Providing a ‘Sound Start’ for Infants Needing Amplification Early Hearing Detection and Intervention (EHDI) Conference 2004 Karen M. Ditty Michelle King.

Providing a ‘Sound Start’ for Infants Needing Amplification

Early Hearing Detection and Intervention Early Hearing Detection and Intervention (EHDI) Conference 2004(EHDI) Conference 2004

Karen M. Ditty Karen M. Ditty Michelle KingMichelle KingToni MaxonToni MaxonIlene BriskinIlene Briskin

States with Insurance mandates for Hearing Aids: Connecticut (October, 2001)Connecticut (October, 2001) Kentucky (July, 2002)Kentucky (July, 2002) Louisiana (January, 2004)Louisiana (January, 2004) Maryland (2001)Maryland (2001) Minnesota (August, 2003)Minnesota (August, 2003) Missouri (current & pending)Missouri (current & pending) Oklahoma (November, 2003)Oklahoma (November, 2003)

Requirements vary between states for: ages covered ages covered amount of coverage amount of coverage benefit period benefit period provider qualifications provider qualifications type of hearing losstype of hearing loss no states require a similar benefit for adultsno states require a similar benefit for adults

Legislation in United StatesStateState AgeAge FreqFreq AmountAmount Who paysWho pays

CTCT <<12yrs 12yrs 2 yrs2 yrs $1000./HA$1000./HA Individual and Grp. Individual and Grp.

KYKY <<18yrs18yrs 3 yrs3 yrs $1400./HA$1400./HA Group and state . No self Group and state . No self funded coveragefunded coverage

LALA <18 yrs<18 yrs 3yrs3yrs $1400./HA$1400./HA Any health insuranceAny health insurance

MDMD MinorsMinors 3 yrs.3 yrs. $1400./HA$1400./HA Any health insuranceAny health insurance

MNMN <<18yrs HL 18yrs HL loss @birthloss @birth

3 yrs3 yrs not listednot listed Fully insured no self Fully insured no self funded coveragefunded coverage

MO*MO* Initial HA Initial HA for infantsfor infants

initialinitial Not listedNot listed Any health InsuranceAny health Insurance

OKOK <<18yrs18yrs 4 yrs4 yrs No limit No limit Any health plan, No self Any health plan, No self pay or ERISA pay or ERISA

Proposed Legislation in United StatesStateState AgeAge FreqFreq AmountAmount Who paysWho pays

MOMO <<19yrs19yrs 3yrs3yrs $1250./HA$1250./HA Every Health Carrier Every Health Carrier offering health benefit offering health benefit plans that are delivered, plans that are delivered, issued for delivery, issued for delivery, continued or renewed continued or renewed after 1/1/2005after 1/1/2005

Connecticut:

PROVIDESPROVIDES Pays up to $1000. for Pays up to $1000. for

hearing aids every 2 yearshearing aids every 2 years Pays up to age 12Pays up to age 12 HoweverHowever, Children with a , Children with a

HL of HL of >>40dB are already 40dB are already funded for hearing aids funded for hearing aids through IDEA Part C through IDEA Part C moniesmonies

DOESN’T PROVIDEDOESN’T PROVIDE Benefit does not really Benefit does not really

cover cost of digital cover cost of digital hearing aidshearing aids

Hearing Aid LegislationIn Kentucky

Trish FreemanTrish Freeman

Pam IsonPam Ison

Michelle KingMichelle King

The Path to Hearing Aid Insurance Legislation Get all interested parties involvedGet all interested parties involved Research current legislation: Is there one you can Research current legislation: Is there one you can

model?model? Identify key person to serve as “watchdog” and Identify key person to serve as “watchdog” and

primary contact for sponsorsprimary contact for sponsors Find a message that resonates and repeat it over Find a message that resonates and repeat it over

and over in various waysand over in various ways Be prepared for opposition and to make Be prepared for opposition and to make

concessionsconcessions Be persistent: don’t give up when you get Be persistent: don’t give up when you get

discourageddiscouraged

KY Origin: Parent Advocate

Proposed hearing aid legislation idea to Proposed hearing aid legislation idea to KCDHH board and asked to form study KCDHH board and asked to form study groupgroup

Key goal was to bring together Key goal was to bring together representatives from all major players in representatives from all major players in the deaf/HOH communitythe deaf/HOH community

