House Bill 0399

CODING: Words stricken are deletions; words underlined are additions.







    Florida House of Representatives - 2000                 HB 399

        By Representatives Prieguez and Wasserman Schultz






  1                      A bill to be entitled

  2         An act relating to newborn hearing screening;

  3         providing legislative intent; providing

  4         definitions; providing requirements for

  5         screening newborns for hearing impairment;

  6         providing for education of parents of newborns;

  7         providing for certain insurance and managed

  8         care coverage; providing for referral for

  9         ongoing services; providing an effective date.

10

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

12

13         Section 1.  Newborn hearing screening.--

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

15  to provide a statewide comprehensive and coordinated

16  interdisciplinary program of early hearing impairment

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

18  goal is to screen all newborns for hearing impairment in order

19  to alleviate the adverse effects of hearing loss on speech and

20  language development, academic performance, and cognitive

21  development.

22         (2)  DEFINITIONS.--

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

24  Administration.

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

26         (c)  "Hearing impairment" means a hearing loss of 30 dB

27  HL or greater in the frequency region important for speech

28  recognition and comprehension in one or both ears,

29  approximately 500 through 4,000 hertz.

30         (d)  "Infant" means an age range from 30 days through

31  12 months.

                                  1

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 2000                 HB 399

    708-107C-00






  1         (e)  "Licensed health care provider" means a physician,

  2  nurse, or audiologist licensed in the state rendering services

  3  within the scope of his or her license.

  4         (f)  "Management" means the habilitation of the

  5  hearing-impaired child.

  6         (g)  "Newborn" means an age range from birth through 29

  7  days.

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

  9  administered to determine the need for an in-depth hearing

10  diagnostic evaluation.

11         (3)  REQUIREMENTS FOR SCREENING OF NEWBORNS; INSURANCE

12  COVERAGE; REFERRAL FOR ONGOING SERVICES.--

13         (a)  Each licensed hospital or other state-licensed

14  birthing facility that provides maternity and newborn care

15  services shall provide that all newborns are, prior to

16  discharge, screened for the detection of hearing loss, to

17  prevent the consequences of unidentified disorders.

18         (b)  Each licensed birth center that provides maternity

19  and newborn care services shall provide that all newborns are,

20  prior to discharge, referred to a licensed audiologist, or to

21  a hospital or other newborn hearing screening provider, for

22  screening for the detection of hearing loss, to prevent the

23  consequences of unidentified disorders. The referral for

24  appointment shall be made within 30 days after discharge.

25  Written documentation of the referral must be placed in the

26  newborn's medical chart.

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

28  object to the screening, the screening must not be completed.

29  In such case, the physician, midwife, or other person who is

30  attending the newborn shall maintain a record that the

31

                                  2

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 2000                 HB 399

    708-107C-00






  1  screening has not been performed and attach a written

  2  objection that must be signed by the parent or guardian.

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

  4  attendance is responsible for coordination and referral to a

  5  licensed audiologist, hospital, or other newborn hearing

  6  screening provider. The referral for appointment shall be made

  7  within 30 days after the birth. In cases in which the home

  8  birth is not attended by a primary health care provider, a

  9  referral to a licensed audiologist, hospital, or other newborn

10  hearing screening provider must be made by the health care

11  provider within the first 3 months after the child's birth.

12         (e)  All newborn and infant hearing screenings shall be

13  conducted by a licensed audiologist, licensed physician, or

14  appropriately supervised individual who has completed

15  documented training specifically for newborn hearing

16  screening. Every licensed hospital shall obtain the services

17  of a licensed audiologist or other newborn hearing screening

18  provider, through employment or contract or written memorandum

19  of understanding, for the purposes of appropriate staff

20  training, screening program supervision, monitoring the

21  scoring and interpretation of test results, rendering of

22  appropriate recommendations, and coordination of appropriate

23  followup services. Appropriate documentation of the screening

24  completion, results, interpretation, and recommendations must

25  be placed in the medical record within 24 hours after

26  completion of the screening procedure.

27         (f)  The screening of a newborn's hearing should be

28  completed before the newborn is discharged from the hospital.

29  If the screening is not completed before discharge due to

30  scheduling or temporary staffing limitations, the screening

31  must be completed within 30 days after discharge. Screenings

                                  3

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 2000                 HB 399

    708-107C-00






  1  completed after discharge or performed because of initial

  2  screening failure must be completed by an audiologist licensed

  3  in the state, or by a hospital or other newborn hearing

  4  screening provider.

  5         (g)  Each hospital shall formally designate a lead

  6  physician responsible for programmatic oversight for newborn

  7  hearing screening. Each birth center shall designate a

  8  licensed health care provider to provide such programmatic

  9  oversight and to ensure that the appropriate referrals are

10  being completed.

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

12  auditory brainstem responses, or evoked otocoustic emissions,

13  or appropriate technology as approved by the United States

14  Food and Drug Administration.

15         (i)  By October 1, 2000, newborn hearing screening must

16  be conducted on all newborns in hospitals in this state on

17  birth admission. When a newborn is delivered in a facility

18  other than a hospital, the parents must be instructed on the

19  importance of having the hearing screening performed and must

20  be given information to assist them in having the screening

21  performed within 3 months after the child's birth.

22         (j)  On or after October 1, 2000, every hospital in the

23  state shall educate the parents of newborns, in lay terms, on

24  the importance of screening the hearing of newborns and of

25  receiving followup care. The educational information shall

26  include a description of the normal auditory, speech, and

27  language development processes in children.

28         (k)  The initial procedure for screening the hearing of

29  the newborn or infant and any medically necessary followup

30  reevaluations leading to diagnosis shall be a covered benefit,

31  reimbursable under Medicaid, under all health insurance

                                  4

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 2000                 HB 399

    708-107C-00






  1  policies and health maintenance organizations as defined in

  2  chapters 627 and 641, Florida Statutes, except for

  3  supplemental policies that only provide coverage for specific

  4  diseases, hospital indemnity, or Medicare supplement, or to

  5  the supplemental policies.

  6         (l)  Any child who is diagnosed as having a permanent

  7  hearing impairment shall be referred to the primary care

  8  physician for medical management, treatment, and followup

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

10  The Infants and Toddlers Program, Individuals with

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

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

13  requires ongoing special hearing services must be referred to

14  the Children's Medical Services Early Intervention Program

15  serving the geographical area in which the child resides.

16         (m)  Any person who is not covered through insurance

17  and cannot afford the costs for testing shall be given a list

18  of newborn hearing screening providers who provide the

19  necessary testing free of charge.

20         Section 2.  This act shall take effect July 1, 2000.

21

22            *****************************************

23                          HOUSE SUMMARY

24
      Provides requirements and procedures for the screening of
25    newborns for hearing impairment. Provides legislative
      intent and definitions. Provides responsibilities of
26    hospitals, birth centers, and health care providers
      attending home births. Provides for the conduct of
27    screenings by certain providers. Specifies timeframes for
      newborn hearing screenings. Requires certain education of
28    parents of newborns on the importance of screening and
      followup care. Provides for certain insurance and managed
29    care coverage, including Medicaid coverage. Provides for
      referral for ongoing care under certain conditions.
30

31

                                  5