[House Report 117-208]
[From the U.S. Government Publishing Office]


117th Congress   }                                      {       Report
                        HOUSE OF REPRESENTATIVES
 1st Session     }                                      {      117-208

======================================================================



 
          EARLY HEARING DETECTION AND INTERVENTION ACT OF 2021

                                _______
                                

December 8, 2021.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

 Mr. Pallone, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 5561]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 5561) to reauthorize a program for early 
detection, diagnosis, and treatment regarding deaf and hard-of-
hearing newborns, infants, and young children, and for other 
purposes, having considered the same, reports favorably thereon 
with an amendment and recommends that the bill as amended do 
pass.

                                CONTENTS

                                                                     Page
  I. Purpose and Summary..............................................  2 
 II. Background and Need for the Legislation..........................  3 
III. Committee Hearings...............................................  4 
 IV. Committee Consideration..........................................  4 
  V. Committee Votes..................................................  4 
 VI. Oversight Findings...............................................  5 
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures  5 
VIII.Federal Mandates Statement.......................................  5  
 IX. Statement of General Performance Goals and Objectives............  5 
  X. Duplication of Federal Programs..................................  5  
 XI. Committee Cost Estimate..........................................  5 
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits......  5 
XIII.Advisory Committee Statement.....................................  5 
XIV. Applicability to Legislative Branch..............................  6 
 XV. Section-by-Section Analysis of the Legislation...................  6 
XVI. Changes in Existing Law Made by the Bill, as Reported............  7 

    The amendment is as follows:
    Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Early Hearing Detection and 
Intervention Act of 2021''.

SEC. 2. REAUTHORIZATION OF PROGRAM FOR EARLY DETECTION, DIAGNOSIS, AND 
                    TREATMENT REGARDING DEAF AND HARD-OF-HEARING 
                    NEWBORNS, INFANTS, AND YOUNG CHILDREN.

  Section 399M(f) of the Public Health Service Act (42 U.S.C. 280g-
1(f)) is amended--
          (1) in paragraph (1), by striking ``$17,818,000 for fiscal 
        year 2018, $18,173,800 for fiscal year 2019, $18,628,145 for 
        fiscal year 2020, $19,056,592 for fiscal year 2021, and 
        $19,522,758 for fiscal year 2022'' and inserting ``$17,818,000 
        for each of fiscal years 2022 through 2026'';
          (2) in paragraph (2), by striking ``$10,800,000 for fiscal 
        year 2018, $11,026,800 for fiscal year 2019, $11,302,470 for 
        fiscal year 2020, $11,562,427 for fiscal year 2021, and 
        $11,851,488 for fiscal year 2022'' and inserting ``$16,000,000 
        for each of fiscal years 2022 through 2026''; and
          (3) in paragraph (3), by striking ``fiscal years 2011 through 
        2015'' and inserting ``fiscal years 2022 through 2026''.

SEC. 3. GAO STUDY ON STATE EARLY HEARING DETECTION AND INTERVENTION 
                    PROGRAMS.

  (a) In General.--The Comptroller General of the United States shall 
conduct a study reviewing State early hearing detection and 
intervention (in this section referred to as ``EHDI'') programs. Such 
study shall--
          (1) analyze how information collected through such programs 
        informs what is known about EHDI activities to ensure that 
        newborns, infants, and young children have access to timely 
        hearing screenings and early interventions, including 
        information on any disparities in such access;
          (2) analyze what is known about how parents use State EHDI 
        websites to seek health and programmatic guidance related to 
        their child's hearing loss diagnosis; and
          (3) identify efforts and any promising practices of the 
        Centers for Disease Control and Prevention, the Health 
        Resources and Services Administration, the National Institute 
        on Deafness and Other Communication Disorders, and State EHDI 
        programs--
                  (A) to address disparities in outreach for, or access 
                to, timely hearing screenings and early interventions; 
                and
                  (B) to ensure that EHDI follow-up services are 
                communicated and made available to medically 
                underserved populations, including racial and ethnic 
                minorities.
  (b) Report.--Not later than two years after the date of the enactment 
of this Act, the Comptroller General shall--
          (1) complete the study under subsection (a) and submit a 
        report on the results of the study to--
                  (A) the Committee on Energy and Commerce of the House 
                of Representatives; and
                  (B) the Committee on Health, Education, Labor, and 
                Pensions of the Senate; and
          (2) make such report publicly available.

