Private School, Religious Vaccine Exemptions Pass House

The West Virginia House of Delegates passed a bill that would grant youth vaccine exemptions for religious purposes, and give private, parochial and virtual schools priority over student vaccine requirements.

Some West Virginia schools could soon have more leniency over vaccine requirements.

House Bill 5105 would remove vaccine requirements for enrolling in private, parochial or virtual public schools in West Virginia.

It would also allow parents or guardians to exempt their child from vaccination because of their religious beliefs.

The bill narrowly passed the West Virginia House of Delegates on Monday, following a vote of 57 to 41. Two lawmakers did not vote.

The bill’s initial draft only applied to students enrolled in virtual public schools, but was amended to also include students in private or parochial schools earlier this month.

Currently, students must receive vaccines for several infectious diseases — like polio, measles and hepatitis B — regardless of the type of school they attend, unless they are homeschooled or medically exempt.

Under the bill, private, parochial and virtual schools would still have the authority to impose their own vaccine requirements. But these schools would have discretion over what vaccine requirements they have in place.

Proponents of the bill described it as a matter of personal choice and religious freedom.

Del. Laura Kimble, R-Harrison, serves as lead sponsor on the bill. Kimble said she drafted the bill after learning that students must be vaccinated to enroll in virtual public school programs, which she called “absurd.”

“We live in West Virginia. We live in the United States of America. We have rights. We have the constitution,” she said. “We acknowledge that we’re guaranteed the right to religious liberty, yet our West Virginia government has attempted to infringe on this right.”

Del. Larry Kump, R-Berkeley, said he does not consider himself anti-vaccine, but that he supports the bill as a matter of personal choice.

“Why should government mandates do this?” he asked fellow lawmakers on the House floor. “This is a personal property or personal liberty and accountability bill.”

But opponents on both sides of the aisle expressed concerns that increasing leniency over vaccines would hurt public health.

Some lawmakers said the success of decades-long vaccine campaigns has removed a sense of urgency in present-day thinking around public health.

“Vaccines have erased these diseases from our memory,” said Del. Ric Griffith, D-Wayne. “We don’t see them, so they don’t happen.”

Del. Anitra Hamilton, D-Monongalia, said vaccines are an important way to curb public health emergencies.

“At the end of the day, this is about protecting not only our children, because if your children catch something, they’re going to take it home to the family,” she said. “This will allow the vaccine to spread to local communities and businesses, and we don’t have enough childcare to support the illnesses that will come,” Hamilton said.

Del. James Akers, R-Kanawha, said he saw value in the state’s current vaccine mandate, and that the bill might also be unfair to families that cannot afford public education.

“I think that we are potentially creating an equal protection problem among schools, because we’ll have a situation where if a parent can afford to send their child to a private or parochial school, then they will not have to be immunized,” he said.

Akers also said he found the bill to be too far-reaching.

“I wish this bill was just about religious exemptions. I would press green every day,” Akers said. “But this bill goes beyond that, and I believe it does pose a risk to public health I simply can’t support.”

After more than two hours of intense debate, lawmakers narrowly approved the bill just days before the deadline for a bill to pass its initial chamber. The bill will now undergo further deliberation in the West Virginia Senate.

Fauci Weighs In On W.Va.’s HIV Rate

HIV Aids is on the rise in Monongalia County as a group of WVU Medical students learned recently on a Zoom call with Dr. Anthony Fauci.

Since January 2018, the West Virginia Bureau for Public Health has been monitoring increased diagnoses of HIV across the state, especially among people who inject drugs.

According to the CDC, 210 new HIV infections occurred in West Virginia in 2022, the most recent federal data. In 2021, 149 people were newly diagnosed with HIV.

According to AIDSVu, an interactive online mapping tool that visualizes the impact of the HIV epidemic on communities across the country, in 2021, there were 2,196 people living with HIV in West Virginia. 

According to the Bureau for Public Health, preliminary reporting shows 83 cases of HIV diagnosed in West Virginia so far in 2023.

In a Zoom call with West Virginia University (WVU) medical students, Dr. Anthony Fauci, former director of the National Institute of Allergy and Infectious Disease, voiced his concern about the number of HIV diagnoses in Morgantown and West Virginia as a whole.

In 2019, Cabell County was the epicenter of a large HIV cluster, however, since then, HIV cases have been increasing in other areas of the state. Currently, this increase is still most significant in Cabell County with a total of 21 positive cases so far in 2023, with Kanawha County at 18 infections so far this year.

Fauci and Dr. Stef Shuster, associate professor of sociology at Michigan State University, visited West Virginia University virtually in a conversation on the history of LGBTQ+ health care in the United States. The conversation was facilitated by Ellen Rodrigues, director of WVU’s LGBTQ+ Center.

While Fauci is known nationally for his work during the COVID-19 pandemic, he has spent 40 years on the forefront of HIV and AIDS research and treatment.

“Many of us across the country think of HIV and AIDS as a disease that is manageable and perhaps in our rearview mirror, right? But we have unfortunately, reliable data showing that right here, in Morgantown, West Virginia, the home of our university, we’ve had, we have now a substantial uptick in cases of HIV AIDS,” Rodrigues said.

