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114th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 114-241
======================================================================
EARLY HEARING DETECTION AND INTERVENTION ACT OF 2015
_______
September 8, 2015.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
_______
Mr. Upton, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 1344]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 1344) to amend the Public Health Service Act to
reauthorize a program for early detection, diagnosis, and
treatment regarding deaf and hard-of-hearing newborns, infants,
and young children, having considered the same, report
favorably thereon with an amendment and recommend that the bill
as amended do pass.
CONTENTS
Page
Purpose and Summary.............................................. 5
Background and Need for Legislation.............................. 5
Hearings......................................................... 5
Committee Consideration.......................................... 6
Committee Votes.................................................. 6
Committee Oversight Findings..................................... 6
Statement of General Performance Goals and Objectives............ 6
New Budget Authority, Entitlement Authority, and Tax Expenditures 6
Earmark, Limited Tax Benefits, and Limited Tariff Benefits....... 6
Committee Cost Estimate.......................................... 6
Congressional Budget Office Estimate............................. 6
Federal Mandates Statement....................................... 9
Duplication of Federal Programs.................................. 9
Disclosure of Directed Rule Makings.............................. 9
Advisory Committee Statement..................................... 9
Applicability to Legislative Branch.............................. 9
Section-by-Section Analysis of the Legislation................... 9
Changes in Existing Law Made by the Bill, as Reported............ 10
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may cited as the ``Early Hearing Detection and Intervention
Act of 2015''.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Deaf and hard-of-hearing newborns, infants, toddlers, and
young children require access to specialized early intervention
providers and programs in order to help them meet their
linguistic and cognitive potential.
(2) Families of deaf and hard-of-hearing newborns, infants,
toddlers, and young children benefit from comprehensive early
intervention programs that assist them in supporting their
child's development in all domains.
(3) Best practices principles for early intervention for deaf
and hard-of-hearing newborns, infants, toddlers, and young
children have been identified in a range of areas including
listening and spoken language and visual and signed language
acquisition, family-to-family support, support from individuals
who are deaf or hard-of-hearing, progress monitoring, and
others.
(4) Effective hearing screening and early intervention
programs must be in place to identify hearing levels in deaf
and hard-of-hearing newborns, infants, toddlers, and young
children so that they may access appropriate early intervention
programs in a timely manner.
SEC. 3. REAUTHORIZATION OF PROGRAM FOR EARLY DETECTION, DIAGNOSIS, AND
TREATMENT REGARDING DEAF AND HARD-OF-HEARING
NEWBORNS, INFANTS, AND YOUNG CHILDREN.
Section 399M of the Public Health Service Act (42 U.S.C. 280g-1) is
amended to read as follows:
``SEC. 399M. EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING DEAF
AND HARD-OF-HEARING NEWBORNS, INFANTS, AND YOUNG
CHILDREN.
``(a) Health Resources and Services Administration.--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, infant, and young childhood hearing
screening, diagnosis, evaluation, and intervention programs and
systems, and to assist in the recruitment, retention, education, and
training of qualified personnel and health care providers for the
following purposes:
``(1) To develop and monitor the efficacy of statewide
programs and systems for hearing screening of newborns,
infants, and young children, prompt evaluation and diagnosis of
children referred from screening programs, and appropriate
educational, audiological, and medical interventions for
children confirmed to be deaf or hard-of-hearing, consistent
with the following:
``(A) Early intervention includes referral to and
delivery of information and services by organizations
such as schools and agencies (including community,
consumer, and parent-based agencies), pediatric medical
homes, 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, and young children.
``(B) Information provided to parents must be
accurate, comprehensive, and, where appropriate,
evidence-based, allowing families to make important
decisions for their child in a timely way, including
decisions relating to all possible assistive hearing
technologies (such as hearing aids, cochlear implants,
and osseointegrated devices) and communication options
(such as visual and sign language, listening and spoken
language, or both).
``(C) Programs and systems under this paragraph shall
offer mechanisms that foster family-to-family and deaf
and hard-of-hearing consumer-to-family supports.