                         I. Purpose and Summary

    H.R. 5561 amends the Public Health Service Act to 
reauthorize early detection, diagnosis, and intervention (EHDI) 
programs for deaf and hard-of-hearing newborns, infants, and 
young children at Health Resources and Services Administration 
(HRSA), the Centers for Disease Control and Prevention (CDC), 
and the National Institutes for Health (NIH) for fiscal years 
2022 through 2026. H.R. 5561 also requires the Comptroller 
General of the United States (GAO) to conduct a study within 
two years of enactment on current information on EHDI 
activities, parent interactions with state EHDI websites, and 
best practices for addressing disparities in outreach and 
access to timely hearing screenings and early interventions as 
well as follow-up services.

                II. Background and Need for Legislation

    Congenital hearing loss refers to hearing loss that is 
present at birth.\1\ It is the most common birth defect with no 
currently available cure.\2\ According to recent CDC data, the 
prevalence of congenital hearing loss in 2019 was 1.7 per 1,000 
babies screened for hearing loss.\3\ Put differently, nearly 
6,000 U.S. infants born in 2019 were identified early with 
permanent hearing loss.\4\
---------------------------------------------------------------------------
    \1\American Speech-Language-Hearing Association, Hearing Loss at 
Birth (Congenital Hearing Loss) (https://www.asha.org/public/hearing/
congenital-hearing-loss/) (accessed November 30, 2021).
    \2\Justine M. Renauld and Martin L. Basch, Congenital Deafness and 
Recent Advances Towards Restoring Hearing Loss, Current Protocols (Mar. 
29, 2021) (https://doi.org/10.1002/cpz1.76).
    \3\Centers for Disease Control and Prevention, Data and Statistics 
About Hearing Loss in Children (June 10, 2021) (https://www.cdc.gov/
ncbddd/hearingloss/data.html).
    \4\Id.
---------------------------------------------------------------------------
    Undetected and untreated hearing loss is linked with 
academic underachievement, as well as delays in speech, 
language, social, and emotional development.\5\\6\ For this 
reason, timely diagnosis and treatment is critical to ensuring 
that all children with hearing loss have the same opportunities 
to succeed as their hearing peers. Research has found that 
children whose hearing loss is identified by six months of age 
have significantly better receptive and expressive skills than 
children whose hearing loss is identified later.\7\ 
Additionally, children identified for hearing loss that receive 
treatment within three- to six-months post-birth, respectively, 
develop better vocabularies than children who are identified 
and treated for hearing loss at later times.\8\
---------------------------------------------------------------------------
    \5\See Note 4.
    \6\Xidong Deng, Marcus Gaffney, and Scott D. Grosse, Early Hearing 
Detection and Intervention in the United States: Achievements and 
Challenges in the 21st Century, China CDC Weekly (May 22, 2020) 
(https://doi.org/10.46234/ccdcw2020.097).
    \7\See Note 3.
    \8\Centers for Disease Control and Prevention, Giving Every Child 
the Gift of Words (June 21, 2021) (https://www.cdc.gov/ncbddd/
hearingloss/features/feature-vocabulary-hearingloss.html).
---------------------------------------------------------------------------
    Hearing loss screening and early intervention were not 
regular practice in the early 1990s. Prior to 1993, only one in 
10 newborns were screened for hearing loss.\9\ In 2000, 
Congress passed and has subsequently reauthorized federal EHDI 
programs at HRSA, CDC, and NIH.\10\ These programs support the 
development of State and territory programs and systems of care 
that identify and support children who are deaf or hard of 
hearing by delivering screening, diagnosis, and early 
intervention services.\11\ EHDI ensures that children who are 
deaf and hard of hearing are identified at an early age through 
appropriate newborn, infant, and early childhood screening and 
receive optimal intervention care to enhance language, 
literacy, cognitive, social, and emotional development.\12\
---------------------------------------------------------------------------
    \9\Health Resources and Services Administration, Early Hearing 
Detection and Intervention (mchb.hrsa.gov/maternal-child-health-
initiatives/early-hearingdetection-and-intervention.html) (accessed 
October 12, 2021).
    \10\Hearing Loss Association of America, Early Hearing and 
Intervention Act (EHDI) (accessed October 12, 2021) (https://
www.hearingloss.org/programs-events/advocacy/know-your-rights/early-
hearing-detection-intervention-act-ehdi/).
    \11\See Note 10.
    \12\See Note 9.
---------------------------------------------------------------------------
    Rates of EHDI services have significantly increased in the 
last 20 years. In 2018, data from CDC reported that 97 percent 
of all infants were screened prior to one month of age, 77.1 
percent of infants received audiological evaluations and 
diagnoses by three months of age, and 70.1 percent of infants 
were enrolled in early intervention services before six months 
of age.\13\
---------------------------------------------------------------------------
    \13\13 Id.
---------------------------------------------------------------------------
    H.R. 5561 would extend funding for the EHDI programs 
through fiscal year 2026, ensuring that these services would 
continue to be available for children that are deaf or hard of 
hearing.

