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HB 717 - Newborns; advisory committee; screenings

Harrell, Sally Roettger (62nd)	Randall, William (Billy) C (127th)	Trense, Sharon (44th)
Graves, David B (125th)	Bordeaux, Tom (151st)	Scheid, III, Charles F (17th)

Status Summary	HC:	H&E	SC:	H&HS	FR:	02/22/99	LA:	04/13/99	Signed by Governor

First Reader Summary

A BILL to amend Chapter 1 of Title 31 of the Official Code of Georgia Annotated, relating to general provisions regarding health, so as to provide for legislative findings and intent; to establish an advisory committee on newborn infants and provide for its selection, compensation, powers, qualifications, and duties; and for other purposes.

Code Sections - 31-1-3.2/ 43-34-45.1

HB 717                                              HB 717/AP 
 
      H. B. No. 717 (AS PASSED HOUSE AND SENATE) 
      By:  Representatives Harrell of the 62nd, Randall of the 
      127th, Trense of the 44th, Graves of the 125th, Bordeaux of 
      the 151st and others 
 
                        A BILL TO BE ENTITLED 
                               AN ACT 
 
 
  1- 1  To amend Chapter 1 of Title 31 of the Official Code of 
  1- 2  Georgia Annotated, relating to general provisions regarding 
  1- 3  health, so as to provide for legislative findings and 
  1- 4  intent; to provide for a definition; to establish an 
  1- 5  advisory committee on newborn infants and provide for its 
  1- 6  selection, compensation, powers, qualifications, and duties; 
  1- 7  to provide for newborn screening of newborn infants under 
  1- 8  certain conditions and for education of parents and 
  1- 9  guardians regarding the importance of such screening and 
  1-10  early identification and intervention; to provide for 
  1-11  hospital and other reports; to provide for rules; to require 
  1-12  the provision of information and encourage cooperative 
  1-13  efforts; to amend Code Section 43-44-7 of the Official Code 
  1-14  of Georgia Annotated, relating to licensing of 
  1-15  speech-language pathology and audiology, so as to provide 
  1-16  for an exemption for certain infant screening; to amend 
  1-17  Article 2 of Chapter 34 of Title 43 of the Official Code of 
  1-18  Georgia Annotated, relating to physicians, so as to provide 
  1-19  for licensing retired physicians; to provide for a short 
  1-20  title; to provide for conditions and limitations; to provide 
  1-21  for liability and immunity from liability; to provide for 
  1-22  statutory construction; to provide for automatic repeal and 
  1-23  expiration of licenses; to provide for effective dates; to 
  1-24  repeal conflicting laws; and for other purposes. 
 
  1-25       BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA: 
 
  1-26                           SECTION 1. 
 
  1-27  Chapter 1 of Title 31 of the Official Code of Georgia 
  1-28  Annotated, relating to general provisions regarding health, 
  1-29  is amended by adding after Code Section 31-1-3.1 a new Code 
  1-30  section to read as follows: 
 
  1-31    "31-1-3.2. 
 
  1-32    (a) The General Assembly finds, determines, and declares: 
 
 
 
 
 
                                 -1- 
 
 
 
  2- 1      (1) That hearing loss occurs in newborn infants more 
  2- 2      frequently than any other health condition for which 
  2- 3      newborn infant screening is required; 
 
  2- 4      (2) That 80 percent of the language ability of a child 
  2- 5      is established by the time the child is 18 months of age 
  2- 6      and that hearing is vitally important to the healthy 
  2- 7      development of such language skills; 
 
  2- 8      (3) That early detection of hearing loss in a child and 
  2- 9      early intervention and treatment has been demonstrated 
  2-10      to be highly effective in facilitating a child's healthy 
  2-11      development in a manner consistent with the child's age 
  2-12      and cognitive ability; 
 
  2-13      (4) That children with hearing loss who do not receive 
  2-14      such early intervention and treatment frequently require 
  2-15      special educational services and that such services are 
  2-16      publicly funded for the vast majority of children with 
  2-17      hearing needs in the state; 
 