``(2) To develop efficient models (both educational and
medical) to ensure that newborns, infants, and young children
who are identified through hearing screening receive followup
by qualified early intervention providers, qualified health
care providers, or pediatric medical homes (including by
encouraging State agencies to adopt such models).
``(3) To provide for a technical resource center in
conjunction with the Maternal and Child Health Bureau of the
Health Resources and Services Administration--
``(A) to provide technical support and education for
States; and
``(B) to continue development and enhancement of
State early hearing detection and intervention
programs.
``(b) Technical Assistance, Data Management, and Applied Research.--
``(1) Centers for disease control and prevention.--The
Secretary, acting through the Director of the Centers for
Disease Control and Prevention, shall make awards of grants or
cooperative agreements to State agencies or their designated
entities for development, maintenance, and improvement of data
tracking and surveillance systems on newborn, infant, and young
childhood hearing screenings, audiologic evaluations, medical
evaluations, and intervention services; to conduct applied
research related to services and outcomes, and provide
technical assistance related to newborn, infant, and young
childhood hearing screening, evaluation, and intervention
programs, and information systems; to ensure high-quality
monitoring of hearing screening, evaluation, and intervention
programs and systems for newborns, infants, and young children;
and to coordinate developing standardized procedures for data
management and assessing program and cost effectiveness. The
awards under the preceding sentence may be used--
``(A) to provide technical assistance on data
collection and management;
``(B) to study and report on the costs and
effectiveness of newborn, infant, and young childhood
hearing screening, evaluation, diagnosis, intervention
programs, and systems;
``(C) to collect data and report on newborn, infant,
and young childhood hearing screening, evaluation,
diagnosis, and intervention programs and systems that
can be used--
``(i) for applied research, program
evaluation, and policy development; and
``(ii) 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, infant,
and young childhood hearing screening, audiologic
evaluations, medical evaluations, and intervention
programs and systems by assessing the health,
intellectual and social developmental, cognitive, and
hearing status of these children at school age; and
``(F) to promote the integration, linkage, and
interoperability of data regarding early hearing loss
and multiple sources to increase information exchanges
between clinical care and public health including the
ability of States and territories to exchange and share
data.
``(2) National institutes of health.--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 related to early hearing
detection and intervention, including development of
technologies and clinical studies of screening methods,
efficacy of interventions, and related research.
``(c) Coordination and Collaboration.--
``(1) In general.--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--
``(A) other Federal agencies;
``(B) 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.) (Medicaid Early and Periodic Screening, Diagnosis
and Treatment Program); title XXI of the Social
Security Act (42 U.S.C. 1397aa et seq.) (State
Children's Health Insurance Program); title V of the
Social Security Act (42 U.S.C. 701 et seq.) (Maternal
and Child Health Block Grant Program); and part C of
the Individuals with Disabilities Education Act (20
U.S.C. 1431 et seq.);
``(C) consumer groups of and that serve individuals
who are deaf and hard-of-hearing and their families;
``(D) appropriate national medical and other health
and education specialty organizations;
``(E) persons who are deaf and hard-of-hearing and
their families;
``(F) 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;
``(G) third-party payers and managed-care
organizations; and
``(H) related commercial industries.
``(2) Policy development.--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, infant, and young
childhood hearing screening, evaluation, diagnosis, and
intervention programs and systems.
``(3) State early detection, diagnosis, and intervention
programs and systems; data collection.--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--
``(A) to establish newborn, infant, and young
childhood hearing screening, evaluation, diagnosis, and
intervention programs and systems under subsection (a);
and
``(B) to develop a data collection system under
subsection (b).
``(d) Rule of Construction; Religious Accommodation.--Nothing in this
section shall be construed to preempt or prohibit any State law,
including State laws which do not require the screening for hearing
loss of newborns, infants, or young children of parents who object to
the screening on the grounds that such screening conflicts with the
parents' religious beliefs.
