BILL NUMBER: AB 1731	AMENDED
	BILL TEXT

	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 require general acute care hospitals with licensed
perinatal services 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  a comprehensive
CCHD screening program   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.
   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. 
   SECTION 1.   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.  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 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. 
    124122.   124121.   For purposes of
this article, "CCHD" means critical congenital heart disease.
    124123.   124122.   (a) (1) A general
acute care hospital with licensed perinatal services 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 or its designee. 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  a comprehensive
CCHD screening program by general acute care hospitals with licensed
perinatal services   the requirement to offer CCHD
screening  on or after July 1, 2013, and a 100-percent
participation rate shall be achieved by 2016.
   (2) 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.