HB 173: "An Act relating to establishing a screening, tracking, and intervention program related to the hearing ability of newborns and infants; providing an exemption to licensure as an audiologist for certain persons performing hearing screening tests; relating to insurance coverage for newborn and infant hearing screening; and providing for an effective date."
00 HOUSE BILL NO. 173 01 "An Act relating to establishing a screening, tracking, and intervention program related to 02 the hearing ability of newborns and infants; providing an exemption to licensure as an 03 audiologist for certain persons performing hearing screening tests; relating to insurance 04 coverage for newborn and infant hearing screening; and providing for an effective date." 05 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 06 * Section 1. The uncodified law of the State of Alaska is amended by adding a new section 07 to read: 08 LEGISLATIVE FINDINGS. The legislature finds that 09 (1) hearing loss occurs in newborns and infants more frequently than any other 10 health condition for which newborn or infant screening is required; 11 (2) 80 percent of the language ability of a child is established by the time the 12 child is 18 months of age, and appropriate language training is vitally important to the healthy 13 development of cognitive, social, emotional, and academic skills;
01 (3) early detection of hearing loss in a child and early intervention and 02 treatment have been demonstrated to be highly effective in facilitating a child's healthy 03 development in a manner consistent with the child's age and cognitive ability; 04 (4) children with hearing loss who do not receive early intervention and 05 treatment frequently require special education services, and these services are publicly funded 06 for the vast majority of children with hearing needs in the state; and 07 (5) appropriate testing and identification of newborns and infants with hearing 08 loss will facilitate early intervention and treatment and may serve the public purpose of 09 promoting the healthy development of children while reducing public expenditures. 10 * Sec. 2. The uncodified law of the State of Alaska is amended by adding a new section to 11 read: 12 LEGISLATIVE INTENT. Subject to the availability of appropriations to implement 13 AS 47.20.300 - 47.20.390, enacted by sec. 6 of this Act, the Department of Health and Social 14 Services shall implement the program required by this Act so that at least 90 percent of all 15 newborns and infants in the state are being screened for hearing loss by January 1, 2003. 16 * Sec. 3. AS 08.11.120(b) is amended to read: 17 (b) Notwithstanding the provisions of this chapter, 18 (1) a nurse licensed under AS 08.68 may perform hearing sensitivity 19 evaluations; 20 (2) an individual licensed as a hearing aid dealer under AS 08.55 may 21 deal in hearing aids; 22 (3) an individual holding a class A certificate issued by the Conference 23 of Executives of American Schools of the Deaf may teach the hearing impaired; 24 (4) an individual may engage in the testing of hearing as part of a 25 hearing conservation program that complies with the regulations of the Occupational 26 Safety and Health Administration of the federal government if the individual is 27 certified to do the testing by a state or federal agency acceptable to the Occupational 28 Safety and Health Administration; 29 (5) an individual may perform a hearing screening test under 30 AS 47.20.310 if authorized to do so under a protocol adopted under 31 AS 47.20.310(e) by the Department of Health and Social Services.
01 * Sec. 4. AS 18.50 is amended by adding a new section to read: 02 Sec. 18.50.162. Notification about hearing screening. When the bureau 03 receives a certificate of live birth under AS 18.50.160 for a newborn who was 04 delivered outside of a hospital, the bureau shall forward the names and addresses of 05 the parents to the department employees who administer the screening program set out 06 in AS 47.20.310 - 47.20.390. Those department employees shall notify the child's 07 parents of the merits of having the child screened for hearing ability. 08 * Sec. 5. AS 21.42 is amended by adding a new section to read: 09 Sec. 21.42.349. Coverage for newborn and infant hearing screening. (a) 10 Except for a fraternal benefit society, a health care insurer that offers, issues for 11 delivery, delivers, or renews in this state a health care insurance plan shall provide 12 coverage for newborn and infant hearing screening under the schedule described in (b) 13 of this section if the plan covers services provided to women during pregnancy and 14 childbirth and the dependents of a covered individual. 15 (b) The minimum coverage required under (a) of this section includes 16 (1) a newborn or infant hearing screening test to be performed within 17 30 days after the child's birth; and 18 (2) if the initial test under (1) of this subsection determines that the 19 child may have a hearing impairment, a confirmatory hearing diagnostic test. 20 (c) The coverage required by this section may be subject to standard policy 21 provisions that are applicable to other benefits, such as deductible or copayment 22 provisions. 23 * Sec. 6. AS 47.20 is amended by adding new sections to read: 24 Article 2. Newborn and Infant Hearing Screening, Tracking, 25 and Intervention Program. 26 Sec. 47.20.300. Department to implement program. The department shall 27 plan, develop, and implement a hearing screening, tracking, and intervention program 28 to facilitate compliance with the requirements of AS 47.20.300 - 47.20.390. 29 Sec. 47.20.310. Screening requirements. (a) Subject to (b) of this section, 30 the physician in attendance at or immediately after the birth of a child in a hospital in 31 this state, or, if a physician is not in attendance at or immediately after the birth, the
