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, Sullivan, R. Miller, Jolivette, Fessler, Evans, Hagan, Strahorn, Peterson, Kilbane, Metzger, Seitz, Flannery, Coates, Schmidt, White, Setzer, Sykes, Latell, Rhine, Widowfield, G. Smith, Lendrum, Olman, Krupinski, Clancy, Key, Niehaus, Hoops, Salerno, Wilson, Faber, Driehaus, Oakar, Beatty, Jones

To amend sections 3701.503, 3701.504, 3701.505,

1

3701.506, and 3701.507 and to enact sections

2

3701.508 and 3701.509 of the Revised Code to

3

require universal hearing screening for newborns

4

and infants.

5

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

Section 1.  That sections 3701.503, 3701.504, 3701.505,	6
3701.506, and 3701.507 be amended and sections 3701.508 and	7
3705.509 of the Revised Code be enacted to read as follows:	8

Sec. 3701.503.  As used in sections 3701.504 to 3701.507	9
3701.509 of the Revised Code:	10

(A) "Parent" means either parent, unless the parents are	11
separated or divorced or their marriage has been dissolved or	12
annulled, in which case "parent" means the parent who is the	13
residential parent and legal custodian.	14

(B) "Guardian" has the same meaning as in section 2111.01 of	15
the Revised Code.	16

(C) "Custodian" means, except as used in division (A) of	17
this section, a government agency or an individual, other than the	18
parent or guardian, with legal or permanent custody of a child as	19
defined in section 2151.011 of the Revised Code.	20

(D) "Address," in the case of an individual, means the	21
individual's residence and, in the case of a government agency,	22
means the office at which the records pertaining to a particular	23
childnewborn or infant are maintained.	24

(E) "RiskHearing screening" means the identification of	25
newborns and infants who are at risk ofmay have a hearing	26
impairment, through the use of a high-risk questionnaire developed	27
by the department of health under division (A) of section 3701.504	28
of the Revised Codea physiologic test performed under the	29
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 a program to be	59
administered by the department of health that requires risk(1)	60
The program shall include a hearing screening of each infant or	61
newborn born in a hospital nursery to determine if the infant	62
meets the hearing-impairment risk criteria established by the	63
department of health under division (A) of this sectionor	64
freestanding birthing center before discharge, unless the infant	65
or newborn is transferred to another hospital.	66

(2) If an infant or newborn is transferred to another	67
hospital before a hearing screening is conducted, the program	68
shall provide for a hearing screening of that infant or newborn	69
when determined to be medically stable.	70

(3) In the case of a newborn not born in or admitted to a	71
hospital from the hospital or center in which the newborn or	72
infant was born, or freestanding birthing center, the program	73
shall provide for a hearing screening before the newborn is thirty	74
days old. The rules adopted under this division shall include a	75
provision that no infant shall be required to undergo risk	76
screening if the infant's parent, guardian, or custodian, if an	77
individual, objects on the grounds that the screening conflicts	78
with his religious tenets and practices.	79

(C) The public health council shall adopt, and may amend or	80
rescind, rules to carry out the purposes of sections 3701.503 to	81
3701.507 of the Revised Code.	82

(B) The department of health shall ensure that the program	83
established under this section is incorporated into early	84
intervention activities of the department in compliance with the	85
"Individuals with Disabilities Education Act," 20 U.S.C.A. 1400 et	86
seq.	87

(C) The department of health shall administer the program	88
established under this section pursuant to rules adopted under	89
section 3701.508 of the Revised Code.	90

Sec. 3701.505.  (A)(1) Each hospital and each freestanding	91
birthing center, in accordance with rules adopted by the public	92
health council under section 3701.504 of the Revised Code, shall	93
provide riskdo all of the following:	94

(a) Conduct a hearing screening ofoneach newborn infants	95
and shall promptlyor infant born in the hospital or center unless	96
the newborn or infant is transferred to another hospital;	97

(b) Conduct a hearing screening on each newborn or infant	98
transferred to the hospital from the hospital or center in which	99
the newborn or infant was born, if the newborn or infant was	100
transferred before a hearing screening was conducted;	101

(c) Inform the parent, guardian, or custodian of the newborn	102
or infant about the screening results and provide a written report	103
of the screening results;	104

(d) Promptly notify anthe newborn's or infant's primary	105
care physician andof the screening results;	106

(e) Notify the department of health of the name of any	107
infant who is identified by a risk screening as at risk for	108
hearing impairment under the criteria established by the	109
department of health under division (A) of section 3701.504 of the	110
Revised Code, and of the name and address of the infant's parent,	111
guardian, or custodianscreening results for each newborn or	112
infant screened.	113

(2) Not later than one year after the rules adopted by the	114
public health council under section 3701.508 of the Revised Code	115
take effect, each hospital and freestanding birthing center shall	116
begin taking the actions required by division (A)(1) of this	117
section in accordance with the rules. The hospital or	118
freestanding birthing center shall continue to take the actions in	119
accordance with the rules thereafter.	120

