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(124th General Assembly)(Substitute House Bill Number 150)
AN ACT
To amend sections 3701.503, 3701.504, 3701.505,
3701.506, 3701.507, 3923.55, and 3923.56 and to
enact sections
3701.508 and 3701.509 of the
Revised
Code to
require universal hearing
screening for
newborns
and infants.
Be it enacted by the General Assembly of the State of Ohio:
SECTION 1. That sections 3701.503, 3701.504, 3701.505,
3701.506, 3701.507, 3923.55, and 3923.56
be amended and sections
3701.508 and
3705.509 of the
Revised Code be enacted
to read as
follows:
Sec. 3701.503. As used in sections 3701.504 to
3701.507
3701.509 of
the Revised Code: (A) "Parent" means either parent, unless the parents are
separated or divorced or their marriage has been dissolved or
annulled, in which case "parent" means the parent who is the
residential parent and legal custodian. (B) "Guardian" has the same meaning as in section 2111.01
of
the Revised Code. (C) "Custodian" means, except as used in division (A) of
this section, a government agency or an individual, other than
the
parent or guardian, with legal or permanent custody of a
child as
defined in section 2151.011
of the Revised Code. (D)
"Address," in the case of an individual, means the
individual's residence and, in the case of a government agency,
means the office at which the records pertaining to a particular
child are maintained. (E) "Risk
Hearing screening" means the identification of
newborns and infants
who
are at risk of
may have a hearing
impairment,
through
the use of
a
high-risk questionnaire developed
by the
department
of health
under division (A) of section 3701.504
of the
Revised
Code
a physiologic test.
(F)(E) "Hearing
assessment
evaluation" means
evaluation
through
the use
of audiological
procedures by
or under the
supervision of
an
audiologist
licensed
under section 4753.07 of
the Revised
Code,
or
by a neurologist or
otolaryngologist, to
identify infants
who
are
at risk of
hearing impairment
physician.
(F) "Hearing impairment" means a loss of hearing
in one or
both ears in the frequency region important for speech recognition
and comprehension. (G) "Newborn" means a child who is less than thirty days
old. (H) "Infant" means a child who is at least thirty days but
less than twenty-four months old. (I) "Freestanding birthing center" has the same meaning as
in section 3702.51 of the Revised Code. (J) "Physician" means an individual authorized under Chapter
4731. of the Revised Code to practice medicine and surgery or
osteopathic medicine and surgery.
(K) "Audiologist" means an individual authorized under
section 4753.07 of the Revised Code to practice audiology. (L) "Hospital" means a hospital that has a maternity unit or
newborn nursery.
(M) "Maternity unit" means any unit or place in a hospital
where women are regularly received and provided care during all or
part of the maternity cycle, except that "maternity unit" does not
include an emergency department or similar place dedicated to
providing emergency health care. (N) "Board of health" means the board of health of a city or
general health district or the authority having the duties of a
board of health under section 3709.05 of the Revised Code. Sec. 3701.504. (A) The department of health shall
establish
and maintain
newborn infant hearing-impairment risk
criteria and
shall develop a high-risk questionnaire
a statewide
hearing
screening, tracking, and early intervention program to identify
infants
who are at risk of
newborn and infant hearing
impairment.
The department shall also establish appropriate protocols for the
treatment and follow-up care of newborns and infants with hearing
impairment. (B)
The public health council shall adopt rules under
Chapter
119. of the Revised Code
establishing a
program
to be
administered
by the department of health
that
requires risk
screening of each
infant in a hospital
nursery
to
determine if
the infant
meets the
hearing-impairment
risk criteria
established
by the
department of
health under
division (A) of this section
In
the case of a child
born in a hospital or freestanding birthing
center, both of the
following apply: (1) The program shall provide for a hearing screening of the
newborn or infant
before discharge, unless the newborn or infant
is being transferred to another hospital. (2) If the newborn or infant is transferred to another
hospital, the program
shall provide for a hearing screening of the
newborn or infant
when determined to be medically appropriate.
