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Current Status Bill Number:View additional legislative information at the LPITS web site.4953 Type of Legislation:General Bill GB Introducing Body:House Introduced Date:20000413 Primary Sponsor:Lourie All Sponsors:Lourie, Allen, Allison, Bailey, Breeland, J. Brown, Clyburn, Davenport, Edge, Emory, Gamble, Gourdine, Govan, Hayes, Hosey, Inabinett, Jennings, Kirsh, Lee, Lloyd, Mack, Maddox, Martin, McGee, McKay, McMahand, Miller, Moody-Lawrence, J.M. Neal, Scott, Simrill, J. Smith, Stuart, Webb and Wilder Drafted Document Number:l:\council\bills\nbd\11991ac00.doc Residing Body:House Subject:Universal Newborn Hearing Screening and Intervention Act, Medical, Minors, Speech, Pathology and Audiology, DHEC History Body Date Action Description Com Leg Involved ______ ________ ______________________________________ _______ ____________ House 20000531 Request for debate withdrawn by Representative Robinson House 20000525 Debate adjourned until Tuesday, 20000530 House 20000523 Request for debate by Representative Barrett Klauber Sandifer Sharpe Witherspoon Hawkins Perry Easterday Lourie Robinson Altman Loftis Littlejohn Kennedy House 20000523 Debate interrupted ------ 20000518 Scrivener's error corrected House 20000517 Committee report: Favorable with 27 H3M amendment House 20000413 Introduced, read first time, 27 H3M referred to Committee Versions of This Bill Revised on May 17, 2000 - Word format Revised on May 18, 2000 - Word format
COMMITTEE REPORT
May 17, 2000
H. 4953
Introduced by Reps. Lourie, Allen, Allison, Bailey, Breeland, J. Brown, Clyburn, Davenport, Edge, Emory, Gamble, Gourdine, Govan, Hayes, Hosey, Inabinett, Jennings, Kirsh, Lee, Lloyd, Mack, Maddox, Martin, McGee, McKay, McMahand, Miller, Moody-Lawrence, J.M. Neal, Scott, Simrill, J. Smith, Stuart, Webb and Wilder
S. Printed 5/17/00--H. [SEC 5/18/00 3:35 PM]
Read the first time April 13, 2000.
To whom was referred a Bill (H. 4953), to amend the Code of Laws of South Carolina, 1976, by adding Section 44-37-40 so as to enact the "Universal Newborn Hearing Screening and Intervention Act", etc., respectfully
That they have duly and carefully considered the same, and recommend that the same do pass with amendment:
Amend the bill, as and if amended, Section 44-37-40(C)(1) page 4, line 18 by deleting /January 1, 2002/ and inserting /June 30, 2001/ so when amended Section 44-37-40(C)(1) reads:
/(C)(1) Beginning no later than June 30, 2001, newborn hearing screening must be conducted on all newborns born in hospitals in this State during birth admission, using procedures recommended or approved by the department. However, when a newborn is delivered in a hospital with an average of less than one hundred deliveries a year, the parents must be instructed on the merits of having the hearing screening performed and must be given information to assist them in having the screening performed within one month of the child's birth date. /
Amend the bill further, Section 44-37-40(C)(2) page 4, line 27 by deleting /July 1, 2001/ and inserting /April 1, 2001/ so when amended Section 44-37-40(C)(2) reads:
/ (2) Beginning no later than April 1, 2001, every hospital in this State shall provide educational information for the parents of newborns born in that hospital concerning the importance of hearing screening. Education may not be considered a substitute for the hearing screening./
Renumber sections to conform.
Amend totals and title to conform.
JOE E. BROWN, for Committee.
FIRST YEAR GENERAL FUNDS: $ 657,937 to 1,385,937
FIRST YEAR FEDERAL AND/OR OTHER FUNDS: $ 511,930
ANNUAL TOTAL THEREAFTER: $ 647,437 to 1,375,437
EXPLANATION OF IMPACT:
Department of Health & Environmental Control (DHEC)
DHEC indicates that this program would require 3.00 FTEs at a cost of $191,867 (including fringe benefits). This includes one Nurse Administrator to oversee this statewide program and two Statistical and Research Analysts to collect and analyze data obtained from hospitals on infants screened. The staff would also provide program oversight and monitoring, and technical support to hospitals. They would promulgate regulations, and report to the Legislature and to hospitals.
Other operating costs are estimated at $239,500. These costs include developing a surveillance and data system, contractual services to train hospital personnel, developing screening protocols, maintaining an electronic reporting system for hospitals to transmit screening results to DHEC, and maintaining a monitoring system to insure that children identified by screening receive early intervention services. Operating funds would also be used to print educational materials, for travel to hospitals throughout the state, and for office supplies. The one-time office set-up cost for the three employees is estimated at $10,500. Total first year administration costs are, therefore, estimated at $441,867, while annual costs thereafter can be estimated at $431,367.
