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DocuSign Envelope ID:8F46C2BA-AC7A-464D-B01A-1E2581B55465 <br /> Division of Public Health <br /> Agreement Addendum <br /> FY 16-17 <br /> Page 1 of 4 <br /> Women's and Children's Health/ <br /> Orange County Health Department Children and Youth <br /> Local Health Department Legal Name DPH Section/Branch Name <br /> Marcia Fort 919-707-5635 <br /> 324 Speech and Hearing Marcia.Fort @dhhs.nc.gov <br /> Activity Number and Description DPH Program Contact <br /> (name,telephone number with area code,and email) <br /> 04/01/2017—05/31/2017 <br /> Service Period DPH Program Signature Date <br /> (only required for a negotiable agreement addendum) <br /> 05/01/2017—06/30/2017 <br /> Payment Period <br /> Original Agreement Addendum <br /> pi Agreement Addendum Revision # (Please do not put the Budgetary Estimate revision#here.) <br /> I. Background: <br /> Hearing loss is the most common congenital birth defect, affecting as many as three infants per thousand <br /> born. Left undetected,hearing loss in infants can negatively impact speech and language acquisition, <br /> academic achievement, and social and emotional development. If detected, however, these negative <br /> impacts can be diminished and even eliminated through early intervention. Infants who fail the initial <br /> newborn hearing screening are at a higher risk than the general population of having a hearing loss. The <br /> most recent data from the Centers for Disease Control and Prevention (CDC), for infants born in 2014, <br /> shows that 34.4% of infants in the United States and 32.7% in the state of North Carolina with a failed <br /> newborn hearing screen are subsequently"lost to follow up." <br /> The primary goal of the North Carolina Early Hearing Detection and Intervention(EHDI) Program is to <br /> ensure that all infants are screened for hearing loss by one month of age; that children with congenital <br /> hearing loss are identified by three months of age; and that all are provided access to appropriate <br /> audiological, educational, and medical intervention by six months of age. <br /> Regional staff support hospital universal newborn hearing screening programs in order to: 1) ensure that <br /> infants receive additional hearing screening when needed, 2) support families through the diagnostic <br /> and/or intervention processes, if necessary, and 3)provide consultation, technical assistance and <br /> resources to public and private agencies for the development and implementation of effective Early <br /> Hearing Detection and Intervention programs. Regional staffing is also needed to provide support and <br /> assistance to parents and families whose children have hearing loss and to provide assistance to other <br /> professionals working with these families. <br /> Health Director Signature (use blue ink) Date <br /> Local Health Department to complete: LHD program contact name: <br /> (If follow-up information is needed by DPH) Phone number with area code: <br /> Email address: <br /> Signature on this page signifies you have read and accepted all pages of this document. <br /> Revised July 2015 <br />