01 person attending the newborn child in a hospital in this state, shall, unless medically 02 contraindicated, cause the child to be tested to determine whether the child has a 03 potential hearing impairment using the methods determined by the department under 04 (e) of this section. Unless medically contraindicated, the screening shall occur before 05 the newborn is released from the hospital or before the infant is 30 days old, 06 whichever is earlier. Each birthing center that provides maternity and newborn care 07 services shall provide that each newborn in the center's care is referred for an 08 appointment to a licensed audiologist or to a hospital or other newborn hearing 09 screening provider before discharge. Unless medically contraindicated, the screening 10 shall occur before the infant is 30 days old. 11 (b) Notwithstanding (a) of this section, the physician or other person at or 12 immediately after the birth of a child in a hospital or birthing center that averages less 13 than 50 births a year is not required to screen the child as described in (a) of this 14 section but shall, before the newborn is released from the hospital or birthing center, 15 refer the child for screening at another facility or with another provider. Unless 16 medically contraindicated, the screening shall occur before the child is 30 days old. 17 (c) If it is determined by testing that a newborn child may have a hearing 18 impairment, the physician or other person who is required under (a) of this section to 19 cause the child to be tested shall 20 (1) refer the child for confirmatory testing; and 21 (2) make reasonable efforts to promptly notify the child's parent that 22 the child may have a hearing impairment and explain to the parent the potential effect 23 of the impairment on the development of the child's speech and language skills. 24 (d) When the Bureau of Vital Statistics receives a certificate of live birth 25 under AS 18.50.160 for a newborn who was delivered at a place other than a hospital, 26 the bureau shall notify the department employees who administer AS 47.20.300 - 27 47.20.390; the department employees shall notify the child's parents of the merits of 28 having a hearing screening performed, and the department shall provide information to 29 the parents to assist the parents in accomplishing the hearing testing within 30 days 30 after the child's birth. 31 (e) The hearing testing required under this section shall use protocols
01 established by the department. At a minimum, the protocols must include the use of at 02 least one of the following physiologic technologies: automated or diagnostic auditory 03 brainstem response (ABR) or otoacoustic emissions (OAE). The department shall 04 consider updating the protocols as information is provided to the department that new 05 physiologic technologies or improvements to existing physiologic technologies will 06 substantially enhance newborn and infant hearing assessment. 07 (f) Notwithstanding (a) of this section, a physician or other person required to 08 cause a newborn hearing screening test under this section is exempt from this 09 requirement if the parent of the newborn child objects to the testing procedure on the 10 grounds that the procedure conflicts with the religious tenets and practices of the 11 parent. The parent shall sign a statement that the parent knowingly refuses the 12 services, and the physician or other person shall have a copy of the signed statement 13 retained in the hospital records of the birth. 14 (g) After appropriate billing, the department shall pay the costs of a screening 15 performed under this section if the department determines that the parents are unable 16 to pay the costs and there is no other private insurance or public program under which 17 the costs are eligible for payment. The department shall establish by regulation 18 standards for payment under this section. 19 Sec. 47.20.320. Reporting and tracking program. (a) The department shall 20 develop and implement a reporting and tracking system for newborns and infants 21 tested for hearing loss in order to provide the department with information and data to 22 effectively plan, establish, monitor, and evaluate the newborn and infant hearing 23 screening, tracking, and intervention program. Evaluation of the program must 24 include evaluation of the initial hearing screening, follow-up components, and the use 25 and availability of the system of services for newborns and infants who are deaf or 26 hard of hearing and their families. 27 (b) A physician or other person attending the birth in the state, or a hospital on 28 behalf of a physician or other person attending the birth, shall report information 29 related to hearing screening required under (a) of this section as specified by the 30 department. Persons providing audiological confirmatory testing and diagnostic 31 services for newborns and infants whose hearing was tested under AS 47.20.310 shall
