Bill Text: IA HF120 | 2017-2018 | 87th General Assembly | Introduced
Bill Title: A bill for an act relating to a cytomegalovirus public health initiative, and providing an appropriation.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2017-01-26 - Introduced, referred to Human Resources. H.J. 127. [HF120 Detail]
Download: Iowa-2017-HF120-Introduced.html
House File 120 - Introduced HOUSE FILE BY COWNIE, STAED, HEATON, GAINES, and ANDERSON A BILL FOR 1 An Act relating to a cytomegalovirus public health initiative, 2 and providing an appropriation. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: TLSB 1378YH (2) 87 pf/nh PAG LIN 1 1 Section 1. NEW SECTION. 136A.5B Cytomegalovirus public 1 2 health initiative ==== congenital cytomegalovirus screening ==== 1 3 public education and awareness program. 1 4 1. a. As used in this section, "congenital cytomegalovirus" 1 5 means cytomegalovirus acquired by an infant before birth. 1 6 b. A birthing hospital, a birth center, or an attending 1 7 health care provider shall ensure that the parent of every 1 8 newborn under the birthing hospital's, birth center's, or 1 9 attending health care provider's care receives information 1 10 regarding congenital cytomegalovirus, including the symptoms 1 11 of and birth defects caused by congenital cytomegalovirus, the 1 12 opportunity for screening prior to and after being discharged 1 13 from the birthing hospital's, birth center's, or attending 1 14 health care provider's care, and follow=up measures to detect 1 15 and treat congenital cytomegalovirus. 1 16 c. A birthing hospital, a birth center, or an attending 1 17 health care provider shall ensure that every newborn delivered 1 18 in a birthing hospital or birth center who fails the initial 1 19 newborn hearing screening administered pursuant to section 1 20 135.131, receives a congenital cytomegalovirus saliva 1 21 screening and that the newborn's parent receives the results 1 22 of that screening prior to being discharged from the birthing 1 23 hospital's, birth center's, or attending health care provider's 1 24 care. 1 25 d. A primary care provider who undertakes primary 1 26 pediatric care of a newborn delivered in a location other 1 27 than a birthing hospital or birth center shall ensure that 1 28 every newborn who fails the initial newborn hearing screening 1 29 administered pursuant to section 135.131 receives a congenital 1 30 cytomegalovirus saliva screening and that the newborn's parent 1 31 receives the results of that screening in accordance with rules 1 32 adopted under this subsection. 1 33 e. If the results of the congenital cytomegalovirus 1 34 screening are positive, the parent of the newborn shall be 1 35 provided with information regarding options for minimizing the 2 1 effects of congenital cytomegalovirus, and the early follow=up 2 2 and intervention options, treatment, and resources available 2 3 for the newborn, including but not limited to those available 2 4 through the local birth=to=three coordinator or similar 2 5 agency, the local area education agency, and local health care 2 6 professionals. 2 7 f. If the results of the congenital cytomegalovirus 2 8 screening are negative, the parent of the newborn shall be 2 9 provided with information regarding follow=up program resources 2 10 to confirm whether the newborn has hearing loss and to provide 2 11 for early intervention. 2 12 g. The provisions of this subsection relating to a required 2 13 congenital cytomegalovirus saliva screening do not apply if a 2 14 parent objects to the screening. If a parent objects to the 2 15 screening of a newborn, the birthing hospital, birth center, 2 16 attending health care provider, or primary care provider shall 2 17 document the refusal in the newborn's medical record and shall 2 18 obtain a written refusal from the parent and report the refusal 2 19 to the department. 2 20 h. The results of a congenital cytomegalovirus screening 2 21 shall be reported in a manner consistent with the reporting of 2 22 the results of metabolic screenings pursuant to section 136A.5, 2 23 and in accordance with rules adopted pursuant to section 2 24 136A.8. 2 25 i. The department may share the congenital cytomegalovirus 2 26 screening results information reported under paragraph "h" with 2 27 agencies and persons involved with newborn and infant hearing 2 28 screenings, follow=up services, and intervention services. 2 29 j. This subsection shall be administered in accordance with 2 30 rules adopted pursuant to section 136A.8. 