Pictured from left are Brook Brunson, a lobbyist for IHS; Alissa Parady, IHS governmental affairs director; Brendon Gehrke, military legislative assistant for Rep. Walz; Robert Hamill, Legislative Assistant for Rep. Duffy; and Matt Eversmann, national spokesperson for Fit to Serve.
By David H. Kirkwood
WASHINGTON, DC—The International Hearing Society (IHS) turned its Fit to Serve campaign up a notch last week with the introduction of federal legislation that would authorize the Department of Veterans Affairs (VA) to hire hearing aid specialists to provide care for veterans with hearing loss, tinnitus, and related conditions.
IHS launched Fit to Serve in February on the premise that hearing aid specialists—who make up a majority of its membership—have the skills and qualifications needed to help the VA meet the spiraling demand on its Audiology and Speech Pathology Service to care for veterans with hearing problems. Currently, the VA relies almost entirely on audiologists, either those employed in VA medical centers or outside practitioners who work with the department on a contractual basis.
Sean Duffy
H.R. 3508, the bill that Congressmen Sean Duffy, a Wisconsin Republican, and Timothy Walz, a Democrat from Minnesota, introduced November 15 on IHS’s behalf would:
• Give the Department of Veterans Affairs (VA) the ability to hire hearing aid specialists internally.
• Require the VA to report annually to Congress on appointment wait times and network provider utilization rates, which will raise awareness of the VA’s work to increase veterans’ access to local and timely hearing healthcare services.
• Direct the VA to update its contracting policies to reflect the new internal hiring classification for hearing aid specialists. (Currently, when the VA refers patients to outside contractors, it sends them only to audiologists.)
IMPROVING CARE FOR VETERANS
IHS’s announcement of the federal legislation, the first ever initiated by the 65-year-old association of hearing care providers, said that its intention is to ensure that America’s veterans have convenient, timely access to high-quality hearing healthcare.
IHS stated, “Despite the VA’s best efforts, the number of veterans in need of adequate hearing healthcare services is quickly surpassing the VA’s ability to adequately respond. Veterans often face long wait times for appointments, significant travel distances to the nearest VA clinic, and limited follow-up care.”
Largely as a result of U.S. soldiers’ exposure to improvised explosive devices (IEDs) during their service in Iraq and Afghanistan, the incidence of hearing loss and tinnitus among veterans of these recent conflicts is extraordinarily high.
IHS said, “The effect of hearing loss can be devastating to veterans, particularly as they adjust to a civilian lifestyle, and may contribute to depression, heightened stress, fatigue, and other challenges. For many veterans, a lack of proper hearing healthcare exacerbates these symptoms, leading to strained relationships and difficulties in maintaining a career.”
It continued, “Fit to Serve is working to lift existing restrictions to allow all qualified hearing aid specialists, alongside the hearing professionals of the VA, to [serve] America’s veterans. H.R. 3508 represents a major step forward in achieving these goals.”
Matthew Eversmann, First Sergeant (ret.), U.S. Army, and national honorary spokesperson for Fit to Serve, commented, “I can’t think of a better way to honor America’s veterans than by improving the healthcare that they have earned. Better hearing healthcare is a vital part of ensuring the quality of life of the men and women who have served our country.”
SPONSORS CITE NEED FOR THE BILL
The two lead sponsors of H.R. 3508 explained why it is needed.
Duffy said, “Veterans in my district are driving up to 90 miles one way just to get hearing services from an audiologist at the VA. These veterans could receive the same service from a local hearing instrument specialist, but under current law, the VA is only allowed to use audiologists.” Duffy added that passing the law would “provide greater freedom, flexibility, and more options for the men and women who have served our grateful nation.”
“Ensuring veterans are able to get the care and support they need at home should be a top priority,” said Walz, the highest ranking enlisted
Timothy Walz
soldier ever to serve in Congress, said. “Our bipartisan, common sense bill simply allows veterans to utilize hearing instrument specialists to get the care they need, which will reduce the burden on VA audiologists and improve the quality of life for veterans in need of care.”
