REPRESENTATIVES Schuring, Hollister, Kearns, Womer Benjamin, Willamowski, Goodman, Boccieri, D.  Miller, Redfern, Carmichael, Cirelli, S. Smith, Metelsky, Ford, DePiero, Barrett, Allen, Woodard, Ogg, Barnes, Britton, Young, Patton

To amend sections 3701.503, 3701.504, 3701.505,

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3701.506, and 3701.507 and to enact section

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3701.508 of the Revised Code to require a hearing

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screening for each newborn born in a hospital.

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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1.  That sections 3701.503, 3701.504, 3701.505,	5
3701.506, and 3701.507 be amended and section 3701.508 of the	6
Revised Code be enacted to read as follows:	7

Sec. 3701.503.  As used in sections 3701.504 to 3701.507 of	8
the Revised Code:	9

(A) "Parent" means either parent, unless the parents are	10
separated or divorced or their marriage has been dissolved or	11
annulled, in which case "parent" means the parent who is the	12
residential parent and legal custodian.	13

(B) "Guardian" has the same meaning as in section 2111.01 of	14
the Revised Code.	15

(C) "Custodian" means, except as used in division (A) of	16
this section, a government agency or an individual, other than the	17
parent or guardian, with legal or permanent custody of a child as	18
defined in section 2151.011 of the Revised Code.	19

(D) "Address," in the case of an individual, means the	20
individual's residence and, in the case of a government agency,	21
means the office at which the records pertaining to a particular	22
childnewborn or infant are maintained.	23

(E) "RiskHearing screening" means the identification of	24
newborns and infants who are at risk ofhave a hearing impairment,	25
through the use of a high-risk questionnaire developed by the	26
department of health under division (A) of section 3701.504 of the	27
Revised Codeautomated or diagnostic auditory brainstem response,	28
otoacoustic emissions, or an equivalent physiologic technology	29
performed under the direction of an audiologist or physician.	30

(F) "Hearing assessmentevaluation" means evaluation through	31
the use of audiological procedures by or under the supervision of	32
an audiologist licensed under section 4753.07 of the Revised Code,	33
or by a neurologist or otolaryngologist, to identify infants who	34
are at risk of hearing impairmentphysician.	35

(G) "Hearing impairment" means a loss of hearing in one or	36
both ears in the frequency region important for speech recognition	37
and comprehension.	38

(H) "Newborn" means a child who is less than thirty days	39
old.	40

(I) "Infant" means a child who is at least thirty days but	41
less than twenty-four months old.	42

(J) "Freestanding birthing center" has the same meaning as	43
in section 3702.51 of the Revised Code.	44

(K) "Physician" means an individual authorized under Chapter	45
4731. of the Revised Code to practice medicine and surgery or	46
osteopathic medicine and surgery.	47

(L) "Audiologist" means an individual authorized under	48
section 4753.07 of the Revised Code to practice audiology.	49

Sec. 3701.504.  (A) The department of health shall establish	50
and maintain newborn infant hearing-impairment risk criteria and	51
shall develop a high-risk questionnairea statewide hearing	52
screening, tracking, and early intervention program to identify	53
infants who are at risk ofnewborn and infant hearing impairment.	54
The department shall also establish appropriate protocols for the	55
treatment and follow-up care of newborns and infants with hearing	56
impairment.	57

(B) The public health council shall adopt rules under	58
Chapter 119. of the Revised Code establishing agoverning the	59
program to be administeredestablished by the department of health	60
that requires riskunder this section. The program shall include	61
a hearing screening of each infant or newborn born in a hospital	62
nursery to determine if the infant meets the hearing-impairment	63
risk criteria established by the department of health under	64
division (A) of this sectionor freestanding birthing center	65
before discharge, or in the case of a newborn not born in or	66
admitted to a hospital or freestanding birthing center, before the	67
newborn is thirty days old. The rules adopted under this division	68
shall include a provision that no infant or newborn shall be	69
required to undergo riska hearing screening if the infant's	70
parent, guardian, or custodian, if an individual,of the infant or	71
newborn objects on the grounds that the screening conflicts with	72
histhe parent's, guardian's, or custodian's religious tenets and	73
practices.	74

(C) The public health council shall adopt, and may amend or	75
rescind, rules to carry out the purposes of sections 3701.503 to	76
3701.507 of the Revised Code.	77

(B) The department of health shall insure that the program	78
established under this section is incorporated into early	79
intervention activities of the department in compliance with the	80
"Individuals with Disabilities Education Act," 20 U.S.C.A. 1400 et	81
seq.	82

