Senate Bill 1980

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    Florida Senate - 1998                                  SB 1980

    By Senator Myers





    27-1419-98

  1                      A bill to be entitled

  2         An act relating to screening the hearing of

  3         infants; providing for universal screening of

  4         the hearing of newborns; providing legislative

  5         intent; providing definitions; requiring

  6         hospitals, birthing centers, and health care

  7         providers at home births to refer newborns to

  8         licensed audiologists for screening; providing

  9         other requirements for the screening program;

10         requiring hearing screening and followup to be

11         procedures covered by health insurance

12         policies, by health maintenance organizations,

13         and by Medicaid; requiring followup referral of

14         hearing-impaired infants to the Children's

15         Medical Services Early Intervention Program;

16         requiring the Department of Health and the

17         Agency for Health Care Administration to

18         coordinate services with a technical advisory

19         panel on screening the hearing of infants;

20         requiring written documentation of hearing

21         screenings; providing an effective date.

22

23  Be It Enacted by the Legislature of the State of Florida:

24

25         Section 1.  Screening of infants' hearing.--

26         (1)  LEGISLATIVE INTENT.--The intent of this section is

27  to provide for a statewide comprehensive and coordinated

28  interdisciplinary program of early hearing-impairment

29  screening, identification, and followup care for newborns. The

30  goal is to screen all newborns for hearing impairment.

31         (2)  DEFINITIONS.--As used in this section, the term:

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    Florida Senate - 1998                                  SB 1980
    27-1419-98




  1         (a)  "Agency" means the Agency for Health Care

  2  Administration.

  3         (b)  "Department" means the Department of Health.

  4         (c)  "Hearing-impaired infant" means an infant who has

  5  an impairment that is a dysfunction of the auditory system of

  6  any type or degree sufficient to interfere with the infant's

  7  acquisition and development of speech and language skills.

  8         (d)  "Infant" means a child from birth to 36 months of

  9  age.

10         (e)  "Management" means the habilitation of the

11  hearing-impaired infant.

12         (f)  "Non-hospital-based providers" means licensed

13  health care professionals whose primary location of service

14  delivery is in a community setting and is not physically

15  located within a hospital.

16         (g)  "Personal supervision" means that a licensed

17  audiologist is on the premises or in the facility and

18  immediately available when the screening is rendered and

19  completed.

20         (h)  "Screening" means a test or battery of tests

21  administered to determine whether there is a need for an

22  in-depth diagnostic evaluation.

23         (3)  REQUIREMENTS.--

24         (a)  Each licensed hospital that provides maternity and

25  newborn-infant care services shall provide that every newborn,

26  before being discharged, be screened for the detection of

27  hearing loss to prevent the consequences of unidentified

28  disorders.

29         (b)  Each licensed birthing center that provides

30  maternity and newborn-infant care services shall provide that

31  every newborn, before being discharged, be referred to a

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    Florida Senate - 1998                                  SB 1980
    27-1419-98




  1  licensed audiologist for screening for the detection of

  2  hearing loss to prevent the consequences of unidentified

  3  disorders. The referral for appointment must be made within 30

  4  days after discharge. Written documentation of the referral

  5  must be placed in the newborn's medical chart.

  6         (c)  If the parents or legal guardians of the newborn

  7  object to the newborn's being screened for hearing impairment,

  8  the screening must not be performed. In such a case, the

  9  physician, midwife, or other person who is attending the

10  newborn shall maintain a record that the screening has not

11  been performed and shall attach to the record any written

12  objection.

13         (d)  For home births, the health care provider in

14  attendance is responsible for coordination and referral to an

15  audiologist for screening to detect hearing loss. The referral

16  for appointment must be made within 30 days after the birth.

17  If a home birth is not attended by a primary health care

18  provider, a referral to a licensed audiologist must be made by

19  the newborn's health care provider within 15 days after the

20  health care provider learns of the birth.

21         (e)  All screenings of infants' hearing must be

22  conducted by or directly supervised by a licensed audiologist.

