COMMITTEE SUBSTITUTE
FOR
Senate Bill No. 168
(By Senators Tomblin, Mr. President, and Buckalew,
By Request of the Executive)
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[Originating in the Committee on Health and Human Resources;
reported February 3, 1998.]
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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; providing an exemption to program participation when it
conflicts with religious beliefs; authorizing the division
of health to provide necessary medical and other needed
referrals; and authorizing the division of health to propose
legislative rules, including penalties, to ensure
implementation of and compliance with the birth score
program.
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: Provided, That no birth score shall be determined or
birth score program implemented if the parent or guardian objects to the birth score program on the grounds that it conflicts with
their religious tenets and practices.
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,
subject to the exception set forth in this subsection.
(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.
On or before June 30, 1998, the division of health shall
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 program, ensure compliance and
assess penalties as needed to implement the provisions of this
article.
NOTE: The purpose of this bill is to establish the
West Virginia birth score program and to provide for its
implementation.
This article is new; therefore, strike-throughs and
underscoring have been omitted.