A bill that was laid over on third reading with a right to amend during the Legislature’s special Saturday Session passed the Senate to the House with all present voting in the affirmative.
A bill that was laid over on third reading with the right to amend during the West Virginia Legislature’s special Saturday session passed the Senate to the House with all present voting in the affirmative.
The laws surrounding how hospitals determine what services they provide in rural counties will change if Senate Bill 613 becomes a law. It passed the Senate Monday with changes to temper the concerns of some who opposed the bill.
The bill aims to amend the state code relating to a certificate of need (CON). Two sections relate to birthing centers, which are healthcare facilities, staffed by nurse midwives, midwives, and/or obstetricians, for mothers in labor, who may be assisted by doulas and coaches.
Sen. Mike Maroney, R-Marshall, explained the bill and its amendments on the Senate floor. He said the bill changes the minimum expenditure and CON for West Virginia from $5 million to $100 million.
In addition, Senate Bill 613 redefines hospital services and adds a definition of inpatient services. The bill also removes constructing, developing, acquiring, or establishing a birthing center as a reviewable service.
Sen. Patricia Rucker, R-Jefferson, spoke in support of Senate Bill 613.
“I want to thank the chair of the Health Committee for his work. This is something that is very important to the Eastern Panhandle and something we’ve been working on for many years,” Rucker said. “Is this perfect? No. Is there more we could do regarding CON? Absolutely. But this is a great first step. And I consider it a really important bill. So thank you and I urge support.”
Senate Bill 89 has been discussed at length this legislative session, in addition to interim meetings. According to Sen. Mike Woelfel, D-Cabell, the legislature has been working to pass a version of this bill for three years.
A bill meant to staff each West Virginia hospital with a qualified sexual assault nurse examiner was amended in the House.
Senate Bill 89 has been discussed at length this legislative session, in addition to interim meetings. According to Sen. Mike Woelfel, D-Cabell, the legislature has been working to pass a version of this bill for three years.
The bill requires all West Virginia hospitals to have sexual assault nurse examiners on staff and on call.
Issues around proper care for victims of sexual assault or abuse were a topic of conversation during interim committee sessions where lawmakers heard from advocates, including two representatives of the Sexual Assault Forensic Examination Commission.
Back in January, two advocates for the bill, Nancy Hoffman, director of the West Virginia Foundation for Rape Information and Services and David Miller, forensic central evidence processing supervisor with the West Virginia State Police, told lawmakers that remaining roadblocks in proper care and criminal proceedings stem from a shortage of trained nurses in combination with travel time and costs, causing long delays for the victims.
Senate Bill 89 addresses those issues by calling on the state’s hospitals to implement training as soon as possible, to meet an 18-month deadline. At the time, Woelfel asked if West Virginia’s hospitals would have a hard time complying. In response, Sen. Mike Maroney, R-Marshall, Health and Human Resources Committee chairman, mentioned interim committee discussions and said the hospitals understood how important this training will be for their patients.
However, two amendments to the bill passed through the House of Delegates today that would allow for verbiage to let hospitals transfer victims to a facility with trained staff or treat them via telehealth.
On the House floor Monday, Del. Amy Summers, R-Taylor, explained the committee substitute for Senate Bill 89 on the House floor.
“As the house looked at that bill, we felt that that was probably unrealistic since only 17 percent of hospitals are staffed with these types of individuals,” Summers said. “Therefore, we changed the bill in the House to require that the SAFE commission, which stands for Sexual Assault Forensic Exam Commission, to update its legislative rules requiring that hospitals have trained health care providers available or they have transfer agreements as provided for in their county plans to complete a sexual assault forensic exam. Available also includes but is not limited to having access to a trained Sexual Assault Forensic Exam Expert via telehealth.”
According to Summers, telehealth or transfers will only be an option if the victim provides their consent.
“It would not be allowed to be done if somebody didn’t give their consent for it,” Summers said. “So, if you research the data on TeleSANE, it’s called, if you find that the reason it’s been created…is because the rural and underserved communities also usually can’t find people. So what they’ll do is they’ll use someone that knows how to perform an exam, but they only get one or one a year, right. They don’t have all of the knowledge that somebody that’s an expert in the field might. So it just works to help supplement that. So that you get the best evidence that you possibly can.”
Senate Bill 89, as amended, was sent back to the Senate for consideration of those two amendments.
Lawmakers on the House Floor discussed the risks and benefits of forgoing a Certificate of Need for birthing centers to open in West Virginia.
Lawmakers on the House Floor discussed the risks and benefits of forgoing a Certificate of Need for birthing centers to open in West Virginia.
After contentious debate from both sides of the aisle, House Bill 2789 passed the House of Delegates with a vote of 73 ayes, 26 nays, 1 absent.
Co-sponsor of the bill, Del. Heather Tully, R-Nicholas, began by explaining that the bill will remove the requirement for Certificate of Need for birthing centers in West Virginia.
The Certificate of Need (CON) is a governmental review process for a new proposed health care center that determines need, consistency with the State Health Plan and financial feasibility.
