By: Moncrief S.B. No. 458
99S0049/1
A BILL TO BE ENTITLED
AN ACT
1-1 relating to the establishment of a newborn and infant hearing
1-2 screening, tracking, and intervention program.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Subtitle B, Title 2, Health and Safety Code, is
1-5 amended by adding Chapter 47 to read as follows:
1-6 CHAPTER 47. HEARING LOSS IN NEWBORNS AND INFANTS
1-7 Sec. 47.001. PURPOSES. The purposes of this chapter are to:
1-8 (1) provide detection of hearing loss in newborns
1-9 during their birth admission;
1-10 (2) prevent delays in language and communication
1-11 caused by late-identified hearing loss that lead to academic
1-12 failure and illiteracy;
1-13 (3) provide the department with the information
1-14 necessary to plan, establish, and evaluate a comprehensive system
1-15 of appropriate services for newborns and infants who have hearing
1-16 loss; and
1-17 (4) provide the department with the information
1-18 necessary to track the incidence and prevalence of hearing loss
1-19 within the state to improve public health.
1-20 Sec. 47.002. DEFINITIONS. In this chapter:
1-21 (1) "Birth admission" means the time after birth that
1-22 a newborn remains in the birthing hospital nursery prior to
1-23 discharge.
1-24 (2) "Health insurance policy" means a group health
2-1 insurance policy, contract, or plan, or an individual policy,
2-2 contract, or plan, with dependent coverage for children that
2-3 provides medical coverage on an expense-incurred service or prepaid
2-4 basis. The term includes:
2-5 (A) a health insurance policy or contract issued
2-6 by a nonprofit corporation or fraternal benefit society;
2-7 (B) a health service plan operating as a health
2-8 maintenance organization, a preferred provider organization, an
2-9 exclusive provider organization, or any other managed care plan, as
2-10 those terms are described in state law; or
2-11 (C) an employee welfare benefit plan as defined
2-12 in Section 3(1), Employee Retirement Income Security Act of 1974
2-13 (29 U.S.C. Section 1002(1)).
2-14 (3) "Hearing loss" means a hearing loss of 30 dB HL or
2-15 greater in the frequency region important for speech recognition
2-16 and comprehension in one or both ears (approximately 500 through
2-17 4,000 Hz). However, as technological advances permit the detection
2-18 of less severe hearing loss, the department shall have the
2-19 authority to modify this definition by rule.
2-20 (4) "Infant" means a child 30 days to 24 months old.
2-21 (5) "Intervention or follow-up care" means the early
2-22 intervention services described in Subchapter III, Individuals with
2-23 Disabilities Education Act (20 U.S.C. Section 1431-1445), as
2-24 amended by Pub. L. No. 105-17.
2-25 (6) "Newborn" means a child from birth to 29 days old.
2-26 (7) "Parent" means a natural parent, stepparent,
3-1 adoptive parent, legal guardian, or other legal custodian of a
3-2 child.
3-3 (8) "Program" means a newborn and infant hearing
3-4 screening, tracking, and intervention program.
3-5 Sec. 47.003. NEWBORN AND INFANT HEARING SCREENING, TRACKING,
3-6 AND INTERVENTION PROGRAM. (a) A birthing hospital, through a
3-7 program certified by the department, shall offer the parents of a
3-8 newborn a hearing screening for the newborn for the identification
3-9 of hearing loss. The screening shall be offered during the birth
3-10 admission.
3-11 (b) The department or its designee shall approve program
3-12 protocols.
3-13 (c) The department shall begin its implementation phase on
3-14 September 1, 1999, for birthing hospitals with 1,000 births or more
3-15 per year.
3-16 (d) By April 1, 2001, all birthing hospitals shall offer the
3-17 hearing screening during the birth admission.
3-18 (e) The department shall maintain data and information on
3-19 all newborns and infants who receive services under a program.
3-20 (f) The department shall ensure that appropriate follow-up
3-21 care is available to families throughout the state, including
3-22 diagnostic evaluation and referral to intervention service programs
3-23 for all newborns and infants who require follow-up services.
3-24 Children identified as having hearing loss will be managed by
3-25 existing state programs, as required by the Individuals with
3-26 Disabilities Education Act (20 U.S.C. Section 1400 et seq.).
4-1 Sec. 47.004. CERTIFICATION OF BIRTHING HOSPITALS. (a) The
4-2 department or its designee shall establish certification criteria
4-3 that a birthing hospital must meet in implementing a newborn
4-4 hearing screening program.
4-5 (b) In order to be certified the birthing hospital shall:
4-6 (1) provide competent hearing screening;
4-7 (2) utilize appropriate staff and physiological
4-8 equipment for hearing screening;
4-9 (3) maintain and report data electronically as
4-10 required by the department;
4-11 (4) provide effective family and physician education;
4-12 and
4-13 (5) refer newborns and infants with abnormal screening
4-14 results for appropriate follow-up services.
4-15 (c) The department shall designate birthing hospitals that
4-16 meet and maintain certification criteria as qualified newborn
4-17 hearing screening providers.
4-18 (d) The department shall recertify birthing hospitals as
4-19 qualified newborn hearing screening providers on a periodic basis
4-20 in order to assure quality services to newborns, infants, and
4-21 families.
