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PRINTER'S NO. 2091
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1478
Session of
2015
INTRODUCED BY ROZZI, O'BRIEN, HARKINS, YOUNGBLOOD, CALTAGIRONE,
THOMAS, BISHOP, KINSEY, V. BROWN, PASHINSKI, McNEILL,
MILLARD, MURT, M. DALEY, A. HARRIS, FARINA, D. COSTA AND
COHEN, AUGUST 10, 2015
REFERRED TO COMMITTEE ON HEALTH, AUGUST 10, 2015
AN ACT
Establishing the Infant Vision Information, Education and
Wellness Program; and providing for powers and duties of the
Department of Health.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Infant Vision
Information, Education and Wellness Act.
Section 2. Legislative findings and purpose.
(a) Findings.--The General Assembly finds as follows:
(1) Early detection of vision-threatening and
potentially life-threatening vision abnormalities is vital
for early treatment of ocular diseases that occur frequently
in newborns and infants.
(2) Emphasis on early detection of vision abnormalities,
including cataracts, glaucoma, leukocoria, retinoblastoma,
retinal abnormalities, systemic diseases with ocular
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manifestations and high refractive errors, can help prevent
long-term disability and developmental delays in children.
(3) Children with abnormal ocular diseases who receive
screening during the neonatal and infant period must be
referred to an ophthalmologist or optometrist for follow-up
consultation and treatment.
(4) The American Academy of Pediatrics currently
recommends red reflex assessment as a component of the vision
evaluation during the neonatal period and during all
subsequent routine health visits.
(5) The red reflex assessment is conducted by a
pediatrician or other primary care provider using an
ophthalmoscope during the neonatal period after birth, at the
age of six weeks and during routine health visits.
(b) Purpose.--The purposes of this act are to provide:
(1) Infant vision screening for all newborns born in a
hospital or within 30 days of the date of birth for those
newborns born outside a hospital to enable these infants and
their families to obtain needed comprehensive evaluation,
treatment and intervention services at the earliest
opportunity and to thus prevent or mitigate the developmental
delays and excessive costs associated with late
identification of vision abnormalities.
(2) The Department of Health with the information
necessary to effectively plan, establish, administer and
evaluate this comprehensive program of appropriate services
for newborns, infants and children who have vision
abnormalities.
Section 3. Definitions.
The following words and phrases when used in this act shall
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have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Birth admission." The time after birth that the newborn
remains in the hospital or birth center prior to discharge.
"Birth center." An entity licensed as a birth center under
the act of July 19, 1979 (P.L.130, No.48), known as the Health
Care Facilities Act.
"Child." An individual who is under 21 years of age.
"Committee." The Department of Health's Newborn Vision
Screening Advisory Committee.
"Department." The Department of Health of the Commonwealth.
"Early intervention." The Statewide system of coordinated,
multidisciplinary, interagency programs in existence on the
effective date of this act maintained by the Department of
Education, the Department of Health and the Department of Human
Services to provide appropriate services to all eligible
infants, children and their families under the act of December
19, 1990 (P.L.1372, No.212), known as the Early Intervention
Services System Act.
"Health care facility." A hospital providing clinically
related health services for obstetrical and newborn care, or a
birth center. The term includes a hospital providing clinically
related health services for obstetrical and newborn care, or a
birth center operated by an agency, the State or local
government. The term does not include an office used primarily
for private or group practice by health care practitioners if no
reviewable clinically related health services are offered.
"Infant." A child 30 days of age up to 24 months of age.
"Newborn." A child up to and including 29 days of age.
"Parent." A natural parent, stepparent, adoptive parent,
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legal guardian or legal custodian of a child.
"Program." The Infant Vision Information, Education and
Wellness Program.
"Secretary." The Secretary of Health of the Commonwealth.
Section 4. The Newborn Vision Screening Advisory Committee.
(a) Membership.--The secretary shall appoint a six-member
Newborn Vision Screening Advisory Committee within the
department. The committee shall:
(1) Advise and make recommendations on issues relating
to the following:
(i) Program regulation and administration.
(ii) Diagnostic testing.
(iii) Technical support.
(iv) Follow-up.
(2) Be comprised of members with experience with infant
eye pathology, pediatric ophthalmology, optometry and common
vision screening and assessment tests.
(b) Compensation.--Members shall serve without compensation
but may be reimbursed for necessary travel and other expenses in
accordance with applicable law and regulations.
(c) Protocol.--On or before June 30, 2016, the department
shall adopt the protocol developed by the American Academy of
Pediatrics to optimally detect the presence of treatable causes
of blindness in infants by two months of age. If a protocol is
not developed on or before June 30, 2016, the department, in
consultation with the committee, shall establish a protocol to
optimally detect the presence of treatable causes of blindness
in infants by two months of age on or before January 1, 2017.
Section 5. Newborn vision screening education and assessment.
(a) Establishment.--The department shall establish the
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Infant Vision Information, Education and Wellness Program,
consisting of the following components:
(1) A system to screen each newborn in this Commonwealth
for vision abnormalities before leaving a hospital.
(2) A system to screen each newborn who is not born in a
hospital within the first 30 days of life.
