BILL NUMBER: AB 1731AMENDED BILL TEXT AMENDED IN SENATE AUGUST 21, 2012 AMENDED IN SENATE JULY 6, 2012 AMENDED IN ASSEMBLY MAY 25, 2012 AMENDED IN ASSEMBLY APRIL 24, 2012 AMENDED IN ASSEMBLY APRIL 9, 2012 INTRODUCED BY Assembly Member Block FEBRUARY 16, 2012 An act to add Article 6.6 (commencing with Section 124121) to Chapter 3 of Part 2 of Division 106 of the Health and Safety Code, relating to public health. LEGISLATIVE COUNSEL'S DIGEST AB 1731, as amended, Block. Newborn screening program: critical congenital heart disease. Existing law provides for the Newborn and Infant Hearing Screening, Tracking, and Intervention program, under which general acute care hospitals with licensed perinatal services, as specified, are required to administer to newborns a hearing screening test for the identification of hearing loss, as prescribed, using protocols developed by the State Department of Health Care Services, or its designee. This bill would , beginning July 1, 2013, require a general acute care hospitals with hospital that has a licensed perinatal services service to offer to parents of a newborn, prior to discharge, a pulse oximetry test for the identification of critical congenital heart disease (CCHD), using protocols approved by the department or its designee , as specified. This bill would require the department to phase in implementation of the requirement to offer CCHD screening on or after July 1, 2013, and require 100% participation by these hospitals by December 31, 2016. This bill would require these hospitals to develop a CCHD screening program, as prescribed. This bill would also provide that the department may designate responsibilities to the State Department of Public Health that are consistent with existing responsibilities set forth for the State Department of Public Health in other state newborn screening programs. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. The Legislature finds and declares the following: (a) Congenital heart disease affects about seven to nine of every 1,000 live births in the United States and is the most common cause of death in the first year of life, with defects accounting for 3 percent of all infant deaths and more than 40 percent of all deaths due to congenital malformations. (b) Critical congenital heart disease (CCHD) is a group of defects that cause severe and life-threatening symptoms and require intervention within the first days or first year of life. (c) Current methods for detecting CCHD generally include prenatal ultrasound screening and careful and repeated clinical examinations. (d) CCHD is often missed during the routine clinical exam that generally is scheduled prior to a newborn's discharge, and many cases of CCHD are also missed during discharge and postdischarge clinical exams. (e) Fetal ultrasound screening programs improve detection of major congenital heart defects. However, prenatal diagnosis alone picks up less than one-half of all cases. (f) Pulse oximetry is a noninvasive test that estimates the percentage of hemoglobin in blood that is saturated with oxygen. (g) Virtually all hospitals, including small hospitals, frequently use pulse oximetry as a standard of care in their newborn nurseries. (h) Many newborn lives could potentially be saved by earlier detection and treatment of CCHD if hospitals were required to perform this simple, noninvasive newborn screening method. SEC. 2. Article 6.6 (commencing with Section 124121) is added to Chapter 3 of Part 2 of Division 106 of the Health and Safety Code, to read: Article 6.6. Newborn Critical Congenital Heart Disease Screening Program 124121. For purposes of this article, "CCHD" means critical congenital heart disease. 124122. (a) (1) A Beginning July 1, 2013, a general acute care hospital with that has a licensed perinatal services service shall offer to parents of a newborn, prior to discharge, a pulse oximetry test for the identification of CCHD, using protocols approved by the State Department of Health Care Services. The ( 2) The protocols for testing for CCHD shall be consistent with those established by the federal Centers for Disease Control and Prevention. The department shall begin phasing in implementation of the requirement to offer CCHD screening on or after July 1, 2013, and a 100-percent participation rate shall be achieved by 2016. (2) ( 3) A hospital described in paragraph (1) shall be responsible for developing a screening program that provides competent CCHD screening, utilizes appropriate staff and equipment for administering the testing, completes the testing prior to the newborn's discharge from a newborn nursery unit, refers infants with abnormal screening results for appropriate care, maintains and reports data as required by the department, and provides physician and family-parent education. (b) A pulse oximetry test provided for pursuant to subdivision (a) shall be performed by a licensed physician, licensed registered nurse, or an appropriately trained individual who is supervised in the performance of the test by a licensed health care professional. (c) This section shall not apply to a newborn whose parent or guardian objects to the test on the grounds that the test is in violation of his or her beliefs. (d) The State Department of Health Care Services may designate responsibilities under this article to the State Department of Public Health that are consistent with existing responsibilities set forth for the State Department of Public Health in other state newborn screening programs.