The
rules
adopted under this
division
shall include a
provision
that
no infant shall be
required to undergo
risk
screening if the
infant's
parent, guardian, or custodian,
if an
individual,
objects
on the
grounds that the screening conflicts
with
his religious
tenets and
practices. (C) The
public health council shall adopt, and may amend
or
rescind, rules to carry out the purposes of sections 3701.503
to
3701.507
department of health shall ensure that the program
established under this section is incorporated into early
intervention activities of the department in compliance with the
"Individuals with Disabilities Education Act," 20 U.S.C.A. 1400 et
seq.
(D) The department of health may assist hospitals and
freestanding birthing centers in acquiring hearing screening
equipment by providing information on grant opportunities or
loans, and, if funds are available, by mass purchasing
equipment
or establishing a grant system with department funds.
(E)
The department of health shall administer the program
established under this section pursuant to rules adopted under
section 3701.508 of the Revised Code. Sec. 3701.505. (A)(1) Each hospital
and each freestanding
birthing center, in accordance with
rules
adopted by the public
health council under section
3701.504
of the
Revised
Code, shall
provide risk
do all of the following: (a) Conduct a hearing
screening
of
on
each newborn
infants
and shall promptly
or infant born in the hospital or center unless
the newborn or infant is transferred to another hospital; (b) Promptly notify
an
the newborn's or infant's
primary
care
attending physician
and
of the screening results; (c) Notify the
department of health of the
name of any
infant
who is
identified by a risk screening as at risk for
hearing
impairment under the criteria established by the
department of
health under division (A) of section 3701.504 of the
Revised
Code, and of the name and address of the
infant's
parent,
guardian, or custodian
screening results for each newborn or
infant screened. (2) A hearing screening conducted under this section shall
be conducted under the direction of an audiologist or physician or
in collaboration with a physician.
Notwithstanding the licensure
requirements of Chapter 4753. of the
Revised Code, a screening may
be conducted by a person who is not
licensed under that chapter. (3) Each hospital and freestanding
birthing center shall take
the actions required by divisions
(A)(1)
and (2) of this
section
in accordance with the rules
adopted under
section 3701.508 of the
Revised Code. A hospital or freestanding birthing center may
commence taking these actions at any time after the effective date
of the rules but not later than June 30, 2004, unless an extension
is granted. The director
may grant an
extension to delay for up
to one year after June 30,
2004, the
requirement of compliance
with the rules if the hospital
or
freestanding birthing center
requesting the extension
demonstrates
justifiable cause for the
extension. Justifiable
cause may
include having ordered but not
yet received hearing
screening
equipment, ongoing efforts to
obtain financing for the
equipment,
or any other cause accepted by
the director. (B)(1)
If an infant
is identified as at risk for
hearing
impairment
and the
hospital at
which the identification was made
also provides hearing
assessment, the hospital shall provide a
hearing assessment for
the infant; if the hospital
does not
provide hearing assessment,
the hospital shall
provide the
infant's parent,
guardian, or custodian
with a list
of
hospitals,
clinics, or other
facilities located
within a
reasonable distance
of the parent's,
guardian's, or
custodian's
address that provide
hearing
assessment. (2)
Each hospital that provides a
hearing assessment
shall
prepare and provide to the infant's parent,
guardian, or
custodian a list of hospitals,
clinics, or other facilities
located within a reasonable distance
of the parent's, guardian's,
or custodian's address that provide
follow-up hearing
evaluations.
(3) Whenever a hearing assessment identifies an infant
as
being hearing impaired, the hospital, clinic, or other facility
providing the assessment shall promptly notify the infant's
primary care physician and the department of health of the
infant's name and the name and address of the
infant's parent,
guardian, or custodian.
(C) Any hospital, clinic, or
other facility
freestanding
birthing center providing a
hearing
assessment
screening in
accordance with division
(B)(A) of this
section
shall be
reimbursed by the department of health at a rate
determined by the
director of health, if both of the following
are
the case:
(1) The
assessment
screening is performed before the
newborn
or infant
attains
nine months of age;
is discharged from the
hospital or freestanding birthing center. (2) The parent, guardian, or custodian is financially
unable
to pay for the hearing
assessment
screening and the hospital,
clinic, or
other facility
freestanding birthing center is not
reimbursed by a third-party
payer
as determined pursuant to rules
adopted under section 3701.508 of the Revised Code. The public health council shall adopt rules pursuant to
Chapter 119. of the Revised Code for determining whether a person
is financially unable to pay for a hearing
assessment
and
defining
third-party payer for the purpose of this section.