``(e) Definitions.--For purposes of this section:
``(1) The term `audiologic', when used in connection with
evaluation, refers to procedures--
``(A) to assess the status of the auditory system;
``(B) 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
``(C) to identify appropriate treatment and referral
options, including--
``(i) linkage to State coordinating agencies
under part C of the Individuals with
Disabilities Education Act (20 U.S.C. 1431 et
seq.) or other appropriate agencies;
``(ii) medical evaluation;
``(iii) hearing aid/sensory aid assessment;
``(iv) audiologic rehabilitation treatment;
and
``(v) referral to national and local
consumer, self-help, parent, and education
organizations, and other family-centered
services.
``(2) The term `early intervention' refers to--
``(A) providing appropriate services for the child
who is deaf or hard of hearing, including nonmedical
services; and
``(B) ensuring the family of the child is--
``(i) provided comprehensive, consumer-
oriented information about the full range of
family support, training, information services,
and language and communication options; and
``(ii) given the opportunity to consider and
obtain the full range of such appropriate
services, educational and program placements,
and other options for their child from highly
qualified providers.
``(3) The term `medical evaluation' refers to key components
performed by a physician, including history, examination, and
medical decisionmaking 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) The term `medical intervention' refers to the process
by which a physician provides medical diagnosis and direction
for medical or surgical treatment options for hearing loss or
related medical disorders.
``(5) The term `newborn, infant, and young childhood hearing
screening' refers to objective physiologic procedures to detect
possible hearing loss and to identify newborns, infants, and
young children who require further audiologic evaluations and
medical evaluations.
``(f) Authorization of Appropriations.--
``(1) Statewide newborn, infant, and young childhood hearing
screening, evaluation and intervention programs and systems.--
For the purpose of carrying out subsection (a), there is
authorized to be appropriated to the Health Resources and
Services Administration $17,800,000 for each of fiscal years
2016 through 2020.
``(2) Technical assistance, data management, and applied
research; centers for disease control and prevention.--For the
purpose of carrying out subsection (b)(1), there is authorized
to be appropriated to the Centers for Disease Control and
Prevention $10,800,000 for each of fiscal years 2016 through
2020.
``(3) Technical assistance, data management, and applied
research; national institute on deafness and other
communication disorders.--No additional funds are authorized to
be appropriated for the purpose of carrying out subsection
(b)(2). Such subsection shall be carried out using funds which
are otherwise authorized (under section 402A or other
provisions of law) to be appropriated for such purpose.''.
Purpose and Summary
H.R. 1344, Early Hearing Detection and Intervention Act of
2015, was introduced on March 10, 2015, by Rep. Guthrie (R-KY)
and Rep. Capps (D-CA), to amend the Public Health Service Act
to reauthorize a program for early detection, diagnosis, and
treatment regarding deaf and hard-of-hearing newborns, infants,
and young children.
Background and Need for Legislation
Hearing loss is the most frequently occurring screening for
newborns. Ninety-eight percent of infants are screened for
hearing loss before they leave the hospital as a result of the
Early Hearing Detection and Intervention (EHDI) program that
this bill would reauthorize. The EHDI program often is cited as
a model of how government at different levels and public and
private agencies should and can work together.
Effective hearing screening and early intervention programs
must be in place to identify hearing levels in deaf and hard-
of-hearing newborns, infants, toddlers, and young children so
that they may access appropriate early intervention programs in
a timely manner. Outcomes are improved greatly for children if
their hearing loss is detected early. Families of deaf and
hard-of-hearing newborns, infants, toddlers, and young children
benefit from comprehensive early intervention programs that
assist them in supporting their child's development in all
domains.
H.R. 1344 would improve upon current programs and extend
services to young children up to the age of five. This is an
important addition because the incidence of hearing loss
triples between birth and five years of age. The
reauthorization would emphasize the importance of the Health
Resources and Services Administration (HRSA), Centers for
Disease Control and Prevention (CDC) and National Institutes of
Health (NIH) partnering to improve outcomes and strengthen the
EHDI program.
