Editor’s Note: The investigative news website ProPublica recently reported that an inexpensive screening test has been credited for saving the lives of newborns. But 17 states don’t require that test. It turns out Hawaii is one of them. Read ProPublica’s report on our site today, too.

Hawaii is one of only 17 states that does not have a law that requires critical congenital heart defect screenings at birth.

Congenital heart defects are the most common birth defects faced by newborns in the United States, according to the Centers for Disease Control and Prevention, and can result in death or disability if not immediately detected.

But the screening, known as a pulse oximetry test, is inexpensive and noninvasive, involving little more than light sensors attached to a baby’s hands and feet to measure the oxygen levels in their blood.

Now, Hawaii lawmakers say they will consider legislation in the coming year to require the test.

In Sept. 2011, the U.S. Secretary of Health and Human Services Kathleen Sebelius added the screenings for congenital heart defects to the “Recommended Uniform Screening Panel” for newborns, which is a best practices guide for hospitals and birthing centers.

Starting with New Jersey, most states have taken action and have legislation in place so all babies are required to be screened for congenital heart defects before leaving the hospital.

While that’s not the case in Hawaii, many of the state’s largest hospitals perform the screening already. The same can’t be said for rural hospitals on neighbor islands.

“Many of the birthing facilities in Hawaii have implemented (congenital heart defect) screening before discharge,” said Sylvia Mann, Hawaii State Genetics Coordinator at the Department of Health. “Kapiolani, Queens, Kaiser, Castle and Tripler all do (the) screening.”

But smaller, rural hospitals, such as Maui Memorial Hospital in Wailuku, don’t necessarily do the screening on every newborn.

The Department of Health drafted a bill this past legislative session — House Bill 905 — that would have required testing for all newborns born in Hawaii.

HB905 stalled in committee and died when the session ended.

According to Don Weisman of the American Heart Association’s Hawaii chapter, the bill ran into problems when the language “overstepped it a little bit.”

The legislation was originally to be only about the pulse oximetry test, as was agreed on by all involved, including the Healthcare Association of Hawaii, the American Heart Association and the Department of Health.

But the department made the language broader so that the bill would cover all future federal health recommendations, preventing officials from having to keep going back to the Legislature every time there was a new one.

Weisman said the Healthcare Association of Hawaii became concerned about the bill being too open-ended and what that might mean for the group in the future. The Department of Health tried to negotiate with the Healthcare Association of Hawaii but weren’t able to come to a deal.

Representatives from the Healthcare Association were unavailable for comment.

Regardless of the failed legislation, all the major birthing centers in the state are implementing the test. The cost, Weisman noted, is as little as 50 cents, and is important to prevent long-term health costs that can occur if parents find out about the defect too late. Fees charged at birthing facilities cover these costs and are recovered through third party payer reimbursements.

Hawaii Medical Service Association, the largest healthcare provider in the state, was not for or against the legislation, according to a spokesperson.

“While there were some who expressed concerns about the way this bill was worded, we’re confident that by working together with legislators, our providers, and our members, we can find a solution that will improve the health of all Hawaii infants,” Vice President of Government Relations Jennifer Diesman said in an email. “However, HMSA has always supported preventive screenings.”

The CDC estimates that one in 555 newborns have a heart defect and require surgery in their first year of life; up to 1,500 newborns go home every year without being diagnosed.

The good news is, of the roughly 20,000 births in Hawaii each year, congenital heart defects affect very few.

Dr. Ralph Shohet, who serves on the board of directors at the American Heart Association and is a professor at the University of Hawaii John A. Burns Medical School, said most cases are caught before a child is even born. This is mainly due to the high level of prenatal care that’s typically received in Hawaii, he said.

“It [the pulse oximetry test] might not affect even one child a year,” Shohet said. However, he still thinks the test is useful.

So while the HB905 — which should have been a “no-brainer,” according to Weisman — didn’t pass, Weisman said there will be a new bill submitted in the upcoming session that would specifically target the pulse oximetry test for congenital heart defects.

He also believes there will be no problems this time around.

“I don’t know who would oppose it,” Weisman said. “The outcome is to save babies lives. Who would fight that?”

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