BILL ANALYSIS Ó
AB 1731
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 1731 (Block)
As Amended August 24, 2012
Majority vote
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|ASSEMBLY: |62-13|(May 30, 2012) |SENATE: |26-8 |(August 29, |
| | | | | |2012) |
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Original Committee Reference: HEALTH
SUMMARY : Establishes the Newborn Critical Congenital Heart
Disease (CCHD) Screening Program and requires hospitals,
beginning July 1, 2013, to offer a pulse oximetry test for the
identification of CCHD to parents of newborns prior to
discharge. Specifically, this bill :
1)Applies the requirement to general acute care hospitals that
has a licensed perinatal service.
2)Requires the Department of Health Care Services (DHCS) to
issue guidance stating that hospitals perform this test in a
manner consistent with those established by the federal
Centers for Disease Control and Prevention (CDC).
3)Requires hospitals to develop a screening program with
specified elements.
4)Requires the pulse oximetry test to be performed by a licensed
physician, licensed registered nurse, or an appropriately
trained individual who is supervised by a licensed health care
professional.
5)Exempts a newborn if the parent or guardian objects on the
grounds that the test is in violation of his or her beliefs.
6)Makes legislative findings and declarations regarding the
incidence of CCHD, current methods of detection, and pulse
oximetry.
The Senate amendments delete the requirement that DHCS begin
phasing in implementation of the requirement to offer CCHD
screening on or after July 1, 2013, and achieve 100%
participation rate by 2016 and make other technical and
AB 1731
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clarifying changes.
AS PASSED BY THE ASSEMBLY , this bill was substantially similar
to the version as passed by the Senate.
FISCAL EFFECT : According to the Senate Appropriations
Committee:
1)One-time costs up to $150,000 (50% General Fund, 50% federal
funds) to the DHCS to develop protocols for screening.
2)Ongoing costs, likely in the low hundreds of thousands of
dollars (50% General Fund, 50% federal funds) to DHCS to
monitor compliance by hospitals.
3)Increased costs to state health coverage programs (including
Medi-Cal, California Public Employees' Retirement System
(CalPERS), and other programs) to pay for screening, between
$600,000 and $1.8 million per year (various funds), depending
on the current level of screening and the cost to conduct the
screening.
4)Potential cost savings to Medi-Cal and other state health
programs, due to earlier diagnosis and intervention for
newborns with critical congenital heart defects. For newborns
diagnosed under the bill as well as those newborns who would
be diagnosed late without screening, state health programs
would incur substantial treatment costs. However, when a
newborn is diagnosed late, there can be substantial costs to
stabilize the newborn before surgery can be attempted. While
it is not possible to say definitively that total costs will
be less with screening under the bill, it appears likely.
COMMENTS : Congenital heart disease (CHD) involves defects of
the walls, valves, arteries, or veins of the heart and occurs in
seven to nine of every 1,000 live births in the United States.
According to the author, this bill is designed to ensure that
newborns are screened for CCHD, (a subset of CHD), by requiring
DHCS to establish statewide screening of newborns by means of
pulse oximetry screening. Pulse oximetry screening is a test
that occurs at the bedside and is a non-invasive test that
estimates the percentage of hemoglobin in the blood that is
saturated with oxygen. Once identified, babies with a CCHD may
be seen by cardiologists and receive special care and treatment
to prevent death or disability. According to the CDC, certain
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hospitals routinely screen all newborns using pulse oximetry
screening. However, currently it is not included in most state
newborn screening panels.
The Secretary of the federal Department of Health and Human
Services (HHS) Advisory Committee on Heritable Disorders in
Newborns and Children (SACHDNC) is charged with making
systematic evidence-based and peer-reviewed recommendations to
the HHS Secretary regarding the most appropriate application of
universal newborn screening tests, technologies, policies,
guidelines and standards for effectively reducing morbidity and
mortality in newborns and children having, or at risk for,
heritable disorders. In 2010, the Secretary adopted the
SACHDNC's Recommended Uniform Screening Panel (RUSP) as a
national standard for newborn screening programs. RUSP included
29 core conditions and 25 secondary conditions which are
disorders that can be detected in the differential diagnosis of
a core disorder. At the same time, the Secretary adopted the
recommendation to add severe combined immunodeficiency (SCID) as
a core condition and related T-cell lymphocycte deficiencies as
a secondary condition to RUSP. California is in the process of
adding the SCID screening as directed by AB 695 (Pan), Chapter
461, Statutes of 2011, which conforms California's Newborn
Screening Program to the Secretary's recommendations. On
September 21, 2011, the Secretary decided to adopt the SACHDNC
recommendation to add CCHD to RUSP.
Analysis Prepared by : Marjorie Swartz / HEALTH / (916)
319-2097
FN: 0005679