SB 451

2026 Regular Session  ENROLLED
  ACT No. 517
 SENATE BILL NO. 451
 BY SENATOR KLEINPETER AND REPRESENTATIVE CHASSION
1AN ACT
2 To amend and reenact the heading of Chapter 30-A of Title 46 of the Louisiana Revised
3Statutes of 1950 and R.S. 46:2261, 2262, the introductory paragraph of 2262.1,
42262.1(4) and (12), and 2263 through 2267, relative to newborn hearing screening;
5to update terminology and definitions; to provide for the purpose of early hearing
6detection and intervention; to provide for the membership, terms, and reimbursement
7for the advisory council; to provide for powers and duties of the advisory council;
8to update rulemaking authority; and to provide for related matters.
9 Be it enacted by the Legislature of Louisiana:
10Section 1. The heading of Chapter 30-A of Title 46 of the Louisiana Revised Statutes
11 of 1950 and R.S. 46:2261, 2262, the introductory paragraph of 2262.1, 2262.1(4) and (12),
12 and 2263 through 2267 are hereby amended and reenacted to read as follows:
13CHAPTER 30-A. IDENTIFICATION OF EARLY HEARING
14LOSS IN INFANTS LAW DETECTION AND INTERVENTION
15§2261. Short title
16This Chapter may be cited as the "Identification of Hearing Loss in Infants
17Law" "Newborn Hearing Screening Law".
18§2262. Purpose
19A. The purpose of the program for early identification of hearing loss is to
20identify deaf or hard of hearing infants at the earliest possible time so that medical
21treatment, early audiological evaluation, selection of amplification, and early
22educational intervention can be provided. hearing detection and intervention is to
23support the early identification of infants who are d/Deaf, hard of hearing, or
24present a risk factor for developing hearing loss through screening and
25audiological evaluation and to ensure that parents and guardians of such infants
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1are provided an opportunity for referral to early intervention and family
2support services. Early detection and intervention ensures the language and
3communication needs of children who are d/Deaf or hard of hearing are
4addressed as early as possible.
5B. Early hearing detection, educational intervention, and coordinated
6systems of care early audiological services are required under Section 399M of the
7Public Health Service Act, 42 U.S.C. 280g-1, as amended by the Early Hearing
8Detection and Intervention (EHDI) Act of 2010, EHDI Act of 2017, Public Law
9115-71, EHDI Act of 2022, Public Law 117-241, and the Education of the
10Handicapped Act, Amendments of 1986, Public Law 99-457.
11C. Early identification and management of the deaf coordinated support for
12infants who are d/Deaf or hard of hearing infant are essential if that infant is to
13acquire the vital language and speech skills needed to achieve maximum potential
14educationally, emotionally, and socially. are critical for maximizing opportunities
15for communicative and linguistic competencies and providing access to literacy,
16education, and social-emotional development.
17D. Appropriate Newborn hearing screening and early identification of
18newborns and infants with hearing loss who are d/Deaf or hard of hearing and
19subsequent opportunities for referral to early intervention and family support
20services will therefore serve the public purpose of promoting the healthy
21development of children and reducing public expenditures for health care, special
22education, and related services.
23§2262.1. Bill of Rights
24In order to ensure that children who are deaf d/Deaf or hard of hearing have
25the same rights and potential to become independent and self-actualizing as children
26who are not deaf d/Deaf or hard of hearing, the Deaf d/Deaf and Hard of Hearing
27Child's Bill of Rights is established so that children who are deaf d/Deaf or hard of
28hearing are entitled:
29*       *      *
30(4) To adult role models who are deaf d/Deaf or hard of hearing.
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1*       *       *
2(12) Where appropriate, to have deaf d/Deaf and hard of hearing adults
3directly involved in determining the extent, content, and purpose of all programs that
4affect their education.
5§2263. Definitions
6Except where the context clearly indicates otherwise, in this Chapter:
7(1) "Advisory council" means the advisory council created pursuant to R.S.
846:2265.
9(2) "Congenital deafness" means the presence of deafness at birth.
