West Virginia's indigent burial program, which budgets about $2 million a year for funeral financial assistance, had already been under pressure from the aging of the baby-boom generation. The program offers an average of $1,250 to help cover funeral expenses for families who can't otherwise afford them.
In the current fiscal year ending June 30, "1,508 burials have been submitted for payment through the Indigent Burial Program,” according to Allison Adler, a spokesman for state DHHR Secretary Bill Crouch. “There are funds remaining for 63 additional burials.”
The program has been around for decades, according to Adler, but only began running out of funds starting in 2013. In 2014, the program ran out of money in June. By 2015, the program's budget was depleted by March, similar to where it stands this year.
Adler didn't respond to a question on the role drug overdoses have played in the program running out of money. But funeral directors such as Robert C. Kimes of the West Virginia Funeral Directors Association blame skyrocketing overdose deaths for the current troubles. In 2015, according to the Centers for Disease Control and Prevention, West Virginia's drug overdose death rate stood at 41.5 cases per 100,000 residents, the highest rate in the country and nearly three times the national average. In 1999, the state's overdose fatality rate was below average.
Nationally, drug overdose deaths accounted for fewer than two out of every 100 fatalities in 2015. But in West Virginia, overdoses claim more than three out of every 100 fatalities. And among certain demographic groups, the likelihood of overdose is much higher: roughly 8 percent of all fatalities among white men age 35 to 64, for instance, and over 28 percent of deaths among white males age 15 to 34.
The state's funeral directors are on the front lines of this trend. “When you get an overdose, typically it's going to be a younger individual who's not financially in a great position,” Kimes said. “I've heard from several funeral directors that the majority of [overdose deaths they deal with] are addressed via the indigent burial program.”
West Virginia is somewhat unique in providing a state-level program for indigent burials, Kimes said. The majority of states don't provide such services at the state level, and most of the ones that do limit them to recipients of Medicaid, SNAP or other social programs for the poor. In many states, funeral assistance is left to the discretion of individual counties or cities.
West Virginia expects a half-billion-dollar budget shortfall in the next fiscal year, making relief from the state unlikely. Social service agencies report being overwhelmed by the number of overdose and addiction cases. In the city of Huntington (population 49,000), for instance, authorities responded to 26 heroin overdose cases in one four-hour span last year.
A Charleston Gazette-Mail investigation last year found that between 2007 and 2012, as the state's drug overdose epidemic skyrocketed, drug wholesalers shipped over 780 million doses of opiate painkillers hydrocodone and oxycodone to the state, or roughly "433 pain pills for every man, woman and child in West Virginia.” Those two drugs killed more than 1,700 West Virginians during that time period, the investigation found.
“That's not the kind of business you want” as a funeral director, Kimes said. “You hate to see a young person's life thrown away.”