MD DHMH Hearing Screen law for newborns??

[reborn]

I had a lovely homebirth about 7.5 weeks ago and I just received a letter from the Dept of Health & Mental Hygiene stating that my baby missed or failed the hospital hearing screen (lol) and I must schedule a follow-up appt within two weeks.  

My midwife never mentioned anything about this to me in all of the paperwork and stuff she gave me to take care of after the birth.  I'm wondering if this test is *really* required by law?  If not, I see no need for it, as my son is extremely sensitive to and startled by even the slightest noise (haha) and is certainly not hearing impaired.  If I suspect there are issues with his hearing in the future, I'm certainly capable of seeking medical advice without any legal obligation to do so.

The letter I received states that "The State of Maryland requires that all newborn infants be screened for possible hearing loss before they are discharged from the hospital."

I wondered if any other MD homebirthers received this letter and what they did about it...  it's actually pretty vague about even how to schedule a test if you missed it.  There's just a hearing helpline 1-800 number included.

Thanks!

[LaurenAnanas]

Yes, it is required by law, and I got that same letter after my son's homebirth.... even though he had and passed a hearing test.  From what I've been able to figure out, it's the only newborn procedure that is "mandatory" in Maryland. I think it's easier to skip vaccines and the heel prick blood screening than the hearing test. So, in the grand scheme of unnecessary stuff, it's the one you probably want to just give in and play nice on.

It's totally painless and non-invasive. If you have insurance, it's probably covered, but you may need a refferal from your ped or family practice doc, I don't know.

For both of my kids, we just went to an audiologist's office for "the newborn hearing exam" and they stuck a little soft probe in each ear that measures ear drum vibrations or something. Then I held the baby in a sound booth, they made a loud noise and watched the baby startle. My daughter slept though hers. My son just made wide eyes at the doc.

We used Audiology Associates in Ellicott City, but I believe they have locations all over. They said almost all of the babies they see are home births. 

If you decide to fight it, I'd love to hear what happens.

[imnottelling]

When did this become law?

My son born in 05 had it done at the hospital.

I don't remember my son born at home in 07 having it done.

My daughter born in 08 had it done (our ped was on vacation; at her appt by the one who took over, he did it).

My daughter born in '10 didn't have it done. Never got any such letter.

Has the law been started in the past year?

It's not the only mandatory procedure AFAIK. Isn't PKU also mandated?

[LaurenAnanas]

My daughter, born in '08, had a hearing screen. Both the birth center and our ped told us it was State law then. If my HB midwife mentioned it this time, I don't remember. 

Here's a website, that says it was enacted in 2000: http://fha.maryland.gov/genetics/inf_hrg.cfm

I don't know for sure about the PKU/newborn screen. Our ped said it was optional but she highly recommended it "just in case." The State website (http://dhmh.maryland.gov/labs/html/nbs.html) talks like it's required but does not cite any laws and uses the word "recommend."

[JamieCatheryn]

Usually those state laws requiring screenings hold the hospital to giving it, not the parents to having it done. But if your ped offers it might as well have it done, not like it's invasive.

[reborn]

Originally Posted by imnottelling 

When did this become law?

My son born in 05 had it done at the hospital.

I don't remember my son born at home in 07 having it done.

My daughter born in 08 had it done (our ped was on vacation; at her appt by the one who took over, he did it).

My daughter born in '10 didn't have it done. Never got any such letter.

Has the law been started in the past year?

It's not the only mandatory procedure AFAIK. Isn't PKU also mandated?

Did you submit paperwork for birth certificate and SS#?  I know some people don't do SS#'s so that's why I ask... I'm guessing that paperwork is how they know I had a baby and didn't have a hearing test... dunno.

[reborn]

Originally Posted by LaurenAnanas 

Yes, it is required by law, and I got that same letter after my son's homebirth.... even though he had and passed a hearing test.  From what I've been able to figure out, it's the only newborn procedure that is "mandatory" in Maryland. I think it's easier to skip vaccines and the heel prick blood screening than the hearing test. So, in the grand scheme of unnecessary stuff, it's the one you probably want to just give in and play nice on.

It's totally painless and non-invasive. If you have insurance, it's probably covered, but you may need a refferal from your ped or family practice doc, I don't know.

For both of my kids, we just went to an audiologist's office for "the newborn hearing exam" and they stuck a little soft probe in each ear that measures ear drum vibrations or something. Then I held the baby in a sound booth, they made a loud noise and watched the baby startle. My daughter slept though hers. My son just made wide eyes at the doc.

We used Audiology Associates in Ellicott City, but I believe they have locations all over. They said almost all of the babies they see are home births. 