(C) A hospital, clinic, or other health care facility at
which a hearing evaluation is performed on a newborn or infant
shall report the results of the evaluation to the attending
physician of the newborn or infant. Sec. 3701.506. The department of health shall prepare and
distribute to all
hospitals
and freestanding birthing centers
required to provide
infant risk
hearing screenings
under
the
program established under section
3701.504 of
the Revised Code
and
each board of health,
information describing factors or
conditions
of hearing loss
and
the effect of such a loss on an
infant or
child's language
development, and information on the
importance of
hearing
screening, hearing evaluation, early intervention,
and
follow-up
care for newborns and infants.
This information shall
be updated
as the department determines necessary.
Upon the
discharge of an
at-risk newborn infant, each such Each hospital
or freestanding birthing center shall
provide
the
infant's parent, guardian, or
custodian
of each newborn
or
infant born in the hospital or freestanding birthing center with
this hearing
loss
the
information
prepared by the department
pursuant to this
section.
Each board of health shall provide the parent, guardian, or
custodian of each newborn or infant born in the area served by the
board who is not born in a hospital or freestanding birthing
center with the information prepared by the department pursuant to
this section. Sec. 3701.507. (A) To assist in implementing sections
3701.503 to
3701.507
3701.509 of the Revised Code, the medically
handicapped children's medical advisory council
created in
section
3701.025 of the Revised Code shall appoint a permanent
infant
hearing screening subcommittee. The subcommittee shall
consist of
the following members: (1) One otolaryngologist; (2) One neonatologist; (3) One pediatrician; (4) One neurologist; (5) One hospital administrator; (6)
One
Two or more audiologists
licensed under section
4753.07
of the Revised Code who are experienced in infant hearing
assessment
screening and evaluation; (7) One
speech
speech-language pathologist licensed under
section 4753.07
of
the Revised Code; (8)
One
Two persons who are each a parent of a
hearing-impaired
child; (9) One geneticist; (10) One epidemiologist; (11) One adult who is deaf or hearing impaired; (12) One representative from an organization for the deaf or
hearing impaired; (13) One family advocate; (14) One nurse from a well-baby neonatal nursery; (15) One nurse from a special care neonatal nursery; (16) One teacher of the deaf who works with infants and
toddlers; (17) One representative of the health insurance industry; (18) One representative of the bureau for children with
medical
handicaps; (19) One representative of the department of education; (20) One representative of the Ohio department of job and
family services who has responsibilities regarding
medicaid; (21) Any other person the advisory council appoints. (B) The infant hearing subcommittee shall: (1) Consult with the director of health regarding the
administration of sections 3701.503 to
3701.507
3701.509 of
the
Revised
Code; (2) Advise and make recommendations regarding proposed
rules
prior to their adoption by the public health council under
section
3701.504
3701.508 of the Revised Code; (3) Consult with the director of health
and advise and make
recommendations regarding program
development and implementation
under sections 3701.503 to
3701.507
3701.509 of the Revised Code,
including
establishment
of newborn
infant hearing-impairment risk
criteria and development of the
high-risk questionnaire under
division (A) of
all of the following: (a) Establishment under section 3701.504 of
the Revised Code
of the statewide hearing screening, tracking, and
early
intervention
program to identify newborn and infant hearing
impairment;
identification (b)
Identification of locations where
assessment of
infants
hearing evaluations may be conducted;
recommendations (c)
Recommendations for methods and
techniques of
risk
hearing screening and hearing
assessment
evaluation;
referral (d)
Referral,
data recording and compilation, and procedures
to encourage
follow-up hearing
assessments
care;
maintenance (e)
Maintenance of a register of
newborns and infants
determined to be at high risk for hearing
impairment
who do not
pass the hearing screening;
and
preparation (f) Preparation of
the information required by section
3701.506 of the Revised Code and any
other information the public
health council
requires the
department of health to provide. (4) Ensure that the infant hearing screening and
assessment
program established under sections 3701.503 to
3701.507 of the
Revised Code is
incorporated into
early
intervention activities of
the department of health in compliance
with the "Education of the
Handicapped Act Amendments of 1986,"
100 Stat. 1145, 20 U.S.C.A.
1400.
