STAND. COM. REP. NO. 2543

Honolulu, Hawaii

RE:    S.B. No. 2194

       S.D. 1

Honorable Donna Mercado Kim

President of the Senate

Twenty-Seventh State Legislature

Regular Session of 2014

State of Hawaii

Madam:

     Your Committees on Health, Commerce and Consumer Protection, and Ways and Means, to which was referred S.B. No. 2194 entitled:

"A BILL FOR AN ACT RELATING TO HEALTH,"

beg leave to report as follows:

     The purpose and intent of this measure is to:

     (1)  Require the Department of Health to require birthing facilities to perform a critical congenital heart defect screening using pulse oximetry on every newborn in its care prior to discharge from the birthing facility;

     (2)  Make an exception for parents, guardians, or other persons having custody or control of the child who object to pulse oximetry screening on the grounds that the tests conflict with their religious tenets and beliefs, and written objection is made a part of the infant's medical record;

     (3)  Require the Department of Health to adopt rules as necessary to effectuate the program for newborn critical congenital heart defect screening using pulse oximetry; and

     (4)  Make an appropriation to support a program for newborn critical congenital heart defect screening using pulse oximetry.

     Your Committees received testimony in support of this measure from the Department of Health, American Heart Association, Kapiolani Medical Center for Women and Children, Kaiser Permanente, American Congress of Obstetricians and Gynecologists, March of Dimes, American Academy of Pediatrics, The Queen's Health Systems, and three individuals.

     Your Committees find that congenital heart defects are structural abnormalities of the heart that are present at birth and are the number one killer of infants with birth defects.  Congenital heart disease is the most common serious birth defect, occurring in one out of four hundred births in Hawaii and accounting for more deaths than any other malformation.  Unfortunately, more than half of patients with a missed diagnosis of critical congenital heart disease will die at home or in an emergency room before their heart disease is recognized.

     Your Committees further find that pulse oximetry is a simple, non-invasive test that helps identify more than ninety percent of heart defects in newborns.  This measure ensures that Hawaii families are provided with the most recent standard of care for newborn health screenings.

     Your Committees have amended this measure by:

     (1)  Requiring birthing facilities to follow procedures, in addition to pulse oximetry tests, as specified by the guidelines of the American Academy of Pediatrics;

     (2)  Deleting the provision mandating the Department of Health to require each birthing facility to perform critical congenital heart defect screenings;

     (3)  Deleting the provision mandating that the person in charge of each institution caring for newborn infants and the responsible physician attending the birth of a newborn, or the person assisting the birth of a child not attended by a physician, ensure that every infant in the person's care be tested for congenital heart defects through pulse oximetry screening;

     (4)  Deleting the provision mandating the Department of Health to adopt rules as necessary to effectuate the purposes of this measure; and

     (5)  Making technical, nonsubstantive amendments for the purposes of clarity and consistency.

     Your Committees note that although the initial investment in the equipment used for pulse oximetry screening may be costly for some birthing facilities, the subsequent costs of pulse oximetry screening are estimated at below $4 per baby.  In fact, Kapiolani Medical Center estimates its cost to implement the screening using reusable equipment at $1 per baby.  Your Committees further note that it is pertinent to discuss whether this measure may be applied to the home birth setting, since home birth practitioners may not have access to the necessary equipment for pulse oximetry screening.

     As affirmed by the records of votes of the members of your Committees on Health, Commerce and Consumer Protection, and Ways and Means that are attached to this report, your Committees are in accord with the intent and purpose of S.B. No. 2194, as amended herein, and recommend that it pass Second Reading in the form attached hereto as S.B. No. 2194, S.D. 1, and be placed on the calendar for Third Reading.

Respectfully submitted on behalf of the members of the Committees on Health, Commerce and Consumer Protection, and Ways and Means,

____________________________ ROSALYN H. BAKER, Chair	____________________________ JOSH GREEN, Chair
	____________________________ DAVID Y. IGE, Chair