N.J. Admin. Code § 8:19-1.3

Current through Register Vol. 56, No. 21, November 4, 2024

Section 8:19-1.3 - Universal newborn hearing screening

(a) Each newborn shall receive hearing screening in accordance with this chapter by no later than the infant attaining the 28th day of life unless the infant has not been medically cleared to receive hearing screening before or as of the infant attaining the 28th day of life, in which case the infant shall receive hearing screening as soon as the infant is medically cleared for hearing screening.

(b) Subject to (b)1 below, the birthing facility, audiologist, midwife or responsible physician, as applicable, performing initial hearing screening in accordance with (a) above shall have discretion to determine the type of physiologic hearing screening measure to be used.

1. The birthing facility, audiologist or responsible physician, as applicable, shall use ABR in screening infants who, prior to the first discharge home, have been patients in the neonatal intensive care unit of one or more birthing facilities for a combined total of longer than five days.

(c) If a birth occurs outside a birthing facility, such as at home, and the newborn is not transferred to a birthing facility, then the midwife or responsible physician shall advise the parent of the availability of newborn hearing screening, and take such action as needed, so as to facilitate the performance of hearing screening of the newborn pursuant to (a) above.

1. If the responsible physician or midwife performs hearing screening on the newborn, the responsible physi-cian or midwife, as applicable, shall make a Newborn Hearing Follow-up Report within 10 business days of the screening, in accordance with 8:19-1.10.

(d) Each birthing facility shall file a plan with the EHDI program detailing how the birthing facility will implement newborn hearing screening in accordance with this chapter by July 31st of each year. The plan shall include, at a minimum:

1. The physiologic hearing screening measure to be performed;

2. The make and model of the hearing screening equipment the birthing facility will use in performing new-born hearing screening;

3. The time frame after birth that the initial screening is to be performed;

4. The qualifications of and training received by personnel designated to perform the physiologic hearing screening measure;

5. The establishment of quality assurance protocols to determine and evaluate the effectiveness of the program in ensuring that all newborns are screened for hearing loss;

6. The month designated for annual performance evaluation of the hearing screening equipment identified in (d)2 above by a technician authorized by the device manufacturer to confirm and, as necessary, provide service and adjustment to ensure, that the device is performing to the manufacturer's specifications;

7. The name of the licensed audiologist or physician designated pursuant to 8:19-1.5(a);

8. The mechanism by which the birthing facility shall ensure the performance of newborn screening in accor-dance with 8:19-1.4 upon an infant who requires transfer to another facility prior to the performance of newborn screening;

9. Guidelines for the provision of follow-up services for newborns who do not pass initial audiologic screening, who are not screened prior to nursery discharge and/or who are at risk for developing late-onset hearing loss;

10. The events or occurrences upon which a birthing facility shall base a determination that an infant is lost to follow-up, and triggering the birthing facility's reporting obligation pursuant to 8:19-1.10(c).

11. The educational and counseling services to be provided to the parents of newborns identified as having, or being at risk for developing, hearing loss;

12. The guidelines for entering hearing screening results and risk indicators for late-onset hearing loss into the EBC system;

13. The protocol to be followed to ensure the confidentiality of any patient-specific information to be reported to the Department pursuant to this chapter; and

14. Ototoxic drug screening procedures for infants and children under the age of three who are admitted to the hospital for medical conditions that require administration of ototoxic medication.

(e) In addition to annually filing a plan with the Department pursuant to (d) above, a birthing facility shall notify the Department within 10 business days of a change to the plan on file with the Department with respect to one or more of the components of the plan required by (d)1, 2, 6, and/or 7 above.

(f) Infants who are too medically unstable to undergo screening by one month of age shall be screened when medically cleared and before discharge to home.

(g) If, upon initial hearing screening, a non-passing result is obtained for one or both of an infant's ears and a birthing facility performs rescreening prior to the infant's first discharge home, the birthing facility, in performing rescreening, shall rescreen both ears.

(h) If, upon initial hearing screening, a non-passing result using ABR is obtained for one or both of an infant's ears and a birthing facility performs rescreening prior to an infant's first discharge home, the facility shall use ABR in performing rescreening.

(i) If, upon initial hearing screening, a non-passing result using OAE is obtained for one or both of an infant's ears and a birthing facility performs rescreening prior to an infant's first discharge home, the facility shall use either OAE or ABR in performing rescreening.

(j) A birthing facility shall rescreen an infant who was discharged home and thereafter is readmitted to a birthing facility, regardless of the result of the infant's initial hearing screening or rescreening, if the readmission is for:

1. Hyperbilirubinemia that requires exchange transfusion; or

2. Culture-positive sepsis.

(k) Subject to (k)1 below, if, upon either initial hearing screening or rescreening, a birthing facility or, as applicable, a responsible physician or midwife, identifies an infant to be in need of rescreening or audiologic evaluation, the person or entity making the identification shall refer the infant for rescreening or audiologic evaluation to individuals who are licensed and trained to perform rescreening or audiologic evaluation pursuant to 8:19-1.5(b).

1. Upon initial hearing screening or rescreening, pursuant to (b)1 above, of infants who, prior to the first dis-charge home, have been patients in the neonatal intensive care unit of one or more birthing facilities for a combined total of longer than five days, a birthing facility, audiologist or responsible physician, as applicable, shall refer infants who do not pass to an audiologist licensed pursuant to 45:3B-1 et seq. and N.J.A.C. 13:44C.

N.J. Admin. Code § 8:19-1.3