West Virginia Board Research Articles

Enhancing and Leveraging the West Virginia's Prescription Drug Monitoring Program (PDMP) for Public Health Surveillance and Clinical Decision Making: A Case Study.

West Virginia has struggled with an overdose epidemic for many years and continues to have the highest overdose death rate in the nation. However, through successful collaboration between the West Virginia Board of Pharmacy and the West Virginia Department of Health via its Violence and Injury Prevention Program, West Virginia has improved data quality, enhanced program development and implementation, and developed strategies to address the overdose epidemic. This multiagency collaboration plays an important role in addressing the overdose epidemic and promotes lasting interagency relationships. One strategy is overcoming barriers to maximizing and utilizing the Prescription Drug Monitoring Program, or PDMP. This strategy allows for a better understanding of a patient's prescription history and ensures safer prescribing practices. In addition, this strategic partnership facilitates the use of PDMP data for epidemiologic studies and public health surveillance, which results in sustainable analyses and dissemination of actionable data that are now driving public health action in West Virginia.

Factors Influencing the Decision to Practice Medicine in West Virginia: Training Experiences

INTRODUCTION The study describes pipeline, training, and contextual experiences and factors that influence the decision to practice medicine in West Virginia (WV). METHODS The cross-sectional study using descriptive statistics was conducted between November 2019 and March 2020 using an online link to an anonymous survey sent to all physicians licensed to practice medicine in WV with an e-mail address on file with the WV Board of Medicine or WV Osteopathic Medical Association at the time of the study. RESULTS More WV medical school graduates identifying as a WV native practiced primary care than non-native WV medical graduates in this sample. More native WV medical graduates practiced primary care than non-native peers; however, both groups chose primary care at a greater rate than out-of-state medical school graduates. Returning to home communities and an established network of family and friends were influential factors for WV medical graduates. More WV natives completed residency in-state (n = 127) compared to out-of-state (n = 55). More than half of the sample (69.4%) participated in at least one pipeline program during medical school (n=153), residency (n = 86), undergraduate (n = 50), other graduate training (n = 18), or K-12 (n = 16). Approximately 24% of all respondents' primary practice was in a rural area, and 60% of respondents practiced in a primary health profession shortage area. DISCUSSION More native WV respondents are currently providing primary care and completed residency in-state compared to non-native respondents. The choice of primary care practice was similar across graduates of WV's three medical schools. A majority of respondents participated in pipeline programming though the effect on career and practice location decisions are unclear. CONCLUSIONS Continued recruitment of WV medical school graduates into in-state residency programs, concurrently with expanded primary care training placements and promotion, may increase the number and retention of WV primary care physicians in the coming years. Further study should examine factors that influence physician choice not to return to WV to practice after residency or fellowship training.

Assessing the impact of social distancing measures implemented during COVID-19 pandemic on medications for opioid use disorder in West Virginia

IntroductionThis study evaluates if social distancing measures instituted during the novel coronavirus SARS-CoV-2 (COVID-19) pandemic were associated with a reduction in Medication for Opioid Use Disorder (MOUD) prescribing in West Virginia. The COVID-19 pandemic necessitated the quick implementation of public health interventions such as social distancing. This led to the use of telemedicine in the clinical setting however implementing telemedicine involves system level and infrastructure level changes within a healthcare environment. This could cause a barrier to MOUD delivery as it is often provided concomitantly with other face to face substance use and mental health services. The purpose of this study is to determine whether social distancing was associated with a reduction in MOUD prescribing in West Virginia, with the goal of adding to the knowledge of how COVID-19 and COVID-19-related mitigation strategies have impacted patients with OUD. MethodsPrescription monitoring data were requested from the West Virginia Board of Pharmacy. We applied interrupted time series modeling to investigate MOUD prescribing practices before and after social distancing took effect. Gabapentin prescriptions were utilized as a control for comparison. ResultsOur study assessed state-wide buprenorphine and Suboxone prescriptions as compared to a control medication and found an increase in dosage of both medications and an increase in number of buprenorphine prescriptions, but a small decrease in buprenorphine/naloxone prescription number related to the dates of implementation of social distancing. Taken together, overall this indicates an increase in prescription number of MOUD prescriptions as well as an increase in dosage. ConclusionThis study suggests that social distancing measures were associated with an increase in both the number of MOUD prescriptions and the number of doses in each prescription. Significant alterations to MOUD delivery in the clinical setting were implemented in a short timeframe with the COVID-19 pandemic. Understanding the implementation of clinical measures to accommodate social distancing measures may provide benefit to transformation of future delivery of MOUD.

