76R11728 CMR-D
By Naishtat, Coleman, et al. H.B. No. 714
Substitute the following for H.B. No. 714:
By Maxey C.S.H.B. No. 714
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the establishment of a newborn hearing screening,
1-3 tracking, and intervention program.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subtitle B, Title 2, Health and Safety Code, is
1-6 amended by adding Chapter 47 to read as follows:
1-7 CHAPTER 47. HEARING LOSS IN NEWBORNS
1-8 Sec. 47.001. DEFINITIONS. In this chapter:
1-9 (1) "Birth admission" means the time after birth that
1-10 a newborn remains in the birthing facility before the newborn is
1-11 discharged.
1-12 (2) "Birthing facility" means:
1-13 (A) a hospital licensed under Chapter 241 that
1-14 offers obstetrical services and is located in a county with a
1-15 population of more than 50,000; or
1-16 (B) a birthing center licensed under Chapter 244
1-17 that is located in a county with a population of more than 50,000.
1-18 (3) "Hearing loss" means a hearing loss of 30 dB HL or
1-19 greater in the frequency region important for speech recognition
1-20 and comprehension in one or both ears, approximately 500 through
1-21 4,000 Hz. As technological advances permit the detection of less
1-22 severe hearing loss, the department may modify this definition by
1-23 rule.
1-24 (4) "Infant" means a child who is at least 30 days but
2-1 who is younger than 24 months old.
2-2 (5) "Intervention or follow-up care" means the early
2-3 intervention services described in Subchapter III, Individuals with
2-4 Disabilities Education Act (20 U.S.C. Sections 1431-1445), as
2-5 amended by Pub. L. No. 105-17.
2-6 (6) "Newborn" means a child younger than 30 days old.
2-7 (7) "Parent" means a natural parent, stepparent,
2-8 adoptive parent, legal guardian, or other legal custodian of a
2-9 child.
2-10 (8) "Physician" means a person licensed to practice
2-11 medicine by the Texas State Board of Medical Examiners.
2-12 (9) "Program" means a newborn hearing screening,
2-13 tracking, and intervention program certified by the department
2-14 under this chapter.
2-15 Sec. 47.002. NEWBORN HEARING SCREENING, TRACKING, AND
2-16 INTERVENTION PROGRAM. (a) A birthing facility, through a program
2-17 certified by the department under Section 47.003, shall offer the
2-18 parents of a newborn a hearing screening for the newborn for the
2-19 identification of hearing loss. The screening shall be offered
2-20 during the birth admission.
2-21 (b) The department or the department's designee shall
2-22 approve program protocols.
2-23 (c) The department shall maintain data and information on
2-24 each newborn who receives services under a program.
2-25 (d) The department shall ensure that intervention is
2-26 available to families for a newborn identified as having hearing
2-27 loss and that the intervention is managed by state programs
3-1 operating under the Individuals with Disabilities Education Act (20
3-2 U.S.C. Section 1400 et seq.).
3-3 (e) The department shall ensure that the intervention
3-4 described by Subsection (d) is available for a newborn identified
3-5 as having hearing loss through the time the child is an infant.
3-6 Sec. 47.003. CERTIFICATION OF SCREENING PROGRAMS. (a) The
3-7 department or the department's designee shall establish
3-8 certification criteria for implementing a program.
3-9 (b) In order to be certified, the program must:
3-10 (1) provide hearing screening using equipment
3-11 recommended by the department;
3-12 (2) use appropriate staff to provide the screening;
3-13 (3) maintain and report data electronically as
3-14 required by the department;
3-15 (4) distribute family and physician educational
3-16 materials standardized by the department; and
3-17 (5) provide information, as recommended by the
3-18 department, on follow-up services for newborns and infants with
3-19 abnormal screening results.
3-20 (c) The department shall certify a program that meets and
3-21 maintains the certification criteria.
3-22 (d) The department shall renew the certification of a
3-23 program on a periodic basis as established by board rule in order
3-24 to ensure quality services to newborns and families.
3-25 (e) A fee may not be charged to certify or recertify a
3-26 program.
3-27 Sec. 47.004. INFORMATION CONCERNING SCREENING RESULTS AND
4-1 FOLLOW-UP CARE. (a) A birthing facility shall distribute to the
4-2 parents of each newborn who is screened educational materials that
4-3 are standardized by the department regarding screening results and
4-4 follow-up care.
4-5 (b) A birthing facility shall report screening results to
4-6 the parents, the physician, and the department.
4-7 (c) Appropriate and necessary care for the infant who needs
4-8 follow-up care should be directed and coordinated by the infant's
4-9 physician, with support from appropriate ancillary services.