2 31 2. a. In accordance with the duties prescribed in section 2 32 136A.3, the center for congenital and inherited disorders 2 33 shall collaborate with state and local health agencies 2 34 and other public and private organizations to develop and 2 35 publish or approve and publish informational materials to 3 1 educate and raise awareness of cytomegalovirus and congenital 3 2 cytomegalovirus among women who may become pregnant, expectant 3 3 parents, parents of infants, birthing hospitals, birth centers, 3 4 attending health care providers, primary care providers, 3 5 and others, as appropriate. The materials shall include 3 6 information regarding all of the following: 3 7 (1) The incidence of cytomegalovirus and congenital 3 8 cytomegalovirus. 3 9 (2) The transmission of cytomegalovirus to a pregnant woman 3 10 or a woman who may become pregnant. 3 11 (3) Birth defects caused by congenital cytomegalovirus. 3 12 (4) Methods of diagnosing congenital cytomegalovirus. 3 13 (5) Available preventive measures to avoid cytomegalovirus 3 14 infection by women who are pregnant or who may become pregnant. 3 15 (6) Early interventions, treatment, and services available 3 16 for children diagnosed with congenital cytomegalovirus. 3 17 b. An attending health care provider shall provide to a 3 18 pregnant woman during the first trimester of the pregnancy, 3 19 the informational materials published under this subsection. 3 20 The center for congenital and inherited disorders shall make 3 21 the informational materials available to attending health care 3 22 providers upon request. 3 23 c. The department shall publish the informational materials 3 24 on its internet site. 3 25 Sec. 2. Section 135.131, subsections 3, 4, and 5, Code 2017, 3 26 are amended to read as follows: 3 27 3. a. A birthing hospital shall screen every newborn 3 28 delivered in the hospital for hearing loss within a time frame 3 29 consistent with the time frame required to comply with the 3 30 screening for congenital cytomegalovirus pursuant to section 3 31 136A.5B and prior to discharge of the newborn from the birthing 3 32 hospital. A birthing hospital that transfers a newborn for 3 33 acute care prior to completion of the hearing screening shall 3 34 notify the receiving facility of the status of the hearing 3 35 screening. The receiving facility shall be responsible for 4 1 completion of the newborn hearing screening and the congenital 4 2 cytomegalovirus screening pursuant to section 136A.5B. 4 3 b. The birthing hospital or other facility completing 4 4 the hearing screening under this subsection shall report the 4 5 results of the screening to the parent or guardian of the 4 6 newborn and to the department in a manner prescribed by rule of 4 7 the department. The birthing hospital or other facility shall 4 8 also report the results of the hearing screening to the primary 4 9 care provider of the newborn or infant upon discharge from the 4 10 birthing hospital or other facility. If the newborn or infant 4 11 was not tested prior to discharge, the birthing hospital or 4 12 other facility shall report the status of the hearing screening 4 13 and congenital cytomegalovirus screening pursuant to section 4 14 136A.5B to the primary care provider of the newborn or infant. 4 15 4. A birth center shall refer the newborn to a licensed 4 16 audiologist, physician, or hospital for screening for 4 17 hearing loss within a time frame consistent with the time 4 18 frame required to comply with the screening for congenital 4 19 cytomegalovirus pursuant to section 136A.5B and prior to 4 20 discharge of the newborn from the birth center.The hearing 4 21 screening shall be completed within thirty days following 4 22 discharge of the newborn.The person completing the hearing 4 23 screening shall report the results of the screening to the 4 24 parent or guardian of the newborn and to the department in a 4 25 manner prescribed by rule of the department. Such person shall 4 26 also report the results of the screening to the primary care 4 27 provider of the newborn. 4 28 5. If a newborn is delivered in a location other than a 4 29 birthing hospital or a birth center, the physician or other 4 30 health care professional who undertakes the pediatric care of 4 31 the newborn or infant shall ensure that the hearing screening 4 32 is performed withinthree months of the date of the newborn's 4 33 or infant's birtha time frame consistent with the time frame 4 34 required by rule to comply with the screening for congenital 4 35 cytomegalovirus pursuant to section 136A.5B. The physician or 5 1 other health care professional shall report the results of the 5 2 hearing screening to the parent or guardian of the newborn or 5 3 infant, to the primary care provider of the newborn or infant, 5 4 and to the department in a manner prescribed by rule of the 5 5 department. 