(3) A system to provide information and instruction to
the parents of each newborn and infant on the merits of
having vision screening performed and receiving follow-up
care.
(b) Program administration.--The department shall, in
cooperation with the committee, provide technical support,
including ophthalmological, optometric and administrative
technical support, to the health care facilities and individuals
implementing the requirements of subsection (a).
(c) Refusal of test.--Screening shall not be required if a
parent of the newborn or infant objects to the screening for any
reason. The refusal must be documented in writing, made a part
of the medical record of the newborn or infant and reported to
the department in a manner prescribed by the department.
(d) Implementation.--The program shall be implemented as
follows:
(1) By July 1, 2017, newborn and infant vision screening
shall be conducted on each live birth in health care
facilities in this Commonwealth during birth admissions using
procedures recommended by the department's advisory
committee, except as provided in subsection (c). If a newborn
is born in a location other than a hospital, the parents must
be instructed on the merits of having the vision screening
performed and given information to assist the parents in
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having the screening performed within 30 days of the
newborn's birth. The department shall determine the
appropriate screening venue for a newborn born outside a
hospital.
(2) If the number of newborns and infants receiving
vision screening does not equal at least 85% of the total
number of live births in this Commonwealth on July 1, 2017,
as shown in the most recent data collected by the department
or falls below 85% annually after July 1, 2017, the
department in consultation with the advisory committee shall
immediately promulgate regulations to implement a State-
administered vision screening program.
(3) By July 1, 2016, each health care facility in this
Commonwealth shall provide information and instruct the
parents of newborns and infants concerning the importance of
screening the vision of newborns and infants and of receiving
follow-up care. The information shall be as follows:
(i) An informational pamphlet developed and supplied
by the department shall explain in lay terms all of the
following:
(A) The importance and process of vision
screening.
(B) The likelihood of a newborn or infant having
vision abnormalities.
(C) Follow-up procedures and available early
intervention services.
(D) A description of the normal vision
developmental process in children.
(ii) The information under subparagraph (i) shall
not preclude the health care facility from providing
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additional material.
(iii) The information may not be considered a
substitute for the vision screening.
(4) By July 1, 2016, every hospital in this Commonwealth
shall report to the department, in a manner prescribed by the
department, the number of newborns and infants screened and
the results of the screening. The department, based on the
information, shall report to the General Assembly by January
1, 2017, and every January 1 thereafter, the following:
(i) The number of hospitals conducting vision
screenings during birth admissions.
(ii) The number of live births in hospitals.
(iii) The number of newborns screened during birth
admissions.
(iv) The number of live births in a location other
than a hospital.
(v) The number of newborns born in a location other
than a hospital who were screened within 30 days of the
date of birth.
(vi) The number of newborns born in a hospital who
passed and the number who did not pass the birth
admission screening, if administered.
(vii) The number of newborns born in a location
other than a hospital who passed and the number who did
not pass a screening within 30 days of the date of birth,
if administered.
(viii) The number of infants who returned for
follow-up rescreening.
(ix) The number of infants who passed the follow-up
rescreening.
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(x) The number of infants recommended for
monitoring, intervention and follow-up care.
Section 6. Reporting and referral.
(a) Duties.--The department shall implement a reporting and
referral system that links vision screening, if necessary, with
optometric and ophthalmologist services and other early
intervention services. The Commonwealth may do all the
following:
(1) Identify 100% of newborns and infants with vision
abnormalities within 30 days of the date of birth.
(2) Provide timely assessment if indicated.
(3) Provide appropriate referral for treatment and
intervention before the age of six months.
(b) Program administration.--The department shall, in
consultation with the committee, provide administrative
technical support to the facilities implementing the reporting
and early intervention referral system under this section.
(c) Implementation.--The department, in consultation with
the committee, shall issue temporary guidelines by July 1, 2016,
implementing a reporting and early intervention referral system
for newborns, infants and children who have been recommended for
further assessment. The temporary guidelines shall expire on
June 30, 2017, or upon promulgation of regulations under section
8, whichever occurs first.
Section 7. Confidentiality of records.
(a) Limitations.--A person, employee or agent of a person
who obtains information under this act may not disclose the
information except to the parent of the infant or child or to
the department for statistical recordkeeping or for appropriate
treatment referral and early intervention services.
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(b) Confidentiality.--
(1) Data obtained directly from the medical records of a
patient shall be considered confidential and shall be for the
confidential use of the department in maintaining the
tracking system and in providing appropriate services. The
information shall be privileged and may not be divulged or
made public in any manner that discloses the identity of the
patient. Information considered confidential under this
paragraph shall be exempt from access under the act of
February 14, 2008 (P.L.6, No.3), known as the Right-to-Know
Law.
(2) Anonymous statistical information collected under
the tracking system shall be considered a public record under
the Right-to-Know Law.
(c) Good faith.--A person who acts in good faith in
complying with this section by reporting newborn and infant
vision screening results to the department may not be held
civilly or criminally liable for furnishing the information
required by this act.
Section 8. Regulations.
The department shall promulgate regulations to implement the
provisions of this act.
Section 9. Effective date.
This act shall take effect in 90 days.
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