HOUSE BILL NO. 109 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. 4:14:12 PM Co-Chair Meyer inquired about the Department of Health & Social Services fiscal note. STEPHANIE BIRCH, SECTION CHIEF, WOMEN'S, CHILDREN'S AND FAMILY HEALTH CARE SERVICES, DIVISION OF PUBLIC HEALTH, DEPARTMENT OF HEALTH & SOCIAL SERVICES, explained that the finance portion of the bill would change in 2008. The Division has been successful in the last four years by being awarded two federal grants; however, the second grant is scheduled to expire in 2008. The half time positions funded uses federal grant money and would be lost. The program manager runs the program that tracks all newborns, which is mandated by the State. Co-Chair Meyer referenced Page 2 of the fiscal note. Ms. Birch clarified where those funds would pay for the early intervention programs and would primarily be treatment services. The Early Intervention Program has a newborn hearing screening service for children needing hearing support services. Co-Chair Meyer asked about the half-time position and if it would be picked up by the State general fund. 4:18:16 PM In response to Vice-Chair Stoltze, Ms. Birch explained that the newborn screening program has been in effect since 1998 in many hospitals. At present time, 23 communities have that screening equipment in their hospitals. Through federal funding, the Division purchased additional equipment for nine communities. The screening test prices range between $20 and $40 dollars and no money is paid to providers. The federal grants provided equipment and training. 4:19:52 PM Representative Hawker indicated his confusion with the fiscal note, the language regarding that "public record and requiring a "reporting and surveillance system for tracking all newborns". He questioned that choice of words, recommending that the verbiage be revised. 4:21:57 PM REPRESENTATIVE JAY RAMRAS, SPONSOR, shared concerns with personal privacy issues. He understood that the legislation would provide statistical tracking of the number of newborns needing services for congenital birth defects. He assured members that the intent was not to use surveillance. Ms. Birch interjected that the word "surveillance" is used as a public health term and is one of the four functions of public health. The intention is to determine how large the statewide problem is by having a methodology. 4:24:42 PM Representative Hawker pointed out an additional provision in the bill, which could solve some problems. The Department proposed that Subsection G be deleted and asked if that had happened. Ms. Birch replied that in the House Labor and Commerce version, on Page 5, Lines 15-19, there was wording in the original bill, discussing how the Department would track any newborns needing financial support. She clarified that the payment methodology was established in a recently revised Medicaid manual. It would not be feasible for the Department to take on the reimbursement costs to the hospitals. Representative Hawker asked if Subsection G had been eliminated from the bill. Ms. Birch affirmed. 4:26:47 PM Representative Hawker suggested that the fiscal note should indicate removal of that language. Co-Chair Meyer requested a more detailed budget outline starting with FY08. 4:27:35 PM Representative Holm asked if there would there be savings at some point, noting it was not indicated in the fiscal note. 4:29:02 PM Representative Ramras appreciated the remarks. He stated that if the birth defect condition were caught early, the State would be able to mitigate some hearing loss to diminish the severity and cognitive development of the young child. By the time the child hits school age, they become a problem of the State of Alaska through one mechanism or another. He believed that there would be a positive fiscal note showing savings to the State at some point. 4:30:40 PM Ms. Birch advised that it had not been reflected in the fiscal note, however, she had looked at Medicaid claims for children who had received treatment in FY03 and FY04. There were a total of 946 recipients with an average cost of $582 dollars each. The number compares to about $760 dollars each in FY02. The preliminary review indicates that if caught early, treatment dollars required for these children would decrease. Representative Holm thought that information should be reflected in the fiscal note. Representative Ramras commented that they could work on that as the bill makes its way to the other body. 4:33:16 PM Vice-Chair Stoltze suggested the note indicate indeterminate. Representative Hawker referenced Page 5, Lines 12-19, stating that the parent could opt out of the procedure if it conflicts with a religious tenet of that family. He warned that language could deny a parent the right to object on grounds other than religious. 4:34:59 PM Representative Ramras stated there was no disagreement in modifying that language. The verbiage was lifted from regulations in the Newborn Metabolic Screening. Representative Hawker MOVED to ADOPT conceptual Amendment #1, Page 5, Line 15, following "religious" adding language "or other". There being NO OBJECTION, it was adopted. Representative Foster MOVED to report HB 109 out of Committee with individual recommendations and with the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. CS HB 109 (FIN) was reported out of Committee with a "do pass" recommendation and with a new fiscal note by the Department of Health & Social Services, a new indeterminate note by the Department of Education & Early Development and a new zero note by the Department of Commerce, Community & Economic Development. 4:37:00 PM