BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                        Senator Elaine K. Alquist, Chair


          BILL NO:       AB 2072                                      
          A
          AUTHOR:        Mendoza                                      
          B
          AMENDED:       June 9, 2010                                
          HEARING DATE:  June 23, 2010                                
          2              
          CONSULTANT:                                                 
          0
          Orr/                                                        
          7
                                                                      
          2               
                                        

                                     SUBJECT

                    Hearing screening: resources and services.

                                     SUMMARY  

          Requires parents of all newborns and infants diagnosed with  
          a hearing loss to be provided specified information on  
          communication options for children with hearing loss.

                             CHANGES TO EXISTING LAW  
          
          Existing federal law:
          Establishes the Individuals with Disabilities Education Act  
          (IDEA) which governs how states and public agencies provide  
          early intervention, special education, and related services  
          to children with disabilities. It addresses the educational  
          needs of children with disabilities from birth to age 21.  
          Part C of the IDEA requires that infants and toddlers with  
          disabilities receive early intervention services from birth  
          through age 3. These services are provided according to an  
          Individualized Family Service Plan (IFSP).
          
          Existing state law:
          Establishes the Children's Medical Services (CMS) Branch  
          within the California Department of Health Care Services  
                                                         Continued---



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          (DHCS), which is responsible for implementing a statewide  
          comprehensive Newborn Hearing Screening Program (NHSP). The  
          NHSP helps identify hearing loss in infants and guide  
          families to the appropriate services needed to develop  
          communication skills. 

          Establishes the Newborn and Infant Hearing Screening,  
          Tracking, and Intervention Act to provide early detection  
          of hearing loss in newborns and provide confirmatory tests,  
          multidisciplinary evaluation, and intervention services at  
          the earliest opportunity for children who fail a hearing  
          screening, and their families.  The Act requires every  
          general acute care hospital with licensed perinatal  
          services to offer every newborn a hearing screening test  
          for the identification of hearing loss, as specified, and  
          provide written information on the availability of  
          community resources and services for children with hearing  
          loss to the parents of those who are diagnosed with a  
          hearing loss.

          Establishes the California Early Start Intervention  
          Services Act, commonly known as the Early Start program,  
          under the California Department of Developmental Services  
          (DDS) which provides various early intervention services  
          for infants and toddlers who have disabilities to enhance  
          their development and to minimize the potential for  
          developmental delays.

          Requires DHCS to establish a system of early hearing  
          detection and intervention centers according to standards  
          by the California Children's Services Program (CCS) that  
          provide technical assistance and consultation to hospitals  
          with hearing screening programs.  Each center is  
          responsible for a separate geographic catchment area of the  
          state. Each center maintains a database of all newborns and  
          infants screened in the catchment area, and is required to  
          ensure appropriate follow-up for infants with abnormal  
          hearing screens, including diagnostic evaluation and  
          referral to intervention service programs if necessary. 

          Requires that parents of all newborns and infants diagnosed  
          with a hearing loss be provided written information on the  
          availability of community resources and services for  
          children with hearing loss. Information shall include  
          listings of local and statewide nonprofit deaf and  




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          hard-of-hearing consumer-based organizations, parent  
          support organizations affiliated with deafness, and  
          programs offered through the Department of Social Services  
          (DSS) Office of Deaf Access, DDS, and the California  
          Department of Education (CDE). 

          Establishes the Genetic Disease Testing Fund in the State  
          Treasury, which is used to fund the newborn screening  
          program.


          The Lanterman Developmental Disabilities Act (AB 846), also  
          known as the Lanterman Act, is gives people with  
          developmental disabilities the right to services and  
          supports that enable them to live a more independent and  
          normal life. The Lanterman Act declares that persons with  
          developmental disabilities have the same legal rights and  
          responsibilities guaranteed all other persons by federal  
          and state constitutions and laws, and charges  regional  
          centers with advocacy for, and protection of, these rights.  



