I
106TH CONGRESS
1ST SESSION
H. R. 1193
To establish programs regarding early detection, diagnosis, and interventions
for newborns and infants with hearing loss.
IN THE HOUSE OF REPRESENTATIVES
MARCH 18, 1999
Mr. WALSH (for himself, Mr. BILIRAKIS, Mr. WAXMAN, Mr. DEAL of Georgia,
Mr. COBURN, Mr. UPTON, Mr. ACKERMAN, Ms. KILPATRICK, Mrs.
KELLY, Mr. SHOWS, Mrs. MORELLA, Mr. MCHUGH, Mr. DUNCAN, Mr.
SHERMAN, Mr. MCNULTY, Mr. FROST, Mrs. MALONEY of New York, Mr.
BALDACCI, Mr. BERMAN, Mr. WEYGAND, Mr. QUINN, Mr. FRELING-
HUYSEN, Mr. KLECZKA, Mr. OLVER, Mr. FOSSELLA, Ms. DELAURO, Mr.
GEJDENSON, Mr. LEWIS of Georgia, Mr. YOUNG of Alaska, Mr. PASTOR,
Mr. DIXON, Mrs. JOHNSON of Connecticut, Mr. FALEOMAVAEGA, Mr.
POMEROY, Ms. ROS-LEHTINEN, Mr. ENGLISH, Mr. FARR of California,
Mr. STRICKLAND, Mr. PAYNE, Mr. DOYLE, Ms. SCHAKOWSKY, Mr.
WEXLER, Mr. ROTHMAN, Ms. SLAUGHTER, Mrs. CAPPS, and Mr. FOLEY)
introduced the following bill; which was referred to the Committee on
Commerce
A BILL
To establish programs regarding early detection, diagnosis,
and interventions for newborns and infants with hearing
loss.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Newborn and Infant
Hearing Screening and Intervention Act of 1999’’.
SEC. 2. EARLY DETECTION, DIAGNOSIS, AND INTERVEN-
TIONS FOR NEWBORNS AND INFANTS WITH
HEARING LOSS.
(a) DEFINITIONS.—For the purposes of this Act only,
the following terms in this section are defined as follows:
(1) HEARING
SCREENING.—Newborn and in-
fant hearing screening consists of objective physio-
logic procedures to detect possible hearing loss and
to identify newborns and infants who, after re-
screening, require further audiologic and medical
evaluations.
(2) 
AUDIOLOGIC
EVALUATION.—Audiologic
evaluation consists of 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 treat-
ment and referral options. Referral options should
include linkage to state IDEA Part C coordinating
agencies or other appropriate agencies, medical eval-
uation, 
hearing 
aid/sensory 
aid 
assessment,
audiologic rehabilitation treatment, national and
local consumer, self-help, parent, and education or-
ganizations, and other family-centered services.
(3) MEDICAL EVALUATION.—Medical evaluation
by a physician consists of 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 identi-
fying appropriate treatment and referral options.
(4) MEDICAL
INTERVENTION.—Medical inter-
vention is the process by which a physician provides
medical diagnosis and direction for medical and/or
surgical treatment options of hearing loss and/or re-
lated medical disorder associated with hearing loss.
(5) AUDIOLOGIC REHABILITATION.—Audiologic
rehabilitation (intervention) consists of procedures,
techniques, and technologies to facilitate the recep-
tive and expressive communication abilities of a child
with hearing loss.
(6) EARLY INTERVENTION.—Early intervention
(e.g., nonmedical) means providing appropriate serv-
ices for the child with hearing loss and ensuring that
families of the child are provided comprehensive,
consumer-oriented information about the full range
of family support, training, information services,
communication options and are given the oppor-
tunity to consider the full range of educational and
program placements and options for their child.
(b) PURPOSES.—The purposes of this Act are to clar-
ify the authority within the Public Health Service Act to
authorize statewide newborn and infant hearing screening,
evaluation and intervention programs and systems, tech-
nical assistance, a national applied research program, and
interagency and private sector collaboration for policy de-
velopment, in order to assist the States in making
progress toward the following goals:
(1) All babies born in hospitals in the United
States and its territories should have a hearing
screening before leaving the birthing facility. Babies
born in other countries and residing in the United
States via immigration or adoption should have a
hearing screening as early as possible.
(2) All babies who are not born in hospitals in
the United States and its territories should have a
hearing screening within the first 3 months of life.
(3) Appropriate audiologic and medical evalua-
tions should be conducted by 3 months for all
newborns and infants suspected of having hearing
loss to allow appropriate referral and provisions for
audiologic rehabilitation, medical and early interven-
tion before the age of 6 months.
(4) All newborn and infant hearing screening
programs and systems should include a component
for audiologic rehabilitation, medical and early inter-
vention options that ensures linkage to any new and
existing state-wide systems of intervention and reha-
bilitative services for newborns and infants with
hearing loss.
(5) Public policy in regard to newborn and in-
fant hearing screening and intervention should be
based on applied research and the recognition that
newborns, infants, toddlers, and children who are
deaf or hard-of-hearing have unique language, learn-
ing, and communication needs, and should be the re-
sult of consultation with pertinent public and private
sectors.
(c) STATEWIDE NEWBORN AND INFANT HEARING
SCREENING, EVALUATION
AND
INTERVENTION
PRO-
GRAMS AND SYSTEMS.—Under the existing authority of
the Public Health Service Act, the Secretary of Health
and Human Services (in this Act referred to as the ‘‘Sec-
retary’’), 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 and
intervention programs and systems for the following pur-
poses:
(1) To develop and monitor the efficacy of
state-wide newborn and infant hearing screening,
evaluation and intervention programs and systems.
Early intervention includes referral to schools and
agencies, including community, consumer, and par-
ent-based agencies and organizations and other pro-
grams 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 hear-
ing newborns, infants, toddlers, and children.
(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 develop-
ment.
(d) TECHNICAL ASSISTANCE, DATA MANAGEMENT,
AND APPLIED RESEARCH.—
(1) CENTERS FOR DISEASE CONTROL AND PRE-
VENTION.—Under the existing authority of the Pub-
lic Health Service Act, the Secretary, acting through
the Director of the Centers for Disease Control and
Prevention, shall make awards of grants or coopera-
tive agreements to provide technical assistance to
State agencies to complement an intramural pro-
gram and to conduct applied research related to
newborn and infant hearing screening, evaluation
and intervention programs and systems. The pro-
gram shall develop standardized procedures for data
management and program effectiveness and costs,
such as—
(A) to ensure quality monitoring of new-
born and infant hearing loss screening, evalua-
tion, 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, evalua-
tion and intervention programs and systems
conducted by State-based programs in order to
answer issues of importance to state and na-
tional 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