SubPart 69-3 - Pregnant Women, Testing for Hepatitis B, Follow-up Care

Effective Date: 
Wednesday, May 22, 1991
Doc Status: 
Complete
Statutory Authority: 
Public Health Law, Section 2500-a

Section 69-3.1 - Definitions

69-3.1 Definitions.

(a) Health care provider means a physician or other health care professional licensed to practice in New York State.

(b) Health care facility means a facility in New York State where children are born including those facilities licensed pursuant to Article 28 of the Public Health Law.

(c) Clinical laboratory means a laboratory which possesses a permit to test for hepatitis B surface antigen (HBsAg) issued under Article 5, Title 5 of the Public Health Law.

(d) Hepatitis B surface antigen (HBsAg) test means a test which has been approved for in vitro diagnostic use by the United States Food and Drug Administration.

(e) Satisfactory specimen means a specimen received by a clinical laboratory in a condition suitable for testing.
 

Effective Date: 
Wednesday, May 22, 1991
Doc Status: 
Complete

Section 69-3.2 - Responsibilities of health care providers attending pregnant women

69-3.2 Responsibilities of health care providers attending pregnant women. At the time a health care provider attending a pregnant woman takes a blood sample to be tested for syphilis (see Section 2803 of the Public Health Law) or at another time when blood is drawn during prenatal care, the provider shall:

(a) submit or cause to be submitted to a clinical laboratory from such a woman, a blood sample to be tested for HBsAg;

(b) record the HBsAg test result, including the date of specimen collection, prominently in the pregnant woman's medical record at or before the time of admission to a health care facility for delivery; and

(c) report all positive HBsAg test results to the local health officer in accordance with Section 2.10 of this Title.
 

Effective Date: 
Wednesday, May 22, 1991
Doc Status: 
Complete

Section 69-3.3 - Responsibilities of health care facilities

69-3.3 Responsibilities of health care facilities.

(a) The health care facility shall assure that the HBsAg test result for every woman admitted for delivery is recorded in the newborn child's medical record.

(b) When a woman who has not been tested for HBsAg during pregnancy is admitted for delivery or if a woman's HBsAg test result is not available at the time of admission for delivery, the health care facility shall:

(1) submit immediately a satisfactory blood specimen from such a woman to a clinical laboratory that will test it for HBsAg and make the test result available within twenty-four hours of admission, or as soon thereafter as practicable, but in no event longer than forty-eight hours of admission. Blood specimens submitted for testing must be marked clearly as "mother/delivery" in order to facilitate reporting of test results; and

(2) record the date and time of the blood collection and the HBsAg test results of such specimens in the medical records of the woman and her newborn child or children.

(c) Report the HBsAg test results for all women with newborn children to the State Department of Health on the Newborn Screening Blood Collection Form and report all positive HBsAg test results for women with newborn children within twenty-four hours of receipt to the local health officer in accordance with Section 2.10 of this Title.

(d) Respond to inquiries from the local health officer to provide pertinent information from the medical records of pregnant women with positive HBsAg test results and their newborn children regarding diagnosis and therapy of hepatitis B provided within the health care facility.

(e) In the case of the inter-facility transfer of a newborn child, the transferring facility shall provide written notification to accompany the child to the receiving hospital indicating:

(1) the HBsAg test result for the child's mother, or

(2) that the HBsAg test result is pending, in which case the test result should be transmitted when it becomes available immediately by telephone and in writing to the receiving hospital, or

(3) that the HBsAg test result is unknown and a blood sample has not been submitted for testing, in which case this testing shall be the responsibility of the facility where the child's mother is located or of her health care provider if she is not within a health care facility.
 

Effective Date: 
Wednesday, May 22, 1991
Doc Status: 
Complete

Section 69-3.4 - Responsibilities of clinical laboratories

69-3.4 Responsibilities of clinical laboratories.

Clinical laboratories shall:

(a) report immediately any initially reactive HBsAg test result from a blood specimen marked "mother/delivery" to the requesting health care provider or health care facility; and

(b) report any positive HBsAg test result to the local health officer within twenty-four hours (see Section 2102 of the Public Health Law).
 

Effective Date: 
Wednesday, May 22, 1991
Doc Status: 
Complete

Section 69-3.5 - Responsibilities of the health care providers attending newborn children of women with a positive HBsAg test result

69-3.5 Responsibilities of the health care providers attending newborn children of women with a positive HBsAg test result.

(a) Health care providers attending newborn children of a woman with a positive HBsAg test result shall offer or cause to be offered immunizing doses of hepatitis B vaccine and hepatitis B immune globulin for each such newborn child within twelve hours of birth unless a licensed physician or health care practitioner practicing under the supervision of a licensed physician determines that the child is not physiologically stable to permit immunization. In such cases the hepatitis B vaccine and hepatitis B immune globulin shall be administered when the child becomes physiologically stable to permit immunization.