10(3) "Deaf" means a hearing level identified as severe to profound, with
11some or complete absence of auditory sensitivity, and is most often represented
12with a lowercase letter "d". The term "Deaf", when written or expressed with
13an uppercase letter "D", specifically refers to a group of deaf individuals who
14identify as a cultural and linguistic minority with specific languages, namely
15visual or tactile methods of communication, and social mores.
16(4) "Department" means the Louisiana Department of Health.
17(5) "Early intervention" means appropriate services for a child who is
18d/Deaf or hard of hearing, in accordance with the EHDI Act of 2017, including
19nonmedical services and ensuring that the family of the child is:
20(a) Provided comprehensive, consumer-oriented information about the
21full range of family support, training, information services, and language
22acquisition in oral and visual modalities.
23(b) Given the opportunity to consider and obtain the full range of such
24appropriate services, educational and program placements, and other options
25for the child from highly qualified providers.
26(6) "Hard of hearing" means a hearing level identified as ranging from
27mild to severe, with some absence of auditory sensitivity.
28(7) "Hearing screening" means utilizing hearing screening technology
29to identify infants in need of additional audiological testing to determine
30hearing status. Procedures may include auditory brainstem response (ABR)
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1screening, otoacoustic emissions (OAE) screening, and other devices approved
2by the office upon recommendation of the advisory council.
3(3)(8) "Deaf Infant who is d/Deaf or hard of hearing infant" means an infant
4who has a disorder of the auditory system of any type or degree, causing hearing loss
5sufficient to interfere with the development of language and speech skills. is d/Deaf
6or hard of hearing from a congenital or acquired nature, unilateral or bilateral,
7of any degree from minimal to profound, and of any type, including a
8conductive, sensory, sensorineural, auditory neuropathy dyssynchrony, or
9mixed hearing condition.
10(4)(9) "Infants susceptible to a hearing disability with risk factors" means
11those infants who are susceptible to hearing loss because they have one or more risk
12factors for developing delayed onset or progressive permanent childhood
13hearing loss.
14(10) "Joint Committee on Infant Hearing" or "JCIH" means a national
15group of representatives that work to address issues that are important to the
16early identification, intervention, and follow-up care of infants who are d/Deaf
17or hard of hearing.
18(11) "Language" means a system of conventional spoken, signed, or
19written means by which human beings, as members of a social group and
20participants in its culture, express themselves. The functions of language in this
21context include communication, identity, connection, cognition, and advocacy.
22(12) "Language systems" means a system of communication approaches
23including but not limited to American Sign Language, spoken English, Pidgin
24Signed English, Manually Coded English, bimodal bilingualism, total
25communication, and cued speech.
26(5)(13) "Office" means the office of public health within the department
27Louisiana Department of Health.
28(6)(14) "Program" means the program that the office of public health
29establishes to provide for the early identification and follow-up of infants susceptible
30to a hearing disability, of deaf or hard of hearing infants, and of infants who have a
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1risk factor for developing progressive hearing loss. support the early detection of
2infants who are d/Deaf or hard of hearing through newborn hearing screening,
3outpatient follow-up screening, audiological evaluation, and referral to and
4enrollment in early intervention and family support services.
5(15) "Refer" means the result of newborn hearing screening that
6indicates further testing is needed.
7(7)(16)(a) "Risk factors" means those criteria or factors, any one of which
8identifies an infant as being susceptible to as classified by JCIH which may result
9in early, progressive, or delayed onset permanent childhood hearing loss.
10(b) The risk factors that identify those neonates, infants from birth through
11the first twenty-eight days, who are susceptible to sensorineural hearing loss
12Perinatal risk factors, as classified by JCIH guidelines include the following:
13(i) Family history of congenital or delayed onset childhood sensorineural
14impairment early, progressive, or delayed onset permanent childhood hearing
15loss.
16(ii) Congenital infection known or suspected to be associated with
17sensorineural hearing loss such as toxoplasmosis, syphilis, rubella, cytomegalovirus,
18and herpes Neonatal intensive care of more than five days.
