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The Maryland Hearing Aid The Maryland Hearing Aid Loan Bank Loan Bank
A Bridge A Bridge
ToTo
Early InterventionEarly Intervention
Paul K.Farrell, Sue Griebler, Ilene BriskinPaul K.Farrell, Sue Griebler, Ilene Briskin
1972 Parent-Infant Pilot Program (0-4) in 2 counties
1975 PL 94-142
1979 Birth Mandate State
1985 Program to Identify Hearing Impaired Infants
1987 Maryland Infants & Toddler Program
2000 Maryland Universal Newborn Hearing Screening
2002 Maryland Hearing Aid Loan Bank
History of Maryland Early Identification of History of Maryland Early Identification of Hearing Loss & InterventionHearing Loss & Intervention
1985: 1985: HIGH RISK REGISTRYHIGH RISK REGISTRY Identify Risk FactorsIdentify Risk Factors
– NICU more than 48 hoursNICU more than 48 hours
– Anatomical malformationAnatomical malformation
– AsphyxiaAsphyxia
– Bacterial meningitisBacterial meningitis
– Low birthweightLow birthweight
– Perinatal infectionPerinatal infection
– Family historyFamily history
– HyperbilirubinanemiaHyperbilirubinanemia
Program for Hearing Program for Hearing Impaired Infants at Impaired Infants at the Maryland State the Maryland State Department of Health Department of Health and Mental Hygiene and Mental Hygiene (DHMH)(DHMH)
Advisory CouncilAdvisory Council
MARYLAND’S MARYLAND’S PATH PATH
TO TO UNIVERSAL NEWBORN UNIVERSAL NEWBORN HEARING SCREENINGHEARING SCREENING
COLLABORATIONCOLLABORATION
American Academy of American Academy of PediatricsPediatrics
A.G. Bell AssociationA.G. Bell Association Advisory CouncilAdvisory Council Educational Audiology Educational Audiology
Assoc.Assoc. Johns Hopkins Johns Hopkins
HospitalHospital
Md. Academy of Md. Academy of AudiologyAudiology
Md. Hospital Assoc.Md. Hospital Assoc. Md. Speech, Language, Md. Speech, Language,
Hearing AssociationHearing Association University of Maryland University of Maryland
HospitalHospital
The Maryland Department of Health and Mental Hygiene The Maryland Department of Health and Mental Hygiene The Maryland State Dept. of EducationThe Maryland State Dept. of Education
CUSHION (Coalition for the Universal Screening of Hearing in CUSHION (Coalition for the Universal Screening of Hearing in Our Newborns)Our Newborns)
Awareness & Legislative Awareness & Legislative SupportSupport
LegislatorsLegislators– High Risk registryHigh Risk registry– Public Policy daysPublic Policy days– Constituent lobbying and testimonyConstituent lobbying and testimony– Professional lobbyingProfessional lobbying– Informational materialsInformational materials
InsurersInsurers
State agency supportState agency support
Other citizens and related advocacy organizationsOther citizens and related advocacy organizations
FINANCIAL CONCERNSFINANCIAL CONCERNS
Maryland Health Care CommissionMaryland Health Care Commission
Insurance IndustryInsurance Industry
Fiscal note: Cost/Benefit studyFiscal note: Cost/Benefit study
1999: 1999: UNIVERSAL NEWBORN UNIVERSAL NEWBORN HEARING SCREENINGHEARING SCREENING
All birthing hospitals All birthing hospitals establish UNHSestablish UNHS
Insurers reimburseInsurers reimburse
Notification providedNotification provided
Existing program & Existing program & Advisory Council Advisory Council expanded and expanded and administered by DHMH administered by DHMH
From Universal Newborn Hearing From Universal Newborn Hearing Screening to the Hearing Aid Loan Screening to the Hearing Aid Loan
Bank Bank Community awarenessCommunity awareness
– Public Service AnnouncementPublic Service Announcement
Amplification legislationAmplification legislation– Grant supportGrant support
– Modified prior legislative approachModified prior legislative approach
Habilitation: In processHabilitation: In process
2001: REDUCING BARRIERS TO 2001: REDUCING BARRIERS TO AMPLIFICATIONAMPLIFICATION
MEDICAL ASSISTANCEMEDICAL ASSISTANCE INSURANCE MANDATEINSURANCE MANDATE
