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W.Va. Legislative Committee: Opinions differ on new state electronic death certificate system

By Autumn Shelton, West Virginia Press Association

CHARLESTON, W.Va. – Speaking at Tuesday’s meeting of the Joint Committee on Government and Finance, State Sen. Tom Takubo, R-Kanawha, was clear on his opinion of West Virginia’s new electronic death certificate filing system.

“I think this system has been horrible. What’s concerning to me is it won’t let you list the primary and the secondary causes of death. It won’t let you do that.,” Sen. Takubo said.

During the meeting, members the committee were provided with updates from numerous state department officials. Of those updates, one area of concern centered around the state’s electronic death certificate filing system and another concern involved the slow implementation of the WV Department of Health and Human Services’ (DHHR) Integrated Eligibility System. 

Dr. Ayne Amjad, director of the Bureau for Public Health, appeared before the committee to speak about the state’s Vital Registration System–used in the preparation of death certificates.

Amjad stated that in January 2019, Netsmart was contracted to provide hosting services and IT support for the system. 

“Around April of 2020, the project was deemed to be at risk” due to unfulfilled change orders and excessive turnover, Amjad explained. “By January of 2021, we did engage our legal counsel to look into that contract for failure to meet their milestones.” 

The DHHR terminated their contract with Netsmart in April of 2021, after paying out $141,000 of the $2.4 million contract. The DHHR has since secured the services of VitalCheck to assume hosting and IT responsibilities. To date, according to Amjad, VitalCheck has been paid $1 million by the state for “the death-registration system that is currently in effect.”

Currently, as Amjad explained, there are “about 5,900 users of the electronic system in the state. That consists of funeral directors, medical certifiers, hospice care facilities, and so on. In 2022, so far, we have registered over 13,500 deaths. The majority of those have been electronic.”

Amjad further stated that user reviews have been generally positive, with only a few complaints. 

“The benefits of the electronic death certificate system – it does improve accuracy and completeness,” Amjad noted. “If anyone has ever filled out those death certificates – and this has happened to me as well – it comes back to you if there’s anything that isn’t legible. This way, it gets to the National Center for Health Statistics faster.”

Addressing the system, Takubo also expressed his concern that death certificates are being completed with an inaccurate cause of death listed simply to expedite an overly-cumbersome filing process.

“I think it’s going to skew data when we’re trying to track some of these things down the road.”

“If providers are not finding what they want, I would hope they’re not just putting something in to get by,” Amjad concluded. “If there’s something missing, a provider can call in and someone will walk them through it. Unless someone tells us, we don’t know what they’re struggling with.” 

To address the DHHR’s Integrated Eligibility System, Justin Davis, assistant to DHHR Cabinet Secretary Bill Crouch, appeared before the committee. 

The Integrated Eligibility System is anticipated to become a single framework to house three of the DHHR’s current operating systems–including the child welfare system, Davis explained. 

The $308 million, 10-year contract with Optum to create this fully integrated system within 29-months was awarded in November 2017. 

However, nearly five years later, numerous policy changes, the pandemic and other factors have prevented the project from moving forward as quickly as was initially anticipated. 

The first phase of the consolidation process “went live in February 2020” when the former online application system inROADS was replaced with WV PATH, Davis said, adding that this switchover modernized the way people can apply for Medicaid, SNAP benefits, energy assistance and more.

Roughly 84% of project funding is federal with remaining funding provided by the state, Davis noted. He said costs have not risen above the initial $308 million contract. 

The ultimate goal of the new system is to allow the DHHR to move quickly with regulatory changes and provide coordinated services for child welfare case management, which has been slated for system integration this year, he stated.

Other speakers appeared before the committee to discuss state-wide projects that are moving along as anticipated — Roads to Prosperity and broadband access.

Jimmy Wriston, cabinet secretary of the Department of Transportation, discussed Roads to Prosperity.

According to Wriston, the Grant Anticipation Revenue Vehicle Bond (GARVEE) projects are complete and in the process of a federal close-out. Depending on the August Redistribution process, which allows states to request additional funds, West Virginia may finish those projects with very little service debt. 

Various General Obligation Bond projects are all “under contract and under construction,” he continued. The 2021 General Obligation Bond (4) project will be under contract by the end of this year. 

WV Turnpike Bond projects should be complete this year, Wriston stated. 

In response to a question from House Speaker Roger Hanshaw, R-Clay, about the impact of inflation on project cost, Wriston said it is putting stress on contracting partners. 

“We do have escalation clauses for asphalt and fuel in our contract,” Wriston explained. “We are struggling, but we are struggling together. We are working through our plans. We are going to put as many projects out as we can afford.” 

Next, Kelly Workman, director of the Office of Broadband, provided a status update of programs designed to introduce broadband to West Virginia’s underserved areas. 

Workman shared the four main strategies of the West Virginia Broadband Investment Plan: leverage private investment, involve local government, encourage public/private partnerships, and connect the unconnected. 

According to Workman, the Office of Broadband has funded 10 separate projects “totaling about $21 million” through their Line Extension Program. 

“Those projects will serve about 6,000 residents,” Workman noted. “They will generate about 430-miles of fiber infrastructure within the state.”

Workman added that two upcoming projects in Preston County will create an additional 150-miles of fiber optic line, while servicing approximately 3,000 residents. 

The Office of Broadband has also partnered with the Department of Natural Resources to determine the most efficient method  to provide broadband service to West Virginia State Parks. Watoga State Park, according to Workman, will be the first to receive such service. 

“The State of West Virginia has received its allocation of Capital Projects Funds,” Workman said. “That’s $136 million that is coming from the U.S. Department of Treasury. Thus far we have allocated one project through that funding source – the Comcast project in the Northern Panhandle. West Virginia was among the first four states in the nation to be approved for that funding.”