BILL ANALYSIS ------------------------------------------------------------ |SENATE RULES COMMITTEE | AB 2072| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ------------------------------------------------------------ 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. CONTINUED AB 2072 Page 2 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 CONTINUED AB 2072 Page 3 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. CONTINUED AB 2072 Page 4 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. CONTINUED AB 2072 Page 5 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. CONTINUED AB 2072 Page 6 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 CONTINUED AB 2072 Page 7 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 CONTINUED AB 2072 Page 8 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 **** END **** CONTINUED