Legislature(2013 - 2014)SENATE FINANCE 532
04/10/2013 09:00 AM Senate FINANCE
| Audio | Topic |
|---|---|
| Start | |
| HB198 | |
| SB87 | |
| HB52 | |
| SB90 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 198 | TELECONFERENCED | |
| + | SB 87 | TELECONFERENCED | |
| += | HB 52 | TELECONFERENCED | |
| + | SB 90 | TELECONFERENCED | |
| + | TELECONFERENCED |
SENATE BILL NO. 87
"An Act requiring screening of newborns for congenital
heart defects; and providing for an effective date."
Senator Micciche introduced the legislation. He related a
story from personal experience. His niece was born in Japan
where newborns were routinely tested for congenital heart
disease. A significant defect was discovered that required
surgery. He detailed that one in one hundred babies were
born in Alaska each year with congenital heart disease; the
number one killer of infants with birth defects. The United
States was "moving toward" adopting Japan's testing
measures. Twenty states were in the process of considering
similar legislation and eight states adopted pilot
programs. The testing was accessible in several major
health facilities in the state. The screening was capable
of finding 75 percent of all congenital heart defects, as
well as other life threatening conditions. He commented
that the test cost $10 and was covered by most health
insurance plans and Medicaid. The cost of early detection
and treatment was much lower than the cost of late
diagnosis and treatment. He furthered that the legislation
required the low cost pulse oximetry testing beginning in
January 2014. Birthing centers, smaller hospitals, and
midwives with fewer than twenty births per year had until
January 2016 to purchase the screening equipment. Parents
could opt out of the screening. He spoke to the zero fiscal
note (FN 1 (DHSS)). He explained that the Department of
Health and Social Services (DHSS) was only required to
manage basic data on the program. He shared that he wanted
to keep impacts from the bill minimal. He offered that no
health care organization or association opposed the
legislation.
Co-Chair Meyer asked how many infants per year were born
with heart disease. Senator Micciche restated that one in
one hundred babies were born with heart defects each year.
Co-Chair Meyer inquired why the effective date was not
until January 1, 2014. Senator Micciche replied that he
wanted to avoid over burdening healthcare facilities
required to purchase the equipment.
Vice-Chair Fairclough noted that many of the hospitals had
the oximetry equipment on its premises. She inquired what
the cost was to purchase the equipment. Senator Micciche
responded that he did not know the exact cost.
Vice-Chair Fairclough asked how the screening worked.
Senator Micciche answered that a device clipped onto the
newborn's finger. The screening was not painful or
invasive.
9:39:52 AM
JILL LEWIS, DEPUTY DIRECTOR, DIVISION OF PUBLIC HEALTH,
DEPARTMENT OF HEALTH AND SOCIAL SERVICES, responded that
she did not know the cost of the screening equipment.
Vice-Chair Fairclough supported the legislation but wanted
to know the cost of the equipment to determine the burden
placed on smaller health care facilities. She asked DHSS to
confirm the cost of the test. Ms. Lewis understood that the
cost of the test was the amount stated by the sponsor.
Senator Bishop concurred with Vice-Chair Fairclough and
wanted to know the cost of the equipment. He wondered
whether grant money was available to help purchase the
equipment. Ms. Lewis responded that she was not aware of
any specific grant program, but that the department would
examine grant options and provide assistance if available.
Senator Olson remarked that oximetry was a huge advance in
non-invasive testing. He queried what provisions were
available for healthcare facilities in rural areas where a
delay in care could cause harm.
STEPHANIE WRIGHTSMAN-BIRCH, DIVISION OF PUBLIC HEALTH,
DEPARTMENT OF HEALTH AND SOCIAL SERVICES (via
teleconference), reported that the cost of the equipment
was approximately $500 to $1000. Some hospitals use more
sophisticated and more expensive equipment. She clarified
that the screening was administered through probes attached
by a Band-Aid applied to the right hand and the left foot
and read oxygen levels through the skin. She explained that
the division set up an advisory committee comprised of
pediatricians, pediatric cardiologists, a direct entry
nurse-midwife, and hospital personnel. The division and
advisory committee were already working with the hospitals
to develop a testing algorithm that would become the
standard for all health care facilities across the state as
recommended by the American Academy of Pediatrics and the
American Academy of Pediatric Cardiologists. She expounded
that Alaska had five pediatric cardiologists who travelled
around the state to cover rural areas as part of their
private practices. The algorithm included guidance to a
rural healthcare provider whether transport was required.
She responded that the screening was for early
identification and intervention measures would be applied
if appropriate.
Senator Olson noted that the test measured the difference
between the oxygenated blood between the hand and the foot.
Ms. Wrightsman-Birch confirmed. She indicated that the test
was rigorously studied for "a number" of years. She stated
that based on data, approximately 200 infants would screen
positive. Approximately twenty to thirty of the positive
infants would require additional intervention.
9:48:01 AM
Senator Olson asked whether the test detected both Atrial
Septal defects (ASD) and Ventral [ventricular] Septal
defects (VSD). Ms. Wrightsman-Birch answered in the
affirmative. She reported that the state had a high number
of VSD cases and noted that VSD often resolved without
treatment. She stated that the chairman of the advisory
committee, Dr. Christiansen, a pediatric cardiologist
reported that the screening also identified Tetralogy of
Fallot and malformation of the heart at much earlier stages
and allowed for treatment before a disease advanced.
Senator Olson wondered what happened with a false negative
screening result. Ms. Wrightsman-Birch answered that the
screening algorithm addressed a positive result by re-
screening up to three times. A pediatric cardiologist was
contacted after a second positive screening result. Simpler
additional testing typically take place before more costly
sophisticated tests were warranted.
Senator Olson commented that he fully supported the
legislation.
Co-Chair Meyer cited analysis from the fiscal note that
required the department "to establish procedures for
submitting reports" for screening. He queried whether DHSS
could accomplish the data collection without additional
appropriations. Ms. Lewis replied that the department was
able to accomplish the requirements with existing
resources.
Senator Olson asked for clarification regarding Section 2
of the legislation. Ms. Lewis explained that Section 2
delayed implementation of the bill for smaller providers
which allowed more time to prepare for the requirements of
the bill.
Co-Chair Meyer OPENED public testimony.
JAMIE MORGAN, AMERICAN HEART ASSOCIATION, SACRAMENTO (via
teleconference), expressed the American Heart Association's
support of SB 87. She communicated that critical congenital
heart defects left untreated can cause death. Research had
proven that expanded use of oximetry screening could detect
90 percent of all defects. Early screening reduced
congenital heart defect hospital costs that amounted to
$2.5 billion each year. She remarked that screening would
save Alaskan babies lives born with congenital heart
defects.
Co-Chair Meyer CLOSED public testimony.
Vice-Chair Fairclough MOVED to REPORT SB 87 out of
committee with individual recommendations and the
accompanying fiscal note.
CSSB 87(HSS) was REPORTED out of committee with a "do pass"
recommendation and with previously published zero fiscal
note: FN1 (DHS).
9:54:26 AM
AT EASE
9:58:02 AM
RECONVENED