Appeals Court: Medicaid Program Must Cover Gender-Affirming Care

The Fourth U.S. Circuit Court of Appeals in Richmond, Virginia, upheld a lower court ruling Monday on a vote of 8 to 6 that the state’s Medicaid exclusion violated federal law.

A federal appeals court has ruled that West Virginia’s Medicaid program must cover gender-affirming surgeries.

The Fourth U.S. Circuit Court of Appeals in Richmond, Virginia, upheld a lower court ruling Monday on a vote of 8 to 6 that the state’s Medicaid exclusion violated federal law.

The Fourth Circuit ruling also applies to North Carolina’s health insurance program for state employees.

The states had argued that cost, rather than bias against transgender beneficiaries, was behind excluding gender-affirming surgeries. West Virginia’s Medicaid program does cover hormone therapy, office visits, counseling and lab work.

The court’s majority found that the states’ exclusion did not apply to the same procedures, such as mastectomies or breast reductions, for patients with cancer or excess breast tissue who are not transgender.

Attorney General Patrick Morrisey, a candidate for governor in the state’s Republican primary, said he’d appeal the case to the U.S. Supreme Court.

“Our state should have the ability to determine how to spend our resources to care for the vital medical needs of our citizens,” Morrisey said in a statement.

The West Virginia lawsuit, filed in 2020 in the U.S. District Court for the Southern District of West Virginia, named the former Department of Health and Human Resources and its former secretary, Bill Crouch, as defendants.

The suit also covered PEIA, the state employees’ health insurance program.

District Judge Robert Chambers ruled against the exclusions in 2022. Morrisey appealed to the Fourth Circuit.

U.S. Department of Agriculture Expands WIC Options

A new rule by the U.S. Department of Agriculture allows more flexibility for families who depend on government assistance for groceries.

A new rule by the U.S. Department of Agriculture allows more flexibility for families who depend on government assistance for groceries.

The West Virginia Department of Health (DH) announced changes to the special supplemental nutrition program for women, infants and children, commonly referred to as WIC.

According to a press release, the program increased the amount of money available to low-income families to purchase fruits and vegetables while allowing more flexibility in selecting foods from a variety of cultures.

“These changes reflect the program’s commitment to promoting healthy eating habits and catering to the diverse nutritional needs of West Virginians. By offering a wider variety of healthy choices, WIC empowers participants to make decisions that boost the health of West Virginians who depend on this program,” said Heidi Staats, director of WV WIC, housed within DH’s Bureau for Public Health.

For 50 years, the federal program has given states the power to provide supplemental food, health care referrals and nutritional education for low-income pregnant, breastfeeding, and non-breast-feeding postpartum women. 

The program also benefits infants and children up to five who are found to be at nutritional risk.

According to the DH, West Virginia WIC serves 70 percent of all babies born in the state.

“In a time of rising food insecurity and high food costs, increasing participants’ purchasing power for healthy foods is critical,” Staats said.  “The Office of Nutrition Services will work diligently to implement the more complex flexibilities of the WIC food package final rule within the two-year regulatory timeline. However, families can immediately access the enhanced Cash Value Benefit to purchase fresh, canned or frozen fruits and vegetables.”
To learn more about WIC services or how to apply for benefits call 304-558-0030. Visit dhhr.wv.gov/WIC for more information.

Judge Orders Some Sanctions Against Department Of Human Services

A U.S. District Court judge has granted some and dismissed some sanctions the Plaintiff’s request against the West Virginia Department of Human Services over missing emails.

Updated on Wednesday, April 3, 2024 at 4:35 p.m.

A judge has ordered some sanctions and dismissed others in a class action lawsuit against the now-split Department of Health and Human Resources (DHHR) for children’s rights related to the foster care system.

Plaintiffs in the suit, A Better Childhood, a New York-based nonprofit, along with Shafer and Shafer and Disability Rights West Virginia, asked for sanctions in the case in January due to lack of evidence retention from the defendants.

U.S. Magistrate Judge Cheryl Eifert said in an order that she did not find the state had intentionally deleted evidence.

“The argument that Defendants produced many documents in discovery does not change the fact that they did not take reasonable actions to preserve the email accounts of the affected custodians,” Eifert wrote in the order.

Eifert ruled that the state department of Human Services has to pay for the plaintiff’s attorney fees and other costs related to bringing the request for sanction.

Earlier this year, attorneys with A Better Childhood presented evidence they believed showed the department purposely deleted emails related to a class action lawsuit.

In a press release, the Department of Human Services said it is pleased with the judge’s sanction decision, but does not agree with all conclusions in the magistrate judge’s decision.

Marcia Robinson Lowry, the lead plaintiff for the class and executive director of A Better Childhood (ABC) said in an email that she thought the court’s decision was reasonable and fair.

