II 

115TH CONGRESS 

1ST SESSION S. 652 

To amend the Public Health Service Act to reauthorize a program for early 

detection, diagnosis, and treatment regarding deaf and hard-of-hearing 

newborns, infants, and young children. 

IN THE SENATE OF THE UNITED STATES 

MARCH 15, 2017 

Mr. PORTMAN (for himself and Mr. KAINE) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to reauthorize a 

program for early detection, diagnosis, and treatment 

regarding deaf and hard-of-hearing newborns, infants, 

and young children. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Early Hearing Detec5 tion and Intervention Act of 2017’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds as follows: 


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1 (1) Deaf and hard-of-hearing newborns, infants, 

2 and young children require access to specialized 

3 early intervention providers and programs in order 

4 to help them meet their linguistic and cognitive po5 tential. 

6 (2) Families of deaf and hard-of-hearing 

7 newborns, infants, and young children benefit from 

8 comprehensive early intervention programs that as9 sist them in supporting their child’s development in 

10 all domains. 

11 (3) Best practices principles for early interven12 tion for deaf and hard-of-hearing newborns, infants, 

13 and young children have been identified in a range 

14 of areas including listening and spoken language and 

15 visual and signed language acquisition, family-to16 family support, support from individuals who are 

17 deaf or hard-of-hearing, progress monitoring, and 

18 others. 

19 (4) Effective hearing screening and early inter20 vention programs must be in place to identify hear21 ing levels in deaf and hard-of-hearing newborns, in22 fants, and young children so that they may access 

23 appropriate early intervention programs in a timely 

24 manner. 


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1 SEC. 3. REAUTHORIZATION OF PROGRAM FOR EARLY DE2 TECTION, DIAGNOSIS, AND TREATMENT RE3 GARDING DEAF AND HARD-OF-HEARING 

4 NEWBORNS, INFANTS, AND YOUNG CHIL5 DREN. 

6 Section 399M of the Public Health Service Act (42 

7 U.S.C. 280g–1) is amended to read as follows: 

8 ‘‘SEC. 399M. EARLY DETECTION, DIAGNOSIS, AND TREAT9 MENT REGARDING DEAF AND HARD-OF10 HEARING NEWBORNS, INFANTS, AND YOUNG 

11 CHILDREN. 

12 ‘‘(a) HEALTH RESOURCES AND SERVICES ADMINIS13 TRATION.—The Secretary, acting through the Adminis14 trator of the Health Resources and Services Administra15 tion, shall make awards of grants or cooperative agree16 ments to develop statewide newborn, infant, and young 

17 childhood hearing screening, diagnosis, evaluation, and 

18 intervention programs and systems, and to assist in the 

19 recruitment, retention, education, and training of qualified 

20 personnel and health care providers (including education 

21 and training of family members) for the following pur22 poses: 

23 ‘‘(1) To develop and monitor the efficacy of 

24 statewide programs and systems for hearing screen25 ing of newborns, infants, and young children, 

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1 fants, and young children referred from screening 

2 programs, and appropriate educational, audiological, 

3 medical, and communications (or language acquisi4 tion) interventions (including family support) for 

5 newborns, infants, and young children identified as 

6 deaf or hard-of-hearing, consistent with the fol7 lowing: 

8 ‘‘(A) Early intervention includes referral 

9 to, and delivery of, information and services by 

10 organizations such as schools and agencies (in11 cluding community, consumer, and family-based 

12 agencies), medical homes for children, and 

13 other programs under part C of the Individuals 

14 with Disabilities Education Act, which offer 

15 programs specifically designed to meet the 

16 unique language and communication needs of 

17 deaf and hard-of-hearing newborns, infants, and 

18 young children. 

19 ‘‘(B) Information provided to parents shall 

20 be accurate, comprehensive, and, where appro21 priate, evidence-based, allowing families to 

22 make important decisions for their children in 

23 a timely way, including decisions relating to all 

24 possible assistive hearing technologies (such as 

25 hearing aids, cochlear implants, and 


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1 osseointegrated devices) and communication 

2 modalities (such as oral and visual communica3 tions and language acquisition services and pro4 grams). 

