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To amend sections 3701.503, 3701.504, 3701.505, | 1 |
3701.506, 3701.507, 3923.55, and 3923.56 and to | 2 |
enact sections 3701.508 and 3701.509 of the Revised | 3 |
Code to require universal hearing screening for | 4 |
newborns and infants. | 5 |
Section 1. That sections 3701.503, 3701.504, 3701.505, | 6 |
3701.506, 3701.507, 3923.55, and 3923.56 be amended and sections | 7 |
3701.508 and 3705.509 of the Revised Code be enacted to read as | 8 |
follows: | 9 |
Sec. 3701.503. As used in sections 3701.504 to
| 10 |
3701.509 of the Revised Code: | 11 |
(A) "Parent" means either parent, unless the parents are | 12 |
separated or divorced or their marriage has been dissolved or | 13 |
annulled, in which case "parent" means the parent who is the | 14 |
residential parent and legal custodian. | 15 |
(B) "Guardian" has the same meaning as in section 2111.01 of | 16 |
the Revised Code. | 17 |
(C) "Custodian" means, except as used in division (A) of | 18 |
this section, a government agency or an individual, other than the | 19 |
parent or guardian, with legal or permanent custody of a child as | 20 |
defined in section 2151.011 of the Revised Code. | 21 |
(D)
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newborns and infants
who
| 27 |
impairment,
through
the use of
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30 |
| 31 |
through
the use
of audiological
procedures by
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(F) "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 |
(G) "Newborn" means a child who is less than thirty days | 39 |
old. | 40 |
(H) "Infant" means a child who is at least thirty days but | 41 |
less than twenty-four months old. | 42 |
(I) "Freestanding birthing center" has the same meaning as | 43 |
in section 3702.51 of the Revised Code. | 44 |
(J) "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 |
(K) "Audiologist" means an individual authorized under | 48 |
section 4753.07 of the Revised Code to practice audiology. | 49 |
(L) "Hospital" means a hospital that has a maternity unit or | 50 |
newborn nursery. | 51 |
(M) "Maternity unit" means any unit or place in a hospital | 52 |
where women are regularly received and provided care during all or | 53 |
part of the maternity cycle, except that "maternity unit" does not | 54 |
include an emergency department or similar place dedicated to | 55 |
providing emergency health care. | 56 |
(N) "Board of health" means the board of health of a city or | 57 |
general health district or the authority having the duties of a | 58 |
board of health under section 3709.05 of the Revised Code. | 59 |
Sec. 3701.504. (A) The department of health shall establish | 60 |
and maintain
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screening, tracking, and early intervention program to identify | 63 |
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The department shall also establish appropriate protocols for the | 65 |
treatment and follow-up care of newborns and infants with hearing | 66 |
impairment. | 67 |
(B)
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born in a hospital or freestanding birthing center, both of the | 74 |
following apply: | 75 |
(1) The program shall provide for a hearing screening of the | 76 |
newborn or infant before discharge, unless the newborn or infant | 77 |
is being transferred to another hospital. | 78 |
(2) If the newborn or infant is transferred to another | 79 |
hospital, the program shall provide for a hearing screening of the | 80 |
newborn or infant
when determined to be medically appropriate.