Lead sponsor of the bill, Del. Kathie Hess Crouse, R-Putnam, spoke from personal experience as a mother, and noted promises made by lawmakers to West Virginians in the wake of the state’s abortion ban last year.
“We just need some more access to facilities, we just told thousands of women throughout this state that they were going to have to give birth, many of those are going to have to travel round trip hours to get to doctors, or birthing facilities, and that is adding too much to them,” Crouse said. “We need to make these closer and allow them to come in where they’re able to sustain.”
Co-sponsor of the bill, Del. Amy Summers, R-Taylor, said expectant mothers in West Virginia need more options for care.
“Moms have a right to choose where they want to have their babies and our only option is the hospital or home,” Summers said. “Birthing centers are a great alternative in between, because what we saw during COVID was a huge increase in home births, where no one’s monitoring that baby unless you do get a nurse midwife to come to your home to provide monitoring, but our people deserve this freedom.”
One delegate who spoke in opposition to House Bill 2789 was Del. Danielle Walker, D-Monongalia.
“You’re looking at an African American woman who had several difficult births and these birthing centers are for healthy pregnancies…forced birth is very diverse. Pregnancy is very diverse,” Walker said. “ It’s in the hospital where I knew that I would not only have an OB, but a cardiac physician there, a pulmonologist there, and these birthing centers won’t have that. They can still apply. So why are we trying to take away this certificate of need?”
Discussion on House Bill 2789 continued as Del. Geno Chiarelli, R-Monongalia, asked Del. Tully about the operating procedures of birthing clinics.
“They have emergency procedures set into place. Birthing centers are usually accredited by an accrediting body. So there’s certain standards, you have to have emergency care and it would be no different than say you had to have a transfer, like from a hospital to a higher level of care,” Tully said. “You would have people there that were trained to take care of that emergency and have an emergency operations plan in place to take care of those patients.”
House Bill 2789 now goes to the Senate for consideration.
Only 18 of the state's 55 counties have hospital birthing centers.
In 2015, Nicole Nichols was pregnant with her third, a little girl. It was a pregnancy with multiple high-risk complications.
At the time, she lived in Looneyville, a small community in rural Roane County and about 19 miles from the county’s hospital. But that year and into the next, she had to drive to a hospital in Charleston for checkups, which is an hour each way.
She scheduled visits around her other kids’ school schedules, and she didn’t always have a reliable vehicle to travel while her husband worked out of town.
“I had to go just about every week. Toward the end I had to go two to three times a week for regular non stress tests because I had a pretty rough pregnancy with her,” Nichols, 31, said.
West Virginia is facing a shortage of obstetricians and places for them to work. Only 18 of its 55 counties have hospital birthing centers.
Roane County is located in the center of the state, an area that is a desert for OB-GYNs. Its local hospital once had a labor and delivery unit but it closed in 2006 due to declining use.
Nicole Nichols
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Courtesy
Nicole Nichols, 31, and her 6-year-old daughter.
Nichols went into early labor multiple times, which includes risks for mom and baby.
“I was in full panic mode in labor very early and scared I was going to lose her,” she said. “That really put her at risk having to travel an hour and an hour and a half to get that labor stopped … had I not made it there in time I don’t know where she would be.”
West Virginia has 20 birthing hospitals after St. Mary’s Hospital in Huntington closed its labor and delivery unit earlier this month. The state has one freestanding birth center.
Nationwide and in the state, births saw a slight increase in 2021 for the first time in seven years, but the overall drop in births coupled with West Virginia’s aging and declining population have made it difficult to sustain birthing centers.
The shortage means there’s a declining number of places for OB-GYNs to work, and this all leads to poorer outcomes for mothers and babies, according to Dr. Angela Cherry. She’s a family medicine physician in Harpers Ferry.
“If there’s not a birthing center there, moms are having to drive more than 30 minutes to a birthing center, which may limit the care they receive even prior to delivery,” Cherry said. “There is an increased risk of having more complications … if they have less prenatal care.”
Cherry said that while telehealth could help fill in the gaps for prenatal care, the state’s internet gaps keep it from being an option for all pregnant women.
West Virginia has some of the country’s worst birthing outcomes, including its rate of infant deaths and preterm births, which can cause a number of serious complications like breathing problems or heart issues.
The state is also having an increase of mothers dying in childbirth, which is connected to the state’s drug epidemic.
“What we’ve seen is those women are just not getting care,” she said.
Cherry presented these concerns to lawmakers in November during legislative interim meetings.
West Virginia isn’t the only state struggling; there’s a national shortage of OB-GYNs.
Cherry said the state’s rural towns struggle to attract OB-GYNs because they’re too far from hospitals and lack local economy. West Virginia University School of Medicine offers a fellowship program that trains family medicine doctors to perform cesarean deliveries, or C-sections, in rural areas that don’t have a birthing hospital and increase obstetrical care. But, Cherry said the program has struggled to place program graduates in West Virginia towns, and those doctors choose to practice in rural communities in other states.
The state could also struggle to recruit OB-GYNs following its recent abortion law, which is one of the most restrictive abortion bans in the country.
Nationally, doctors and a health care recruiting firm have said states with restrictive abortion measures have trouble recruiting OB-GYNs because doctors fear they could be prosecuted for health care decisions.