5 ‘‘(C) Programs and systems under this 

6 paragraph shall offer mechanisms that foster 

7 family-to-family and deaf and hard-of-hearing 

8 consumer-to-family supports. 

9 ‘‘(2) To continue to provide technical support to 

10 States, through one or more technical resource cen11 ters, to assist in further developing and enhancing 

12 State early hearing detection and intervention pro13 grams. 

14 ‘‘(3) To identify or develop efficient models 

15 (educational and medical) to ensure that newborns, 

16 infants, and young children who are identified 

17 through screening as deaf or hard of hearing receive, 

18 as appropriate, follow-up by qualified early interven19 tion providers, qualified health care providers, or 

20 medical homes for children and referrals to early 

21 intervention services under part C of the Individuals 

22 with Disabilities Education Act. State agencies shall 

23 be encouraged to effectively increase the rate of such 

24 follow-up and referral. 


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1 ‘‘(b) TECHNICAL ASSISTANCE, DATA MANAGEMENT, 

2 AND APPLIED RESEARCH.— 

3 ‘‘(1) CENTERS FOR DISEASE CONTROL AND

4 PREVENTION.— 

5 ‘‘(A) IN GENERAL.—The Secretary, acting 

6 through the Director of the Centers for Disease 

7 Control and Prevention, shall make awards of 

8 grants or cooperative agreements to provide 

9 technical assistance to State agencies or des10 ignated entities of States— 

11 ‘‘(i) for the development, mainte12 nance, and improvement of data tracking 

13 and surveillance systems on newborn, in14 fant, and young childhood hearing screen15 ing, audiologic evaluations, medical evalua16 tions, language-acquisition evaluations, and 

17 intervention services; 

18 ‘‘(ii) to conduct applied research re19 lated to services and outcomes; 

20 ‘‘(iii) to provide technical assistance 

21 related to newborn, infant, and young 

22 childhood hearing screening, evaluation, 

23 and intervention programs, and informa24 tion systems; 


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1 ‘‘(iv) to ensure high-quality moni2 toring of hearing screening, evaluation, 

3 and intervention programs and systems for 

4 newborns, infants, and young children; and 

5 ‘‘(v) to coordinate developing stand6 ardized procedures for data management 

7 and assessing program and cost effective8 ness. 

9 ‘‘(B) USE OF AWARDS.—The awards under 

10 subparagraph (A) may be used— 

11 ‘‘(i) to provide technical assistance on 

12 data collection and management; 

13 ‘‘(ii) to study and report on the costs 

14 and effectiveness of newborn, infant, and 

15 young childhood hearing screening, evalua16 tion, diagnosis, intervention programs, and 

17 systems in order to address issues of im18 portance to State and national policy mak19 ers; 

20 ‘‘(iii) to collect data and report on 

21 newborn, infant, and young childhood 

22 hearing screening, evaluation, diagnosis, 

23 and intervention programs and systems 

24 that can be used for applied research, pro25 gram evaluation, and policy development; 


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1 ‘‘(iv) to identify the causes and risk 

2 factors for congenital hearing loss; 

3 ‘‘(v) to study the effectiveness of new4 born, infant, and young childhood hearing 

5 screening, audiologic evaluations, medical 

6 evaluations, and intervention programs and 

7 systems by assessing the health, intellec8 tual and social developmental, cognitive, 

9 and hearing status of children at school 

10 age; and 

11 ‘‘(vi) to promote the integration, link12 age, and interoperability of data regarding 

13 early hearing loss and multiple sources to 

14 increase information exchanges between 

15 clinical care and public health, including 

16 the ability of States and territories to ex17 change and share data. 