Sec. 3701.508. (A) The public health council shall adopt
rules
governing the
statewide hearing screening, tracking, and
early
intervention
program established under section 3701.504 of
the
Revised Code,
including rules that do all of the following:
(1) Specify how hospitals and freestanding birthing centers
are to comply with the requirements of section 3701.505 of the
Revised Code, including methods to be used for hearing
screening,
except that with regard to the physiologic equipment to be used
for hearing
screening, the rules may require only that the
equipment be
capable of giving reliable results and may not
specify particular
equipment or a particular type of equipment;
(2) Provide that no newborn or infant shall be required to
undergo a hearing screening if the parent, guardian, or custodian
of the newborn or infant objects on the grounds that the screening
conflicts with the parent's, guardian's, or custodian's religious
tenets and practices;
(3) Provide for situations in which the parent, guardian,
or custodian of a newborn or infant objects to a hearing screening
for reasons other than religious tenets and practices; (4) Specify how the department of health will determine
whether a person is financially unable to pay for a hearing
screening and define "third-party payer" for the purpose of
reimbursement of hearing screening by the department under section
3701.505 of the Revised Code;
(5) Specify an inexpensive and efficient format and
procedures for the submission of hearing screening
information
from hospitals and freestanding birthing centers to
the department
of health;
(6) Specify a procedure whereby the department may conduct
timely reviews of hearing screening information
submissions for
purposes of quality assurance, training, and
disease prevention
and control;
(7)
Specify any additional information that hospitals and
freestanding birthing centers are to provide to the medically
handicapped children's medical advisory council's infant hearing
screening subcommittee under section 3701.509 of the Revised Code. (B) In addition to the rules adopted under division (A) of
this section, the council shall adopt rules that specify the
training that must be completed by persons who will conduct
hearing screenings. In adopting these rules, the council shall
consider incorporating cost-saving training methods, including
computer-assisted learning and on-site training. Neither the rules
nor the director of health may establish a minimum educational
level for persons conducting hearing screenings. (C) All rules adopted under this section shall be adopted in
accordance with Chapter 119. of the Revised Code and shall be
adopted so as to take effect not
later than six months after the
effective date of this section. Sec. 3701.509. (A) The department of health shall develop a
mechanism to analyze and interpret the hearing screening
information to be reported under division (B) of this
section.
The department shall notify all hospitals and
freestanding
birthing centers subject to the reporting
requirements of the date
the department anticipates that the
mechanism will be complete.
After the mechanism is complete, the
department shall notify each
hospital and freestanding birthing
center subject to the reporting
requirement of the date by which
the hospital or center must
submit its first report. (B) Subject to division (A) of this section and in accordance
with rules adopted by the
public health council under section
3701.508 of the Revised Code,
each hospital and freestanding
birthing center that has
conducted
a hearing screening required by
section 3701.505 of the
Revised
Code shall
provide to
the
department of health for use
by
the medically
handicapped
children's medical
advisory council's
infant hearing
screening
subcommittee information
specifying all
of the following: (1) The number of newborns born in the hospital or
freestanding birthing center and the number of newborns and
infants not screened because they were
transferred to another
hospital; (2) The number of
newborns and infants referred to the
hospital or freestanding
birthing center for a hearing screening
and the number of those newborns and infants who
received a
hearing
screening; (3) The number of newborns and
infants who
did
not pass
the
hearing screenings conducted by the hospital or
freestanding
birthing center; (4) Any other information concerning the program established
under section 3701.504 of the Revised Code. (C) The department of health shall conduct a timely review of
the information submitted by hospitals and freestanding
birthing
centers in accordance with rules adopted by the public
health
council under section 3701.508 of the Revised Code.
(D) The infant hearing screening subcommittee, with the
support of the department of health, shall compile
and
summarize
the information submitted to the department by
hospitals
and
freestanding birthing centers under
division (B) of
this
section.
Beginning
with the first year after the mechanism
developed under
division (A) of this section is complete, the
subcommittee shall
annually prepare and transmit a report to
the
director
of health,
the
speaker of the house of
representatives,
and the
president of
the senate. The
council
shall make the
report
available to the
public. (E) The department and all members of the subcommittee shall
maintain the confidentiality of patient-identifying information
submitted
under division (B) of this section and section 3701.505
of the Revised Code. The information is
not a public
record under
section 149.43 of the Revised Code,
except to the extent that the
information is
used in preparing
reports under this section.
