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EHDI: Early Hearing Detection & Intervention

Last Modified: 06/29/2023

State EHDI/UNHS Mandates: Summaries

State Year Mandate Summary
Arkansas 1995 All hospitals required to complete a questionnaire for all newborns indicating the presence of high-risk indicators. Information is sent to the Department of Health, which must notify parents, provide them with educational information and a list of places where the parents can obtain additional information about the infant' s auditory functioning.
1999 Establishes advisory board. Requires every birthing hospital with more than 50 births per year to provide a hearing screen for each birth. Requires Medicaid to cover above and beyond the current per diem rate. Hospitals must forward test results via a report to the Department of Health. Requires that hospitals provide information to parents on medical and audiological follow-up care and screening locations. Parents may decline based on religious preferences.
California 1983 Establishes a system to screen newborn infants at high risk for deafness and create and maintain a system of follow-up and assessment for infants identified by such screening in neonatal intesive care units (NICUs).
1998 Requires all acute-care hospitals which are approved for California Children' s Services (CCS) funding (approximately 80% of the 540,000 annual births in California are in these hospitals) to offer a hearing screening test to parents of all newborns using procedures approved by the Department of Health. Establishes a system of early hearing detection and intervention centers to assist hospitals, maintain a statewide database, and ensure appropriate follow-up for infants referred from screening. Requires Department of Health to give parents of children diagnosed with hearing loss information about community resources and services and to conduct community outreach and development. Requires hospitals and providers of audiological follow-up and diagnostic services to report data to the state' s reporting and tracking system. Amended wording in the 1983 law to require screening of all newborns and infants who receive care in a CCS-approved neonatal intensive care units (NICUs). (Note: Even though this law does not require all newborns in the state to be screened, it is included in this section because it does require hospitals to screen over 370,000 babies a year.)
Colorado 1997 Establishes the legislature' s intent that by July 1, 1999, newborn hearing screening will be conducted for no fewer than 85% of all newborns. Requires all hospitals in the state to implement a program by July 1, 1997 to educate parents of newborns about the importance of early identification of hearing loss followed by appropriate intervention. Appoints an uncompensated advisory committee to develop an implementation plan by December 1, 1998. Requires all hospitals to report annually to the advisory committee the results of their screening program. If the number of babies screened does not reach 85% or more of all newborns by July 1, 1999, the state will promulgate rules requiring hearing screening of newborns.
Connecticut 1981 Legislation requires development of a plan to implement and operate a program of early identification of infant hearing impairment based on risk factors. Parents are to be notified of such infants at risk, informed about resources available for further testing and treatment, and given information about financial assistance available through the Department of Health Services.
1997 Legislation requires any health care institution providing child-birth services to include newborn hearing screening as a part of its standard of care by July 1, 2001. Directs the Department of Health to develop regulations for implementation.
Georgia 1978 Requires State Department of Health to develop guidelines for the detection of hearing impairment in infants determined to be at-risk and to develop rules and regulations to ensure that all such high-risk infants are evaluated within one year of their birth.
1999 Declares that it is beneficial to screen newborns for hearing loss and establishes a goal of screening at least 95% of all infants born in hospitals by July 1, 2001. Requires the Board of Human Resources, with assistance from an Advisory Committee, to develop rules and regulations, including appropriate objective and physiologically-based methods for screening, guidelines for reporting, and a means for assuring referral for appropriate follow-up services. Stipulates who is authorized to perform hearing screening.
Hawaii 1990 The Department of Health is to provide a statewide comprehensive and coordinated interdisciplinary program of early hearing impairment screening, identification, and follow-up for children from birth to 36 months of age and their families. The Department of Health is responsible for developing: (a) appropriate methodology to establish, implement, and evaluate the program; (b) guidelines for screening, identification, diagnosis, and monitoring of infants with hearing impairment and infants at risk for delayed onset of hearing impairment; (c) a plan, in conjunction with the State Department of Education, to involve the parents or guardians with the medical and educational follow-up and management; and (d) a plan for the collection of data and evaluation of the program
2001 The purpose of the 2001 amendment is to strengthen the 1990 mandate by requiring screening of all newborn infants for hearing loss.  It also requires that results be reported to the Department of Health, to reduce the risk that an infant will miss the opportunity for screening, follow-up diagnostic evaluation for a positive screen, and provision of early intervention services if permanent hearing loss is diagnosed.  The amendment clarifies minimum areas that the department shall address in administrative rules.
Illinois 1999 Mandates all hospitals performing deliveries to screen all infants prior to discharge by December 31, 2002. The Department of Human Services has overall responsibilities in the implementation of the newborn hearing screening act. Hospitals must report results to Department of Health. Establishes an advisory board. The Department of Health will provide a tracking and follow-up program for infants failing the hearing screening, a referral system for early intervention, and an application process for financial assistance through the Division of Specialized Care for Children. Parents may decline hearing screen based on religious preferences.
