[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 956 Introduced in Senate (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.
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