Newborn Screening Saves Lives Reauthorization Act Of 2013 (H
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The Newborn Screening Saves Lives Reauthorization Act of 2014 () is a bill that would amend the
Public Health Service Act The Public Health Service Act is a United States federal law enacted in 1944. The full act is codified in Title 42 of the United States Code (The Public Health and Welfare), Chapter 6A (Public Health Service). Contents The act clearly establis ...
to reauthorize grant programs and other initiatives to promote expanded screening of newborns and children for heritable disorders. The bill was introduced into the
United States House of Representatives The United States House of Representatives, often referred to as the House of Representatives, the U.S. House, or simply the House, is the Lower house, lower chamber of the United States Congress, with the United States Senate, Senate being ...
during the
113th United States Congress The 113th United States Congress was a meeting of the legislative branch of the United States federal government, from January 3, 2013, to January 3, 2015, during the fifth and sixth years of Presidency of Barack Obama, Barack Obama's presiden ...
. A companion bill, , was introduced into the
United States Senate The United States Senate is the upper chamber of the United States Congress, with the House of Representatives being the lower chamber. Together they compose the national bicameral legislature of the United States. The composition and pow ...
. There is no record in this article that the proposed bill ever became US Federal statutory law.


Background

Newborn screening programs test for a number of different conditions using a number of different laboratorial methodologies. There is also bedside testing for
hearing loss Hearing loss is a partial or total inability to Hearing, hear. Hearing loss may be present at birth or acquired at any time afterwards. Hearing loss may occur in one or both ears. In children, hearing problems can affect the ability to Language ...
using evoked auditory potentials and
congenital heart defects A congenital heart defect (CHD), also known as a congenital heart anomaly and congenital heart disease, is a defect in the structure of the heart or great vessels that is present at birth. A congenital heart defect is classed as a cardiovascular ...
using
pulse oximetry Pulse oximetry is a noninvasive method for monitoring a person's oxygen saturation. Peripheral oxygen saturation (SpO2) readings are typically within 2% accuracy (within 4% accuracy in 95% of cases) of the more accurate (and invasive) reading of ...
. Newborn screening started out using simple bacterial inhibition assays to screen for a single disorder, starting with
phenylketonuria Phenylketonuria (PKU) is an inborn error of metabolism that results in decreased metabolism of the amino acid phenylalanine. Untreated PKU can lead to intellectual disability, seizures, behavioral problems, and mental disorders. It may also resu ...
in the early 1960s. With this testing methodology, newborn screening required one test to detect one condition. As
mass spectrometry Mass spectrometry (MS) is an analytical technique that is used to measure the mass-to-charge ratio of ions. The results are presented as a ''mass spectrum'', a plot of intensity as a function of the mass-to-charge ratio. Mass spectrometry is use ...
became more widely available, the technology allowed rapid determination of a number of acylcarnitines and
amino acid Amino acids are organic compounds that contain both amino and carboxylic acid functional groups. Although hundreds of amino acids exist in nature, by far the most important are the alpha-amino acids, which comprise proteins. Only 22 alpha am ...
s from a single dried blood spot. This increased the number of conditions that could be detected by newborn screening. Enzyme assays are used to screen for
galactosemia Galactosemia (British galactosaemia, from Greek γαλακτόζη + αίμα, meaning galactose + blood, accumulation of galactose in blood) is a rare genetic metabolic disorder that affects an individual's ability to metabolize the sugar galacto ...
and
biotinidase deficiency Biotinidase deficiency is an autosomal recessive metabolic disorder in which biotin is not released from proteins in the diet during digestion or from normal protein turnover in the cell. This situation results in biotin deficiency. Biotin is an ...
. Immunoassays measure
thyroid hormones File:Thyroid_system.svg, upright=1.5, The thyroid system of the thyroid hormones T3 and T4 rect 376 268 820 433 Thyroid-stimulating hormone rect 411 200 849 266 Thyrotropin-releasing hormone rect 297 168 502 200 Hypothalamus rect 66 216 386 25 ...
for the diagnosis of
congenital hypothyroidism Congenital hypothyroidism (CH) is thyroid hormone deficiency present at birth. If untreated for several months after birth, severe congenital hypothyroidism can lead to growth failure and permanent intellectual disability. Infants born with cong ...
and
17α-hydroxyprogesterone 17α-Hydroxyprogesterone (17α-OHP), also known as 17-OH progesterone (17-OHP), or hydroxyprogesterone (OHP), is an endogenous progestogen steroid hormone related to progesterone. It is also a chemical intermediate in the biosynthesis of many ot ...
for the diagnosis of
congenital adrenal hyperplasia Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders characterized by impaired cortisol synthesis. It results from the deficiency of one of the five enzymes required for the synthesis of cortisol in the adrenal cortex. ...
. Molecular techniques are used for the diagnosis of
cystic fibrosis Cystic fibrosis (CF) is a rare genetic disorder that affects mostly the lungs, but also the pancreas, liver, kidneys, and intestine. Long-term issues include difficulty breathing and coughing up mucus as a result of frequent lung infections. O ...
and
severe combined immunodeficiency Severe combined immunodeficiency (SCID), also known as Swiss-type agammaglobulinemia, is a rare genetic disorder characterized by the disturbed development of functional T cells and B cells caused by numerous genetic mutations that result in diffe ...
. The first newborn screening law, the
Newborn Screening Saves Lives Act of 2007 President George W. Bush signed the Newborn Screening Saves Lives Act of 2007 (Pub.L.110-204) (NBSSLA) into law on April 24, 2008, a day before DNA Day. The Act amended the Public Health Service Act to establish grant programs concerning newbor ...
(), was passed in 2008. The law established national standards for newborn screenings.