  2-18      (5) That appropriate testing and identification of 
  2-19      newborn infants with hearing loss will facilitate early 
  2-20      intervention and treatment and may therefore serve the 
  2-21      public purposes of promoting the healthy development of 
  2-22      children and reducing public expenditure; 
 
  2-23      (6) The American Academy of Pediatrics, the American 
  2-24      Speech-Language-Hearing Association, the American 
  2-25      Academy of Audiology, and the American Academy of 
  2-26      Otolaryngology, Head and Neck Surgery have recently 
  2-27      endorsed the implementation of universal newborn hearing 
  2-28      screenings and recommended that such screenings be 
  2-29      performed in all birthing hospitals and coordinated by 
  2-30      state departments of public health; and 
 
  2-31      (7) That consumers should be entitled to know whether 
  2-32      the hospital at which they choose to deliver their 
  2-33      infant provides newborn hearing screening. 
 
  2-34    (b) As used in this Code section, the term 'newborn 
  2-35    infant' means an infant after delivery but before 
  2-36    discharge from the hospital. 
 
  2-37    (c) For reasons specified in subsection (a) of this Code 
  2-38    section, the General Assembly determines that it would be 
  2-39    beneficial and in the best interests of the development of 
  2-40    the children of the state that newborn infants' hearing be 
  2-41    screened. 
 
 
 
                                 -2- 
 
 
 
  3- 1      (d)(1) There is established an advisory committee on 
  3- 2      hearing in newborn infants for the purpose of studying 
  3- 3      and collecting the informational data specified in this 
  3- 4      Code section and reporting such information to the 
  3- 5      General Assembly and Governor by December 1 of the first 
  3- 6      year following the year this Code section first becomes 
  3- 7      effective, and for the purpose of providing 
  3- 8      recommendations to hospitals, physicians, and other 
  3- 9      health care institutions, the Department of Human 
  3-10      Resources, and the public concerning, but not limited 
  3-11      to, the following: 
 
  3-12        (A) Appropriate methodologies to be implemented for 
  3-13        hearing screening of newborn infants, which 
  3-14        methodologies shall be objective and physiologically 
  3-15        based.  An audiologist licensed pursuant to Chapter 44 
  3-16        of Title 43 shall perform such screening and a person 
  3-17        not licensed as an audiologist may perform such 
  3-18        screening provided such screening by the unlicensed 
  3-19        person is performed pursuant to the exception in 
  3-20        subsection (h) of Code Section 43-44-7; 
 
  3-21        (B) The number of births sufficient to qualify a 
  3-22        hospital or health institution to arrange otherwise 
  3-23        for hearing screenings; and 
 
  3-24        (C) Guidelines for reporting and the means to assure 
  3-25        that identified children received referral for 
  3-26        appropriate follow-up services. The advisory committee 
  3-27        on hearing in newborn infants shall present its 
  3-28        findings and recommendations to the Board of Human 
  3-29        Resources.  Said board shall consider the findings and 
  3-30        recommendations of such advisory committee in the 
  3-31        adoption of rules and regulations for purposes of such 
  3-32        screening. 
 
  3-33      (2) The advisory committee on hearing in newborn infants 
  3-34      shall consist of at least 11 members who shall be 
  3-35      appointed by the director of the Division of Public 
  3-36      Health of the Department of Human Resources.  Such 
  3-37      advisory committee shall be a joint subcommittee of: 
 
  3-38        (A) The Maternal & Infant Health Council; and 
 
  3-39        (B) The State Interagency Coordinating Council for 
  3-40        Early Intervention. 
 
  3-41      There shall be one member from each of these councils on 
  3-42      the advisory committee.  Members appointed to the 
 
 
 
                                 -3- 
 
 
 
  4- 1      committee shall have training, experience, or interest 
  4- 2      in the area of hearing conditions of children and shall 
  4- 3      include at least one audiologist, one pediatrician, one 
  4- 4      hospital administrator from a hospital which offers 
  4- 5      perinatal services, one deaf or hard of hearing adult, 
  4- 6      and one parent of a deaf or hard of hearing child.  In 
  4- 7      addition, the Speaker of the House of Representatives 
  4- 8      shall appoint one member from the House of 
  4- 9      Representatives, and the President of the Senate shall 
  4-10      appoint one member from the Senate to serve on the 
  4-11      advisory committee. 
 
