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Workers fear changes to health plan
Public Employees Insurance Agency
faces $48 million shortfall this year
by Martha Bryson Hodel
THEASSOCIATEDPRESS
Linda Adkins is the picture of health. With a rosy complexion set off
by a black turtleneck sweater and bright blond hair framing her cheerful
face, the Sherman High School librarian’s appearance gives no clue to her
past health crises, which include diabetes-related blindness and kidney
failure.
“If it hadn’t been for the Public Employees Insurance Agency, I would
not be alive,” Adkins said in an interview last week. Other problems resulting
from her diabetes at one point threatened to leave her in a wheelchair,
unable to walk.
“I’m probably one of their nightmares, but I have nothing but praise
for PEIA,” she said.
But changes are coming to the state’s second-largest insurance program,
which finances health benefits to an estimated 201,000 West Virginians.
That includes 95,000 teachers and other state, county and municipal employees
and their dependents.
By June 30, the end of the current fiscal year, the agency is expected
to be $48.5 million short of what it needs to pay this year’s expenses.
Gov. Cecil Underwood has asked the Legislature to appropriate $10.7
million that will cover increased premiums paid by employers in the coming
fiscal year. The Legislature has contributed to PEIA funding in just three
of the past eight years.
The PEIA subcommittee of the Senate Finance Committee meets today,
according to Finance Chairman Oshel Craigo, D-Putnam.
The governor’s proposal will be just a starting point, Craigo said.
“We’ll fund more than that,” he said. “We’re going to fund PEIA totally.
We just don’t know what plan yet.”
The changes proposed by PEIA’s finance board do not include an increase
in employees’ premiums. But that doesn’t mean employees won’t bear the
cost, said Daniel Haney, executive director of the West Virginia Education
Association.
“The new plan’s design — including co-pays, deductibles, out-of-pocket
maximums and a preferred provider plan — increases costs to employees by
$48.5 million,” Haney said. “In some cases, out-of-pocket maximums are
doubled or even tripled for employees,” he said.
Most of the increases are intended to change the way beneficiaries
use the plan. Overuse is a problem, Craigo said.
And that’s what worries Linda Adkins and others like her.
Adkins has often traveled out of state for the care she needed, to
facilities like the Cleveland Clinic and Johns Hopkins University in Baltimore.
Her concern about PEIA changes is that others may not be able to receive
the care that has helped her.
“I would not like to see other people delay getting treatment they
need because they’re afraid of what it will cost,” she said.
Stricken by diabetic retinopathy in the early 1980s, Adkins was receiving
laser treatments from a Charleston ophthalmologist.
“But my eyes kept hemorrhaging,” she said. “I became totally blind
in my left eye and then my right eye began to hemorrhage.”
Then her husband read about the Wilmer Eye Institute at Johns Hopkins
in Baltimore and how they helped Sugar Ray Leonard, whose vision was threatened
by his years as a boxer.
“Wilmer had medical equipment that was not available locally at the
time,” Adkins said. “I made many trips to Wilmer during the course of a
year and a half, but my vision was saved.
“The doctors there told me that if I had not gotten the bleeding stopped,
I would surely have lost my sight,” she said.
“The sad thing is that my local doctor did not refer me; I went on
my own.”
Adkins also had to refer herself to the Cleveland Clinic for treatment
of an open sore on her foot. Although she was being treated locally for
the sore, doctors at the Cleveland Clinic realized she had osteomyelitis,
a bone infection that could have confined her to a wheelchair.
Then there was the kidney transplant she had in 1990, the installation
of an insulin pump and the enormous amounts of medicine she must take to
stave off rejection of her new kidney and keep other problems under control.
In spite of what she sees as good health insurance, she works a second
job part-time, as a reference librarian at the University of Charleston,
to cover her medical bills.
“I know that I’m lucky, and that I have the taxpayers of West Virginia
to thank for that,” she said. “But I do believe that health care should
be a right.”
Her concern about the proposed changes in the PEIA program are that
others may not be able to receive the care that has helped her.
“I would not like to see other people delay getting treatment they
need because they’re afraid of what it will cost,” she said.
“Unfortunately, we don’t have a Cleveland Clinic here in West Virginia.
And I’m afraid that other people might not be able to go after the top-notch
care that I have had.”
Status of major bills
BUDGET: (SB125 HB2200) Introduced Jan. 13 in both houses. Pending in
House and Senate finance committees.
GRAY MACHINES: (SB164) Making it a felony to possess a video poker
machine or any amusement device that could be used for gambling. Introduced
in Senate Jan. 20. Pending in Senate Judiciary Committee.
GRADUATED DRIVERS LICENSE: (2634) Implements a graduated drivers license
for people under 18. Introduced in House Feb. 3. Pending in House Roads
and Transportation Committee.