Provisions of the bill

''This summary is based largely on the summary provided by the
Congressional Research Service The Congressional Research Service (CRS) is a public policy research institute of the United States Congress. Operating within the Library of Congress, it works primarily and directly for members of Congress and their committees and staff on a c ...
, a
public domain The public domain (PD) consists of all the creative work A creative work is a manifestation of creative effort including fine artwork (sculpture, paintings, drawing, sketching, performance art), dance, writing (literature), filmmaking, ...
source.'' The Newborn Screening Saves Lives Reauthorization Act of 2014 would amend the
Public Health Service Act The Public Health Service Act is a United States federal law enacted in 1944. The full act is codified in Title 42 of the United States Code (The Public Health and Welfare), Chapter 6A (Public Health Service). Contents The act clearly establis ...
to extend and revise a grant program for screening, counseling, and other services related to heritable disorders. The bill would expand eligible grantees to include a health professional organization and an early childhood health system. The bill would extend a grant program to evaluate the effectiveness of screening, counseling, or health care services in reducing the morbidity and mortality caused by heritable disorders in newborns and children. Expands the program to include evaluation of treatment and follow-up care for newborns and their families after screening and diagnosis. The bill would extend for five years the operation of the Advisory Committee on Heritable Disorders in Newborns and Children. Authorizes the
United States Secretary of Health and Human Services The United States secretary of health and human services is the head of the United States Department of Health and Human Services, and serves as the principal advisor to the president of the United States on all health matters. The secretary is ...
(HHS) to continue the Advisory Committee after such time. Requires the Advisory Committee to meet in person at least twice each year. The bill would extend the clearinghouse for
newborn screening Newborn screening (NBS) is a public health program of screening in infants shortly after birth for conditions that are treatable, but not clinically evident in the newborn period. The goal is to identify infants at risk for these conditions earl ...
information. Expands the duties of the clearinghouse to include: (1) maintaining current data on the number of conditions for which screening is conducted in each state; and (2) establishing or disseminating guidelines for services and personnel necessary for follow-up, diagnosis, counseling, and treatment of to conditions detected by newborn screening. The bill would extend requirements for the Secretary to provide for quality assurance of laboratories involved in screening newborns and children for heritable disorders. The bill would extend the Interagency Coordinating Committee on Newborn and Child Screening. The bill would authorize the Secretary to have the Hunter Kelly Newborn Screening Research Program to: (1) provide research and data for newborn conditions under review by the Advisory Committee to be added to the Recommended Uniform Screening Panel; and (2) conduct pilot studies on conditions recommended by the Advisory Committee to ensure that screenings are ready for nationwide implementation. The bill would direct the Secretary, acting through the Director of the
Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
(CDC), to award grants to, or enter into cooperative agreements with, eligible entities to develop longitudinal follow-up and tracking programs for newborn screening.


Congressional Budget Office report

''This summary is based largely on the summary provided by the
Congressional Budget Office The Congressional Budget Office (CBO) is a federal agency within the legislative branch of the United States government that provides budget and economic information to Congress. Inspired by California's Legislative Analyst's Office that manages ...
, as ordered reported by the House Committee on Energy and Commerce on April 3, 2014. This is a
public domain The public domain (PD) consists of all the creative work A creative work is a manifestation of creative effort including fine artwork (sculpture, paintings, drawing, sketching, performance art), dance, writing (literature), filmmaking, ...
source.'' H.R. 1281 would amend the Public Health Service Act to reauthorize grant programs and other initiatives to promote expanded screening of newborns and children for heritable disorders. Authority to operate those programs expired at the end of fiscal year 2013. However, the Congress appropriated funds for fiscal year 2014 to continue the programs in 2014. The
Congressional Budget Office The Congressional Budget Office (CBO) is a federal agency within the legislative branch of the United States government that provides budget and economic information to Congress. Inspired by California's Legislative Analyst's Office that manages ...
(CBO) estimates that implementing H.R. 1281 would cost $80 million over the 2015-2019 period, assuming appropriation of the necessary amounts. H.R. 1281 would not affect direct spending or revenues; therefore,
pay-as-you-go Pay as you go or PAYG may refer to: Finance * Pay-as-you-go tax, or pay-as-you-earn tax * Pay-as-you-go pension plan * PAYGO, the practice in the US of financing expenditures with current funds rather than borrowing * PAUG, a structured financia ...
procedures do not apply. H.R. 1281 contains no intergovernmental or private-sector mandates as defined in the
Unfunded Mandates Reform Act The Unfunded Mandates Reform Act of 1995 (UMRA''(pdf)https://www.govinfo.gov/content/pkg/USCODE-1995-title2/html/USCODE-1995-title2-chap25.htm (text)] restricts the federal government of the United States, federal imposition of unfunded mandates on ...
and would impose no costs on state, local, or tribal governments.