5 6 Sec. 3. Section 136A.2, Code 2017, is amended by adding the 5 7 following new subsections: 5 8 NEW SUBSECTION. 1A. "Birth center" means birth center as 5 9 defined in section 135.61. 5 10 NEW SUBSECTION. 1B. "Birthing hospital" means a private 5 11 or public hospital licensed pursuant to chapter 135B that has 5 12 a licensed obstetric unit or is licensed to provide obstetric 5 13 services. 5 14 NEW SUBSECTION. 7A. "Primary care provider" means a health 5 15 care provider who undertakes primary pediatric care of a 5 16 newborn delivered in a location other than a birthing hospital 5 17 or birth center. 5 18 Sec. 4. ADOPTION OF RULES. The rules adopted by the 5 19 department of public health pursuant to section 136A.8 as 5 20 directed in this Act shall include all of the following: 5 21 1. Protocols for the saliva screening for congenital 5 22 cytomegalovirus. 5 23 a. The protocols shall ensure that if the newborn is 5 24 delivered in a birthing hospital or birth center, any 5 25 saliva specimen required for the screening is collected 5 26 within twenty=four hours of the newborn's birth, and that an 5 27 appropriate lab receives and processes the specimen and reports 5 28 the results of the processing to the birthing hospital, birth 5 29 center, or attending health care provider within twenty=four 5 30 hours of receipt of the specimen by the lab. 5 31 b. The protocols shall ensure that if the newborn is 5 32 delivered in a location other than a birthing hospital or 5 33 birth center, the saliva specimen required for screening is 5 34 collected, and the appropriate lab receives and processes the 5 35 specimen and reports the results of the processing to the 6 1 primary care provider within the time frame specified by rule. 6 2 2. Protocols for determining whether a birthing hospital, a 6 3 birth center, an attending health care provider, or a primary 6 4 care provider is responsible for completion of the congenital 6 5 cytomegalovirus screening process for a newborn, depending upon 6 6 the circumstances of the birth. 6 7 3. The specific obligations of the birthing hospital, 6 8 birth center, attending health care provider, primary care 6 9 provider, lab, and other persons involved in the congenital 6 10 cytomegalovirus screening process. 6 11 4. Provisions related to the sharing by the department of 6 12 congenital cytomegalovirus screening results information with 6 13 agencies and persons involved with newborn and infant hearing 6 14 screenings, follow=up services, and intervention services to 6 15 protect the confidentiality of the individuals involved. 6 16 Sec. 5. CYTOMEGALOVIRUS EDUCATION PROGRAM GRANT ==== 6 17 APPROPRIATION. There is appropriated from the general fund of 6 18 the state to the department of public health for the fiscal 6 19 year beginning July 1, 2017, and ending June 30, 2018, the 6 20 following amount or so much thereof as is necessary for the 6 21 purpose designated: 6 22 For a grant awarded through a request for proposals process 6 23 to an Iowa=based nonprofit prenatal education program to assist 6 24 maternal health care providers in educating women who may 6 25 become pregnant, expectant parents, and parents of infants 6 26 about the strategies to prevent, the risks presented by, and 6 27 the minimization of the effects of congenital cytomegalovirus: 6 28 .................................................. $ 100,000 6 29 EXPLANATION 6 30 The inclusion of this explanation does not constitute agreement with 6 31 the explanation's substance by the members of the general assembly. 6 32 This bill creates a cytomegalovirus public health initiative 6 33 including congenital cytomegalovirus (CMV) screening 6 34 requirements and a public education and awareness program. 