BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                  AB 2072|
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                                 THIRD READING


          Bill No:  AB 2072
          Author:   Mendoza (D)
          Amended:  8/20/10 in Senate
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  5-1, 6/23/10
          AYES:  Alquist, Aanestad, Leno, Negrete McLeod, Pavley
          NOES:  Romero
          NO VOTE RECORDED:  Strickland, Cedillo, Cox

           SENATE APPROPRIATIONS COMMITTEE  :  10-1, 8/12/10
          AYES:  Kehoe, Ashburn, Alquist, Emmerson, Leno, Price,  
            Walters, Wolk, Wyland, Yee
          NOES:  Corbett

           ASSEMBLY FLOOR  :  57-7, 4/29/10 - See last page for vote


           SUBJECT  :    Hearing screening:  resources and services

           SOURCE  :     California Coalition


           DIGEST  :    This bill requires the Department of Health Care  
          Services to develop an unbiased, comprehensive,  
          evidence-based informational pamphlet for newborns and  
          infants identified as deaf or hard of hearing about visual  
          and auditory communication and language options including,  
          but not limited to, American Sign Language, and Listening  
          and Spoken Language, that would help a parent make informed  
          decisions for his or her child. 

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           Senate Floor Amendments  of 8/20/10 clarify the  
          audiologists' role in the provision of information  
          described in the bill, make clarifying and substantive  
          changes to the stakeholder panel in the bill, and clarify  
          the entities that are excluded from making donations to the  
          fund created by this bill.

           ANALYSIS :    Existing law:

          1.Establishes the Newborn and Infant Hearing Screening,  
            Tracking, and Intervention Act which 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. 

          2.Establishes the California Early Start Intervention  
            Services Act, commonly known as the Early Start program,  
            provides various early intervention services for infants  
            and toddlers who have disabilities to enhance their  
            development and to minimize the potential for  
            developmental delays. 

          This bill:

          1. Requires the Department of Health Care Services to  
             develop an unbiased, comprehensive, evidence-based  
             informational pamphlet for newborns and infants  
             identified as deaf or hard of hearing about visual and  
             auditory communication and language options including,  
             but not limited to, American Sign Language, and  
             Listening and Spoken Language, that would help a parent  
             make informed decisions for his or her child.  The  
             pamphlet must take into account the different values and  
             beliefs of the parents of deaf and hard of hearing  
             children.  The pamphlet must contain both benefits and  
             risks of all options, convey educational attainment  
             outcomes, and clearly convey that those options may be  
             used simultaneously.  The pamphlet must also include  
             information about educational programs for children  
             provided by local educational agencies, the California  

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             Schools for the Deaf, nonpublic schools and agencies,  
             and parent-to-parent support resources through the local  
             family resource centers.

          2. Requires that a parent of a newborn or infant identified  
             as deaf or hard of hearing must be provided specified  
             information.  The information must be provided:

             A.   By an audiologist immediately upon identification  
               of a newborn or infant as deaf or hard of hearing.   
               The audiologist shall note in the newborn's or  
               infant's record that the parent has received the  
               informational pamphlet.  During the course of  
               evaluation and treatment, the audiologist shall inform  
               and counsel the parent of all available communication  
               and language options as described in the pamphlet. 

             B.   By a local provider for the Early Start Program.

          3. Requires the department to convene an advisory  
             stakeholder panel to contribute to the development of  
             the information pamphlet.  The members of the panel will  
             receive no compensation for their services.  The panel  
             will be composed of 15 members, as follows:

                   An adult who is deaf or hard of hearing, and who  
                uses auditory-oral language, appointed by the  
                Governor.

                   An adult who is deaf or hard of hearing, and who  
                uses American Sign Language, appointed by the  
                Governor.

                   An educator of the deaf in an auditory-oral  
                educational setting, appointed by the Senate  
                Committee on Rules.

                   An educator of the deaf in an American Sign  
                Language setting, appointed by the Senate Committee  
                on Rules.

