Legislature(2003 - 2004)

05/06/2003 03:11 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
HB 108-SCREENING NEWBORNS FOR HEARING ABILITY                                                                                 
Number 0402                                                                                                                     
CHAIR WILSON announced  that the next order of  business would be                                                               
HOUSE  BILL  NO.   108,  "An  Act  relating   to  establishing  a                                                               
screening,  tracking, and  intervention  program  related to  the                                                               
hearing ability  of newborns and infants;  providing an exemption                                                               
to  licensure as  an audiologist  for certain  persons performing                                                               
hearing  screening  tests;  relating to  insurance  coverage  for                                                               
newborn  and  infant  hearing screening;  and  providing  for  an                                                               
effective date."                                                                                                                
Number 0480                                                                                                                     
PAUL LABOLLE,  Staff to Representative Richard  Foster, presented                                                               
HB 108 on behalf of  Representative Foster, sponsor, and answered                                                               
questions  from the  committee.   He read  the following  sponsor                                                               
statement into the record:                                                                                                      
     With the  discovery that a  baby's brain  develops more                                                                    
     rapidly   than   previously   believed,   concern   for                                                                    
     identification of  infant-hearing defects  has achieved                                                                    
     a new prominence.                                                                                                          
     Over 30  states have  passed legislation  that provides                                                                    
     universal  newborn hearing  screening.   Several  other                                                                    
     states  screen  a   significant  portion  of  newborns.                                                                    
     Approximately  10,000 babies  are born  in Alaska  each                                                                    
     year.   Out  of that  number, thirty-to-forty  of these                                                                    
     newborns  are likely  to have  some type  of congenital                                                                    
     hearing loss.                                                                                                              
     Even  though many  hospitals  and  clinics, within  the                                                                    
     state,  screen  high-risk   or  premature  infants  for                                                                    
     hearing loss,  about 50% of newborns  with hearing loss                                                                    
     are not identified.                                                                                                        
     Most newborns with congenital hearing  loss who are not                                                                    
     identified  at birth  will not  be identified  until 18                                                                    
     months or  three years  of age.   By this  time certain                                                                    
     critical   periods    for   language    and   cognitive                                                                    
     development  have passed.   When  hearing  loss is  not                                                                    
     detected,  it  can result  in  lifelong  delays in  the                                                                    
     development of language, and other cognitive skills.                                                                       
     Since hearing loss is more  common that any other birth                                                                    
     defect  and  since  it  has  a  significant  impact  on                                                                    
     cognitive  development, infant  screening  should be  a                                                                    
     priority within the state.                                                                                                 
     This bill would insure  that newborns are screened, and                                                                    
     that a  reporting and  tracking system  is implemented.                                                                    
     The Department  of Health & Social  Services would have                                                                    
     the  responsibility  to  effectively  plan,  establish,                                                                    
     monitor, and  evaluate both the  screening availability                                                                    
     and tracking/reporting system.                                                                                             
REPRESENTATIVE SEATON asked where the funding for the program                                                                   
will come from.                                                                                                                 
Number 0610                                                                                                                     
REPRESENTATIVE  WOLF  said  the  fiscal note  shows  the  funding                                                               
sources in FY  04 for $46,000 comes from general  funds.  He said                                                               
he does  not see any  federal receipts in  this fiscal note.   He                                                               
said he  believes that the  state already has programs  like this                                                               
set up since  his children have all been tested.   When his first                                                               
son was  born prematurely,  the hospital  tested him  for hearing                                                               
Number 0626                                                                                                                     
CHAIR WILSON commented that in  Wrangell the hospital has quite a                                                               
lot  of  modern technology  available,  but  would not  have  the                                                               
equipment to  test for  hearing impairment for  infants.   In the                                                               
case of  Wrangell there are  only about 12  births per year.   It                                                               
seems  likely  that  the  hospital  would  have  to  contact  the                                                               
