
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document not affected by Public Laws enacted between
  January 23, 2000 and December 4, 2001]
[CITE: 42USC247b-4a]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                    CHAPTER 6A--PUBLIC HEALTH SERVICE
 
                SUBCHAPTER II--GENERAL POWERS AND DUTIES
 
                    Part B--Federal-State Cooperation
 
Sec. 247b-4a. Early detection, diagnosis, and interventions for 
        newborns and infants with hearing loss
        

(a) Definitions

    For the purposes of this section only, the following terms in this 
section are defined as follows:

                        (1) Hearing screening

        Newborn and infant hearing screening consists of objective 
    physiologic procedures to detect possible hearing loss and to 
    identify newborns and infants who, after rescreening, 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 treatment and referral options. Referral options should 
    include linkage to State IDEA part C coordinating agencies 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.

                       (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 identifying appropriate treatment and referral 
    options.

                      (4) Medical intervention

        Medical intervention is 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.

                    (5) Audiologic rehabilitation

        Audiologic rehabilitation (intervention) consists of procedures, 
    techniques, and technologies to facilitate the receptive and 
    expressive communication abilities of a child with hearing loss.

                       (6) Early intervention

        Early intervention (e.g., nonmedical) means providing 
    appropriate services 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 opportunity to consider the full range of educational and 
    program placements and options for their child.

(b) Purposes

    The purposes of this section are to clarify the authority within the 
Public Health Service Act [42 U.S.C. 201 et seq.] to authorize statewide 
newborn and infant hearing screening, evaluation and intervention 
programs and systems, technical assistance, a national applied research 
program, and interagency and private sector collaboration for policy 
development, 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 evaluations 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 intervention 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 intervention options that ensures linkage to any 
    new and existing statewide systems of intervention and 
    rehabilitative services for newborns and infants with hearing loss.
        (5) Public policy in regard to newborn and infant 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, learning, and 
    communication needs, and should be the result of consultation with 
    pertinent public and private sectors.

(c) Statewide newborn and infant hearing screening, evaluation and 
        intervention programs and systems

    Under the existing authority of the Public Health Service Act [42 
U.S.C. 201 et seq.], the Secretary of Health and Human Services (in this 
section referred to as 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 and intervention 
programs and systems for the following purposes:
        (1) To develop and monitor the efficacy of statewide newborn and 
    infant hearing screening, evaluation and intervention programs and 
    systems. Early intervention includes referral to 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 [20 U.S.C. 1431 et 
    seq.], which offer programs specifically designed to meet the unique 
    language and communication needs of deaf and hard-of-hearing 
    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 
    development.

(d) Technical assistance, data management, and applied research

           (1) Centers for Disease Control and Prevention

        Under the existing authority of the Public Health Service Act 
    [42 U.S.C. 201 et seq.], 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, 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

        Under the existing authority of the Public Health Service Act, 
    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.

(e) Coordination and collaboration

                           (1) In general

        Under the existing authority of the Public Health Service Act 
    [42 U.S.C. 201 et seq.], 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 [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.]; 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

        Under the existing authority of the Public Health Service Act, 
    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 and intervention programs and systems.

       (3) State early detection, diagnosis, and intervention 
                    programs and systems; data collection

        Under the existing authority of the Public Health Service Act, 
    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 and 
    intervention programs and systems under subsection (c) of this 
    section and to develop a data collection system under subsection (d) 
    of this section.

(f) Rule of construction

    Nothing in this section shall be construed to preempt any State law.

(g) Authorization of appropriations

        (1) Statewide newborn and infant hearing screening, 
              evaluation and intervention programs and systems

        For the purpose of carrying out subsection (c) of this section 
    under the existing authority of the Public Health Service Act [42 
    U.S.C. 201 et seq.], there are authorized to the Health Resources 
    and Services Administration appropriations in the amount of 
    $5,000,000 for fiscal year 2000, $8,000,000 for fiscal year 2001, 
    and such sums as may be necessary for fiscal year 2002.

       (2) Technical assistance, data management, and applied 
            research; Centers for Disease Control and Prevention

        For the purpose of carrying out subsection (d)(1) of this 
    section under the existing authority of the Public Health Service 
    Act, there are authorized to the Centers for Disease Control and 
    Prevention, appropriations in the amount of $5,000,000 for fiscal 
    year 2000, $7,000,000 for fiscal year 2001, and such sums as may be 
    necessary for fiscal year 2002.

       (3) Technical assistance, data management, and applied 
             research; National Institute on Deafness and Other 
                           Communication Disorders

        For the purpose of carrying out subsection (d)(2) of this 
    section under the existing authority of the Public Health Service 
    Act, there are authorized to the National Institute on Deafness and 
    Other Communication Disorders appropriations for such sums as may be 
    necessary for each of the fiscal years 2000 through 2002.

(Pub. L. 106-113, div. B, Sec. 1000(a)(4) [title VI, Sec. 601], Nov. 29, 
1999, 113 Stat. 1535, 1501A-276.)

                       References in Text

    The Public Health Service Act, referred to in subsecs. (b) to (e) 
and (g), is act July 1, 1944, ch. 373, 58 Stat. 682, as amended, which 
is classified generally to this chapter (Sec. 201 et seq.). For complete 
classification of this Act to the Code, see Short Title note set out 
under section 201 of this title and Tables.
    The Individuals with Disabilities Education Act, referred to in 
subsecs. (c)(1) and (e)(1), is title VI of Pub. L. 91-230, Apr. 13, 
1970, 84 Stat. 175, as amended. Part C of the Act is classified 
generally to subchapter III (Sec. 1431 et seq.) of chapter 33 of Title 
20, Education. For complete classification of this Act to the Code, see 
section 1400 of Title 20 and Tables.
    The Social Security Act, referred to in subsec. (e)(1), is act Aug. 
14, 1935, ch. 531, 49 Stat. 620, as amended. Titles V, XIX, and XXI of 
the Act are classified generally to subchapters V (Sec. 701 et seq.), 
XIX (Sec. 1396 et seq.), and XXI (Sec. 1397aa et seq.), respectively, of 
chapter 7 of this title. For complete classification of this Act to the 
Code, see section 1305 of this title and Tables.

                          Codification

    Section was enacted as part of the Departments of Labor, Health and 
Human Services, and Education, and Related Agencies Appropriations Act, 
2000, and not as part of the Public Health Service Act which comprises 
this chapter.
