Revision: Dec. 22, 2011, midnight
SB 348-FN – AS INTRODUCED
2012 SESSION
01/04
SENATE BILL 348-FN
AN ACT relative to the pulse oximetry test for newborns.
SPONSORS: Sen. Barnes, Jr., Dist 17
COMMITTEE: Health and Human Services
This bill adds the pulse oximetry test to the medical screenings required for newborns.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
12-2892
01/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twelve
AN ACT relative to the pulse oximetry test for newborns.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Name of Act. This act shall be known as “Parker’s Law” after Parker Bolton who was born with a severe congenital heart defect (CHD) known as hypoplastic left heart syndrome (HLHS). Parker spent his first 3 months in a hospital and before the age of 2½ he underwent 3 open heart surgeries. Because of early intervention and excellent medical care, Parker is expected to lead a normal life. Although he still has to undergo more surgeries and may need a full heart transplant in the future, he has proven to be a very resilient and happy child.
2 Findings. The general court finds and declares that:
I. Congenital heart defects (CHDs) are structural abnormalities of the heart that are present at birth. CHDs range in severity from simple problems such as holes between chambers of the heart, to severe malformations, such as the complete absence of one or more chambers or valves. Some critical CHDs can cause severe and life-threatening symptoms which require intervention within the first days of life.
II. According to the United States Secretary of Health and Human Services’ Advisory Committee on Heritable Disorders in Newborns and Children, congenital heart disease affects approximately 7 to 9 of every 1,000 live births in the United States and Europe. The federal Centers for Disease Control and Prevention states that CHD is the leading cause of infant death due to birth defects.
III. Current methods for detecting CHDs generally include prenatal ultrasound screening and repeated clinical examinations. While prenatal ultrasound screenings can detect some major congenital heart defects, these screenings, alone, identify less than half of all CHD cases, and critical CHD cases are often missed during routine clinical exams performed prior to a newborn’s discharge from a birthing facility.
IV. Pulse oximetry is a non-invasive test that estimates the percentage of hemoglobin in blood that is saturated with oxygen. When performed on a newborn a minimum of 24 hours after birth, pulse oximetry screening is often more effective at detecting critical, life-threatening CHDs which otherwise go undetected by current screening methods. Newborns with abnormal pulse oximetry results require immediate confirmatory testing and intervention.
V. Many newborn lives could potentially be saved by earlier detection and treatment of CHDs if the state required health care providers attending newborn children to perform this simple, non-invasive newborn screening in conjunction with current CHD screening methods.
3 New Section; Newborn Screening Tests; Pulse Oximetry Test Required. Amend RSA 132 by inserting after section 10-a the following new section:
132:10-aa Newborn Screening; Pulse Oximetry Test Required. The physician, hospital, nurse midwife, midwife, or other health care provider attending a newborn child shall perform a pulse oximetry screening, a minimum of 24 hours after birth, on every newborn child.
4 New Paragraph; Rulemaking. Amend RSA 132:10-b by inserting after paragraph V the following new paragraph:
VI. Pulse oximetry screening as required under RSA 132:10-aa.
5 Effective Date. This act shall take effect 60 days after its passage.
LBAO
12-2892
12/05/11
SB 348-FN - FISCAL NOTE
AN ACT relative to the pulse oximetry test for newborns.
FISCAL IMPACT:
The Department of Health and Human Services states this bill will increase state, county and local expenditures by an indeterminable amount in FY 2012 and each year thereafter. There will be no fiscal impact on state, county, and local revenue.
METHODOLOGY:
The Department of Health and Human Services states this bill adds pulse oximetry to the medical screenings required for newborns and requires the Department to include pulse oximetry screening in its administrative rules for newborn screening. The Department indicates the bill does not specify the type of regulatory oversight required, but assumes the bill will replicate other components of the newborn screening program such as newborn hearing and screening for metabolic disorders, and a new program component would be developed within the Maternal and Child Health budget. The Department assumes the program would be responsible for: communicating with hospitals and healthcare providers to inform them of the new requirement; establishing the criteria for the screening process and reporting requirements; and for providing on-site inspection to ensure compliance and appropriate follow up diagnostic testing and treatment is performed. The Department states this work would be performed annually by a full-time Program Coordinator and the work required could not be accomplished within the Department’s current operating budget. Based on these assumptions the Department has estimated the following costs, assuming an effective date of April 1, 2012:
FY 2012 |
FY 2013 |
FY 2014 |
FY 2015 |
FY 2016 | |
Full-time Program Coordinator, Labor Grade 25 |
11,188 |
46,722 |
48,770 |
50,915 |
53,138 |
Benefits |
5,755 |
25,573 |
27,654 |
29,922 |
32,391 |
Current Expenses: mail, copying, supplies, and telephone |
1,000 |
2,000 |
2,000 |
2,000 |
2,000 |
Rent |
1,794 |
7,860 |
8,017 |
8,178 |
8,341 |
In-State Travel |
250 |
1,000 |
1,000 |
1,000 |
1,000 |
Equipment |
3,500 |
- |
- |
- |
- |
Total Expenditures |
23,487 |
83,155 |
87,441 |
92,015 |
96,870 |
The Department states implementation of pulse oximetry screening would result in increased healthcare costs due to early identification of Critical Congenital Heart Disease and the associated surgical interventions and confirmatory testing. These costs would be born by Medicaid, third party insurers, and / or hospitals. County and local expenditures would increase for the counties and municipalities that fund employee healthcare. These amounts cannot be estimated.