Hearings
The Subcommittee on Health held a hearing on H.R. 1344 on
June 25, 2015. The Subcommittee received testimony from:
Joanne Kurtzberg, M.D., President, Cord
Blood Association;
Jeff Chell, M.D., Chief Executive Officer,
National Marrow Donor Program;
Patti Freemyer Martin, PhD, Director of
Audiology and Speech Language Pathology, Arkansas
Children's Hospital;
Stephen W. Patrick, M.D., M.P.H., M.S.,
Assistant Professor of Pediatrics and Health Policy,
Department of Pediatrics, Vanderbilt University School
of Medicine; and,
Mishka Terplan, M.D., M.P.H., FACOG, Medical
Director, Behavior Health System Baltimore.
Committee Consideration
On July 23, 2015, the Subcommittee on Health met in open
markup session and forwarded H.R. 1344 to the full Committee,
as amended, by a voice vote. On July 29, 2015, the full
Committee on Energy and Commerce met in open markup session and
ordered H.R. 1344 reported to the House, as amended, by a voice
vote.
Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list the record votes
on the motion to report legislation and amendments thereto.
There were no record votes taken in connection with ordering
H.R. 1344 reported. A motion by Mr. Upton to order H.R. 1344
reported to the House, as amended, was agreed to by a voice
vote.
Committee Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII of the Rules of the
House of Representatives, the Committee has not held hearings
on this legislation.
Statement of General Performance Goals and Objectives
The goal of the legislation is to reauthorize Federal
programs related to early detection, diagnosis, and treatment
regarding deaf and hard-of-hearing newborns, infants, and young
children.
New Budget Authority, Entitlement Authority, and Tax Expenditures
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee finds that H.R.
1344, would result in no new or increased budget authority,
entitlement authority, or tax expenditures or revenues.
Earmark, Limited Tax Benefits, and Limited Tariff Benefits
In compliance with clause 9(e), 9(f), and 9(g) of rule XXI
of the Rules of the House of Representatives, the Committee
finds that H.R. 1344 contains no earmarks, limited tax
benefits, or limited tariff benefits.
Committee Cost Estimate
The Committee adopts as its own the cost estimate prepared
by the Director of the Congressional Budget Office pursuant to
section 402 of the Congressional Budget Act of 1974.
Congressional Budget Office Estimate
Pursuant to clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, the following is the cost estimate
provided by the Congressional Budget Office pursuant to section
402 of the Congressional Budget Act of 1974:
U.S. Congress,
Congressional Budget Office,
Washington, DC, September 2, 2015.
Hon. Fred Upton,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 1344, the Early
Hearing Detection and Intervention Act of 2015.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Lisa Ramirez-
Branum.
Sincerely,
Keith Hall.
Enclosure.
H.R. 1344--Early Hearing Detection and Intervention Act of 2015
Summary: H.R. 1344 would amend the Public Health Service
Act to authorize research and public health activities related
to early detection, diagnosis, and treatment of hearing loss in
newborns, infants, and young children. Those activities are
conducted by the Health Resources and Services Administration
(HRSA), the Centers for Disease Control and Prevention (CDC),
and the National Institutes of Health (NIH).
CBO estimates that implementing H.R. 1344 would cost $212
million over the 2016-2020 period, assuming appropriation of
the specified and necessary amounts. Enacting H.R. 1344 would
not affect direct spending or revenues; therefore, pay-as-you-
go procedures do not apply.
H.R. 1344 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act (UMRA).
Estimated cost to the Federal Government: The estimated
budgetary impact of H.R. 1344 is shown in the following table.
The costs of this legislation fall within budget function 550
(health).
----------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
-------------------------------------------------------
2016 2017 2018 2019 2020 2016-2020
----------------------------------------------------------------------------------------------------------------
CHANGES IN SPENDING SUBJECT TO APPROPRIATION
HRSA:
Authorization Level................................. 18 18 18 18 18 89
Estimated Outlays................................... 9 16 17 18 18 78
CDC:
Authorization Level................................. 11 11 11 11 11 55
Estimated Outlays................................... 4 9 10 11 11 45
NIH:
Estimated Authorization Level....................... 21 21 22 22 23 109
Estimated Outlays................................... 6 18 21 22 22 89
Total Changes:
Estimated Authorization Level................... 50 50 51 51 52 253
Estimated Outlays............................... 19 43 48 51 51 212
----------------------------------------------------------------------------------------------------------------
Notes: Components may not add to totals because of rounding. HRSA = Health Resources and Services
Administration; CDC = Centers for Disease Control and Prevention; NIH = National Institutes of Health.
