2007 California Health and Safety Code Article 6.5. Newborn And Infant Hearing Screening, Tracking, And Intervention Program

CA Codes (hsc:124115-124120.5)

124115.  This article shall be known, and may be cited as, the
Newborn and Infant Hearing Screening, Tracking and Intervention Act.



124115.5.  (a) The Legislature finds and declares all of the
following:
   (1) Hearing loss occurs in newborns more frequently than any other
health condition for which newborn screening is currently required.

   (2) Early detection of hearing loss, early intervention, and
followup services before six months of age, have been demonstrated to
be highly effective in facilitating the development of a child's
health and communication and cognitive skills.
   (3) The State of California supports the National Healthy People
2000 goals, which promote early identification of children with
hearing loss.
   (4) Children of all ages can receive reliable and valid screening
for hearing loss in a cost-effective manner.
   (5) Appropriate screening and identification of newborns and
infants with hearing loss will facilitate early intervention during
this critical time for development of communication, and may,
therefore, serve the public purposes of promoting the healthy
development of children and reducing public expenditure for health
care and special education and related services.
   (b) The purposes of this article shall be to do all of the
following:
   (1) Provide early detection of hearing loss in newborns, as soon
after birth as possible, to enable children who fail a hearing
screening and their families and other caregivers to obtain needed
confirmatory tests or multidisciplinary evaluation, or both, and
intervention services, at the earliest opportunity.
   (2) Prevent or mitigate delays of language and communication
development that could lead to academic failures associated with late
identification of hearing loss.
   (3) Provide the state with the information necessary to
effectively plan, establish, and evaluate a comprehensive system of
appropriate services for parents with newborns and infants who have a
hearing loss.



124116.  As used in this article:
   (a) "Birth admission" means the time after birth that the newborn
remains in the hospital nursery prior to discharge.
   (b) "CCS" means the California Children's Services program
administered through the State Department of Health Services.
   (c) "Department" means the State Department of Health Services.
   (d) "Followup services" means all of the following:
   (1) All services necessary to diagnose and confirm a hearing loss.

   (2) Ongoing audiological services to monitor hearing.
   (3) Communication services, including, but not limited to, aural
rehabilitation, speech, language, social, and psychological services.

   (4) Necessary support of the infant and family.
   (e) "Hearing loss" means a hearing loss of 30 decibels or greater
in the frequency region important for speech recognition and
comprehension in one or both ears (from 500 through 4000 Hz).
However, as technology allows for changes to this definition through
the detection of less severe hearing loss, the department may modify
this definition by regulation.
   (f) "Infant" means a child 29 days through 12 months old.
   (g) "Intervention services" means the early intervention services
described in Part C of the Individuals with Disabilities Education
Act (20 U.S.C. Sec. 1475 et seq.).
   (h) "Newborn" means a child less than 29 days old.
   (i) "Newborn hearing screening services" means those hearing
screening tests that are necessary to achieve the identification of
all newborns and infants with a hearing loss.
   (j) "Parent" means a natural parent, adoptive parent, or legal
guardian of a child.


124116.5.  (a) (1) Every general acute care hospital with licensed
perinatal services in this state shall administer to every newborn,
upon birth admission, a hearing screening test for the identification
of hearing loss, using protocols approved by the department or its
designee.
   (2) In order to meet the department's certification criteria, a
general acute care hospital shall be responsible for developing a
screening program that provides competent hearing screening, utilizes
appropriate staff and equipment for administering the testing,
completes the testing prior to the newborn's discharge from a newborn
nursery unit, refers infants with abnormal screening results,
maintains and reports data as required by the department, and
provides physician and family-parent education.
   (b) A hearing screening test provided for pursuant to subdivision
(a) shall be performed by a licensed physician, licensed registered
nurse, licensed audiologist, or an appropriately trained individual
who is supervised in the performance of the test by a licensed health
care professional.
   (c) Every general acute care hospital that has not been approved
by the California Children's Services (CCS) program and that has
licensed perinatal services that provide care in fewer than 100
births annually shall, if it does not directly provide a hearing
screening test, enter into an agreement with an outpatient infant
hearing screening provider certified by the department to provide
hearing screening tests.
   (d) This section shall not apply to any newborn whose parent or
guardian objects to the test on the grounds that the test is in
violation of his or her beliefs.