  4-12      (3) The members of the advisory committee on hearing in 
  4-13      newborn infants shall serve without compensation. 
 
  4-14      (4) The advisory committee on hearing in newborn infants 
  4-15      shall meet as often as necessary to study and collect 
  4-16      the information necessary and report to the General 
  4-17      Assembly and Governor by December 1 of the first year 
  4-18      following the year this Code section first becomes 
  4-19      effective, to develop and make the recommendations 
  4-20      specified in paragraph (1) of this subsection in a 
  4-21      sufficiently timely manner to allow for state-wide 
  4-22      hearing screening of newborn infants by July 1 of the 
  4-23      second year following the year this Code section first 
  4-24      becomes effective, and to make recommendations to 
  4-25      promote universal newborn infant hearing screening 
  4-26      pursuant to subsection (h) of this Code section. 
 
  4-27      (5) This subsection is automatically repealed effective 
  4-28      July 1 of the fifth year following the year this Code 
  4-29      section first becomes effective. 
 
  4-30    (e) It is the intent of the General Assembly that, by July 
  4-31    1 of the second year following the year this Code section 
  4-32    first becomes effective, newborn hearing screening be 
  4-33    conducted on no fewer than 95 percent of all newborn 
  4-34    infants born in hospitals in this state, using procedures 
  4-35    established by rule and regulation of the Board of Human 
  4-36    Resources after review of any recommendations of the 
  4-37    advisory committee on hearing in newborn infants, created 
  4-38    in subsection (d) of this Code section.  Toward that end, 
  4-39    on and after July 1 of the first year following the year 
  4-40    this Code section first becomes effective, every licensed 
  4-41    or certified hospital and physician shall educate the 
  4-42    parents of newborn infants born in such hospitals of the 
  4-43    importance of screening the hearing of newborn infants and 
  4-44    follow-up care.  Education shall not be considered a 
 
 
                                 -4- 
 
 
 
  5- 1    substitute for the hearing screening described in this 
  5- 2    subsection.  Every licensed or permitted hospital shall 
  5- 3    report annually to the Department of Human Resources 
  5- 4    concerning the following: 
 
  5- 5      (1) The number of newborn infants born in the hospital; 
 
  5- 6      (2) The number of newborn infants screened; 
 
  5- 7      (3) The number of newborn infants who passed the 
  5- 8      screening, if administered; and 
 
  5- 9      (4) The number of newborn infants who did not pass the 
  5-10      screening, if administered. 
 
  5-11    (f) The advisory committee on hearing in newborn infants 
  5-12    shall determine which hospitals or other health care 
  5-13    providers in this state are ordering and administering 
  5-14    newborn hearing screening to newborn infants on a 
  5-15    voluntary basis and the number of newborn infants 
  5-16    screened.  The advisory committee on hearing in newborn 
  5-17    infants shall report to the General Assembly and Governor 
  5-18    by December 1 of the first year following the year this 
  5-19    Code section first becomes effective concerning the 
  5-20    following: 
 
  5-21      (1) The number of hospitals and other health care 
  5-22      providers administering such voluntary screenings; 
 
  5-23      (2) The number of newborn infants screened as compared 
  5-24      to the total number of infants born in such hospitals 
  5-25      and institutions; 
 
  5-26      (3) The number of newborn infants who passed the 
  5-27      screening, if administered; and 
 
  5-28      (4) The number of newborn infants who did not pass the 
  5-29      screening, if administered. 
 
  5-30    (g) Subject to available appropriations, the advisory 
  5-31    committee on hearing in newborn infants shall make the 
  5-32    report described in subsection (f) of this Code section 
  5-33    available throughout the state and specifically available 
  5-34    to physicians whose practice includes the practice of 
  5-35    obstetrics or the care of newborn infants, to consumer 
  5-36    groups, to managed care organizations, and to the media. 
 