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(C) The
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established under this section is incorporated into early | 90 |
intervention activities of the department in compliance with the | 91 |
"Individuals with Disabilities Education Act," 20 U.S.C.A. 1400 et | 92 |
seq. | 93 |
(D) The department of health may assist hospitals and | 94 |
freestanding birthing centers in acquiring hearing screening | 95 |
equipment by providing information on grant opportunities or | 96 |
loans, and, if funds are available, by mass purchasing equipment | 97 |
or establishing a grant system with department funds. | 98 |
(E) The department of health shall administer the program | 99 |
established under this section pursuant to rules adopted under | 100 |
section 3701.508 of the Revised Code. | 101 |
Sec. 3701.505. (A)(1) Each hospital and each freestanding | 102 |
birthing center | 103 |
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(a) Conduct a hearing
screening
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the newborn or infant is transferred to another hospital; | 108 |
(b) Promptly notify
| 109 |
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(c) Notify the
department of health of the
| 111 |
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115 | |
guardian, or custodianscreening results for each newborn or | 116 |
infant screened. | 117 |
(2) A hearing screening conducted under this section shall | 118 |
be conducted under the direction of an audiologist or physician or | 119 |
in collaboration with a physician. Notwithstanding the licensure | 120 |
requirements of Chapter 4753. of the Revised Code, a screening may | 121 |
be conducted by a person who is not licensed under that chapter. | 122 |
(3) Each hospital and freestanding birthing center shall take | 123 |
the actions required by divisions (A)(1) and (2) of this section | 124 |
in accordance with the rules adopted under section 3701.508 of the | 125 |
Revised Code. A hospital or freestanding birthing center may | 126 |
commence taking these actions at any time after the effective date | 127 |
of the rules but not later than June 30, 2004, unless an extension | 128 |
is granted. The director may grant an extension to delay for up | 129 |
to one year after June 30, 2004, the requirement of compliance | 130 |
with the rules if the hospital or freestanding birthing center | 131 |
requesting the extension demonstrates justifiable cause for the | 132 |
extension. Justifiable cause may include having ordered but not | 133 |
yet received hearing screening equipment, ongoing efforts to | 134 |
obtain financing for the equipment, or any other cause accepted by | 135 |
the director. | 136 |
(B) | 137 |
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birthing center providing a
hearing
| 158 |
accordance with division
| 159 |
reimbursed by the department of health at a rate determined by the | 160 |
director of health, if both of the following are the case: | 161 |
(1) The
| 162 |
or infant
| 163 |
hospital or freestanding birthing center. | 164 |
(2) The parent, guardian, or custodian is financially unable | 165 |
to pay for the hearing
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reimbursed by a third-party payer as determined pursuant to rules | 168 |
adopted under section 3701.508 of the Revised Code. | 169 |
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(C) A hospital, clinic, or other health care facility at | 174 |
which a hearing evaluation is performed on a newborn or infant | 175 |
shall report the results of the evaluation to the attending | 176 |
physician of the newborn or infant. | 177 |
Sec. 3701.506. The department of health shall prepare and | 178 |
distribute to all hospitals and freestanding birthing centers | 179 |
required to provide
| 180 |
program established under section 3701.504 of the Revised Code and | 181 |
each board of health, information describing factors or conditions | 182 |
of hearing loss and the effect of such a loss on an infant or | 183 |
child's language development, and information on the importance of | 184 |
hearing screening, hearing evaluation, early intervention, and | 185 |
follow-up care for newborns and infants. This information shall | 186 |
be updated
as the department determines necessary.
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Each hospital or freestanding birthing center shall provide | 189 |
the
| 190 |
infant born in the hospital or freestanding birthing center with | 191 |
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pursuant to this section. | 193 |
Each board of health shall provide the parent, guardian, or | 194 |
custodian of each newborn or infant born in the area served by the | 195 |
board who is not born in a hospital or freestanding birthing | 196 |
center with the information prepared by the department pursuant to | 197 |
this section. | 198 |
Sec. 3701.507. (A) To assist in implementing sections | 199 |
3701.503 to
| 200 |