4-10 Sec. 47.005. TECHNICAL ASSISTANCE BY DEPARTMENT. The
4-11 department shall consult with a birthing facility and provide to
4-12 the facility technical assistance associated with the
4-13 implementation of a certified program.
4-14 Sec. 47.006. INFORMATION MANAGEMENT, REPORTING, AND TRACKING
4-15 SYSTEM. (a) The department shall provide each birthing facility
4-16 with the appropriate information management, reporting, and
4-17 tracking software for the program. The information management,
4-18 reporting, and tracking system must be capable of providing the
4-19 department with information and data necessary to plan, monitor,
4-20 and evaluate the program, including the program's screening,
4-21 follow-up, diagnostic, and intervention components.
4-22 (b) A qualified hearing screening provider, hospital,
4-23 audiologist, or intervention specialist may access the information
4-24 management, reporting, and tracking system to provide information,
4-25 where available, to the department, including information relating
4-26 to:
4-27 (1) newborns born in each birthing facility;
5-1 (2) newborns screened during birth admission;
5-2 (3) newborns passing the birth admission screening;
5-3 (4) families refusing the birth admission screening;
5-4 (5) newborns who need follow-up care;
5-5 (6) infants who receive follow-up care;
5-6 (7) infants identified with hearing loss;
5-7 (8) infants at risk for progressive hearing loss;
5-8 (9) infants who are referred for intervention
5-9 services; and
5-10 (10) case level information necessary to report
5-11 required statistics to the Maternal and Child Health Bureau on an
5-12 annual basis.
5-13 Sec. 47.007. CONFIDENTIALITY AND GENERAL ACCESS TO DATA.
5-14 (a) The information management, reporting, and tracking system
5-15 required by this chapter must meet confidentiality requirements in
5-16 accordance with required state and federal privacy guidelines.
5-17 (b) Data obtained through the information management,
5-18 reporting, and tracking system under this chapter are for the
5-19 confidential use of the department, the department's designee, and
5-20 the persons or public or private entities that the department
5-21 determines are necessary to carry out the functions of the tracking
5-22 system.
5-23 Sec. 47.008. IMMUNITY FROM LIABILITY. A birthing facility,
5-24 a clinical laboratory, an audiologist, a physician, a registered
5-25 nurse, or any other officer or employee of a birthing facility, a
5-26 laboratory, a physician, or an audiologist is not criminally or
5-27 civilly liable for furnishing information to the department or its
6-1 designee as required by this chapter.
6-2 SECTION 2. Section 36.004, Health and Safety Code, is
6-3 amended by adding Subsection (i) to read as follows:
6-4 (i) A hearing screening performed under this section is in
6-5 addition to any hearing screening test performed under Chapter 47.
6-6 SECTION 3. Section 32.024, Human Resources Code, is amended
6-7 by adding Subsection (v) to read as follows:
6-8 (v) The department by rule shall provide a screening test
6-9 for hearing loss as required by Chapter 47, Health and Safety Code,
6-10 and any necessary diagnostic follow-up care related to the
6-11 screening test to a child younger than 30 days old who receives
6-12 medical assistance.
6-13 SECTION 4. Article 21.53F, Insurance Code, as added by
6-14 Chapter 683, Acts of the 75th Legislature, Regular Session, 1997,
6-15 is amended by amending Sections 3 and 4 and adding Sections 5, 6,
6-16 and 7 to read as follows:
6-17 Sec. 3. REQUIRED BENEFIT FOR CHILDHOOD IMMUNIZATIONS. [(a)]
6-18 A health benefit plan that provides benefits for a family member of
6-19 the insured shall provide coverage for each covered child described
6-20 by Section 5 of this article [Subsection (b) of this section], from
6-21 birth through the date the child is six years of age, for:
6-22 (1) immunization against:
6-23 (A) diphtheria;
6-24 (B) haemophilus influenzae type b;
6-25 (C) hepatitis B;
6-26 (D) measles;
6-27 (E) mumps;
7-1 (F) pertussis;
7-2 (G) polio;
7-3 (H) rubella;
7-4 (I) tetanus; and
7-5 (J) varicella; and
7-6 (2) any other immunization that is required by law for
7-7 the child.
7-8 Sec. 4. REQUIRED BENEFITS FOR SCREENING TEST FOR HEARING
7-9 IMPAIRMENT. (a) A health benefit plan that provides benefits for
7-10 a family member of the insured shall provide coverage for each
7-11 covered child described by Section 5 of this article for:
7-12 (1) a screening test for hearing loss from birth
7-13 through the date the child is 30 days old, as required under
7-14 Chapter 47, Health and Safety Code; and
7-15 (2) necessary diagnostic follow-up care related to the
7-16 screening test from birth through the date the child is 24 months
7-17 old.
