```

[House Report 114-241]
[From the U.S. Government Publishing Office]

114th Congress   }                                     {        Report
                        HOUSE OF REPRESENTATIVES
 1st Session     }                                     {       114-241

======================================================================

 
          EARLY HEARING DETECTION AND INTERVENTION ACT OF 2015

                                _______
                                

 September 8, 2015.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

  Mr. Upton, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 1344]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 1344) 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, having considered the same, report 
favorably thereon with an amendment and recommend that the bill 
as amended do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     5
Background and Need for Legislation..............................     5
Hearings.........................................................     5
Committee Consideration..........................................     6
Committee Votes..................................................     6
Committee Oversight Findings.....................................     6
Statement of General Performance Goals and Objectives............     6
New Budget Authority, Entitlement Authority, and Tax Expenditures     6
Earmark, Limited Tax Benefits, and Limited Tariff Benefits.......     6
Committee Cost Estimate..........................................     6
Congressional Budget Office Estimate.............................     6
Federal Mandates Statement.......................................     9
Duplication of Federal Programs..................................     9
Disclosure of Directed Rule Makings..............................     9
Advisory Committee Statement.....................................     9
Applicability to Legislative Branch..............................     9
Section-by-Section Analysis of the Legislation...................     9
Changes in Existing Law Made by the Bill, as Reported............    10

    The amendment is as follows:
    Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may cited as the ``Early Hearing Detection and Intervention 
Act of 2015''.

SEC. 2. FINDINGS.

  The Congress finds as follows:
          (1) Deaf and hard-of-hearing newborns, infants, toddlers, and 
        young children require access to specialized early intervention 
        providers and programs in order to help them meet their 
        linguistic and cognitive potential.
          (2) Families of deaf and hard-of-hearing newborns, infants, 
        toddlers, and young children benefit from comprehensive early 
        intervention programs that assist them in supporting their 
        child's development in all domains.
          (3) Best practices principles for early intervention for deaf 
        and hard-of-hearing newborns, infants, toddlers, and young 
        children have been identified in a range of areas including 
        listening and spoken language and visual and signed language 
        acquisition, family-to-family support, support from individuals 
        who are deaf or hard-of-hearing, progress monitoring, and 
        others.
          (4) Effective hearing screening and early intervention 
        programs must be in place to identify hearing levels in deaf 
        and hard-of-hearing newborns, infants, toddlers, and young 
        children so that they may access appropriate early intervention 
        programs in a timely manner.

SEC. 3. REAUTHORIZATION OF PROGRAM FOR EARLY DETECTION, DIAGNOSIS, AND 
                    TREATMENT REGARDING DEAF AND HARD-OF-HEARING 
                    NEWBORNS, INFANTS, AND YOUNG CHILDREN.

  Section 399M of the Public Health Service Act (42 U.S.C. 280g-1) is 
amended to read as follows:

``SEC. 399M. EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING DEAF 
                    AND HARD-OF-HEARING NEWBORNS, INFANTS, AND YOUNG 
                    CHILDREN.

  ``(a) Health Resources and Services Administration.--The Secretary, 
acting through the Administrator of the Health Resources and Services 
Administration, shall make awards of grants or cooperative agreements 
to develop statewide newborn, infant, and young childhood hearing 
screening, diagnosis, evaluation, and intervention programs and 
systems, and to assist in the recruitment, retention, education, and 
training of qualified personnel and health care providers for the 
following purposes:
          ``(1) To develop and monitor the efficacy of statewide 
        programs and systems for hearing screening of newborns, 
        infants, and young children, prompt evaluation and diagnosis of 
        children referred from screening programs, and appropriate 
        educational, audiological, and medical interventions for 
        children confirmed to be deaf or hard-of-hearing, consistent 
        with the following:
                  ``(A) Early intervention includes referral to and 
                delivery of information and services by organizations 
                such as schools and agencies (including community, 
                consumer, and parent-based agencies), pediatric medical 
                homes, and other programs mandated by part C of the 
                Individuals with Disabilities Education Act, which 
                offer programs specifically designed to meet the unique 
                language and communication needs of deaf and hard-of-
                hearing newborns, infants, and young children.
                  ``(B) Information provided to parents must be 
                accurate, comprehensive, and, where appropriate, 
                evidence-based, allowing families to make important 
                decisions for their child in a timely way, including 
                decisions relating to all possible assistive hearing 
                technologies (such as hearing aids, cochlear implants, 
                and osseointegrated devices) and communication options 
                (such as visual and sign language, listening and spoken 
                language, or both).
                  ``(C) Programs and systems under this paragraph shall 
                offer mechanisms that foster family-to-family and deaf 
                and hard-of-hearing consumer-to-family supports.
          ``(2) To develop efficient models (both educational and 
        medical) to ensure that newborns, infants, and young children 
        who are identified through hearing screening receive followup 
        by qualified early intervention providers, qualified health 
        care providers, or pediatric medical homes (including by 
        encouraging State agencies to adopt such models).
          ``(3) To provide for a technical resource center in 
        conjunction with the Maternal and Child Health Bureau of the 
        Health Resources and Services Administration--
                  ``(A) to provide technical support and education for 
                States; and
                  ``(B) to continue development and enhancement of 
                State early hearing detection and intervention 
                programs.
