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The floodgates have opened in West Virginia for a service that is become more and more vital every year. As the opioid epidemic continues to set records for overdose rates, the death-care business has become the most visible metric of just how devastating the crisis has been. In Ohio, local coroners have resorted to using cold storage trailers after running out of space at the morgue. While in the hardest hit state, West Virginia, another business has been morbidly booming as a result of the rising death toll: transportation.

According to a recent audit of West Virginia’s Office of the Chief Medical Examiner (OCME), a single vendor, Tri-State Mortuary Services, was responsible for the vast majority of body transports for the last nine years. In 2012, for example, Tri-State accounted for 95 percent of the transportation business conducted with the state’s health officials.

That near-monopoly came as a result of an unknown and invalid hand-written contract which bound the OCME to Tri-State’s services for a 10-year period beginning in 2008. The letter stated that the Poca based funeral home would be the “sole transport company” employed by the Department of Health and Human Resources (DHHR) and will, “provide transportation service to the Office of the Chief Medical Examiner, the State of WV thru the year 2018…”

That contract was cut short this year when the funeral home was suspended and charges were brought against its owner, Chad Harding, who pled guilty this week.

Now that market has been opened to more than 170 private transport companies lying in wait to take over. But the truly staggering thing which shows the extent to which the opioid crisis has affected West Virginia is the amount of money that was made in the body transport business. Tri-State alone was paid over $3.2 million for its services since 2003.

GettyImages 870984526 The opioid crisis has turned body transportation into a booming business
BOSTON, MA – OCTOBER 31: Hearses of various makes and models are on exhibit during the National Funeral Directors Association’s annual convention at the Boston Convention and Exhibition Center on Oct. 31, 2017. (Photo by David L. Ryan/The Boston Globe via Getty Images)

In the period covered by the 10-year contract, auditors found that the OCME had paid $76,281 more than it should have due to miscalculations and improper billing practices. Among those practices were ‘per-body’ charges which amounted to $23,503 in overcharged bills. West Virginia’s DHHR additionally paid private companies nearly $1 million to transport 4,200 bodies in 2017. That number was almost double that of the bodies transported in 2015.

Experts believe that it’s certainly the opioid crisis that is driving these numbers up. West Virginia is currently the most highly affected state with some counties reporting nearly 100 fatal overdoses for every 100,000 citizens. Statewide that number is 33.5 compared to the national average of 13.4. In 2016, the state set a record with 818 fatal opioid-related overdoses – that’s one every 12 hours.

West Virginia state law demands that the DHHR pay for the transport of the dead so that families aren’t left hanging. But the state’s Department of Revenue Expenditure exempts this service from a shocking level or regulations leaving this particular sector of the economy widely unregulated and open to abuse according to auditors.

The reason given for these exemptions by the Medical Examiner’s Office was the unpredictability of the job: “OCME continues to require the exemption for body transport services due to the unpredictable nature of when and to what extent transport services will be required…” the auditor’s report stated.

The DHHR maintains that they have a regulated system and keep a list of all vendors which have to comply with a “Transport Agreement”. But it appears that being placed on that list might be far easier than it sounds.

“All you need is $2 million of liability insurance, a van, a cot and a driver,” Rob Kimes of the Funeral Directors Association told the Charleston Gazette-Mail in a report form July.

GettyImages 814614004 The opioid crisis has turned body transportation into a booming business
WARREN, OH – JULY 14: Medical workers and police treat a woman who has overdosed on heroin, the second case in a matter of minutes, on July 14, 2017, in Warren, Ohio. According to recent statistics, at least 4,149 Ohioans died from drug overdoses in 2016, a 36 percent leap from just the previous year and making Ohio the leader in the nation’s overdose deaths. (Photo by Spencer Platt/Getty Images)

Meanwhile, other funerary services within the state are really struggling to keep up with the crisis. The government’s Indigent Burial Program is meant to provide funds to families who cannot afford funeral services. Each year the program receives $2 million from the state budget. In 2017 that fund ran out as early as February and it’s been drained well before the end of the fiscal year in June for every year since 2013.

When it comes to loose regulations, West Virginia isn’t alone. It’s nearby states like Pennsylvania and New Jersey also employ private transportation services which do not have to be licensed by the state. In fact, since these expenses are left to state regulators, many states have opted to hire out private contractors. The result has been a booming, yet certainly necessary, private business in the wake of a terrible epidemic and it’s provided yet another metric by which to measure its full impact.

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