Ketchikan Hospital and request that  they send over the device to                                                               
do the testing.  She told the committee  it is not a test that is                                                               
done everywhere, especially in smaller communities.                                                                             
MR. LABOLLE  responded that  90 percent of  the hospitals  in the                                                               
state  already do  infant screening;  however, small  communities                                                               
without hospitals are  not covered.  This bill  would provide for                                                               
those births.   This bill  sets up  a tracking program  for those                                                               
children that are screened so that  the state can follow them and                                                               
assure they receive the necessary treatment.                                                                                    
CHAIR  WILSON commented  that the  first year's  funding is  only                                                               
MR. LABOLLE replied that the reason  for the small fiscal note is                                                               
that there  is currently a  federal grant.   That grant  will run                                                               
out in 2005 and  that is why there is a large  jump in the fiscal                                                               
CHAIR  WILSON asked  Mr. Labolle  if he  knows how  many children                                                               
would not be screened if this bill does not pass.                                                                               
MR. LABOLLE replied that Lisa  Owens, who is online, could better                                                               
respond to that questions.                                                                                                      
Number 0808                                                                                                                     
SARA   GAAR,  M.D.,   Project  Director,   Alaska  Dual   Sensory                                                               
Impairment Services and Special  Education Services, testified in                                                               
support of HB 108.  Dr. Gaar  told the committee the service is a                                                               
state  and   federally  funded   project  that   serves  children                                                               
throughout Alaska  from birth  to 22  years of  age who  are both                                                               
deaf  and  blind  or  dual-sensory impaired.    This  service  is                                                               
located  at the  Special Education  Service Agency  in Anchorage.                                                               
She told the committee she  strongly supports the newborn hearing                                                               
screening,  intervention,   and  tracking  program.     Permanent                                                               
hearing  loss occurs  three  times  in every  1,000  births.   In                                                               
Alaska that  is about 30  to 40 children  a year being  born with                                                               
permanent hearing loss.                                                                                                         
DR. GAAR  said although  the numbers sound  low, hearing  loss is                                                               
the most common  congenital disorder in the United States.   If a                                                               
child's hearing  loss is not  detected at birth, it  is typically                                                               
two to three  years before the child is identified,  as delays in                                                               
speech and  language acquisition become  apparent.  She  said the                                                               
most significant impact of hearing  loss is the delay in language                                                               
acquisition  and academic  achievement.   These negative  impacts                                                               
occur  with children  with mild  to moderate  loss of  hearing as                                                               
well as those with severe and profound range of hearing loss.                                                                   
DR. GAAR said  the average deaf child graduates  from high school                                                               
with a language and academic  achievement level of a fourth-grade                                                               
hearing  student.   The average  hard-of-hearing child  graduates                                                               
from high  school with reading  scores at the  fifth-grade level.                                                               
These are  really unacceptable academic achievement  levels, and,                                                               
sadly,  they have  not shown  any signs  of improvement  for more                                                               
than 30 years when the data was first collected.                                                                                
Number 0936                                                                                                                     
DR.  GAAR  pointed  out  that  these  delays  can  be  prevented.                                                               
Research  shows  that the  critical  variable  in preventing  low                                                               
achievement  is early  identification of  hearing loss  and early                                                               
intervention, which is  a critical factor.  That  is what newborn                                                               
screening can provide.   The most highly regarded  study and much                                                               
research supports the importance  of early identification between                                                               
zero and six months  of age.  After six months of  age there is a                                                               
significant  difference in  terms  of potential  for the  child's                                                               
language acquisition and academic performance later.                                                                            
DR. GAAR said the cost of  newborn screening is only about $25 to                                                               
$35  per child.    The cost  of not  screening  or identifying  a                                                               
child's  hearing  loss  early   and  subsequently  providing  the                                                               
appropriate  intervention  leaves  the   child  with  a  lifelong                                                               
language  disadvantage.     Without  early   identification,  the                                                               
chances  of  that  child  ever  catching  up  linguistically  and                                                               