“Good Orthodoxy” and the Legacy Of Barnette

This Essay applies the much-revered case of West Virginia Board of Education v. Barnette, which held that public school students may not be forced to stand and salute the American flag, to what I call the “good orthodoxy” context. In so doing, I hope to build a bridge between partisans on issues of free speech. In good orthodoxy cases, the individual claiming a right against compelled speech seeks to overturn a law or policy that was designed to remedy the harms committed against or to otherwise benefit historically marginalized groups. These good orthodoxy cases are both similar to and different from Barnette, where the Supreme Court held that the state cannot compel “unanimity of opinion” in support of patriotism or nationalism. Using examples such as public accommodations laws that compel production of expressive goods, union dues for public sector unions, and diversity statements at public law schools, I will demonstrate how new groups of dissenters are created in response to policies designed to protect historically marginalized or disadvantaged groups — instead of laws designed to compel respect for authority. Because of the differences between Barnette and the good orthodoxy cases, I argue that courts should be cautious before holding that the modern cases implicate pure speech, as opposed to expressive conduct or unprotected conduct. However, when pure speech is implicated, these laws or policies should be generally overturned as failing to satisfy strict scrutiny. Specifically, dignitary interests designed to protect individuals’ sense of acceptance in the community should generally not be considered sufficient to compel unanimity of opinion, and indeed, dignitary interests often indicate that what is being imposed is conformity to particular values.

Obergefell and the Reconstituting of America

We typically assess Supreme Court decisions in legalistic terms, and sometimes in more instrumentalist or pragmatic terms. So we ask whether a decision is justified under conventional legal reasoning, and we try to predict the practical consequences of a decision. But major constitutional decisions – Whitney v. California, West Virginia Board of Education v. Barnette, Brown v. Board of Education – may have an even more important function in expressing and, crucially, shaping and constituting our national self-understanding. This essay, written for a conference at the John Paul II Institute on “The Implications of Obergefell and Its Aftermath for Law and the Human Person,” argues that although it is largely futile to consider Obergefell in legalistic terms – the decision scarcely even pretends to offer a legal rationale and although the decision’s practical consequences for marriage and family are speculative, the decision is crucially important in its symbolic and community-constituting aspects. Perhaps Obergefell’s most significant feature is that it authoritatively embraces a conception of America that is “progressive” and that marginalizes faith and tradition as components of our national character.

Predicting Rural Practice and Service to Indigent Patients: Survey of Dental Students Before and After Rural Community Rotations

Community-based clinical rotations in rural areas expose dental students to diverse patient populations, practice models, and career opportunities as well as rural culture. The aims of this study at West Virginia University were to determine the best predictors of rural practice, assess the predictive validity of students' intention to practice in a rural area before and after their rural rotations, and evaluate the relationship between students' intention to practice in a rural area and intention to provide care for indigent patients. Online survey data were submitted pre- and post-rural clinical rotation by 432 of 489 dental students over the study period 2001-12, yielding an 88% response rate. In 2013, practice addresses from the West Virginia Board of Dentistry were added to the student database. The results showed that significant predictors of rural practice site were intended rural practice choice, rural hometown, and projected greater practice accessibility for indigent patients. The likelihood of students' predicting they would choose a rural practice increased after completion of their rural rotations. After the rotations, students predicted providing greater accessibility to indigent patients; these changes occurred for those who changed their predictions to rural practice choice after the rotations and those who subsequently entered rural practice. The dental students with a rural background or a greater service orientation were also more likely to expect to enter a rural practice and actually to do so after graduation. These findings suggest that dental school curricula that include rural rotations may increase students' sensitivity to issues of indigent patients and increase students' likelihood of rural practice choice.

