme Court dictated the states to decide in its opinion on the Affordable Care Act.

However, Stollings said this mainly will be an executive decision, not legislative.

"With that Medicaid expansion comes workforce issues and we did study those," he said. "We're trying to get more people to stay in primary care. We see the average debt with med students and we're realizing that's going to be a real problem."

To address this problem, Stollings said there will be a bill introduced to increase loan forgiveness for those willing to work in primary care in underserved areas.

Another area the Legislature will address is West Virginia's burden of chronic disease and tobacco usage. Stollings said the Legislature could look at reducing school children's sedentary time by mandating a certain amount of exercise per day.

"We have made significant improvements in the availability of sugary drinks in the school system," Stollings said. "We're trying to get the most rigorous anti-sugary drinks we can come up with."

So what about efforts to make adults healthier and reduce chronic disease?

Stollings said in the past, there has been an attempt to increase the soft drink tax. This did not come out of the interim subcommittee, however.

"That was a pretty big tax," he said. "Whether or not they come up with a soft drink. … There's been a lot of talk and wishing we could bring that up."

Stollings said there also has been discussion about increasing the tobacco tax. He said this wasn't an interim bill but he "certainly wouldn't be surprised to see a soft drink tax and a tobacco tax increase."

Stollings said the Legislature also may look at encouraging joint-use agreements with school systems so non-students can use the gyms in the evenings.

Oral health will be another main topic in the Legislature. Stollings said first off, members of the Legislature must look at rewriting the Dental Practice Act and the Pharmacy Practice Act.

"It has to be updated to keep up with national standards of what is going on," he said. "It hasn't been rewritten in a long time. It says how you practice dentistry and how you practice pharmacy. It's more of a general thing than a specific thing."

Under that same topic, legislators also will look at who can place sealants on teeth. Currently, even dental hygienists trained to place the sealants can't — only dentists can.

"Public health hygienists have extra training to do this," he added. "It would protect the kids from cavities and decay."

Substance abuse is another area the Legislature will address, Stollings said, noting that the Legislature may tweak a Senate bill passed last year.

Last year's bill, according to a past The State Journal article, provided several approaches to control meth production, increase oversight over methadone treatment centers and to establish new regulatory and licensing requirements for pain management centers.

The bill also creates new programs and databases to control the manufacturing of meth, including the Controlled Substance Monitoring Program database review committee, which is tasked with querying the database to make determinations on a case-by-case basis on unusual prescribing patterns.

Further, the bill restricts the amount of pseudoephedrine to 3.6 grams per day, 7.2 grams per month and 48 grams per year. Beginning Jan. 1, a pharmacy or retail establishment is required to electronically submit, in real time, government ID information to the Multi-State Real-Time Tracking System before selling pseudoephedrine products.

Stollings said he also hopes the Legislature will come up with an office of actuarial studies, where members could find out the state's return on investment on certain health topics.

"The office of actuarial studies will make a lot of sense," he added. "We want to push to try to get that."