There are many advantages for being able to perform newborn screening blood collection in the home setting. The family can avoid taking their newborn to a hospital-based laboratory and the screening will be done by a trusted person already known to the family. You and your client have flexibility in scheduling the best time for the screening, keeping in mind that it should be collected as close to the 24-hour mark after birth as possible.

Peer discussions on newborn screening blood collection at home or in an out-of-hospital setting in this video:

Many midwives begin educating their clients on required newborn screening during pregnancy. This allows for the family to ask questions and to make decisions for their family about newborn screening. The California Newborn Screening (NBS) Program provides you with education materials regarding newborn screening to share with the parents.

Education Resources​

The Newborn Screening: Important Information for Parents tri-fold (Engli​sh and Spanish, PDF) is a tool that lends itself to a discussion with the parents. It is available in 12 languages on the NBS Program Information for Families web page.

In California, a newborn screening specimen must be collected within 12 to 48 hours of birth, with 24 hours of life being the optimal time for collection. A general overview video (not California-specific) on newborn screening blood spot collection:

Test Request Form (TRF)

A complete Test Request Form (TRF) is needed for every California birth, whether performed at home or at a freestanding birth center. Newborn screening documentation using the TRF must be completed within 12 to 48 hours of birth. All birth attendants should keep the TRF's yellow copy and provide the TRF's pink/blue copy to the family. The family will use the pink/blue copy to help the pediatrician get the results and use the copy for registering the birth.

Please make sure to follow the instructions outlined in the Newborn Screening Program Collection Poster (PDF) and communicate the importance of this form with the child's parents.

Shipping your newborn screening specimens to the processing laboratory:

• Newborn screening blood specimens and the TRF must be sent to processing laboratory no later than the next business day after collection and filling out TRF using contracted shipping vendor(s), such as GLS
  
• A log sheet must be filled out and placed in the shipping envelope, even if only one specimen and TRF is placed in the envelope
• Shipping labels are provided to you from the California Newborn Screening Program to order labels or envelopes

• To schedule specimen pick-up from GLS, please call 916-458-0930
  

Online specimen tracking

Online specimen tracking (OST) is a way for you to track and make sure the specimens you have collected and sent to the processing laboratory have been received. You can go online within 7 days after shipping your specimen(s). This is an important measure to make sure the specimen(s) are not lost and thus prevent any delays in getting results.

Request OST training for yourself or any a new provider by emailing this address: NBSOST@cdph.ca.gov

Please visit our NBS Program Online Specimen Tracking web page to find out more about OST.

Billing and payment for newborn screening

After the newborn screening specimen has been processed, the parents will be sent an invoice for the test along with a form for their insurance information. By filling out and sending back the insurance form, the California Newborn Screening Program will bill the parents' insurance directly for the screening.

The parents will always have the choice of paying the invoice themselves as well if they do not wish to use their insurance as a payor for the screening.

For invoice payment and billing Information and the current Newborn Screening Program fee, please see the NBS Program Billing and Payment FAQ web page.

California, like many other states, stores newborn screening blood spot collection cards​. The blood spots may be used to improve the screening program or to develop screens and tests for new disorders.

The blood spots may also be used for studies about diseases in women and children. The stored blood spot cards do not have information, such as names or addresses, that can be used to identify you or your baby. The NBS Program follows all federal and state privacy and research laws.​

If you do not want your baby's or your own blood spots to be stored, you can request for them to be destroyed. This is your right. You can make this request after newborn screening has been completed. Remember, if you request that the blood spots be destroyed, they will never be available to you or your baby in the future for any additional screening or testing.

Visit the NBS Program "What Happens to My Baby's Blood Spots After the Newborn Screening Test?" web page for more information. To ask the NBS Program to destroy your baby's or your own blood spots, please do the following:

• Complete and submit this form: Parent Request to Have Newborn Blood Specimen Card Destroyed (CDPH 4410) (PDF)
• Contact the California Biobank Program Coordinator at (510) 412-1500 or CaliforniaBiobank@cdph.ca.gov if you have any questions.
  

Midwives and other out of hospital providers are mandated to collect, educate, and inform families about newborn screening blood collection. Please refer to the text below:

Newborn screening is mandated by the California Code of Regulations, Title 17 – all babies born in California are required to get screened soon after birth – regardless of birth plan or setting, including those born at home or in an out-of-hospital setting.

CCR, Title 17, §6500.55. Out-of-Hospital Newborn Screening Providers. "Out-of-Hospital Newborn Screening Providers" means: (a) all healthcare professionals including, but not limited to, licensed midwives (LM), certified nurse midwives (CNM), registered nurses (RN), physician assistants (PA), pediatric nurse practitioners (PNP), physicians/medical doctors (MD), doctors of osteopathy (DO), and naturopathic doctors (ND), who are licensed or certified by the State to provide maternal care and to deliver pregnant women in alternative settings other than perinatal licensed health facilities including, but not limited to, private homes and clinics and (b) staff of health care entities, such as clinics and free-standing independent laboratories that are authorized by the Department to collect newborn screening specimens in alternative settings other than perinatal licensed health facilities.

Out-of-Hospital Newborn Screening Providers​ - California Code of Regulations

Testimonials of how participating in newborn screening helped these families and babies. Please feel free to share them with your clients when educating them about newborn screening.

Tips

This section contains tips on collecting a newborn screening specimen in the community birth setting.

There are many advantages as well as special considerations for collecting a newborn screen at home or at a birthing center. A video discussion and some important tips for newborn screening blood collection at home:

California newborn screening resources

Data

Did you know that just under 450,000 babies are born in California annually and that over 5000 babies are born at home or in a birth center. For detailed information, please visit the California Open Data Portal: Statewide Live Birth Profiles

Timeliness

Timeliness in newborn screening specimen collection is of vital importance. Please see the video below to review the key components of a successful and timely newborn screening process: California Newborn Screening Timeliness Project - YouTube

Additional components of California newborn screening

• Newborn Hearing Screening Program
• Critical Congenital Heart Disease (CCHD) screening in California (PDF)

California education resources

• For individuals and families
  
• For health care providers
  

Additional newborn screening resources

• Baby's First Test: California
  
• New Steps: NewSTEPs 360