West Virginia Code
The Legislature finds that treatment for pain is an important element in health care. Unlike diseases such as hypertension and diabetes, pain is a subjective experience. There is no objective measure of pain intensity. Consequently, the clinical and medical judgement of a prescriber is more essential in rendering effective treatment of a person’s level of pain.
The treatment of chronic pain has a significant impact on the individual and society as a whole. Most chronic pain problems start with an acute nociceptive pain episode. Effective early care is paramount in managing chronic pain. To that end, prescribers should have the flexibility to effectively treat patients who present with chronic pain. However, there must be a balance between proper treatment for chronic pain and the abuse of the opioids found most effective in its treatment.
The abuse of pain medication in this state continues to be a nearly insurmountable plague. Substance abuse continues to contribute to unnecessary deaths, causes countless societal breakdowns and causes a strain on our state and its citizens both financially and emotionally. In an effort to address this crisis the state has created a regulatory framework with the intended goal of curbing overprescribing and overuse of prescription pain medication. This regulation, however, has resulted in unforeseen outcomes often causing patients seeking pain treatment to suffer from a lack of treatment options.
Accordingly, the Legislature finds that a comprehensive review of the regulatory structure in place to provide oversight to prescribers whose practice has a significant focus on pain management needs to be undertaken. In order to gain the necessary insight into effective treatment for chronic pain and to maintain the state’s interest in protecting its citizens from the proliferation of prescription pain medication, the Legislature hereby creates the Coalition for Responsible Chronic Pain Management.
There is created the Coalition for Responsible Chronic Pain Management. The administrative functions of the coalition shall be the responsibility of staff assigned to the Joint Committee on Health to be in the best interest of the state and its citizens.
The Coalition for Responsible Chronic Pain Management shall consist of the following members:
(1) The Dean of the School of Public Health at West Virginia University, or his or her designee, who shall serve as chair of the coalition.
(2) A physician who is a board-certified pain specialist.
(3) Three physicians licensed to practice in this state pursuant to article three or article fourteen, chapter thirty of this code who shall be appointed by the President of the Senate and the Speaker of the House of Delegates in consultation with the cochairs of the Joint Committee on Health. Two of these physicians’ practices shall have been classified as a pain clinic pursuant to the regulations promulgated under article five-h of this chapter. The third physician shall be a primary care physician who is not classified as a pain clinic.
(4) A pharmacist licensed to practice in this state pursuant to article five, chapter thirty of this code who shall be appointed by the President of the Senate and the Speaker of the House of Delegates in consultation with the cochairs of the Joint Committee on Health.
(5) A consumer of health care services directly impacted by the regulation of pain clinics who is appointed by the President of the Senate and the Speaker of the House of Delegates in consultation with the cochairs of the Joint Committee on Health.
(6) A chiropractor licensed pursuant to the provisions of article sixteen, chapter thirty of this code who is appointed by the President of the Senate and the Speaker of the House of Delegates in consultation with the cochairs of the Joint Committee on Health.
(7) A Physical Therapist, licensed under chapter thirty of this code, experienced in the area management of chronic pain by physical, behavioral and other nonpharmacological means who is appointed by the President of the Senate and the Speaker of the House of Delegates in consultation with the cochairs of the Joint Committee on Health.
(8) Membership on the coalition shall be equally distributed among the congressional districts of this state and each congressional district shall be represented in the membership of the coalition.
(9) The cochairs of the Joint Committee on Health shall serve as nonvoting members, ex-officio.
(a) The Coalition for Responsible Chronic Pain Management shall:
(1) Meet at least quarterly, or at the call of the chairman. A quorum shall be a simple majority of the coalition.
(2) Keep accurate records of the actions of the coalition.
(3) Make recommendations to the Legislature as required by this article.
(b) At a minimum, the coalition shall:
(1) Undertake a review of chronic pain regulations contained in article five-h of this chapter and any legislative rules promulgated pursuant to said article to ascertain if a less cumbersome, but equally or more effective manner exists to provide necessary regulation of prescriber practices characterized as pain clinics.
(2) Review the statutory provisions of the Controlled Substance Monitoring Database provided for in article nine, chapter sixty-a of this code. The purpose of this review is to ascertain if there is a more effective manner for prescribers to access the database which would provide sufficient regulation over the prescription of chronic pain medication while still allowing access to patients with established chronic pain conditions.
(3) Provide guidance to the Legislature on potential statutory solutions relative to regulation of chronic pain medications.
(4) Consult with a quality improvement organization.
(5) Establish workgroups and clinical advisory committees as the coalition deems necessary to address pertinent issues related to chronic pain management and to provide consistency in the development of further regulation.
(6) Consult with entities and persons with a particular expertise as the coalition deems necessary in the fulfillment of their duties. This can include public and private sector partnerships.
(7) Offer any additional guidance to the Legislature which the coalition sees is within its scope which would further enhance the provider patient relationship in the effective treatment and management of chronic pain.
(8) Make recommendations regarding regulations of wholesalers of controlled substances or terminal distributors of dangerous drugs.
(9) Provide insight into whether “take back” programs or limitations on prescriber furnished controlled substances would be effective in this state.
(10) The coalition shall report its findings to the Joint Committee on Health by December 31, 2017, and annually thereafter until the coalition terminates pursuant to the provisions of this article. The report shall include, at a minimum, the following:
(A) Conclusions and recommendations to promote a better means for regulation of chronic pain clinics while protecting the rights and needs of chronic pain patients.
(B) Recommendations for statutory and regulatory modifications.
(C) Identification of any action which may be taken by the Legislature to better foster a balance between the clinical judgment of prescribers and the needs of chronic pain patients and the state interest in maintaining an effective regulatory structure.
(D) Any other ancillary issues relative to chronic pain management.
The coalition shall terminate on December 31, 2020, unless continued by act of the Legislature.