  ``(b) Technical Assistance, Data Management, and Applied Research.--
          ``(1) Centers for disease control and prevention.--The 
        Secretary, acting through the Director of the Centers for 
        Disease Control and Prevention, shall make awards of grants or 
        cooperative agreements to State agencies or their designated 
        entities for development, maintenance, and improvement of data 
        tracking and surveillance systems on newborn, infant, and young 
        childhood hearing screenings, audiologic evaluations, medical 
        evaluations, and intervention services; to conduct applied 
        research related to services and outcomes, and provide 
        technical assistance related to newborn, infant, and young 
        childhood hearing screening, evaluation, and intervention 
        programs, and information systems; to ensure high-quality 
        monitoring of hearing screening, evaluation, and intervention 
        programs and systems for newborns, infants, and young children; 
        and to coordinate developing standardized procedures for data 
        management and assessing program and cost effectiveness. The 
        awards under the preceding sentence may be used--
                  ``(A) to provide technical assistance on data 
                collection and management;
                  ``(B) to study and report on the costs and 
                effectiveness of newborn, infant, and young childhood 
                hearing screening, evaluation, diagnosis, intervention 
                programs, and systems;
                  ``(C) to collect data and report on newborn, infant, 
                and young childhood hearing screening, evaluation, 
                diagnosis, and intervention programs and systems that 
                can be used--
                          ``(i) for applied research, program 
                        evaluation, and policy development; and
                          ``(ii) to answer issues of importance to 
                        State and national policymakers;
                  ``(D) to identify the causes and risk factors for 
                congenital hearing loss;
                  ``(E) to study the effectiveness of newborn, infant, 
                and young childhood hearing screening, audiologic 
                evaluations, medical evaluations, and intervention 
                programs and systems by assessing the health, 
                intellectual and social developmental, cognitive, and 
                hearing status of these children at school age; and
                  ``(F) to promote the integration, linkage, and 
                interoperability of data regarding early hearing loss 
                and multiple sources to increase information exchanges 
                between clinical care and public health including the 
                ability of States and territories to exchange and share 
                data.
          ``(2) National institutes of health.--The Director of the 
        National Institutes of Health, acting through the Director of 
        the National Institute on Deafness and Other Communication 
        Disorders, shall, for purposes of this section, continue a 
        program of research and development related to early hearing 
        detection and intervention, including development of 
        technologies and clinical studies of screening methods, 
        efficacy of interventions, and related research.
  ``(c) Coordination and Collaboration.--
          ``(1) In general.--In carrying out programs under this 
        section, the Administrator of the Health Resources and Services 
        Administration, the Director of the Centers for Disease Control 
        and Prevention, and the Director of the National Institutes of 
        Health shall collaborate and consult with--
                  ``(A) other Federal agencies;
                  ``(B) State and local agencies, including those 
                responsible for early intervention services pursuant to 
                title XIX of the Social Security Act (42 U.S.C. 1396 et 
                seq.) (Medicaid Early and Periodic Screening, Diagnosis 
                and Treatment Program); title XXI of the Social 
                Security Act (42 U.S.C. 1397aa et seq.) (State 
                Children's Health Insurance Program); title V of the 
                Social Security Act (42 U.S.C. 701 et seq.) (Maternal 
                and Child Health Block Grant Program); and part C of 
                the Individuals with Disabilities Education Act (20 
                U.S.C. 1431 et seq.);
                  ``(C) consumer groups of and that serve individuals 
                who are deaf and hard-of-hearing and their families;
                  ``(D) appropriate national medical and other health 
                and education specialty organizations;
                  ``(E) persons who are deaf and hard-of-hearing and 
                their families;
                  ``(F) other qualified professional personnel who are 
                proficient in deaf or hard-of-hearing children's 
                language and who possess the specialized knowledge, 
                skills, and attributes needed to serve deaf and hard-
                of-hearing newborns, infants, toddlers, children, and 
                their families;
                  ``(G) third-party payers and managed-care 
                organizations; and
                  ``(H) related commercial industries.
          ``(2) Policy development.--The Administrator of the Health 
        Resources and Services Administration, the Director of the 
        Centers for Disease Control and Prevention, and the Director of 
        the National Institutes of Health shall coordinate and 
        collaborate on recommendations for policy development at the 
        Federal and State levels and with the private sector, including 
        consumer, medical, and other health and education professional-
        based organizations, with respect to newborn, infant, and young 
        childhood hearing screening, evaluation, diagnosis, and 
        intervention programs and systems.
          ``(3) State early detection, diagnosis, and intervention 
        programs and systems; data collection.--The Administrator of 
        the Health Resources and Services Administration and the 
        Director of the Centers for Disease Control and Prevention 
        shall coordinate and collaborate in assisting States--
                  ``(A) to establish newborn, infant, and young 
                childhood hearing screening, evaluation, diagnosis, and 
                intervention programs and systems under subsection (a); 
                and
                  ``(B) to develop a data collection system under 
                subsection (b).
  ``(d) Rule of Construction; Religious Accommodation.--Nothing in this 
section shall be construed to preempt or prohibit any State law, 
including State laws which do not require the screening for hearing 
loss of newborns, infants, or young children of parents who object to 
the screening on the grounds that such screening conflicts with the 
parents' religious beliefs.
  ``(e) Definitions.--For purposes of this section:
          ``(1) The term `audiologic', when used in connection with 
        evaluation, refers to procedures--
                  ``(A) to assess the status of the auditory system;
                  ``(B) to establish the site of the auditory disorder, 
                the type and degree of hearing loss, and the potential 
                effects of hearing loss on communication; and
                  ``(C) to identify appropriate treatment and referral 
                options, including--
                          ``(i) linkage to State coordinating agencies 
                        under part C of the Individuals with 
                        Disabilities Education Act (20 U.S.C. 1431 et 
                        seq.) or other appropriate agencies;
                          ``(ii) medical evaluation;
                          ``(iii) hearing aid/sensory aid assessment;
                          ``(iv) audiologic rehabilitation treatment; 
                        and
                          ``(v) referral to national and local 
                        consumer, self-help, parent, and education 
                        organizations, and other family-centered 
                        services.