  5-37    (h) If the number of newborn infants screened does not 
  5-38    equal or exceed 95 percent of all newborn infants born in 
  5-39    hospitals in this state by July 1 of the second year 
  5-40    following the year this Code section first becomes 
 
 
 
                                 -5- 
 
 
 
  6- 1    effective or falls below 95 percent at any time 
  6- 2    thereafter, the advisory committee shall continue to work 
  6- 3    with hospitals and physicians to achieve that goal.  The 
  6- 4    advisory committee shall advise and assist hospitals and 
  6- 5    physicians regarding the conditions and procedures under 
  6- 6    which a parent or guardian of a child may object to and 
  6- 7    thereby exempt the child from such screening for religious 
  6- 8    reasons.  The advisory committee shall study and address 
  6- 9    those hospitals with a low volume of births, as determined 
  6-10    by the Department of Human Resources based upon 
  6-11    recommendations by the advisory committee on hearing in 
  6-12    newborn infants, which may arrange otherwise for newborn 
  6-13    infant hearing screening. 
 
  6-14    (i) A physician, registered professional nurse, including 
  6-15    a certified nurse midwife, or other health professional 
  6-16    attending a birth outside a hospital or institution shall 
  6-17    provide information, as established by the department, to 
  6-18    parents regarding places where the parents may have their 
  6-19    infants' screening and the importance of such screening. 
 
  6-20    (j) The department shall encourage the cooperation of 
  6-21    local health departments, health care clinics, school 
  6-22    districts, health care providers, and any other 
  6-23    appropriate resources to promote the screening of newborn 
  6-24    infants' hearing and early identification and intervention 
  6-25    for those determined to have hearing loss for those 
  6-26    infants born outside a hospital or institution." 
 
  6-27                          SECTION 1.1. 
 
  6-28  Article 2 of Chapter 34 of Title 43 of the Official Code of 
  6-29  Georgia Annotated, relating to physicians, is amended by 
  6-30  adding after Code Section 43-34-45 a new Code section to 
  6-31  read as follows: 
 
  6-32    "43-34-45.1. 
 
  6-33    (a) This Code section shall be known and may be cited as 
  6-34    the "Georgia Volunteers in Medicine Health Care Act." 
 
  6-35    (b) Notwithstanding any other provision of law, the board 
  6-36    may issue a special license to qualifying physicians under 
  6-37    the terms and conditions set forth in this Code section. 
  6-38    The special license may only be issued to a person who: 
 
  6-39      (1) Is currently licensed to practice medicine in any 
  6-40      medical-licensing jurisdiction in the United States and 
  6-41      whose license is in good standing; or 
 
 
 
                                 -6- 
 
 
 
  7- 1      (2) Is retired from the practice of medicine and not 
  7- 2      currently engaged in such practice either full time or 
  7- 3      part time and has, prior to retirement, maintained full 
  7- 4      licensure in good standing in any medical-licensing 
  7- 5      jurisdiction in the United States. 
 
  7- 6    (c) The special licensee shall be permitted to practice 
  7- 7    medicine only in the noncompensated employ of public 
  7- 8    agencies or institutions or not-for-profit agencies, 
  7- 9    not-for-profit institutions, nonprofit corporations, or 
  7-10    not-for-profit associations which provide medical services 
  7-11    only to indigent patients in medically underserved or 
  7-12    critical-need population areas of the state, as determined 
  7-13    by the board. 
 
  7-14    (d) The person applying for the special license under this 
  7-15    Code section shall submit to the board a copy of his or 
  7-16    her medical degree, a copy of his or her license in his or 
  7-17    her current or previous licensing and regulating 
  7-18    jurisdiction, and a notarized statement from the employing 
  7-19    agency, institution, corporation, or association, on a 
  7-20    form prescribed by the board, whereby he or she agrees 
  7-21    unequivocally not to receive compensation for any medical 
  7-22    services he or she may render while in possession of the 
  7-23    special license. 
 
  7-24    (e) The examination by the board, any application fees, 
  7-25    and all licensure and renewal fees must be waived for the 
  7-26    holder of the special license under this Code section and 
  7-27    do not apply to such person. 
 