4-22 Sec. 47.005. INFORMATION CONCERNING SCREENING RESULTS AND
4-23 FOLLOW-UP CARE. A birthing hospital shall prepare for the parents
4-24 of all newborns and infants who are screened written information on
4-25 the screening results and the necessary steps for follow-up care.
4-26 Sec. 47.006. INSURANCE COVERAGE. (a) Except as otherwise
5-1 provided by this section, a health insurance policy that is
5-2 delivered, issued for delivery, renewed, extended, or modified in
5-3 this state by a health care insurer shall provide coverage for an
5-4 initial newborn hearing screening and for necessary diagnostic
5-5 follow-up care related to the screening.
5-6 (b) Except as otherwise provided by this section, if a
5-7 health insurance policy provides coverage or benefits to a resident
5-8 of this state, the policy shall be deemed to be delivered in this
5-9 state within the meaning of this chapter regardless of whether the
5-10 health care insurer issuing or delivering the policy is located
5-11 within or outside this state.
5-12 (c) Benefits for a newborn and infant hearing screening test
5-13 and any necessary audiological follow-up care shall be subject to
5-14 copayment and coinsurance provisions of a health insurance policy
5-15 to the extent that other medical services covered by the policy are
5-16 subject to those provisions, except that benefits for the screening
5-17 test shall be exempt from deductible or dollar-limit provisions in
5-18 the health insurance policy. This exemption must be explicitly
5-19 provided for in the policy.
5-20 (d) Notwithstanding Subsections (a) and (b), this section
5-21 shall not be construed to require a health insurance policy to
5-22 include coverage for a newborn and infant hearing screening test
5-23 for an individual who is a resident of this state if the individual
5-24 is employed outside this state and the individual's employer
5-25 maintains a health insurance policy for the individual as an
5-26 employment benefit.
6-1 Sec. 47.007. RULES. The commissioner of insurance shall
6-2 adopt rules necessary for the implementation of this chapter. The
6-3 commissioner of insurance may consult with the commissioner and
6-4 other appropriate entities in adopting rules under this section.
6-5 Sec. 47.008. TECHNICAL ASSISTANCE BY DEPARTMENT. The
6-6 department shall establish the infrastructure to provide technical
6-7 assistance and consultation to birthing hospitals with regard to
6-8 preimplementation and implementation planning, information
6-9 management, ongoing program performance, and follow-up services.
6-10 Sec. 47.009. INFORMATION MANAGEMENT, REPORTING, AND TRACKING
6-11 SYSTEM. (a) The department shall provide all birthing hospitals
6-12 with the appropriate information management, reporting, and
6-13 tracking software for the program. The information management,
6-14 reporting, and tracking system shall be capable of providing the
6-15 department with information and data necessary to plan, monitor,
6-16 and evaluate the program, including the program's screening,
6-17 follow-up, diagnostic, and intervention components.
6-18 (b) All qualified newborn hearing screening providers,
6-19 hospitals, audiologists, and intervention specialists, as specified
6-20 by the department, shall have access to the information management,
6-21 reporting, and tracking system to provide information to the
6-22 department including:
6-23 (1) newborns born in each birthing hospital;
6-24 (2) newborns screened during birth admission;
6-25 (3) newborns passing the birth admission screening;
6-26 (4) families refusing the birth admission screening;
7-1 (5) newborns who need follow-up care;
7-2 (6) infants who receive follow-up care;
7-3 (7) infants identified with hearing loss;
7-4 (8) infants at risk for progressive hearing loss;
7-5 (9) infants who are referred for intervention
7-6 services; and
7-7 (10) case level information necessary to report
7-8 required statistics to the Maternal and Child Health Bureau on an
7-9 annual basis.
7-10 Sec. 47.010. CONFIDENTIALITY AND GENERAL ACCESS TO DATA.
7-11 (a) The information management, reporting, and tracking system
7-12 required by this chapter must meet confidentiality requirements in
7-13 accordance with required state and federal privacy guidelines.
7-14 (b) Data obtained through the information management,
7-15 reporting, and tracking system under this chapter are for the
7-16 confidential use of the department, its designee, and the persons
7-17 or public or private entities that the department determines are
7-18 necessary to carry out the functions of the tracking system.
7-19 Sec. 47.011. IMMUNITY FROM LIABILITY. A health facility, a
7-20 clinical laboratory, an audiologist, a physician, a registered
7-21 nurse, or any other officer or employee of a health facility
7-22 laboratory, a physician, or an audiologist shall not be criminally
7-23 or civilly liable for furnishing information to the department or
7-24 its designee pursuant to the requirements of this chapter.
7-25 SECTION 2. This Act takes effect September 1, 1999, and
7-26 applies to all insurance policies, individual and otherwise,
8-1 subscriber contracts, and group insurance certificates issued under
8-2 any group master policy that are delivered, issued for delivery, or
8-3 renewed on or after January 1, 2000. A policy delivered, issued
8-4 for delivery, or renewed before January 1, 2000, is governed by the
8-5 law as it existed immediately before the effective date of this
8-6 Act, and that law is continued in effect for this purpose.
8-7 SECTION 3. The importance of this legislation and the
8-8 crowded condition of the calendars in both houses create an
8-9 emergency and an imperative public necessity that the
8-10 constitutional rule requiring bills to be read on three several
8-11 days in each house be suspended, and this rule is hereby suspended.