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Lawmakers Discuss Vaccination Laws

West Virginia allows for medical exemptions to vaccines but does not allow for exemptions based on religious or philosophical beliefs. Some lawmakers would like to see those laws change.

West Virginia lawmakers discussed medical exemptions with vaccine experts during a meeting of the West Virginia Legislature’s Joint Committee on Children and Families.

West Virginia allows for medical exemptions to vaccines but does not allow for exemptions based on religious or philosophical beliefs.

According to Shannon Kolman, senior policy specialist in the National Conference of State Legislatures’ Health Program, vaccinations are required when a child is enrolled in a public school.

“Some states specifically spell out which vaccines are required in statutes, and other states refer to an administrative body such as the Department of Health or the Department of Education to adopt rules regarding which vaccines will be required,” Kolman said. “Some examples are states like West Virginia, also including Kentucky, New York, Ohio and Pennsylvania, expressively list the vaccines that are required for school in statute.”

However, a parent or guardian is able to apply for a medical exemption to vaccination through a physician.

“All states have immunization laws for school entry that grant exemptions to children for medical reasons,” Kolman said. “So if the vaccine is medically contraindicated, every state allows a child to have an exemption for medical reasons.”

Some lawmakers would like to see vaccination laws changed in the state. Sen. Michael Azinger, R-Wood, spoke against vaccine laws during the meeting.

“We live in America, and if a parent says they don’t want their kid to have a vaccine, they have a constitutional right to do that,” Azinger said. “And here we sit one of these little clumps of states that say that you can’t have a religious exemption. Lord have mercy. Our country was founded on religion, right? The First Amendment, and here we have this, this doctor who’s a very intelligent guy, and I appreciate him coming. But how in God’s name, do you think ‘Doc’ and these folks that DHHR, have the right to tell the parents that they have to vaccinate their children?”

Dr. Joseph Evans, former chief medical officer of Marshall Health and former chair of the Department of Pediatrics at Marshall University, said the World Health Organization has identified vaccine hesitancy as one of the top 10 threats to global health.

“Thanks to our vaccine laws, our state is among the best and safest from vaccine-preventable illness,” Evans said. “We are a model for other states trying to decrease vaccine-preventable diseases. And therefore I think we need to keep our vaccine laws. If it’s not broke, don’t fix it.”

Sen. Patricia Rucker, R-Jefferson, questioned Evans on the efficacy of vaccines.

“So you do make it sound that having this vaccination just provides a protection,” Rucker said. “Have you not ever heard of people getting an illness even though they were vaccinated against it and actually some getting the illness from the vaccine?”

Evans responded, “Well, you don’t get the illness from the vaccine.”

Rucker replied: “That has happened. That has been documented that some folks can trace back their illness to the vaccine.”

Rucker did not cite her source, but the Centers For Disease Control (CDC) studies the adverse effects of vaccines.

Shannon McBee, state epidemiologist, explained the process of compulsory school immunization law exemption to members of the committee.

“West Virginia is considered to have an exemplary immunization model with no recorded outbreaks of measles,” McBee said. “The most common requests that are approved by the Bureau for Public Health are for children who have immunosuppressive medications or have a documented severe reaction to a vaccine or a recipient of an organ transplant.”

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

Lawmakers Grow Impatient With Lack Of Health Action

Lawmakers questioned West Virginia’s State Health Officer Matthew Christiansen during a meeting of the Joint Committee on Health about the agency’s lack of action.

Commissioner of the Department of Health and Human Resources’ Bureau for Public Health and West Virginia State Health Office, Matthew Christiansen, presented a state health plan to the West Virginia Legislature’s Joint Committee on Health.

However, lawmakers questioned the plan’s similarities to past years and the lack of specific goals.

Del. Mike Pushkin, D-Kanawha, thanked Christiansen for his report but asked if anything the legislature has done has helped improve the state’s health outcomes.

“We’ve been here long enough to see similar reports from other state health officials,” Pushkin said. “Have we seen any movement? Are we still at the bottom of every list or at the top of every rung list when it comes to poor public health outcomes? Has anything we’ve done here, moved the needle at all?”

Christiansen answered that there have been improvements in insurance access and accessibility to health care.

“Health care services and insurance coverage is one that we are consistently in the top 10 or so in the nation,” Christiansen said. “And so we do a good job at that; however, we still struggle with transportation issues, as you and I have discussed in the past, and accessibility of that health care access.”

Pushkin responded that the legislature expanded Medicaid for West Virginia residents years ago.

Starting Jan. 1, 2014, West Virginia expanded Medicaid under the Affordable Care Act. Under the expanded eligibility guidelines, adults aged 19 to 64 are eligible for Medicaid with a household income up to 138 percent of the poverty level.

For a single adult in 2023, that amounts to $20,120 in total annual income.