Department of Health & Human Services (DHHS)
DHHS estimates that approximately half of the State's 56,000 newborns each year are Medicaid eligible. At $26 per screening the total cost for all Medicaid eligible newborns is estimated at $728,000 (28,000 X $26). Based on a State match rate of 29.68% the impact on the General Fund of the State can be estimated at $216,070.
Non-Medicaid Eligible Newborns
The bill does not specify who is to pay for the screening of non-Medicaid-eligible newborns. Therefore, this cost could be paid by the parent or from State General Fund appropriations. If the parent is designated as responsible for this cost there would be no additional impact to the General Fund of the State. However, if it is the legislative intent that this cost be paid by the State the impact on the General Fund of the State can be estimated at $728,000 (28,000 non- Medicaid eligible newborns X $26).
An implementation schedule based on the two scenarios concerning responsibility for non-Medicaid eligible newborns is as follows:
State Does Not Assume Cost State Assumes Cost
For Non Medicaid Newborns For Non Medicaid Newborns
State General Federal State General Federal
ITEM Funds Funds Funds Funds
DHEC Administration 431,367 - 431,367 -
One-time office set-up 10,500 - 10,500 -
Medicaid Eligible
Newborns 216,070 511,930 216,070 511,930
Non-Medicaid Eligible
Newborns - - 728,000
TOTAL First Year
Estimate $657,937 $511,930 $1,385,937 $511,930
Approved By:
Don Addy
Office of State Budget
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TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 44-37-40 SO AS TO ENACT THE "UNIVERSAL NEWBORN HEARING SCREENING AND INTERVENTION ACT" INCLUDING PROVISIONS TO REQUIRE NEWBORN HEARING SCREENING AND PROVIDING EDUCATIONAL INFORMATION ON THE IMPORTANCE OF THESE SCREENINGS; TO ESTABLISH EVALUATION AND INTERVENTION PROCEDURES AND SERVICES; TO REQUIRE THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL TO ESTABLISH REPORTING PROCEDURES FOR THESE SCREENINGS WHICH MUST BE FOLLOWED BY HOSPITALS, AUDIOLOGISTS, AND EARLY INTERVENTIONISTS; TO REQUIRE THE DEPARTMENT TO ESTABLISH MONITORING AND MEASUREMENT OF THE EFFECTIVENESS OF THESE SCREENINGS AND INTERVENTIONS; TO REQUIRE THE DEPARTMENT TO ESTABLISH THE NEWBORN HEARING SCREENING AND INTERVENTION ADVISORY COUNCIL; AND TO PROHIBIT PERFORMING A SCREENING IF A PARENT DISSENTS BASED ON RELIGIOUS BELIEFS.
Whereas, The General Assembly finds that:
(1) hearing loss occurs in newborns more frequently than any other health condition for which newborn screening is currently required;
(2) hearing is vital to the healthy development of spoken language skills. Eight percent of a child's ability to learn speech, language, and related cognitive skills is established by the time the child is thirty-six months of age;
(3) newborns can receive reliable and valid screening for hearing loss in a cost effective manner;
(4) identification of hearing loss as close to birth as possible coupled with early intervention and treatment before six months of age allows maximum development of a child's communication skills during the critical time period for speech and language learning;
(5) early detection of hearing loss and early intervention and treatment before six months of age will reduce public expenditure for health care, special education, and related services;
(6) universal newborn hearing screening, with early evaluation and intervention, are included in both the Healthy People 2000 and Healthy People 2010 Objectives for the nation; and
Whereas, the General Assembly further finds that the purpose of this act is to:
(1) provide early detection of hearing loss, from inner ear or middle ear causes, in newborns at the birthing facility or as soon after birth as possible;
(2) enable these newborns and their families or caregivers to obtain needed multi-disciplinary evaluation, treatment, and intervention services at the earliest opportunity;
(3) maximize development of the auditory system for each newborn to prevent or mitigate the developmental delay and academic failures associated with hearing loss; and
(4) integrate universal newborn hearing screening with early intervention services for children birth to thirty-six months as consistent with the "Infants and Toddlers with Disabilities Act", as provided for in Article 21, Chapter 7, Title 44, and Part C of the "Individuals with Disabilities Education Act" and Title V of the Social Security Act. Now, therefore,
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. The 1976 Code is amended by adding:
"Section 44-37-40. (A) This section may be cited as the 'Universal Newborn Hearing Screening and Intervention Act'.
(B) For purposes of this section:
(1) 'Advisory council' means the Newborn Hearing Screening and Intervention Advisory Council.
(2) 'Audiologist' means an individual licensed to practice audiology by the South Carolina Board of Examiners in Speech-Language Pathology and Audiology.
