The Maryland Hearing Aid Loan Bank A Bridge To Early Intervention Paul K.Farrell, Sue Griebler, Ilene Briskin.

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

pfarrell@msde.state.md.us

Sue Griebler

Educational Consultant

(410) 767-2331

sgriebler@msde.state.md.us

Ilene Briskin

Education\Health Care Consultant

Public Policy\Grant Writing

ilenebriskin@comcast.net

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