H. B. 4024
(By Mr. Speaker, Mr. Kiss, and Delegate Ashley)
[By Request of the Executive]
[Introduced January 16, 1998; referred to the
Committee on Health and Human Resources then Finance.]
A BILL to amend chapter sixteen of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, by adding
thereto a new article, designated article twenty-two-a,
relating to establishing the West Virginia birth score
program; establishing legislative findings and intent;
authorizing the division of health to establish and
implement a birth score program which identifies newborn
children at high risk for postneonatal mortality,
debilitating conditions and developmental delays and refers
those children to primary care physicians for subsequent
follow-up care; requiring hospitals, birthing facilities,
attending physicians and other persons attending a birth to
require and ensure that a birth score is determined;
authorizing the division of health to provide necessary medical and other needed referrals; authorizing the division
of health to propose legislative rules; establishing
penalties for failure to comply with the program; and
creation of a special fund.
Be it enacted by the Legislature of West Virginia:
That chapter sixteen of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, be amended by
adding thereto a new article, designated article twenty-two-a, to
read as follows:
ARTICLE 22A. BIRTH SCORE PROGRAM.
§16-22A-1. Legislative findings; intent; purpose.
(a)The Legislature hereby finds that until 1984, West
Virginia had one of the highest rates of postneonatal mortality
in the United States, which is defined as infants dying between
one month and one year of age. In the early 1980s, studies in
West Virginia showed that infants at greatest risk of dying
during the first year after birth had poor attendance at regular
physician visits and often received minimal health care. The
system for assessing infants at risk for postneonatal mortality,
debilitating conditions and developmental delays was erratic and
many West Virginia physicians were poorly trained about risk
assessment. Uniform guidelines for at-risk infants to enter care
did not exist.
(b)In 1985, the birth scoring system, a cooperative effort
between the division of health and the West Virginia University
department of pediatrics was initiated. The goals of the scoring
system were: (1) To identify newborns at greatest risk for death
between one month and one year of age; and (2) to link high risk
infants with physicians for close follow-up during the first year
of life.
(c)Since its inception, the birth scoring system has been
expanded to identify and link infants at risk for debilitating
conditions and developmental delays with necessary and available
services. The program has been greatly successful in identifying
at-risk newborns and in obtaining appropriate medical care for
those infants.
(d)With the success of the birth scoring system at
reducing postneonatal mortality rates in the state, it is the
intention of the Legislature to establish the birth score system
as a universal, preventive program to be enacted at the delivery
of each newborn in the state. The purpose of this article is to
ensure that all of the state's birthing hospitals and facilities
adopt and implement this prevention program.
§16-22A-2. Birth score program established.
(a)The division of health within the department of health
and human resources is hereby authorized to establish and implement a birth score program designed to combat postneonatal
mortality and to detect debilitating conditions and possible
developmental delays in newborn infants in the state.
(b)The purpose and goals of the birth score program
are to reduce the incidence of postneonatal mortality and
disease by:
(1)Identifying newborns at greatest risk for death between
one month and one year of age; and
(2)Linking these infants with physicians for close
follow-up during the first year of life.
(c)The birth score of a newborn infant shall be
determined pursuant to the program established by the division
of health by trained hospital or birthing facility personnel
immediately after the infant is delivered.
§16-22A-3. Determination of birth score; referral to physician.
(a)Any hospital or birthing facility in which an infant is
born, any physician attending the infant, or any other person
attending the infant if not under the care of a physician, shall
require and ensure that a birth score is determined for the
newborn infant in order to assess the level of risk for
postneonatal mortality, debilitating conditions and developmental
delays. Any infant delivered at a nonlicensed facility,
including, but not limited to, home births, shall have a birth score determined by the child's primary physician within ten days
of birth.
(b)When any infant receives a high risk birth score, as
determined by the program established by this article, the
parents shall be informed of the birth score and its
implications, and then linked with a local primary care physician
for a recommended six visits in the first six months of the
infant's life.
(c)The division of health, in cooperation with other state
departments and agencies, may provide necessary medical and other
referrals for services related to infants determined to be at
high risk for postneonatal mortality and other debilitating
conditions and developmental delays.
§16-22A-4. Rules.
The division of health may propose rules for legislative
approval in accordance with the provisions of article three,
chapter twenty-nine-a of this code as may be needed to establish
the birth score program and to implement the provisions of this
article.
§16-22A-5. Civil penalties; birthscore mandate fund.
(a)The secretary of the department of health and human
resources may assess a civil penalty for violation of this
article. Upon the secretary determining there is probable cause to believe that a health care provider is knowingly violating any
portion of this article, or any plan, order, directive, rule or
regulation issued pursuant to this article, the secretary shall
provide such health care provider with written notice which shall
state the nature of the alleged violation and the time and place
at which such health care provider shall appear to show cause why
a civil penalty should not be imposed, at which time and place
such health care provider shall be afforded an opportunity to
cross-examine the secretary's witnesses and afforded the
opportunity to present testimony and enter evidence in support of
its position. The hearing shall be conducted in accordance with
the administrative hearings provisions of section four, article
five, chapter twenty-nine-a of this code. The hearing may be
conducted by the secretary or a hearing officer appointed by the
secretary. The secretary or hearing officer shall have the power
to subpoena witnesses, papers, records, documents, and other data
in connection with the alleged violations and to administer oaths
or affirmations in any such hearing. If, after reviewing the
record of such hearing, the secretary determines that such health
care provider is in violation of this article or any plan, order,
directive, rule, or regulation issued pursuant to this article,
the secretary may assess a civil penalty of not less than fifty
dollars nor more than five hundred dollars. Any health care provider assessed shall be notified of the assessment in writing
and the notice shall specify the reasons for the assessment and
its amount. In any appeal by the health care provider in the
circuit court, the scope of the court's review, which shall
include a review of the amount of the assessment, shall be as
provided in section four, article five, chapter twenty-nine-a of
this code for the judicial review of contested administrative
cases. If the health care provider fails to pay the amount of
the assessment to the secretary within thirty days, the attorney
general may institute a civil action in the circuit court of
Kanawha County to recover the amount of the assessment.
(b)All penalty assessments collected pursuant to
subsection (a) shall be deposited in "The Birthscore Mandate
Fund" hereby created as a special fund in the state treasury.
Expenditures from this fund shall be made by the bureau of public
health for payment of the costs of the birthscore mandate program
as they are defined in this article and for the reimbursement to
the bureau of its expenses in administering the payment of the
costs from the fund.
NOTE: The purpose of this bill is to establish the West
Virginia birth score program and to create the birthscore mandate
fund.
This article is new; therefore, strike-throughs and
underscoring have been omitted.