– For minor childrenFor minor children
– $1400 per ear$1400 per ear
– Licensed audiologist Licensed audiologist prescribes, fits and prescribes, fits and dispensesdispenses
– ExceptionsExceptions» Out of state employers Out of state employers
and insurersand insurers
» ERISA plansERISA plans
HEARING AID LOAN HEARING AID LOAN BANKBANK
– Maryland State Dept. Maryland State Dept. of Educationof Education
– Children 0-3 yearsChildren 0-3 years– FundingFunding– Licensed audiologist Licensed audiologist
prescribes, fits and prescribes, fits and dispensesdispenses
– First earmolds First earmolds providedprovided
Mission Mission
The Hearing Aid Loan Bank will provide The Hearing Aid Loan Bank will provide access to amplification as soon as access to amplification as soon as possible following a diagnosis of possible following a diagnosis of hearing loss in an infant or toddler. This hearing loss in an infant or toddler. This is essential to emerging language and is essential to emerging language and healthy social/emotional development healthy social/emotional development that are the foundation for school that are the foundation for school readiness and success.readiness and success.
Getting StartedGetting Started
The basics: Getting off the groundThe basics: Getting off the ground How does the loaner program work?How does the loaner program work? Who qualifies for the program?Who qualifies for the program? Hearing Aid Loan PeriodHearing Aid Loan Period Budget OutlineBudget Outline Hearing Aids and EarmoldsHearing Aids and Earmolds Manufacturer supportManufacturer support
The Basics: Getting off the The Basics: Getting off the groundground
ApplicationApplication Policies & ProceduresPolicies & Procedures Audiologist SurveyAudiologist Survey BrochureBrochure PurchasingPurchasing Public AwarenessPublic Awareness Family Satisfaction SurveyFamily Satisfaction Survey
How the Loan Bank WorksHow the Loan Bank WorksUniversal Newborn Hearing Screening
Protocol
Confirmation Of Hearing LossBy Hospital/Community Audiologist
Referral to Local Infants &Toddlers program
Referral to Loan Bank
Permanent Hearing Aids Or Cochlear Implant
LITP Service Coordinator Audiology Services
Who qualifies for the program?Who qualifies for the program?
UninsuredUninsured Underinsured Underinsured Experience delays in acquiring hearing aidsExperience delays in acquiring hearing aids Uncertain audiologic diagnosis Uncertain audiologic diagnosis Families accessing use of alternativeFamilies accessing use of alternative
technology, i.e, cochlear implanttechnology, i.e, cochlear implant
How to Apply for Hearing AidsHow to Apply for Hearing AidsReferring Audiologist Information:Referring Audiologist Information: All audiometric data (e.g. OAE/ABR,BOA)All audiometric data (e.g. OAE/ABR,BOA) A recommendation for suitable amplificationA recommendation for suitable amplification Medical Clearance for hearing aids from child’s Medical Clearance for hearing aids from child’s
physicianphysician
Parent/Legal Guardian Information:Parent/Legal Guardian Information: Statement indicating the reason the parent or Statement indicating the reason the parent or
guardian has no immediate access to hearing aidsguardian has no immediate access to hearing aids Statement indicating insurance coverage, or a lack Statement indicating insurance coverage, or a lack
of coverageof coverage A statement indicating the reason assistance from A statement indicating the reason assistance from
the loan bank is requestedthe loan bank is requested
Hearing Aid Loan PeriodHearing Aid Loan Period
Standard length of the hearing aid loan is Standard length of the hearing aid loan is six-months.six-months.
A loan extension, in 3 month intervals, may A loan extension, in 3 month intervals, may be granted upon written request from the be granted upon written request from the parent.parent.
