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H.R.3424
Departments of Labor, Health, and Human Services, and Education, and
Related Agencies Appropriations Act, 2000 (Introduced in the House)
TITLE VI--EARLY DETECTION , DIAGNOSIS, AND INTERVENTIONS
FOR NEWBORNS AND INFANTS WITH HEARING LOSS
SEC. 601. (a) DEFINITIONS- For the purposes of this section only, the
following terms in this section are defined as follows:
(1) HEARING SCREENING-
Newborn and infant hearing
screening consists of objective physiologic procedures to detect possible
hearing loss and to identify
newborns and infants who, after rescreening, require further audiologic and
medical evaluations.
(2) AUDIOLOGIC EVALUATION- Audiologic evaluation consists of procedures
to assess the status of the auditory system; to establish the site of the
auditory disorder; the type and degree of hearing loss, and the potential
effects of hearing loss on
communication; and to identify appropriate treatment and referral options.
Referral options should include linkage to State IDEA part C coordinating
agencies or other appropriate agencies, medical evaluation, hearing aid/sensory aid assessment,
audiologic rehabilitation treatment, national and local consumer, self-help,
parent, and education organizations, and other family-centered
services.
(3) MEDICAL EVALUATION- Medical evaluation by a physician consists of
key components including history, examination, and medical decision making
focused on symptomatic and related body systems for the purpose of
diagnosing the etiology of hearing loss and related physical
conditions, and for identifying appropriate treatment and referral
options.
(4) MEDICAL INTERVENTION -
Medical intervention is the
process by which a physician provides medical diagnosis and direction for
medical and/or surgical treatment options of hearing loss and/or related medical
disorder associated with hearing loss.
(5) AUDIOLOGIC REHABILITATION- Audiologic rehabilitation (intervention ) consists of
procedures, techniques, and technologies to facilitate the receptive and
expressive communication abilities of a child with hearing loss.
(6) EARLY INTERVENTION - Early intervention (e.g., nonmedical)
means providing appropriate services for the child with hearing loss and ensuring that
families of the child are provided comprehensive, consumer-oriented
information about the full range of family support, training, information
services, communication options and are given the opportunity to consider
the full range of educational and program placements and options for their
child.
(b) PURPOSES- The purposes of this section are to clarify the authority
within the Public Health Service Act to authorize statewide newborn and infant
hearing screening, evaluation
and intervention programs and
systems, technical assistance, a national applied research program, and
interagency and private sector collaboration for policy development, in order
to assist the States in making progress toward the following goals:
(1) All babies born in hospitals in the United States and its
territories should have a hearing screening before leaving the
birthing facility. Babies born in other countries and residing in the United
States via immigration or adoption should have a hearing screening as early as possible.
(2) All babies who are not born in hospitals in the United States and
its territories should have a hearing screening within the first 3
months of life.
(3) Appropriate audiologic and medical evaluations should be conducted
by 3 months for all newborns and infants suspected of having hearing loss to allow appropriate
referral and provisions for audiologic rehabilitation, medical and early intervention before the age of 6
months.
(4) All newborn and infant hearing screening programs and
systems should include a component for audiologic rehabilitation, medical
and early intervention options that ensures
linkage to any new and existing statewide systems of intervention and rehabilitative
services for newborns and infants with hearing loss.
(5) Public policy in regard to newborn and infant hearing screening and intervention should be based on
applied research and the recognition that newborns, infants, toddlers, and
children who are deaf or hard-of-hearing have unique language,
learning, and communication needs, and should be the result of consultation
with pertinent public and private sectors.
