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Indiana’s Universal Newborn Hearing Screening Program. Weilin Long, M.A., M.P.A. Indiana State Department of Health Newborn Screening Section. Some of the Key Players Who Are With Me Today:. Charlene Graves , M.D., Medical Director of Indiana State Newborn Screening Programs
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Indiana’s Universal Newborn Hearing Screening Program Weilin Long, M.A., M.P.A. Indiana State Department of Health Newborn Screening Section
Some of the Key Players Who Are With Me Today: Charlene Graves, M.D., Medical Director of Indiana State Newborn Screening Programs Cindy Lawrence, M.A.T., Assistant Director of Indiana School for the Deaf Outreach Program Jane Metzger, M.Aud., Regional Consultant Molly Pope, M.A.T., Regional Consultant Coordinator Michelle Wagner-Escobar, M.A., Regional Consultant
History • Professional sensibility/concerns • Parent/consumer advocacy • IPN’s subcommittee - 1998 • Public Law 91-1999 • Advisory Committee appointed by the Governor – 1999-2000 • Program preparation and full implementation – hospital screening - 2000
History • Less than 20 hospitals with UNHS program in 1994 • 46 with UNHS in 1996 • 99 with UNHS in 2000 (94%) • 102 with UNHS in 2001 (100%) • 105 with UNHS in 2002 (100%) Including 2 midwife facilities
5/1999 UNHS Law • Legislatively mandated program “… every infant shall be given a physiologic hearing screening examination at the earliest feasible time for the detection of hearing impairments” IC 16-41-17-2
Program Goals • Physically screen all infants in Indiana prior to discharge from hospital; • Perform diagnostic evaluation by three months of age; and • Enroll in early intervention by six months of age
Identify Key Players • ISDH • First Steps • Hospitals • Primary care physicians • Specialists/audiologists • Public health nurses • Parents/families
Technology • Promote communication • Encourage collaboration • Adopt NBS follow-up models • Outreach to local communities • Learn from other states • Develop tracking and follow-up data system
8/2001 Regional Outreach Program • Transit the program from hospital-centered screening program (1st year) to community-based, culturally sensitive program . MCHB funded First Transition
Regional Outreach Program • Involve community/family • Ensure technical assistance available to local communities • Promote timely diagnostic evaluation and early intervention • Refine Indiana’s UNHS through outreach activities
3/2002 Centralized Follow-up System • Full-time nurse consultant position • Follow-up with hospital, PCP, PHN, parent . Not screening . Screening not completed . Unauthorized refusal . Lost of follow-ups . Transferred without screening Ronnie Reuveny Second Transition
Current Status (January – December 2002) • 100% hospitals/birthing institutions participated and reported • 98% infants were screened • 9.7% did not pass initial screenings • 97.5% of those who did not pass initial screening received repeat screening • 1.4% (1131) did not pass repeat screening • 1709 referrals were made for not passed screenings - 967 to First Steps; 551 to PCPs; and 191 to specialists • 422 referrals were made due to high risk factors – 422 to First Steps, 203 to PCP, and 73 to specialists
Current Status (January – December 2002) • Out of 967 babies who did not pass hearing screening and were referred to First Steps, 922 have received follow-up services
?…?…?…? • What happened to those who did not pass hearing screening before they left the hospital? • Did they receive adequate information about early intervention services? • Were they informed of audiologic resource available in their area? • What happened to those who chose not to use First Step early intervention services? Third Transition
10/2002 Another Transition … • Formed a Parent Focus Group - Develop a Parent Satisfaction Survey _ Evaluate program and identify needs and gaps • Surveyed 320 licensed audiologists in Indiana - Identify audiologists available in Indiana - Outreach, educate and implement audiologic assessment evaluation and report system
1/2003 Audiologic Evaluation and Report System • Guidelines • Report forms and instructions • System by regions • Tracking and follow-ups
Audiologic Evaluation and Report System • Encourage audiologists to provide information to the ISDH UNHS - history - degree and type of hearing loss - referral information Help to identify those who chose not to use First Steps early intervention services
10/2002 - Ensure Funding • Increase state NBS fee to include budget for UNHS • Rule change is in process
Next Transition… • Medical homes • Early intervention to accessible schools
For More Information… • Please visit our display booth THANK YOU!