23  Each licensed hospital shall obtain the services of a licensed

24  audiologist through employment, contract, or written

25  memorandum of understanding for the purposes of appropriate

26  staff training, screening-program supervision, scoring and

27  interpretation of test results, rendering of appropriate

28  recommendations, and coordination of appropriate followup

29  services. The audiologist also has responsibility for

30  providing appropriate documentation in the medical record

31  within 24 hours after providing the screening recommendations.

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    Florida Senate - 1998                                  SB 1980
    27-1419-98




  1         (f)  The screening of a newborn's hearing must be

  2  completed before the newborn is discharged from the hospital

  3  or birthing center. If the screening is not completed due to

  4  scheduling or temporary staffing limitations, the screening

  5  must be completed within 30 days after discharge. Screenings

  6  completed after discharge or performed because of initial

  7  screening failure must be performed by an audiologist licensed

  8  in this state.

  9         (g)  Each hospital shall formally designate a lead

10  physician who is responsible for programmatic oversight. Each

11  birthing center shall designate a health care provider who

12  shall provide programmatic oversight and ensure that the

13  appropriate referrals are being completed. 

14         (h)  Each screening of a newborn's hearing must include

15  auditory brainstem responses (ABR), evoked otocoustic

16  emissions, or appropriate technology as approved by the

17  federal Food and Drug Administration (FDA).

18         (i)  The initial procedure for screening the hearing of

19  a newborn and any followup, medically necessary reevaluations

20  leading to diagnosis must be a covered benefit reimbursable

21  under Medicaid and by all health insurance policies and health

22  maintenance organizations as defined in chapters 627 and 641,

23  Florida Statutes, except for supplemental policies that

24  provide coverage only for specific diseases, hospital

25  indemnity, Medicare supplement, or other supplemental

26  policies.

27         (j)  Any child who is diagnosed as having a permanent

28  hearing impairment shall be referred to his or her primary

29  care physician for medical management, treatment, and followup

30  services. Furthermore, in accordance with Pub. L. No. 105-17,

31  The Infants and Toddlers Program, Individuals with

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    Florida Senate - 1998                                  SB 1980
    27-1419-98




  1  Disabilities Education Act, any child from birth to 36 months

  2  of age who is diagnosed as having a hearing impairment that

  3  requires ongoing special hearing services must be referred to

  4  the Children's Medical Services Early Intervention Program

  5  serving the geographic area in which the child resides. 

  6         (k)  The department and agency shall work in

  7  coordination with a technical advisory panel on screening the

  8  hearing of infants to ensure the provision of a comprehensive

  9  and coordinated interdisciplinary program of early screening

10  for hearing impairment, identification of hearing impairment,

11  and followup care for hearing-impaired infants from birth to

12  36 months of age. The technical advisory panel shall make

13  recommendations to the department and the agency regarding

14  minimum qualifications, training requirements, and

15  quality-assurance measures that all individuals who provide

16  this service must adhere to.

17         (l)  All hospitals and birthing centers, outpatient

18  facilities, and non-hospital-based providers shall maintain

19  written documentation of screenings of infants' hearing which

20  must include the date of the screenings, test results,

21  interpretations, and recommendations. The agency, in

22  coordination with the department, shall develop a

23  hearing-evaluation data form that must be used by all

24  institutions. Specifications for data to be collected under

25  this section must be developed by the agency in coordination

26  with the department and the technical advisory panel. All

27  institutions that perform screenings of infants' hearing shall

28  submit reports on such screenings to the agency. The reports

29  provided to the agency must be shared with Children's Medical

30  Services, which shall have lead responsibility for tracking

31  children who have been identified as having a hearing loss,

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    Florida Senate - 1998                                  SB 1980
    27-1419-98




  1  for assuring appropriate referral followup services, and for

  2  conducting epidemiological analyses of data.

  3         Section 2.  This act shall take effect October 1, 1998.

  4

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  6                          SENATE SUMMARY

  7    Provides for a program of screening the hearing of
      newborn infants and for followup services to infants, age
  8    birth to 36 months, who are diagnosed as having a hearing
      impairment. Provides that such screenings and related
  9    services must be covered by health insurance policies and
      by health maintenance organizations. (See bill for
10    details.)

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