18 ‘‘(2) NATIONAL INSTITUTES OF HEALTH.—The 

19 Director of the National Institutes of Health, acting 

20 through the Director of the National Institute on 

21 Deafness and Other Communication Disorders, 

22 shall, for purposes of this section, continue a pro23 gram of research and development on the efficacy of 

24 new screening techniques and technology, including 


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1 clinical studies of screening methods, studies on effi2 cacy of intervention, and related research. 

3 ‘‘(c) COORDINATION AND COLLABORATION.— 

4 ‘‘(1) IN GENERAL.—In carrying out programs 

5 under this section, the Administrator of the Health 

6 Resources and Services Administration, the Director 

7 of the Centers for Disease Control and Prevention, 

8 and the Director of the National Institutes of Health 

9 shall collaborate and consult with— 

10 ‘‘(A) other Federal agencies; 

11 ‘‘(B) State and local agencies, including 

12 agencies responsible for early intervention serv13 ices pursuant to title XIX of the Social Security 

14 Act (Medicaid Early and Periodic Screening, 

15 Diagnosis and Treatment Program), title XXI 

16 of the Social Security Act (State Children’s 

17 Health Insurance Program), title V of the So18 cial Security Act (Maternal and Child Health 

19 Block Grant Program), and part C of the Indi20 viduals with Disabilities Education Act; 

21 ‘‘(C) consumer groups of, and that serve, 

22 individuals who are deaf and hard-of-hearing 

23 and their families; 


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1 ‘‘(D) appropriate national medical and 

2 other health and education specialty organiza3 tions; 

4 ‘‘(E) individuals who are deaf or hard-of5 hearing and their families; 

6 ‘‘(F) other qualified professional personnel 

7 who are proficient in deaf or hard-of-hearing 

8 children’s language and who possess the special9 ized knowledge, skills, and attributes needed to 

10 serve deaf and hard-of-hearing newborns, in11 fants, young children, and their families; 

12 ‘‘(G) third-party payers and managed-care 

13 organizations; and 

14 ‘‘(H) related commercial industries. 

15 ‘‘(2) POLICY DEVELOPMENT.—The Adminis16 trator of the Health Resources and Services Admin17 istration, the Director of the Centers for Disease 

18 Control and Prevention, and the Director of the Na19 tional Institutes of Health shall coordinate and col20 laborate on recommendations for policy development 

21 at the Federal and State levels and with the private 

22 sector, including consumer, medical, and other 

23 health and education professional-based organiza24 tions, with respect to newborn and infant hearing 


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1 screening, evaluation, diagnosis, and intervention 

2 programs and systems. 

3 ‘‘(3) STATE EARLY DETECTION, DIAGNOSIS, 

4 AND INTERVENTION PROGRAMS AND SYSTEMS; DATA

5 COLLECTION.—The Administrator of the Health Re6 sources and Services Administration and the Direc7 tor of the Centers for Disease Control and Preven8 tion shall coordinate and collaborate in assisting 

9 States— 

10 ‘‘(A) to establish newborn, infant, and 

11 young childhood hearing screening, evaluation, 

12 diagnosis, and intervention programs and sys13 tems under subsection (a); and 

14 ‘‘(B) to develop a data collection system 

15 under subsection (b). 

16 ‘‘(d) RULE OF CONSTRUCTION; RELIGIOUS ACCOM17 MODATION.—Nothing in this section shall be construed to 

18 preempt or prohibit any State law, including State laws 

19 that do not require the screening for hearing loss of 

20 newborns, infants, or young children of any parent that 

21 objects to the screening on the grounds that such screen22 ing conflicts with the parent’s religious beliefs. 