          This bill:
          Requires that parents of newborns and infants diagnosed  
          with hearing loss be provided written or electronic  
          information from the National Institute on Deafness and  
          Other Communication Disorders on American Sign Language,  
          total communication, cued Speech and Listening and Spoken  
          Language communication options for children with hearing  
          loss, including information about deaf and hard-of-hearing  
          organizations, agencies and early intervention centers, and  
          educational programs. 

          Stipulates that this information be provided by an  
          audiologist at a follow up appointment after diagnosis with  
          a hearing loss and also by a local Early Start Program  
          provider upon initial contact with the parents of a newly  
          diagnosed infant. 


          Provides that neither the state, an audiologist, nor Early  
          Start Program provider incur any cost for the  
          implementation of this bill. 





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                                  FISCAL IMPACT  

          This bill is keyed nonfiscal. 

                           BACKGROUND AND DISCUSSION  

          This bill seeks to require that parents of an infant  
          diagnosed with hearing loss be provided with written or  
          electronic information on American Sign Language (ASL),  
          Total Communication, Cued Speech, and Listening and Spoken  
          language. This bill also seeks to clarify that parents  
          should be provided information about deaf and  
          hard-of-hearing organizations, agencies, early intervention  
          centers, and educational programs. 

          The author contends that parents of infants who are newly  
          diagnosed with hearing loss are often unfamiliar with the  
          resources and options that are available to them.  
          Specifically, the author claims that parents of newborns  
          diagnosed with hearing loss are not provided information on  
          all options and modalities for treatment and education of  
          their children. The author claims that over the past fifty  
          years, there have been numerous advances in technology as  
          well as growing awareness about the importance of  
          delivering services to children in a variety of  
          communication modalities to ensure their development and  
          ensure continued access to communication. This bill would  
          assure that parents are given unbiased information and  
          resources so that they can determine the most appropriate  
          treatment for their child. 

          Causes of hearing loss
          According to the National Center for Health Statistics 36  
          million (17%) American adults have some degree of hearing  
          loss. About 1 in every 1,000 infants is born deaf. Another  
          1 in every 1,000 infants has a hearing impairment  
          significant enough to make speaking difficult. According to  
          the National Institute on Deafness and Other Communication  
          Disorders (NIDCD), more than half of all deafness or  
          hearing impairment is believed to have genetic cause(s).  
          About 90 percent of infants who are born deaf are born to  
          hearing parents. Sometimes babies and toddlers who may have  




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          had minimal or no hearing loss at birth show signs of  
          later-onset hearing loss. Additional screening is then  
          especially important, since hearing loss of any kind can  
          affect a child's speech and language development. 

          Sensorineural hearing loss (also called nerve deafness or  
          sensorineural deafness) is loss of hearing resulting from  
          problems in the inner ear, in the nerve from the inner ear  
          to the brain, or in the brain. In sensorineural hearing  
          loss, the damage lies in the inner ear, the acoustic nerve,  
          or both. Most physicians call this condition "nerve  
          deafness." Common causes of sensorineural hearing loss  
          include old age, Menieres disease, ototoxic medications  
          (such as high-dose aspirin or certain strong diuretics),  
          immune disorders, and noise exposure.  

          Conductive hearing loss is due to any condition that  
          interferes with the transmission of sound through the outer  
          and middle ear to the inner ear. This type of hearing loss  
          can be successfully treated in most cases.  In central  
          hearing loss, the problem lies in the central nervous  
          system, at some point within the brain. Interpreting speech  
          is a complex task. Some people can hear perfectly well but  
          have trouble interpreting or understanding what is being  
          said. Although information about central hearing loss is  
          accumulating, it remains somewhat a mystery in otology (the  
          medical specialty of ear medicine and surgery). 
          Frequently, a person experiences two or more types of  
          hearing impairment, and this is called mixed hearing loss.  
          This term is used only when both conductive and  
          sensorineural hearing losses are present in the same ear. 