19(iii) Craniofacial anomalies including morphologic abnormalities of the pinna
20and ear canal, absent philtrum, low hairline, et cetera Hyperbilirubinemia with
21exchange transfusion regardless of length of stay.
22(iv) Birth weight less than one thousand five hundred grams or less than three
23and three tenths pounds Aminoglycoside administration for more than five days.
24(v) Hyperbilirubinemia at a level exceeding indication for exchange
25transfusion Asphyxia or hypoxic ischemic encephalopathy.
26(vi) Ototoxic medications, including but not limited to the aminoglycosides
27used for more than five days, such as gentamicin, tobramycin, kanamycin,
28streptomycin, and loop diuretics used in combination with aminoglycosides
29Extracorporeal membrane oxygenation (ECMO).
30(vii) Bacterial meningitis In utero infections, such as herpes, rubella,
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1syphilis, toxoplasmosis, Zika, and cytomegalovirus (CMV).
2(viii) Severe depression at birth, which may include infants with Apgar scores
3of zero to three at five minutes or those who fail to initiate spontaneous respiration
4by ten minutes or those with hypotonia persisting to two hours of age Certain birth
5conditions or findings such as craniofacial malformations including microtia,
6atresia, ear dysplasia, oral facial clefting, white forelock, microphthalmia,
7congenital microcephaly, congenital or acquired hydrocephalus, and temporal
8bone abnormalities.
9(ix) Prolonged mechanical ventilation for a duration equal to or greater than
10ten days, such as persistent pulmonary hypertension.
11(x)(ix) Stigmata or other findings associated with a syndrome known to
12include sensorineural hearing loss, such as Waardenburg or Usher Syndrome.
13(xi)(x) Other risk factors added or deleted by the office of public health upon
14recommendation of the advisory council for early identification of deaf d/Deaf or
15hard of hearing children.
16(c) The factors that identify those infants aged twenty-nine days to two years
17who are susceptible to sensorineural hearing loss Perinatal or postnatal risk
18factors, as classified by JCIH include the following:
19(i) Parent or caregiver concerns regarding hearing, speech, language, or
20developmental delay. Culture-positive infections associated with sensorineural
21hearing loss including confirmed bacterial and viral meningitis or encephalitis,
22especially herpes viruses and varicella.
23(ii) Bacterial meningitis. Events associated with hearing loss such as
24significant head trauma, basal skull or temporal bone fractures, or
25chemotherapy.
26(iii) Neonatal risk factors that may be associated with progressive
27sensorineural hearing loss, such as cytomegalovirus, prolonged mechanical
28ventilation, and inherited disorders. Caregiver concern regarding hearing, speech,
29language, developmental delay, or developmental regression.
30(iv) Head trauma, especially with either longitudinal or transverse fracture
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1of the temporal bone.
2(v) Stigmata or other findings associated with syndromes known to include
3sensorineural hearing loss, such as Waardenburg or Usher Syndrome.
4(vi) Ototoxic medications, including but not limited to the aminoglycosides
5used for more than five days, such as gentamicin, tobramycin, kanamycin,
6streptomycin, and loop diuretics used in combination with aminoglycosides.
7(vii) Neurodegenerative disorders such as neurofibromatosis, myoclonic
8epilepsy, Werdnig-Hoffman disease, Tay-Sachs disease, infantile Gaucher's disease,
9Niemann-Pick disease, any metachromatic leukodystrophy, or any infantile
10demyelinating neuropathy.
11(viii) Childhood infectious diseases known to be associated with
12sensorineural hearing loss, such as mumps or measles.
13(ix)(iv) Other risk factors added or deleted by the office of public health upon
14recommendation of the advisory council for early identification of deaf or hard of
15hearing children created in R.S. 46:2265.
16(8) "Screening for hearing loss" means employing a device for identifying
17whether an infant has a disorder of the auditory system, but may not necessarily
18provide a comprehensive determination of hearing thresholds in the speech range.