6 35 The bill requires a birthing hospital, birth center, or 7 1 attending health care provider to ensure that the parent of 7 2 every newborn under the birthing hospital's, birth center's, 7 3 or attending health care provider's care receives information 7 4 regarding congenital CMV, including the symptoms of and 7 5 birth defects caused by congenital CMV, the opportunity for 7 6 screening prior to and after being discharged from the birthing 7 7 hospital's, birth center's, or attending health care provider's 7 8 care; and follow=up measures to detect and treat congenital 7 9 CMV. 7 10 The bill requires a birthing hospital, birth center, or 7 11 attending health care provider to ensure that every newborn 7 12 delivered in a birthing hospital or birth center who fails the 7 13 initial newborn hearing screening receives a congenital CMV 7 14 saliva screening and that the parent of the newborn receives 7 15 the results of the screening prior to being discharged from 7 16 the birthing hospital's, birth center's, or attending health 7 17 care provider's care. The bill requires similar duties of a 7 18 primary care provider who undertakes primary pediatric care 7 19 of a newborn delivered in a location other than a birthing 7 20 hospital or birth center. If the results of the congenital 7 21 CMV screening are positive, the parent of the newborn shall 7 22 be provided with information regarding options for minimizing 7 23 the effects of congenital CMV and the early follow=up and 7 24 intervention options, treatment, and resources available for 7 25 the newborn. If the results of the congenital CMV screening 7 26 are negative, the parent is to be provided with information 7 27 regarding follow=up program resources to confirm whether the 7 28 newborn has hearing loss and to provide for early intervention. 7 29 The bill provides that the required congenital CMV saliva 7 30 screening does not apply if a parent objects to the screening. 7 31 If a parent objects to the screening of a newborn, the birthing 7 32 hospital, birth center, attending health care provider, 7 33 or primary care provider shall document the refusal in the 7 34 newborn's medical record and shall obtain a written refusal 7 35 from the parent and report the refusal to the department of 8 1 public health. 8 2 Under the bill, the results of a congenital CMV screening 8 3 shall be reported in a manner consistent with the reporting 8 4 of the results of metabolic screenings and in accordance with 8 5 rules adopted by the center for congenital and inherited 8 6 disorders with the assistance of the department of public 8 7 health. The bill is also to be administered in accordance with 8 8 those rules. 8 9 The bill also requires the center for congenital and 8 10 inherited disorders, in collaboration with state and local 8 11 health agencies and other public and private organizations, 8 12 to develop and publish or approve and publish informational 8 13 materials to educate and raise awareness of CMV and congenital 8 14 CMV among women who may become pregnant, expectant parents, 8 15 parents of infants, birthing hospitals, birth centers, 8 16 attending health care providers, primary care providers, and 8 17 others, as appropriate. An attending health care provider is 8 18 required to provide the informational materials to a pregnant 8 19 woman during the first trimester of the pregnancy, and the 8 20 center for congenital and inherited disorders is required to 8 21 make the informational materials available to attending health 8 22 care providers upon request. The department of public health 8 23 is required to publish the informational materials on its 8 24 internet site. 8 25 The bill provides that the rules adopted under the bill shall 8 26 include protocols for the saliva screening for congenital CMV, 8 27 depending upon the location of the delivery of the newborn. 8 28 The protocols are also to determine whether a birthing 8 29 hospital, a birth center, an attending health care provider, 8 30 or a primary care provider is responsible for completion of 8 31 the congenital CMV screening of a newborn depending upon the 8 32 circumstances of the birth as well as the specific obligations 8 33 of the birthing hospital, birth center, attending health 8 34 care provider, primary care provider, lab, and other persons 8 35 involved in the congenital CMV screening process. 9 1 The bill makes conforming changes to the universal newborn 9 2 and infant hearing screening section of the Code. 9 3 The bill appropriates $100,000 from the general fund of the 9 4 state to the department of public health for FY 2017=2018 for a 9 5 grant to an Iowa=based nonprofit prenatal education program to 9 6 assist maternal health care providers in educating women who 9 7 may become pregnant, expectant parents, and parents of infants 9 8 about the risks of, strategies to prevent, and minimization of 9 9 the effects of congenital cytomegalovirus. LSB 1378YH (2) 87 pf/nh
