West Virginia has strong liability protections in place for health care providers, admirable access to medical facilities, and adequate hospital capacity overall. However, the state faces challenges with high rates of chronic disease risk factors and fatal injuries, as well as weak Disaster Preparedness plans.
West Virginia has a strong Medical Liability Environment, with the nation's eighth lowest average malpractice award payment ($170,416). West Virginia is one of only 8 states that has enacted special liability protections for Emergency Medical Treatment and Labor Act-mandated care. The medical liability cap on non-economic damages, abolishment of joint and several liability, and collateral source rule reform work to hold down excessive judgments. Case certification by expert witnesses helps ensure that only cases with merit are advanced. These and other reforms help West Virginia maintain a fair legal atmosphere that promotes good practice and protects patient access to care.
Despite its rural and mountainous geography, West Virginia fares well in certain aspects of Access to Emergency Care. It has the fifth highest per capita rates of staffed inpatient beds (455.3 per 100,000 people) and psychiatric care beds (47.5 per 100,000 people). West Virginians also have above-average access to emergency departments and level I or II trauma centers. The state ranks fifth in the nation for the low proportion of people needing but not receiving substance abuse treatment (7.0%).
West Virginia has bright spots in its Quality and Patient Safety Environment, despite a subpar showing in the category. The state has dedicated funding for both quality improvement and a state emergency medical services director. West Virginia developed systems of care for stroke and ST-elevation myocardial infarction (STEMI) patients and has triage and destination policies for trauma patients. These policies help ensure that patients in West Virginia receive prompt and appropriate medical attention.
West Virginia ranks poorly in Public Health and Injury Prevention, largely due to risk factors for chronic disease. It has the second highest rate of adults who smoke (28.6%), the third highest rate of adult obesity (32.4%), and a childhood obesity rate higher than the national average (18.5%). West Virginia's children face other risks as well: The state has one of the lowest rates of childhood immunizations in the nation (69.3%). In terms of injury, West Virginia has some of the highest rates of motor vehicle-related deaths, fatal occupational injuries, and accidental firearm-related deaths and the highest rate of accidental poisoning deaths, which include overdoses (25.4 deaths per 100,000 people).
West Virginia lacks many important statewide Disaster Preparedness policies and plans, leaving the state potentially vulnerable to emergency situations. The state's medical response plan does not address patients dependent on medications, and it has one of the lowest rates of behavioral health professionals registered in the Emergency System for Advance Registration of Volunteer Health Professionals. West Virginia also lacks systems that help state officials track and respond to emerging disasters, such as a patient-tracking system, a syndromic surveillance system, or a surveillance system for common emergency department presentations.
West Virginia must undertake a concentrated public health response to combat numerous health risk behaviors. It has the second highest rate of tobacco use but weak anti-smoking legislation. Prohibiting smoking in bars, restaurants, and workplaces would not only discourage smoking but protect workers and other patrons from secondhand smoke exposure. The state's dangerously high obesity rates for adults and worrisome health markers for children also require a public health strategy. West Virginia is making strides to address these issues: In recognition of the public health disparities facing West Virginians and in concert with its land grant mission, West Virginia University has established the state's only School of Public Health. This new school now has nearly 50 faculty members dedicated to improving public health indicators over time; the dean of the new school is an emergency medicine physician.
West Virginia is also acting to address the state's high injury rates. The West Virginia Department of Health and Human Resources has established a new Violence and Injury Prevention Program (VIPP) within the Bureau for Maternal and Child Health. The VIPP has a full-time coordinator and has initiated a series of statewide planning efforts designed to address the notable injury disparities in the state with the engagement of the emergency medicine community. In addition, West Virginia University has received an additional 5 years of funding from the Centers for Disease Control and Prevention (CDC) for its CDC-designated Injury Control Research Center and is supporting the efforts of the VIPP.