If you decide to fight it, I'd love to hear what happens.

Thanks for the info!  It would be fun to fight it, but pointless.   The only reason I don't want to do it, other than hating to be forced to do stuff like this, is that it would be a PITA and another thing to pay for (hopefully insurance will cover).  Fighting it would be a much bigger PITA, so...  I will ask my pediatrician about it.  I just think it's weird that neither my ped or midwife mentioned this in all the times I've seen them since the birth.  Are they trying to get me arrested?  I'm breaking the LAW! 

[imnottelling]

My midwife submits the BC/SS stuff....

Watch them come to me in 5 years and see that their records show my daughter never had her hearing tested...what are they going to do? Force it after she's talking up a storm? :)

M/W confirmed for me it is mandatory, and if my ped doesn't do it, I can go elsewhere to do it...heh. As if I care. I don't mind the testing done on premises, but the hassle of bringing a newborn somewhere if there is no reason to suspect an issue is too much for the postpartum mommy. There is enough other things to take care of!

[raelize]

huh. i had both babies born at home and nobody ever even suggested it. born in 2005 and 2008. we submitted our paperwork for birth cert and SS through our M/W and we did all the well baby check ups and nobody ever told us. i'm not worried about their hearing, but i guess it falls under the hospital following through, not on me seeking it out. 

[hb2mom]

Maryland (1999)

Each hospital with obstetrical services must establish a universal hearing screening program for all newborns prior to discharge, as part of Maryland's Program for Hearing-Impaired Infants. Hospitals must complete the High Risk Questionnaire (HRQ) for Infant Hearing Loss for all live births to be submitted to the Department of Health, and refer at-risk infants for hearing screening before discharge, if possible. Alternative birthing sites must complete and submit the HRQ to the Department. The Program also includes an Advisory Council to advise the Department on screening protocols; a system for gathering and maintaining confidential data; methods to inform parents and primary care providers of screening results; a telephone hot line for information and services; and an educational program for families, professionals, and the public. Managed care organizations and health insurance carriers must provide coverage for screenings and hospitals must provide the results of the screenings to the Department as part of the required birth event information.

Maryland Code of Regulations 10.11.02 (Program for Hearing-Impaired Infants)

http://www.asha.org/Advocacy/state/bill_status/

The law is not that your baby must be tested, but that hospitals with OB services must provide a hearing screening program.  So neither you nor your midwife are breaking the law by not having your newborn screened.  The purpose of hearing screening programs are to identify babies who have any level of hearing deficit so that parents can become informed and be prepared for early intervention.

As you can see, the law also includes that insurance must cover it.

If your ped didn't mention it, it's probably because since most babies have it done in the hospital, it's not part of their routine care at the first office visit.  They just don't think of it.

Homebirth midwives should be aware of this screening option for parents and let them know how to get it done if they choose to do it.  It's a simple, non-invasive test best done while the baby is asleep.  It does not need to be done in the first few days or even weeks after birth, you go when and if you want to.

http://www.babyhearing.org/hearingamplification/newbornscreening/howscreeningworks.asp

Google brings up audiology centers in the Balto-Annapolis area - it doesn't have to be in a hospital setting, as Lauren previous poster mentioned.

[secondimpression]

DD was born at home a year ago and we never got a letter like that either. Our ped recommended it but didn't have the equipment in her office to do it and we just never got around to it really. She also said that the state will pay for it if a child doesn't have insurance and isn't eligible for medical assistance. DS had it done when he was born and slept through the whole procedure which took all of a few seconds to do, no big deal.

[IdentityCrisisMama]

I am getting the letters too.  HM/CPM and I applied for SSN/BC by myself.  My DC's doctor (Morgan-Cooper, she has a lot of HB clients and seems very supportive of the issues/needs of HB families) did warn me though so we were prepared for the hassle.  Interesting that the law is not for parents.  Perhaps worth just responding to the letter if you're interested in fighting.  I'm just sucking it up and doing it.  Monday, in fact.  I'll be bummed if I have to pay my copay.  Ah...the hassle of HB in Maryland.  

[reborn]

Sooo I went and did the screen.  I had to pay a $40 copay.  Today I received a bill for $191.02!!  Apparently the insurance company paid $231.02, and that still left $191.02 for me to pay.  OMG.  I'm soooo annoyed.  $240 for a useless test that I didn't need.  We were in the office for all of 10 minutes and the "doctor" just put these earbuds in his ears... it was all computerized.  how could it have possibly cost that much?! Grrrr...