Budget OutlineBudget Outline
PersonnelPersonnel CommunicationsCommunications TravelTravel Contractual ServicesContractual Services SuppliesSupplies EquipmentEquipment
Hearing Aids and EarmoldsHearing Aids and Earmolds
Digital Hearing Aids - Binaural FittingDigital Hearing Aids - Binaural Fitting Earmolds (1st set)Earmolds (1st set)
The dispensing audiologist is responsible The dispensing audiologist is responsible for fitting and monitoring the hearing aid for fitting and monitoring the hearing aid and earmold during the loan period and earmold during the loan period
Manufacturer SupportManufacturer Support
Educate key sales representativeEducate key sales representative Discount purchasingDiscount purchasing Donations on individual case basisDonations on individual case basis
Making a DifferenceMaking a Difference
0
10
20
30
40
50
60
70
2003 2004
HearingAids
May- Dec. 2003 May- Dec. 2003
20 Hearing Aids 20 Hearing Aids disbursed to 10 disbursed to 10 families families
In 2004 61 hearing In 2004 61 hearing aids were disbursed to aids were disbursed to 32 families32 families
The Good News!The Good News!
As of March, As of March, 2005 the return 2005 the return rate for loaned rate for loaned hearing aids is hearing aids is 100%100%
Maryland Infants and Toddlers Staff Maryland Infants and Toddlers Staff Development ProgramsDevelopment Programs
Grants from DHMH/Sponsored by MSDEGrants from DHMH/Sponsored by MSDE
““Beginning the Journey:Intervention for Infants and Toddlers Beginning the Journey:Intervention for Infants and Toddlers with Hearing Loss and their Families - 2003with Hearing Loss and their Families - 2003
““Continuing the Journey: Supporting Families in Continuing the Journey: Supporting Families in Understanding: The Grieving Process Associated with Understanding: The Grieving Process Associated with Hearing Loss and Intervention with Infants and Toddlers Hearing Loss and Intervention with Infants and Toddlers with Cochlear Implants” - 2004with Cochlear Implants” - 2004
““Team Collaboration: Everyone Has a Role to Play” - 2005Team Collaboration: Everyone Has a Role to Play” - 2005
Parent support and participation is an integral part of Parent support and participation is an integral part of each conferenceeach conference
StrengthsStrengths
SchoolSchoolReadinessReadiness
EIEI
Early Intervention
Early Intervention
EI
EI
EIEI
EI
EI
Early Early DetectionDetection
Of Hearing Of Hearing LossLoss
UNHSUNHS
UN
HS
UN
HS
UNHSUNHS
Loan Bank
Loan Bank
Loan
Ban
k
Loan
Ban
k
Loan Bank
Loan Bank
Loan
Ban
k
Loan
Ban
k
Fast Fast AccessAccessHearing Hearing
AidsAids
FOR MORE LEGISLATIVE FOR MORE LEGISLATIVE INFORMATION…INFORMATION…
www.mlis.state.md.uswww.mlis.state.md.us
– 1999: HB 8841999: HB 884; ; UNIVERSAL NEWBORN HEARING UNIVERSAL NEWBORN HEARING SCREENINGSCREENING
– 2001: HB 1602001: HB 160; ; HEALTH INSURANCE – HEARING HEALTH INSURANCE – HEARING AIDS- COVERAGE FOR CHILDRENAIDS- COVERAGE FOR CHILDREN
– 2001: HB 2822001: HB 282; ; STATE DEPARTMENT OF STATE DEPARTMENT OF EDUCATION – HEARING AID LOAN BANK EDUCATION – HEARING AID LOAN BANK PROGRAM – ESTABLISHMENT AND OPERATIONPROGRAM – ESTABLISHMENT AND OPERATION
Contact InformationContact InformationPaul K. Farrell
Director, Maryland Hearing Aid Loan Bank
(410) 767-0739
Sue Griebler
Educational Consultant
(410) 767-2331
Ilene Briskin
Education\Health Care Consultant
Public Policy\Grant Writing
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