                   A parent representative of a child who primarily  
                uses auditory-oral communication methods, appointed  
                by the Governor.

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                   A parent representative of a child who primarily  
                uses American Sign Language, appointed by the  
                Governor.

                   A representative of a nonprofit organization that  
                services primarily auditory-oral learners, appointed  
                by the Speaker of the Assembly.

                   A representative of a nonprofit organization that  
                services primarily American Sign Language, appointed  
                by the Speaker of the Assembly.

                   A researcher engaged in the study of  
                auditory-oral communication for persons who are deaf  
                or hard of hearing, appointed by the Governor.

                   A researcher engaged in the study of visual  
                language, including, but not limited to, American  
                Sign Language and communication modalities for  
                persons who are deaf or hard of hearing, appointed by  
                the Governor.

                   Two adults who are deaf or hard of hearing, and  
                who primarily use other visual communication  
                modalities, appointed by the Governor.

                   An audiologist who specializes in evaluating and  
                treating infants, appointed by the Speaker of the  
                Assembly.

                   A physician who specializes in pediatric  
                otolaryngology, appointed by the Senate Committee on  
                Rules.

                   The Superintendent of Public Instruction, or his  
                or her designee, who shall be and ex officio member.

              A.    At least five members of the panel appointed by  
                the Governor, one member appointed by the Senate  
                Committee on Rules, and one member appointed by the  
                Speaker of the Assembly, shall be deaf or hard of  
                hearing adults.


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              B.    All members of the panel shall be appointed no  
                later than January 1, 2012.  An appointee to the  
                panel shall not serve for more than five years.

              C.    A member of the panel shall not have a financial  
                relationship or a conflict of interest with any  
                entity that has contributed funding.

          1. Requires the panel to commence operations on January 1,  
             2012, and provide recommendations after 6 months of  
             commencement. 

          2. Requires the department to consider written input and  
             information submitted by members of the public and  
             review and revise the information every two years if  
             necessary, and requires the panel to remain in existence  
             until January 1, 2017.

          3. States that the panel shall hold meeting as the  
             department's headquarters and the number of meetings  
             shall not exceed six in this six-month period.

          4. Requires that donors disclose any commercial interests  
             at the time of the donation.

           Background
           
          The California Newborn Hearing Screening program,  
          administered by the California Department of Health Care  
          Services (DHCS), is a comprehensive coordinated system of  
          early identification, intervention, and support services  
          for infants with hearing loss and their families.  The goal  
          of the program is to identify infants with a hearing loss  
          prior to three months of age and to link infants with early  
          intervention services by six months.  According to DHCS,  
          infants begin developing speech and language from the  
          moment they are born. Studies show that hearing loss occurs  
          in approximately two to four out of 1000 babies.  DHCS  
          states that, prior to the Newborn Hearing Screening  
          program, unfortunately, hearing loss was often not  
          identified until 18 months to three years.  If an infant  
          has hearing loss in one or both ears, early identification  
          is crucial to preventing delayed speech and language  
          development. 

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          In California, infants who do not pass the initial hearing  
          screening in the hospital are referred for a rescreening  
          which could be performed before one month of age.  Infants  
          who do not pass the rescreening are referred for a  
          diagnostic hearing evaluation.  Upon identification of  
          hearing loss, infants and their families are referred to  
          the local Early Start Program, a multi-agency effort by the  
          Department of Developmental Services and the California  
          Department of Education for access to early intervention  
          and related services.  Currently parents are provided a  
          packet of information which includes:  "Communicating with  
          Your Child" which provides information about local, state  
          and national resources and the DHCS Web site provides links  
          to local, state, and national resources.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  No    
          Local:  No

          According to the Senate Appropriations Committee: 

                          Fiscal Impact (in thousands)

           Major Provisions                2010-11     2011-12     
           2012-13   Fund  

          Advisory Panel                     $126      $252 Private

           SUPPORT  :   (Verified  8/20/10)