Procedural history

The Newborn Screening Saves Lives Reauthorization Act of 2014 was introduced into the
United States House of Representatives The United States House of Representatives, often referred to as the House of Representatives, the U.S. House, or simply the House, is the Lower house, lower chamber of the United States Congress, with the United States Senate, Senate being ...
on March 20, 2013 by Lucille Roybal-Allard, Rep. Lucille Roybal-Allard (D, CA-40). The bill was referred to the
United States House Committee on Energy and Commerce The Committee on Energy and Commerce is one of the oldest standing committees of the United States House of Representatives. Established in 1795, it has operated continuously—with various name changes and jurisdictional changes—for more tha ...
and the
United States House Energy Subcommittee on Health The U.S. House Committee on Energy and Commerce Subcommittee on Health is a subcommittee within the Committee on Energy and Commerce A committee or commission is a body of one or more persons subordinate to a deliberative assembly. A committee ...
. The bill was reported (amended) on June 19, 2014 alongsid
House Report 113-478


Debate and discussion

The
March of Dimes March of Dimes is a United States nonprofit organization that works to improve the health of mothers and babies. The organization was founded by President Franklin D. Roosevelt in 1938, as the National Foundation for Infantile Paralysis, to comba ...
encouraged its supporters to "tell Congress that you support" the bill. The March of Dimes described the bill as reauthorizing "critical federal activities that assist states in improving and expanding their newborn screening programs, supporting parents and provider newborns screening education, and ensuring laboratory quality and surveillance." The
Muscular Dystrophy Association The Muscular Dystrophy Association (MDA) is an American 501(c)(3) umbrella organization that works to support people with neuromuscular diseases. Founded in 1950 by Paul Cohen, who lived with muscular dystrophy, it works to combat neuromuscular di ...
(MDA) supported the bill, arguing that "many of the drug therapies currently under development for MDA's community will be of most benefit if administered either presymptomatically or early in the progression of the disease. Thus, for some of the diseases in MDA's program, the availability of a newborn screening program at the time of treatment availability presents the best opportunity for impacting optimal and potential lifesaving treatment outcomes." Rep. Roybal-Allard, who introduced the bill, argued that "newborn screening not only transforms and save lives - it saves money." According to Roybal-Allard, in
California California is a U.S. state, state in the Western United States, located along the West Coast of the United States, Pacific Coast. With nearly 39.2million residents across a total area of approximately , it is the List of states and territori ...
"newborns are screened for more than 40 preventable and treatable conditions – and for every one dollar California spends on screening, it yields a benefit of over $9 as we prevent disease in children who are diagnosed with these treatable conditions." Rep.
Mike Simpson Michael Keith Simpson (born September 8, 1950) is an American politician and former dentist serving as the U.S. representative for since 1999. The district covers most of the eastern portion of the state, including Idaho Falls, Pocatello, Sun ...
(R-ID), who cosponsored the bill, said that "the bill reflects the realities of reduced budgets Washington, but continues and strengthens the well established system of monitoring and evaluating infant conditions soon after birth. Just one small blood sample from the newborn’s foot identifies infants with genetic or other conditions that can be treated quickly and effectively, saving and improving thousands of lives." The
National Association of Neonatal Nurses The National Association of Neonatal Nurses (NANN) is a professional organization for neonatal nursing, neonatal nurses in the United States. NANN was founded in 1984 by five neonatal nurses: Patricia Johnson, Linda Bellig, Tracy Karp, Charles Rai ...
also supported the bill.


See also

*
List of bills in the 113th United States Congress The bills of the 113th United States Congress list includes proposed federal laws that were introduced in the 113th United States Congress. This Congress lasted from January 3, 2013, to January 3, 2015. The United States Congress is the bicamer ...
*
Newborn screening Newborn screening (NBS) is a public health program of screening in infants shortly after birth for conditions that are treatable, but not clinically evident in the newborn period. The goal is to identify infants at risk for these conditions earl ...
*
Newborn Screening Saves Lives Act of 2007 President George W. Bush signed the Newborn Screening Saves Lives Act of 2007 (Pub.L.110-204) (NBSSLA) into law on April 24, 2008, a day before DNA Day. The Act amended the Public Health Service Act to establish grant programs concerning newbor ...
*
List of disorders included in newborn screening programs This is a list of disorders included in newborn screening programs around the world, along with information on testing methodologies, disease incidence and rationale for being included in screening programs. American College of Medical Genetics re ...


References


External links


Library of Congress - Thomas H.R. 1281beta.congress.gov H.R. 1281GovTrack.us H.R. 1281OpenCongress.org H.R. 1281Congressional Budget Office's report on H.R. 1281
{{DEFAULTSORT:Newborn Screening Saves Lives Reauthorization Act of 2014 (H.R. 1281 113th Congress) Acts of the 113th United States Congress Newborn screening