124117.  The department or its designee shall approve hospitals for
participation as newborn hearing screening providers.  These
facilities shall then receive payment from the department for the
newborn hearing screening services provided to newborns and infants
eligible for the Medi-Cal or CCS programs in accordance with this
article.



124118.  The department or its designee shall provide every general
acute care hospital that has licensed perinatal services, or neonatal
intensive care unit (NICU), as specified in Section 123975, written
information on the current and most effective means available to
screen the hearing of newborns and infants, and shall provide
technical assistance and consultation to these hospitals in
developing a system of screening each newborn and infant receiving
care at the facility. The information shall also include the
mechanism for referral of newborns and infants with abnormal test
results.



124118.5.  (a) The department shall establish a system of early
hearing detection and intervention centers that shall provide
technical assistance and consultation to hospitals in the startup and
ongoing implementation of a facility hearing screening program and
followup system.
   (b) The early hearing detection and intervention centers shall be
chosen by the department according to standards and criteria
developed by the California Children's Services (CCS) program. Each
center shall be responsible for a separate geographic catchment area
as determined by the program.
   (c) Each center shall be required to develop a system that shall
provide outreach and education to hospitals in its catchment area,
approve hospitals on behalf of the department for participation as
newborn hearing screening providers, maintain a database of all
newborns and infants screened in the catchment area, ensure
appropriate followup for newborns and infants with an abnormal
hearing screening, including diagnostic evaluation and referral to
intervention services programs if the newborn or infant is found to
have a hearing loss, and provide coordination with the CCS and local
early intervention programs as defined in Title 14 (commencing with
Section 95000) of the Government Code.



124119.  (a) The department shall develop and implement a reporting
and tracking system for newborns and infants tested for hearing loss.

   (b) The system shall provide the department with information and
data to effectively plan, establish, monitor, and evaluate the
Newborn and Infant Hearing Screening, Tracking and Intervention
Program, including the screening and followup components, as well as
the comprehensive system of services for newborns and infants who are
deaf or hard-of-hearing and their families.
   (c) Every general acute care hospital with licensed perinatal
services, or NICU in this state shall report to the department or the
department's designee information as specified by the department to
be included in the department's reporting and tracking system.
   (d) All providers of audiological followup and diagnostic services
provided under this article shall report to the department or the
department's designee information as specified by the department to
be included in the department's reporting and tracking system.
   (e) The information compiled and maintained in the tracking system
shall be kept confidential in accordance with Chapter 5 (commencing
with Section 10850) of Part 1 of Division 9 of the Welfare and
Institutions Code, the Information Practices Act of 1977 (Chapter 1
(commencing with Section 1798) of Title 1.8 of Part 4 of Division 3
of the Civil Code), and the applicable requirements and provisions of
Part C of the federal Individuals with Disabilities Education Act
(20 U.S.C. Sec. 1475 et seq.).
   (f) Data collected by the tracking system obtained directly from
the medical records of the newborn or infant shall be for the
confidential use of the department and for the persons or public or
private entities that the department determines are necessary to
carry out the intent of the reporting and tracking system.
   (g) A health facility, clinical laboratory, audiologist,
physician, registered nurse, or any other officer or employee of a
health facility or laboratory or employee of an audiologist or
physician, shall not be criminally or civilly liable for furnishing
information to the department or its designee pursuant to the
requirements of this section.


124119.5.  Parents of all newborns and infants diagnosed with a
hearing loss shall be provided written information on the
availability of community resources and services for children with
hearing loss, including those provided in accordance with the federal
Individuals with Disabilities Education Act (20 U.S.C. Sec. 1400 et
seq.), through the reporting and tracking system followup procedures.
  Information shall include listings of local and statewide nonprofit
deaf and hard-of-hearing consumer-based organizations, parent
support organizations affiliated with deafness, and programs offered
through the State Department of Social Services, Office of Deaf
Access, State Department of Developmental Services, and the State
Department of Education.



124120.  The department may conduct a community outreach and
awareness campaign to inform medical providers, pregnant women, and
the families of newborns and infants on the availability of the
newborn hearing screening program and the value of early hearing
testing.  The outreach and awareness campaign shall be conducted by
an independent contractor.



124120.5.  A newborn hearing screening test shall not be performed
without the written consent of the parent.