Early Hearing Detection and Intervention (EHDI) programs in the United States and around the globe track newborn hearing screenings, identification of infants with hearing loss, and early intervention status. In the United States, EHDI programs are administered by the Department of Health and Human Services (HHS), and within HHS, the Health Resources and Services Administration (HRSA). By using data from the Centers for Disease Control and Prevention (CDC), HRSA measures EHDI program performance. EHDI program performance is rated using the 1-3-6 benchmark.
For decades, HRSA and CDC have actively addressed state challenges in meeting EHDI benchmarks. For example, the shortage of experienced pediatric audiologists is a challenge to improving access to timely diagnosis. HHS is helping states with its technical assistance centers, and one recommendation included using telehealth to overcome provider shortages.
Among other initiatives, HHS agencies like HRSA took action to improve the EHDI program’s ability to identify and address disparities in access to services for children who are d/Deaf and hard of hearing. In 2021, HRSA required state EHDI programs to submit diversity and inclusion plans to identify and address disparities in EHDI service access.
The Early Hearing Detection and Intervention Act of 2022 includes a provision for the Government Accountably Office (GAO) to review the EHDI program. The most recent review found the following:
- GAO found that HRSA cannot determine whether individual state EHDI programs’ efforts have successfully addressed disparities in access (HRSA did not require states to set performance goals as part of their diversity and inclusion plans).
- GAO found that HRSA did not assess the results of the plans to understand how the plans might be updated or used to better address disparities in access in the 2024–2029 funding cycle.
Upon completion of their review, GAO is making two recommendations to HRSA:
(1) Require state EHDI programs to set performance goals that can be used to measure progress in addressing any identified disparities in access for underserved populations
(2) Assess the results of state EHDI programs’ access disparities performance and use it to inform future plans. HHS agreed with these recommendations.
The U.S. Government Accountability Office (GAO) provides Congress with timely, fact-based, non-partisan information that can be used to improve government and save taxpayers billions of dollars.
Reference
U.S. Government Accountability Office. (2025) Hearing Detection and Intervention: Program Connects Deaf or Hard of Hearing Infants and Children to Services, but Actions Needed to Improve Access. GAO. (accessed January 30, 2025).
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