academically  are significantly  reduced.   This is  such a  high                                                               
price to  pay for  a situation  that can  be prevented.   Newborn                                                               
screening can  identify those babies  at less than six  months of                                                               
age.  Waiting until  two to three years of age is  too late.  Dr.                                                               
Gaar urged the committee to pass HB 108.                                                                                        
Number 1025                                                                                                                     
PHILLIP  HOFSTEADER,  M.D.,  Audiologist,  North  Sound  Regional                                                               
Hospital, testified in  support of HB 108  and answered questions                                                               
from the members.  Dr.  Hofsteader commented that Dr. Gaar really                                                               
said much  of what  he wanted  to share with  the committee.   He                                                               
told the committee  that what Dr. Gaar said is  entirely true and                                                               
that there  is statistical data to  back that up.   The 3-out-of-                                                               
1,000-births  figure is  actually a  little low.   There  is data                                                               
that says  it is  actually 4 or  5 out of  1,000 births  that are                                                               
hearing  impaired.   This is  significant.   Language development                                                               
begins  in  the  first  two   years  of  life.    Not  targeting,                                                               
diagnosing,  or intervening  with that  hearing loss  will create                                                               
delays.   The  cost-effectiveness  of the  program  is much  more                                                               
successful  if there  is early  intervention at  birth.   Doctors                                                               
Vickie  Thompson and  Albert Mehl  did a  study in  Colorado that                                                               
confirmed  this fact.   The  program itself  is not  only morally                                                               
significant, but cost-effective.                                                                                                
Number 1109                                                                                                                     
REPRESENTATIVE WOLF  commented that  the previous  testifier [Dr.                                                               
Gaar] said the  cost of screening is  $25 to $30 per  child.  The                                                               
fiscal note  shows about  780 children statewide  who need  to be                                                               
screened.   He said  he understands  the importance  of screening                                                               
because he has a son who  is a special-needs child who is hearing                                                               
impaired and his son does have a speech problem.                                                                                
REPRESENTATIVE WOLF said  he doesn't believe $25 is  too much for                                                               
a family  to have pay  to have  their newborn child  screened for                                                               
hearing loss.   It is  the cost  of having a  pizza.  He  said he                                                               
would  invest that  in his  child  even if  he did  not have  the                                                               
money.   If it  was necessary  he said  he would  sell a  pint of                                                               
blood.   He  also pointed  out that  there are  so many  programs                                                               
nationwide that  address these problems.   For instance  March of                                                               
Dimes offers assistance.  He said  he is concerned about having a                                                               
fiscal note  on this  bill when  the state  of Alaska  has fiscal                                                               
problems.     He  asked   when  parents   are  going   to  assume                                                               
responsibilities for their children.                                                                                            
Number 1228                                                                                                                     
MR. LABOLLE responded that one  provision of the bill, Section 5,                                                               
page  3, lines  9-23, mandates  insurance coverage  that must  be                                                               
provided.   Under  mandatory insurance  minimums provided  within                                                               
the  bill, the  first screening  for newborn  infant for  hearing                                                               
loss  must be  covered by  the insurance  company and  subsequent                                                               
hearing tests  that are necessary  would also have to  be covered                                                               
by insurance.   He  told the committee  his understanding  of the                                                               
fiscal note is that the  primary cost involved deals with setting                                                               
up the tracking system and  administering the program itself, and                                                               
not so much the expense of testing.                                                                                             
CHAIR  WILSON said  this committee  will be  looking at  the bill                                                               
with respect to the policy issue.   She wants members to focus on                                                               
whether the state should implement such  a program.  She said her                                                               
intent,  if the  members wish,  is to  the pass  the bill  out of                                                               
committee and send  it to the House Finance  Committee, where the                                                               
fiscal issues will be addressed.                                                                                                
Number 1296                                                                                                                     
REPRESENTATIVE  SEATON asked  if  the state  tracks children  for                                                               
anything else.                                                                                                                  
MR. LABOLLE  responded that  he knows  there are  other mandatory                                                               
testing policies, but isn't sure if the state tracks them.                                                                      
Number 1314                                                                                                                     
REPRESENTATIVE SEATON  said he is  a little concerned  about this                                                               
tracking program and isn't sure  what that entails.  Unless there                                                               
is a communicable  disease, he said, he is fairly  sure the state                                                               
does not  track children.   Representative Seaton asked  if every                                                               
newborn child is screened and  tracked, whether or not he/she has                                                               
tested positively  for a hearing impairment  or not.  He  said if                                                               
that is the case, he is not comfortable with that.                                                                              
Number 1380                                                                                                                     
STEPHANIE  BIRCH, Children  Health Unit  Manager, Maternal  Child                                                               
and Family Health Section, Division  of Public Health, Department                                                               
of Health  and Social  Services, testified in  support of  HB 108                                                               
and answered  questions from the  members.   She said two  of the                                                               
programs  in  her  section  are  the  newborn  hearing  screening                                                               
program  and  the  metabolic  screening  program.    There  is  a                                                               
mandated metabolic  screening and  tracking program  for newborns                                                               
with  metabolic  disorders.     Children  are  screened  for  six                                                               
metabolic disorders,  and the division monitors  and tracks those                                                               
kids for  follow-up, as well as  for a diagnosis for  the rest of                                                               
their  lives.   It  is important  to make  sure  kids with  these                                                               
problems receive  medical treatment and  have medical homes.   It                                                               
is also important  to know the rates at which  these occur in the                                                               
population.   As a  result of having  that information  the state                                                               
and medical providers benefit.                                                                                                  
MS. BIRCH,  in response  to the question  about the  fiscal note,                                                               
said  part  of those  funds  are  for  the tracking  program  and                                                               
intervention services.  The children  who are identified would be                                                               
put into an early intervention  program that provides specialized                                                               
resources for  hearing loss.   The number of  children identified                                                               
in the zero-to-three age grouping has  increased.  There may be a                                                               
need for  additional resources.   The cost  of these  services is                                                               
fixed in most  communities, but it tends to be  more expensive in                                                               
the  Bush communities.   Hospitals  have accepted  the costs  and                                                               
have  rolled  them into  maternity  packages,  which include  the                                                               
screening  portion for  newborns.   So  the $25  to  $30 cost  is                                                               
already taken  care of either through  insurance reimbursement or                                                               
through rolling the cost into the maternity charges.                                                                            
Number 1522                                                                                                                     
REPRESENTATIVE  SEATON commented  that  while  there is  tracking                                                               
taking place  already for children  with metabolic  problems, the                                                               
way he  reads this bill it  appears all children will  be tracked                                                               
whether they have hearing impairment or not.                                                                                    
MS. BIRCH responded that the  newborn metabolic screening program                                                               
tracks all children;  however, there is a  more detailed tracking                                                               
of children  identified with metabolic  disorders.   This program                                                               
would have screening on record for  all children.  There may be a                                                               
large number  of children who  will fall into  high-risk category                                                               
and may not be identified at  birth.  A child can develop hearing                                                               
loss in  the first  three years  of life  because of  exposure to                                                               
illnesses while they  were in utero, or  because medications they                                                               
may have received  puts them at risk of  developing hearing loss.                                                               
The  tracking program  would track  those children  through their                                                               
third birthday.                                                                                                                 
Number 1590                                                                                                                     
MR.  LABOLLE   responded  to  Representative   Seaton's  question                                                               
concerning tracking of all children.   He told the committee that                                                               
only the  initial screening  is tracked  for those  found without                                                               
hearing loss.   If, however, the newborn does not  fall into that                                                               
category,  then  they will  not  be  subject to  confirmatory  or                                                               
follow-up testing.   Only the  initial hearing screening  will be                                                               
sent to the department.                                                                                                         
REPRESENTATIVE SEATON  commented that  as he  reads the  bill, it                                                               
appears all newborns are tracked,  whether they are shown to have                                                               
hearing loss or not.  He asked  Mr. Labolle if he would point out                                                               
the  section in  the  bill  where it  clarifies  that only  those                                                               
newborns with hearing loss will be tracked.                                                                                     
MR.  LABOLLE  responded  that  every  child  screened  will  have                                                               
his/her  screening reported  to  the  department; however,  those                                                               
passing  the screening  without any  signs of  hearing disability                                                               
will  not have  subsequent screening.   Only  those children  who                                                               
require subsequent screening are tracked by the department.                                                                     
Number 1667                                                                                                                     
CHAIR  WILSON referred  to page  5, lines  17-22, where  it talks                                                               
about  the tracking  and prevention  program.   It says  "initial                                                               
hearing  screening,   follow-up  components,  and  the   use  and                                                               
availability of the  system of services for  newborns and infants                                                               
who are deaf  and hard of hearing and their  families."  She said                                                               
her interpretation  of this language indicates  that the tracking                                                               
and intervention will  be on the infants who are  deaf or hard of                                                               
hearing and their families.                                                                                                     
MS. BIRCH,  in response to Representative  Seaton, clarified that                                                               
all newborns  would be  screened, and  those screenings  would be                                                               
reported  to the  department.   The only  children that  would be                                                               
followed up  through their third  birthday are children  who fall                                                               
into a high-risk  category or have questionable  signs of hearing                                                               
loss.   There is a list  of criteria that the  department uses to                                                               
determine  which children  need to  be followed.   Currently  the                                                               
department is tracking about 300 children per year.                                                                             
Number 1773                                                                                                                     
LISA OWENS,  Director, Speech Therapist, and  Audiologist, Alaska                                                               
Speech and Hearing  Clinic, testified in support of HB  108.  She                                                               
told  the committee  she supports  the  bill because  there is  a                                                               
significant difference  in language development  between children                                                               
who  are  identified early  and  receive  early intervention  and                                                               
those  that do  not.    She clarified  that  when  she refers  to                                                               
children who are  identified early, she is  referring to children                                                               
who are identified  before six months of age.   Much research has                                                               
been  done on  brain  development and  studies  are showing  that                                                               
critical brain connections  are made in the first  three years of                                                               
life.   This also includes  the hearing  sense.  If  children are                                                               
deprived of  hearing sound for  the first  few years of  life, it                                                               
doesn't allow  their brains to make  these important connections.                                                               
These  children may  have  lifelong  problems including  auditory                                                               
processing,  language  development,   academic  achievement,  and                                                               
social interaction with peers.   Ms. Owens asked the committee to                                                               
listen to families who are willing  to share their stories.  If a                                                               
child is not  identified as hearing impaired by two  years of age                                                               
there are  significant gaps that may  never be closed.   She said                                                               
it would be a  shame to have even one child  not be identified at                                                               
birth.   The  state has  quality services  available.   There are                                                               
three to  four newborns in  every 1,000 who are  hearing impaired                                                               
which makes it the most common  condition for newborns.  She said                                                               
she knows that  Alaska faces some tough financial  times, but the                                                               
cost of educating these kids  will be significant if not detected                                                               
Number 1951                                                                                                                     
MARTIN   BEALS,   M.D.,   Pediatrician,   American   Academy   of                                                               
Pediatricians,  testified  in support  of  HB  108, and  answered                                                               
questions from  the members.   Dr. Beals told the  committee that                                                               
the  American   Academy  of  Pediatrics  has   recommended  early                                                               
screening  program  with  follow-up  as this  bill  suggests  for                                                               
several  years  now.   The  academy  prefers universal  screening                                                               
versus the high-risk screening which  was mentioned by one of the                                                               
representatives  [Representative  Wolf]  who  said  his  son  was                                                               
screened  because of  his  premature  birth.   He  said that  the                                                               
medical community has been doing  high risk screening on children                                                               
for  over  20 years.    However,  half  of the  hearing  impaired                                                               
children were being missed by  only screening high-risk children.                                                               
This program is  an attempt to screen all children  because it is                                                               
difficult to know  who is high risk until the  screening is done.                                                               
Once  the infants  are  screened,  it is  important  to get  them                                                               
properly diagnosed if they have  a hearing impairment so they can                                                               
go on  and get some  of the benefits  that Dr. Gaar  talked about                                                               
earlier.  If this bill is  passed, a mandate from the state would                                                               
allow  the medical  community to  equalize some  of the  services                                                               
throughout  the  state.    Most  pediatricians  are  behind  this                                                               
program and  it has  been done  for years  in Anchorage.   Almost                                                               
every  birthing  hospital  will  have the  capacity  to  do  this                                                               
program, but  without some statewide  coordination there  will be                                                               
big peaks  and valleys in what  kind of follow-up is  going to be                                                               
done.   Early  diagnosis leads  to the  intervention that  allows                                                               
these children to be more advanced  in their abilities to take on                                                               
speech language communication.   Dr. Beals told  the committee he                                                               
is  very concerned  about the  Health  Insurance Portability  and                                                               
Accountability  Act   (HIPAA)  regulations   and  confidentiality                                                               
concerns that  come up whenever  there is information  sharing in                                                               
situations where there  is no support by a  legislative body that                                                               
says  this is  an important  thing to  follow-up on.   A  mandate                                                               
would allow doctors to communicate  better with professionals and                                                               
hospitals to allow the information to  get to the people who need                                                               
it, basically, the families.                                                                                                    
Number 2063                                                                                                                     
CHAIR WILSON commented that this  screening would probably save a                                                               
lot of money, too.                                                                                                              
DR. BEALS said he believes so,  but no insurance company will see                                                               
this as a  money-saving device, in itself.  However,  there is no                                                               
question  that individual  families will  see benefits,  not just                                                               
monetarily, but emotionally, socially and other ways, as well.                                                                  
LISA  SIMON,  Quota  International of  Fairbanks,  testified  via                                                               
teleconference  in support  of HB  108.   She told  the committee                                                               
that Quota  International of Fairbanks is  a service organization                                                               
whose main  focus is teaching hearing  impaired and disadvantaged                                                               
women and  children.  Ms. Simon  said she supports this  bill and                                                               
would like to see it passed out of committee.                                                                                   
Number 2101                                                                                                                     
SUSAN  WALKER testified  in  support of  HB 108.    She told  the                                                               
committee that she is  a parent of a deaf child.   He just turned                                                               
four  years old  and  was born  in  Anchorage.   He  is a  happy,                                                               
healthy child and  was diagnosed with a profound  hearing loss at                                                               
six months  of age.  The  reason that her son's  hearing loss was                                                               
diagnosed  so early  is that  he  has a  twin sister  and it  was                                                               
apparent that  he had issues  with sound and was  developing very                                                               
differently than his sister.  She  told the committee he is doing                                                               
very well.   He speaks  and his language  is on or  above average                                                               
for the  hearing impaired due to  the fact that his  hearing loss                                                               
was  caught at  such an  early  age.   She said  that she  really                                                               
supports  HB 108  because as  a  parent she  knows an  individual                                                               
cannot tell if a  child is deaf.  If they  are healthy and happy,                                                               
and are  always on the move,  they look like they  are responding                                                               
normally  and it  is so  difficult to  say that  the child  has a                                                               
hearing loss.   For the most part it is  invisible; a parent will                                                               
not see it.   A pediatrician will not see  it, either, because it                                                               
is not  something detectable by  doing a ear  check.  It  is very                                                               
important that children are screened at birth.                                                                                  
Number 2157                                                                                                                     
MS. WALKER  told the  committee her son  is doing  well attending                                                               
school in  the Anchorage School  District.   He is an  oral child                                                               
and  if someone  sat down  with books  with him,  they would  not                                                               