The introduction of H.R. 3508 was the product of many months of work. IHS members held more than 100 meetings with members of Congress and their staffs. They also spoke with leaders of seven national veterans service organizations and with industry partners.
IHS, which is based in Livonia, MI, is now working to recruit co-sponsors for the legislation. It is also urging its members to spread word of H.R. 3508 “to colleagues and friends who want to see veterans get the hearing healthcare they deserve.”
Author’s note:
On November 19 I left a telephone message and sent an e-mail to the VA Media room requesting a comment from the VA on H.R. 3508 and the Fit to Serve campaign. Thus far, I have received no response.
Tinnitus is the number one service related disability of veterans returning from Iraq and Afghanistan. The number of veterans receiving service connected disability due to tinnitus has been increasing at the rate of 15% per year. At this rate, 2014 will see 1.5 million vets receiving military compensation for tinnitus at a cost to American taxpayers of over $2.26 billion.
Source: http://www.tinnitusformula.com/library/iraq-afghanistan-veterans-tinnitus-hearing-loss/
Barry,
You bring up an important topic about tinnitus which leads me to make a point about quality of care and services for veterans. Hearing instrument specialists have scope of practice which is limited to basic (non-diagnostic) hearing screenings for the sole purpose of selling and fitting hearing aids. Comprehensive diagnostic procedures along with many treatment services (including for tinnitus as well as balance disorders) are not within the scope of practice for a hearing instrument specialist (H.I.S.). Licensure for an H.I.S/hearing aid dealer in most states requires no formal education beyond a high school diploma or equivalent. Licensure to sell hearing aids does not, by itself, encompass the best healthcare practices that veterans deserve. The VA is not a perfect system (and any veteran knows that dealing with the government can have its challenges), but quality and comprehensive care should never be sacrificed.
Further, contrary to the press releases being put out by the IHS, the VA and many audiologists actually staff and utilize support personnel such as technicians, assistants, aids, and even hearing instrument specialists. When diagnosis and treatment is provided under the guidance of the audiologist, these support personnel are a great asset and allow for increased availability of services while ensuring the highest level of care are delivered and underlying medical conditions are not missed. This model is already an option for use by the VA so that individuals do not have to travel great distances or have long wait times, but rather can obtain services including diagnostic, treatment, and rehabilitation from contracted local audiology practices (which may also employ support personnel including hearing instrument specialists). In addition, the increased availability and utilization of tele-health practices will also afford better access to quality health care for veterans.
Myself a veteran with tinnitus, a former hearing instrument specialist and current doctor of audiology, I am highly aware of the hearing healthcare industry and obviously have my own personal biases. These biases are formed by my collective experiences and my opinion is that this legislation does NOT serve the best interests of veterans, but rather jeopardizes the quality of care and puts the veteran at risk for missed diagnoses and untreated or inappropriately managed problems.
We all know we can be convinced of things “that are for our own good” only to find out that it caused another problem and really did not solve the first one. In fact, some might argue that this is the definition of “politics.”
Sincerely,
Clint
The above commenting is the exact definition of “politics”
The idea that Licensed Hearing Instrument Specialists are unfit or to infer that their skills and abilities are that of being substandard in aiding veterans or any other individual with their hearing needs, Tinnitus or not is preposterous.
The ENT referral criterion exists for reason. The patient either falls within the criterion or he/she does not. While the above commenting points out specific instances that Clint has observed in his experiences, it does not effectively communicate a clear picture as to what confident meaning this would make to hearing impaired veterans as a whole. The thought of being able to help the paying public and others on programs like Medicaid on a daily basis, but having to continue to turn away veterans who are in desperate need of something as simple as a clean & check of their instruments, an adjustment, or new fitting is absurd.
Speaking for the over 9000 specialists nationwide, who have undoubtedly helped a down and out vet with a hearing aid issue, some after just returning from a VA site being assisted by an Audiologist, respectfully dismiss the thought of being a subordinate in this campaign, and will keep calm and carry on as we have done now for well over 50 years.
Regards,
Cameron Ellison HIS,COHC
Clint, could not have said it better myself. As an audiologist, the HIS has zero business attempting to do anything more than a hearing screening. The idea that a Veteran would fall into their hands is frightening!