House of Representatives
File No. 786
January Session, 2015
(Reprint of File No. 512)
As Amended by House Amendment
Approved by the Legislative Commissioner
May 8, 2015
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Section 19a-55 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2015):
(a) The administrative officer or other person in charge of each institution caring for newborn infants shall cause to have administered to every such infant in its care an HIV-related test, as defined in section 19a-581, a test for phenylketonuria and other metabolic diseases, hypothyroidism, galactosemia, sickle cell disease, maple syrup urine disease, homocystinuria, biotinidase deficiency, congenital adrenal hyperplasia and such other tests for inborn errors of metabolism as shall be prescribed by the Department of Public Health. The tests shall be administered as soon after birth as is medically appropriate. If the mother has had an HIV-related test pursuant to section 19a-90 or 19a-593, the person responsible for testing under this section may omit an HIV-related test. The Commissioner of Public Health shall (1) administer the newborn screening program, (2) direct persons identified through the screening program to appropriate specialty centers for treatments, consistent with any applicable confidentiality requirements, and (3) set the fees to be charged to institutions to cover all expenses of the comprehensive screening program including testing, tracking and treatment. The fees to be charged pursuant to subdivision (3) of this subsection shall be set at a minimum of fifty-six dollars. The Commissioner of Public Health shall publish a list of all the abnormal conditions for which the department screens newborns under the newborn screening program, which shall include screening for amino acid disorders, organic acid disorders and fatty acid oxidation disorders, including, but not limited to, long-chain 3-hydroxyacyl CoA dehydrogenase (L-CHAD) and medium-chain acyl-CoA dehydrogenase (MCAD).
(b) In addition to the testing requirements prescribed in subsection (a) of this section, the administrative officer or other person in charge of each institution caring for newborn infants shall cause to have administered to (1) every such infant in its care [(1)] a screening test for (A) cystic fibrosis, [(2) a screening test for] (B) severe combined immunodeficiency disease, and [(3) on and after January 1, 2013, a screening test for] (C) critical congenital heart disease, and (2) any newborn infant who fails a newborn hearing screening, as described in section 19a-59, a screening test for cytomegalovirus, provided such screening test shall be administered within available appropriations on and after January 1, 2016. Such screening tests shall be administered as soon after birth as is medically appropriate.
(c) On and after the occurrence of the following: (1) The development and validation of a reliable methodology for screening newborns for adrenoleukodystrophy using dried blood spots and quality assurance testing methodology for such test or the approval of a test for adrenoleukodystrophy using dried blood spots by the federal Food and Drug Administration; and (2) the availability of any necessary reagents for such test, the administrative officer or other person in charge of each institution caring for newborn infants shall cause to have administered to every such infant in its care a test for adrenoleukodystrophy.
(d) The administrative officer or other person in charge of each institution caring for newborn infants shall report any case of cytomegalovirus that is confirmed as a result of a screening test administered pursuant to subdivision (3) of subsection (b) of this section to the Department of Public Health in a form and manner prescribed by the Commissioner of Public Health.
[(d)] (e) The provisions of this section shall not apply to any infant whose parents object to the test or treatment as being in conflict with their religious tenets and practice. The commissioner shall adopt regulations, in accordance with the provisions of chapter 54, to implement the provisions of this section.
This act shall take effect as follows and shall amend the following sections:
July 1, 2015
The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose. In general, fiscal impacts are based upon a variety of informational sources, including the analyst's professional knowledge. Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.
OFA Fiscal Note
The bill requires hospitals to test for cytomegalovirus when a newborn fails a hearing screening. This requirement may have a fiscal impact for the University of Connecticut Health Center (UCHC). The cytomegalovirus test at UCHC costs approximately $150. As only a few infants annually fail the newborn hearing screening at UCHC, any cost incurred at UCHC is expected to be minimal. Additionally, such costs may be offset by private insurance billing, to the extent that the test is a covered service. The bill also requires hospitals to report positive tests for cytomegalovirus to the Department of Public Health.
House “A” added the reporting requirement for hospitals. There was no associated fiscal impact.
The Out Years
OLR Bill Analysis
Starting January 1, 2016, this bill requires all health care institutions caring for newborn infants to test those who fail a newborn hearing screening for cytomegalovirus (CMV). It requires the testing to be done (1) within available appropriations and (2) as soon as is medically appropriate, unless, as allowed by law, their parents object on religious grounds.
Like existing law that requires these institutions to test newborn infants for cystic fibrosis, severe combined immunodeficiency disease, and critical congenital heart disease, the test for CMV is not part of the state's newborn screening program for genetic and metabolic disorders. That program, in addition to screening, directs parents of identified infants to counseling and treatment.
The bill also requires health care institutions to report CMV cases confirmed by the screening to the Department of Public Health (DPH) in a form and manner the commissioner prescribes.
*House Amendment “A” requires health care institutions to report confirmed CMV cases to DPH.
EFFECTIVE DATE: July 1, 2015
CMV is a type of herpesvirus, which places it in a group with chickenpox, shingles, and mononucleosis. Although usually harmless in healthy adults and children, CMV in newborns can lead to hearing loss or developmental disabilities. Transmission from mother to fetus occurs during pregnancy.
HB 5271, reported favorably by the Public Health Committee, requires health care institutions to test newborns for globoid cell leukodystrophy once certain conditions are met.
Public Health Committee