01 report information as specified by the department in regulation. 02 (c) The information received under (b) of this section shall be compiled and 03 maintained by the department in the tracking system. The information shall be kept 04 confidential in accordance with the applicable provisions of 20 U.S.C. 1439 05 (Individuals with Disabilities Education Act), as amended by P.L. 105-17. Data 06 collected by the department that was obtained from the medical records of the 07 newborn or infant shall be for the confidential use of the department and are not public 08 records subject to disclosure under AS 40.25.110. Aggregate statistical data without 09 identifying information compiled from the information received is public information. 10 (d) A hospital or other health facility, clinical laboratory, audiologist, 11 physician, registered nurse, officer or employee of a health facility or clinical 12 laboratory, or an employee of an audiologist, physician, or registered nurse is not 13 criminally or civilly liable for furnishing information in good faith to the department 14 or its designee under this section. The furnishing of information in accordance with 15 this section is not a violation of AS 08 or AS 18 or regulations adopted under AS 08 or 16 AS 18 for licensees under those statutes. 17 Sec. 47.20.330. Intervention program. (a) The department shall establish 18 guidelines for the provision of follow-up care for newborn and infant children in the 19 state who have been identified as having or being at risk of developing a hearing loss. 20 The services recommended must include appropriate follow-up care for newborns and 21 infants with abnormal or inconclusive test results, such as diagnostic evaluation, 22 referral, and coordination of early intervention service programs if the newborn or 23 infant is found to have a hearing loss. 24 (b) The parents of all newborns and infants diagnosed with a hearing loss, as 25 reported to the department, shall be provided by the department with written 26 information on the availability of follow-up care through community resources and 27 government agencies, including those provided in accordance with 20 U.S.C. 1400 - 28 1491 (Individuals with Disabilities Education Act), as amended. Information provided 29 by the department must include listings of local and statewide nonprofit deaf and hard 30 of hearing consumer-based organizations, parent support organizations affiliated with 31 deafness, counseling and educational services, and programs offered through the
01 department and the Department of Education and Early Development. 02 Sec. 47.20.340. Outreach campaign. The department shall conduct a 03 community outreach and awareness campaign to inform medical providers, pregnant 04 women, and families of newborns and infants of the newborn and infant hearing 05 screening, tracking, and intervention program and the value of early hearing testing. 06 Sec. 47.20.350. Report. The department shall prepare an annual report for the 07 governor about the newborn and infant hearing screening, tracking, and intervention 08 program administered under AS 47.20.300 - 47.20.390. The report must include 09 recommendations on improving the testing program, including strategies to increase 10 the rate of early screening and the use of appropriate early intervention techniques. 11 The department shall notify the legislature that the report is available. 12 Sec. 47.20.390. Definitions. In AS 47.20.300 - 47.20.390, 13 (1) "commissioner" means the commissioner of health and social 14 services; 15 (2) "department" means the Department of Health and Social Services; 16 (3) "follow-up care" means all of the following: 17 (A) services necessary to diagnose and confirm a hearing loss; 18 (B) ongoing audiological services to monitor hearing; 19 (C) communication services, including aural rehabilitation, 20 speech, language, social, and psychological services; 21 (D) support services for the infant and family; and 22 (E) early intervention services described in 20 U.S.C. 1431 - 23 1445 (Individuals with Disabilities Education Act), as amended by P.L. 105- 24 17; 25 (4) "hearing loss" means a hearing loss of 30 decibels or greater in the 26 frequency region important for speech recognition and comprehension in one or both 27 ears, approximately 500 through 4000 Hz; 28 (5) "infant" means a child 30 days to 24 months old; 29 (6) "newborn" means a child less than 30 days old; 30 (7) "parent" means a natural parent, stepparent, adoptive parent, legal 31 guardian, or other legal custodian of the child;
01 (8) "program" means the newborn and infant hearing, tracking, and 02 intervention screening program established under AS 47.20.300 - 47.20.390. 03 * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to 04 read: 05 TRANSITION: REGULATIONS. Notwithstanding sec. 9 of this Act, the 06 Department of Health and Social Services may proceed to develop and adopt regulations 07 required to implement this Act. The regulations take effect under AS 44.62 (Administrative 08 Procedure Act), but not before the effective date of the relevant provision of this Act. 09 * Sec. 8. The uncodified law of the State of Alaska is amended by adding a new section to 10 read: 11 INSTRUCTION TO REVISOR. In AS 47.20.060 - 47.20.290, the revisor shall delete 12 "this chapter" and insert "AS 47.20.060 - 47.20.290." 13 * Sec. 9. AS 47.20.300, enacted by sec. 6 of this Act, and secs. 7 and 8 of this Act take 14 effect immediately under AS 01.10.070(c). 15 * Sec. 10. Except as provided in sec. 9 of this Act, this Act takes effect January 1, 2002.