19Procedures may include auditory brainstem response (ABR) screening, evoked
20otoacoustic emissions (EOAE) screening, and other devices approved by the office
21upon recommendation of the advisory council.
22(17) "Sign language" means a visual-spatial communication system
23consisting of manual gestures, facial expressions, and body language. Sign
24language uses vision to receptively understand communication and movement
25to expressively communicate.
26(18) "Spoken language" means an audible-verbal communication system
27consisting of sounds. Spoken language uses audition to receptively understand
28communication and voice to expressively communicate.
29(19) "Young adult" means an individual between eighteen to twenty-six
30years of age as defined by the National Institutes of Health.
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1§2264. Identification of hearing loss in infants Early detection and intervention
2for children who are d/Deaf or hard of hearing
3A. The office shall establish, in consultation with the advice of the Louisiana
4Commission for the Deaf and the advisory council created in R.S. 46:2265 and
5other key constituents, a program for the early identification and follow-up of
6infants susceptible to a hearing disability, deaf or hard of hearing infants, and infants
7susceptible to developing progressive hearing loss hearing detection and
8intervention of infants and children who are d/Deaf or hard of hearing. The
9program shall, at a minimum:
10(1) Develop criteria or factors to identify those infants who are likely deaf or
11hard of hearing and infants who may develop a progressive hearing loss, including
12the risk factors set forth in this Chapter, and develop a susceptibility questionnaire
13for infant hearing loss. Collect and track data related to newborn hearing
14screening, risk factor reporting, audiological testing, and early intervention.
15(2) Create a susceptibility registry to include, but not be limited to, the
16identification of infants susceptible to hearing loss, deaf or hard of hearing infants,
17and infants susceptible to developing progressive hearing loss. Provide access to
18and training on the early hearing detection and intervention data management
19system to birth hospital newborn hearing screening supervisors and birth
20hospital staff, freestanding birth center newborn hearing screening supervisors
21and birth center staff, outpatient audiological testing providers, and other
22necessary providers as deemed appropriate by the program.
23(3) Provide to the hospitals and other birthing sites the susceptibility
24questionnaire for infant hearing loss and require that the form be completed for any
25newborn prior to discharge from the hospital or other birthing site. As to infants
26susceptible to a hearing disability, copies of the completed susceptibility
27questionnaire shall be distributed to the susceptibility registry of the office, the
28parent or guardian, and, if known, the infant's primary care physician and the
29provider of audiological services. Require all birth hospitals, freestanding birth
30centers, and outpatient audiological testing providers to report newborn
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1hearing screening results, the reason for no screening, outpatient screening
2results, and results of diagnostic audiological evaluation, including hearing
3status, to the program.
4(4) Require for all newborn infants that the hospital of birth or that hospital
5to which the newborn infant may be transferred provide hearing screening for
6hearing loss by auditory brainstem response (ABR) screening, evoked otoacoustic
7emissions (EOAE) (OAE) screening, or any other screening device approved by the
8office before discharge to identify children in need of further audiological
9assessment. The results of that screening for hearing loss shall be provided to the
10susceptibility registry of the office program, the parent or guardian, and if known,
11the primary care physician and the provider of audiological services.
12(5) Develop and provide to the birth hospitals, freestanding birth centers,
13outpatient facilities, and pediatric diagnostic audiology centers or other birthing
14sites appropriate written materials regarding hearing loss, and require that the
15hospitals or other birthing sites provide this written material to all parents or
16guardians of newborn infants for families of newborn infants, infants in need of
17follow up after newborn hearing screening, infants with risk factors, or infants
18diagnosed as d/Deaf or hard of hearing.
19(6) Develop methods to contact parents or guardians of infants susceptible
20to a hearing disability, of deaf or hard of hearing infants, and of infants susceptible
21to developing progressive hearing loss. Develop and provide web-accessible early
22hearing detection and intervention guidelines that include birthing facilities
23newborn hearing screening guidelines, freestanding birth center newborn
24hearing screening guidelines, outpatient hearing screening guidelines, and
25pediatric diagnostic audiology guidelines.