“The court found that defendants’ ‘communications failures were negligent, perhaps grossly negligent’ and that defendants cannot use the destroyed documents to suggest that defendants were not ‘deliberately indifferent.’ The court also agreed to award plaintiffs fees for the costs of bringing this motion, a highly unusual remedy at this stage of the litigation,” Lowry wrote in an email. This is yet another instance of the very serious problems that are afflicting the state’s child welfare system, and, most importantly, the children who are suffering in it.”

The Class Action Lawsuit

The lawsuit alleges the DHHR failed to properly care for thousands of foster kids, putting some in dangerous and unsafe situations.

In the original court filing, the plaintiffs allege, “Children in West Virginia’s foster care system have been abused and neglected, put in inadequate and dangerous placements, institutionalized and segregated from the outside world, left without necessary services, and forced to unnecessarily languish in foster care for years.”

The group filed a complaint in federal court in October 2019, denouncing the DHHR’s “over-reliance” on shelter care, shortages in case workers and a “failure to appropriately plan for the children in its custody.”

The following year, a motion for class action status was filed but left undecided when the case was dismissed in 2021. In 2022, that decision was reversed by the Fourth U.S. Circuit Court of Appeals and the class action motion was renewed in May 2023.

According to the DHHR Child Welfare Dashboard, on March 29, 2024, there are 6,111 

children in state care.

The Missing Emails

In a January email, Whitney Wetzel, a DHHR spokesperson said the DHHR instructed the West Virginia Office of Technology (WVOT) to preserve all emails relevant to the case.

“Unfortunately, a litigation hold was not placed by WVOT on certain email accounts, resulting in some emails not being preserved,” Wetzel said in an email. “Subsequently, Gov. Jim Justice has directed WVOT to develop an updated form and process for legal hold requests.”

Wetzel also said in an email that all emails of current employees, including all emails between current employees and former employees, have been preserved.

“Therefore, the majority of relevant emails involving dozens of employees are available to be produced to plaintiffs in this case, as requested,” Wetzel said in an email. “Over the last four years, DoHS (West Virginia Department of Human Services) and its predecessor agency have preserved and produced to plaintiffs more than 1.2 million pages of documents, including hundreds of thousands of emails and attachments.”

In November, defendants in the case filed a motion in opposition to the plaintiffs’ motion for sanctions, apologizing to the court and the plaintiffs for the lost electronically stored information.

In the midst of an ongoing class action lawsuit and possible sanctions for lack of record keeping, the state health department’s top attorney retired.

DHHR General Counsel April Robertson retired effective Jan. 2, 2024, said Jessica Holstein, a spokesperson for the DHHR, in an email.

The news of Robertson’s retirement came after attorneys who brought the class action lawsuit announced in October that they were filing for sanctions because the DHHR had failed to preserve about three years of requested emails.

Robertson gave a deposition on Nov. 21, 2023, stating that she had been general counsel at the DHHR since May of 2019, the duration of the pendency of the class action litigation.

The lawyer questioning Robertson, J. Alexander Meade of Shaffer & Shaffer PLC, asked her if the general counsel’s office had followed up with the Office of Technology to ensure that the electronically stored information of the named defendants or individuals within the matter was being preserved. 

She responded that she did not follow up, and when asked why, she said, “I had no reason to assume that there would be any problem.” She later testified she had never needed to follow up on a litigation hold with the Office of Technology.

Robertson testified that she submitted the litigation hold in December 2019 via email. She said she received signed acknowledgments from the individuals who were subject to the litigation hold, but not from the Office of Technology.

“I can’t speak to what they may read or not read in their inboxes,” Robertson said in her deposition.

Meade asked Robertson about the purpose of the acknowledgment form if no signed acknowledgment was received from the Office of Technology.

“The purpose in my mind is primarily to make sure our DHHR folks are seeing it and making sure that they understand,” Robertson said.

‘Incredible Careless or Willful Destruction’

Robertson also testified that, before September 2023, she was not aware of the Office of Technology’s policy regarding the deletion or purging of electronically stored information about staff who had separated from state employment.

“What we have learned is it seems that there’s a great deal of either incredible carelessness or willful destruction of documents,” said Lowry. “It’s very unclear what’s happening.”

In an affidavit, Michael Folio, legal director of Disability Rights of West Virginia (DRWV) and a previous attorney at the DHHR, testified that officials at the agency, namely Robertson and previous DHHR Secretary Bill Crouch, knew about policies surrounding preserving documents.

“Well, I had conversations with each of April Robertson and Bill Crouch, that arose as a result of an employee’s emails not having been preserved who was going to be a witness in a pending civil action,” Folio said. “And I raised the issue at that time about the spoilation of evidence. And this was wholly unrelated to the foster care lawsuits.”

Lowry said in a lawsuit similar to this one, she has to show that not only were the children’s constitutional rights violated, but that it was done with deliberate indifference to the children’s rights.

“The way you usually do it is by getting emails from the key players,” Lowry said. “And showing that there’s a pattern of saying that they knew about it, they knew about the harm being put on children, etc. Because people don’t admit it.”

However, in this case, the emails and the evidence they contained have not been turned over to the plaintiffs.