KCDHH Study Group Once members were identified, the study group met Once members were identified, the study group met

to:to: plan strategy for getting bill introduced and passedplan strategy for getting bill introduced and passed draft language of bill that would be acceptable to draft language of bill that would be acceptable to

all parties modeled after MD.all parties modeled after MD. identify potential bill sponsors and co-sponsorsidentify potential bill sponsors and co-sponsors develop talking points develop talking points establish email network as mechanism for establish email network as mechanism for

generating grassroots action when neededgenerating grassroots action when needed

Steps Taken to Generate Grassroots Support

Flyers – parents – community partnersFlyers – parents – community partners Newsletter articlesNewsletter articles Letters to EditorLetters to Editor Media Coverage Media Coverage Flyers to LegislatorsFlyers to Legislators Email NetworkEmail Network Committee TestimonyCommittee Testimony Meetings with Key LegislatorsMeetings with Key Legislators

2002 Legislative Session

Bill introduced and passed this session:Bill introduced and passed this session:SB152: SB152: An act relating to health An act relating to health

insurance coverage for hearing aidsinsurance coverage for hearing aids

SB 152      AN ACT relating to health insurance coverage AN ACT relating to health insurance coverage

for hearing aids and related services. for hearing aids and related services.      Create a new section of Subtitle 17A of      Create a new section of Subtitle 17A of KRS Chapter 304 to require all health benefit KRS Chapter 304 to require all health benefit plans to provide coverage for hearing aids plans to provide coverage for hearing aids and related services for persons under 18 and related services for persons under 18 years of age; amend KRS 18A.225 to require years of age; amend KRS 18A.225 to require all health benefit plans for state employees to all health benefit plans for state employees to provide coverage for hearing aids and related provide coverage for hearing aids and related persons for dependents under 18 years of persons for dependents under 18 years of age.age.

SB 152 PRO/CON:

PROVIDESPROVIDES Hearing Aids/earmoldsHearing Aids/earmolds Related ServicesRelated Services Up to age 18Up to age 18 Up to $1,400 per Up to $1,400 per

impaired ear every 36 impaired ear every 36 monthsmonths

DOESN’T PROVIDEDOESN’T PROVIDE Batteries, cordsBatteries, cords For 18 and olderFor 18 and older for 40% of all insured for 40% of all insured

in KY because self-in KY because self-funded plans don't funded plans don't have to follow the have to follow the mandatemandate

What the law means Coverage – for someCoverage – for some Those outside of state jurisdiction are: Those outside of state jurisdiction are:

Self-funded insurance Self-funded insurance ERISA is covered by the Department ERISA is covered by the Department

of Labor, Federal Employee Program, of Labor, Federal Employee Program, and Medicare. and Medicare.

The law only affects new or re-issued The law only affects new or re-issued policies. policies.

CURRENT STATUS

Some insurances are payingSome insurances are paying Health Care Providers must seek Health Care Providers must seek

verification and follow guidelinesverification and follow guidelines Families must continue to be vigilant Families must continue to be vigilant

advocates for their children’s needsadvocates for their children’s needs Continue to push for improved legislationContinue to push for improved legislation

Key Steps to Success

InspirationInspiration MotivationMotivation TeamworkTeamwork PersistencePersistence

www.lrc.state.ky.us/recarch/02rs/SB152.htmwww.lrc.state.ky.us/recarch/02rs/SB152.htm

LouisianaPROVIDESPROVIDES Pays up to $1400. for Pays up to $1400. for

hearing aids every 3yrs hearing aids every 3yrs Pays up to age 18 Pays up to age 18 HoweverHowever, Children are , Children are

covered if are on Medicaid covered if are on Medicaid (approx. 35% of 1,359 (approx. 35% of 1,359 Hearing Impaired in LA)Hearing Impaired in LA)

Children’s Special Health Children’s Special Health services provide hearing services provide hearing aids to a many more aids to a many more hearing impaired. Law hearing impaired. Law intended to capture all intended to capture all other deaf and hard of other deaf and hard of hearing children.hearing children.

PROVIDESPROVIDESAllows parents to buy “Up” Allows parents to buy “Up” on digital hearing aids if they on digital hearing aids if they choose at their own cost.choose at their own cost.

