The Register-Herald, Beckley, West Virginia

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April 5, 2014

W.Va. leaders speaking up against black lung clinic funding caps

— West Virginia’s national and state representatives are taking Washington to task and hoping that their efforts to eliminate a cap on grant funding for black lung disease clinics are successful.

Clinics in the state were granted $1.4 million last year but must now adhere to a country-wide cap of $900,000 per application. The grants are applied for and administered by the West Virginia Department of Health and Human Resources.

West Virginia’s national representatives have been in “lengthy discussions” with both state and U.S. Department of Health and Human Services officials about the black lung program since February, a media release from Sen. Jay Rockefeller’s office said Thursday.

Congressman Nick Rahall, D-W.Va., said fighting for more funding is an uphill battle in light of different philosophies in Congress about the size of government and what it funds.

“I have been among coal miners all my life and seen the terrible effects of black lung up close. I have seen far too many black lung victims, who should be active and strong, struggle just to climb up the staircase in their homes,” Rahall said Friday. “I hear repeatedly from the spouses and family members of black lung victims pleading for funding for clinics, and I have fought tooth and nail for that funding — a very tough fight in this Congress with the Republican leadership advocating cuts in any and all spending with little regard for the impact on our state’s black lung clinics and medical care to stricken miners.”

And, Rahall said, the Affordable Care Act, vilified by many, particularly aids coal miners and their families.

“When the critics of the new health care law advocate its full repeal, little do many of them know that the law expands the eligibility of miners to medical benefits for black lung — a provision that I fought to enact for years,” he said. “Preserving the additional assistance for black lung victims and their widows is one of the principal reasons why I have consistently opposed full repeal of the new law.”

The release offered statements from both Rockefeller, D-W.Va., and Sen. Joe Manchin, D-W.Va., as well as Rahall.

“We need to do more to help miners who are suffering from this disease, not less,” Rockefeller said. “West Virginia has among the highest rates of black lung disease in the nation, and miners throughout Appalachia deserve our absolute best efforts at providing the health care treatment they so badly need.”

Manchin said coal “keeps our lights on, heats our homes and powers our businesses.

“Every single miner who suffers from black lung disease should receive the best medical care possible,” he continued. “It is essential that we find a long-term solution to this issue so that our eight black lung clinics around our great state will get the funding they need to treat their patients.”

In a letter to Mary K. Wakefield, administrator of the Health Resources and Services Administration, Rockefeller, Manchin and Rahall said West Virginia is the only state that received more than $900,000 for Black Lung clinics in fiscal year 2014, and asked that the cap be eliminated. The letter said “one of the most troubling aspects” of the cap is that all applicants will be deprived of the opportunity to qualify for funding based on the need for services.

According to the letter, West Virginia has particular concerns about that because the state’s disease rates and occurrences “vastly” exceed other parts of the country.

The National Institute for Occupational Safety and Health’s Coal Workers’ Health Surveillance Program says that “more coal miners in West Virginia were diagnosed with black lung than any other state between 1970 and 2009, as well as the most recent period from 2005-2009.” More West Virginia miners also suffered from progressive massive fibrosis, the most severe and fatal stage of the disease, NIOSH said.

Further, the letter says a 2012 study puts the Mountain State at the top of the list for “prevalence and severity of pneumoconiosis, and younger miners are suffering from the disease, which is now affecting miners earlier in their careers.”

A study done by the Rural Health Research Center at West Virginia University says that central Appalachia, including parts of West Virginia, “tend to have not only the most cases of (black lung disease), but also the most severe cases.

“The cap of $900,000, which would cut our state’s funding by at least 35 percent, appears to be inconsistent with the findings of this HRSA-funded study,” the letter said.

Gov. Earl Ray Tomblin weighed in, as well, with a letter to DHHS Secretary Kathleen Sebelius.

“The recent change within the structure of the federal Black Lung Clinic program will jeopardize our ability to provide nearly 8,500 West Virginians suffering from black lung disease with the critical care and services they need,” Tomblin said.

Tomblin asked Sebelius to reconsider the cap for grant applications.

Martin Kramer, director of communications for the Health Resources and Services Administration, an agency within the DHHS, said it is not accurate to characterize the cap on grant applications as a funding cut.

“It is critical to understand that the maximum funding award only applies to individual applicants — not the total amount of funding a single state could receive,” Kramer said in an e-mail.  “For example, multiple entities in West Virginia — including the state government and community-based organizations can submit applications as long as there are different lead applicants serving different patients.”

Rockefeller, Manchin and Rahall addressed that idea in their letter, and said the scenario may cause West Virginia to lose even more funding.

“It ... 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,” the letter said. “Our clinics rely on the expertise of the West Virginia Department of Health and Human Resources to apply for and administer the grant, so that they can focus on providing services to more than 8,400 patients.”

Kramer said the reverse is also true, and depending on how well a grant application scored, the state could be “above, below or at the same prior funding levels.”

He said the funding strategy was announced in 2012 and is designed to better distribute funding based on the growing prevalence of pneumoconiosis nationally.

The West Virginia Bureau for Public Health has been a recipient of the Black Lung Clinic Grant program since 1979 and has provided oversight and technical assistance for black lung clinics statewide.

Local black lung clinics are in Princeton, Whitesville, Oceana, Montcalm, Rainelle, Meadow Bridge and Scarbro.

A call for comment to the Raleigh-Boone Medical Center in Whitesville was not returned Friday.

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