          ``(2) The term `early intervention' refers to--
                  ``(A) providing appropriate services for the child 
                who is deaf or hard of hearing, including nonmedical 
                services; and
                  ``(B) ensuring the family of the child is--
                          ``(i) provided comprehensive, consumer-
                        oriented information about the full range of 
                        family support, training, information services, 
                        and language and communication options; and
                          ``(ii) given the opportunity to consider and 
                        obtain the full range of such appropriate 
                        services, educational and program placements, 
                        and other options for their child from highly 
                        qualified providers.
          ``(3) The term `medical evaluation' refers to key components 
        performed by a physician, including history, examination, and 
        medical decisionmaking focused on symptomatic and related body 
        systems for the purpose of diagnosing the etiology of hearing 
        loss and related physical conditions, and for identifying 
        appropriate treatment and referral options.
          ``(4) The term `medical intervention' refers to the process 
        by which a physician provides medical diagnosis and direction 
        for medical or surgical treatment options for hearing loss or 
        related medical disorders.
          ``(5) The term `newborn, infant, and young childhood hearing 
        screening' refers to objective physiologic procedures to detect 
        possible hearing loss and to identify newborns, infants, and 
        young children who require further audiologic evaluations and 
        medical evaluations.
  ``(f) Authorization of Appropriations.--
          ``(1) Statewide newborn, infant, and young childhood hearing 
        screening, evaluation and intervention programs and systems.--
        For the purpose of carrying out subsection (a), there is 
        authorized to be appropriated to the Health Resources and 
        Services Administration $17,800,000 for each of fiscal years 
        2016 through 2020.
          ``(2) Technical assistance, data management, and applied 
        research; centers for disease control and prevention.--For the 
        purpose of carrying out subsection (b)(1), there is authorized 
        to be appropriated to the Centers for Disease Control and 
        Prevention $10,800,000 for each of fiscal years 2016 through 
        2020.
          ``(3) Technical assistance, data management, and applied 
        research; national institute on deafness and other 
        communication disorders.--No additional funds are authorized to 
        be appropriated for the purpose of carrying out subsection 
        (b)(2). Such subsection shall be carried out using funds which 
        are otherwise authorized (under section 402A or other 
        provisions of law) to be appropriated for such purpose.''.

                          Purpose and Summary

    H.R. 1344, Early Hearing Detection and Intervention Act of 
2015, was introduced on March 10, 2015, by Rep. Guthrie (R-KY) 
and Rep. Capps (D-CA), 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.

                  Background and Need for Legislation

    Hearing loss is the most frequently occurring screening for 
newborns. Ninety-eight percent of infants are screened for 
hearing loss before they leave the hospital as a result of the 
Early Hearing Detection and Intervention (EHDI) program that 
this bill would reauthorize. The EHDI program often is cited as 
a model of how government at different levels and public and 
private agencies should and can work together.
    Effective hearing screening and early intervention programs 
must be in place to identify hearing levels in deaf and hard-
of-hearing newborns, infants, toddlers, and young children so 
that they may access appropriate early intervention programs in 
a timely manner. Outcomes are improved greatly for children if 
their hearing loss is detected early. Families of deaf and 
hard-of-hearing newborns, infants, toddlers, and young children 
benefit from comprehensive early intervention programs that 
assist them in supporting their child's development in all 
domains.
    H.R. 1344 would improve upon current programs and extend 
services to young children up to the age of five. This is an 
important addition because the incidence of hearing loss 
triples between birth and five years of age. The 
reauthorization would emphasize the importance of the Health 
Resources and Services Administration (HRSA), Centers for 
Disease Control and Prevention (CDC) and National Institutes of 
Health (NIH) partnering to improve outcomes and strengthen the 
EHDI program.

                                Hearings

    The Subcommittee on Health held a hearing on H.R. 1344 on 
June 25, 2015. The Subcommittee received testimony from:
           Joanne Kurtzberg, M.D., President, Cord 
        Blood Association;
           Jeff Chell, M.D., Chief Executive Officer, 
        National Marrow Donor Program;
           Patti Freemyer Martin, PhD, Director of 
        Audiology and Speech Language Pathology, Arkansas 
        Children's Hospital;
           Stephen W. Patrick, M.D., M.P.H., M.S., 
        Assistant Professor of Pediatrics and Health Policy, 
        Department of Pediatrics, Vanderbilt University School 
        of Medicine; and,
           Mishka Terplan, M.D., M.P.H., FACOG, Medical 
        Director, Behavior Health System Baltimore.

                        Committee Consideration

    On July 23, 2015, the Subcommittee on Health met in open 
markup session and forwarded H.R. 1344 to the full Committee, 
as amended, by a voice vote. On July 29, 2015, the full 
Committee on Energy and Commerce met in open markup session and 
ordered H.R. 1344 reported to the House, as amended, by a voice 
vote.

                            Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list the record votes 
on the motion to report legislation and amendments thereto. 
There were no record votes taken in connection with ordering 
H.R. 1344 reported. A motion by Mr. Upton to order H.R. 1344 
reported to the House, as amended, was agreed to by a voice 
vote.

                      Committee Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee has not held hearings 
on this legislation.

         Statement of General Performance Goals and Objectives

    The goal of the legislation is to reauthorize Federal 
programs related to early detection, diagnosis, and treatment 
regarding deaf and hard-of-hearing newborns, infants, and young 
children.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee finds that H.R. 