26(7) Establish a telephone hotline to communicate information about hearing
27loss, hearing screening, audiological evaluation, and other services for deaf or hard
28of hearing infants. Provide oversight of newborn hearing screening performance
29at each birth hospital and freestanding birth center through monitoring of
30newborn hearing screening data for completeness, accuracy, and timeliness.
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1Oversight monitoring criteria may be added or deleted by the office upon
2recommendation of the advisory council created in R.S. 46:2265.
3(8) Provide that when a screening indicates a hearing loss, audiological
4evaluation shall be done as soon as practical. The parents or guardians of the infant
5shall be provided with information on locations at which medical and audiological
6follow up can be obtained. Maintain a website that promotes early hearing
7identification and a coordinated system of support for children who are d/Deaf
8and hard of hearing. In addition to program contacts and provider and family
9resources, materials that stress the critical nature of addressing language and
10communication development for children who are d/Deaf or hard of hearing
11shall be made available.
12(9) Provide that when the result of newborn hearing screening is referred
13or further testing is needed, birth facilities shall provide families and caregivers
14with follow-up hearing testing information inclusive of reason for follow-up,
15what to expect, and appointment details, such as the date, time, location, and
16contact information for follow-up, which is recommended to take place within
17one month. In the circumstance that an appointment for follow-up is unable to
18be established at the time of discharge from a birth hospital or freestanding
19birth center, at a minimum, parents or guardians shall be provided with
20information on locations for audiological follow-up.
21(10) Provide that when a child is reported as d/Deaf or hard of hearing,
22communication with families and caregivers regarding the importance of
23enrolling in early intervention and referral to existing statewide opportunities
24for children who are d/Deaf or hard of hearing in accordance with the Early
25Hearing Detection and Intervention Act of 2022, 42 U.S.C. 201 and related
26amendments shall occur as soon as is practical.
27(11) Communicate with and connect families and caregivers of children
28who are d/Deaf or hard of hearing to support services for the purpose of
29building empowered families in Louisiana through access to individuals with
30lived experience, direct emotional support, resources and training, and family
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1and community events aimed to build connection in accordance with the 42
2U.S.C. 280g-1 and related amendments. No-cost, trained, and unbiased support
3shall be provided through:
4(a) Family-to-family support.
5(b) Adults who are d/Deaf or hard of hearing.
6B. The office shall consult with the advisory council and implement the
7program.
8C. The office shall develop a system for the collection of data, determine the
9cost-effectiveness of the program, and disseminate statistical reports to the Louisiana
10Commission for the Deaf. The program shall maintain a database for the
11collection of early hearing detection and intervention data, and disseminate
12information to partners and stakeholders. Information shall be shared annually,
13at a minimum, with the advisory council for the Early Hearing Detection and
14Intervention Program and the Louisiana Commission for the Deaf board of
15commissioners.
16D. The office, in cooperation with the state Department of Education, shall
17develop a plan to coordinate early educational and audiological services for infants
18identified as deaf or hard of hearing.
19E. The office shall follow current practices and applicable guidelines that are
20currently utilized in Louisiana and will shall consider practices and guidelines that
21may be established by the National Institute on Deafness and other Communication
22Disorders (NIDCD) established by the JCIH.
23§2265. Advisory council creation; membership; terms; quorum; compensation
24A. There is hereby created an advisory council for the program of early
25identification of deaf hearing detection and intervention for d/Deaf or hard of
26hearing infants. The council shall consist of fourteen twenty-one members as
27follows:
28(1) An otolaryngologist or otologist.
29(2) An audiologist with extensive experience in evaluating infants.
30(3) A neonatologist.
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1(4) A pediatrician.
2(5) A deaf person who is d/Deaf, DeafBlind, or hard of hearing.
3(6) A young adult who is d/Deaf, DeafBlind, or hard of hearing.
4(6)(7) A hospital administrator.
5(7)(8) A speech and language pathologist.
6(8)(9) A school teacher or administrator certified in education of the deaf
7d/Deaf and hard of hearing.