Indiana 1999 Requires that every infant be given a physiologic hearing screening examination for the detection of hearing impairments at the earliest feasible time, but no later than July 1, 2000. Establishes a newborn hearing screening and intervention advisory board. Hospitals are required to start screening as soon as they have the appropriate equipment.
Kansas 1990 Newborn infant hearing-impaired risk criteria and a questionnaire to identify high-risk infants to be developed. Each medical care facility must provide risk screening of newborn infants and promptly notify the infant' s parents or guardian, primary care physician, and the Secretary of Health and Environment that the infant is high risk. Parents/guardians must be given information on the developmental and language effects of hearing loss and a listing of medical care facilities which provide follow-up hearing evaluations. Establishes a system to gather and maintain data and a statewide registry.
1999 Requires all babies to be screened for hearing loss within 8 days of birth unless a different time period is medically indicated. Informed consent for such screening must be obtained from parents.
Louisiana 1992 Requires the State Department of Health to develop criteria to identify infants at-risk for hearing impairment and to create a high-risk registry. Hospitals are required to administer a high-risk questionnaire for all newborns prior to discharge and do follow-up screening by ABR or other screening devices. Written materials regarding hearing impairment must be disseminated to parents and an advisory council for the hearing detection program must be established.
1999 Requires that all newborn infants receive, before discharge, a hearing screening using auditory brainstem response, evoked otoacoustic emissions, or any other screening device approved by the office of public health. Results to be reported to an at-risk registry, the parent or guardian, and, if known, the primary care physician and the provider of audiologic services. The office of public health, with the advice of the Louisiana Commission for the Deaf and an advisory council, to adopt rules and regulations by July 1, 2000.
Maryland 1985 Establishes a program for the early identification and follow-up of infants who have a risk factor for developing a hearing impairment. The program is operated under the auspices of the Advisory for Hearing-Impaired Infants and Children.
1999 Requires all birthing hospitals to provide newborn hearing screening for all babies by July 1, 2000. Also establishes an Advisory Committee to advise the Department of Health and requires hospitals to report data about newborn hearing screening to the Department of Health. Requires Health Maintenance Organizations and Health Insurers to make newborn hearing screening a covered benefit.
Massachusetts 1971 Existing legislation (revised in 1985) established high-risk factors for hearing impairment in infants. Parents or guardians must be provided with literature describing conditions which cause children to be at high-risk for hearing impairment. The Department of Health is required to offer parents of high-risk children complete diagnostic evaluations at approved centers.
1998 Legislation requires that a hearing screening test be performed on all newborns in a birthing hospital or birthing center. Parents may refuse the test for religious reasons. Hearing screening tests are required to be a covered benefit of most health insurance policies. In the absence of a third-party payer, costs of newborn hearing screening and any subsequent diagnostic evaluation will be paid by the state. The date by which hospitals must comply with the law is not specified. Establishes an uncompensated advisory committee to the Department of Health for the operation of the newborn hearing screening program.
Mississippi 1974 Establishes a central registry within the State Department of Education for hearing and visually impaired persons under age 12. In 1979, a section of the Mississippi Code was amended to place responsibility for the registry under the State Department of Health.
1997 Requires babies born in a hospital after January 1, 1998 to be evaluated to determine if the child has a potential hearing impairment. The physician attending the birth is responsible to refer the child for confirmatory testing and make reasonable efforts to notify and educate the parents. The State Department of Health is required to track all infants who do not pass the newborn screening test, to establish an advisory committee, and to assure the best possible outcome for infants and toddlers identified through the program.
Missouri 1999 Requires that every infant born after January 1, 2002 to be screened for hearing loss using procedures approved by Department of Health. Parents must be given information on hearing loss and implications. Hospitals to promote further diagnostic evaluations and report results to Department. Establishes Department of Health as agency to maintain tracking and system for follow-up. Authorizes an uncompensated advisory committee. Requires Medicaid and all other third-party insurance to cover screening, necessary rescreening, audiological assessment and follow-up, and initial amplification. Parents may decline the hearing screen on religious grounds.
New York 1999 Requires the health commissioner, in consultation with health care providers or their representatives, to establish a program to screen newborn infants for hearing problems by April 1, 2000. Program to include the most cost-effective methods for detecting hearing problems as early as possible and follow-up screening, referral, and care. The program must provide for the reimbursement of health care providers who do screening. Each institution caring for newborn infants is required to administer such a program or refer the patient for screening after discharge.
North Carolina 1999 Includes hearing screening in the state' s newborn screening program. By regulation, requires bilateral physiological screening unless parents object on religious grounds. Also requires report to the local health department of all neonates who failed screening or were not successfully screened.
