Frequently Asked Questions
What is the California Newborn Hearing Screening Program?
Why are we screening infants for hearing loss?
How are infants screened? What is ABR? What is OAE?
What happens when an infant does not pass a hearing screening?
What is the role of the Hearing Coordination Centers? Where are they located?
Why are inpatient screenings only done at CCS-approved hospitals?
If an infant is missed or if screening is declined in the hospital can a screening be performed at a later time?
How much does it cost? What if the infant is not eligible for CCS coverage?
Why aren't all infants being screened?
What happens when an infant is diagnosed with a hearing loss?
How can I learn more about the NHSP?
The Newborn Hearing Screening Program (NHSP) is a comprehensive coordinated system of early identification and provision of appropriate intervention and support services for infants with hearing loss and their families. The goal of the program is to identify infants with a hearing loss prior to three months of age and to link infants with early intervention services by six months of age.
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Infants begin developing speech and language from the moment they are born. Studies show that hearing loss occurs in approximately 2-4 out 1000 babies. Unfortunately, hearing loss is often not identified until 18 months to 3 years of age. If an infant has a hearing loss in one or both ears, early identification is crucial to preventing delayed speech and language development. Therefore, it is important that hearing loss be identified as early as possible so that intervention services can be provided.
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There are two methods that may be used to screen a newborn's hearing: Auditory Brainstem Response (ABR) and/or Otoacoustic Emissions (OAE). These tests can be performed while the baby is asleep or quiet and does not require the infant's participation. Sounds (tones or clicks) are played through small earphones and responses to the sounds are automatically measured. Both tests are quick, painless, and non-invasive.
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Infants who do not pass the initial hearing screening in the hospital are referred for a rescreening which should be performed before one month of age. Infants who do not pass the rescreening are referred to a California Children's Services (CCS)-approved Type C Communication Center (or Level 3 Hearing and Speech Center) for a diagnostic hearing evaluation. A referral to the local CCS program for authorization of the evaluation is also made. Upon identification of a hearing loss, infants and their families are referred to the local Early Start Program (Not DHCS) for access to early intervention and related services.
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Three Hearing Coordination Centers (HCC) have been established: Bay Area/Northern California HCC at John Muir Health in Pleasant Hill, Southern California HCC at Miller Children's Hospital in Long Beach and South-Eastern California HCC at Loma Linda University Medical Center in Loma Linda. Each HCC is responsible for serving the populations and facilities in specified geographic areas. The functions of the HCCs include:
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assisting hospitals to develop and implement their screening programs
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certifying hospitals to participate as screening sites
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monitoring programs of the participating hospitals
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assuring that infants with abnormal hearing screenings receive necessary follow-up including rescreening, diagnostic evaluation, treatment, and referral to early intervention service agencies, as appropriate
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providing information to families and providers so they can more effectively advocate with commercial health plans to access appropriate treatment
The Centers, a concept unique to California's NHSP, are a very critical program component. The Centers assure that the system operates efficiently; the screenings and services are of high quality; and, most importantly, babies failing the hearing screening test are not lost to follow-up. In states without coordinated tracking systems, up to 50 percent of the infants who fail the inpatient screen do not receive the necessary services to determine if a hearing loss is present. It is essential that infants who do not pass the screening tests receive prompt evaluation and intervention if appropriate. Otherwise, the benefit and purpose of early screening and identification is lost.
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The inpatient screening offered by the NHSP is performed by CCS-approved hospitals as authorized by Health and Safety Code Section 123975 and 124115 et seq. Other hospitals may offer screening programs, but at this time only CCS-approved hospitals are eligible for participation in the NHSP. Only participating hospitals are eligible for State reimbursement for hearing screening services provided to Medi-Cal eligible and uninsured infants.
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Yes, the parent or guardian can request screening through the baby's primary care provider (PCP), who can refer the family to one of the NHSP-certified outpatient screening providers. This should be done in the first months of life, since some of the screening equipment is calibrated specifically for infants less than six months of age.
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The State cannot dictate the fee that hospitals and outpatient providers charge for newborn hearing screening services. The NHSP approves hospitals and outpatient providers for participation as newborn hearing screening providers. These facilities are eligible for State-funded reimbursement for hearing screening provided to Medi-Cal eligible infants and those who are uninsured. The reimbursement rate is $30 for inpatient screening services and $30 for outpatient screening services.
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The current statute applies only to CCS-approved acute care hospitals that have licensed perinatal services or a CCS-approved neonatal intensive care unit (NICU).
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The infant should be referred for a complete medical evaluation with an otolaryngologist (an ear doctor) and a complete eye examination with an ophthalmologist (an eye doctor). At the same time the child should be receiving ongoing audiologic (hearing) care and should be referred to the Early Start Program (Not DHCS) where the family can be linked with support services and begin a program for language stimulation.
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Call our toll free number 1-877-388-5301 or 916-322-5794 for more information.
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