“I guess what I’m getting at, we’ve heard for years about the determinants of poor public health outcomes, whether it was in regards to children with adverse childhood experiences, or with other socio-economic factors that leads to these outcomes,” Pushkin said. “There have been a lot of plans and I’d hoped that this body, that the legislature is able to actually address it at some point, or we’re going to continue to be at the bottom of every list that we don’t want to be on.”

Del. Amy Summers, R-Taylor, said she and other members of the joint committee on health grew frustrated at the inaction.

“Where I think we reach frustration is that we never get past the planning stage. And we want to be where we get three to six measurable goals, and what will they be? And how are we going to measure them, and okay, we achieve these things, and let’s move to the next thing,” Summers said. “But we never seem to get to that point. And I think that’s just all of our desire, yours as well, is to change some things.”

Christiansen said the current state health plan will be the one implemented, but it will take time.

“This will be that,” Christiansen said. “The State Health Improvement Plan will be that plan that will have a clear set of priorities, a big part of our assessment and survey processes around that stakeholder engagement piece to make sure that we’re bringing other people to the table, acknowledging that we again can’t do those things alone as the Bureau for Public Health but that we need all of our other public health and health care partners at the table.”

Lawmakers Hear Updates On DHHR Reorganization

The three appointed secretaries of the new bureaus of the DHHR provided lawmakers with updates on restructuring within the department. Legislation passed in 2023 required the department to be reorganized and split into three agencies after concerns of inefficiencies in the system.

Members of the Legislative Oversight Commission on Health and Human Resources Accountability voiced concerns about the restructuring of the Department of Health and Human Resources on Tuesday.

The three appointed secretaries of the new bureaus of the DHHR provided lawmakers with updates on restructuring the department. Legislation passed in 2023 required the department to be split and reorganized after concerns of inefficiencies in the massive agency.

The new secretaries are Dr. Sherri Young, incoming secretary of the Department of Health, Dr. Cynthia Persily, incoming secretary of the Department of Human Services and Michael Caruso, incoming secretary of the Department of Health Facilities.

Young said and her fellow secretaries are identifying critical vacancies in their departments and consolidating some empty positions.

“We have met with our respective new departments, within our bureaus and offices so that we can better understand what needs they have as far as critical vacancies and what positions need to be filled, and how we could be more administratively responsible with the positions that haven’t been filled for quite some time,” she said.

Young also reported a decrease in vacancies in the Bureau for Social Services, the Bureau for Child Support Enforcement, the Bureau for Medical Services and the Bureau for Behavioral Health.

However, the Department of Health Facilities, the Bureau for Public Health and the Bureau for Family Assistance increased in vacancies.

Caruso explained the problem in his presentation.

“Basically, we don’t pay our people enough on an hourly rate,” Caruso said. “All right, and neither does the rest of the systems. The fact is that most of our employees have just jumped to the contracted services.”

Caruso also reported that he brought in Baker Tilly US, LLP, an advisory, tax and assurance firm, to do a benchmark study on all facilities and perform a complete financial review.

“Those studies were completed last week, those studies will be integrated, and we will educate our leadership team as well as our CEOs over the next week and a half,” Caruso said.

Health Management Information Systems, or HMIS, are software used to manage and analyze healthcare data. Caruso said he is looking to improve the Department of Health Facilities’ HMIS.

“We are looking internally to improve that process and improve that program, as well as potentially looking at other outside vendors to cover our emergency or electronic medical records,” Caruso told lawmakers.

Persily reported a reduced vacancy rate in the Department of Human Services and accredited that to pay raises and access to behavioral health services for Child Protective Services workers.

“So the work that you did in the last session, to increase salaries, to provide regional salary differentials, it’s worked. We have reduced significantly the vacancies in that particular job classification,” Persily said. “I believe that in January last year, when you heard about this, the rate was about 30 percent. And our rate at the end of July was 17 percent.”

Lawmakers questioned the secretaries on their proposed structuring of the departments, voicing concerns about the level of bureaucracy operating in the agency.

Del. Amy Summers, R-Taylor, asked the secretaries to be proactive instead of reactive in their planning.

“My only concern is I don’t want to duplicate what we’ve been doing when we have this great opportunity to create something new,” Summers said.

Persily said she and the other secretaries will have a model in place by January 1, 2024, the deadline for the department to split, but advocated for flexibility.

“We are not going to be wedded to a model if it doesn’t work, and we will constantly be improving that model as we move along. And so any changes would be for efficiency, and for functionality,” Persily said. “But what I will say is that you will, you will see some consistencies across the three departments, you will see that we there are some things that each department needs.”

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

Lawmakers Learn WVU Budget Overhaul Highlights Economy-Driven Education

The school’s planned academic department cuts and reorganizations are focused on increasing enrollment demand and building a state-wide workforce economy.

