The Maryland Hearing Aid Loan Bank

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The Maryland Hearing Aid Loan Bank

• A Bridge
• To
• Early Intervention
• Paul K.Farrell, Sue Griebler, Ilene Briskin

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History of Maryland Early Identification of
Hearing Loss Intervention

• 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

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1985 HIGH RISK REGISTRY

• Identify Risk Factors
• NICU more than 48 hours
• Anatomical malformation
• Asphyxia
• Bacterial meningitis
• Low birthweight
• Perinatal infection
• Family history
• Hyperbilirubinanemia

• Program for Hearing Impaired Infants at the
  Maryland State Department of Health and Mental
  Hygiene (DHMH)
• Advisory Council

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MARYLANDS PATH TO UNIVERSAL NEWBORN HEARING
SCREENING
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COLLABORATION
The Maryland Department of Health and Mental
Hygiene The Maryland State Dept. of Education
CUSHION (Coalition for the Universal Screening of
Hearing in Our Newborns)

• American Academy of Pediatrics
• A.G. Bell Association
• Advisory Council
• Educational Audiology Assoc.
• Johns Hopkins Hospital

• Md. Academy of Audiology
• Md. Hospital Assoc.
• Md. Speech, Language, Hearing Association
• University of Maryland Hospital

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Awareness Legislative Support

• Legislators
• High Risk registry
• Public Policy days
• Constituent lobbying and testimony
• Professional lobbying
• Informational materials
• Insurers
• State agency support
• Other citizens and related advocacy organizations

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FINANCIAL CONCERNS

• Maryland Health Care Commission
• Insurance Industry
• Fiscal note Cost/Benefit study

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1999 UNIVERSAL NEWBORN HEARING SCREENING

• All birthing hospitals establish UNHS
• Insurers reimburse
• Notification provided
• Existing program Advisory Council expanded and
  administered by DHMH

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From Universal Newborn Hearing Screening to the
Hearing Aid Loan Bank

• Community awareness
• Public Service Announcement
• Amplification legislation
• Grant support
• Modified prior legislative approach
• Habilitation In process

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2001 REDUCING BARRIERS TO AMPLIFICATION

• MEDICAL ASSISTANCE
• INSURANCE MANDATE
• For minor children
• 1400 per ear
• Licensed audiologist prescribes, fits and
  dispenses
• Exceptions
• Out of state employers and insurers
• ERISA plans

• HEARING AID LOAN BANK
• Maryland State Dept. of Education
• Children 0-3 years
• Funding
• Licensed audiologist prescribes, fits and
  dispenses
• First earmolds provided

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Mission

• The Hearing Aid Loan Bank will provide access to
  amplification as soon as possible following a
  diagnosis of hearing loss in an infant or
  toddler. This is essential to emerging language
  and healthy social/emotional development that
  are the foundation for school readiness and
  success.

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Getting Started

• The basics Getting off the ground
• How does the loaner program work?
• Who qualifies for the program?
• Hearing Aid Loan Period
• Budget Outline
• Hearing Aids and Earmolds
• Manufacturer support

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The Basics Getting off the ground

• Application
• Policies Procedures
• Audiologist Survey
• Brochure
• Purchasing
• Public Awareness
• Family Satisfaction Survey

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How the Loan Bank Works
Universal Newborn Hearing Screening Protocol
Confirmation Of Hearing Loss By
Hospital/Community Audiologist
Referral to Local Infants Toddlers program
Referral to Loan Bank
LITP Service Coordinator
Audiology Services
Permanent Hearing Aids Or Cochlear Implant
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Who qualifies for the program?

• Uninsured
• Underinsured
• Experience delays in acquiring hearing aids
• Uncertain audiologic diagnosis
• Families accessing use of alternative technology,
  i.e, cochlear implant

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How to Apply for Hearing Aids

• Referring Audiologist Information
• All audiometric data (e.g. OAE/ABR,BOA)
• A recommendation for suitable amplification
• Medical Clearance for hearing aids from childs
  physician
• Parent/Legal Guardian Information
• Statement indicating the reason the parent or
  guardian has no immediate access to hearing aids
• Statement indicating insurance coverage, or a
  lack of coverage
• A statement indicating the reason assistance from
  the loan bank is requested

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Hearing Aid Loan Period

• Standard length of the hearing aid loan is
  six-months.
• A loan extension, in 3 month intervals, may be
  granted upon written request from the parent.

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Budget Outline

• Personnel
• Communications
• Travel
• Contractual Services
• Supplies
• Equipment

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Hearing Aids and Earmolds

• Digital Hearing Aids - Binaural Fitting
• Earmolds (1st set)
• The dispensing audiologist is responsible
  for fitting and monitoring the hearing aid and
  earmold during the loan period

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Manufacturer Support

• Educate key sales representative
• Discount purchasing
• Donations on individual case basis

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Making a Difference

• May- Dec. 2003
• 20 Hearing Aids disbursed to 10 families
• In 2004 61 hearing aids were disbursed to 32
  families

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The Good News!

• As of March, 2005 the return rate for loaned
  hearing aids is 100

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Maryland Infants and Toddlers Staff Development
Programs

• Grants from DHMH/Sponsored by MSDE
• Beginning the JourneyIntervention for Infants
  and Toddlers with Hearing Loss and their Families
  - 2003
• Continuing the Journey Supporting Families in
  Understanding The Grieving Process Associated
  with Hearing Loss and Intervention with Infants
  and Toddlers with Cochlear Implants - 2004
• Team Collaboration Everyone Has a Role to Play
  - 2005
• Parent support and participation is an integral
  part of each conference

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Strengths
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FOR MORE LEGISLATIVE INFORMATION

• www.mlis.state.md.us
• 1999 HB 884 UNIVERSAL NEWBORN HEARING SCREENING
• 2001 HB 160 HEALTH INSURANCE HEARING AIDS-
  COVERAGE FOR CHILDREN
• 2001 HB 282 STATE DEPARTMENT OF EDUCATION
  HEARING AID LOAN BANK PROGRAM ESTABLISHMENT AND
  OPERATION

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Contact Information
Paul K. Farrell Director, Maryland Hearing Aid
Loan Bank [phone] pfarrell_at_msde.state.md.us
Sue Griebler Educational Consultant (410)
767-2331 sgriebler_at_msde.state.md.us Ilene
Briskin Education\Health Care Consultant Public
Policy\Grant Writing ilenebriskin_at_comcast.net
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