          Newborn screening 
          The California Newborn Hearing Screening Program (NHSP) was  
          established as a result of Assembly Bill 2780, Chapter 310,  
          Statutes of 1998. This law requires the establishment of a  
          comprehensive hearing screening program for the early  
          detection of hearing loss in newborns and infants, with  
          access to diagnostic evaluations and follow-up services,  
          and provisions for data collection and reporting. The  
          Department of Health Care Services (Department),  
          specifically the Children's Medical Services (CMS) Branch,  
          has responsibility for the implementation and oversight of  
          this program. 





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          The NHSP is a comprehensive and coordinated system of early  
          identification, tracking and monitoring of hearing  
          screening, access to diagnostic services, and coordination  
          of appropriate intervention and support services for  
          newborns and infants with hearing loss. The goal of the  
          program is to identify newborns and infants with a hearing  
          loss prior to three months of age and to implement  
          audiological and early intervention services by six months  
          of age.

          Under the NHSP, all hospitals with licensed perinatal  
          services are required to provide inpatient hearing  
          screening for all newborns, with the parent's permission,  
          prior to hospital discharge. All infants receiving care in  
          an intensive care nursery or neonatal intensive care unit  
          must receive inpatient infant hearing screening services  
          prior to discharge. Inpatient infant hearing screening  
          includes a repeat hearing screen prior to discharge if the  
          newborn or infant did not pass the initial inpatient  
          hearing screening.

          California has over 550,000 births per year. It is  
          anticipated that the NHSP will result in the identification  
          of an estimated 1,100 newborns and infants born each year  
          with a significant hearing loss who will be linked with  
          appropriate follow-up and early intervention services.  

          Existing law requires the Newborn Screening Program  
          (program) to provide continuous screening services to all  
          California births to protect the health and safety of the  
          newborns affected with preventable heritable disorders.   
          The program mandates that the operation of the program be  
          fully supported from the fees collected, therefore fees may  
          be adjusted as necessary. The total newborn screening  
          program fee is currently $102.75. The fees collected from  
          the hospital of birth are deposited in a special fund  
          called the Genetic Disease Testing Fund (GDTF).  The GDTF  
          is used to pay expenses of program operations including  
          costs of supplies, forms, educational materials and  
          contracts with private vendors for laboratory analysis,  
          tracking of positive test results, data processing and fee  
          collection.

          Hearing Coordination Centers (HCCs)
          The Hearing Coordination Centers is a concept unique to  




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          California's newborn hearing screening program. The  
          functions of the Centers include: assisting hospitals to  
          develop and implement their screening programs, certifying  
          hospitals to participate as screening sites, monitoring  
          programs of the participating hospitals, assuring that  
          infants with abnormal hearing screenings receive necessary  
          follow-up including rescreening, diagnostic evaluation,  
          treatment, and referral to early intervention service  
          agencies, as appropriate providing information to families  
          and providers so they can more effectively advocate with  
          commercial health plans to access appropriate treatment.  
          Each HCC has a geographic service area for which it is  
          responsible. In states without coordinated tracking  
          systems, up to 50% of the infants who fail the inpatient  
          screen do not receive the necessary services to determine  
          if a hearing loss is present. It is essential that infants  
          who do not pass the screening tests receive prompt  
          evaluation and intervention if appropriate. Otherwise, the  
          benefit and purpose of early screening and identification  
          is lost. 

          Early Start Program
          In 1998, California passed Assembly Bill 2780, investing  
          approximately six million dollars in the development and  
          implementation of the California Newborn Hearing Screening  
          Program (NHSP). The program established a comprehensive,  
          coordinated system of identifying infants with hearing loss  
          and linking them with appropriate services, including the  
          Individuals with Disabilities Education Improvement Act  
          (IDEA) Part C early intervention services (called Early  
          Start in California). 

          Consequently, the Parentlinks program, funded through the  
          California Endowment and sponsored by the California  
          Coalition of Agencies Serving the Deaf and Hard of Hearing,  
          was established to provide intensive parent-to-parent  
          support to enable parents to become knowledgeable about  
          issues related to hearing loss, to advocate for the rights  
          of their children, and to make informed decisions about  
          raising their children. Parentlinks employed parent mentors  
          who provided families with specific information about  
          hearing loss, and linked families with the local Early  
          Start program. 