          California Coalition (source)
          American Federation of State, County and Municipal  
          Employees
          California Association of Private Special Education Schools
          California Coalition
          California Hospital Association
          California Speech-Language Hearing Association 

           OPPOSITION  :    (Verified  8/24/10)

          ASL Presents LLC
          California Academy of Audiology
          California Association of the Deaf
          California Association of the Deaf, Sacramento Chapter

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          Center on Deaf Inland Empire Community
          Deaf and Hard of Hearing Service Center, Inc.
          Deaf Counseling, Advocacy, and Referral Agency
          IMPACT
          NorCal Services for Deaf and Hard of Hearing 

           ARGUMENTS IN SUPPORT  :    Supporters of this bill state that  
          more children are born with permanent hearing loss than any  
          other birth defect.  Supporters maintain that recent  
          advances in technology and educational practice make it  
          possible for most deaf or hard-of hearing children to make  
          similar progress to their typically-hearing peers if  
          diagnosis and treatment happen early, preferably during the  
          first few months of life.  According to supporters, one of  
          the most important things for parents of a newly-identified  
          child who is deaf or hard of hearing is knowing that they  
          will be able to communicate with their child.  Supporters  
          assert that the method of communication chosen by parents  
          is a very personal decision, and parents need to know what  
          alternatives are available.  Supporters argue that programs  
          and resources are available in California to support  
          various options, but many parents of newly-identified deaf  
          or hard of hearing children do not even know what options  
          exist.  Supporters maintain that this bill will ensure that  
          all parents of children diagnosed with hearing loss will be  
          provided information about communication options and  
          resources which will result in less confusion about the  
          availability of resources. 

           ARGUMENTS IN OPPOSITION  :    The opposition of this bill  
          states that they believe that each infant and toddler,  
          including those identified deaf and hard of hearing, should  
          have every opportunity to learn language.  The opposition  
          argues that the focus of this bill about "communication  
          options" is misleading and picking one option over another  
          would only rob the child of the ability and opportunity for  
          full language acquisition.  According the opposition,  
          Californians who are deaf request the need for sign  
          language to be respected and support early intervention  
          services acquiring sign language as well as English.  The  
          opposition also argues that audiologists are not the  
          appropriate experts to advise parents and families about  
          language acquisition because audiologists are trained to  
          measure and "treat" hearing loss by recommending hearing  

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          aids or cochlear implants.  The opposition maintains that  
          it is the right of a deaf infant and toddler to acquire  
          full language acquisition through visual language so that  
          by the time the child starts Kindergarten and first grade,  
          the child is ready to learn, receive an education,  
          ultimately graduate, enter postsecondary education and  
          enter the world of work as productive tax-paying citizens. 

           ASSEMBLY FLOOR  :  
          AYES:  Anderson, Arambula, Beall, Bill Berryhill, Tom  
            Berryhill, Blakeslee, Blumenfield, Bradford, Charles  
            Calderon, Conway, Cook, Coto, Davis, De Leon, DeVore,  
            Emmerson, Eng, Feuer, Fletcher, Fong, Fuentes, Fuller,  
            Furutani, Gaines, Galgiani, Garrick, Gilmore, Hagman,  
            Hall, Harkey, Hayashi, Hernandez, Hill, Huber, Huffman,  
            Knight, Lieu, Logue, Ma, Mendoza, Miller, Nava, Nestande,  
            Niello, Nielsen, Norby, Portantino, Ruskin, Silva,  
            Solorio, Swanson, Torlakson, Torres, Tran, Villines,  
            Yamada, John A. Perez
          NOES:  Adams, Chesbro, Monning, Salas, Skinner, Smyth,  
            Audra Strickland
          NO VOTE RECORDED:  Ammiano, Bass, Block, Brownley,  
            Buchanan, Caballero, Carter, De La Torre, Evans,  
            Jeffries, Jones, Bonnie Lowenthal, V. Manuel Perez,  
            Saldana, Torrico 


          CTW:nlk  8/24/10   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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