Sec. 3701.505.  (A) Each hospital and each freestanding	83
birthing center, in accordance with rules adopted by the public	84
health council under section 3701.504 of the Revised Code, shall	85
provide riskdo all of the following:	86

(1) Conduct a hearing screening ofoneach newborn infants	87
and shall promptlyor infant born in the hospital or center;	88

(2) Inform the parent, guardian, or custodian of the newborn	89
or infant about the screening results and provide a written report	90
of the screening results;	91

(3) Promptly notify anthe newborn's or infant's primary	92
care physician andof the screening results;	93

(4) Notify the department of health of the name of any	94
infant who is identified by a risk screening as at risk for	95
hearing impairment under the criteria established by the	96
department of health under division (A) of section 3701.504 of the	97
Revised Code, and of the name and address of the infant's parent,	98
guardian, or custodianscreening results for each newborn or	99
infant screened.	100

(B)(1) If an infant or newborn is identified by a hearing	101
screening as at risk for hearing impairment and the hospital at	102
which the identification was made also provides hearing	103
assessment, the hospital shall provide a hearing assessment for	104
the infant; if the hospital does not provide hearing assessment,	105
the hospital or freestanding birthing center shall provide the	106
newborn's or infant's parent, guardian, or custodian with a list	107
of hospitals, clinics, or other facilities located within a	108
reasonable distance of the parent's, guardian's, or custodian's	109
address that provide hearing assessmentevaluations.	110

(2) Each hospital that provides a hearing assessment shall	111
prepare and provide to the infant's parent, guardian, or	112
custodian a list of hospitals, clinics, or other facilities	113
located within a reasonable distance of the parent's, guardian's,	114
or custodian's address that provide follow-up hearing evaluations.	115

(3) Whenever a hearing assessment identifies an infant as	116
being hearing impaired, the hospital, clinic, or other facility	117
providing the assessment shall promptly notify the infant's	118
primary care physician and the department of health of the	119
infant's name and the name and address of the infant's parent,	120
guardian, or custodian	121

(2) A hospital, clinic, or other facility performing the	122
hearing evaluation on a newborn or infant shall report the results	123
of the evaluation to the newborn's or infant's parent, guardian,	124
or custodian, primary care physician, and the department of	125
health.	126

(C) Any hospital, clinic, or other facilityfreestanding	127
birthing center providing a hearing assessmentscreening in	128
accordance with division (B)(A) of this section shall be	129
reimbursed by the department of health at a rate determined by the	130
director of health, if both of the following are the case:	131

(1) The assessmentscreening is performed before the newborn	132
or infant attains nine months of age;is discharged from the	133
hospital or freestanding birthing center, or in the case of a	134
newborn not born in or admitted to a hospital or freestanding	135
birthing center, before the newborn is thirty days old.	136

(2) The parent, guardian, or custodian is financially unable	137
to pay for the hearing assessmentscreening and the hospital,	138
clinic, or other facilityfreestanding birthing center is not	139
reimbursed by a third-party payer.	140

The public health council shall adopt rules pursuant to	141
Chapter 119. of the Revised Code for determining whether a person	142
is financially unable to pay for a hearing assessmentscreening	143
and defining third-party payer for the purpose of this section.	144

Sec. 3701.506.  The department of health shall prepare and	145
distribute to all hospitals and freestanding birthing centers	146
required to provide infant riskhearing screenings under the	147
program established under section 3701.504 of the Revised Code,	148
information describing factors or conditions of hearing loss and	149
the effect of such a loss on an infant or child's language	150
development, and information on the importance of hearing	151
screening, hearing evaluation, early intervention, and follow-up	152
care for newborns and infants. This information shall be updated	153
as the department determines necessary. Upon the discharge of an	154
at-risk newborn infant, each such	155

Each hospital or freestanding birthing center shall provide	156
the infant's parent, guardian, or custodian of each newborn or	157
infant born in the hospital or freestanding birthing center with	158
this hearing lossthe information prepared by the department	159
pursuant to this section.	160

Sec. 3701.507.  (A) To assist in implementing sections	161
3701.503 to 3701.5073701.508 of the Revised Code, the medically	162
handicapped children's medical advisory council created in section	163
3701.025 of the Revised Code shall appoint a permanent infant	164
hearing screening subcommittee. The subcommittee shall consist of	165
the following members:	166

(1) One otolaryngologist;

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(2) One neonatologist;

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(3) One pediatrician;

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(4) One neurologist;

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(5) One hospital administrator;