1344, would result in no new or increased budget authority, 
entitlement authority, or tax expenditures or revenues.

       Earmark, Limited Tax Benefits, and Limited Tariff Benefits

    In compliance with clause 9(e), 9(f), and 9(g) of rule XXI 
of the Rules of the House of Representatives, the Committee 
finds that H.R. 1344 contains no earmarks, limited tax 
benefits, or limited tariff benefits.

                        Committee Cost Estimate

    The Committee adopts as its own the cost estimate prepared 
by the Director of the Congressional Budget Office pursuant to 
section 402 of the Congressional Budget Act of 1974.

                  Congressional Budget Office Estimate

    Pursuant to clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives, the following is the cost estimate 
provided by the Congressional Budget Office pursuant to section 
402 of the Congressional Budget Act of 1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                 Washington, DC, September 2, 2015.
Hon. Fred Upton,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 1344, the Early 
Hearing Detection and Intervention Act of 2015.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Lisa Ramirez-
Branum.
            Sincerely,

                                                        Keith Hall.
    Enclosure.

H.R. 1344--Early Hearing Detection and Intervention Act of 2015

    Summary: H.R. 1344 would amend the Public Health Service 
Act to authorize research and public health activities related 
to early detection, diagnosis, and treatment of hearing loss in 
newborns, infants, and young children. Those activities are 
conducted by the Health Resources and Services Administration 
(HRSA), the Centers for Disease Control and Prevention (CDC), 
and the National Institutes of Health (NIH).
    CBO estimates that implementing H.R. 1344 would cost $212 
million over the 2016-2020 period, assuming appropriation of 
the specified and necessary amounts. Enacting H.R. 1344 would 
not affect direct spending or revenues; therefore, pay-as-you-
go procedures do not apply.
    H.R. 1344 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA).
    Estimated cost to the Federal Government: The estimated 
budgetary impact of H.R. 1344 is shown in the following table. 
The costs of this legislation fall within budget function 550 
(health).

----------------------------------------------------------------------------------------------------------------
                                                                 By fiscal year, in millions of dollars--
                                                         -------------------------------------------------------
                                                            2016     2017     2018     2019     2020   2016-2020
----------------------------------------------------------------------------------------------------------------
                                  CHANGES IN SPENDING SUBJECT TO APPROPRIATION
 
HRSA:
    Authorization Level.................................       18       18       18       18       18         89
    Estimated Outlays...................................        9       16       17       18       18         78
CDC:
    Authorization Level.................................       11       11       11       11       11         55
    Estimated Outlays...................................        4        9       10       11       11         45
NIH:
    Estimated Authorization Level.......................       21       21       22       22       23        109
    Estimated Outlays...................................        6       18       21       22       22         89
    Total Changes:
        Estimated Authorization Level...................       50       50       51       51       52        253
        Estimated Outlays...............................       19       43       48       51       51        212
----------------------------------------------------------------------------------------------------------------
Notes: Components may not add to totals because of rounding. HRSA = Health Resources and Services
  Administration; CDC = Centers for Disease Control and Prevention; NIH = National Institutes of Health.

    Basis of estimate: CDC, HRSA, and NIH administer programs 
that support activities to detect, diagnose, and treat early 
hearing loss in newborns and infants. The Congress appropriated 
approximately $50 million for such activities in 2015. For this 
estimate, CBO assumes that the legislation will be enacted near 
the beginning of fiscal year 2016, that the authorized amounts 
will be appropriated in each year, and that spending will 
follow historical patterns for the authorized programs. CBO 
estimates that implementing H.R. 1344 would cost $212 million 
over the 2016-2020 period, assuming appropriation of the 
specified and estimated amounts.
    HRSA: The bill would authorize the appropriation of $17.8 
million for each of fiscal years 2016-2020 for HRSA to 
administer the Universal Newborn Screening program. The program 
makes grants to states to support testing of infants prior to 
hospital discharges, audiologic evaluation by three months of 
age, and early intervention activities. CBO estimates 
implementing those provisions would cost $78 million over the 
2016-2020 period.
    CDC: H.R. 1344 would authorize the appropriation of $10.8 
million annually for each of fiscal years 2016-2020 for CDC to 
make grants and provide technical assistance to states to 
promote screening and to support surveillance activities and 
research about the causes of hearing loss among newborns, 
infants, and young children. In addition, the bill would 
authorize CDC to conduct research, monitor state programs, and 
develop procedures for assessing services, costs, and outcomes 
in those programs. CBO estimates implementing those provisions 
would cost $45 million over the 2016-2020 period.
    NIH: The bill would authorize NIH to conduct research on 
early detection and treatment of hearing loss. The authority 
for research programs at NIH expired at the end of fiscal year 
2009; however, the Congress has continued to appropriate funds 
to operate those programs across all areas of research at NIH. 
Based on information from the agency, CBO estimates that the 
National Institute on Deafness and Other Communication 
Disorders at NIH spent about $21 million on such research in 
fiscal year 2014. Based on historical program expenditures at 
NIH and adjusting for inflation, CBO estimates that 
implementing this provision would cost $89 million over the 
2016-2020 period, assuming appropriation of the necessary 
amounts.
    Pay-As-You-Go considerations: None.
    Intergovernmental and private-sector impact: H.R. 1344 
contains no intergovernmental or private-sector mandates as 
defined in UMRA and would impose no costs on state, local, or 
tribal governments. Grant funds authorized in the bill would 
benefit states that provide hearing screening, evaluation, and 
intervention programs to newborns, infants, and young children.