          Communication modalities and visual languages




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          While English and Spanish are spoken languages, American  
          Sign Language is a complete visual language in which the  
          brain processes linguistic information through the eyes.   
          The shape, placement, and movement of the hands, as well as  
          facial expressions and body movements, all play important  
          parts in conveying information. ASL has its own grammar,  
          word order, and sentence structure. Persons using ASL can  
          share feelings, jokes, and complete ideas using ASL.  Like  
          any other language, ASL must be learned, and any child can  
          learn ASL as a first language. 

          ASL is not a universal language; each country has its own  
          sign language, and regions have dialects, much like the  
          many languages spoken all over the world.  Like any spoken  
          language, ASL is a language with its own unique rules of  
          grammar and syntax and grows and changes over time.  
          According to the National Association of the Deaf (NAD),  
          ASL is used predominantly in the United States and in many  
          parts of Canada. ASL is accepted by many high schools,  
          colleges, and universities in fulfillment of modern and  
          "foreign" language academic degree requirements across the  
          United States. 

          According to a January 2008 policy statement of NAD, deaf  
          infants and children should be given the opportunity to  
          acquire and develop proficiency in ASL as early as  
          possible. NAD takes the position that as a fully accessible  
          visual language, ASL should be made available to every deaf  
          infant, in addition to any assistive technologies that may  
          be used to take advantage of the deaf infant's access to  
          the language(s) used by their families and care providers.

          According the Clearinghouse on Disabilities and Gifted   
          Education, Total Communication is an approach to deaf  
          education that aims to make use of a number of models of  
          communication such as sign language, oral, auditory,  
          written and visual aids, depending on the particular needs  
          and abilities of the child.  Total Communication is a  
          philosophy rather than a methodology. As a result, the  
          implementation of Total Communication philosophy with one  
          child could look entirely different  than its  
          implementation with another child.

          According to the National Cued Speech Association (NCSA),  
          Cued Speech is s system of communication used with and  




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          among deaf or hard of hearing people.  NCSA maintains that  
          it is a phonetic-based system which makes traditionally  
          spoken languages accessible by using a small number of  
          handshapes (representing consonants) in different locations  
          near the mouth (representing vowels), as a supplement to  
          lipreading.

          There are other visual languages as well, including  
          Manually Coded English (MCE), Conceptually Accurate Signed  
          English (CASE). There are also additional visual language  
          building blocks that can assist in communication such as  
          finger spelling and speech (lip) reading. 

          Families who have children with hearing loss often need to  
          learn special skills to help their children learn language.  
          These skills can be used together with hearing aids,  
          cochlear implants, and other devices that help children  
          hear.

          Cochlear implants and other amplification systems 
          A cochlear implant is a small, complex electronic device  
          that can help to provide a sense of sound to a person who  
          is profoundly deaf or severely hard-of-hearing. According  
          to the Alexander Graham Bell Association for the Deaf and  
          Hard of Hearing (AG Bell), cochlear implants were developed  
          in the 1970s to help profoundly deaf individuals who gained  
          little or no benefit from hearing aids. When hearing is  
          functioning normally, complicated parts of the inner ear  
          convert sound waves in the air into electrical impulses,  
          which are sent to the brain and recognized as sound. A  
          cochlear implant works in a similar manner.  When  
          surgically implanted behind the ear, the electronic device  
          is able to bypass damaged hearing cells and stimulate the  
          auditory nerve to restore partial hearing. Cochlear  
          implants provide enhanced sound detection and the potential  
          for greater speech understanding.

          The implant consists of an external portion that sits  
          behind the ear and a second portion that is surgically  
          placed under the skin. An implant has 1) a microphone,  
          which picks up sound from the environment; 2) a speech  
          processor, which selects and arranges sounds picked up by  
          the microphone; 3) a transmitter and receiver/stimulator,  
          which receive signals from the speech processor and convert  
          them into electric impulses; and 4) an electrode array,  




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          which is a group of electrodes that collects the impulses  
          from the stimulator and sends them to different regions of  
          the auditory nerve. The implant is turned on by an  
          audiologists four to six weeks after surgery, and may  
          require many adjustments thereafter.  

