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