GREENBRIER BILL: (SB380, HB2594) Allowing The Greenbrier hotel to open
a casino. Introduced in House and Senate Feb. 2. Pending in Senate Judiciary
Committee and House Finance Committee.
HELMET BILL: (HB2403, SB237) Allowing experienced adults to ride motorcycles
without helmets. Introduced in the House and Senate Jan. 27. Pending in
the House Roads and Transportation Committee and the Senate Transportation
Committee.
JOINT CUSTODY: (SB367 HB2598) Making joint child custody the preference
in divorce, separation or annulment. Introduced in Senate Jan. 29. Introduced
in House Feb. 2. Pending in Senate and House judiciary committees.
MOUNTAINTOP REMOVAL: (SB146) To repeal 1998 mountaintop removal mining
law. Introduced in the Senate Jan. 15. Pending in Committee on Energy,
Industry and Mining. (SB414) Creating Office of Explosives and Blasting.
Introduced in Senate Feb. 3. Pending in Committee on Energy, Industry and
Mining.
NUDE DANCING (SB69) To prohibit nude dancing in private clubs. Introduced
in Senate Jan. 13. Pending in Senate Judiciary Committee.
OPEN MEETING: (HB2005) Revising the Open Government Meetings Act. Introduced
Jan. 13. Pending in House Judiciary Committee.
SMOKELESS TOBACCO TAX: (HB2379) Imposing a tax on smokeless tobacco
and directing the proceeds to the Children’s Health Insurance Program.
Introduced in the House Jan. 26. Pending in House Finance Committee.
All Clarksburg Fire Department
officers receive full certification
by James Fisher
STAFF WRITER
Being a firefighter involves more than just putting out fires — it
also means intense and nearly constant training.
That training and study has made the Clarksburg Fire Department just
the second department in the state to have all its officers meet the National
Fire Protection Association’s standards to be certified as Fire Officer
Level 1.
The certification means that the officers have taken classes in various
aspects of firefighting, including hazardous materials, arson detection
and personnel and field situation management. They now meet the national
standards set by the fire protection association.
“This may be something down the road that every officer in the state
will need to have,” said Lt. Rick Lafferty.
The only other department in the state that has all its officers certified
is Beckley, according to Dean Otto, spokesman for the Clarksburg department.
Beckley’s department is comparable in size to Clarksburg’s, and may even
be a little smaller, he said, so they may have fewer officers.
The West Virginia Fire Marshal’s office does not require all officers
to meet this standard right now, but Lafferty said many other states do.
He said they are moving toward requiring all officers to be certified.
Most of the officers have been involved in training over the years
that put them close to meeting the requirements, Lafferty said. At an officers
meeting last year, it was decided that the rest of the training should
be completed to get the officers certified, said Lt. Robert Webb.
“We decided to start with the officers and then work our way down through
the department,” he said.
After researching what was necessary to meet the standards, Lafferty
said, the officers discovered that most of them were very close and would
only need a few more classes.
The most recent round of classes involved leadership, incident safety
and arson detection for first responders.
Except for a few specific areas, there are no state or national requirements
for yearly training, Lafferty said. Clarksburg firefighters have just always
been involved in on-going training.
“That’s just the way we are,” he said. “There are certain things we
have to keep up on, like haz-mat, but the rest of it just benefits us to
keep up on it.”
Next generation of yo-yo
experts go head-to-head
by Troy Graham
STAFF WRITER
CHARLESTON — Harrison County’s legislative delegation will introduce
a bill that would allow counties to give cash refunds to taxpayers when
they are overcharged because of clerical errors.
Current law only allows for taxpayers who are overcharged to be credited
that amount on the following year’s taxes. But for senior citizens who
would pay no personal or real estate taxes in the next year because of
the homestead exemption or any other reason, there is no way to credit
them the money.
The Harrison County Commission was presented with a case this year
where a woman was mistakenly taxed. Because she qualified for a homestead
exemption, there was no way to return the money.
Following that case, county officials asked the Harrison County delegation
to introduce a bill that would allow for cash refunds in such cases. The
bill would only allow for cash refunds when there is no other way to credit
the money to a taxpayer.
“The point is if we owe people money because of a tax error we should
pay them,” said Delegate Frank Angotti, D-Harrison.
All four Harrison County delegates will sponsor the bill in the House,
and Harrison County Senator Joe Minard will sponsor it in the Senate, he
said.
“That’s just a glitch in the law,” said Jim Harris, the Harrison County
administrator. “I think it’s happened in the past.”
In most cases, the amount of money overcharged is less than $40, Angotti
said. But the county needs a way to refund the money “if it’s 10 cents,”
Harris said.
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