    Estimate prepared by: Federal costs: Lisa Ramirez-Branum, 
Ellen Werble, and Rebecca Yip; Impact on state, local, and 
tribal governments: J'nell Blanco Suchy; Impact on the private 
sector: Amy Petz.
    Estimate approved by: Holly Harvey, Deputy Assistant 
Director for Budget Analysis.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

                    Duplication of Federal Programs

    No provision of H.R. 1344 would establish or reauthorize a 
program of the Federal Government known to be duplicative of 
another Federal program, a program that was included in any 
report from the Government Accountability Office to Congress 
pursuant to section 21 of Public Law 111-139, or a program 
related to a program identified in the most recent Catalog of 
Federal Domestic Assistance.

                  Disclosure of Directed Rule Makings

    The Committee estimates that enacting H.R. 1344 
specifically directs to be completed no rule making within the 
meaning of 5 U.S.C. 551.

                      Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by this 
legislation.

                  Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

             Section-by-Section Analysis of the Legislation

Section 1. Short title

    Section 1 states that the legislation may be cited as the 
``Early Hearing Detection and Intervention Act of 2015.''

Section 2. Findings

    Section 2 includes relevant findings.

Section 3. Reauthorization of program for early detection, diagnosis, 
        and treatment regarding deaf and hard-of-hearing newborns, 
        infants and young children

    Section 3 would reauthorize various grant programs. The 
HRSA grants would develop and monitor the efficacy of statewide 
programs and systems for hearing screenings, ensure prompt 
evaluation and diagnosis and ensure patients receive 
appropriate interventions.
    The CDC would be directed to award grants or enter into 
cooperative agreements to provide assistance on data collection 
and management and to study and report on the costs and 
effectiveness of screening and other programs.
    Section 3 would promote coordination and collaboration 
among the Administrator of the HRSA, Director of the CDC and 
Director of the NIH on policy and program development at the 
Federal and State levels. The Committee encourages them to 
engage with patient groups, appropriate national medical and 
other health and education specialty organizations, payers, 
related commercial industry, and other qualified professional 
personnel.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, and existing law in which no 
change is proposed is shown in roman):

                       PUBLIC HEALTH SERVICE ACT

           *       *       *       *       *       *       *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

           *       *       *       *       *       *       *

PART P--ADDITIONAL PROGRAMS

           *       *       *       *       *       *       *

[SEC. 399M. EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING HEARING 
                    LOSS IN NEWBORNS AND INFANTS.

  [(a) Statewide Newborn and Infant Hearing Screening, 
Evaluation and Intervention Programs and Systems.--The 
Secretary, acting through the Administrator of the Health 
Resources and Services Administration, shall make awards of 
grants or cooperative agreements to develop statewide newborn 
and infant hearing screening, evaluation, diagnosis, and 
intervention programs and systems, and to assist in the 
recruitment, retention, education, and training of qualified 
personnel and health care providers, for the following 
purposes:
          [(1) To develop and monitor the efficacy of statewide 
        programs and systems for hearing screening of newborns 
        and infants; prompt evaluation and diagnosis of 
        children referred from screening programs; and 
        appropriate educational, audiological, and medical 
        interventions for children identified with hearing 
        loss. Early intervention includes referral to and 
        delivery of information and services by schools and 
        agencies, including community, consumer, and parent-
        based agencies and organizations and other programs 
        mandated by part C of the Individuals with Disabilities 
        Education Act, which offer programs specifically 
        designed to meet the unique language and communication 
        needs of deaf and hard of hearing newborns, infants, 
        toddlers, and children. Programs and systems under this 
        paragraph shall establish and foster family-to-family 
        support mechanisms that are critical in the first 
        months after a child is identified with hearing loss.
          [(2) To collect data on statewide newborn and infant 
        hearing screening, evaluation and intervention programs 
        and systems that can be used for applied research, 
        program evaluation and policy development.
          [(3) Other activities may include developing 
        efficient models to ensure that newborns and infants 
        who are identified with a hearing loss through 
        screening receive follow-up by a qualified health care 
        provider, and State agencies shall be encouraged to 
        adopt models that effectively increase the rate of 
        occurrence of such follow-up.
  [(b) Technical Assistance, Data Management, and Applied 
Research.--
          [(1) Centers for disease control and prevention.--The 
        Secretary, acting through the Director of the Centers 
        for Disease Control and Prevention, shall make awards 
        of grants or cooperative agreements to provide 
        technical assistance to State agencies to complement an 
        intramural program and to conduct applied research 
        related to newborn and infant hearing screening, 
        evaluation and intervention programs and systems. The 
        program shall develop standardized procedures for data 
        management and program effectiveness and costs, such 
        as--
                  [(A) to ensure quality monitoring of newborn 
                and infant hearing loss screening, evaluation, 
                diagnosis, and intervention programs and 
                systems;
                  [(B) to provide technical assistance on data 
                collection and management;
                  [(C) to study the costs and effectiveness of 
                newborn and infant hearing screening, 
                evaluation and intervention programs and 
                systems conducted by State-based programs in 
                order to answer issues of importance to State 
                and national policymakers;
                  [(D) to identify the causes and risk factors 
                for congenital hearing loss;
                  [(E) to study the effectiveness of newborn 
                and infant hearing screening, audiologic and 
                medical evaluations and intervention programs 
                and systems by assessing the health, 
                intellectual and social developmental, 
                cognitive, and language status of these 
                children at school age; and
                  [(F) to promote the sharing of data regarding 
                early hearing loss with State-based birth 
                defects and developmental disabilities 
                monitoring programs for the purpose of 
                identifying previously unknown causes of 
                hearing loss.