23 ‘‘(e) DEFINITIONS.—For purposes of this section: 

24 ‘‘(1) The term ‘audiologic’, when used in con25 nection with evaluation, means procedures— 


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1 ‘‘(A) to assess the status of the auditory 

2 system; 

3 ‘‘(B) to establish the site of the auditory 

4 disorder, the type and degree of hearing loss, 

5 and the potential effects of hearing loss on com6 munication; and 

7 ‘‘(C) to identify appropriate treatment and 

8 referral options, including— 

9 ‘‘(i) linkage to State agencies coordi10 nating the programs under part C of the 

11 Individuals with Disabilities Education Act 

12 or other appropriate agencies; 

13 ‘‘(ii) medical evaluation; 

14 ‘‘(iii) hearing aid or sensory aid as15 sessment; 

16 ‘‘(iv) audiologic rehabilitation treat17 ment; and 

18 ‘‘(v) referral to national and local con19 sumer, self-help, family, and education or20 ganizations, and other family-centered 

21 services. 

22 ‘‘(2) The term ‘early intervention’ means— 

23 ‘‘(A) providing appropriate services for the 

24 child who is deaf or hard of hearing, including 

25 nonmedical services; and 


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1 ‘‘(B) ensuring the family of the child is— 

2 ‘‘(i) provided comprehensive, con3 sumer-oriented information about the full 

4 range of family support, training, informa5 tion services, and language acquisition in 

6 oral and visual modalities; and 

7 ‘‘(ii) given the opportunity to consider 

8 and obtain the full range of such appro9 priate services, educational and program 

10 placements, and other options for the child 

11 from highly qualified providers. 

12 ‘‘(3) The term ‘medical evaluation’ means key 

13 components performed by a physician, including his14 tory, examination, and medical decisionmaking fo15 cused on symptomatic and related body systems for 

16 the purpose of diagnosing the etiology of hearing 

17 loss and related physical conditions, and for identi18 fying appropriate treatment and referral options. 

19 ‘‘(4) The term ‘medical intervention’ means the 

20 process by which a physician provides medical diag21 nosis and direction for medical or surgical treatment 

22 options for hearing loss or other medical disorders 

23 associated with hearing loss. 

24 ‘‘(5) The term ‘newborn, infant, and young 

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1 logic procedures to detect possible hearing loss and 

2 to identify newborns, infants, and young children up 

3 to 3 years of age who require further audiologic 

4 evaluations and medical evaluations. 

5 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.— 

6 ‘‘(1) STATEWIDE NEWBORN, INFANT, AND

7 YOUNG CHILDHOOD HEARING SCREENING, EVALUA8 TION AND INTERVENTION PROGRAMS AND SYS9 TEMS.—For the purpose of carrying out subsection 

10 (a), there are authorized to be appropriated to the 

11 Health Resources and Services Administration 

12 $17,818,000 for fiscal year 2018, $18,173,800 for 

13 fiscal year 2019, $18,628,145 for fiscal year 2020, 

14 $19,056,592 for fiscal year 2021, and $19,522,758 

15 for fiscal year 2022. 

16 ‘‘(2) TECHNICAL ASSISTANCE, DATA MANAGE17 MENT, AND APPLIED RESEARCH; CENTERS FOR DIS18 EASE CONTROL AND PREVENTION.—For the purpose 

19 of carrying out subsection (b)(1), there are author20 ized to be appropriated to the Centers for Disease 

21 Control and Prevention $10,800,000 for fiscal year 

22 2018, $11,026,800 for fiscal year 2019, 

23 $11,302,470 for fiscal year 2020, $11,562,427 for 

24 fiscal year 2021, and $11,851,488 for fiscal year 

25 2022. 


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1 ‘‘(3) TECHNICAL ASSISTANCE, DATA MANAGE2 MENT, AND APPLIED RESEARCH; NATIONAL INSTI3 TUTE ON DEAFNESS AND OTHER COMMUNICATION

4 DISORDERS.—For the purpose of carrying out sub5 section (b)(2), there are authorized to be appro6 priated to the National Institute on Deafness and 

7 Other Communication Disorders, $22,400,000 for 

8 fiscal year 2018, $22,870,400 for fiscal year 2019, 

9 $23,442,160 for fiscal year 2020, $23,981,329 for 

10 fiscal year 2021, and $24,580,862 for fiscal year 

11 2022.’’. 

Æ 


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