Letter From the Editor

At its founding in 1986, the Journal of Child Neurology had its Editorial Office in the University of Rochester Whipple Park apartment of the founding Editor, Roger A. Brumback. Later that year, the Editorial Office moved me to the University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma. Ten years later, when the University of Oklahoma found it inconvenient to house an editorial office, the Journal of Child Neurology Editorial Office was set up in space at the law office of my wife Mary Brumback, who then served as the Editorial Assistant. In 2001, I relocated to the Creighton University School of Medicine and the Journal of Child Neurology Editorial Office was established at the Creighton University Medical Center. Now after more than a dozen years in that location, I am moving to the picturesque West Virginia community of Lewisburg (named ‘‘America’s Coolest Small Town’’), which is located in the heart of the Greenbrier Valley near the historic Greenbrier Resort, and Mary Brumback will resume her duties as the Editorial Assistant. I am taking a position at the West Virginia School of Osteopathic Medicine (Figure 1), which will enthusiastically provide the necessary support for the Journal of Child Neurology Editorial Office. The West Virginia School of Osteopathic Medicine was founded in December 1972 as the Greenbrier College of Osteopathic Medicine by 4 visionary physicians— O. J. Bailes, Frank Wallington, Carlton Apgar, and Don Newell, Sr—who recognized the importance of training physicians to meet the rural health care needs of West Virginia (at that time, West Virginia ranked 49th out of 50 states in the number of physicians relative to state population). The next year (1973), a US$1.3 million grant through the Hill-Burton Act (the Hospital Survey and Construction Act enacted in 1946 to provide health care facilities with federal grants and loans for construction and modernization) helped to renovate the former dormitories of the Greenbrier Military School into classrooms and laboratories for the new medical school. The Greenbrier Military School had been an all-male, privately owned military boarding school for grades 7 through 12 that was initially chartered in Lewisburg in 1812. One of the notable graduates from 1937 was Robert Lewis Evans, who went on to found Bob Evans Farms, Inc and the Bob Evans Restaurants. As military activities experienced increasing public disapproval during the late 1960s and early 1970s, private military academies suffered financially and, in 1972 it was decided to close the Greenbrier Military School. This afforded founders of the Greenbrier College of Osteopathic Medicine the ideal opportunity to acquire a beautiful campus for their enterprising undertaking (Figure 2). In October 1974, the first class of 36 students entered the new medical school. Two years later, in January 1976, the medical school became a state-supported institution under the governance of the West Virginia Board of Regents and was renamed the West Virginia School of Osteopathic Medicine. Over the years, the medical school has grown in stature and expanded its class size to the current 200 entering students each year. Classes for the first 2 years are conducted on the Lewisburg Campus, while the thirdand fourth -year students take clinical rotations throughout West Virginia at the Statewide Campus. In

Knowledge, attitudes, and practices of veterinary facility owners regarding rabies preexposure prophylaxis—West Virginia, 2011

To assess the knowledge, attitudes, and practices regarding rabies preexposure prophylaxis among veterinary facility owners in West Virginia and to compare facilities in counties where raccoon rabies virus variant (RRVV) is or is not enzootic. Cross-sectional telephone survey. 124 owners of facilities licensed by the West Virginia Board of Veterinary Medicine. In 2011, an owner of each licensed facility in West Virginia was contacted by telephone to complete a questionnaire regarding practice demographics, knowledge of rabies epidemiology, and preexposure prophylaxis policies. Data from facilities in counties where RRVV is enzootic were compared with data from facilities in counties where RRVV is not enzootic. Prevalence ratios and 95% confidence intervals were calculated to quantify the strength of associations. Owners of 124 of the 162 (77%) veterinary facilities participated in the survey. West Virginia veterinarians were knowledgeable of rabies epidemiology in the state. Respondents agreed that veterinarians (122/124 [98%]) and technicians and assistants (111/124 [90%]) should receive preexposure prophylaxis. Fifty-six (45%) respondents required that veterinarians receive preexposure prophylaxis, whereas 19 (15%) respondents required that technicians and assistants receive preexposure prophylaxis. A preexposure prophylaxis policy was in effect at 20 of 64 (31%) facilities in counties where RRVV is enzootic and 6 of 60 (10%) facilities in counties where RRVV is not enzootic. Concerns related to cost of preexposure prophylaxis were reported. Except for veterinarians, veterinary staff in West Virginia did not commonly receive preexposure prophylaxis or regular assessments of serum rabies virus neutralizing antibody titers. All veterinary practices are encouraged to consider revising or implementing a preexposure prophylaxis policy based on the Advisory Committee on Immunization Practices' recommendations.

