BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
AB 1731 (Block) - Newborn screening program: critical congenital
heart disease.
Amended: July 6, 2012 Policy Vote: Health 8-0
Urgency: No Mandate: No
Hearing Date: August 6, 2012
Consultant: Brendan McCarthy
This bill meets the criteria for referral to the Suspense File.
Bill Summary: AB 1731 requires hospitals to offer newborn
screening for critical congenital heart defects.
Fiscal Impact:
One-time costs up to $150,000 (50% General Fund, 50%
federal funds) to the Department of Health Care Services to
develop protocols for screening.
Ongoing costs, likely in the low hundreds of thousands of
dollars (50% General Fund, 50% federal funds) to the
Department to monitor compliance by hospitals.
Increased costs to state health coverage programs
(including Medi-Cal, 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.
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, that
appears likely.
Background: Under current state law, the Department of Public
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Health operates a newborn screening program to test for certain
heritable or congenital diseases. A blood sample is collected
from newborns and tested by the Department at off-site
laboratories. The Department coordinates follow up services if
test results are positive.
In addition, the Department of Health Care Services manages the
Newborn Hearing Screening Program. Under this program, newborns
are screened for hearing problems by hospital personnel, prior
to discharge. If a problem is diagnosed, the Department is
responsible for directing parents to appropriate follow up
services.
Critical congenital heart defects are a group of conditions
characterized by defects in the structure of the heart at birth.
There are seven conditions that are typically classified as
critical congenital heart defects. According to the Centers for
Disease Control and Prevention, about 12 newborns per 10,000
have a critical congenital heart defect.
Proposed Law: AB 1731 would require hospitals to offer newborn
screening for critical congenital heart defects.
Specifically, the bill:
Would require hospitals to offer pulse oximetry screening
for critical congenital heart defects.
Would require the Department of Health Care Services to
specify protocols for testing, based on Centers for Disease
Control and Prevention protocols.
Would require the Department to begin phasing in the
requirement by July 1, 2013, with full participation by
2016.
Would require hospitals to be responsible for screening,
referral for appropriate care, and reporting data to the
Department.
Would specify which health care personnel can perform the
test.
Would not require a newborn to be screened if the test
violates the parents' beliefs.
Would authorize the Department to designate
responsibilities to the Department of Public Health.
Related Legislation: SB 1072 (Strickland) would have required
the Department of Public Health to screen for two additional
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types of genetic diseases. That bill was held on this
committee's Suspense File.
Proposed Author Amendments: The author proposes to eliminate the
Department of Health Care Services' authority to designate
responsibilities under the bill to the Department of Public
Health.