(c) STATEWIDE NEWBORN AND INFANT HEARING SCREENING, EVALUATION AND
INTERVENTION PROGRAMS AND
SYSTEMS- Under the existing authority of the Public Health Service Act, the
Secretary of Health and Human Services (in this section referred to as the
`Secretary'), acting through the Administrator of the Health Resources and
Services Administration, shall make awards of grants or cooperative agreements
to develop statewide newborn and infant hearing screening, evaluation and
intervention programs and
systems for the following purposes:
(1) To develop and monitor the efficacy of statewide newborn and infant
hearing screening, evaluation
and intervention programs and
systems. Early intervention includes referral to
schools and agencies, including community, consumer, and parent-based
agencies and organizations and other programs mandated by part C of the
Individuals with Disabilities Education Act, which offer programs
specifically designed to meet the unique language and communication needs of
deaf and hard-of-hearing
newborns, infants, toddlers, and children.
(2) To collect data on statewide newborn and infant hearing screening, evaluation and
intervention programs and
systems that can be used for applied research, program evaluation and policy
development.
(d) TECHNICAL ASSISTANCE, DATA MANAGEMENT, AND APPLIED RESEARCH-
(1) CENTERS FOR DISEASE CONTROL AND PREVENTION- Under the existing
authority of the Public Health Service Act, the Secretary, acting through
the Director of the Centers for Disease Control and Prevention, shall make
awards of grants or cooperative agreements to provide technical assistance
to State agencies to complement an intramural program and to conduct applied
research related to newborn and infant hearing screening, evaluation and
intervention programs and
systems. The program shall develop standardized procedures for data
management and program effectiveness and costs, such as--
(A) to ensure quality monitoring of newborn and infant hearing loss screening,
evaluation, and intervention
programs and systems;
(B) to provide technical assistance on data collection and
management;
(C) to study the costs and effectiveness of newborn and infant hearing screening, evaluation and
intervention programs and
systems conducted by State-based programs in order to answer issues of
importance to State and national policymakers;
(D) to identify the causes and risk factors for congenital hearing loss;
(E) to study the effectiveness of newborn and infant hearing screening, audiologic and
medical evaluations and intervention programs and systems
by assessing the health, intellectual and social developmental, cognitive,
and language status of these children at school age; and
(F) to promote the sharing of data regarding early hearing loss with State-based
birth defects and developmental disabilities monitoring programs for the
purpose of identifying previously unknown causes of hearing loss.
(2) NATIONAL INSTITUTES OF HEALTH- Under the existing authority of the
Public Health Service Act, the Director of the National Institutes of
Health, acting through the Director of the National Institute on Deafness
and Other Communication Disorders, shall for purposes of this section,
continue a program of research and development on the efficacy of new
screening techniques and technology, including clinical studies of screening
methods, studies on efficacy of intervention , and related
research.
(e) COORDINATION AND COLLABORATION-
(1) IN GENERAL- Under the existing authority of the Public Health
Service Act, in carrying out programs under this section, the Administrator
of the Health Resources and Services Administration, the Director of the
Centers for Disease Control and Prevention, and the Director of the National
Institutes of Health shall collaborate and consult with other Federal
agencies; State and local agencies, including those responsible for early intervention services pursuant to
title XIX of the Social Security Act (Medicaid Early and Periodic Screening,
Diagnosis and Treatment Program); title XXI of the Social Security Act
(State Children's Health Insurance Program); title V of the Social Security
Act (Maternal and Child Health Block Grant Program); and part C of the
Individuals with Disabilities Education Act; consumer groups of and that
serve individuals who are deaf and hard-of-hearing and their families;
appropriate national medical and other health and education specialty
organizations; persons who are deaf and hard-of-hearing and their families; other
qualified professional personnel who are proficient in deaf or hard-of-hearing children's language and who
possess the specialized knowledge, skills, and attributes needed to serve
deaf and hard-of-hearing
newborns, infants, toddlers, children, and their families; third-party
payers and managed care organizations; and related commercial
industries.
(2) POLICY DEVELOPMENT- Under the existing authority of the Public
Health Service Act, the Administrator of the Health Resources and Services
Administration, the Director of the Centers for Disease Control and
Prevention, and the Director of the National Institutes of Health shall
coordinate and collaborate on recommendations for policy development at the
Federal and State levels and with the private sector, including consumer,
medical and other health and education professional-based organizations,
with respect to newborn and infant hearing screening, evaluation and
intervention programs and
systems.