7-18 (b) The commissioner may adopt rules to implement the
7-19 requirement of this section.
7-20 (c) This section applies to any health benefit plan that
7-21 provides coverage or benefits to a resident of this state, without
7-22 regard to whether the issuer of the health benefit plan is located
7-23 within or outside this state. This section does not require the
7-24 issuer of a health benefit plan to provide coverage under this
7-25 section for the child of a resident of this state who:
7-26 (1) is employed outside of this state; and
7-27 (2) is covered under a health benefit plan maintained
8-1 for the individual by the individual's employer as an employment
8-2 benefit.
8-3 Sec. 5. COVERED CHILDREN. [(b)] A child is entitled to
8-4 benefits under this article [section] if the child, as a result of
8-5 the child's relationship to an enrollee in the health benefit plan,
8-6 would be entitled to benefits under an accident and sickness
8-7 insurance policy under Subsection (K), (L), or (M), Section 2,
8-8 Chapter 397, Acts of the 54th Legislature, 1955 (Article 3.70-2,
8-9 Vernon's Texas Insurance Code).
8-10 Sec. 6 [4]. APPLICATION OF DEDUCTIBLE, COPAYMENT, OR
8-11 COINSURANCE REQUIREMENT [FIRST DOLLAR COVERAGE REQUIRED]. (a)
8-12 Benefits required under Section 3 of this article may not be made
8-13 subject to a deductible, copayment, or coinsurance requirement.
8-14 This subsection [(b) Subsection (a) of this section] does not
8-15 prohibit the application of a deductible, copayment, or coinsurance
8-16 requirement to another service provided at the same time as the
8-17 immunization.
8-18 (b) Benefits required under Section 4 of this article may be
8-19 subject to copayment and coinsurance requirements, but may not be
8-20 subject to a deductible requirement or dollar limit. The
8-21 requirements of this subsection must be stated in the coverage
8-22 document.
8-23 Sec. 7. RULES. The commissioner may adopt rules as
8-24 necessary to implement this article.
8-25 SECTION 5. The heading of Article 21.53F, Insurance Code, as
8-26 added by Chapter 683, Acts of the 75th Legislature, Regular
8-27 Session, 1997, is amended to read as follows:
9-1 Art. 21.53F. COVERAGE FOR CERTAIN BENEFITS FOR CHILDREN
9-2 [CHILDHOOD IMMUNIZATIONS]
9-3 SECTION 6. (a) This Act takes effect September 1, 1999.
9-4 (b) Not later than May 1, 2000, each birthing facility with
9-5 at least 1,000 births in a year shall offer newborn hearing
9-6 screening during the birth admission as required by Section 47.002,
9-7 Health and Safety Code, as added by this Act.
9-8 (c) Not later than April 1, 2001, each birthing facility
9-9 shall offer the hearing screening during the birth admission as
9-10 required by Section 47.002, Health and Safety Code, as added by
9-11 this Act.
9-12 SECTION 7. The Texas Board of Health shall adopt the rules
9-13 required by Section 47.003, Health and Safety Code, as added by
9-14 this Act, not later than December 1, 1999.
9-15 SECTION 8. (a) Except as provided by Subsection (b) of this
9-16 section, not later than January 1, 2000, the Health and Human
9-17 Services Commission and each appropriate health and human services
9-18 agency that operates part of the state medical assistance program
9-19 under Chapter 32, Human Resources Code, shall adopt the rules
9-20 required by Section 32.024(v), Human Resources Code, as added by
9-21 this Act.
9-22 (b) If, before implementing Section 32.024(v), Human
9-23 Resources Code, as added by this Act, the Health and Human Services
9-24 Commission determines that a waiver or authorization from a federal
9-25 agency is necessary for implementation, the commission shall
9-26 request the waiver or authorization and may delay implementing that
9-27 provision until the waiver or authorization is granted.
10-1 SECTION 9. The change in law made by Section 4 of this Act
10-2 applies only to a health benefit plan that is delivered, issued for
10-3 delivery, or renewed on or after January 1, 2000. A health benefit
10-4 plan that is delivered, issued for delivery, or renewed before
10-5 January 1, 2000, is governed by the law as it existed immediately
10-6 before the effective date of this Act, and that law is continued in
10-7 effect for that purpose.
10-8 SECTION 10. The importance of this legislation and the
10-9 crowded condition of the calendars in both houses create an
10-10 emergency and an imperative public necessity that the
10-11 constitutional rule requiring bills to be read on three several
10-12 days in each house be suspended, and this rule is hereby suspended.