DOES NOT PROVIDEDOES NOT PROVIDEself-funded plans do not self-funded plans do not have to abide by the mandatehave to abide by the mandateOut of state insurance Out of state insurance companies do not have to companies do not have to follow mandate.follow mandate.

Barriers to overcomein Louisiana Hearing aid dealers wanted to join the Hearing aid dealers wanted to join the

legislationlegislation Original plan was to only have Original plan was to only have

Audiologists as providers of hearing aids Audiologists as providers of hearing aids for infants and children within the for infants and children within the legislationlegislation

Dealers were included as most insurance Dealers were included as most insurance carriers required a Masters degree to be carriers required a Masters degree to be providers and many would not qualify.providers and many would not qualify.

Barriers to overcomein Louisiana Opposition from the insurance lobbyistOpposition from the insurance lobbyist

Critical to work on language with the Critical to work on language with the insurance lobbyist so that the bill would insurance lobbyist so that the bill would not be opposed by the lobbyist.not be opposed by the lobbyist.

Defining comprehensive audiometry Defining comprehensive audiometry correctly so that it would be appropriate correctly so that it would be appropriate for the population.for the population.

MARYLAND’S PLEDGE TO CHILDREN WHO ARE DEAF OR HARD OF HEARING

DEBRA DOYLE ALLEN, M.A.

ILENE BRISKIN, SC. D.

SETTING THE STAGE

DEMOGRAPHICS

CUSHION

HISTORY

BUILDING UNHS

Model

Reimbursement

Legislation

Awareness

BUILDING LEGISLATIVE SUPPORT

Awareness and education

State agency support

Voter interest

Special interest lobbying

1999: UNIVERSAL NEWBORN HEARING SCREENING

All birthing hospitals to establish UNHS

Insurers to reimburse

Notification to be provided

Existing program and advisory council to be adapted

FROM UNHS TO EHDI

Community awareness

Amplification

Habilitation

2001: Reducing Barriers to Amplification

Insurance Mandate

For minor children $1400 per ear Licensed

audiologist prescribes, fits and dispenses

Hearing Aid Loan Bank Children 0-3 years Maryland State

Dept. of Education Funding

FOR MORE INFORMATION…

mlis.state.md.us

1999: HB 884; UNIVERSAL NEWBORN HEARING SCREENING

2001: HB 160; HEALTH INSURANCE – HEARING AIDS- COVERAGE FOR CHILDREN

HB 282; STATE DEPARTMENT OF EDUCATION – HEARING AID LOAN

BANK PROGRAM – ESTABLISHMENT AND OPERATION

Minnesota

PROVIDESPROVIDES Pays for hearing aid for Pays for hearing aid for

each year every 3 years. each year every 3 years. (no price limit set)(no price limit set)

Pays up to age 18Pays up to age 18

DOES NOT PROVIDEDOES NOT PROVIDE Self Insured carriers do Self Insured carriers do

not have to paynot have to pay Out of state carriers do not Out of state carriers do not

have to pay.have to pay. Hearing aids not covered Hearing aids not covered

unless hearing loss unless hearing loss occurred at birth.occurred at birth.

Missouri:

CURRENTLYCURRENTLY

PROVIDESPROVIDES Hearing AidsHearing Aids Initial hearing aid onlyInitial hearing aid only

PROPOSED PROPOSED LEGISLATIONLEGISLATION

Hearing AidsHearing Aids Related ServicesRelated Services Up to age 18Up to age 18 Up to $1,400 per Up to $1,400 per

impaired ear every 36 impaired ear every 36 monthsmonths

Oklahoma

Provides HAs to children Provides HAs to children <<18 yrs. (previous 18 yrs. (previous bill was for bill was for <<13 years)13 years)

Only licensed audiologists could dispense Only licensed audiologists could dispense (hearing aid dealers were setting a standard (hearing aid dealers were setting a standard of care of $500./HA)of care of $500./HA)

Modified previous bill, but still needed Modified previous bill, but still needed more work. Stressed importance of being at more work. Stressed importance of being at the capitol to watch the bill as it goes the capitol to watch the bill as it goes through the process.through the process.

Grassroots efforts work!http://www.audiology.org/professional/gov/

http://capwiz.com/audiology/home/

http://www.asha.org/about/legislation-advocacy/grassroots

http://www.asha.org/about/legislation-advocacy/state/issues/ha_reimbursement.htm