FIRST REGULAR SESSION
SENATE BILL NO. 513
90TH GENERAL ASSEMBLY
INTRODUCED BY SENATORS BLAND AND DePASCO.
Read 1st time March 1, 1999, and 1,000 copies ordered printed.
TERRY L. SPIELER, Secretary.
L2012.01I
AN ACT
Relating to screening for hearing loss in newborns.
Section 1. 1. Effective January 1, 2002, every infant born in this state shall be screened for hearing loss in accordance with the provisions of sections 1 to 6 of this act.
2. The screening procedure shall include the use of at least one of the following physiological technologies:
(1) Automated or diagnostic auditory brainstem response (ABR);
(2) Otoacoustic emissions (OAE); or
(3) Other technologies approved by the department of health.
3. Every newborn delivered on or after January 1, 2002, in an ambulatory surgical center or hospital shall be screened for hearing loss prior to discharge of the infant from the facility. Such facilities shall report the screening results on all newborns to the parents or guardian of the newborn, and the department of health in a manner prescribed by the department.
4. If a newborn is delivered in a place other than the facilities listed in subsection 3 of this section, the physician or person who professionally undertakes the pediatric care of the infant shall ensure that the newborn hearing screening is performed within three months of the date of the infant's birth. Such physicians and persons shall report the screening results on all newborns to the parents or guardian of the newborn, and the department of health in a manner prescribed by the department.
5. The provisions of this section shall not apply if the parents of the newborn or infant object to such testing on the grounds that such tests conflict with their religious tenets and practices.
6. As provided in subsection 5 of this section, the parent of any child who fails to have the hearing screening test administered after notice of the requirement for such test shall have such refusal documented in writing. Such physicians, persons or administrators shall obtain the written refusal and make such refusal part of the medical record of the infant, and shall report such refusal to the department of health in a manner prescribed by the department.
7. The physician or person who professionally undertakes the pediatric care of the newborn, and administrators of public health facilities, ambulatory surgical centers or hospitals shall provide to the parents or guardians of newborns a written packet of educational information developed and supplied by the department of health describing the screening, how it is conducted, the nature of the hearing loss, and the possible consequences of treatment and nontreatment for hearing loss prior to administering the screening.
8. All facilities or persons described in subsections 3 and 4 of this section who voluntarily provide hearing screening to newborns prior to January 1, 2002, shall report such screening results to the department of health in a manner prescribed by the department.
9. All facilities or persons described in subsections 3 and 4 of this section shall provide the parents or guardians of newborns who fail the hearing screening with educational materials that:
(1) Communicate the importance of obtaining further hearing screening or diagnostic audiological assessment to confirm or rule out hearing loss;
(2) Identify community resources available to provide rescreening and diagnostic audiological assessments; and
(3) Provide other information as prescribed by the department of health.
10. Any person who acts in good faith in complying with the provisions of this section by reporting the newborn hearing screening results to the department of health, or the parents or guardians of a newborn shall not be civilly or criminally liable for furnishing the information required by this section.
11. The department of health shall provide audiological and administrative technical support to facilities implementing the requirements of this section, including, but not limited to, assistance in:
(1) Selecting state-of-the-art newborn hearing screening equipment;
(2) Developing and implementing newborn hearing screening procedures that result in appropriate failure rates;
(3) Developing and implementing training for individuals administering screening procedures;
(4) Developing and distributing educational materials for families;
(5) Identifying community resources for delivery of rescreening and pediatric audiological assessment services; and
(6) Implementing reporting requirements.
Such audiological technical support shall be provided by individuals qualified to administer newborn and infant hearing screening, rescreening and diagnostic audiological assessment.
Section 2. 1. The department of health shall establish and maintain a newborn hearing screening surveillance and monitoring system for newborns who have been reported with possible hearing loss for the purpose of confirming the presence or absence of hearing loss, and referring those with hearing loss for early intervention services.
2. The department of health shall establish standards and follow-up procedures for all newborns reported with possible hearing loss pursuant to the provisions of section 1 of this act. Such standards and procedures shall include, but not be limited to:
(1) Rescreening;
(2) Diagnostic audiological assessment;
(3) Individuals qualified to administer rescreening and diagnostic audiological assessment;
(4) Time lines for administering rescreening and diagnostic pediatric audiological assessment; and
(5) Time lines and content of contacts to be made by the surveillance and monitoring system.
3. The results of rescreening and diagnostic audiological assessment procedures shall be reported to the department of health in a manner prescribed by the department. Any person who acts in good faith in complying with this section in reporting rescreening or diagnostic audiological assessment procedures to the department of health, or the parents or guardians of a newborn shall not be civilly or criminally liable for furnishing the information required by this section.
4. Any newborn with a confirmed hearing loss in the surveillance and monitoring system shall be referred to the appropriate point of contact for the Part C of the Individuals with Disabilities Education Act (IDEA) system of early intervention services (First Steps) and shall be reported to the Missouri commission for the deaf for census purposes.