Lowry said the loss of that information brought her to ask the judge for sanctions against the DHHR.

**Editor’s note: This story has been updated with Marcia Lowry’s remarks. Additionally, this story was further updated on April 3 to clarify the term health department.

Former DHHR Official Pleads Guilty In COVID Test Fraud Case

A West Virginia man pleaded guilty to making false statements to federal investigators while he was an official with the West Virginia Department of Health and Human Resources.

Timothy Priddy, 49, of Buffalo, pleaded guilty Monday in federal court to making a false statement. Priddy admitted that he lied to federal investigators about the verification of invoices for COVID-19 testing that he certified while an official with the West Virginia Department of Health and Human Resources (DHHR).

According to court documents and statements made in court, Priddy was interviewed by federal agents on Aug. 2, 2022 while he was the director of the DHHR’s Center for Threat Preparedness.

In his previous position as Deputy Director, his duties included reviewing and verifying the accuracy of certain invoices submitted to the DHHR by vendors supplying COVID-19 testing and mitigation services before certifying the invoices for payment.

The agents asked Priddy about invoices submitted by a particular vendor that had billed the state of West Virginia tens of millions of dollars for COVID-19 testing and related services.

One series of invoices of interest to the federal investigation related to a COVID-19 testing program for K-12 students, faculty and staff returning to school after the winter holiday break. 

Priddy certified the K-12 testing program invoices without making any effort to verify their accuracy. Priddy falsely told the agents that he certified the invoices only after two individuals working with the K-12 testing program verified the invoices involved. 

Priddy admitted that he knew that statement was false.

William Thompson, the United States Attorney for the Southern District of West Virginia, said this case is unique in COVID-19 fraud cases he is trying in that Priddy stood nothing to gain financially in committing his crimes.

“He just basically cost the state quite a bit of money by not doing his job and not following through on it,” Thompson said.

Priddy is scheduled to be sentenced on May 9, 2024, and faces a maximum penalty of five years in prison, three years of supervised release, and a $250,000 fine.

Chief United States District Judge Thomas E. Johnston presided over the hearing. Assistant United States Attorneys Joshua Hanks and Holly Wilson are prosecuting the case.

A Bill To Restructure DHHR On The Move And Lawmakers Weigh In On Education Legislation

On this episode of The Legislature Today, dozens, if not hundreds, of bills have been introduced in the West Virginia Legislature this year that involve education. Randy Yohe spoke with Senate Education Chair Sen. Amy Grady, R-Mason, and teacher Del. Jeff Stephens, R-Marshall, about what some of those bills mean for public education in West Virginia.

On this episode of The Legislature Today, dozens, if not hundreds, of bills have been introduced in the West Virginia Legislature this year that involve education. Randy Yohe spoke with Senate Education Chair Sen. Amy Grady, R-Mason, and teacher Del. Jeff Stephens, R-Marshall, about what some of those bills mean for public education in West Virginia.

Also, in the House, the bill to officially rename the West Virginia Department of Health and Human Resources (DHHR) has now passed both the House and Senate. Bills increasing penalties for child abuse and candidate residence passed on third reading. Randy Yohe has the story.

The Senate completed action on a bill that makes it a felony to give someone drugs that cause them to die. The chamber introduced other bills today and sent the Controlled Substances Act, Senate Bill 219, over to the House of Delegates. Briana Heaney has the story.

And, tourism industry partners and organizations from across the state gathered at the Capitol to recognize Tourism Day. Briana Heaney has the story, and she found a potentially underserved market.

Finally, the Gas and Oil Association of West Virginia held its winter meeting in Charleston last week. Curtis Tate stopped by and has this story.

Having trouble viewing the video below? Click here to watch it on YouTube.

The Legislature Today is West Virginia’s only television/radio simulcast devoted to covering the state’s 60-day regular legislative session.

Watch or listen to new episodes Monday through Friday at 6 p.m. on West Virginia Public Broadcasting.

Camping Ban In Wheeling And State Lawmakers Talk DHHR Restructuring, This West Virginia Morning

On this West Virginia Morning, a new camping ban went into effect in Wheeling this month. But as Chris Schulz reports, advocates for the unhoused community are pushing back. 

On this West Virginia Morning, a new camping ban went into effect in Wheeling this month. But as Chris Schulz reports, advocates for the unhoused community are pushing back. 

Also, in this show, in our latest episode of The Legislature Today, Emily Rice sat down with Del. Amy Summers, R-Taylor, and Sen. Charles Trump, R-Morgan, to discuss why the Department of Health and Human Resources (DHHR) was broken up into three separate agencies and how it is going.

West Virginia Morning is a production of West Virginia Public Broadcasting which is solely responsible for its content.

Support for our news bureaus comes from Shepherd University.

Eric Douglas produced this episode.

Listen to West Virginia Morning weekdays at 7:43 a.m. on WVPB Radio or subscribe to the podcast and never miss an episode. #WVMorning

Exit mobile version