Newborn Hearing Screening Grants for States Resulting from Title VI (the Walsh bill) of the FY2000 Labor-HHS-Education Appropriations Act of 1999

The following questions and answers (Q & A) are provided to offer guidance on provisions passed as part of the Walsh bill. The answers reflect ASHA's current understanding of the impact of the legislation and initial discussions with the Health Services and Resources Administration (HRSA) and the Centers for Disease Control and Prevention (CDC) on the implementation of these provisions.

The Newborn Infant Hearing Screening and Intervention Act of 1999 (as introduced by Representative James Walsh (R-NY)), was incorporated as separate section, Title VI, under the Labor-Health and Human Services (HHS)-Education and Related Agencies Appropriations Act of 1999, H.R. 3424. The appropriations bill was bundled into a single piece of legislation with four of the 13 annual appropriations bills as the Omnibus Budget Reconciliation Act of 1999, H.R. 3194, which was signed into law by President Clinton on November 29, 1999.

For information on advocating in your state to establish a newborn hearing screening and intervention programs, or finding out what your state is doing regarding this subject, contact Charlie Diggs at 800-498-2071, ext. 4151 or email at cdiggs@asha.org. For information on advocacy before Congress, contact Reed Franklin at 800-498-2071, ext. 4473 or email at mailto:rfrankin@asha.org. For information about establishing an infant hearing screening program, or related practice policy information, contact Evelyn Cherow at 800-498-2071, ext. 4135 or echerow@asha.org.

Thousands of ASHA members and consumers were involved in bringing this issue to the attention of Members of Congress and the Administration. This victory was the result of a coordinated initiative of ASHA members' grassroots efforts to influence Congress in conjunction with ASHA's professional lobbyists working on Capitol Hill, and ASHA's working in coalition with other health care, education, and consumer organizations. Every element was essential to victory and every action taken by an ASHA member contributed to our success.

ASHA members are requested to logon to ASHA's Gateway to Action, and select "Newborn Hearing Screening" to send an email or letter to Members of Congress to thank them for supporting this important legislation, and request their support for the fully authorized funding level of $15 million for FY 2001.

Q: What does passage of the infant hearing screening grants for states mean?

A: The legislation enables up to three years of funds for state grants to develop infant hearing screening and intervention programs. It also specifies that three federal agencies-the Health Resources and Services Administration (HRSA), the Centers for Disease Control and Prevention (CDC), and the National Institute on Deafness and Other Communication Disorders (NIDCD)-will work together to:

develop and expand statewide screening programs;
link screening programs with community-based intervention efforts;
monitor the impact of early detection and intervention activities; and
provide technical assistance on data management and applied research.

Q: What impact is this federal legislation expected to have on statewide infant hearing screening and intervention programs?

A: The new federal grants to states are expected to be a catalyst to advance newborn screening and intervention programs. They should also help to better coordinate and draw attention to this important issue. Every day in the United States, 33 babies on average (or 12,000 each year) are born with permanent hearing loss, making it the most prevalent birth defect. Passage of the bill comes on the heels of a tremendous surge of new state laws this year. Twenty-two states-more than double the number from last year-have adopted legislation or state-wide programs to support newborn hearing screening and intervention programs.

Q: What can ASHA members do to take advantage of these new funds?

A: In general, states need to apply for the grants through HRSA and the CDC. Information on the HRSA grants is listed below. Further information and applications for the CDC grants is under development by the agency. ASHA will disseminate this information as soon as it is available. Twenty-two states have adopted legislation to support newborn infant hearing screening programs. The availability of federal grants to help establish infant hearing screening programs will make such programs much more appealing to states.

Applications for universal newborn hearing and follow-up programs under the HRSA initiative are open to state agencies with the capacity to implement a statewide universal newborn hearing screening program for all newborn infants in the state. A second category of grants are open to public and private entities with an organizational infrastructure capable of providing technical assistance and training on a national level. Preference will be given to entities with demonstrated capability and national expertise in providing technical assistance to states on the implementation of statewide universal newborn hearing screening programs.

The project period for the HRSA grants will be up to four years, starting April 1, 2000. Approximately $2.5 million per year will be available for applications to state agencies. Approximately $325,000 per year will be available for applications in the technical assistance category. The application deadline date is January 15, 2000. Application guidance for HRSA's Maternal and Child Health Bureau (MCHB) program grants are available in either an Adobe Acrobat or WordPerfect 6.1 file format via the Internet at: http://www.mchb.hrsa.gov/. If you have difficulty accessing the MCHB home page via the Internet and need technical assistance, please contact the Information Technology Branch at 301-443-8989 or webmaster@psc.gov.

The Centers for Disease Control and Prevention (CDC) have preliminarily announced that state agencies or universities representing states will be asked to apply for cooperative agreement grants to assist in the development of tracking and data systems for early hearing detection and intervention (EHDI) state programs. There will be two levels of funding for states developing these tracking and data systems. Further information on the CDC grants should be available in late March or early April, with awards expected for summer 2000. ASHA will disseminate further information on the ASHA Web site and its electronic mailing lists as soon as it becomes available.

Q: Now that the Walsh bill has been passed, what are the next steps in ASHA's advocacy campaign to promote universal newborn hearing screening and intervention?

A: Although ASHA has achieved a significant victory in passing this federal legislation after almost 10 years of work, we now need to:

expand funding for the Walsh bill in the federal FY2001 budget to $15 million;
redouble our efforts to pass state legislation for universal infant hearing screening and intervention programs;
undertake a comprehensive campaign to raise awareness of consumer and parent organizations, as well as other health providers and decision makers, about the benefits of early detection and intervention for hearing loss which is the most common congenital disorder in newborns; and
work with private health plans and Medicaid to ensure payment for these programs.

Q: When will ASHA's advocacy efforts for expanded screening for the FY2001 federal budget begin? What should ASHA members be requesting from their federal lawmakers?

A: Today. The Clinton Administration is preparing its Fiscal Year (FY) 2001 federal budget. ASHA has already been in contact with the other advocacy groups and the agencies involved in implementing the Walsh bill recommending that $15 million in next year's budget be requested (as authorized by the recently passed law) to support the state grant programs being established by HRSA and the CDC, as well as more directed funds for research on efficacy of early hearing loss detection and intervention by the NIDCD.

ASHA members are requested to logon to ASHA's Gateway to Action, and select "Newborn and Infant Hearing Screening Legislation" to send an email or letter to Members of Congress to thank them for cosponsoring this important legislation and/or ask them to support increased funding for Fiscal Year 2001 appropriations bill. Please logon at http://congress.nw.dc.us/asha where a model letter can be emailed directly to your Member of Congress, or a letter can be easily drafted on your personal or business stationery.

Q: How can ASHA members and state associations become involved in efforts to pass laws to ensure early detection and intervention for hearing loss?

A: ASHA member involvement is critical. ASHA is actively lobbying at the federal level and assisting state associations, legislators, and executive agencies to enact legislation or other sustained programs that will provide coverage for hearing screening for newborns and infants. But as with all advocacy efforts, individual members' advocacy is critical. ASHA has developed resources to assist you in being an advocate for newborn and infant hearing screening.

A comprehensive resource on newborn and infant hearing advocacy is now available on ASHA's Web site. The Newborn & Infant Hearing Screening Action Center is available at www.asha.org/infant_hearing/. The site includes information for consumers, guidelines for practitioners, current status of state laws and bills, action plans for ASHA member involvement, model legislation for states, links for writing to Congress about support for the new federal funding, talking points on early detection and intervention for hearing loss, a reference resource section, and background information.

Q: What continues to need to be done in terms of raising awareness for infant screening and intervention programs?

A: ASHA intends to further its leading role in early hearing loss detection and intervention under the Walsh bill, with interested federal, state, and local officials, as well as ASHA members involved or interested in advancing these programs. The goal of the Association is to ensure that all children born in the United States have access to and coverage for early screening for hearing loss and appropriate intervention as early as possible to give children identified with hearing loss the optimal resources to develop speech and language acquisition skills comparable with their peers..

In addition, ASHA will continue to expand its collaboration with consumer and parent organizations, as well as other health providers and decision makers, about the benefits of early detection and intervention for hearing loss which is the most common congenital disorder in newborns.

ASHA has established work groups to revise and develop preferred practices guidelines in pediatric audiology and offers professional consultation in developing programs on early detection and intervention for infants with hearing loss through ASHA's Audiology Practice and Consultation unit.

For more information, contact Evelyn Cherow at 800-498-2071, ext. 4135; email at echerow@asha.org or logon to ASHA's Audiology Web section at http://professional.asha.org/audiology/index.htm.

Check out ASHA’s Model Universal Newborn Hearing Bill on ASHA’s Web site.