Hearing Coordination Centers: A Model to Improve Loss to Follow-up Hallie W. Morrow, MD, MPH, FAAP California Department of Health Services Sacramento, CA

Faculty Disclosure Information In the past 12 months, I have not had a significant financial interest or other relationship with the manufacturer(s) of the product(s) or provider(s) of the service(s) that will be discussed in my presentation. This presentation will not include discussion of pharmaceuticals or devices that have not been approved by the FDA or discussion of unapproved or off-label uses of pharmaceuticals or devices.

Hearing Coordination Centers Responsible for one or more geographic service areas

Hearing Coordination Center Staff Director Audiologist Registered Nurse Clerical Support Parent

Hearing Coordination Center Activities Hospital Certification –Certify and re-certify hospitals as meeting standards Quality Assurance Monitoring

Hearing Coordination Center Activities Infant Tracking and Monitoring –Collect data All infant information and results reported on paper reporting forms –Track appointments for individual infants –Contact providers if no results are received –Generate correspondence to infants PCP

Hearing Coordination Center Activities Infant Tracking and Monitoring (cont.) –Refer to local EPSDT program if infant no shows appointments or provider cannot contact the family –Contact all families of infants identified with hearing loss –Assure referral to EI has been made

Tracking and Monitoring Procedure Manual Flowcharts spell out tracking and monitoring activities Define when to close a case Specify content of letters to families and providers Describe contact attempts with providers

Tracking and Monitoring Procedure Manual Outpatient Screen Required –Appointment has been scheduled –No appointment scheduled –Referral to local EPSDT program Diagnostic Evaluation Needed –Reporting form received –Reporting form not received –No appointment scheduled

Tracking and Monitoring Procedure Manual Hearing Loss Identified Nursery Transfers –Within an HCCs geographic service area –Outside an HCCs geographic service area –To a long term care facility –To a non-certified unit or NICU Infants Who Reside Outside of California

California Program Data 2004 WBN%NICU%Total # admissions WBN343,71189% 343,711 # discharges NICU 44,32211%44,322 Statewide Total 388,033

California Program Data 2004 WBN%NICU%Total% # screened334,02297%40,07490%374, % # refer6,4581.9%1,0162.5%7,4742.0% # waived2,2490.7%350.1%2,2840.6% # missed1,3060.4%3610.8%1,6670.4%

California Program Data 2005 (Preliminary) WBN%NICU%Total% # screened344,03798%41,22292%385,25998% # refer 6, %9962.4%7,8852.0% # waived1,3400.4%230.1%1,3630.3% # missed1,1300.3%2600.6% %

California Program Data 2004 WBN%NICU%Total% Hearing Loss IDd % % % By 3 mo of age30376%180 60% % IFSP initiated21153%157 53% % By 6 mo of age15975%114 73% % PCP IDd91490%94285%185687%

California Program Data 2004 Total% Lost to follow-up7625.7% Appointments not scheduled27336%

Additional Information Information about the California Newborn Hearing Screening Program and the Hearing Coordination Centers is available at: