Know the Benefits

The California Newborn Hearing Screening program, a component of the 1998-99 Early Childhood Development Initiative, establishes a comprehensive coordinated system (See NHSP Flow Chart) of early identification and provision of appropriate services for infants with hearing loss by:

Offering the parents of approximately 400,000 infants the opportunity to have their newborn babies screened for hearing loss at the time of the hospitalization for birth.

Tracking and monitoring of up to 25,000 infants to assure that appropriate follow-up testing and diagnostic evaluations are completed.
Providing access to medical treatment and other appropriate educational and support services
Providing coordinated care through collaboration with those agencies delivering early intervention services to infants and their families.

The incidence of permanent significant hearing loss is approximately 2-4 per every 1000 infants. It is the most common congenital condition for which there is a screening program. It is estimated that the Newborn Hearing Screening Program will identify 1200 infants with hearing loss each year.

The major focus of the program is to assure that every infant, who does not pass a hearing test, is linked quickly and efficiently with the appropriate diagnostic and treatment services and with the other intervention services needed for the best possible outcome. Recent research shows infants with hearing loss, who have appropriate diagnosis, treatment and early intervention services initiated before six months of age, are likely to develop normal language and communication skills.

The California Newborn Hearing Screening Program has two major components:

1. Screening

2. Geographically Based Hearing Coordination Centers

1. Screening

All California Children's Services (CCS) approved hospitals will offer hearing screenings to all newborns born in their hospitals and will perform hearing screenings on all infants receiving care in a CCS approved neonatal intensive care unit (NICU) prior to the infant's discharge. The Department of Health Care Services will assure the quality of the screening tests by certifying that the hospital's hearing screening program meets CCS standards. This certification will allow the hospitals to be reimbursed by the State for Medi-Cal eligible infants. The process will be phased in so that the nearly 200 CCS approved hospitals will have certified programs by December 2002.

When fully implemented, this program will serve approximately 400,000 infants, over 70 percent of the total births in California. Funding is available to separately reimburse hospitals for the testing of infants whose care is paid for by the Medi-Cal program. This will provide payment for about 50 percent of the infants tested.

Hospitals to be certified must demonstrate that an internal system is present that:
uses appropriately trained and supervised individuals to perform the tests
uses appropriate equipment
has a commitment to staff physician education
has a commitment to family/parent education
has policies and procedures in place to assure the forwarding of test results and referral of infant with abnormal test results

2. Geographically Based Hearing Coordination Centers

The Centers, a concept unique to California's newborn hearing screening program, are a very critical component. The Centers will 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% 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.

Each Center will be responsible for a specified geographic area. The functions of the Centers include:
assisting hospitals to develop and implement their screening programs,
certifying hospitals to participate as screening sites
monitoring programs of the participating hospitals
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 providing information to families and providers so they can more effectively advocate with commercial health plans to access appropriate treatment.