                        III. Committee Hearings

    For the purposes of section 3(c) of rule XIII of the Rules 
of the House of Representatives, the following hearing was used 
to develop or consider H.R. 5561:
    The Subcommittee on Health held a legislative hearing on 
October 20, 2021, entitled ``Enhancing Public Health: 
Legislation to Protect Children and Families.'' The 
Subcommittee received testimony from the following witnesses:
           Bruce L. Cassis, D.D.S., M.A.G.D., 
        President, Academy of General Dentistry;
           Raymond DuBois, M.D., Ph.D., Former 
        President, American Association for Cancer Research;
           Donald M. Lloyd-Jones, M.D., Sc.M., 
        President, American Heart Association;
           Ellyn Miller, President and Founder, 
        Smashing Walnuts Foundation; and
           Rick Nolan, Former U.S. Representative of 
        Minnesota.

                      IV. Committee Consideration

    Representatives Brett Guthrie (R-KY) and Doris Matsui (D-
CA) introduced H.R. 5561, the ``Early Hearing Detection and 
Intervention Act of 2021,'' on October 12, 2021, and it was 
referred to the Committee on Energy and Commerce. Subsequently, 
on October 13, 2021, H.R. 5561 was referred to the Subcommittee 
on Health. A legislative hearing was held on the bill on 
October 20, 2021.
    On November 4, 2021, the Subcommittee on Health met in open 
markup session, pursuant to notice, to consider H.R. 5561 and 8 
other bills. No amendments were offered during consideration of 
the bill. Upon conclusion of consideration of the bill, the 
Subcommittee on Health agreed to report the bill favorably to 
the full Committee, without amendment, by a voice vote.
    On November 17, 2021, the full Committee met in open markup 
session, pursuant to notice, to consider H.R. 5561 and 11 other 
bills. During consideration of the bill, an amendment offered 
by Representative Matsui was agreed to by a voice vote. Upon 
conclusion of consideration of the bill, the full Committee 
agreed to a motion on final passage offered by Representative 
Pallone (D-NJ), Chairman of the Committee, to order H.R. 5561 
reported favorably to the House, amended, by a voice vote.

                           V. Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list each record vote 
on the motion to report legislation and amendments thereto. The 
Committee advises that there were no record votes taken on H.R. 
5561.

                         VI. Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1) 
of rule X of the Rules of the House of Representatives, the 
oversight findings and recommendations of the Committee are 
reflected in the descriptive portion of the report.

 VII. New Budget Authority, Entitlement Authority, and Tax Expenditures

    Pursuant to 3(c)(2) of rule XIII of the Rules of the House 
of Representatives, the Committee adopts as its own the 
estimate of new budget authority, entitlement authority, or tax 
expenditures or revenues contained in the cost estimate 
prepared by the Director of the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 
1974.
    The Committee has requested but not received from the 
Director of the Congressional Budget Office a statement as to 
whether this bill contains any new budget authority, spending 
authority, credit authority, or an increase or decrease in 
revenues or tax expenditures.

                    VIII. 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.

       IX. Statement of General Performance Goals and Objectives

    Pursuant to clause 3(c)(4) of rule XIII, the general 
performance goal or objective of this legislation is to 
reauthorize EHDI programs for newborns, infants, and young 
children.

                   X. Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 5561 is known to be duplicative of another Federal 
program, including any program that was included in a report to 
Congress pursuant to section 21 of Public Law 111-139 or the 
most recent Catalog of Federal Domestic Assistance.

                      XI. Committee Cost Estimate

    Pursuant to clause 3(d)(1) of rule XIII, 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.

    XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits

    Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the 
Committee finds that H.R. 5561 contains no earmarks, limited 
tax benefits, or limited tariff benefits.

                   XIII. Advisory Committee Statement

    No advisory committee within the meaning of section 5(b) of 
the Federal Advisory Committee Act was created by this 
legislation.

                XIV. 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.

           XV. Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 designates that the Act may be cited as the 
``Early Hearing Detection and Intervention Act of 2021.''

Sec. 2. Reauthorization of program for early detection, diagnosis, and 
        treatment regarding deaf and hard-of-hearing newborns, infants, 
        and young children

    Section 2 amends the Public Health Service Act to authorize 
$17.8 million for programmatic activities at HRSA for each of 
fiscal years 2022 through 2026 to award grants or cooperative 
agreements to develop statewide newborn, infant, and young 
child hearing screening, evaluation, diagnosis, and 
intervention programs and systems, as well as provide for the 
recruitment, retention, education, and training of qualified 
personnel to conduct such activities.
    Section 2 also authorizes $16 million for programmatic 
activities at CDC for each of fiscal years 2022 through 2026 
for grants or cooperative agreements to provide technical 
assistance to State agencies or designated entities of States 
related to hearing screening, evaluation, diagnosis, and 
intervention services.
    In addition, Section 2 authorizes such sums as necessary 
for programmatic activities at the National Institute on 
Deafness and Other Communication Diseases for each of fiscal 
years 2022 through 2026 for research and development on the 
efficacy of new screening techniques, technology, and 
intervention, including clinical studies of screening methods 
and other related research.

Sec. 3. GAO study on State Early Hearing Detection and Intervention 
        programs

    Section 3 requires GAO to conduct a study reviewing State 
EHDI programs. This study shall (1) analyze how information 
collected through State EHDI programs informs what is known 
about EHDI activities to ensure newborns, infants, and young 
children have access to timely hearing screenings and early 
interventions, including information on any disparities in such 
access; (2) analyze parent use of State EHDI websites when 
seeking health and programmatic guidance related to their 
child's hearing loss diagnosis; and (3) identify efforts and 
best practices of CDC, HRSA, and the National Institute on 
Deafness and Other Communication Disorders, and State EHDI 
programs to address disparities in outreach for or access to 
timely hearing screenings and early intervention as well as 
follow-up services. GAO shall complete the study and issue a 
report to the House Committee on Energy and Commerce and the 
Senate Committee on Health, Education, Labor, and Pensions 
within two years of enactment.

       XVI. 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 italics, 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 DEAF AND 
                    HARD-OF-HEARING NEWBORNS, INFANTS, AND YOUNG 
                    CHILDREN.

