S 956 IS
106th CONGRESS
1st Session
S. 956
To establish programs regarding early detection, diagnosis, and
interventions for newborns and infants with hearing loss.
IN THE SENATE OF THE UNITED STATES
May 4, 1999
Ms. SNOWE (for herself, Mr. HARKIN, and Mr. FRIST) introduced the following
bill; which was read twice and referred to the Committee on Health, Education,
Labor, and Pensions
A BILL
To establish programs regarding early detection, diagnosis, and
interventions for newborns and infants with hearing loss.
Be it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the `Newborn and Infant Hearing Screening and
Intervention Act of 1999'.
SEC. 2. EARLY DETECTION, DIAGNOSIS, AND INTERVENTIONS FOR NEWBORNS AND
INFANTS WITH HEARING LOSS.
(a) DEFINITIONS- In this Act:
(1) AUDIOLOGIC EVALUATION- The term `audiologic evaluation' means
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
linkages to State coordinating agencies for purposes of part C of the
Individuals with Disabilities Education Act (20 U.S.C. 1431 et seq.) 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.
(2) AUDIOLOGIC REHABILITATION- The term `audiologic rehabilitation'
means procedures, techniques, and technologies to facilitate the receptive
and expressive communication abilities of a child with hearing loss.
(3) EARLY INTERVENTION- The term `early intervention' means providing
appropriate services for a child with hearing loss and ensuring that the
family of the child is provided with 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.
(4) HEARING SCREENING- The term `hearing screening' with respect to
newborns and infants means objective physiologic procedures to detect
possible hearing loss and to identify newborns and infants who, after
rescreening, require further audiologic and medical evaluations.
(5) MEDICAL EVALUATION- The term `medical evaluation' means evaluation
by a physician consisting 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.
(6) MEDICAL INTERVENTION- The term `medical intervention' means the
process by which a physician provides medical diagnosis and direction for
medical or surgical treatment options of hearing loss or related medical
disorder associated with hearing loss.
(7) SECRETARY- The term `Secretary' means the Secretary of Health and
Human Services.
(b) PURPOSES- The purposes of this Act 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 state-wide
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, 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 (20
U.S.C. 1431 et seq.), 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 (42
U.S.C. 1396 et seq.) (particularly early and periodic screening, and
diagnosis services described in section 1905(r) of such title (42 U.S.C.
1396f(r))), title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.)
(the State Children's Health Insurance Program), title V of the Social
Security Act (42 U.S.C. 701 et seq.) (the Maternal and Child Health Block
Grant Program), Part C of the Individuals with Disabilities Education Act
(20 U.S.C. 1431 et seq.), 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 Act 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 be appropriated to the Health Resources and
Services Administration, $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 be appropriated to the Centers for Disease
Control and Prevention, $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 be appropriated to
the National Institute on Deafness and Other Communication Disorders such
sums as may be necessary for each of the fiscal years 2000 through
2002.
END