Oregon 1999 All hospitals with more than 200 births per year to provide hearing screens to newborns within one month of birth using equipment and procedures approved by Department of Health. Hospitals screening 200 or more births per year are to provide parents with information from Health Division. Familes of babies who were screened and did not pass are provided lists of diagnostic facilities and EI institutions. Requires hospitals to report to the Division annually the following (annual aggregate numbers of total newborns screened by hospitals, total newborns with abnormal screening tests; and by educational institutions, the total number of children receiving EI services as deaf or hard-of-hearing. No reporting of number of children diagnosed with hearing loss). Establishes an advisory committee. Parents may not be denied services because of inability to pay. Parents may decline the hearing screen based on religious preferences.
Rhode Island 1988 Every newborn infant must be screened for hearing impairment based on high-risk guidelines established by the director of the Department of Health. Cost of audiological evaluation of high-risk infants borne by the state in the absence of third-party payment.
1992 Requires every newborn infant to be evaluated for the detection of hearing impairment and specifies that the testing shall be a covered benefit reimbursable by all health insurers. Establishes a Hearing Impairments Testing Advisory Council.
Tennessee 2008 Requires that every newborn infant shall be screened for hearing loss prior to discharge from the hospital or birthing center. The attending health care professional is required to refer a child born in a setting other than a hospital or other birthing facility to the Department of Health or an appropriate hearing screening provider. All screening results must be reported to the Department of Health. The Department of Health is also required to refer any child who does not pass the hearing screening test to the Tennessee Early Intervention System (TEIS) of the Department of Education for follow-up. The hearing screening test will be covered by any health insurance policy; effective July 1, 2008. Parents are allowed to refuse the hearing screening test on grounds of religious practices.
Texas 1999 Requires hospitals in counties with more than 50,000 people and more than 100 births per year to provide hearing screening of all newborns and submit information to the Department. Parents must provide informed consent. Hospitals to distribute educational information. Department to provide tracking and follow-up software. Requires health insurance companies to cover the cost of hearing screening. Gives hospitals immunity for liability. Hospitals with more than 1000 births per year must begin by May 1, 2000; hospitals with less than 100 births per year must begin by April 1, 2001. The law only takes effect if money for implementation is appropriated.
Utah 1998 Creates an uncompensated Newborn Hearing Screening Committee and requires hospitals to evaluate every newborn infant for detection of hearing loss using ABR, EOAE, or other appropriate technology approved by the Committee. Requires hospitals to report results of screening to the Department of Health. The Department of Health must establish rules for the program and to coordinate a central data management system.
Virginia 1986 Requires the State Department of Health to maintain a system for the purpose of identifying and monitoring infants who are at risk for hearing impairment. A registry is to be maintained by the Department of Health for those children diagnosed with hearing impairment. Information packets on hearing and speech/language development are to be given to the parent/guardian of each infant transferred or discharged from the newborn nursery.
1998 Legislation requires most health insurance policies issued or renewed after July 1, 1998 to cover the costs of infant hearing screenings and all necessary follow-up diagnostic audiological examinations. Beginning July 1, 1999, all hospitals with neonatal intensive care services must give a hearing screening test to all infants prior to discharge. Beginning July 1, 2000, all other hospitals must give a hearing screening test to all infants prior to discharge. Infants who do not pass the screen shall be referred to a center approved by the Board of Health for a diagnostic audiological examination. The Board of Health shall establish the methodology, procedures, and timing for hearing screening tests and reporting. An advisory committee is created to assist in the design, implementation, and revision of the hearing identification and monitoring system.
West Virginia 1991 Legislation established a commission for the hearing impaired which maintains a registry for all hearing impaired persons and a clearinghouse of information and provides training and out-reach programs.
1998 Legislation requires all infants born in a licensed facility after July 1, 2000 to have a test for hearing loss unless parents refuse. For infants delivered at non-licensed facilities, including home births, parents must be informed of the need to obtain a test during the first month of life. The Director of Health is authorized to establish by legislative rule a cost-effective testing protocol, reporting and referral system and a reasonable fee schedule for testing newborn hearing which shall be a reimbursable benefit under most health insurance policies. The state is required to pay for infants eligible for medical assistance, and hospitals must cover the costs for uninsured patients, but are allowed to bill parents for those services. Parents who do not have health insurance may refuse testing. Also establishes a non-compensated advisory board to oversee the operation of the program, which includes parent/family representation.
Wisconsin 1999 Wisconsin enacted legislation in 1999 that requires by August 2003, birthing hospitals to collectively screen at least 88% of newborns for hearing loss. If the Department of Health and Family Services determines this level of screening has not occurred, universal newborn hearing screening will become a mandate for hospitals beginning January 2004. (Section 2439r, 253.115).
Wyoming 1999 Requires every child to be screened for major hearing defects by July 1, 1999. Parents must provide informed consent. State Health Department will develop rules and regulations for implementation and report to the legislature on the status of the program by November 1, 2000.