641—3.10 (135) Conducting and reporting screening results and diagnostic audiologic assessments to the department.  Any facility, licensed audiologist or health care professional conducting newborn hearing screens, rescreens, or diagnostic audiologic assessments shall report the results within six working days for any child under three years of age to the department utilizing the department’s designated reporting system. The facility shall conduct the diagnostic hearing assessment in accordance with the Pediatric Audiologic Diagnostic Protocol contained at Appendix A. Results of a hearing screen, rescreen or diagnostic audiologic assessment shall be reported as follows.
	 3.10(1) Reports shall include:
	  a.   	 The name and date of birth of the child.
	  b.   	 The name, address, and telephone number, if available, of the mother of the child. If the mother is not the person designated as legally responsible for the child’s care, the name, address, and telephone number of the parent, as defined in 641—3.1(135), shall be reported.
	  c.   	 The name of the primary care provider for the child.
	  d.   	 Known risk indicators for hearing loss.
	 3.10(2) Results of the newborn hearing screening shall be reported as either “pass” or “refer” for each ear separately.
	 3.10(3) Results of the hearing rescreen shall be reported as either “pass” or “refer” for each ear separately.
	 3.10(4) If an assessment results in a diagnosis of normal hearing for both ears, this shall be reported.
	 3.10(5) Any diagnosis of hearing loss shall also be reported except for transient conductive hearing loss lasting for less than 90 days in the professional judgment of the practitioner.
	 3.10(6) Diagnostic audiologic assessment results shall include a statement of the severity (mild, moderate, moderately severe, severe, profound, or undetermined) and type (sensorineural, conductive, mixed, or undetermined) of hearing loss.
[ARC 8232B, IAB 10/7/09, effective 11/11/09]