Nothing in this division prohibits the department from
providing patient-identifying information to other entities as it
considers necessary to implement the statewide tracking and early
intervention components of the program established under section
3701.504 of the Revised Code. Any entity that receives
patient-identifying information from the department shall maintain
the confidentiality of the information.
Sec. 3923.55. (A) As used in this section and section
3923.56 of the Revised Code: (1) "Child health supervision services" means periodic
review of a child's physical and emotional status performed by a
physician
or, by a health care professional under the
supervision
of a physician, or, in the case of hearing screening,
by an
individual acting in accordance with section 3701.505 of the
Revised Code. (2) "Periodic review" means a review performed in
accordance
with the recommendations of the American academy of
pediatrics and
includes a history, complete physical examination,
developmental
assessment, anticipatory guidance, appropriate
immunizations, and
laboratory tests. (3) "Physician" means a person authorized under Chapter
4731. of the Revised Code to practice medicine and surgery or
osteopathic medicine and surgery. (B) Notwithstanding section 3901.71 of the Revised Code,
each policy of individual or group sickness and
accident insurance
delivered, issued for delivery, or renewed in
this state on or
after the effective date
of this amendment, that provides coverage
for
family members of the insured shall provide, with respect to
that
coverage, that any benefits applicable for children shall
include
benefits for child health supervision services from the
moment of
birth until age nine. (C) A policy that provides the benefits described in
division (B) of this section may limit the benefits to cover only
the expenses of child health supervision services that are
performed by one physician or by a health care professional under
the supervision of one physician during the course of any one
visit. (D) Copayments and deductibles shall be reasonable and
shall
not be a barrier to the necessary utilization of child
health
supervision services by covered persons. (E) Benefits for child health supervision services that
are
provided to a child during the period from birth to age one
shall
not exceed a maximum limit of
five hundred dollars, including
benefits
for the hearing screening required by the program
established
under section 3701.504 of the Revised Code. The
benefits for the hearing screening shall not exceed a maximum
limit of seventy-five dollars.
Benefits for child health
supervision
services that are provided
to a child during any year
thereafter
shall not exceed
a maximum limit of one hundred fifty
dollars per
year. (F) This section does not apply to any policy that
provides
coverage for specific diseases or accidents only, or to
any
hospital indemnity, medicare supplement, or other policy that
offers only supplemental benefits.
Sec. 3923.56. (A) Notwithstanding section 3901.71
of the
Revised Code, each employee benefit plan established
or maintained
in this state on or after the
effective date of this amendment
that
provides coverage for family members of the employee shall
provide, with respect to that coverage, that any benefits
applicable for children shall include benefits for child health
supervision services from the moment of birth until age nine. (B) A plan that provides the benefits described in
division
(A) of this section may limit the benefits to cover only
the
expenses of child health supervision services that are
performed
by one physician or by a health care professional under
the
supervision of one physician during the course of any one
visit. (C) Copayments and deductibles shall be reasonable and
shall
not be a barrier to the necessary utilization of child
health
supervision services by covered persons. (D) Benefits for child health supervision services that
are
provided to a child during the period from birth to age one
shall
not exceed a maximum limit of
five hundred dollars, including
benefits
for the hearing screening required by the program
established
under section 3701.504 of the Revised Code. The
benefits for the hearing screening shall not exceed a maximum
limit of
seventy-five dollars. Benefits for child health
supervision
services that are
provided
to a child during any year
thereafter
shall not exceed
a maximum limit of one hundred fifty
dollars per
year.
SECTION 2. That existing sections 3701.503, 3701.504,
3701.505, 3701.506,
3701.507, 3923.55, and 3923.56 of the Revised
Code are hereby
repealed.
SECTION 3. A hospital shall continue to comply with the risk
screening requirements of section 3701.505 of the Revised Code in
effect prior to the effective date of this act until the hospital
complies or is required to comply with the rules adopted under
section 3701.508 of the Revised Code. A hospital or freestanding
birthing center is not required to comply with the risk screening
requirements in effect prior to the effective date of this act
after the hospital or center commences compliance with the rules.
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