(B)(1) If an infant is identified as at risk for hearing	121
impairment and the hospital at which the identification was made	122
also provides hearing assessment, the hospital shall provide a	123
hearing assessment for the infant; if the hospital does not	124
provide hearing assessmentor newborn does not pass the hearing	125
screening, the hospital or freestanding birthing center shall	126
provide the newborn's or infant's parent, guardian, or custodian	127
with a list of hospitals, clinics, or other facilities located	128
within a reasonable distance of the parent's, guardian's, or	129
custodian's address that provide hearing assessmentevaluations	130
for newborns, infants, and toddlers.	131

(2) Each hospital that provides a hearing assessment shall	132
prepare and provide to the infant's parent, guardian, or	133
custodian a list of hospitals, clinics, or other facilities	134
located within a reasonable distance of the parent's, guardian's,	135
or custodian's address that provide follow-up hearing evaluations.	136

(3) Whenever a hearing assessment identifies an infant as	137
being hearing impaired, the hospital, clinic, or other facility	138
providing the assessment shall promptly notify the infant's	139
primary care physician and the department of health of the	140
infant's name and the name and address of the infant's parent,	141
guardian, or custodianA hospital, clinic, or other facility	142
performing the hearing evaluation on a newborn or infant shall	143
report the results of the evaluation to the newborn's or infant's	144
parent, guardian, or custodian, primary care physician, and the	145
department of health.	146

(C) Any hospital, clinic, or other facilityfreestanding	147
birthing center providing a hearing assessmentscreening in	148
accordance with division (B)(A) of this section shall be	149
reimbursed by the department of health at a rate determined by the	150
director of health, if both of the following are the case:	151

(1) The assessmentscreening is performed before the newborn	152
or infant attains nine months of age;is discharged from the	153
hospital or freestanding birthing center, or in the case of a	154
newborn not born in or admitted to a hospital or freestanding	155
birthing center, before the newborn is thirty days old.	156

(2) The parent, guardian, or custodian is financially unable	157
to pay for the hearing assessmentscreening and the hospital,	158
clinic, or other facilityfreestanding birthing center is not	159
reimbursed by a third-party payer as determined pursuant to rules	160
adopted under section 3701.508 of the Revised Code.	161

The public health council shall adopt rules pursuant to	162
Chapter 119. of the Revised Code for determining whether a person	163
is financially unable to pay for a hearing assessment and defining	164
third-party payer for the purpose of this section.	165

Sec. 3701.506.  The department of health shall prepare and	167
distribute to all hospitals and freestanding birthing centers	168
required to provide infant riskhearing screenings under the	169
program established under section 3701.504 of the Revised Code,	170
information describing factors or conditions of hearing loss and	171
the effect of such a loss on an infant or child's language	172
development, and information on the importance of hearing	173
screening, hearing evaluation, early intervention, and follow-up	174
care for newborns and infants. This information shall be updated	175
as the department determines necessary. Upon the discharge of an	176
at-risk newborn infant, each such	177

Each hospital or freestanding birthing center shall provide	178
the infant's parent, guardian, or custodian of each newborn or	179
infant born in the hospital or freestanding birthing center with	180
this hearing lossthe information prepared by the department	181
pursuant to this section.	182

Sec. 3701.507.  (A) To assist in implementing sections	183
3701.503 to 3701.5073701.509 of the Revised Code, the medically	184
handicapped children's medical advisory council created in section	185
3701.025 of the Revised Code shall appoint a permanent infant	186
hearing screening subcommittee. The subcommittee shall consist of	187
the following members:	188

(1) One otolaryngologist;

189

(2) One neonatologist;

190

(3) One pediatrician;

191

(4) One neurologist;

192

(5) One hospital administrator;

193

(6) OneTwo or more audiologists licensed under section	194
4753.07 of the Revised Code who are experienced in infant hearing	195
assessmentscreening and evaluation;	196

(7) One speechspeech-language pathologist licensed under	197
section 4753.07 of the Revised Code;	198

(8) OneTwo persons who are each a parent of a	199
hearing-impaired child;	200

(9) One geneticist;

201

(10) One epidemiologist;

202

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

203

(12) One representative from an organization for the deaf or	204
hearing impaired;	205

(13) One family advocate;

206

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

207

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

208

(16) One teacher of the deaf who works with infants and	209
toddlers;	210

(17) One representative of the health insurance industry;

211

(18) One representative of the bureau for children with	212
medical handicaps;	213

(19) One representative of the department of education;

214

(20) One representative of the Ohio department of job and	215
family services who has responsibilities regarding medicaid;	216

(21) Any other person the advisory council appoints.