          [(2) National institutes of health.--The Director of 
        the National Institutes of Health, acting through the 
        Director of the National Institute on Deafness and 
        Other Communication Disorders, shall for purposes of 
        this section, continue a program of research and 
        development on the efficacy of new screening techniques 
        and technology, including clinical studies of screening 
        methods, studies on efficacy of intervention, and 
        related research.
  [(c) Coordination and Collaboration.--
          [(1) In general.--In carrying out programs under this 
        section, the Administrator of the Health Resources and 
        Services Administration, the Director of the Centers 
        for Disease Control and Prevention, and the Director of 
        the National Institutes of Health shall collaborate and 
        consult with other Federal agencies; State and local 
        agencies, including those responsible for early 
        intervention services pursuant to title XIX of the 
        Social Security Act (Medicaid Early and Periodic 
        Screening, Diagnosis and Treatment Program); title XXI 
        of the Social Security Act (State Children's Health 
        Insurance Program); title V of the Social Security Act 
        (Maternal and Child Health Block Grant Program); and 
        part C of the Individuals with Disabilities Education 
        Act; consumer groups of and that serve individuals who 
        are deaf and hard-of-hearing and their families; 
        appropriate national medical and other health and 
        education specialty organizations; persons who are deaf 
        and hard-of-hearing and their families; other qualified 
        professional personnel who are proficient in deaf or 
        hard-of-hearing children's language and who possess the 
        specialized knowledge, skills, and attributes needed to 
        serve deaf and hard-of-hearing newborns, infants, 
        toddlers, children, and their families; third-party 
        payers and managed care organizations; and related 
        commercial industries.
          [(2) Policy development.--The Administrator of the 
        Health Resources and Services Administration, the 
        Director of the Centers for Disease Control and 
        Prevention, and the Director of the National Institutes 
        of Health shall coordinate and collaborate on 
        recommendations for policy development at the Federal 
        and State levels and with the private sector, including 
        consumer, medical and other health and education 
        professional-based organizations, with respect to 
        newborn and infant hearing screening, evaluation, 
        diagnosis, and intervention programs and systems.
          [(3) State early detection, diagnosis, and 
        intervention programs and systems; data collection.--
        The Administrator of the Health Resources and Services 
        Administration and the Director of the Centers for 
        Disease Control and Prevention shall coordinate and 
        collaborate in assisting States to establish newborn 
        and infant hearing screening, evaluation, diagnosis, 
        and intervention programs and systems under subsection 
        (a) and to develop a data collection system under 
        subsection (b).
  [(d) Rule of Construction; Religious Accommodation.--Nothing 
in this section shall be construed to preempt or prohibit any 
State law, including State laws which do not require the 
screening for hearing loss of newborn infants or young children 
of parents who object to the screening on the grounds that such 
screening conflicts with the parents' religious beliefs.
  [(e) Definitions.--For purposes of this section:
          [(1) The term ``audiologic evaluation'' refers to 
        procedures to assess the status of the auditory system; 
        to establish the site of the auditory disorder; the 
        type and degree of hearing loss, and the potential 
        effects of hearing loss on communication; and to 
        identify appropriate treatment and referral options. 
        Referral options should include linkage to State 
        coordinating agencies under part C of the Individuals 
        with Disabilities Education Act or other appropriate 
        agencies, medical evaluation, hearing aid/sensory aid 
        assessment, audiologic rehabilitation treatment, 
        national and local consumer, self-help, parent, and 
        education organizations, and other family-centered 
        services.
          [(2) The terms ``audiologic rehabilitation'' and 
        ``audiologic intervention'' refer to procedures, 
        techniques, and technologies to facilitate the 
        receptive and expressive communication abilities of a 
        child with hearing loss.
          [(3) The term ``early intervention'' refers to 
        providing appropriate services for the child with 
        hearing loss, including nonmedical services, and 
        ensuring that families of the child are provided 
        comprehensive, consumer-oriented information about the 
        full range of family support, training, information 
        services, and language and communication options and 
        are given the opportunity to consider and obtain the 
        full range of such appropriate services, educational 
        and program placements, and other options for their 
        child from highly qualified providers.
          [(4) The term ``medical evaluation by a physician'' 
        refers to key components including history, 
        examination, and medical decision making focused on 
        symptomatic and related body systems for the purpose of 
        diagnosing the etiology of hearing loss and related 
        physical conditions, and for identifying appropriate 
        treatment and referral options.
          [(5) The term ``medical intervention'' refers to the 
        process by which a physician provides medical diagnosis 
        and direction for medical and/or surgical treatment 
        options of hearing loss and/or related medical disorder 
        associated with hearing loss.
          [(6) The term ``newborn and infant hearing 
        screening'' refers to objective physiologic procedures 
        to detect possible hearing loss and to identify 
        newborns and infants who require further audiologic and 
        medical evaluations.
  [(f) Authorization of Appropriations.--
          [(1) Statewide newborn and infant hearing screening, 
        evaluation and intervention programs and systems.--For 
        the purpose of carrying out subsection (a), there are 
        authorized to be appropriated to the Health Resources 
        and Services Administration such sums as may be 
        necessary for fiscal years 2011 through 2015.
          [(2) Technical assistance, data management, and 
        applied research; centers for disease control and 
        prevention.--For the purpose of carrying out subsection 
        (b)(1), there are authorized to be appropriated to the 
        Centers for Disease Control and Prevention such sums as 
        may be necessary for fiscal years 2011 through 2015.