handicapped children's medical advisory council created in section | 201 |
3701.025 of the Revised Code shall appoint a permanent infant | 202 |
hearing screening subcommittee. The subcommittee shall consist of | 203 |
the following members: | 204 |
(1) One otolaryngologist; | 205 |
(2) One neonatologist; | 206 |
(3) One pediatrician; | 207 |
(4) One neurologist; | 208 |
(5) One hospital administrator; | 209 |
(6)
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(7) One
| 213 |
section 4753.07 of the Revised Code; | 214 |
(8)
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hearing-impaired child; | 216 |
(9) One geneticist; | 217 |
(10) One epidemiologist; | 218 |
(11) One adult who is deaf or hearing impaired; | 219 |
(12) One representative from an organization for the deaf or | 220 |
hearing impaired; | 221 |
(13) One family advocate; | 222 |
(14) One nurse from a well-baby neonatal nursery; | 223 |
(15) One nurse from a special care neonatal nursery; | 224 |
(16) One teacher of the deaf who works with infants and | 225 |
toddlers; | 226 |
(17) One representative of the health insurance industry; | 227 |
(18) One representative of the bureau for children with | 228 |
medical handicaps; | 229 |
(19) One representative of the department of education; | 230 |
(20) One representative of the Ohio department of job and | 231 |
family services who has responsibilities regarding medicaid; | 232 |
(21) Any other person the advisory council appoints. | 233 |
(B) The infant hearing subcommittee shall: | 234 |
(1) Consult with the director of health regarding the | 235 |
administration of sections 3701.503 to
| 236 |
Revised Code; | 237 |
(2) Advise and make recommendations regarding proposed rules | 238 |
prior to their adoption by the public health council under section | 239 |
240 |
(3) Consult with the director of health and advise and make | 241 |
recommendations regarding program development and implementation | 242 |
under sections 3701.503 to
| 243 |
including
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246 |
(a) Establishment under section 3701.504 of the Revised Code | 247 |
of the statewide hearing screening, tracking, and early | 248 |
intervention program to identify newborn and infant hearing | 249 |
impairment;
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(b)Identification of locations where
| 251 |
hearing evaluations may be conducted;
| 252 |
(c)Recommendations for methods and
techniques of
| 253 |
hearing screening and hearing
| 254 |
(d)Referral, data recording and compilation, and procedures | 255 |
to encourage
follow-up hearing
| 256 |
(e)Maintenance of a register of newborns and infants | 257 |
258 | |
pass the hearing screening;
| 259 |
(f) Preparation of the information required by section | 260 |
3701.506 of the Revised Code and any other information the public | 261 |
health council requires the department of health to provide. | 262 |
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Sec. 3701.508. (A) The public health council shall adopt | 269 |
rules governing the statewide hearing screening, tracking, and | 270 |
early intervention program established under section 3701.504 of | 271 |
the Revised Code, including rules that do all of the following: | 272 |
(1) Specify how hospitals and freestanding birthing centers | 273 |
are to comply with the requirements of section 3701.505 of the | 274 |
Revised Code, including methods to be used for hearing screening, | 275 |
except that with regard to the physiologic equipment to be used | 276 |
for hearing screening, the rules may require only that the | 277 |
equipment be capable of giving reliable results and may not | 278 |
specify particular equipment or a particular type of equipment; | 279 |
(2) Provide that no newborn or infant shall be required to | 280 |
undergo a hearing screening if the parent, guardian, or custodian | 281 |
of the newborn or infant objects on the grounds that the screening | 282 |
conflicts with the parent's, guardian's, or custodian's religious | 283 |
tenets and practices; | 284 |
(3) Provide for situations in which the parent, guardian, | 285 |
or custodian of a newborn or infant objects to a hearing screening | 286 |
for reasons other than religious tenets and practices; | 287 |
(4) Specify how the department of health will determine | 288 |
whether a person is financially unable to pay for a hearing | 289 |
screening and define "third-party payer" for the purpose of | 290 |
reimbursement of hearing screening by the department under section | 291 |
3701.505 of the Revised Code; | 292 |
(5) Specify an inexpensive and efficient format and | 293 |
procedures for the submission of hearing screening information | 294 |
from hospitals and freestanding birthing centers to the department | 295 |
of health; | 296 |
(6) Specify a procedure whereby the department may conduct | 297 |
timely reviews of hearing screening information submissions for | 298 |
purposes of quality assurance, training, and disease prevention | 299 |
and control; | 300 |
(7) Specify any additional information that hospitals and | 301 |