[spontamyous]

Just wanted to thank reborn for starting this thread - we had our daughter at a birth center and were told we would be required to complete the newborn hearing screen on our own time/dime. (Considering how much I saved our insurance company by having Emerson out of the hospital, this seems crazy, but that's a separate issue...) After contacting two centers that did not file with our insurance (CareFirst BC/BS) and charged base rates of $130 and $174, we ended up going to the audiology center at Georgetown University on Wisconsin Ave NW (202-944-5300). The test was very quick as others have mentioned and they said we did not owe a copay, even though it's usually $25 for specialists. When/if I get a bill, I'll update - but it sounds as though the best thing to do to save money is to ask "do you file through XXX insurance?" when you're making your appointment - if they say no, keep looking! 

I know this is a really old topic, but I'd love to hear if anyone successfully dodged the screening entirely since the wording of the law puts the onus on the hospital. We personally didn't have the energy to fight the system this time.

[secondimpression]

Originally Posted by spontamyous 

Just wanted to thank reborn for starting this thread - we had our daughter at a birth center and were told we would be required to complete the newborn hearing screen on our own time/dime. (Considering how much I saved our insurance company by having Emerson out of the hospital, this seems crazy, but that's a separate issue...) After contacting two centers that did not file with our insurance (CareFirst BC/BS) and charged base rates of $130 and $174, we ended up going to the audiology center at Georgetown University on Wisconsin Ave NW (202-944-5300). The test was very quick as others have mentioned and they said we did not owe a copay, even though it's usually $25 for specialists. When/if I get a bill, I'll update - but it sounds as though the best thing to do to save money is to ask "do you file through XXX insurance?" when you're making your appointment - if they say no, keep looking! 

I know this is a really old topic, but I'd love to hear if anyone successfully dodged the screening entirely since the wording of the law puts the onus on the hospital. We personally didn't have the energy to fight the system this time.

Yeah, I'm curious what's going on with this as well?

I just had #3 at home on 4/2 and we haven't recieved anything except a SSN. Heh, vital records didn't even notify us that his birth certificate was on record this time. Nothing from our pediatrician beyond the same that I posted in my last response after #2 was born.

[notaperfectmom]

I think all the questions have been answered at this point...but I do actually know it is mandatory because I happen to know one of the people who was instrumental in getting the law passed. There were no newborn hearing screens when her daughter was born 35 years ago and no one realized her daughter was deaf until she was 18 months old (and trust me - this was NOT a negligent mother).  If you clap your hands near a person who is deaf they many not "hear" the sound but they can sense a change in air pressure so it's more difficult than you might think to realize an infant has issues. Anyway they missed a huge window of opportunity for intervention. Her brother is also deaf, was immediately diagnosed and has done much better because of it.

Unlike some other newborn procedures and tests it is totally painless and non-invasive....they did it at our pediatrician's office after our homebirth.

On the other hand if you have real concerns, I DO think you should be able to refuse any test. If it helps, my understanding is that the mandatory part had to do with forcing health insurance companies/medicare to pay for it. But just also wanted you to know there were some real families and people behind the reason you got that letter.

[IdentityCrisisMama]

I don't know about the mandatory thing but I had been meaning to come back to this to post about our experiences. First, I will say that I wonder how effective the hospital screening is. I took my baby when she was maybe a few months old and they did not get a good reading at all. She had a lot of wax and the technician didn't seem to feel like she could tell what the heck was going on. We have insurance (Blue Cross) and we paid under $20 out of pocket -- I think it was $9. I think insurance paid about $120. I would recommend checking the prices at your audiologist and confirming insurance coverage before you go so you don't get over charged like a PP did - what a bummer that is! 

[imnottelling]

Originally Posted by secondimpression Heh, vital records didn't even notify us that his birth certificate was on record this time.

Just curious, was his BC actually filed? I also got no notice, and am still unsure if I'll have an issue obtaining a BC for my daughter. I have no idea why I shouldn't get a notice just because it was a HB -- it goes through the same channels by the time the BC is filed.

[secondimpression]

Originally Posted by imnottelling 

Just curious, was his BC actually filed? I also got no notice, and am still unsure if I'll have an issue obtaining a BC for my daughter. I have no idea why I shouldn't get a notice just because it was a HB -- it goes through the same channels by the time the BC is filed.

His BC was on record when we requested a copy about a month after he was born, no problems there. Just never got the card in the mail I got with the first two and thought that was odd. Maybe he slipped through a crack somewhere and that's why I haven't gotten any formal notice about the screening test? Not that it changes what we've done for him medically, I just find it curious that we seem to be the odd ones to not get the notice and he definitely hasn't had the hearing test.