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(6) OneTwo or more audiologists licensed under section	172
4753.07 of the Revised Code who are experienced in infant hearing	173
assessment;	174

(7) One speech pathologist licensed under section 4753.07 of	175
the Revised Code;	176

(8) OneTwo persons who are the parent of a hearing-impaired	177
child;	178

(9) One geneticist;

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(10) One epidemiologist;

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(11) One adult who is deaf or hearing impaired;

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(12) One representative from an organization for the deaf or	182
hearing impaired;	183

(13) One family advocate;

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(14) One nurse from a well-baby neonatal nursery;

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(15) One nurse from a special care neonatal nursery;

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(16) One teacher of the deaf who works with infants and	187
toddlers;	188

(17) One representative of the health insurance industry;

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(18) One representative of bureau of children with medical	190
handicaps;	191

(19) One representative of the department of education;

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(20) One representative of the Ohio department of job and	193
family services who has responsibilities regarding medicaid;	194

(21) Any other person the advisory council appoints.

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(B) The infant hearing subcommittee shall:

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(1) Consult with the director of health regarding the	197
administration of sections 3701.503 to 3701.5073701.508 of the	198
Revised Code;	199

(2) Advise and make recommendations regarding proposed rules	200
prior to their adoption by the public health council under section	201
3701.504 of the Revised Code;	202

(3) Consult with the director of health and advise and make	203
recommendations regarding program development and implementation	204
under sections 3701.503 to 3701.5073701.508 of the Revised Code,	205
including establishment of newborn infant hearing-impairment risk	206
criteria and development of the high-risk questionnaire under	207
division (A) ofall of the following:	208

(a) Establishment under section 3701.504 of the Revised Code	209
of the statewide hearing screening, tracking, and early	210
intervention program to identify newborn hearing impairment;	211
identification	212

(b)Identification of locations where assessment of infants	213
hearing evaluations may be conducted; recommendations	214

(c)Recommendations for methods and techniques of risk	215
hearing screening and hearing assessmentevaluation; referral	216

(d)Referral, data recording and compilation, and procedures	217
to encourage follow-up hearing assessmentscare; maintenance	218

(e)Maintenance of a register of newborns and infants	219
determined to be at high risk for hearing impairmentwho do not	220
pass the hearing screening; and preparation	221

(f) Preparation of the information required by section	222
3701.506 of the Revised Code and any other information the public	223
health council requires the department of health to provide.	224

(4) Ensure that the infant hearing screening and assessment	225
program established under sections 3701.503 to 3701.507 of the	226
Revised Code is incorporated into early intervention activities of	227
the department of health in compliance with the "Education of the	228
Handicapped Act Amendments of 1986," 100 Stat. 1145, 20 U.S.C.A.	229
1400.	230

Sec. 3701.508.  (A) Not later than the first day of each	231
November, each hospital and freestanding birthing center shall	232
provide to the department of health for use by the medically	233
handicapped children's medical advisory council's infant hearing	234
screening subcommittee information specifying all of the following	235
for the preceding year:	236

(1) The number of newborns born in the hospital or	237
freestanding birthing center;	238

(2) The number and percentage of newborns born in the	239
hospital or freestanding birthing center who received a hearing	240
screening;	241

(3) The number of newborns born in the hospital or	242
freestanding birthing center whose parents, guardians, or	243
custodians received the information described in section 3701.506	244
of the Revised Code;	245

(4) The number and percentage of newborns born in the	246
hospital or freestanding birthing center who did not pass the	247
hearing screening;	248

(5) The number and percentage of newborns born in the	249
hospital or freestanding birthing facility whose parent, guardian,	250
or custodian was provided with a copy of the list described in	251
division (B)(1) of section 3701.505 of the Revised Code.	252

(B) The infant hearing screening subcommittee shall compile	253
and summarize the information submitted to the subcommittee by	254
hospitals and freestanding birthing centers under division (A) of	255
this section and, beginning with the first year after this section	256
becomes effective, annually prepare and transmit a report to the	257
director of health, the speaker of the house of representatives,	258
and the president of the senate. The council shall make the	259
report available to the public.	260

(C) The department and all members of the subcommittee shall	261
maintain the confidentiality of patient-identifying information	262
submitted under division (A) of this section and section 3701.505	263
of the Revised Code. The information is not a public record under	264
section 149.43 of the Revised Code, except to the extent that the	265
information is used in preparing reports under this section.	266

Section 2.  That existing sections 3701.503, 3701.504,	268
3701.505, 3701.506, and 3701.507 of the Revised Code are hereby	269
repealed.	270