5. Except as provided in this section, the information contained in the surveillance and monitoring system shall be confidential and shall not be divulged or made public in a manner that discloses the identity of an individual. The department of health may disclose and exchange such information as is necessary to provide follow-up services for newborns identified with hearing loss to the following persons without a parent's or guardian's written release:
(1) Employees of public agencies, departments and political subdivisions who need to know such information to carry out their public duties; or
(2) Health care professionals or their agents who undertake the pediatric care of the newborn.
If any person discloses such information for any other purposes, such person is guilty of an unauthorized release of confidential information and the person who discloses is liable for civil damages.
Section 3. The IDEA Part C data system shall monitor the delivery of early intervention services to those infants identified by the newborn hearing screening program and report annually to the department of health. Information collected shall be sufficient to document the early intervention services provided, including the type of amplification or other assistive technologies, and the status of outcomes as identified on the individualized family service plan (IFSP).
Section 4. 1. There is hereby established a "Newborn Hearing Screening Advisory Committee".
2. The committee shall advise and assist the department of health in:
(1) Developing rules, regulations and standards for screening, rescreening and diagnostic audiological assessment;
(2) Developing forms for reporting screening, rescreening and diagnostic audiological assessment results to the surveillance and monitoring system;
(3) Designing a technical assistance program to support facilities implementing the screening program and those conducting rescreening and diagnostic audiological assessment;
(4) Developing educational materials to be provided to families; and
(5) Evaluating program outcomes to increase effectiveness and efficiency.
The committee shall also report information concerning the newborn hearing screening program to the state interagency coordinating council, as requested, to ensure coordination of programs within the state's early intervention system, and to identify and eliminate areas of duplication.
3. The committee shall be composed of the following twelve members, with no less than two such members being deaf or hard of hearing, appointed by the director of the department of health:
(1) Three consumers, including one deaf individual who experienced hearing loss in early childhood, one hard of hearing individual who experienced hearing loss in early childhood and one parent of a child with a hearing loss;
(2) Two audiologists who have experience in evaluation and intervention of infants and young children;
(3) Two physicians who have experience in the care of infants and young children, one of which shall be a pediatrician;
(4) One representative of an organization with experience in providing early intervention services for children with hearing loss;
(5) One representative of the Missouri school for the deaf;
(6) One representative of a hospital with experience in the care of newborns;
(7) One representative of the Missouri commission for the deaf;
(8) One representative from each of the departments of health, elementary and secondary education, mental health, social services and insurance.
4. The department of health member shall chair the first meeting of the committee. At the first meeting, the committee shall elect a chairperson from its membership. The committee shall meet at the call of the chairperson, but not less than four times a year.
5. The department of health shall provide technical and administrative support services as required by the committee. Such services shall include technical support from individuals qualified to administer infant hearing screening, rescreening and diagnostic audiological assessments.
6. Members of the committee shall receive no compensation for their services as members but shall be reimbursed for expenses incurred as a result of their duties as members of the committee.
7. The committee shall adopt written bylaws to govern its activities.
Section 5. 1. Each policy issued by an entity offering individual and group health insurance which provides coverage on an expense-incurred basis, individual or group health service, or indemnity type contracts issued by a nonprofit corporation, individual and group service contracts issued by a health maintenance organization, all self-insured group health arrangements to the extent not preempted by federal law, and all health care plans provided by managed health care delivery entities of any type or description that are delivered, issued for delivery, continued or renewed in this state shall provide coverage for the newborn hearing screening required in section 1 of this act, and any necessary rescreening, audiological assessment and follow-up, and amplification as described in section 2 of this act.
2. The health care service required by this section shall not be subject to any greater deductible or copayment than other similar health care services provided by the policy, contract or plan.
3. This section shall not apply to a supplemental insurance policy, including a life care contract, accident-only policy, specified disease policy, hospital policy providing a fixed daily benefit only, Medicare supplement policy, long-term care policy or any other supplemental policy as determined by the director of the department of insurance.
4. Coverage for newborn hearing screening and any necessary rescreening and audiological assessment shall be provided to newborns eligible for medical assistance pursuant to section 208.151, RSMo, and the children's health program pursuant to sections 208.631 to 208.660, RSMo, with payment for the newborn hearing screening required in section 1 of this act, and any necessary rescreening, audiological assessment and follow-up, and amplification as described in section 2 of this act.
Section 6. 1. The director of the department of health may promulgate rules and regulations to implement the provisions of sections 1, 2 and 4 of this act. The director of the department of elementary and secondary education may promulgate rules and regulations to implement the provisions of section 3 of this act. The directors of the departments of insurance and social services may promulgate rules and regulations to implement the provisions of section 5 of this act.
2. No rule or portion of a rule promulgated pursuant to the provisions of sections 1 to 6 of this act shall become effective unless it has been promulgated pursuant to the provisions of chapter 536, RSMo.