realize he has a hearing loss.                                                                                                  
Number 2185                                                                                                                     
MARY   GRISCO,   Executive   Director,   All   Alaska   Pediatric                                                               
Partnership, testified  via teleconference in support  of HB 108.                                                               
She told  the committee  the partners  include the  Alaska Native                                                               
Medical Center,  the Alaska Native Regional  Hospital, Providence                                                               
Alaska  Medical Center,  Fairbanks  Memorial  Hospital, State  of                                                               
Alaska,  Valley  Hospital,  and Elmendorf  Medical  Group.    The                                                               
organization  has  been interested  in  supporting  this kind  of                                                               
legislation for several years.  As  the members may know, many of                                                               
the hospitals  doing the screening  have been  frustrated because                                                               
there  is  no  way  of   tracking  or  following  up  on  infants                                                               
identified with  hearing loss.   She pointed  out that  the costs                                                               
that are avoided  later are the educational costs  down the road.                                                               
Most school  districts in  the state  can provide  information on                                                               
what it  costs to provide services  to a child with  hearing loss                                                               
that has  not been identified  until they enter  school, compared                                                               
to a child  like Ms. Walker's who was identified  at an early age                                                               
and can  be in the  regular classroom with no  classroom support.                                                               
She urge the committee to pass this legislation.                                                                                
Number 2244                                                                                                                     
MARIE   LAVIGNE,  Executive   Director,   Alaska  Public   Health                                                               
Association, testified  via teleconference in support  of HB 108.                                                               
She  told   the  committee  the  association   is  interested  in                                                               
developing  sound  health  policies   to  benefit  all  Alaskans.                                                               
Recognizing  the   importance  of  universal  screening   of  all                                                               
newborns is  a critical public  health intervention.   The Alaska                                                               
Public Health Association encourages  the committee to support HB
108.   Ms.  Lavigne  highlighted public  health strategies  which                                                               
included the  cost savings of  early intervention, and  urged the                                                               
committee  not to  stop with  the screening  itself because  what                                                               
happens  after the  screening  is important.    Families need  to                                                               
receive  appropriate information  and services  following hearing                                                               
screening and  have their  children begin  receiving intervention                                                               
at five  to six months  of age.  It  is also critical  to develop                                                               
teams that  work with the  child to  measure the impact  of early                                                               
identification of hearing  loss, track the gains  made, and areas                                                               
that need development.                                                                                                          
Number 2300                                                                                                                     
MS. LAVIGNE quoted Dr. Marion  Downs, a world-renowned pioneer in                                                               
pediatric audiology, as saying the following:                                                                                   
     If  a child  can  be identified  at  birth and  receive                                                                    
     immediate intervention, then we have  done our job.  On                                                                    
     the other  hand, if we  do not detect the  hearing loss                                                                    
     until  the child  reaches two  years of  age or  later,                                                                    
     that child  in most cases  has lost the  opportunity to                                                                    
     catch up  with others of  her own  age.  Why,  with all                                                                    
     the  tools we  have, would  we  not seize  the time  to                                                                    
     establish   a    model   for   screening    and   early                                                                    
MS. LAVIGNE  said those are  the challenges before  the committee                                                               
today.   HB  108 takes  an  important step  in universal  hearing                                                               
screening which would  build on the success of the  60 percent of                                                               
Alaska's  hospitals   and  birthing  centers  that   are  already                                                               
screening newborns.   To  assure that  all newborns  are screened                                                               
and that  a tracking  system is setup  will assure  that Alaska's                                                               
children who are deaf or  hearing impaired will receive the early                                                               
intervention services they need to fulfill their potential.                                                                     
Number 2333                                                                                                                     
REPRESENTATIVE WOLF moved to report  HB 108 out of committee with                                                               
individual  recommendations and  the  accompanying fiscal  notes.                                                               
There  being no  objection, HB  108 was  reported from  the House                                                               
Health, Education and Social Services Standing Committee.                                                                       

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