September/October - West Virginia State Medical Association

Bureau for Public Health | NEWS
Impact of Healthcare Reform on the Victims of
Domestic Violence
The new healthcare reform law will
offer benefits to the victims of domestic,
sexual, dating and intimate partner
violence that they have not previously
known. In general, the law will make
healthcare more affordable and easier
to obtain and it includes several new
programs and protections to prevent
abuse and/or ways for people to
treat abuse before it gets worse.
One important change is that,
beginning on January 1, 2014, the
law prohibits insurance companies,
healthcare providers and health
programs that receive federal funds
from denying coverage to women
who are survivors of domestic or
sexual violence as a “pre-existing
condition.” Incredibly, prior to
the healthcare reform bill, seven
states actually allowed insurers to
deny health coverage to domestic
violence survivors on this basis.
Recent reviews of home visitation
models have found that up to 48% of
women surveyed who receive home
visiting services report incidents
Caregiver Consent Act
of domestic violence. The new law
provides $1.5 billion over 5 years to
develop and implement evidence-based
maternal, infant and early childhood
visitation models to reduce infant
and maternal mortality, improve
prenatal, maternal and newborn
health, prevent child injuries and
maltreatment, improve parenting skills,
school readiness and family economic
self-sufficiency while reducing or
addressing juvenile delinquency,
crime and domestic violence. In
formulating their plans, states are
required to do need assessments
and to identify at-risk communities,
including communities with high
concentrations of domestic violence.
Pregnancy and domestic violence
are tragically intertwined. Research
shows a clear link that unintended
pregnancies increase women and
girls’ risk for violence, and violence
increases women and girls’ risk for
unintended pregnancies. Beginning
in 2014 each state will receive funds
for personal responsibility education
programs aimed at reducing pregnancy
rates in youth between 10 – 19 years
of age. The new law allocates $75
million a year to be apportioned
among the states based on the size
of a state’s youth population, but no
state will receive less than $250,000.
The new law establishes the
National Prevention, Health Promotion,
and Public Health Council to provide
coordination and leadership at
the federal level with respect to
prevention, wellness, public health
and integrative healthcare. Elsewhere
in the law, the council is tasked
with including domestic violence
screening in its national priorities
report. Screening for domestic violence
is considered a primary prevention
or early intervention service.
Readers interested in violence
prevention and related topics may
contact the Family Violence Prevention
Fund Policy Office at (202) 682-1212 or
visit them online at www.endabuse.org.
In March 2010, the WV Legislature
passed HB 4374, the Caregiver
Consent Act. It took effect July
1st. The purpose of the legislation
is to allow a caregiver, who is
not a parent, legal custodian or
guardian of a minor, to consent to
healthcare for a minor through the
use of an affidavit. The law provides
for the revocation or termination
of consent, provider good faith
reliance on the affidavit, exceptions
to an affidavit’s applicability and
penalties for a false statement in
an affidavit. The Department of
Health and Human Resources has
developed a form Affidavit, which is
available on the WVDHHR website,
http://www.wvdhhr.org/. It’s
the first item in the “Links to…”
column on the left hand menu.
In the Act, the term “Caregiver”
is defined as: “any person who is
at least eighteen year of age and:
(A) is related by blood, marriage
or adoption to the minor, but
who is not the legal custodian or
guardian of the minor; or (B) has
resided with the minor continuously
during the immediately preceding
period of six months or more.”
The Act enables caregivers to
consent to a variety of healthcare
actions for the minor, including,
developmental screening, mental
health screening and treatment,
ordinary and necessary medical
and dental exams and treatment,
preventive care including
immunizations, TB testing, wellchild
care, and non-emergency
diagnosis and treatment.
Further, the Act enables healthcare
providers to accept caregiver consent
forms, unless they know that a
parent or legal guardian has made
a contravening decision. It protects
providers from criminal and civil
liability for accepting the Caregiver
Consent form in good faith. The aim
of this new law it to protect both the
providers and the caregivers while
allowing for healthcare services
to minors who are in need.
September/October 2010 | Vol. 106
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