          [(3) Technical assistance, data management, and 
        applied research; national institute on deafness and 
        other communication disorders.--For the purpose of 
        carrying out subsection (b)(2), there are authorized to 
        be appropriated to the National Institute on Deafness 
        and Other Communication Disorders such sums as may be 
        necessary for fiscal years 2011 through 2015.]

SEC. 399M. EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING DEAF AND 
                    HARD-OF-HEARING NEWBORNS, INFANTS, AND YOUNG 
                    CHILDREN.

  (a) Health Resources and Services Administration.--The 
Secretary, acting through the Administrator of the Health 
Resources and Services Administration, shall make awards of 
grants or cooperative agreements to develop statewide newborn, 
infant, and young childhood hearing screening, diagnosis, 
evaluation, and intervention programs and systems, and to 
assist in the recruitment, retention, education, and training 
of qualified personnel and health care providers for the 
following purposes:
          (1) To develop and monitor the efficacy of statewide 
        programs and systems for hearing screening of newborns, 
        infants, and young children, prompt evaluation and 
        diagnosis of children referred from screening programs, 
        and appropriate educational, audiological, and medical 
        interventions for children confirmed to be deaf or 
        hard-of-hearing, consistent with the following:
                  (A) Early intervention includes referral to 
                and delivery of information and services by 
                organizations such as schools and agencies 
                (including community, consumer, and parent-
                based agencies), pediatric medical homes, and 
                other programs mandated by part C of the 
                Individuals with Disabilities Education Act, 
                which offer programs specifically designed to 
                meet the unique language and communication 
                needs of deaf and hard-of-hearing newborns, 
                infants, and young children.
                  (B) Information provided to parents must be 
                accurate, comprehensive, and, where 
                appropriate, evidence-based, allowing families 
                to make important decisions for their child in 
                a timely way, including decisions relating to 
                all possible assistive hearing technologies 
                (such as hearing aids, cochlear implants, and 
                osseointegrated devices) and communication 
                options (such as visual and sign language, 
                listening and spoken language, or both).
                  (C) Programs and systems under this paragraph 
                shall offer mechanisms that foster family-to-
                family and deaf and hard-of-hearing consumer-
                to-family supports.
          (2) To develop efficient models (both educational and 
        medical) to ensure that newborns, infants, and young 
        children who are identified through hearing screening 
        receive followup by qualified early intervention 
        providers, qualified health care providers, or 
        pediatric medical homes (including by encouraging State 
        agencies to adopt such models).
          (3) To provide for a technical resource center in 
        conjunction with the Maternal and Child Health Bureau 
        of the Health Resources and Services Administration--
                  (A) to provide technical support and 
                education for States; and
                  (B) to continue development and enhancement 
                of State early hearing detection and 
                intervention programs.
  (b) Technical Assistance, Data Management, and Applied 
Research.--
          (1) Centers for disease control and prevention.--The 
        Secretary, acting through the Director of the Centers 
        for Disease Control and Prevention, shall make awards 
        of grants or cooperative agreements to State agencies 
        or their designated entities for development, 
        maintenance, and improvement of data tracking and 
        surveillance systems on newborn, infant, and young 
        childhood hearing screenings, audiologic evaluations, 
        medical evaluations, and intervention services; to 
        conduct applied research related to services and 
        outcomes, and provide technical assistance related to 
        newborn, infant, and young childhood hearing screening, 
        evaluation, and intervention programs, and information 
        systems; to ensure high-quality monitoring of hearing 
        screening, evaluation, and intervention programs and 
        systems for newborns, infants, and young children; and 
        to coordinate developing standardized procedures for 
        data management and assessing program and cost 
        effectiveness. The awards under the preceding sentence 
        may be used--
                  (A) to provide technical assistance on data 
                collection and management;
                  (B) to study and report on the costs and 
                effectiveness of newborn, infant, and young 
                childhood hearing screening, evaluation, 
                diagnosis, intervention programs, and systems;
                  (C) to collect data and report on newborn, 
                infant, and young childhood hearing screening, 
                evaluation, diagnosis, and intervention 
                programs and systems that can be used--
                          (i) for applied research, program 
                        evaluation, and policy development; and
                          (ii) to answer issues of importance 
                        to State and national policymakers;
                  (D) to identify the causes and risk factors 
                for congenital hearing loss;
                  (E) to study the effectiveness of newborn, 
                infant, and young childhood hearing screening, 
                audiologic evaluations, medical evaluations, 
                and intervention programs and systems by 
                assessing the health, intellectual and social 
                developmental, cognitive, and hearing status of 
                these children at school age; and
                  (F) to promote the integration, linkage, and 
                interoperability of data regarding early 
                hearing loss and multiple sources to increase 
                information exchanges between clinical care and 
                public health including the ability of States 
                and territories to exchange and share data.
          (2) National institutes of health.--The Director of 
        the National Institutes of Health, acting through the 
        Director of the National Institute on Deafness and 
        Other Communication Disorders, shall, for purposes of 
        this section, continue a program of research and 
        development related to early hearing detection and 
        intervention, including development of technologies and 
        clinical studies of screening methods, efficacy of 
        interventions, and related research.
  (c) Coordination and Collaboration.--
          (1) In general.--In carrying out programs under this 
        section, the Administrator of the Health Resources and 
        Services Administration, the Director of the Centers 
        for Disease Control and Prevention, and the Director of 
        the National Institutes of Health shall collaborate and 
        consult with--
                  (A) other Federal agencies;
                  (B) State and local agencies, including those 
                responsible for early intervention services 
                pursuant to title XIX of the Social Security 
                Act (42 U.S.C. 1396 et seq.) (Medicaid Early 
                and Periodic Screening, Diagnosis and Treatment 
                Program); title XXI of the Social Security Act 
                (42 U.S.C. 1397aa et seq.) (State Children's 
                Health Insurance Program); title V of the 
                Social Security Act (42 U.S.C. 701 et seq.) 