217

(B) The infant hearing subcommittee shall:

218

(1) Consult with the director of health regarding the	219
administration of sections 3701.503 to 3701.5073701.509 of the	220
Revised Code;	221

(2) Advise and make recommendations regarding proposed rules	222
prior to their adoption by the public health council under section	223
3701.5043701.508 of the Revised Code;	224

(3) Consult with the director of health and advise and make	225
recommendations regarding program development and implementation	226
under sections 3701.503 to 3701.5073701.509 of the Revised Code,	227
including establishment of newborn infant hearing-impairment risk	228
criteria and development of the high-risk questionnaire under	229
division (A) ofall of the following:	230

(a) Establishment under section 3701.504 of the Revised Code	231
of the statewide hearing screening, tracking, and early	232
intervention program to identify newborn hearing impairment;	233
identification	234

(b)Identification of locations where assessment of infants	235
hearing evaluations may be conducted; recommendations	236

(c)Recommendations for methods and techniques of risk	237
hearing screening and hearing assessmentevaluation; referral	238

(d)Referral, data recording and compilation, and procedures	239
to encourage follow-up hearing assessmentscare; maintenance	240

(e)Maintenance of a register of newborns and infants	241
determined to be at high risk for hearing impairmentwho do not	242
pass the hearing screening; and preparation	243

(f) Preparation of the information required by section	244
3701.506 of the Revised Code and any other information the public	245
health council requires the department of health to provide.	246

(4) Ensure that the infant hearing screening and assessment	247
program established under sections 3701.503 to 3701.507 of the	248
Revised Code is incorporated into early intervention activities of	249
the department of health in compliance with the "Education of the	250
Handicapped Act Amendments of 1986," 100 Stat. 1145, 20 U.S.C.A.	251
1400.	252

Sec. 3701.508. (A) The public health council shall adopt	253
rules in accordance with Chapter 119. of the Revised Code	254
governing the statewide hearing screening, tracking, and early	255
intervention program established under section 3701.504 of the	256
Revised Code, including rules that do all of the following:	257

(1) Specify how hospitals and freestanding birthing centers	258
are to comply with the requirements of section 3701.505 of the	259
Revised Code, including methods and devices to be used for hearing	260
screening.	261

(2) Provide that no infant or newborn shall be required to	262
undergo a hearing screening if the parent, guardian, or custodian	263
of the infant or newborn objects on the grounds that the screening	264
conflicts with the parent's, guardian's, or custodian's religious	265
tenets and practices;	266

(3) Specify how the department of health will determine	267
whether a person is financially unable to pay for a hearing	268
screening and define "third-party payer" for the purpose of	269
reimbursement of hearing screening by the department under section	270
3701.505 of the Revised Code.	271

(4) Specify any additional information that hospitals and	272
freestanding birthing centers are to provide to the medically	273
handicapped children's medical advisory council's infant hearing	274
screening subcommittee under section 3701.509 of the Revised Code.	275

(B) The rules shall be adopted so as to take effect not	276
later than six months after the effective date of this section.	277

Sec. 3701.509.  (A) Not later than the first day of each	278
November, each hospital and freestanding birthing center that has	279
conducted a hearing screening required by section 3701.505 of the	280
Revised Code shall provide to the department of health for use by	281
the medically handicapped children's medical advisory council's	282
infant hearing screening subcommittee information specifying all	283
of the following for the preceding year:	284

(1) The number of newborns born in the hospital or	285
freestanding birthing center;	286

(2) The number and percentage of newborns and infants born	287
in the hospital or freestanding birthing center who received a	288
hearing screening;	289

(3) The number of newborns and infants born in the hospital	290
or freestanding birthing center whose parents, guardians, or	291
custodians received the information described in section 3701.506	292
of the Revised Code;	293

(4) The number and percentage of newborns and infants born	294
in the hospital or freestanding birthing center who did not pass	295
the hearing screening;	296

(5) The number and percentage of newborns and infants born	297
in the hospital or freestanding birthing facility whose parent,	298
guardian, or custodian was provided with a copy of the list	299
described in division (B)(1) of section 3701.505 of the Revised	300
Code;	301

(6) Any other information concerning the program established	302
under section 3701.504 of the Revised Code.	303

(B) The infant hearing screening subcommittee, with the	304
support of the department of health, shall compile and summarize	305
the information submitted to the subcommittee by hospitals and	306
freestanding birthing centers under division (A) of this section	307
and, beginning with the first year after this section becomes	308
effective, annually prepare and transmit a report to the director	309
of health, the speaker of the house of representatives, and the	310
president of the senate. The council shall make the report	311
available to the public.	312

(C) The department and all members of the subcommittee shall	313
maintain the confidentiality of patient-identifying information	314
submitted under division (A) of this section and section 3701.505	315
of the Revised Code. The information is not a public record under	316
section 149.43 of the Revised Code, except to the extent that the	317
information is used in preparing reports under this section.	318

Section 2.  That existing sections 3701.503, 3701.504,	320
3701.505, 3701.506, and 3701.507 of the Revised Code are hereby	321
repealed.	322