Fauci responded that an uptick in HIV cases “surprises and dismays” him.

“The fact that you have an increase probably reflects two things,” Fauci said. “It’s the lack of PrEP (pre-exposure prophylaxis) accessibility, for those who are susceptible and a lack of accessibility to treatment for those who are already infected.”

Dr. Judith Feinberg is a professor of behavioral medicine and psychiatry and professor of medicine in infectious diseases, and the vice chair of medicine for research at WVU. She confirmed the recent outbreak or cluster of HIV and AIDS in Morgantown, defining a cluster as 10 infections or more.

“The one in Mon County, there are a couple of recent outbreaks, but the one in Mon county involves 10 men who have sex with men and they’ve been identified and offered care,” Feinberg said. “And I believe the majority are being cared for actually at what is called the positive health clinic here.”

Feinberg said that with modern preventative medication accessible and information available, cases of HIV and AIDs should be falling, not rising.

“Relative to the fact that before 2017, only an average of maybe 75 to 77 new cases were diagnosed a year, 10 new cases is a lot and in recent years since 2017, because we’ve had a number of HIV outbreaks across the state, that number has doubled,” Feinberg said. “I believe for 2021, which is the last year we have full reporting on it’s something like 139. And it’s been running about double ever since 2017 and that’s really because that’s the point at which HIV entered the community of people who inject drugs.”

Feinberg said there are two major behavioral risks associated with HIV.Fauci agreed with Feinberg’s conclusion about the reason for an uptick in cases in West Virginia. 

“Injecting drugs has really recently overtaken men who have sex with men as the primary behavior behavioral risk for HIV,” Fauci said. “And how can we do better with this? Well, first of all, we need a public, we need the public to understand that this is happening.”

According to the West Virginia  2020-2022 Substance Use Response Plan, from 2014 to 2017, the drug overdose death rate in West Virginia increased from a rate of 35.5 per 100,000 to 57.8 per 100,000, far exceeding any other state in the nation.

“Drug addiction, as we all know, is a disease and not a crime,” Fauci said. “And when you’re trying to prevent someone from getting infected from injection drug use, that’s a very difficult problem unless you get sterile needles a little as a needle exchange, but for sexual transmission, we should be looking in the community about why is there lack of the access to what we know is a highly effective prevention. That’s my only comment about that. Very disturbing.”

That prevention is available as a pill to be taken frequently, or a shot, taken on a less frequent basis.

“That is entirely preventable,” Fauci said. “We now have pre-exposure prophylaxis that’s either in an oral form with a drug that you could take every day or in association with your sexual contact, or now most recently, highly, highly effective, injectable long acting every couple of months, pre-exposure prophylaxis that the efficacy of that in preventing perfection, if utilized properly, is 90 plus percent 98 percent, sometimes close to 100 percent.”

With preventative medication available, experts think it is a lack of public perception of HIV and AIDs as a threat that leads to an uptick in infections.

“Changing public perception has been really hard. And I think, as I said, I think what happened is that this entered the public knowledge and the public imagination decades ago, in this more limited context of you know, men who have sex with men,” Feinberg said. “So I think, you know, education and having an awareness is really key, right?”

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.

W.Va. Air Quality Alert Extended

The West Virginia Department of Environmental Protection has issued a statewide air quality advisory for fine particulate matter until midnight Tuesday.

The West Virginia Department of Environmental Protection has issued a statewide air quality advisory for fine particulate matter until midnight Tuesday.

An air quality advisory was also issued Monday as smoke from wildfires in Canada moved into the region.

Air Quality Index scores, particularly in the Northern Panhandle, may be in the 101-150 range, which can cause health effects in sensitive groups including children, people suffering from asthma, heart or lung disease, and the elderly. 

Per the U.S. Environmental Protection Agency, citizens in areas with poor air quality are encouraged to limit their time outdoors and avoid strenuous activities. 

N-95 masks can help reduce smoke inhalation and potential health risks. 

Citizens are encouraged to check the AirNow website to see real time air quality data in their area and surrounding states. Please make sure you are viewing the interactive map for your area using the “contours” setting.

Federal Funding To Bolster Health Care In W.Va.

The U.S. Department of Health and Human Services has invested nearly $3.5 million in West Virginia to support statewide hospital emergency preparedness efforts, vaccinate children and build a public health arthritis program.

The U.S. Department of Health and Human Services has invested nearly $3.5 million in West Virginia to support statewide hospital emergency preparedness efforts, vaccinate children and build a public health arthritis program.

According to a press release from Sen. Joe Manchin’s office, the money will be split between three initiatives: 

  • Immunization and vaccines for children initiatives will receive the most funding, at $1.8 million.
  • The hospital preparedness program will receive $1.4 million
  • State public health approaches to addressing arthritis will receive $225,000.

“Making these critical investments in all stages of our healthcare infrastructure will ensure West Virginians have the resources they need to thrive and prosper,” Manchin said. “I’m pleased HHS is investing nearly $3.5 million in these three initiatives, and I look forward to seeing the positive impacts these investments will have on the health and well-being of our communities.” 

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

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