Lawmakers in Hawaii Aim to Pump Life Into Heart Defects Bill

Honolulu Civil Beat - February 25, 2014

By: Manjari Fergusson

A simple test that can save babies lives isn't mandatory in Hawaii.

Last year, a measure that would have required newborns to be screened for congenital heart defects before leaving the hospital didn't make it through the House's health committee. More than 30 states have already enacted similar measures.

Hoping to resuscitate the issue, a constituent approached Sen. Mike Gabbard about writing and sponsoring a bill, Senate Bill 2194, with more precise language than last year's bill, which some lawmakers believe was so broad that it resulted in its demise.

Gabbard, a father of five, believes the measure is important for families. “I’m aware of cases where parents don’t find out their babies have heart defects until it’s too late,” he said. “The test is a good thing to ensure that newborns get the emergency care they need as quickly as possible.”

American Heart Association data shows that the $1 test, known as a pulse oximetry screening, is quick and non-invasive and measures the blood's oxygen saturation levels to identify newborns with low levels.

In places where they use it, the test catches up to 30 percent of newborns with congenital heart defects. As many as 60 percent are caught during prenatal testing, and some are found by physical examinations after birth.

Congenital heart defects occur in eight out of every 1,000 live births, and account for more than a quarter of infant deaths from birth defects.

'Quick' and 'Cheap'

The bill's progress hasn’t been smooth sailing this year; the bill, which would specifically require birthing centers to screen newborns using pulse oximetry, almost died when it didn’t get a hearing scheduled by the Feb. 13 legislative deadline, but a last-ditch effort by Don Weisman of the American Heart Association Hawaii Chapter kept it alive.
The measure got referred to the Hawaii Senate Health, Commerce and Consumer Affairs, and the Ways and Means committees. Those committees are scheduled to hear the bill on Wednesday.

Gabbard is hopeful the bill will keep moving forward. “It seems like a no-brainer to me. It’s quick and it's cheap.”

Julie Passos knows what it’s like to have a child with the condition. She feels lucky to have found out prior to the birth of her son in 1998. She's an active volunteer with Kardiac Kids, a support group at Kapiolani Medical Center for families with children who have congenital heart defects.

Due to problems she was having during her pregnancy, Passos went to the ER two months before her son was born, but multiple ultrasounds did not show that there was anything unusual with his heart.

“It was a coincidence that the nurse put her hand on the plug and his heart rate dipped, so I stayed 20 minutes longer and it dipped again,” Passos recalled. “Had I just given birth normally, he looked like a normal baby. He wasn’t blue," which is a telltale sign of heart problems.

If it weren't for her other health problems, Passos says, her baby's congenital heart defect may have gone undetected.

While most birthing centers began to conduct the test after it was recommended in 2010 by the U.S. Department of Health and Human Services, two hospitals in Hawaii have not fully implemented the screening. Maui Memorial Medical Center in Wailuku only administers the test to babies that are insured by Kaiser Permanente when Kaiser doctors order it, and Hilo Medical Center doesn’t do the test at all.

“If I was in the Hilo area or on Maui, I would have big concerns,” he said. “The test is so cheap. Why not do it on all babies?”

Hospitals absorb the costs of the test into birthing fees, and don’t need additional sources of funding.

Hawaii is one of the few states that doesn't already have a law in place mandating such screenings. Over 30 states have enacted laws requiring the test. Illinois, Michigan, Missouri, New York, and South Carolina have joined that group in 2014, while other states are working on legislation. In Virginia, the governor is expected to sign the pulse oximetry bill into law.

Passos says that in many cases doctors already do catch heart defects before birth. But for the babies, such a test could make all the difference. “The pulse-ox test only takes a few minutes, and it could save a life."

While the test may affect relatively few babies born in Hawaii, according to Weisman, passing the law shouldn’t be a question.

“If you don’t catch it, by the time you get the baby back to the hospital, the problems cascade and you can end up losing the baby," he said. “If you’re the parent of that one baby who gets saved through this screening, it’s worth it.”