          Cochlear implants, coupled with intensive postimplantation  
          therapy, may help young children to acquire speech,  
          language, and social skills. Most children who receive  
          implants are between two and six years old. Early  
          implantation provides exposure to sounds that can be  
          helpful during the critical period when children learn  
          speech and language skills. It may be recommended that a  
          child with an implant get training with a speech language  
          pathologist, who teaches children how to learn speech and  
          language. This training can help a child understand the new  
          sounds that he or she hears with a cochlear implant.

          Cochlear implants can cost between $40,000 and $90,000.  
          Many insurance companies and state Medicaid programs help  
          pay for the costs.   According to the Food and Drug  
          Administration (FDA), as of April 2009, approximately  
          188,000 people worldwide have received implants. In the  
          United States, roughly 41,500 adults and 25,500 children  
          have received them. There are risks associated with  
          cochlear implants, and the extent that an implant will lead  
          to full hearing in a child is not predictable.  

          There are many other devices available to assist children  
          and adults with hearing loss. Some of these include hearing  
          aids, FM systems, telephone amplifiers, flashing and  
          vibrating alarms, Infra red listening devices, TTY (Text  
          Telephone or teletypewriter), and more.  

          Not all technological developments have been universally  
          accepted by the deaf community.  The cochlear implant  
          inspires both strong support and vehement opposition. Among  
          deaf people, the implants are generally hailed as a boon  
          for individuals who lost their hearing later in life, but  
          their use for deaf children became controversial.  The  
          effectiveness and risks of the implants are a major part of  
          the debate, but there is an additional conflict between  
          those who view deafness as a physical impairment and those  
          who see it as a valued part of cultural identity.  As  
          cochlear implant surgery has become more common in deaf  




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          children and implants have become more widely used, the  
          emphasis of the debate has changed. The focus now is on the  
          deaf child's exposure to visual language and the type of  
          support and educational services the child receives.
                                    
          Educational achievement of deaf and hard of hearing pupils 
          According to CDE, the deaf students who are most likely to  
          succeed academically are those children who are born to  
          deaf parents. Children born into homes where they have  
          access to the visual language of their families (typically  
          ASL), acquire that language at the same rate that hearing  
          children of hearing parents acquire spoken language.  
          Because they enter school with age-appropriate language  
          skills, they are well prepared to develop literacy skills. 

          However, more than 90 percent of children with hearing loss  
          are born to hearing parents, most of whom have had no  
          previous exposure to deafness.  For deaf and  
          hard-of-hearing children who are born to hearing parents,  
          research shows that the most important factors that will  
          lead to their success in school are: age of identification  
          and parent involvement. When a child's hearing loss is  
          identified by six months of age and the child and his  
          parents are enrolled in intensive and appropriate Early  
          Start services aimed at the development of language skills  
          (spoken and/or signed) that child is likely to acquire  
          language skills commensurate with his hearing peers and  
          cognitive abilities. 

          Audiologists scope of practice
          According to the Academy of Doctors of Audiology, an  
          audiologist is a person who, by virtue of academic degree,  
          clinical training, and license to practice, provides an  
          array of services related to the identification, diagnosis  
          and treatment of persons with auditory and balance  
          disorders, and the prevention of these disorders.  
          Audiologists are independent practitioners who provide  
          services in hospitals, clinics, schools, and private  
          practices. The audiologist is responsible for the  
          evaluation and fitting of amplification devices, including  
          assistive listening devices. The audiologist determines the  
          appropriateness of amplification systems for persons with  
          hearing impairment, evaluates benefit, and provides  
          counseling and training regarding their use. They  
          prescribe, fit, sell, and dispense hearing aids and other  




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          amplification systems. In the NHSP, audiologists are most  
          often the provider that conducts follow up testing of  
          infants who do not pass their initial hearing screening  
          test, and ultimately issue the diagnosis of hearing loss. 
          
