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House Bill No. 910
MassHAFCC
"An Act to Provide Coverage
for Hearing Aids For Children"
"Children need to be able to hear, not just in the classroom, but also because
hearing affects language competence, cognitive development, social and emotional
well-being, and academic achievement,"
"Children who cannot hear well — that is, when their hearing loss is untreated or
under-treated — could face a life of underperformance and broken dreams."
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(Sergei Kochkin, Ph.D)
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Types of Hearing Loss
• Conductive
• Sensorineural
• Mixed
• Unilateral
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A decrease in sound caused
by a problem in the outer or
middle ear (e.g., wax, eardrum
perforation, fluid in the middle
ear).
A loss caused by damage to
the inner ear or along the
auditory nerve.
A conductive loss and a
sensorineural loss occurring at
the same time.
Affects only one ear.
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Degree of Hearing Loss
Degree of hearing loss
Normal
Slight
Mild
Moderate
Moderately severe
Severe
Profound
Hearing loss range (dB HL)
-10 to 15
16 to 25
26 to 40
41 to 55
56 to 70
71 to 90
91+
Degree of hearing loss refers to the severity of the loss.
The numbers represent a person’s threshold, which is
the softest intensity at which sound is perceived.
Source: American Speech-Language Hearing Association
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Universal Newborn Hearing
Screening Program
• In 1998, Massachusetts passed a law that mandates hearing
screening for all newborns before leaving a hospital or birthing
center. (Chapter 111, Section 67F)
• 1 of every 4 infants who do not pass a hearing screening in
Massachusetts will be diagnosed with a hearing loss.
(Executive Office of Health and Human Services)
• A goal of newborn hearing screening is long-term cost savings
because early identification results in improved language abilities,
lower educational and vocational costs, and increased lifetime
productivity.
• However, once hearing loss is diagnosed and hearing aids are
prescribed, parents or caregivers must pay out-of-pocket for hearing
aids, which cost upwards of $2,000 each.
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Effect of No Insurance Coverage
Diagnosis of hearing loss (ideally via Newborn Hearing Screening or later)
Hearing aids deemed medically necessary
No insurance coverage
Delayed access to hearing aids
Continued decreased access to sound and speech
resulting in delay in communication skills
Greater probability for delays in language,
education, social skills, emotional health
and lifetime productivity
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Increase lifetime costs for special
education services, social services
and medical care
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“normal” range
“mild” HL
“moderate” HL
“severe” HL
“profound” HL
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Incidence of Pediatric
Hearing Loss in MA in 2007
• In 2007, 212 infants out of 78,724 births in
MA were diagnosed with permanent
(sensorineural) hearing loss.
• Of these 212 children, approximately 150
will have hearing loss that makes them
eligible for hearing aids.
Information provided by Universal Newborn Screening Program, MA DPH
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Distribution of Children Born in MA
with Hearing Loss in 2007
0.4%
0.1%
0.2%
0.3%
0.3%
0.4%
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Distribution of Children Born in MA
with Hearing Loss in 2007
EOHHS* Region of Residence
Total Births
Total with perm. Hearing Loss
(%)
Overall
78724
212 (0.3)
Boston
21802
32 (0.1)
Central
9485
32 (0.3)
Metro West
16357
41 (0.3)
Northeast
11452
43 (0.4)
Southeast
10287
41 (0.4)
Western
9074
21 (0.2)
Out of State
n/a
2 (n/a)
* Executive Office of Health and Human Services
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How Hearing Aids Work
• A microphone picks up sound waves, converts them to
electrical impulses and sends them to an amplifier that
makes them louder.
• A circuit modifies the electrical impulses with the
prescribed amount of amplification.
• A receiver converts the amplified sound back to sound
waves and delivers them through the ear canal.
• A battery supplies power to the hearing aid.
• Hearing aids allow users to also rely on their residual
hearing to respond to sound.
• The most common hearing aid worn by children is a
behind-the-ear aid.
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Early Amplification is Key
“Children who are early identified and receive
intervention prior to six months of age have
significantly better receptive language,
expressive language, personal-social skills,
receptive vocabulary, expressive vocabulary and
speech production.”
Source: Apuzzo & Yoshinagi-Itano, 1995; Moeller, 1998; Yoshinaga-Itano
et al, in press; Yoshinaga-Itano & Apuzzo, in press.
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Massachusetts House Bill No. 910
• Filed by Representative S. Garballey (Arlington) in
January 2009.
• Mandates insurance coverage for the cost of hearing
aids for children up to 18 years old.
• Up to $1,600 per hearing aid every 3 years.
• Allows insured to choose higher priced hearing aid and
pay the difference in cost.