West Virginia University Vice President for Strategic Initiatives Rob Alsop told members of the Joint Standing Committee on Finance Monday the school’s planned academic department cuts and reorganizations are focused on increasing enrollment demand and building a state-wide workforce economy.

“We’re going to stop doing a few things, and we have to trim some of our majors,” Alsop said. “We’re doing so with a plan to not only balance our budget, but to allow us to invest in the programs that are going to remain and invest in the programs that are necessary for the growth of West Virginia’s economy.”

The university proposes eliminating several dozen academic programs affecting hundreds of students to address a $45 million budget shortfall.

“We’re still going to offer over 300 majors in Morgantown,” Alsop said. “We’re going to continue to have significant Liberal Arts offerings and our students will have the opportunity for a well rounded education.”

Alsop said the school will key many current and future investments to its technological and industrial programs, all in an effort to grow West Virginia’s economy and workforce.

“If we don’t increase market share, and have programs that are relevant and driving enrollment, we could lose another 5,000 students over the next decade,” Alsop said. “We’re trying to position ourselves so that that does not happen.”

Alsop said seniors and juniors losing programs in liberal arts, humanities and others will be “taught out” in those courses. He said freshmen and sophomores can take another academic path or transfer to another institution.

He said dropping another 5,000 students would mean $72.5 million dollars in revenue loss.

“So we have to be attuned to the needs of our students,” Alsop said. “And what’s driving enrollment. As we work through this transition, I want you to know this transformation for our students is our priority.”

Alsip noted that WVU Medicine, made up of the WVU hospitals in Morgantown, and the WVU Health System has increased from 5 to 25 state-wide members over the past ten years.

“And so when we talk about a robust set of offerings for our students, I mentioned nursing, pharmacy medicine, occupational physical therapy and on down the line,” Alsop said. ”Not only do those kids have all of those academic programs to get at WVU, they now have an affiliated academic health system, where they can go anywhere they want to in the state and serve as part of the WVU network.”

The WVU Board of Governors will vote on the recommended cuts Sept. 15.

Death Certificate Delays Discussed In Legislative Meeting

Dr. Sherri Young, the new Secretary of the Department of Health, discussed staffing shortages in the Office of the Medical Examiner during a meeting of the Legislative Oversight Committee on Health and Human Resources Accountability.

Some families are waiting months to receive a loved one’s death certificate from the state Medical Examiner’s office, a health committee for the legislature learned this week.

She said the office has severe staffing needs and the need for more space.

“Actually, we do need about seven to 10 spaces for us to be able to complete multiple autopsies at one time,” Young said “We have three tables open at the time at this time. So the ability to be able to work on multiple reviews at the same time would be much, much needed as well.”

Sen. Amy Grady, R-Mason, asked about the delay in death certificates.

“I had a lot of questions and concerns about the amount of time it takes for people to get finalized death certificates,” Grady said. “But there’s a bad backlog. Some people are waiting for two years, which causes financial hardship a lot of times on the families. Is there a plan?”

Young said that the average wait for a death certificate is 200 to 250 days in West Virginia and suggested areas for improvement.

“Some immediate plans would be, as we discussed with Senator Takubo, the ability to do the labs in-house so that we can get the toxicology piece much faster, being able to do more targeted exams, are starting with the X-ray machine that they have purchased,” Young said. “Implementing those are some of the short-term fixes. Long-term fixes are going to be facility-based, and staffing based so that we can get more folks in to help with that issue.”

She said the state needs 12 medical examiners and currently has three. These shortages are in part because only about 17 pathologists graduate with a forensic pathologist degree each year in the U.S., according to Young.

Governor Considers Special Session Request

Gov. Jim Justice has addressed a request from the House of Delegates Democratic Caucus to call a special session of the legislature next month.

Last week, the House of Delegates Democratic Caucus delivered a letter to Gov. Jim Justice urging him to call a Special Legislative Session during the upcoming interim meetings Aug. 6 – Aug. 8.

In the letter the caucus suggests the session focus on the state’s corrections and foster care employment shortfalls as well as what they call a higher education funding crisis.

During an administrative briefing Wednesday afternoon, Justice gave his position on the three issues, saying he supports doing any and everything to improve foster care. He also said the state needs to help out its universities, but the economics of the situation need to be better understood.

“The shortfall in regard to corrections, I’ve sent it up twice,” Justice said. “Really, and truly, this should have been done a long, long, long time ago. So don’t anybody now ask me from the legislature side, as to ‘We really want you to send us and send this off” and everything. For God’s sakes, alive! It should have already been done.”

The governor did not rule out the possibility of calling a special session and says he will evaluate it more seriously when his chief of staff is back in Charleston.

In response to a question, Justice said that the August interim session would be the right time to call a special session.

“The August interim is the time that we should do this. We ought to do it right now,” he said. “That’s just all there is to it.”