Basis of estimate: CDC, HRSA, and NIH administer programs
that support activities to detect, diagnose, and treat early
hearing loss in newborns and infants. The Congress appropriated
approximately $50 million for such activities in 2015. For this
estimate, CBO assumes that the legislation will be enacted near
the beginning of fiscal year 2016, that the authorized amounts
will be appropriated in each year, and that spending will
follow historical patterns for the authorized programs. CBO
estimates that implementing H.R. 1344 would cost $212 million
over the 2016-2020 period, assuming appropriation of the
specified and estimated amounts.
HRSA: The bill would authorize the appropriation of $17.8
million for each of fiscal years 2016-2020 for HRSA to
administer the Universal Newborn Screening program. The program
makes grants to states to support testing of infants prior to
hospital discharges, audiologic evaluation by three months of
age, and early intervention activities. CBO estimates
implementing those provisions would cost $78 million over the
2016-2020 period.
CDC: H.R. 1344 would authorize the appropriation of $10.8
million annually for each of fiscal years 2016-2020 for CDC to
make grants and provide technical assistance to states to
promote screening and to support surveillance activities and
research about the causes of hearing loss among newborns,
infants, and young children. In addition, the bill would
authorize CDC to conduct research, monitor state programs, and
develop procedures for assessing services, costs, and outcomes
in those programs. CBO estimates implementing those provisions
would cost $45 million over the 2016-2020 period.
NIH: The bill would authorize NIH to conduct research on
early detection and treatment of hearing loss. The authority
for research programs at NIH expired at the end of fiscal year
2009; however, the Congress has continued to appropriate funds
to operate those programs across all areas of research at NIH.
Based on information from the agency, CBO estimates that the
National Institute on Deafness and Other Communication
Disorders at NIH spent about $21 million on such research in
fiscal year 2014. Based on historical program expenditures at
NIH and adjusting for inflation, CBO estimates that
implementing this provision would cost $89 million over the
2016-2020 period, assuming appropriation of the necessary
amounts.
Pay-As-You-Go considerations: None.
Intergovernmental and private-sector impact: H.R. 1344
contains no intergovernmental or private-sector mandates as
defined in UMRA and would impose no costs on state, local, or
tribal governments. Grant funds authorized in the bill would
benefit states that provide hearing screening, evaluation, and
intervention programs to newborns, infants, and young children.
Estimate prepared by: Federal costs: Lisa Ramirez-Branum,
Ellen Werble, and Rebecca Yip; Impact on state, local, and
tribal governments: J'nell Blanco Suchy; Impact on the private
sector: Amy Petz.
Estimate approved by: Holly Harvey, Deputy Assistant
Director for Budget Analysis.
Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
Duplication of Federal Programs
No provision of H.R. 1344 would establish or reauthorize a
program of the Federal Government known to be duplicative of
another Federal program, a program that was included in any
report from the Government Accountability Office to Congress
pursuant to section 21 of Public Law 111-139, or a program
related to a program identified in the most recent Catalog of
Federal Domestic Assistance.
Disclosure of Directed Rule Makings
The Committee estimates that enacting H.R. 1344
specifically directs to be completed no rule making within the
meaning of 5 U.S.C. 551.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 states that the legislation may be cited as the
``Early Hearing Detection and Intervention Act of 2015.''
Section 2. Findings
Section 2 includes relevant findings.
Section 3. Reauthorization of program for early detection, diagnosis,
and treatment regarding deaf and hard-of-hearing newborns,
infants and young children
Section 3 would reauthorize various grant programs. The
HRSA grants would develop and monitor the efficacy of statewide
programs and systems for hearing screenings, ensure prompt
evaluation and diagnosis and ensure patients receive
appropriate interventions.