• Supporters include:
–
–
–
–
–
Audiologists at Children’s Hospital
Private audiologists in MA
Parents, including members of MassHAFCC
Speech-language pathologists
Teachers of the Deaf
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Other Costs Related to Owning and
Maintaining Hearing Aids
(NOT covered by insurance )
Item
Replacement Need
Estimated cost
Ear molds
Every 3-6 months (more often for
young children due to ear growth)
~$300.00/pair
Batteries
Dependent on degree of hearing loss
(~1 week)
$15.99 for 16 batteries
Battery testers
~Every 1-2 years
~$9.99 per unit
Dry and Storage containers
~Every 3 years
~$100.00 per unit
Desiccant (drying briks)
~Every 2 months
~$10.00 for 3 briks
Cleaning Wipes
Dependent of frequency of use
~$19.95 for box of 100
Testing Stethoscope
~Every 1-2 years
~$30.00
Clips for Younger children
Dependent of activity level of child
~$9.95 per unit
Tubing Air Blower
~Every 1-2 years
~$7.95 per unit
Hearing Aid sweat bands
~Every year
~$21.95
Lubricant (Oto-ease)
Dependent of frequency of use
~$3.50 for 1 ounce
Loss and Damage Insurance
Yearly
Individualized
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http://monarch.tamu.edu/~smrs/09434649.gif
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States that Have Passed
Hearing Aid Legislation
• 2001:
•
•
•
•
•
•
•
2002:
2003:
2004:
2007:
2008:
2009:
2010:
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Maryland, Connecticut,
Oklahoma, Rhode Island
Kentucky
Minnesota
Louisiana, Missouri
New Mexico, Maine
Colorado, Delaware, New Jersey
Arkansas, Wisconsin
North Carolina, New Hampshire
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Basic Facts:
Pediatric Hearing Loss
•
•
•
•
•
#1 birth defect: ~ 3 of every 1,000 births in the U.S.
More than 90 % of children diagnosed with hearing loss are born to parents
who have typical hearing.
In 2002 alone, over 70,000 students (ages 6-21) received Special Education
services due to their hearing loss. 1
Children who do not receive early intervention cost schools an additional
$420,000 and face overall lifetime costs of $1 million in special education,
lost wages, and health complications.2
There are 1.4 million children with hearing loss in America (1.7%
prevalence); yet only 12% use hearing aids (as identified by their parents).3
– 1 out of 5 (22%) parents said they were unable to afford hearing aids
– On average, a pair of hearing aids costs $4,000
Alexander Graham Bell Association for the Deaf and Hard of Hearing
1US Department of Education
2International Journal of Pediatric Otorhinolaryngology, 1995
3Better Hearing Institute national survey of 53000 households
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Basic Facts:
Pediatric Hearing Loss
A 2007 Better Hearing Institute Study determined the
most serious problems experienced with untreated
hearing loss were:
–
–
–
–
–
–
–
Social skills (52%)
Language/speech development (51%)
Grades in school (50%)
Emotional health (42%)
Relationships with peers (38%)
Self-esteem (37%)
Relationships with family (36%)
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Basic Facts:
Pediatric Hearing Loss
• Babies and young children learn to talk by listening to the voices of
family members and caregivers from the time they are born. Any
degree of hearing loss has the potential to interrupt speech and
language development.
• Early intervention combined with the use of hearing aids enables a
child with hearing loss to develop language skills comparable to
their hearing peers by the time they enter first grade.
• Today, most infants have a hearing loss screening before they leave
the hospital. Early detection of a hearing loss means earlier access
to hearing technology and early intervention, and a better
opportunity for a child to develop spoken language.
Source: Alexander Graham Bell Association for the Deaf and Hard of Hearing
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Educational Impact
• Any degree of hearing loss can be educationally significant for
children. Even children with mild to moderate hearing losses can
miss up to 50% of classroom discussions.
• 37% of children with only minimal hearing loss fail at least one grade
(Bess, 1998).
• Unmanaged hearing loss in children can affect their speech and
language development, academic capabilities and educational
development, and self-image and social/emotional development.
• Studies estimate that as much as 90% of what young children learn
is attributable to incidental conversations around them (Flexer,
1993).
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MassHAFCC
The Massachusetts Hearing Aids for Children
Coalition is a statewide network of families of
children who are deaf or hard of hearing and
professionals working together to maximize a
child’s lifetime potential through educational,
medical, social and emotional support.
MassHAFCC’s current focus is to work to pass
legislation in MA that would compel insurance
companies to cover the cost of hearing aids for
children.
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Contact Information
Lisa Adams: [email protected]
President, MassHAFCC
Yahoo Group:
http://health.groups.yahoo.com/group/MassHAFCC/
Facebook:
http://www.facebook.com/home.php?#!/group.php?gid=107850185906
949
Blog:
http://masshafcc.blogspot.com/
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