  7-28    (f) If at the time application is made for the special 
  7-29    license the physician is not in compliance with the 
  7-30    continuing medical education requirements established by 
  7-31    the board, the physician shall be issued a nonrenewable 
  7-32    temporary license to practice for six months provided the 
  7-33    applicant is otherwise qualified for such license. 
 
  7-34    (g) The liability of persons practicing medicine under and 
  7-35    in compliance with a special license issued under this 
  7-36    Code section and the liability of their employers for such 
  7-37    practice shall be governed by Code Section 51-1-29.1. 
 
  7-38    (h) Nothing contained in this Code section shall be 
  7-39    construed to authorize the holder of the special license 
  7-40    provided for in this Code section to perform surgery or 
  7-41    any surgical procedure. 
 
 
 
 
                                 -7- 
 
 
 
  8- 1    (i) This Code section, being in derogation of the common 
  8- 2    law, shall be strictly construed." 
 
  8- 3                          SECTION 1.2. 
 
  8- 4  Code Section 43-44-7 of the Official Code of Georgia 
  8- 5  Annotated, relating to licensing of speech-language 
  8- 6  pathology and audiology, is amended by adding at the end a 
  8- 7  new subsection to read as follows: 
 
  8- 8    "(h) A person who is not licensed as an audiologist may 
  8- 9    perform nondiagnostic electro-physiologic screening of the 
  8-10    auditory system,  using otoacoustic emissions or auditory 
  8-11    brainstem response technology, as part of a planned and 
  8-12    organized screening effort for the initial identification 
  8-13    of communication disorders in infants under the age of 
  8-14    three months, provided that: 
 
  8-15      (1) The person not licensed as an audiologist has 
  8-16      completed a procedure specific training program directed 
  8-17      by an audiologist licensed under this chapter; 
 
  8-18      (2) The screening equipment and protocol used are fully 
  8-19      automated and the protocol is not accessible for 
  8-20      alteration or adjustment by the person not licensed as 
  8-21      an audiologist; 
 
  8-22      (3) The results of the screening are determined 
  8-23      automatically by the programmed test equipment, without 
  8-24      discretionary judgment by the person not licensed as an 
  8-25      audiologist, and are only reported as 'pass or fail' or 
  8-26      'pass or refer;' 
 
  8-27      (4) An audiologist licensed under this chapter is 
  8-28      responsible for the training of the person not licensed 
  8-29      as an audiologist, the selection of the screening 
  8-30      program protocol, the determination of administration 
  8-31      guidelines, the periodic monitoring of the performance 
  8-32      of the person not licensed as an audiologist, and the 
  8-33      screening program results; and 
 
  8-34      (5) The participation of the person not licensed as an 
  8-35      audiologist in such an automated screening program is 
  8-36      limited to the recording of patient demographic 
  8-37      information; the application of earphones, electrodes, 
  8-38      and other necessary devices; the initiation of the test; 
  8-39      the recording of the results; and the arrangement of the 
  8-40      referral for those who do not pass the screening to an 
  8-41      audiologist licensed under this chapter for follow-up 
  8-42      evaluation." 
 
 
                                 -8- 
 
 
 
  9- 1                           SECTION 2. 
 
  9- 2  Section 1 of this Act shall become effective only if funds 
  9- 3  are specifically appropriated for purposes of Section 1 of 
  9- 4  this Act in an appropriations Act making specific reference 
  9- 5  to Section 1 of this Act and shall become effective when 
  9- 6  funds so appropriated become available for expenditure; the 
  9- 7  commissioner of human resources shall not be required to 
  9- 8  enforce any portion of Section 1 of this Act for which funds 
  9- 9  are not specifically appropriated.  The remainder of this 
  9-10  Act shall become effective July 1, 1999. 
 
  9-11                          SECTION 2.1. 
 
  9-12  Section 1.1 of this Act shall be automatically repealed July 
  9-13  1, 2002, upon which date any special license issued pursuant 
  9-14  to Section 1.1 of this Act shall also expire. 
 
  9-15                           SECTION 3. 
 
  9-16  All laws and parts of laws in conflict with this Act are 
  9-17  repealed. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                 -9-