Senate Bill No. 168
(By Senators Tomblin, Mr. President, and Buckalew,
By Request of the Executive)
[Originating in the Committee on Finance;
reported February 26, 1998.]
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
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 the year one
thousand nine hundred eighty-four, 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 were not taken regularly to a physician 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 the year one thousand nine hundred eighty-five, 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
(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 shall 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, debilating 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: 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.
(b)When any infant receives a high risk birth score, as
determined by the program established by this article, the
division of health shall inform the parents of the birth score
and its implications, and shall link them 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.
On or before the thirtieth day of June, one thousand nine
hundred ninety-eight, the division of health shall propose
legislative rules for promulgation 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