(b) Health care providers attending newborn children of a pregnant woman admitted for delivery without a HBsAg test result available shall offer or cause to be offered immunizing doses of hepatitis B vaccine and hepatitis B immune globulin for each such newborn child immediately upon receiving a blood test result showing that the woman has a positive HBsAg test.

(c) If a woman's HBsAg test result is not available and her newborn child is to be discharged from the health care facility or 48 hours has elapsed since birth and if, in the health care provider's medical judgement the mother has a reasonable likelihood of being positive for HBsAg, the provider shall offer or cause to be offered for such a newborn child, immunizing doses of hepatitis B vaccine and hepatitis B immune globulin.

(d) After administering hepatitis B vaccine or hepatitis B immune globulin to a newborn child, the health care provider shall record in the child's medical record the date and time of immunization and the dosage, the manufacturer's lot number and the sites of injection for hepatitis B vaccine and hepatitis B immune globulin and shall provide the woman with a certificate of immunization for her child stating the immunizing agents administered and the dates of administration.
 

Effective Date: 
Wednesday, May 22, 1991
Doc Status: 
Complete

Section 69-3.6 - Responsibilities of health care providers providing follow-up care for newborn children of women with a positive HBsAg test result

69-3.6 Responsibilities of health care providers providing follow-up care for newborn children of women with a positive HBsAg test result. Health care providers providing follow-up care for newborn children of women with a positive HBsAg test result shall arrange for follow-up immunizing doses of hepatitis B vaccine to be administered one and six months or one, two and twelve months after the first dose.

Effective Date: 
Wednesday, May 22, 1991
Doc Status: 
Complete

Section 69-3.7 - Responsibilities of the parent or legal guardian

69-3.7 Responsibilities of the parent or legal guardian. The parent or guardian of any child born to a woman with a positive HBsAg test result shall have administered to such child immunizing doses of hepatitis B immune globulin and hepatitis B vaccine at birth as well as follow-up doses of hepatitis B vaccine.

Effective Date: 
Wednesday, May 22, 1991
Doc Status: 
Complete

Section 69-3.8 - Responsibilities of the local health officer

69-3.8 Responsibilities of the local health officer.

(a) If the parent or legal guardian of a child requiring hepatitis B immunization pursuant to this Subpart is unable to pay for the services of a private physician or other authorized practitioner to administer the follow-up doses of hepatitis B vaccine, such person shall present such child to the health officer of the county in which the child resides, who shall then administer the follow-up hepatitis B vaccine without charge.

(b) The local health officer shall make a report within 30 days of initiation of follow-up and within 30 days of the completion of follow-up to the Commissioner of Health for each newborn child of a HBsAg-positive woman. Such report shall include verification of the woman's HBsAg test result and details of the child's followup care.
 

Effective Date: 
Wednesday, May 22, 1991
Doc Status: 
Complete

Section 69-3.9 - Medical exemption from immunization.

69-3.9 Medical exemption from immunization. If any licensed physician or health care practitioner practicing under the supervision of a licensed physician certifies that a follow-up dose of hepatitis B vaccine may be detrimental to a child's health, the requirements of this Subpart regarding follow-up immunizations shall be inapplicable until such immunization is found no longer to be detrimental to such child's health. The nature and duration of the medical exemption must be stated in the child's medical record.
 

Effective Date: 
Wednesday, May 22, 1991
Doc Status: 
Complete

Section 69-3.10 - Religious exemption from immunization

69-3.10 Religious exemption from immunization. The provisions of this Subpart regarding immunizations shall not apply in the case of any child whose parent or legal guardian holds genuine and sincere religious beliefs which prohibit immunization and who notifies the person charged with administering such immunization of the religious objection hereto. The health care provider attending the child shall document the religious objection exemption in the child's medical record, including a statement signed by the parents or legal guardian stating that they hold genuine and sincere religious beliefs which prohibit immunization and that they acknowledge that they have been informed about the risk to the child's health by withholding hepatitis B immunization.
 

Effective Date: 
Wednesday, May 22, 1991
Doc Status: 
Complete

Section 69-3.11 - Failure to obtain required immunization

69-3.11 Failure to obtain required immunization. Barring a valid medical contraindication or religious exemption from hepatitis B immunization, if the parent or legal guardian of a child born to a woman with a positive HBsAg test result is unwilling to have the infant immunized, the health care provider attending the child, or the local health officer if vaccine is to be administered under section 3.8 of this Subpart, shall make a report of suspected child abuse or maltreatment (See Section 415 of the Social Services Law).
 

Effective Date: 
Wednesday, May 22, 1991
Doc Status: 
Complete