(3) STATE EARLY DETECTION , DIAGNOSIS, AND INTERVENTION PROGRAMS AND SYSTEMS;
DATA COLLECTION- Under the existing authority of the Public Health Service
Act, the Administrator of the Health Resources and Services Administration
and the Director of the Centers for Disease Control and Prevention shall
coordinate and collaborate in assisting States to establish newborn and
infant hearing screening,
evaluation and intervention
programs and systems under subsection (c) and to develop a data collection
system under subsection (d).
(f) RULE OF CONSTRUCTION- Nothing in this section shall be construed to
preempt any State law.
(g) AUTHORIZATION OF APPROPRIATIONS-
(1) STATEWIDE NEWBORN AND INFANT HEARING SCREENING, EVALUATION AND
INTERVENTION PROGRAMS AND
SYSTEMS- For the purpose of carrying out subsection (c) under the existing
authority of the Public Health Service Act, there are authorized to the
Health Resources and Services Administration appropriations in the amount of
$5,000,000 for fiscal year 2000, $8,000,000 for fiscal year 2001, and such
sums as may be necessary for fiscal year 2002.
(2) TECHNICAL ASSISTANCE, DATA MANAGEMENT, AND APPLIED RESEARCH; CENTERS
FOR DISEASE CONTROL AND PREVENTION- For the purpose of carrying out
subsection (d)(1) under the existing authority of the Public Health Service
Act, there are authorized to the Centers for Disease Control and Prevention,
appropriations in the amount of $5,000,000 for fiscal year 2000, $7,000,000
for fiscal year 2001, and such sums as may be necessary for fiscal year
2002.
(3) TECHNICAL ASSISTANCE, DATA MANAGEMENT, AND APPLIED RESEARCH;
NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS- For the
purpose of carrying out subsection (d)(2) under the existing authority of
the Public Health Service Act, there are authorized to the National
Institute on Deafness and Other Communication Disorders appropriations for
such sums as may be necessary for each of the fiscal years 2000 through
2002.
TITLE VII--DENALI COMMISSION
SEC. 701. DENALI COMMISSION- Section 307 of Title III--Denali Commission
of Division C--Other Matters of Public Law 105-277 is amended by adding a new
subsection at the end thereof as follows:
`(c) DEMONSTRATION HEALTH PROJECTS- In order to demonstrate the value of
adequate health facilities and services to the economic development of the
region, the Secretary of Health and Human Services is authorized to make
grants to the Denali Commission to plan, construct, and equip demonstration
health, nutrition, and child care projects, including hospitals, health care
clinics, and mental health facilities (including drug and alcohol treatment
centers) in accordance with the Work Plan referred to under section 304 of
Title III--Denali Commission of Division C--Other Matters of Public Law
105-277. No grant for construction or equipment of a demonstration project
shall exceed 50 percentum of such costs, unless the project is located in a
severely economically distressed community, as identified in the Work Plan
referred to under section 304 of Title III--Denali Commission of Division
C--Other Matters of Public Law 105-277, in which case no grant shall exceed 80
percentum of such costs. To carry out this section, there is authorized to be
appropriated such sums as may be necessary.
TITLE VIII--WELFARE-TO-WORK AND CHILD SUPPORT AMENDMENTS OF 1999
SEC. 801. FLEXIBILITY IN ELIGIBILITY FOR PARTICIPATION IN WELFARE-TO-WORK
PROGRAM.
(a) IN GENERAL- Section 403(a)(5)(C)(ii) of the Social Security Act (42
U.S.C. 603(a)(5)(C)(ii)) is amended to read as follows:
`(ii) GENERAL ELIGIBILITY- An entity that operates a project with
funds provided under this paragraph may expend funds provided to the
project for the benefit of recipients of assistance under the program
funded under this part of the State in which the entity is located
who--
`(I) has received assistance under the State program funded under
this part (whether in effect before or after the amendments made by
section 103 of the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996 first apply to the State) for at least 30
months (whether or not consecutive); or
`(II) within 12 months, will become ineligible for assistance
under the State program funded under this part by reason of a
durational limit on such assistance, without regard to any exemption
provided pursuant to section 408(a)(7)(C) that may apply to the
individual.'.