                (Maternal and Child Health Block Grant 
                Program); and part C of the Individuals with 
                Disabilities Education Act (20 U.S.C. 1431 et 
                seq.);
                  (C) consumer groups of and that serve 
                individuals who are deaf and hard-of-hearing 
                and their families;
                  (D) appropriate national medical and other 
                health and education specialty organizations;
                  (E) persons who are deaf and hard-of-hearing 
                and their families;
                  (F) other qualified professional personnel 
                who are proficient in deaf or hard-of-hearing 
                children's language and who possess the 
                specialized knowledge, skills, and attributes 
                needed to serve deaf and hard-of-hearing 
                newborns, infants, toddlers, children, and 
                their families;
                  (G) third-party payers and managed-care 
                organizations; and
                  (H) related commercial industries.
          (2) Policy development.--The Administrator of the 
        Health Resources and Services Administration, the 
        Director of the Centers for Disease Control and 
        Prevention, and the Director of the National Institutes 
        of Health shall coordinate and collaborate on 
        recommendations for policy development at the Federal 
        and State levels and with the private sector, including 
        consumer, medical, and other health and education 
        professional-based organizations, with respect to 
        newborn, infant, and young childhood hearing screening, 
        evaluation, diagnosis, and intervention programs and 
        systems.
          (3) State early detection, diagnosis, and 
        intervention programs and systems; data collection.--
        The Administrator of the Health Resources and Services 
        Administration and the Director of the Centers for 
        Disease Control and Prevention shall coordinate and 
        collaborate in assisting States--
                  (A) to establish newborn, infant, and young 
                childhood hearing screening, evaluation, 
                diagnosis, and intervention programs and 
                systems under subsection (a); and
                  (B) to develop a data collection system under 
                subsection (b).
  (d) Rule of Construction; Religious Accommodation.--Nothing 
in this section shall be construed to preempt or prohibit any 
State law, including State laws which do not require the 
screening for hearing loss of newborns, infants, or young 
children of parents who object to the screening on the grounds 
that such screening conflicts with the parents' religious 
beliefs.
  (e) Definitions.--For purposes of this section:
          (1) The term ``audiologic'', when used in connection 
        with evaluation, refers to procedures--
                  (A) to assess the status of the auditory 
                system;
                  (B) to establish the site of the auditory 
                disorder, the type and degree of hearing loss, 
                and the potential effects of hearing loss on 
                communication; and
                  (C) to identify appropriate treatment and 
                referral options, including--
                          (i) linkage to State coordinating 
                        agencies under part C of the 
                        Individuals with Disabilities Education 
                        Act (20 U.S.C. 1431 et seq.) or other 
                        appropriate agencies;
                          (ii) medical evaluation;
                          (iii) hearing aid/sensory aid 
                        assessment;
                          (iv) audiologic rehabilitation 
                        treatment; and
                          (v) referral to national and local 
                        consumer, self-help, parent, and 
                        education organizations, and other 
                        family-centered services.
          (2) The term ``early intervention'' refers to--
                  (A) providing appropriate services for the 
                child who is deaf or hard of hearing, including 
                nonmedical services; and
                  (B) ensuring the family of the child is--
                          (i) provided comprehensive, consumer-
                        oriented information about the full 
                        range of family support, training, 
                        information services, and language and 
                        communication options; and
                          (ii) given the opportunity to 
                        consider and obtain the full range of 
                        such appropriate services, educational 
                        and program placements, and other 
                        options for their child from highly 
                        qualified providers.
          (3) The term ``medical evaluation'' refers to key 
        components performed by a physician, including history, 
        examination, and medical decisionmaking focused on 
        symptomatic and related body systems for the purpose of 
        diagnosing the etiology of hearing loss and related 
        physical conditions, and for identifying appropriate 
        treatment and referral options.
          (4) The term ``medical intervention'' refers to the 
        process by which a physician provides medical diagnosis 
        and direction for medical or surgical treatment options 
        for hearing loss or related medical disorders.
          (5) The term ``newborn, infant, and young childhood 
        hearing screening'' refers to objective physiologic 
        procedures to detect possible hearing loss and to 
        identify newborns, infants, and young children who 
        require further audiologic evaluations and medical 
        evaluations.
  (f) Authorization of Appropriations.--
          (1) Statewide newborn, infant, and young childhood 
        hearing screening, evaluation and intervention programs 
        and systems.--For the purpose of carrying out 
        subsection (a), there is authorized to be appropriated 
        to the Health Resources and Services Administration 
        $17,800,000 for each of fiscal years 2016 through 2020.
          (2) Technical assistance, data management, and 
        applied research; centers for disease control and 
        prevention.--For the purpose of carrying out subsection 
        (b)(1), there is authorized to be appropriated to the 
        Centers for Disease Control and Prevention $10,800,000 
        for each of fiscal years 2016 through 2020.
          (3) Technical assistance, data management, and 
        applied research; national institute on deafness and 
        other communication disorders.--No additional funds are 
        authorized to be appropriated for the purpose of 
        carrying out subsection (b)(2). Such subsection shall 
        be carried out using funds which are otherwise 
        authorized (under section 402A or other provisions of 
        law) to be appropriated for such purpose.

           *       *       *       *       *       *       *

                                  [all]
```