BILL ANALYSIS
SENATE HEALTH AND HUMAN SERVICES
COMMITTEE ANALYSIS
Senator Diane E. Watson, Chairperson
BILL NO: SB 555
AUTHOR: WATSON
AMENDED: FEBRUARY 24, 1997 (AS INTRODUCED)
HEARING DATE: APRIL 23, 1997
FISCAL: APPROPRIATIONS
RECOMMEND:CONSENT CALENDAR
CONSULTANT:
LaDuke
SUBJECT
Child health: infant hearing loss.
SUMMARY
This bill intends to protect children by establishing an
Infant Hearing Loss Identification and Intervention
Program.
ABSTRACT
Current law:
Requires the Department of Health Services (DHS) to
administer various programs relating to infant and
child health.
This measure would:
Require DHS to establish an Infant Hearing Loss
Identification and Intervention Program.
For purposes of the program DHS would:
Coordinate this program statewide in order to
screen and identify all newborn infants with
hearing impairments and refer those infants to
local agencies and services.
Develop a pamphlet explaining diagnostic procedures
for detecting hearing loss and resources
available for hearing infants and children to be
distributed to parents and guardians of newborn
infants prior to hospital discharge.
Produce a standardization of techniques and
methodology for identifying hearing loss in
infants.
Develop a tracking system to ensure that infants
identified with or at risk for hearing loss have
access to evaluation, follow-up and intervention
services.
Set up a statewide registry to maintain information
on infants identified with hearing loss for
follow-up and statistical purposes:
Require hospitals and other agencies screening
infants for hearing loss to report
information to the registry within 48 hours;
and
Make statistical information available to
federal, state and private organizations
serving children and adults with
disabilities.
Create an advisory commission to provide
consultation and make recommendations on all
aspects of the program.
Evaluate and report on cost effectiveness of the
program to the Legislature by December 31, 2000.
FISCAL IMPACT
Undetermined. New costs could be associated with the
expansion of services. However, this program has potential
for federal financial participation.
BACKGROUND AND DISCUSSION
In 1982, the Federal Joint Committee on Infant Hearing
recommended identification of infants at risk for hearing
loss in terms of specific risk factors and suggested
follow-up audiologic evaluation until an accurate
assessment of hearing could be made. In 1990, this
position was modified to expand the list of risk factors
and recommend a specific hearing screening protocol. And
in 1994 in concert with the national initiative Healthy
People 2000 (U.S. Department of Health and Human Services,
Public Health Service) which promotes early identification
of children with hearing loss, they issued a statement
addressing the need to identify all infants with hearing
loss.
The prevalence of newborn and infant severe and mild
hearing loss is estimated to range from 1.5 to 6 per 1,000
births. While the risk factor screening identifies only
50% of infants with significant hearing loss, failure to
identify the remaining 50% of children with hearing loss
results in diagnosis and intervention at an unacceptably
late age.
A successful infant hearing program would detect
hearing loss that will interfere with normal development of
speech and oral language. Because normal hearing is
critical for speech and oral language development as early
as the first 6 months of life, it is desirable to identify
infants with hearing loss before 3 months of age.
Various research has shown that children whose hearing
loss were identified before or at least by 6 months of age
demonstrate larger expressive vocabularies, higher
expressive language skills and higher language
comprehension scores that those children whose hearing loss
were identified after the age of 6 months.
In order to achieve this objective, the National
Institute for Health (NIH) panel on Early Identification of
Hearing Impairment in Infants and Young Children recommends
universal screening for hearing impairment prior to 3
months of age. Because of the unique accessibility of
almost all infants in the newborn nursery, the NIH
consensus panel recommends screening of all newborns both
high and low risk, for hearing impairment prior to hospital
discharge.
The average age of identification of hearing loss in
the United States is 2 and 1/2 years, and the hearing loss
in 70% of deaf and hard of hearing children are initially
identified by parents.
Since the first 3 years of life is the most important
period for language and communication development, the
delayed identification of hearing loss would have adverse
impact on language acquisition, academic success,
social/emotional development and ultimately career and
employment opportunities.
The technology for cost effective, noninvasive and
quick hearing screening is available today, and the most
notable is the Transient Evoked Otoacoustic Emissions. The
unique accessibility of almost all infants in newborn
nurseries allows for the establishment of a universal
hearing screening.
Thus, S.B. 555 intends to set forth recommendations of
the Federal Joint Committee on Infant Hearing and the March
1993 NIH consensus statement on Early Identification of
Hearing Impairment in Infants and Young Children by setting
up a program within DHS to detect hearing impairments in
newborn infants and providing parents or guardians with
educational materials, access to assessment, follow-up and
intervention services.
COMMENT
Concern has arisen that this legislation may produce
an unwanted intrusion into the lives of families who have a
similar goal, but whose religious perspective leads them to
choose spiritual means to deal with such challenges. In
addition, it has been noted that the confidentiality
language could be more concise. The author has agreed to
have language drafted and will amend the bill in the future
to address these concerns.
Staff recommends that this bill be placed on the
Proposed Consent Calendar.
POSITIONS
Support: California Coalition of Agencies serving the
Deaf
and Hard of Hearing (Sponsors)
Association of Regional Center Agencies
American Society for the Deaf
California Center for Law and the Deaf
California Congress of Parents, Teachers,
and Students, Inc.
California School of Professional Psychology
(CSPP)
CAL-ED (California Educators for the Deaf)
Christian Science Committee on Publication
for Northern California (If Amended)
DCARA (Deaf Counseling, Advocacy, and
Referral Agency)
Deaf Community Services of San Diego, Inc.
House Ear Institute (CARE) Children's
Auditory Research
and Evaluation Center
IMPACT (Independently Merging Parent
Associations of
California - Together for deaf and hard
of hearing
children.
Lawrence M. Siegel, Attorney at Law
NorCal Center on Deafness
Oppose: None reported.
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