freestanding birthing centers are to provide to the medically | 302 |
handicapped children's medical advisory council's infant hearing | 303 |
screening subcommittee under section 3701.509 of the Revised Code. | 304 |
(B) In addition to the rules adopted under division (A) of | 305 |
this section, the council shall adopt rules that specify the | 306 |
training that must be completed by persons who will conduct | 307 |
hearing screenings. In adopting these rules, the council shall | 308 |
consider incorporating cost-saving training methods, including | 309 |
computer-assisted learning and on-site training. Neither the rules | 310 |
nor the director of health may establish a minimum educational | 311 |
level for persons conducting hearing screenings. | 312 |
(C) All rules adopted under this section shall be adopted in | 313 |
accordance with Chapter 119. of the Revised Code and shall be | 314 |
adopted so as to take effect not later than six months after the | 315 |
effective date of this section. | 316 |
Sec. 3701.509. (A) The department of health shall develop a | 317 |
mechanism to analyze and interpret the hearing screening | 318 |
information to be reported under division (B) of this section. | 319 |
The department shall notify all hospitals and freestanding | 320 |
birthing centers subject to the reporting requirements of the date | 321 |
the department anticipates that the mechanism will be complete. | 322 |
After the mechanism is complete, the department shall notify each | 323 |
hospital and freestanding birthing center subject to the reporting | 324 |
requirement of the date by which the hospital or center must | 325 |
submit its first report. | 326 |
(B) Subject to division (A) of this section and in accordance | 327 |
with rules adopted by the public health council under section | 328 |
3701.508 of the Revised Code, each hospital and freestanding | 329 |
birthing center that has conducted a hearing screening required by | 330 |
section 3701.505 of the Revised Code shall provide to the | 331 |
department of health for use by the medically handicapped | 332 |
children's medical advisory council's infant hearing screening | 333 |
subcommittee information specifying all of the following: | 334 |
(1) The number of newborns born in the hospital or | 335 |
freestanding birthing center and the number of newborns and | 336 |
infants not screened because they were transferred to another | 337 |
hospital; | 338 |
(2) The number of newborns and infants referred to the | 339 |
hospital or freestanding birthing center for a hearing screening | 340 |
and the number of those newborns and infants who received a | 341 |
hearing screening; | 342 |
(3) The number of newborns and infants who did not pass the | 343 |
hearing screenings conducted by the hospital or freestanding | 344 |
birthing center; | 345 |
(4) Any other information concerning the program established | 346 |
under section 3701.504 of the Revised Code. | 347 |
(C) The department of health shall conduct a timely review of | 348 |
the information submitted by hospitals and freestanding birthing | 349 |
centers in accordance with rules adopted by the public health | 350 |
council under section 3701.508 of the Revised Code. | 351 |
(D) The infant hearing screening subcommittee, with the | 352 |
support of the department of health, shall compile and summarize | 353 |
the information submitted to the department by hospitals and | 354 |
freestanding birthing centers under division (B) of this section. | 355 |
Beginning with the first year after the mechanism developed under | 356 |
division (A) of this section is complete, the subcommittee shall | 357 |
annually prepare and transmit a report to the director of health, | 358 |
the speaker of the house of representatives, and the president of | 359 |
the senate. The council shall make the report available to the | 360 |
public. | 361 |
(E) The department and all members of the subcommittee shall | 362 |
maintain the confidentiality of patient-identifying information | 363 |
submitted under division (B) of this section and section 3701.505 | 364 |
of the Revised Code. The information is not a public record under | 365 |
section 149.43 of the Revised Code, except to the extent that the | 366 |
information is used in preparing reports under this section. | 367 |
Nothing in this division prohibits the department from | 368 |
providing patient-identifying information to other entities as it | 369 |
considers necessary to implement the statewide tracking and early | 370 |
intervention components of the program established under section | 371 |
3701.504 of the Revised Code. Any entity that receives | 372 |
patient-identifying information from the department shall maintain | 373 |
the confidentiality of the information. | 374 |
Sec. 3923.55. (A) As used in this section and section | 376 |
3923.56 of the Revised Code: | 377 |
(1) "Child health supervision services" means periodic | 378 |
review of a child's physical and emotional status performed by a | 379 |
physician
| 380 |