Barnette's Big Blunder

Among the most celebrated statements ever issued in a Supreme Court opinion is Justice Robert Jackson's resounding declaration in Barnette v. West Virginia Board that [i]f there is any fixed star in our constitutional constellation, it is that official, high petty, can prescribe what shall be orthodox in politics, nationalism, religion, other matters of opinion force citizens to confess by word act their faith therein. By using the preposition or rather than and, Jackson asserted two constitutional prohibitions: government may not force citizens to confess an orthodoxy, but government may also not prescribe any orthodoxy. Upon reflection, however, the no prescription prohibition is manifestly untenable, and neither Justices nor scholars have ever tried to apply it in any consistent way. Nonetheless, this impossible prohibition exerts a powerful and unfortunate rhetorical influence over constitutional discourse: recent examples discussed in the article include work by respected legal scholars including Kent Greenawalt and Michael McConnell and judicial decisions including the recent Newdow decision on the Pledge of Allegiance. This article first explains why the no prescription prohibition could not possibly be taken at face value. The article then considers the various ways in which courts and scholars have tried to qualify reinterpret that prohibition (such as by limiting the prohibition to religion), and it argues that these efforts do not succeed in avoiding the decisive objections to a no prescribed orthodoxy principle. Our constitutional discourse would be more honest and cogent, the article concludes, if Barnette's no prescription principle were excised root and branch.

A road well traveled

Yates v. University of West Virginia Board of Trustees is a good case that covers a legal principle applicable to orthodontists practicing in roughly half of the country. The short version of a lengthy fact pattern shows that the plaintiff suffered from blockage in the iliac artery. The plaintiff’s physician could have treated the problem in 1 of 2 ways. The first, let’s call it the more conservative approach, was to refer the patient to an interventional radiologist to perform an angioplasty, followed by stent placement and subsequent treatments with urokinase to help dissolve the clot. The second method, perhaps a more aggressive approach, was to consult a vascular surgeon with the idea of performing a femoral artery crossover, which is essentially a bypass. The treating physician recommended the more conservative approach. Secondary complications arose from the kinase therapy, embolisms were thrown off, and, after 19 days of treatment, the patient’s right leg was amputated below the knee.

Administrators from Small Programs Won Support and a National Role

When Perley Isaac Reed became the first director of the West Virginia University School of Journalism, he told his friends he was counting on help from the boys. He was depending, he said, on their advice, collegiality, and support. After all, the men he called the boys--the deans, directors and professors of large, prestigious, long-established schools, including Walter of Missouri, Willard Bleyer of Wisconsin and Harry Harrington of Northwestern--were longtime colleagues, mentors and compatriots. They shared his zeal to advance education. Indeed, they helped him launch his one-man, sub-department in 1920, and they encouraged him throughout his 19-year crusade to transform a lone class, tucked inside the English department's course offerings, into an autonomous school of journalism--one of only six in the country in 1939. Reed assumed he could count on the big boys because, over three decades, he worked as hard to develop an academic fellowship as he did to develop a school of journalism. A tireless campaigner, prolific letter writer, and world-class networker, Reed corresponded, conferenced, and kibitzed with the cream of the crop in American education, eventually inviting the majority of the country's most distinguished school administrators to Morgantown to see his setup for instruction and witness the vital relationship between the state press and West Virginia's program. Reed was proud of both his school and his efforts to establish national support for it. He believed his hard work had paid off, and with a little help from his influential friends, West Virginia was ready to enter the big leagues of education. It was a sincere fellowship, Reed later said of his association with his academic peers. Everybody appeared eager to help everybody else. By 1939, when Reed finally persuaded the West Virginia Board of Governors to declare his department a free-standing school, he believed he had also persuaded the top names in education to invite West Virginia University into the burgeoning ranks of recognized and approved schools and departments. He assumed his long-time colleagues, housed primarily in large, well-heeled Midwestern universities, would welcome him into their anointed fold--the approximately 30 schools and departments comprising the decades-old, highly respected American Association of Schools and Departments of Journalism (AASDJ). A self-proclaimed pragmatist and non-academician, Reed thought American academia of the 1940s, like American democracy of that era, was inclusive, liberal and participatory. He thought a little guy, with a solid medium-sized school, and a lot of grit and gumption, could find a fair hearing. He believed his vision of small classes, one-on-one instruction, and a regional grassroots philosophy would find favor among the AASDJ fellowship. He discovered he was wrong. West Virginia rejected In 1941, when Reed applied for admission in AASDJ, the organization, which together with the American Council on Education in Journalism (ACEJ), inspected and ranked schools nationwide, postponed action on his request. World War II, and its restrictions on travel, prevented the on-site visit necessary for AASDJ to consider Reed's application. In 1943, when Reed again, requested AASDJ admission, the organization sent Ralph O. Nafziger of Wisconsin to inspect the Morgantown school. Nafziger's visit resulted in a less than positive critique of West Virginia's fledgling School of Journalism and an AASDJ refusal to act on Reed's application. Reed was stunned and hurt. The journalism executives, whom he had counted as kindred spirits, now seemed to feed on different meat. According to Reed, the post-Walter Williams AASDJ was obsessed with the notion of accreditation rooted in exclusivity. …

