US Government Accountability Office GAO

HEARING DETECTION AND INTERVENTION: Program Connects Deaf or Hard of Hearing Infants and Children to Services, but Actions Needed to Improve Access

2025 US2025hearingDetectIntervene
SCALE
  • - About one in every 500 infants is identified as deaf or hard of hearing. Receiving early intervention services can help children meet speech, language, social, and emotional development milestones.
  • - HRSA provides grants to 59 states and territories (states) to suport their data tracking and referral efforts.
  • - For the current grant cycle, HRSA awarded $235,000 per year to each state. In addition, HRSA has provided additional funding through competitive grant opportunities to state EHDI programs for targeted purposes.
COMPLIANCE FOCUS
  • - Early Hearing Detection and Intervention Act of 2022
  • - Early Hearing Detection and Intervention (EHDI) program, administered by the Department of Health and Human Services (HHS)
PERFORMANCE ASPECT
  • - measuring program performance
  • - addressing state programs’ reported challenges, incl. benchmarks
  • - identify and address disparities in the program access
1. Goal-setting - Requirements

Health Resources and Services Administration (HRSA) required state Early Hearing Detection and Intervention (EHDI) programs to submit diversity and inclusion plans in 2021 to identify and address disparities in EHDI service access—differences in availability of services between groups defined by characteristics such as ethnicity or economic resources. However, GAO found that HRSA is unable to determine whether individual state EHDI programs’ efforts have been successful in addressing disparities in access because HRSA did not require states to set performance goals as part of their diversity and inclusion plans.

2. Analysis - Problem formulation

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. With a requirement in place for state EHDI programs to set and report on performance goals, states can demonstrate their progress in addressing access disparities for their identified underserved populations. In addition, HRSA’s assessment of states’ progress can inform future plans to support state EHDI programs.

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The items above were selected and named by the e-Government Subgroup of the EUROSAI IT Working Group on the basis of publicly available report of the author Supreme Audit Institutions (SAI). In the same way, the Subgroup prepared the analytical assumptions and headings. All readers are encouraged to consult the original texts by the author SAIs (linked).