The CDC would be directed to award grants or enter into
cooperative agreements to provide assistance on data collection
and management and to study and report on the costs and
effectiveness of screening and other programs.
Section 3 would promote coordination and collaboration
among the Administrator of the HRSA, Director of the CDC and
Director of the NIH on policy and program development at the
Federal and State levels. The Committee encourages them to
engage with patient groups, appropriate national medical and
other health and education specialty organizations, payers,
related commercial industry, and other qualified professional
personnel.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italic, and existing law in which no
change is proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE
* * * * * * *
PART P--ADDITIONAL PROGRAMS
* * * * * * *
[SEC. 399M. EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING HEARING
LOSS IN NEWBORNS AND INFANTS.
[(a) Statewide Newborn and Infant Hearing Screening,
Evaluation and Intervention Programs and Systems.--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, diagnosis, and
intervention programs and systems, and to assist in the
recruitment, retention, education, and training of qualified
personnel and health care providers, for the following
purposes:
[(1) To develop and monitor the efficacy of statewide
programs and systems for hearing screening of newborns
and infants; prompt evaluation and diagnosis of
children referred from screening programs; and
appropriate educational, audiological, and medical
interventions for children identified with hearing
loss. Early intervention includes referral to and
delivery of information and services by 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. Programs and systems under this
paragraph shall establish and foster family-to-family
support mechanisms that are critical in the first
months after a child is identified with hearing loss.
[(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.
[(3) Other activities may include developing
efficient models to ensure that newborns and infants
who are identified with a hearing loss through
screening receive follow-up by a qualified health care
provider, and State agencies shall be encouraged to
adopt models that effectively increase the rate of
occurrence of such follow-up.
[(b) Technical Assistance, Data Management, and Applied
Research.--
[(1) Centers for disease control and prevention.--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,
diagnosis, 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.--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.
[(c) Coordination and Collaboration.--
[(1) In general.--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.--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,
diagnosis, and intervention programs and systems.
[(3) State early detection, diagnosis, and
intervention programs and systems; data collection.--
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, diagnosis,
and intervention programs and systems under subsection
(a) and to develop a data collection system under
subsection (b).
[(d) Rule of Construction; Religious Accommodation.--Nothing
in this section shall be construed to preempt or prohibit any
State law, including State laws which do not require the
screening for hearing loss of newborn infants or young children
of parents who object to the screening on the grounds that such
screening conflicts with the parents' religious beliefs.
[(e) Definitions.--For purposes of this section:
[(1) The term ``audiologic evaluation'' refers to
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
coordinating agencies under part C of the Individuals
with Disabilities Education Act 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) The terms ``audiologic rehabilitation'' and
``audiologic intervention'' refer to procedures,
techniques, and technologies to facilitate the
receptive and expressive communication abilities of a
child with hearing loss.
[(3) The term ``early intervention'' refers to
providing appropriate services for the child with
hearing loss, including nonmedical services, and
ensuring that families of the child are provided
comprehensive, consumer-oriented information about the
full range of family support, training, information
services, and language and communication options and
are given the opportunity to consider and obtain the
full range of such appropriate services, educational
and program placements, and other options for their
child from highly qualified providers.
[(4) The term ``medical evaluation by a physician''
refers to 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.
[(5) The term ``medical intervention'' refers to 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.
[(6) The term ``newborn and infant hearing
screening'' refers to objective physiologic procedures
to detect possible hearing loss and to identify
newborns and infants who require further audiologic and
medical evaluations.
[(f) Authorization of Appropriations.--
[(1) Statewide newborn and infant hearing screening,
evaluation and intervention programs and systems.--For
the purpose of carrying out subsection (a), there are
authorized to be appropriated to the Health Resources
and Services Administration such sums as may be
necessary for fiscal years 2011 through 2015.
[(2) Technical assistance, data management, and
applied research; centers for disease control and
prevention.--For the purpose of carrying out subsection
(b)(1), there are authorized to be appropriated to the
Centers for Disease Control and Prevention such sums as
may be necessary for fiscal years 2011 through 2015.
