State Laws Improve Hearing Screening Follow-Up Recently enacted state legislation in Kentucky and Iowa will increase the number of infants who receive follow-up diagnostic assessments and early intervention services after failing a newborn hearing screening. The new laws reflect a growing nationwide trend to implement Phase II initiatives in early hearing detection and intervention (EHDI). The ... Policy Analysis
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Policy Analysis  |   July 01, 2009
State Laws Improve Hearing Screening Follow-Up
Author Notes
  • Rend Al-Mondhiry, JD, director of state legislative and regulatory advocacy, can be reached at ral-mondhiry@asha.org or 800-498-2071, ext. 5665.
    Rend Al-Mondhiry, JD, director of state legislative and regulatory advocacy, can be reached at ral-mondhiry@asha.org or 800-498-2071, ext. 5665.×
Article Information
Regulatory, Legislative & Advocacy / Policy Analysis
Policy Analysis   |   July 01, 2009
State Laws Improve Hearing Screening Follow-Up
The ASHA Leader, July 2009, Vol. 14, 9. doi:10.1044/leader.PA2.14092009.9
The ASHA Leader, July 2009, Vol. 14, 9. doi:10.1044/leader.PA2.14092009.9
Recently enacted state legislation in Kentucky and Iowa will increase the number of infants who receive follow-up diagnostic assessments and early intervention services after failing a newborn hearing screening. The new laws reflect a growing nationwide trend to implement Phase II initiatives in early hearing detection and intervention (EHDI).
The successful Phase I effort to mandate newborn hearing screening in all hospitals and birthing centers raised the number of newborns screened from 38% in 2000 to 96% in 2009. Phase II extends that effort with initiatives that improve tracking and surveillance to reduce the number of cases lost to follow-up; address privacy concerns associated with the exchange of health-related information; provide comprehensive coverage of early intervention and amplification devices; and promote an unbiased, family-centered approach to help parents make the best early intervention choice for their child.
Nationally, 46% of the infants born in 2006 did not complete follow-up after a failed newborn hearing screening and are considered “lost to follow-up” or “lost to documentation.” The new laws will help ensure that newborns and infants with hearing loss receive needed audiological and early intervention services and will help reduce the number of infants lost to follow-up by strengthening the requirements for reporting hearing screening results and diagnostic assessments.
Kentucky
The Kentucky law requires the Kentucky Commission for Children with Special Health Care Needs to establish standards for infant audiological assessment and diagnostic centers based on national standards, including those established by ASHA and the Joint Committee on Infant Hearing (JCIH).
The law includes new reporting requirements: Diagnostic centers must provide data to the commission within 48 hours regarding children ages birth to 3 who are newly identified with permanent hearing loss and also must refer those children to the state’s early intervention system. In addition, if a newborn fails a hearing screening, the hospital or birthing center must forward the screening report to the child’s primary care provider, the child’s parent(s), the commission, and an audiological assessment and diagnostic center, if follow-up is needed. (Previously the law did not require the report to be sent to a diagnostic center.)
Finally, the law also expands the definition of “infant at risk for late-onset, progressive hearing loss, or both”; the expanded definition will help identify more infants who have a higher-than-normal risk of becoming deaf or hard of hearing, and who should therefore be monitored for hearing loss.
Iowa
In Iowa, the new law requires a hospital, birthing center, or person performing a hearing screening to report the results or screening status to the primary care provider of the infant upon discharge from a hospital or birthing facility, not to just the infant’s parents, as previously required. The information must now include, in addition to existing reporting requirements, information about the primary care provider, any known risk indicators for hearing loss, and other information specified by the Iowa Department of Public Health.
An audiologist who conducts diagnostic audiological assessments of newborns and infants will now be required to do so in accordance with the department’s standards; the audiologist’s report to the department must now include the assessment results and any known risk indicators.
Strengthened Requirements
With mandates to report hearing screening and diagnostic assessment data, states are helping to ensure that all newborn infants are screened and that those with hearing loss—or at risk for later-onset hearing loss—are identified as early as possible and receive appropriate follow-up services. The new laws in Kentucky and Iowa reflect a growing trend to strengthen reporting and documentation requirements and improve all aspects of EHDI, such as enrollment in early intervention services and mandated coverage of hearing aids by insurance providers.
Other aspects of EHDI, however, remain in need of improvement, such as the availability of culturally competent family resources, information for parents of children with hearing loss, and use of computerized data management systems to record, track, and monitor hearing health throughout childhood.
ASHA is continuing to work with state associations and EHDI professionals nationwide to advance and implement Phase II objectives. ASHA plans to update the model bill in the near future to incorporate the next phase of its EHDI campaign: promoting lifetime screening. ASHA will focus on the importance of continued hearing screening at 12–18 months, pre-kindergarten, and elementary school.
For more information on EHDI, including Phase II state model legislation and talking points, state laws, and federal information, go to ASHA’s Early Hearing Detection & Intervention Action Center.
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FROM THIS ISSUE
July 2009
Volume 14, Issue 9