By David H. Kirkwood
WASHINGTON, DC–Contending that the increasing number of U.S. veterans with hearing problems has outstripped the ability of the Department of Veterans Affairs (VA) to meet their needs effectively, the International Hearing society (IHS) has launched a campaign to make hearing aid specialists eligible to provide to veterans with hearing evaluations and hearing aid services.
Under current VA regulations, the free hearing aids and audiologic services to which qualified veterans are entitled must be provided—with only rare exceptions–by audiologists. These audiologists are either VA employees or independent audiologists working under contract with the VA.
IHS, whose members are predominantly hearing aid specialists, points out that these non-audiologist practitioners are licensed in every state to provide hearing care to adults and have been designated by the Federal Office of Policy and Management government as approved providers for people insured under the Federal Employees Health Benefits (FEHB) Program. Surely, IHS argues, hearing aid specialists are also “fit to serve” America’s veterans and to do their part to ensure that those who defended their country in uniform get the care they deserve.
LAUNCHED ON CAPITOL HILL
The Fit to Serve Campaign was officially launched on February 28 when 14 IHS members and staff visited the Washington offices of 18 members of Congress. Their goal was to raise awareness of the need for veterans to have improved access to hearing care services and to explain how hearing aid specialists can help provide that.
Among the participants was Tom Higgins, BC-HIS, president of the organization. As a U.S. Navy veteran, he has often expressed his frustration at having to turn away veterans coming into his practice in Ramsey, NJ, because the VA program does not allow hearing aid specialists to serve “our nation’s heroes.”
In a March 14 e-mail message to the membership, Higgins reported on the visits by IHS members to their representatives in Congress and their staff. Higgins wrote:
“We shared your stories of long waits [by veterans] for appointments, inadequate programming, limited follow-up services, and veterans being turned away for simple repairs because they had no appointment. We told them how hearing aid specialists are uniquely qualified to help the VA meet the need for high-quality, local, and timely hearing evaluations and hearing aid services.”
As IHS’s manager of government affairs, Alissa Parady is playing a key role in Fit to Serve. Parady, who is based in Washington, told Hearing News Watch that the members of Congress and their staffs who met with the IHS delegates responded positively to the initiative and were very interested in what the visiting hearing aid specialists told them about their experiences with veterans and the VA.
For example, at one meeting on February 28, Richard Giles, BC-HIS, the Pacific governor for IHS, informed Rep. Jaime Herrera Beutler (R-WA), who represents his district, about a veteran who had recently come to his office in Vancouver, WA. The man was distraught because neither the new hearing aids he had received from the VA nor his backup instrument was working and he had been unable to get them fixed in a timely manner. (According to the VA’s hearing aid handbook, hearing aids brought by a veteran to an audiology clinic for repair usually take two to three weeks to be returned; those shipped to the VA’s Denver Distribution Center take four to six weeks.)
The veteran, who was terminally ill, told Giles that he had come to him after being turned away from his local VA clinic because he didn’t have an appointment for that day. He had previously scheduled an appointment for April to have his new instruments looked at, but when his backup failed he was desperate to get help sooner.
Although Giles found that the new hearing aids needed to be returned to the manufacturer, he was quickly able to fix the back-up instrument, which allowed the veteran and his family to communicate during his final weeks.
After hearing this account, Herrera Beutler was shocked, Giles said. “Her jaw dropped, and she told a staff member ‘Take care of this!’”
A LONG TIME IN THE PLANNING
Although Fit to Serve was officially launched only three weeks ago, IHS leaders have been laying the groundwork for more than a year.
Parady said that with the aging of Vietnam War veterans and the high percentage of veterans of Iraq and Afghanistan who suffer from hearing loss and tinnitus, the VA has been unable to keep up with the growing demand for audiologic services.
“We aren’t finding fault with the VA,” said Parady. “It’s a wonderful institution.” But, she added, “The audiologists are so overwhelmed they may not have time to do as much counseling and follow-up.”
As a result, she said, IHS members report seeing more and more veterans coming to their offices either to buy hearing aids out of their own pocket because they don’t want to wait to get them free from the VA or to get help with the hearing aids provided by the VA. These developments convinced IHS that the time had come for hearing aid specialists to be allowed to help serve veterans’ hearing needs in the same way that non-VA audiologists have done for many years.
To this end, Parady, Higgins, and Kathleen Mennillo, the executive director of IHS, met in February 2012 with Lucille Beck, PhD, who is director of the VA’s Audiology and Speech Pathology Program and also chief consultant of the VA’s Rehabilitation Services.
According to Parady, Beck said that the VA was taking steps to increase its ability to serve veterans. These included making greater use of audiology assistants and developing tele-audiology programs to serve patients who don’t have easy access to a VA clinic. Parady said that Beck expressed confidence that the VA would be able to handle its caseload through these programs.
(Editor’s note: My attempts to reach Beck and the VA’s media relations office have not yet been successful, but I welcome their comments on the Fit to Serve campaign and this post.)
PETITIONING FOR A NEW POLICY
The society stepped up its campaign last December when Mennillo sent a seven-page letter to the VA’s director of regulation, policy and management. The letter, submitted in response to requests for public comment on a proposed new rule regarding non-VA medical services in general, explained in detail why IHS believes current VA policy “does not adequately serve the hearing healthcare needs of veterans” and why it “recommends hearing aid specialists be permitted to provide hearing evaluations and hearing aid services for veterans as non-VA providers.”
Mennillo wrote, “Hearing aid specialists can and are ready and willing to help the VA meet their goals stated in a 2012 VA presentation (“Meeting the Challenges of VA Audiology Care in the 21st Century”) to the Association of VA Audiologists: “Improve access to care in rural and highly rural areas; improve access to specialty care; reduce time spent in travel and time off work; reduce costs.”
She contended that because of rising demand for services, “VA clinics are increasingly unable to meet the hearing healthcare needs of veterans. As a result, veterans are experiencing long wait times to get appointments, limited follow-up services, and extensive time spent traveling to their nearest VA clinic (which may be several hours away).”
Mennillo added that hearing aid specialists, who number about 9000 in the U.S., are fully qualified to serve veterans. “Contrary to outdated and inaccurate perceptions,” she stated, “hearing aid specialists do not simply fit and ‘sell’ hearing aids,” but are full-fledged hearing care providers. In fact, she argued, “As they move into independent practice, hearing aid specialists typically have as much, if not more experience performing hearing evaluations and fitting and dispensing hearing aids than an average new AuD (doctor of audiology) program graduate.”
Mennillo’s letter received no response.
The Fit to Serve campaign is IHS’s most ambitious lobbying initiative in many years. To improve its chances for success, the organization has hired Brownstein Hyatt Farber Schreck, a leading Washington lobbying firm, and has retained a public relations firm.
The campaign is expected to cost IHS $115,000 in 2013, which will be paid for entirely through member donations.