State Sen. Hannah Geffert, D-Berkeley, said her area is struggling to recruit OB-GYNs. During a presentation on maternal health, she asked Dr. David Didden with the state Office of Maternal, Child and Family Health if the abortion law would further impact recruitment.
Didden responded, “I think we can send the message that we are in support of reproductive health for women, and that this is a promising place to come and practice medicine. But, it’s a tough sell and it’s not just in medicine … We are going to continue to establish best practices and standards of care, and I hope we’ll be able to convince more providers that this is a good place to practice medicine.”
Nichols’ daughter is now six years old and thriving, and the family has moved from Roane County.
She hopes state leaders will focus on bringing OB-GYNs to rural areas as she knows other mothers from Roane who have struggled to get necessary appointments for mother and baby due to travel distance, money and transportation challenges.
“For people who can’t get to Charleston, it’s a lot easier for them to find a ride that’s 10 to 20 minutes compared to an hour or hour and half,” Nichols said.
Two individuals are presumed positive for a variant of the swine flu after visiting the swine barn at the Jackson County Fair last week.
During Thursday’s regular COVID-19 press conference, Gov. Jim Justice started with his now regular rundown of the state’s COVID-19 numbers. He quickly moved on to announce that swine flu had been detected in the state.
Two individuals are presumed positive for influenza A H3N2v, a variant of the swine flu, after visiting the swine barn at the Jackson County Fair last week.
State Epidemiologist Shannon McBee said the risk to the public is low, but others who visited the fair’s swine barn should be on the lookout for flu-like symptoms.
“If they are exhibiting flu-like symptoms: fever, cough, sore throat, that they visit their health care providers, especially if they’re at high risk for influenza complications,” McBee said. “These are going to be children, individuals who are elderly, or have compromising immune systems or pregnant women, so they see their health care provider and are evaluated to see if they need antivirals.”
The same influenza antiviral drugs used to treat seasonal influenza can be used for treatment of swine flu infection in humans. According to the Centers for Disease Control and Prevention, early steps to make a vaccine against H3N2v have been taken including the production of a pilot H3N2v vaccine and preliminary clinical studies.
McBee said state health officials are working with the CDC to confirm the presumptive positives and with the Department of Agriculture to confirm infection in the pigs.
0804 COVID Update
Later in the press conference, coronavirus czar Dr. Clay Marsh said that as COVID-19 hospitalizations hover around 350, state medical leaders are keeping a close eye on hospital capacity.
However, he also stressed the importance of preventing infection with vaccination and testing.
“As we watch this, we are both looking at hospital capacity, we are also very keen to look at the age of people that are hospitalized, and try to gain insight into how BA.5 and the severity of the people getting infected is starting to correlate, so that we can try to target a group of older West Virginians who are at higher risk with both targeted information about staying up to date with vaccinations, and being very aggressive about that if they have any new symptoms,” Marsh said.
With 77 percent of people who have died of COVID-19 in the United States being over the age of 65, Marsh stressed the importance for those 50 and older of staying up to date with their COVID-19 vaccines.
Gov. Jim Justice and his COVID-19 advisors are keeping a close eye on the state’s hospitals as COVID-19 cases continue to rise across West Virginia.
Gov. Jim Justice and his COVID-19 advisors are keeping a close eye on the state’s hospitals as COVID-19 cases continue to rise across West Virginia.
According to the West Virginia Department of Health and Human Resources COVID-19 dashboard, there were 330 COVID-19 patients hospitalized on Thursday, up 24 from Tuesday.
However, during his comments Ret. Maj. Gen. Jim Hoyer noted that there were 54 new COVID-19 patients admitted to hospitals Thursday.
“Should things not change, we are on a path to a Labor Day timeframe to be at that 500 mark in the hospital,” Hoyer said.
The 500 mark is a reference to the state’s total hospital bed capacity for COVID-19 patients.
Hoyer discussed ongoing assessments and preparations for a continued rise in cases, including an upcoming tabletop exercise to be undertaken by the Joint Interagency Task Force the first week of August.
The tabletop exercise is a preparedness activity that allows participants like the state hospital association and the National Guard to deal with a simulated incident scenario that can highlight flaws in response planning.
Dr. Clay Marsh also emphasized the importance of maintaining and protecting the state’s hospital capacity.
“We are closely monitoring that and and looking at perhaps a lower threshold for us to to activate other approaches in anticipation, making sure that we maintain hospital capacity,” he said.
Marsh shared data from the genome sequencing of COVID-19 at West Virginia University and Marshall University. The data showed the BA.5 variant jumped from being just one percent of all COVID-19 cases in West Virginia in the last week of June, to representing 33 percent of all cases in the state in the first week of July.
“We know that the BA.5 variant is by far now the most infectious variant that we’ve seen today,” Marsh said. “And we know that it also has the ability to reinfect people.”
He said this included not only those who have recently recovered from a bout of COVID-19, but also those several months out from their last vaccination. Marsh said that is why the White House is considering making all adults in America eligible for a fourth vaccine shot.
West Virginians are encouraged to check if they are eligible for another shot using the state’s vaccine calculator.
