November 28, 2018
From The Well…

Wednesday, November 28, 2018



Takubo says senators should get along

Senate Majority Leader designee Tom Takubo told Hoppy Kercheval yesterday morning members of the 2019 State Senate on both sides of the aisle—Democrat and Republican—should get along and provide leadership to the people of West Virginia.


Takubo, who has good relations with Democrats and Republicans, admitted the majority leader’s job will be time consuming and add to his already busy life as a pulmonary specialist physician. He said he brings to the legislative job management skills learned as a busy physician in a large practice.


“At the end of the day,” Takubo told Hoppy, “what’s right is right, and what’s wrong is wrong. Most of the time, Republicans and Democrats get along fine.”


Takubo replaces Ohio Sen. Ryan Ferns as majority leader. Ferns was defeated in the November general election. “Takubo has a good bedside manner, so to speak,” wrote one health care lobbyist. “He’s not nearly as abrasive as Ferns.”


“Tom,” writes another, “is well-liked by senators. He will do fine.”


Later, we’ll look at some of Takubo’s legislative endeavors and find out how people think he will handle the anti-vaxxer movement.


Food Establishment Rule moves forward

The Legislative Rule-Making Review Committee on Tuesday approved the Bureau for Public Health’s Food Establishments Rule  (64CSR17), which includes the 2013 Food Code.


The approval came after BPH reached an agreement with the West Virginia Hospitality and Travel Association to add language to the rule allowing permitted facilities 72 hours to correct a priority violation (formerly known as a critical violation), and 10 days to correct a foundation violation (formerly known as a non-critical violation.)


When the 2013 Food Code was written, with national stakeholder input from the hospitality industry, “critical violations” were changed to priority violations and priority foundation violations. Priority foundation violations are generally thought to be less critical.


Kanawha-Charleston Health Department and the Putnam County Health Department endorsed the rule when it was filed with the Secretary of State. Stanley Mills, RS, director of environmental services, noted that the provisions of the 2013 Food Code are more food-service-establishment friendly than previous food code versions.


After last-minute WVHTA opposition during the 2018 legislative session, BPH withdrew the 2018 version of the rule, which was practically identical to the rule initially filed for 2019 consideration.


The rule will be considered during the 2019 session.


Rule ties newborn testing fees to insurance reimbursement rates

LRMRC members approved 64CSR91, which removes the cap the BPH may charge to cover the cost of laboratory testing for screenings of newborns at the bureau’s Office of Laboratory Services.


According to the initial filing, “The cap is replaced with language that authorizes the bureau to bill the birthing facility or individual attending the birth for services provided for each newborn screen consistent with prevailing health insurance reimbursement rates for newborn screening to cover the administrative, laboratory and follow-up costs associated with the performance of screening tests required by this rule.”


The rule was laid over in November because BPH did not file a fiscal note—the document that tells legislators how much implementation of a rule will cost.


The fiscal note presented to the committee said the change will generate revenue of approximately $167,000, with projected expenses of $147,000.

BPH General Counsel Brian Skinner said the costs for the statutorily required tests will most likely be linked to the reimbursement for screenings paid by BPH’s sister bureau, the Bureau for Medical Services. BPH has been previously unsuccessful in estimating the cost of testing. Last year’s estimate of approximately $90 per screening plunged the program into a nearly half-million dollar deficit.


Rule governing nursing program accreditation moves after compromise

The West Virginia RN Board  has taken into account comments received from seven organizations regarding its drastic rewrite of 19CSR01, the rule governing approval and accreditation of registered nurse training programs.

Legislative attorney Carl Fletcher told LRMRC members the interested parties have met and agreed to several changes. (These will be available when the agency files the LRMRC-approved rule with the secretary of state.)


We reported in August:

While some of the comments suggested procedural changes, several were frank in their statements the board was misguided in the rule filed for public comment.


Dr. Toni DiChiacchio, president of the West Virginia Nurses Association, wrote, “From receipt of input from WVNA members and nursing stakeholders we respectfully submit [Emphasis ours.] the following comments…”


Charleston Area Medical Center President and Chief Executive Officer David Ramsey, was less diplomatic, commenting, “The proposed rule, in some cases, ignores clear legislative intent. [Emphasis ours.] …It appears the board intends to maintain, as one of its major functions, oversight and control of nursing education in West Virginia. I would encourage the board to focus instead on protecting the public through post-licensure oversight as is the case with most if not all other licensing boards…Taken as a whole, the rules are somewhat vague, duplicative and confusing…”


Brandon Hatfield, general counsel for the West Virginia Hospital Association, agrees, commenting “There are numerous provisions that are vague and lacking necessary specificity [Emphasis ours.] This could lead to inconsistent application by the board and create uncertainty for applicants.”


Dr. Pamela Alderman, director of the Capito Department of Nursing at the University of Charleston, submitted seven pages of suggested amendments and ended with the questions, “Did the RN Board carefully review the proposed changes related to the current nursing shortage? How will the proposed changes impact other legislative rules already in place?”


Megan Freeland Roskovensky, government relations director for the West Virginia Health Care Association, the nursing home trade association, echoed Alderman’s comments noting, “We reviewed the board’s proposed changes…not as a nursing program regulated by the rule but as a health care provider that recognizes the ever-increasing need for nurses in our state.”


The rule comes about with the passage by the legislature and approval by the governor of HB 4156, which removed the broad-ranging control the board had relating to nursing schools.


In its place, the bill provides, “A nursing program is determined to be board approved if the program is accredited by a national nursing accrediting agency recognized by the United States Department of Education. The accreditation is considered board approved and is exempt from board rules that require ongoing approval if the school or program maintains this accreditation.”


The agency-approved rule maintains the board’s tight grip on any new program, prior to accreditation, and on programs that lose national accreditation. The board seems to maintain at least marginal program approval by requiring nursing programs have “continuing board approval, which means … board approval of a nursing education program because the program meets the requirements of West Virginia Code…, any other applicable laws and rules and, when applicable, has current accreditation by a national nursing accrediting agency recognized by the United States Department of Education.”



Administration proposes to reduce availability of Rx drugs for cancer, AIDS, other conditions. The New York Times reports, “The Trump administration proposed … to cut costs for Medicare by reducing the number of prescription drugs that must be made available to people with cancer, AIDS, depression, schizophrenia and certain other conditions.”



Court rejects Justice residency petition. MetroNews reports, “Getting a court ruling on whether Gov. Jim Justice abides by the state Constitution’s residency requirements may indeed be slippery like an eel.


“The state Supreme Court this month rejected a petition taking aim at the governor’s daily whereabouts.”


State agencies must go through process to use state line of credit. WCHS reports, “When it comes to making big purchases, state agencies will have to go through a review process if they want to use the state’s $25 million line of credit…”



WVU has new method of surgical training. WVU News reports, “A new method of surgical training at the West Virginia University School of Medicine can not only improve the performance of new surgeons, but also save lives on the battlefield.”

Leave a Comment

Error! This email is not valid.