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The Maryland Hearing Aid Loan Bank A Bridge To Early Intervention Paul K.Farrell, Sue Griebler, Ilene Briskin 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 1985: HIGH RISK REGISTRY Program for Hearing Impaired Infants at the Maryland State Department of Health and Mental Hygiene (DHMH) Advisory Council Identify Risk Factors – – – – – – – – NICU more than 48 hours Anatomical malformation Asphyxia Bacterial meningitis Low birthweight Perinatal infection Family history Hyperbilirubinanemia MARYLAND’S PATH TO UNIVERSAL NEWBORN HEARING SCREENING 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 Md. Academy of Pediatrics Audiology A.G. Bell Association Md. Hospital Assoc. Advisory Council Md. Speech, Language, Educational Audiology Hearing Association Assoc. University of Maryland Johns Hopkins Hospital Hospital 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 FINANCIAL CONCERNS Maryland Health Care Commission Insurance Industry Fiscal note: Cost/Benefit study 1999: UNIVERSAL NEWBORN HEARING SCREENING All birthing hospitals establish UNHS Insurers reimburse Notification provided Existing program & Advisory Council expanded and administered by DHMH 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 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 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. 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 The Basics: Getting off the ground Application Policies & Procedures Audiologist Survey Brochure Purchasing Public Awareness Family Satisfaction Survey 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 Audiology Services LITP Service Coordinator Permanent Hearing Aids Or Cochlear Implant 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 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 child’s 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 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. Budget Outline Personnel Communications Travel Contractual Services Supplies Equipment 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 Manufacturer Support Educate key sales representative Discount purchasing Donations on individual case basis Making a Difference 70 60 50 40 Hearing Aids 30 20 10 0 2003 2004 May- Dec. 2003 20 Hearing Aids disbursed to 10 families In 2004 61 hearing aids were disbursed to 32 families The Good News! As of March, 2005 the return rate for loaned hearing aids is 100% Maryland Infants and Toddlers Staff Development Programs Grants from DHMH/Sponsored by MSDE “Beginning the Journey:Intervention 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 Strengths Early Detection Of Hearing Loss Fast Access Hearing Aids School Readiness 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 Contact Information Paul K. Farrell Director, Maryland Hearing Aid Loan Bank (410) 767-0739 [email protected] Sue Griebler Educational Consultant (410) 767-2331 [email protected] Ilene Briskin Education\Health Care Consultant Public Policy\Grant Writing [email protected] QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture.