- Are hospitals required to provide documentation to the state describing their plan for conducting newborn hearing screening?
- Are hospitals required to complete and submit hearing related fields in the Electronic Birth Certificate?
- Are hospitals required to provide parents with a copy of the Newborn Hearing Follow-up Report if additional outpatient testing is needed?
- What is the hospital’s responsibility for ensuring that infants have follow-up after hospital discharge?
- When does the hospital’s responsibility for ensuring follow-up end?
- What about children who live in New Jersey , but receive follow-up care out of state?
- What about children who live out of state?
- How do hospitals get reimbursed for the cost of testing?
1. Are hospitals required to provide documentation to the state describing their plan for conducting newborn hearing screening?
According to P.L. 2001, c. 373, C:26:2-103.4:
Every hospital that provides inpatient maternity services and every birthing center licensed in the State pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) shall be required to provide for newborn screening for hearing loss for all newborns born at the facility. The hospital or birthing center shall file a plan with the department, in a manner and on forms prescribed by the commissioner, detailing how the hospital or birthing center will implement the newborn hearing screening requirements.
2.Are hospitals required to complete and submit hearing related fields in the Electronic Birth Certificate?
According to N.J.A.C. 8:19-1.6(a):
For each live newborn born at, or transferred to a birthing facility that has elected to participate in the submission of birth certificates electronically by means of the Electronic Birth Certificate Registration System, the birthing facility shall report, within one week of the newborn's discharge or transfer, the EBC fields or information identified below to the Department by means of the Electronic Birth Certificate Registration System in the manner prescribed by the State Registrar of Vital Statistics for the submission of EBCs the mother's first name; the mother's last name; the child's first name; the child's last name; sex; race; primary language; hearing screening results for each ear; the screening methodology used for each ear; the date of screening for each ear; initial screening vs. rescreening indicator; indicator if referral was made for audiologic follow-up; the name of the provider to whom referral was made, if applicable; and specific neonatal conditions and procedures (family history of hearing loss, TORCH, congenital syphilis, persistent pulmonary hypertension, stigmata/syndromes associated with hearing loss, hyperbilirubinemia, meningitis, exchange transfusion, ECMO, ototoxic medication, days of mechanical ventilation, one and five minute Apgar scores, birthweight, NICU admission and discharge dates).
3. Are hospitals required to provide parents with a copy of the Newborn Hearing Follow-up Report if additional outpatient testing is needed?
According to N.J.A.C. 8:19-1.9(j):
When follow-up is required in accordance with N.J.A.C 8:19-1.9(b) or N.J.A.C 8:19-1.9(c), the birthing facility shall provide parents with a Newborn Hearing Follow-up Report form with the demographic information completed either prior to discharge or by one month of age.
4. What is the hospital’s responsibility for ensuring that infants have follow-up after hospital discharge?
The newborn hearing screening law (PL 2001, Chapter 373, C.26.2.-103.4 (c)) states that hospitals should have “guidelines for the provision of follow-up services for infants identified as having or being at risk of developing a hearing loss.” The law and current regulations do not indicate what form these guidelines should take or what activities should be considered sufficient.
The EHDI program expects hospitals to determine and document their plan for ensuring follow-up and to evaluate the success of their plan. The EHDI program expects hospitals to ensure that their guidelines for ensuring follow-up are successful.
Hospitals, primary care providers, the New Jersey EHDI program, and parents all bear some responsibility for ensuring that appropriate follow-up occurs.
Some strategies for ensuring follow-up for children who need additional testing include:
- Ensuring parents have a copy of the “Newborn Hearing Follow-Up Report” (form SCH-2) to bring to the provider of follow-up care to ensure that follow-up testing is reported to the EHDI program.
- Providing parents with written documentation in their primary language describing the inpatient testing results and the reason that additional testing is needed.
- Providing parents with personalized education regarding the inpatient results and the importance of follow-up testing, and allowing the opportunity for parents to ask questions.
- Providing the baby’s primary care provider with written notification that the baby needs additional testing.
- Making an appointment for follow-up audiologic testing prior to the baby’s discharge from the hospital.
- If an appointment cannot be made, providing the parent with a list of audiologic testing providers in their area that may be able to provide follow-up testing.
- Providing referral to a facility or provider located near the parent’s home and/or familiar to the parents.
- Making reminder phone calls to the family to encourage the completion of follow-up testing.
- Sending written reminders to the family in their primary language to encourage the completion of follow-up testing.
- Utilize quarterly reports generated by the New Jersey EHDI program to identify children who have not completed follow-up for targeted outreach.
5.When does the hospital’s responsibility for ensuring follow-up end?
When the hospital has established a plan for ensuring follow-up, their responsibility ends when that plan has been implemented to the best of their abilities. The New Jersey EHDI program expects hospitals to notify the EHDI program when known barriers to the receipt of follow-up care are encountered, such as letters returned undeliverable, families known to have moved out of state, or families refusing follow-up testing.
6.What about children who live in New Jersey , but receive follow-up care out of state?
It is the expectation of the New Jersey EHDI program that if parents give a Newborn Hearing Follow-up Report (SCH-2 form) to the provider of the follow-up care, that provider, even if out of state, will complete the form and return it to the New Jersey EHDI program.
Since the New Jersey EHDI program can not enforce compliance of out of state providers, the New Jersey EHDI program asks hospitals or physicians to report out of state evaluations to the New Jersey EHDI program.
7.What about children who live out of state?
New Jersey hospitals have routine follow-up strategies, such as educating parents and providing the parents and primary care providers with written documentation of test results. These follow-up strategies should be exercised on all infants born at their facility including those who live out of state.
Families can be referred to their home state’s EHDI program with questions regarding follow-up options in their area.
8.How do hospitals get reimbursed for the cost of testing?
New Jersey’s newborn hearing screening law specifically addresses reimbursement and reads: “Screening for newborn hearing loss by appropriate electrophysiologic screening measures and periodic monitoring of infants for delayed onset hearing loss, pursuant to PL 2001, c373 (C26:2-103 et al.). Payment for this screening service shall be separate and distinct from payment for routine new baby care in the form of a newborn hearing screening fee as negotiated with the provider and facility.
Providers are encouraged to bill insurance companies for the service to be appropriately compensated for this testing.
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