(b) NONCUSTODIAL PARENTS-
(1) IN GENERAL- Section 403(a)(5)(C) of such Act (42 U.S.C.
603(a)(5)(C)) is amended--
(A) by redesignating clauses (iii) through (viii) as clauses (iv)
through (ix), respectively; and
(B) by inserting after clause (ii) the following:
`(iii) NONCUSTODIAL PARENTS- An entity that operates a project with
funds provided under this paragraph may use the funds to provide
services in a form described in clause (i) to noncustodial parents with
respect to whom the requirements of the following subclauses are
met:
`(I) The noncustodial parent is unemployed, underemployed, or
having difficulty in paying child support obligations.
`(II) At least 1 of the following applies to a minor child of the
noncustodial parent (with preference in the determination of the
noncustodial parents to be provided services under this paragraph to
be provided by the entity to those noncustodial parents with minor
children who meet, or who have custodial parents who meet, the
requirements of item (aa)):
`(aa) The minor child or the custodial parent of the minor child
meets the requirements of subclause (I) or (II) of clause (ii).
`(bb) The minor child is eligible for, or is receiving, benefits
under the program funded under this part.
`(cc) The minor child received benefits under the program funded
under this part in the 12-month period preceding the date of the determination
but no longer receives such benefits.
`(dd) The minor child is eligible for, or is receiving, assistance
under the Food Stamp Act of 1977, benefits under the supplemental security
income program under title XVI of this Act, medical assistance under title XIX
of this Act, or child health assistance under title XXI of this Act.
`(III) In the case of a noncustodial parent who becomes enrolled
in the project on or after the date of the enactment of this clause,
the noncustodial parent is in compliance with the terms of an oral or
written personal responsibility contract entered into among the
noncustodial parent, the entity, and (unless the entity demonstrates
to the Secretary that the entity is not capable of coordinating with
such agency) the agency responsible for administering the State plan
under part D, which was developed taking into account the employment
and child support status of the noncustodial parent, which was entered
into not later than 30 (or, at the option of the entity, not later
than 90) days after the noncustodial parent was enrolled in the
project, and which, at a minimum, includes the
following:
`(aa) A commitment by the noncustodial parent to cooperate, at the
earliest opportunity, in the establishment of the paternity of the minor child,
through voluntary acknowledgement or other procedures, and in the establishment
of a child support order.
`(bb) A commitment by the noncustodial parent to cooperate in the
payment of child support for the minor child, which may include a modification
of an existing support order to take into account the ability of the
noncustodial parent to pay such support and the participation of such parent in
the project.
`(cc) A commitment by the noncustodial parent to participate in
employment or related activities that will enable the noncustodial parent to
make regular child support payments, and if the noncustodial parent has not
attained 20 years of age, such related activities may include completion of high
school, a general equivalency degree, or other education directly related to
employment.
`(dd) A description of the services to be provided under this
paragraph, and a commitment by the noncustodial parent to participate in such
services, that are designed to assist the noncustodial parent obtain and retain
employment, increase earnings, and enhance the financial and emotional
contributions to the well-being of the minor child.
In order to protect custodial parents and children who may be at
risk of domestic violence, the preceding provisions of this subclause
shall not be construed to affect any other provision of law requiring
a custodial parent to cooperate in establishing the paternity of a
child or establishing or enforcing a support order with respect to a
child, or entitling a custodial parent to refuse, for good cause, to
provide such cooperation as a condition of assistance or benefit under
any program, shall not be construed to require such cooperation by the
custodial parent as a condition of participation of either parent in
the program authorized under this paragraph, and shall not be
construed to require a custodial parent to cooperate with or
participate in any activity under this clause. The entity operating a
project under this clause with funds provided under this paragraph
shall consult with domestic violence prevention and intervention organizations in
the development of the project.'.
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