[(3) Technical assistance, data management, and
applied research; national institute on deafness and
other communication disorders.--For the purpose of
carrying out subsection (b)(2), there are authorized to
be appropriated to the National Institute on Deafness
and Other Communication Disorders such sums as may be
necessary for fiscal years 2011 through 2015.]
SEC. 399M. EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING DEAF AND
HARD-OF-HEARING NEWBORNS, INFANTS, AND YOUNG
CHILDREN.
(a) Health Resources and Services Administration.--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,
infant, and young childhood hearing screening, diagnosis,
evaluation, and intervention programs and systems, and to
assist in the recruitment, retention, education, and training
of qualified personnel and health care providers for the
following purposes:
(1) To develop and monitor the efficacy of statewide
programs and systems for hearing screening of newborns,
infants, and young children, prompt evaluation and
diagnosis of children referred from screening programs,
and appropriate educational, audiological, and medical
interventions for children confirmed to be deaf or
hard-of-hearing, consistent with the following:
(A) Early intervention includes referral to
and delivery of information and services by
organizations such as schools and agencies
(including community, consumer, and parent-
based agencies), pediatric medical homes, 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, and young children.
(B) Information provided to parents must be
accurate, comprehensive, and, where
appropriate, evidence-based, allowing families
to make important decisions for their child in
a timely way, including decisions relating to
all possible assistive hearing technologies
(such as hearing aids, cochlear implants, and
osseointegrated devices) and communication
options (such as visual and sign language,
listening and spoken language, or both).
(C) Programs and systems under this paragraph
shall offer mechanisms that foster family-to-
family and deaf and hard-of-hearing consumer-
to-family supports.
(2) To develop efficient models (both educational and
medical) to ensure that newborns, infants, and young
children who are identified through hearing screening
receive followup by qualified early intervention
providers, qualified health care providers, or
pediatric medical homes (including by encouraging State
agencies to adopt such models).
(3) To provide for a technical resource center in
conjunction with the Maternal and Child Health Bureau
of the Health Resources and Services Administration--
(A) to provide technical support and
education for States; and
(B) to continue development and enhancement
of State early hearing detection and
intervention programs.
(b) Technical Assistance, Data Management, and Applied
Research.--
(1) Centers for disease control and prevention.--The
Secretary, acting through the Director of the Centers
for Disease Control and Prevention, shall make awards
of grants or cooperative agreements to State agencies
or their designated entities for development,
maintenance, and improvement of data tracking and
surveillance systems on newborn, infant, and young
childhood hearing screenings, audiologic evaluations,
medical evaluations, and intervention services; to
conduct applied research related to services and
outcomes, and provide technical assistance related to
newborn, infant, and young childhood hearing screening,
evaluation, and intervention programs, and information
systems; to ensure high-quality monitoring of hearing
screening, evaluation, and intervention programs and
systems for newborns, infants, and young children; and
to coordinate developing standardized procedures for
data management and assessing program and cost
effectiveness. The awards under the preceding sentence
may be used--
(A) to provide technical assistance on data
collection and management;
(B) to study and report on the costs and
effectiveness of newborn, infant, and young
childhood hearing screening, evaluation,
diagnosis, intervention programs, and systems;
(C) to collect data and report on newborn,
infant, and young childhood hearing screening,
evaluation, diagnosis, and intervention
programs and systems that can be used--
(i) for applied research, program
evaluation, and policy development; and
(ii) 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,
infant, and young childhood hearing screening,
audiologic evaluations, medical evaluations,
and intervention programs and systems by
assessing the health, intellectual and social
developmental, cognitive, and hearing status of
these children at school age; and
(F) to promote the integration, linkage, and
interoperability of data regarding early
hearing loss and multiple sources to increase
information exchanges between clinical care and
public health including the ability of States
and territories to exchange and share data.
(2) National institutes of health.--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 related to early hearing detection and
intervention, including development of technologies and
clinical studies of screening methods, efficacy of
interventions, and related research.