8(10) An early intervention provider who works with children who are
9d/Deaf or hard of hearing and their families.
10(9)(11) A parent who chose the oral method for his deaf or hard of hearing
11child of a child who is d/Deaf, DeafBlind, or hard of hearing who uses spoken
12language.
13(10)(12) A parent of a deaf or hard of hearing child utilizing total
14communication who is d/Deaf, DeafBlind, or hard of hearing who uses sign
15language or other mode of signed communication.
16(11) A representative of the state Department of Education designated by the
17superintendent of education.
18(13) A person who is d/Deaf, DeafBlind, or hard of hearing and is the
19parent of a child who is d/Deaf, DeafBlind, or hard of hearing.
20(14) A parent of a child who is d/Deaf, DeafBlind, or hard of hearing who
21is enrolled in early intervention.
22(15) A representative from a Louisiana-based family support
23organization for families whose children are d/Deaf or hard of hearing.
24(16) A representative from the Louisiana Association of the Deaf.
25(12)(17) A representative or designee of the office designated by the
26assistant secretary of the office.
27(13)(18) A representative or designee from the Louisiana Commission for
28the Deaf.
29(14) A representative from the Louisiana Association of the Deaf.
30(19) A representative of the state Department of Education with
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1experience in d/Deaf education, special education, or early childhood designated
2by the superintendent of education.
3(20) A representative or designee of Louisiana Part C early intervention.
4(21) A representative or designee from the Governor's Office of
5Disability Affairs.
6B. Members of the council in accordance with Paragraphs (A)(1) through
7(10), (13), and (14) (16) shall be appointed by the governor, shall serve three-year
8terms, and shall be subject to Senate confirmation. Other members are not subject
9to Senate confirmation.
10C. Members of the council in accordance with Paragraphs (A)(17) through
11(21) representing offices and departments of state government shall serve four-year
12terms concurrent with that of the governor and shall not be subject to Senate
13confirmation. Other members shall serve three-year terms, except that in making the
14initial appointments, four members shall be appointed for a one-year term, four shall
15be appointed for two-year terms, and four shall be appointed for three-year terms. No
16member may serve more than two consecutive terms.
17D. Each member shall serve without compensation, but shall be reimbursed
18for actual travel and other expenses incurred in the performance of their duties
19in accordance with travel regulations of the division of administration. Officers
20of the council shall be reimbursed for necessary and other expenses incurred in
21the performance of their duties.
22E. A majority of the members of the council shall constitute a quorum for the
23transaction of all business.
24F. The members of the council shall elect from their membership a chairman,
25and a vice chairman, and secretary.
26§2266. Powers, duties, functions of the advisory council
27The advisory council shall:
28(1) Advise and recommend risk factors or criteria for infants who are likely
29deaf d/Deaf or hard of hearing and infants who may develop a delayed onset or
30progressive hearing loss.
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1(2) Advise the office as to newborn hearing screening and follow-up, setting
2standards for the program, monitoring and reviewing the program, and providing
3quality assurance for the program.
4(3) Advise the office as to integrating the program for early identification of
5deaf detection of d/Deaf or hard of hearing infants with existing medical,
6audiological, and early infant education programs.
7(4) Advise the office as to materials, resources, and information to be
8distributed to the public concerning deaf or hard of hearing infants early hearing
9detection and intervention.
10(5) Advise the office on the implementation of the program for early
11identification and follow-up of infants susceptible to a hearing disability, deaf or
12hard of hearing infants, detection and intervention for infants identified as d/Deaf
13or hard of hearing and infants who are at risk of developing delayed onset or
14progressive hearing loss.
15§2267.Effective date; rules Rules and regulations
16The office of public health shall, by July 1, 2000, adopt rules and regulations
17necessary to implement maintain the program in accordance with the Administrative
18Procedure Act.
  PRESIDENT OF THE SENATE
  SPEAKER OF THE HOUSE OF REPRESENTATIVES
  GOVERNOR OF THE STATE OF LOUISIANA
 APPROVED:
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