Satellite delivery of graduate courses for teachers of gifted students

In the summer of 1988, a special grant from the West Virginia Board of Regents was obtained by the author to deliver a course on curriculum and strategies for teaching gifted children and youth via satellite television. The course used a combination of telelectures and tele-conferences by master teachers and university professors to develop an understanding of several curricular models in current use.

Social Welfare Spending: Accounting for Changes from 1950 to 1978. By Robert J. Lampman. Orlando, Florida: Academic Press, 1984. 232 pp. $29.50

Journal Article Social Welfare Spending: Accounting for Changes from 1950 to 1978. By Robert J. Lampman. Orlando, Florida: Academic Press, 1984. 232 pp. $29.50 Get access Social Welfare Spending: Accounting for Changes from 1950 to 1978. By Lampman Robert J.. Orlando, Florida: Academic Press, 1984. 232 pp. $29.50. Leon Ginsberg Leon Ginsberg West Virginia Board of Regents, Charleston Search for other works by this author on: Oxford Academic PubMed Google Scholar Social Work, Volume 31, Issue 3, May-June 1986, Pages 230–231, https://doi.org/10.1093/sw/31.3.230-a Published: 01 May 1986

The Economics and Politics of Race: An International Perspective. By Thomas Sowell. New York: William Morrow & Co., 1983. 324 pp. $15.95

The Economics and Politics of Race: An International Perspective. By Thomas Sowell. New York: William Morrow & Co., 1983. 324 pp. $15.95 Get access The Economics and Politics of Race: An International Perspective. By Sowell Thomas. New York: William Morrow & Co., 1983. 324 pp. $15.95. Leon H. Ginsberg Leon H. Ginsberg West Virginia Board of Regents, Charleston Search for other works by this author on: Oxford Academic PubMed Google Scholar Social Work, Volume 30, Issue 3, May-June 1985, Page 280, https://doi.org/10.1093/sw/30.3.280 Published: 01 May 1985

Desegregation of Higher Education in West Virginia

As reports published in the 1955 and 1956 Yearbook Numbers of the JOURNAL contained considerable data on desegregation of higher institutions, this account will be concerned chiefly with certain developments omitted from these surveys or occurring since their preparation. The state of West Virginia, which had in 1955 an estimated population of 2,005,000, of which 5.7 per cent were Negro, maintains 11 higher institutions. Nine of these are four-year colleges under control and management of the West Virginia Board of Education, and two, West Virginia University and Potomac State School of West Virginia University, a junior college, are under control of the University Board of Governors. Graduate work is offered at only one of the institutions under West Virginia Board of Education control, Marshall College; West Virginia State College, until July 1957 a land grant institution, and Bluefield State College, were formerly maintained for Negro students. Ten colleges, of which three are junior colleges, are maintained under private and denominational auspices. Names of all institutions of collegiate grade are listed under of Students. Integration has not been limited to educational institutions. The West Virginia Board of Education, also the lay governing body for the public schools and special schools, is made up of ten members, at least one of whom must, by law, be a Negro. The State Department of Education, but little involved in affairs of higher institutions except through teacher certification, has until recently been integrated in secretarial and professional staff. Only the latter is now integrated.

West Virginia lobotomy project.

The West Virginia Board of Control authorized a lobotomy project in the state hospitals in 1952. During 12 days in the summer of that year 228 patients were subjected to transorbital lobotomy. There were four fatalities, two of them due to hemorrhage and two to dehydration as proved by necropsy. A year later 85 of the patients operated on were out of the hospital. Most of these, as well as all the hospitalized ones, were studied from the standpoint of social adjustment. This was a major project, some pilot studies in previous years having yielded promising results. The program did not meet with wholehearted acceptance by relatives of patients, so that a control group was available whose relatives refused permission for operation. This control group numbered 202 patients. One year later five of these patients were out of the hospital, and two had died. Of the 195 patients remaining in