(c) Coordination and Collaboration.--
(1) In general.--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--
(A) other Federal agencies;
(B) 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.) (Medicaid Early
and Periodic Screening, Diagnosis and Treatment
Program); title XXI of the Social Security Act
(42 U.S.C. 1397aa et seq.) (State Children's
Health Insurance Program); title V of the
Social Security Act (42 U.S.C. 701 et seq.)
(Maternal and Child Health Block Grant
Program); and part C of the Individuals with
Disabilities Education Act (20 U.S.C. 1431 et
seq.);
(C) consumer groups of and that serve
individuals who are deaf and hard-of-hearing
and their families;
(D) appropriate national medical and other
health and education specialty organizations;
(E) persons who are deaf and hard-of-hearing
and their families;
(F) 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;
(G) third-party payers and managed-care
organizations; and
(H) related commercial industries.
(2) Policy development.--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, infant, and young childhood hearing screening,
evaluation, diagnosis, and intervention programs and
systems.
(3) State early detection, diagnosis, and
intervention programs and systems; data collection.--
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--
(A) to establish newborn, infant, and young
childhood hearing screening, evaluation,
diagnosis, and intervention programs and
systems under subsection (a); and
(B) to develop a data collection system under
subsection (b).
(d) Rule of Construction; Religious Accommodation.--Nothing
in this section shall be construed to preempt or prohibit any
State law, including State laws which do not require the
screening for hearing loss of newborns, infants, or young
children of parents who object to the screening on the grounds
that such screening conflicts with the parents' religious
beliefs.
(e) Definitions.--For purposes of this section:
(1) The term ``audiologic'', when used in connection
with evaluation, refers to procedures--
(A) to assess the status of the auditory
system;
(B) 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
(C) to identify appropriate treatment and
referral options, including--
(i) linkage to State coordinating
agencies under part C of the
Individuals with Disabilities Education
Act (20 U.S.C. 1431 et seq.) or other
appropriate agencies;
(ii) medical evaluation;
(iii) hearing aid/sensory aid
assessment;
(iv) audiologic rehabilitation
treatment; and
(v) referral to national and local
consumer, self-help, parent, and
education organizations, and other
family-centered services.
(2) The term ``early intervention'' refers to--
(A) providing appropriate services for the
child who is deaf or hard of hearing, including
nonmedical services; and
(B) ensuring the family of the child is--
(i) provided comprehensive, consumer-
oriented information about the full
range of family support, training,
information services, and language and
communication options; and
(ii) given the opportunity to
consider and obtain the full range of
such appropriate services, educational
and program placements, and other
options for their child from highly
qualified providers.
(3) The term ``medical evaluation'' refers to key
components performed by a physician, including history,
examination, and medical decisionmaking 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) The term ``medical intervention'' refers to the
process by which a physician provides medical diagnosis
and direction for medical or surgical treatment options
for hearing loss or related medical disorders.
(5) The term ``newborn, infant, and young childhood
hearing screening'' refers to objective physiologic
procedures to detect possible hearing loss and to
identify newborns, infants, and young children who
require further audiologic evaluations and medical
evaluations.
(f) Authorization of Appropriations.--
(1) Statewide newborn, infant, and young childhood
hearing screening, evaluation and intervention programs
and systems.--For the purpose of carrying out
subsection (a), there is authorized to be appropriated
to the Health Resources and Services Administration
$17,800,000 for each of fiscal years 2016 through 2020.
(2) Technical assistance, data management, and
applied research; centers for disease control and
prevention.--For the purpose of carrying out subsection
(b)(1), there is authorized to be appropriated to the
Centers for Disease Control and Prevention $10,800,000
for each of fiscal years 2016 through 2020.
(3) Technical assistance, data management, and
applied research; national institute on deafness and
other communication disorders.--No additional funds are
authorized to be appropriated for the purpose of
carrying out subsection (b)(2). Such subsection shall
be carried out using funds which are otherwise
authorized (under section 402A or other provisions of
law) to be appropriated for such purpose.
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