          The CDC includes audiologists among the professional  
          support network of a family of a child with hearing loss,  
          and recommends parents consult them for advice along with  
          other specified health and service providers.

          Related bills
          ACR 169 (Carter) of 2009 would proclaim the month of June  
          as Hearing Aid Awareness Month. Pending in the Assembly. 
          
          Prior legislation
          AB 1307 (Buchanan) of 2009 would have required the  
          department to consider   inclusion in the statewide screening  
          program of conditions recommended by the American College  
          of Medical Genetics (ACMG) or other specified entities. The  
          department would be required to adopt the recommendations  
          within one year of their publication unless the department  
          determines that screening for the recommended conditions is  
          not necessary for advancing newborn health and notifies  
          appropriate committees of the Legislature of that  
          determination. Pending in Senate Appropriations Committee.

          SB 527 (Steinberg) of 2008, would have required the State  
          Department of Developmental Services to partner with at  
          least one regional center to implement a 2-year Autism  
          Spectrum Disorders Early Screening, Intervention, and  
          Treatment Pilot Program in at least 3 key geographic areas.  
          The pilot program would have established best practices for  
          early screening, diagnosis, referral, and treatment for  
          children with ASD. Vetoed by the Governor, who claimed the  
          provisions of the bill can be accomplished administratively  
          with funding from private, non-state general fund sources.

          AB 2555 (Torrico) Chapter 245, Statutes of 2008, requires  
          the existing notice of parent rights and procedural  
          safeguards provided to parents or guardians of pupils with  
          disabilities to include information regarding the state  
          special schools for pupils who are deaf, hard of hearing,  
          blind, visually impaired, or deaf-blind.
          
          AB 2780 (Gallegos), Chapter 310, Statutes of 1998.  The  




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          Health Services Budget Act establishesd the Infant Hearing  
          Screening Program to provide hearing screening tests for  
          children at risk for deafness and a system to provide  
          follow-up and assessment services.
          
          AB 1836 (Eastin), Chapter 1126, Statutes of 1994, expanded  
          legislative intent and made other changes related to  
          special education for hard-of-hearing and deaf pupils.  
          States intent that individuals with exceptional needs be  
          offered special assistance programs which take into  
          consideration, for hard-of-hearing or deaf children, the  
          individual's need for a sufficient number of age and  
          language mode peers and for special education teachers who  
          are proficient in the individual pupil's primary language  
          mode.
          
          Arguments in support
          The California Medical Association (CMA) believes it is  
          imperative that patients and their families receive  
          adequate information about a health condition and treatment  
          options in order to make informed decisions about their  
          health care and future treatment. This is especially  
          important for children who have been diagnosed with hearing  
          loss. CMA states that as long as parents are equipped with  
          unbiased, balanced, and accurate information about the  
          communication options available, they can discuss these  
          options with their child's health care team and make the  
          best decision for their child as to how he or she will  
          communicate with the world around them. 

          The California Academy of Audiology claims to be the  
          primary professional caregivers who treat hearing impaired  
          children, and wants to ensure that the parents of all  
          newborns diagnosed with a hearing loss will be provided  
          written information on all communication options for their  
          kids at the earliest appropriate time, so that they make  
          the best intervention decision possible. 

          California Lutheran University writes in support of this  
          bill citing their status as one of the few credentialed  
          program providers that prepare teachers for the deaf. They  
          claim that given the diversity of the deaf population of  
          students, it is imperative that all approaches are  
          presented equally to families. In  no way does a  
          presentation to families of all options, settings, services  




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          and approaches denigrate or dismiss any other option,  
          language, cultural group, or approach. The more information  
          a family has, the better and easier their decision will be.  
           
          
          Arguments in opposition
          California Educators of the Deaf believes this bill should  
          specify that information given to parents be vetted by  
          California stakeholders, including educators of the deaf  
          and hard of hearing, deaf community members, and parents.  
          They believe the California Department of Education should  
          be responsible for this. They also contend that the bill is  
          sponsored by directors of private oral education schools,  
          and that the broader deaf education community already  
          recognizes the variety of opportunities for deaf children. 