(3) 'Audiologic evaluation' means an evaluation consisting of procedures to assess the status of the auditory system; to establish the site of an auditory disorder; the type and degree of hearing loss, and the potential effects of hearing loss on communication; and to identify appropriate treatment and referral options. Referral options for evaluation should include linkage to state Part C 'Individuals with Disabilities Education Act' coordinating agencies or other appropriate agencies, medical evaluation, hearing aid/sensory aid assessment, audiologic rehabilitation treatment, national and local consumer, self-help, parent and education organizations, and other family centered services.
(4) 'Auditory habilitation' means intervention which includes the use of procedures, techniques, and technologies to facilitate the receptive and expressive communication abilities of a child with hearing loss.
(5) 'Birth admission' means the time after birth that the newborn remains in the hospital nursery before discharge.
(6) 'Commissioner' means the Commissioner of the South Carolina Department of Health and Environmental Control.
(7) 'Department' means the South Carolina Department of Health and Environmental Control.
(8) 'Early Intervention' means providing appropriate services for a child with hearing loss and ensuring that the family of the child is provided comprehensive, consumer-oriented information about the full range of family support, training, information services, and communication options and is given the opportunity to consider the full range of educational and program placements and options for this child.
(9) 'Hearing loss' for newborns and neonates means failure to pass the brainstem auditory evoked response performed at the audiologic evaluation. Current hearing screening technology detects levels of hearing loss as low as 35 decibels.
(10) 'Hearing screening' means newborn and infant hearing screening consisting of objective physiologic procedures to detect possible hearing loss and to identify newborns and infants who, after rescreening, require further audiologic and medical evaluations.
(11) 'Infant' means a child twenty-nine days to twenty-four months old.
(12) 'Medical intervention' means the process by which a physician provides medical diagnosis and direction for medical or surgical treatment options for hearing loss or related medical disorders associated with hearing loss.
(13) 'Newborn' means a child up to twenty-eight days old.
(14) 'Normal hearing' for newborns and infants is 0-15 decibels hearing level. Any hearing level greater than 15 decibels can adversely affect speech and language development. The greater the hearing level the greater the adverse impact on speech and language development.
(15) 'Parent' means a natural parent, stepparent, adoptive parent, legal guardian, or other legal custodian of a child.
(16) Part C of 'Individuals with Disabilities Education Act' means the federal 'Early Intervention Program for Infants and Toddlers with Disabilities and Developmental Delay Act' which encourages exemplary practices that lead to improved teaching and learning experiences for children with developmental delay, and that can result in more productive independent adult lives, including employment.
(C)(1) Beginning no later than January 1, 2002, newborn hearing screening must be conducted on all newborns born in hospitals in this State during birth admission, using procedures recommended or approved by the department. However, when a newborn is delivered in a hospital with an average of less than one hundred deliveries a year, the parents must be instructed on the merits of having the hearing screening performed and must be given information to assist them in having the screening performed within one month of the child's birth date.
(2) Beginning no later than July 1, 2001, every hospital in this State shall provide educational information for the parents of newborns born in that hospital concerning the importance of hearing screening. Education may not be considered a substitute for the hearing screening.
(3) When a newborn is delivered somewhere other than a hospital, the parents must be instructed on the merits of having the screening performed and must be given information to assist them in having the screening performed within one month of the child's birth date. The department shall determine the appropriate screening venue for newborns who are born in facilities other than hospitals.
(D)(1) Newborns referred as a result of the screening process shall receive an audiologic evaluation by an audiologist and a medical evaluation by a physician or otolaryngologist, or both, as indicated.
(2) Newborns and infants referred as a result of the evaluation process shall receive medical intervention, audiologic habilitation, early intervention services, and augmentative hearing devices.
(3)(a) The department, upon consultation with the South Carolina Health Alliance, shall establish newborn hearing screening reporting procedures which must be followed by hospitals, audiologists, and early interventionists.
(b) The department also shall establish procedures to monitor and measure the effectiveness of newborn and infant hearing screening and intervention and shall report annually to the General Assembly and to participating hospitals.
(c) Subject to available appropriations, the department shall make reports required pursuant to this subsection available throughout the State, specifically to physicians whose practice includes the practice of obstetrics, neonatology, or the care of newborns and infants, to consumer groups, managed care organizations, other third party payers, and the media.
(E) The department shall establish the Newborn Hearing Screening and Intervention Advisory Council, consisting of representatives of agencies, professional disciplines, hospitals, and consumers to advise the department on matters related to the implementation of this section and duties of the department under this section.
(F) No test may be performed if the parent of a newborn dissents on the ground that the test conflicts with a personal religious belief or practice.
(G) The department may promulgate regulations to the extent necessary to implement the provisions of this section."
SECTION 2. This act takes effect July 1, 2000.
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