Story by David Beard, The Dominion Post 

CHARLESTON, W.Va. — The House of Delegates on Monday passed a couple elections bills unanimously with minimal discussion. The big debate of the day was about an amendment to a bill dealing with the supervision of nurse anesthetists.

HB 4432 was on second reading. The primary object of the 25-page bill is to allow physician assistants to own their own practice. The subject of debate was a short section near the end to change how certified registered nurse anesthetists (CRNAs) are supervised.

Current code allows a person trained in a certified program accredited by the American Association of Nurse Anesthetists to administer anesthesia under supervision of a physician or dentist. The new section changes that to allow a CRNA to administer anesthesia in cooperation with a physician, podiatrist or dentist.

Cooperation is defined as working together with each contributing an area of expertise in accord with their training levels. The provision is permissive, allowing each hospital to set its own policy.

Delegate Steve Westfall, R-Jackson, proposed the amendment in the Health Committee, where it was defeated. But it stirred wider discussion and committee chair Amy Summers, R-Taylor, brought it to the floor as a committee amendment to allow fuller debate.

Westfall said, “I’d like to leave status quo as it is now. … I think it’s working.” He doesn’t oppose CRNAs doing their job, they just need to be supervised.

Delegate John Hardy, R-Berkeley, said that anesthesiologists testified against the new CRNA provision in committee, saying it will be detrimental. “We’re trying to fix something here that I don’t think is broken at all.”

And Delegate Bob Fehrenbacher, R-Wood, cited a four-year study conducted at 245 hospitals that showed patient outcomes were worse when anesthesia care was not directed by anesthesiologists – more patients died.

While CRNAs entering training are now required to earn doctorates, not all have them yet and it’s too soon to change things, he said. “Today we’re not there.”

Delegate Heather Tully, R-Nicholas, pointed out that the study Fehrenbacher cited dated back to 2000 and used old data, and the Centers for Medicare and Medicaid Services does not regard it as valid or accurate.

Delegate Evan Worrell, R-Cabell, said 43 other states allow what’s proposed in the bill. He pointed to the CRNAs and students sitting in the gallery and said that adopting the amendment would be telling them, “Hey, go somewhere else and practice.”

Summers said that the cooperation model in the bill arose from a COVID executive order and was viewed as a pilot study – and no complaints arose.

The amendment failed 31-65.

HB 4432 will be on third reading for passage on Tuesday.

Other bills

HB 4274 came back to the House from the Senate for concurrence with some technical amendments. The 723-page bill renames the Department of Health and Human Resources as the three new departments: Human Services, Health, and Health Facilities. The delegates concurred with the fixes and re-passed it unanimously. It heads to the governor.

HB 4428 requires candidates for any state, county, or local office to have their principle residence in the district they aim to represent. It exempts circuit and family court judges and prosecuting attorneys, who are not required to do so elsewhere in code. It passed 96-0 and goes to the Senate.

HB 4552 requires that the party affiliation of a candidate for partisan office match the party designation on their voter registration card. It passed 96-0 and goes to the Senate.

HB 4302 increases the criminal penalties for child abuse resulting in injury; child abuse creating risk of injury; child neglect resulting in injury; and child neglect creating risk of injury. It also passed 96-0 and goes to the Senate.