          The Greater Los Angeles Agency on Deafness believes that  
          providing information to parents of hearing loss is vital,  
          but believes AB 2072 as written is flawed and neglects key  
          components to insure that parents receive thorough and  
          unbiased information.  They believe the bill would bypass  
          the state's newborn hearing screening policies and that the  
          bill does not provide for any state accountability or  
          oversight. 

          ASL Rose opposes the bill and does not believe that early  
          identification of deaf newborns automatically yields  
          positive results in the majority of situations, nor that  
          auditory-verbal therapy has benefits for deaf children with  
          residual hearing. 

                                  PRIOR ACTIONS

           Assembly Health Committee:    10-4
          Assembly Floor:          57-7

                                     COMMENTS

           1.  Suggested amendments.  Both supporters and opposition  
          to this bill agree that any information provided to parents  
          of deaf children should be unbiased, based on scientific  
          facts, and come from a reliable, neutral third-party  
          source. To address this, the committee suggests amendments  
          to require that either DDS or CDE develop or approve the  
          use of standardized, objective pamphlet of information  




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          about communication options for children who are deaf or  
          hard-of-hearing, that is sufficient to allow the child'  
          parents to make an informed decision. This information  
          shall be decided upon by the department in conjunction with  
          a stakeholder panel, comprised of representatives of the  
          various communication options. The cost for developing the  
          pamphlet and conducting the stakeholder panel shall be  
          covered through the development of an additional state fund  
          to accept private donations for this purpose. The  
          provisions of the bill shall only be made operative after  
          sufficient funds have been collected to cover necessary  
          expenses. 

                                    POSITIONS 
                                        

          Support:   California Coalition (sponsor)
                     American Federation of State, County and  
          Municipal Employees, AFL-CIO 
                           (AFCSME)
                  Alexander Graham Bell Association for the Deaf and  
                     Hard of Hearing (AG Bell)
                      Alexander Graham Bell Association for the Deaf  
          and Hard of Hearing,
                             California Chapter (CA AG Bell)
                 California Academy of Audiology (CAA)
                 California Association of Private Special Education  
          Schools (CAPSES)
                 California Association of Private School  
          Organizations (CAPSO) 
                 California Department of Education (if amended)
                 California Hospital Association (CHA)   
                 California Lutheran University
                 California Medical Association (CMA)
                 Children Specialty Care Coalition
                 Hearing Loss Association of California
                 Modern Deaf Communication
                 National Cued Speech Association
                 West Coast Cued Speech Programs
                 Several Individuals

          Oppose:  American Society for Deaf Children 
                 Alliance for Language and Literacy for Deaf Children  
          (ALL for Deaf
                      Children)




          STAFF ANALYSIS OF ASSEMBLY BILL 2072 (Mendoza)        Page  
          16


          

                 ASL Presents
                 ASL Rose
                 Alternative Solutions Center
                 California Association of the Deaf
                 California Deaf Newborn Identification & Advocacy  
          Stakeholder Coalition 
                    (CENIAS)
                 California Educators of the Deaf
                 Center On Deaf Inland Empire Community
                 Coalition of Individuals with Individuals with  
          Cochlear Implants
                 Conference of Educational Administrators of Schools  
                 and Program for the   
                     Deaf, Inc.
                 Convo Communications
                 Deaf and Hard of Hearing Service Center, Inc.
                 Deaf Bilingual Coalition
                 Deaf Children First
                 Deaf Counseling Advocacy & Referral Agency (DCARA)
                 Deaf Hope
                 Deafhood Yoga
                 IMPACT
                 National Asian Deaf Congress
                 National Center on Deafness, California State  
          University Northridge
                 NorCal Services for Deaf and Hard of Hearing
                 Orange County Deaf Equal Access Foundation
                 Parent Links
                 Sacramento Valley Registry of Interpreters for the  
          Deaf
                 Signs for Intelligence LLC
                 Silicon Valley Independent Living Center
                 Special Education Local Plan Area Administrators
                 Tri-County GLAD
                 Western Interpreting Network (WIN)
                 Several individuals




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