  (a) Statewide Newborn, Infant, and Young Child 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, 
infant, and young child 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 (including, as 
appropriate, education and training of family members), 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 (referred to in this 
        section as ``children''); prompt evaluation and 
        diagnosis of children referred from screening programs; 
        and appropriate educational, audiological, medical, and 
        communication (or language acquisition) interventions 
        (including family support), for children identified as 
        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 family-
                based agencies), in health care settings 
                (including medical homes for children), and in 
                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 children.
                  (B) Information provided to families should 
                be accurate, comprehensive, up-to-date, and 
                evidence-based, as appropriate, to allow 
                families to make important decisions for their 
                children in a timely manner, including 
                decisions with respect to the full range of 
                assistive hearing technologies and 
                communications modalities, as appropriate.
                  (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 continue to provide technical support to 
        States, through one or more technical resource centers, 
        to assist in further developing and enhancing State 
        early hearing detection and intervention programs.
          (3) To identify or develop efficient models 
        (educational and medical) to ensure that children who 
        are identified as deaf or hard-of-hearing through 
        screening receive follow-up by qualified early 
        intervention providers or qualified health care 
        providers (including those at medical homes for 
        children), and referrals, as appropriate, including to 
        early intervention services under part C of the 
        Individuals with Disabilities Education Act. State 
        agencies shall be encouraged to effectively increase 
        the rate of such follow-up and referral.
  (b) Technical Assistance, Data Management, and Applied 
Research.--
          (1) Centers for disease control and prevention.--
                  (A) In general.--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 or 
                designated entities of States--
                          (i) to develop, maintain, and improve 
                        data collection systems related to 
                        newborn, infant, and young child 
                        hearing screening, evaluation 
                        (including audiologic, medical, and 
                        language acquisition evaluations), 
                        diagnosis, and intervention services;
                          (ii) to conduct applied research 
                        related to newborn, infant, and young 
                        child hearing screening, evaluation, 
                        and intervention programs and outcomes;
                          (iii) to ensure quality monitoring of 
                        hearing screening, evaluation, and 
                        intervention programs and systems for 
                        newborns, infants, and young children; 
                        and
                          (iv) to support newborn, infant, and 
                        young child hearing screening, 
                        evaluation, and intervention programs, 
                        and information systems.
                  (B) Use of awards.--The awards made under 
                subparagraph (A) may be used--
                          (i) to provide technical assistance 
                        on data collection and management, 
                        including to coordinate and develop 
                        standardized procedures for data 
                        management;
                          (ii) to assess and report on the cost 
                        and program effectiveness of newborn, 
                        infant, and young child hearing 
                        screening, evaluation, and intervention 
                        programs and systems;
                          (iii) to collect data and report on 
                        newborn, infant, and young child 
                        hearing screening, evaluation, 
                        diagnosis, and intervention programs 
                        and systems for applied research, 
                        program evaluation, and policy 
                        improvement;
                          (iv) to identify the causes and risk 
                        factors for congenital hearing loss;
                          (v) to study the effectiveness of 
                        newborn, infant, and young child 
                        hearing screening, audiologic and 
                        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
                          (vi) to promote the integration and 
                        interoperability of data regarding 
                        early hearing loss across multiple 
                        sources to increase the flow of 
                        information between clinical care and 
                        public health settings, 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 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--
                  (A) other Federal agencies;
                  (B) State and local agencies, including 
                agencies 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;
                  (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) individuals who are deaf or 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 
                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 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--
                  (A) to establish newborn, infant, and young 
                child 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 that do not require the 
screening for hearing loss of children of parents who object to 
the screening on the grounds that such screening conflicts with 
the parent's religious beliefs.
  (e) Definitions.--For purposes of this section:
          (1) The term ``audiologic'', when used in connection 
        with evaluation, means 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 or other appropriate agencies;
                          (ii) medical evaluation;
                          (iii) assessment for the full range 
                        of assistivehearing technologies 
                        appropriate for newborns, infants, and 
                        young children;
                          (iv) audiologic rehabilitation 
                        treatment; and
                          (v) referral to national and local 
                        consumer, self-help, parent, family, 
                        and education organizations, and other 
                        family-centered services.
          (2) The term ``early intervention''means--
                  (A) providing appropriate services for the 
                child who is deaf or hard-of-hearing, including 
                nonmedical services; and
                  (B) ensuring that the family of the child 
                is--
                          (i) provided comprehensive, consumer-
                        oriented information about the full 
                        range of family support, training, 
                        information services, and language 
                        acquisition in oral and visual 
                        modalities; and
                          (ii) given the opportunity to 
                        consider and obtain the full range of 
                        such appropriate services, educational 
                        and program placements, and other 
                        options for the child from highly 
                        qualified providers.
           (3) The term ``medical evaluation''means key 
        components performed by a physician 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) The term ``medical intervention''means the 
        process by which a physician provides medical diagnosis 
        and direction for medical or surgical treatment options 
        for hearing loss or other medical disorders associated 
        with hearing loss.
          (5) The term ``newborn, infant, and young child 
        hearing screening'' means objective physiologic 
        procedures to detect possible hearing loss and to 
        identify newborns, infants, and young children under 3 
        years of age 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 [$17,818,000 for fiscal 
        year 2018, $18,173,800 for fiscal year 2019, 
        $18,628,145 for fiscal year 2020, $19,056,592 for 
        fiscal year 2021, and $19,522,758 for fiscal year 2022] 
        $17,818,000 for each of fiscal years 2022 through 2026.
          (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 [$10,800,000 
        for fiscal year 2018, $11,026,800 for fiscal year 2019, 
        $11,302,470 for fiscal year 2020, $11,562,427 for 
        fiscal year 2021, and $11,851,488 for fiscal year 2022] 
        $16,000,000 for each of fiscal years 2022 through 2026.
          (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] fiscal 
        years 2022 through 2026.

           *       *       *       *       *       *       *


                                  [all]