of a physician, or, in the case of hearing screening, by an | 381 |
individual acting in accordance with section 3701.505 of the | 382 |
Revised Code. | 383 |
(2) "Periodic review" means a review performed in accordance | 384 |
with the recommendations of the American academy of pediatrics and | 385 |
includes a history, complete physical examination, developmental | 386 |
assessment, anticipatory guidance, appropriate immunizations, and | 387 |
laboratory tests. | 388 |
(3) "Physician" means a person authorized under Chapter | 389 |
4731. of the Revised Code to practice medicine and surgery or | 390 |
osteopathic medicine and surgery. | 391 |
(B) Notwithstanding section 3901.71 of the Revised Code, | 392 |
each policy of individual or group sickness and accident insurance | 393 |
delivered, issued for delivery, or renewed in this state on or | 394 |
after the effective date of this amendment, that provides coverage | 395 |
for family members of the insured shall provide, with respect to | 396 |
that coverage, that any benefits applicable for children shall | 397 |
include benefits for child health supervision services from the | 398 |
moment of birth until age nine. | 399 |
(C) A policy that provides the benefits described in | 400 |
division (B) of this section may limit the benefits to cover only | 401 |
the expenses of child health supervision services that are | 402 |
performed by one physician or by a health care professional under | 403 |
the supervision of one physician during the course of any one | 404 |
visit. | 405 |
(D) Copayments and deductibles shall be reasonable and shall | 406 |
not be a barrier to the necessary utilization of child health | 407 |
supervision services by covered persons. | 408 |
(E) Benefits for child health supervision services that are | 409 |
provided to a child during the period from birth to age one shall | 410 |
not exceed a maximum limit of five hundred dollars, including | 411 |
benefits for the hearing screening required by the program | 412 |
established under section 3701.504 of the Revised Code. The | 413 |
benefits for the hearing screening shall not exceed a maximum | 414 |
limit of seventy-five dollars. Benefits for child health | 415 |
supervision services that are provided to a child during any year | 416 |
thereafter shall not exceed a maximum limit of one hundred fifty | 417 |
dollars per year. | 418 |
(F) This section does not apply to any policy that provides | 419 |
coverage for specific diseases or accidents only, or to any | 420 |
hospital indemnity, medicare supplement, or other policy that | 421 |
offers only supplemental benefits. | 422 |
Sec. 3923.56. (A) Notwithstanding section 3901.71 of the | 423 |
Revised Code, each employee benefit plan established or maintained | 424 |
in this state on or after the effective date of this amendment | 425 |
that provides coverage for family members of the employee shall | 426 |
provide, with respect to that coverage, that any benefits | 427 |
applicable for children shall include benefits for child health | 428 |
supervision services from the moment of birth until age nine. | 429 |
(B) A plan that provides the benefits described in division | 430 |
(A) of this section may limit the benefits to cover only the | 431 |
expenses of child health supervision services that are performed | 432 |
by one physician or by a health care professional under the | 433 |
supervision of one physician during the course of any one visit. | 434 |
(C) Copayments and deductibles shall be reasonable and shall | 435 |
not be a barrier to the necessary utilization of child health | 436 |
supervision services by covered persons. | 437 |
(D) Benefits for child health supervision services that are | 438 |
provided to a child during the period from birth to age one shall | 439 |
not exceed a maximum limit of five hundred dollars, including | 440 |
benefits for the hearing screening required by the program | 441 |
established under section 3701.504 of the Revised Code. The | 442 |
benefits for the hearing screening shall not exceed a maximum | 443 |
limit of seventy-five dollars. Benefits for child health | 444 |
supervision services that are provided to a child during any year | 445 |
thereafter shall not exceed a maximum limit of one hundred fifty | 446 |
dollars per year. | 447 |
Section 2. That existing sections 3701.503, 3701.504, | 448 |
3701.505, 3701.506, 3701.507, 3923.55, and 3923.56 of the Revised | 449 |
Code are hereby repealed. | 450 |
Section 3. A hospital shall continue to comply with the risk | 451 |
screening requirements of section 3701.505 of the Revised Code in | 452 |
effect prior to the effective date of this act until the hospital | 453 |
complies or is required to comply with the rules adopted under | 454 |
section 3701.508 of the Revised Code. A hospital or freestanding | 455 |
birthing center is not required to comply with the risk screening | 456 |
requirements in effect prior to the effective date of this act | 457 |
after the hospital or center commences compliance with the rules. | 458 |