The national board of trustees of HLAA publishes Policy Statements on specific topics of concern to people with hearing loss. These documents give background information on issues and how they affect people with hearing loss. Policy Statements may recommend what action needs to be taken to resolve a problem and provide best practices for improving services and programs. Policy Statements are written on emerging issues and with input from various stakeholders. The Policy Statements are voted for adoption by the full board. Policy Statements may be used by HLAA state organizations, chapters and individual members for information and for advocacy when discussing issues of concern to people with hearing loss with legislators, industry, the media, the public at large, businesses and to support requests for communication accessibility.
How to use HLAA Policy Statements
Through the Hearing Loss Association of America network discuss the various aspects of a particular issue. This can also be an excellent way to educate new members about different aspects of hearing loss. Policy Statements can be published in your chapter newsletter. If one of the Policy Statements reflects a particular issue for your chapter or for some members, a chapter might want to gather a group of members to approach a legislator or government agency for help in addressing the issue and use the Policy Statements for written explanation of the problem.
Assistive Device Warranty Laws (Lemon Laws)
The Assistive Device Warranty (ADW) laws, also known as "lemon laws", is a blanket term for consumer protection laws that are being passed in state legislatures throughout the country. Its primary intent was to protect elderly and disabled consumers against faulty motorized wheelchairs, but this original purpose was soon extended to apply to all types of assistive technology devices, including hearing aids.
Cochlear implants (CI) are designed to provide a person access to acoustic information while completely bypassing the normal route of sound transmission to the cochlea. They accomplish this by directly activating the nerve fibers normally stimulated by sounds traveling through the middle ear and into the cochlea.
Dispensing Hearing Aids
The Hearing Loss Association of America recommends that binaural hearing aids be the normal fitting practice, to be modified by clinical considerations and the expressed wishes of the hearing aid user. There are two reasons for this recommendation.
Educating Hard of Hearing Children
The Hearing Loss Association of America views the sense of hearing as a human birthright, one that should be valued and exploited as fully as possible regardless of what system a person employs as a primary communication mode.
Group Hearing Aid Orientation Programs
The decision to purchase one or more hearing aids is not one that hearing aid users take lightly. Beyond the specifics of where to go and what unit to buy, they have had to first accept the reality of their own hearing impairments. For many people, this is a difficult period in their lives and they need all the help, information, guidance and support that they can get.
Hearing Assistance Technologies (HAT)
Hearing aids are effective and help the vast majority of people with hearing loss hear better. They are a crucial and necessary component in any effort designed to mitigate the consequences of a hearing loss. But some problems caused by a hearing loss either cannot be helped by a hearing aid, or the aid working alone may be inadequate.
Hearing Health Care for People with Hearing Loss
Even though a hearing loss is one of the most common of physical and sensory impairments, it is also perhaps the most misunderstood and underestimated. It has been called the "invisible" condition since it is not possible to "see" a hearing loss directly, only its effects upon behavior and communication.
Hearing Screening in Schools
A hearing loss is not only a frequent occurrence in school children, but can have more severe consequences than are generally realized. As reported in the Journal of the American Medical Association, the incidence of unilateral or bilateral hearing loss among children from 6 to 19 years of age was found to be almost 15 percent using a criterion of 16 dB or more in either the high or the low frequencies (Niskar et al., l998).
Insurance Coverage of Hearing Aids
If you wish to urge your employer to include hearing aids as an eligible expense in your insurance policy, HLAA has some advice for you. Begin by identifying the office responsible for managing and making decisions about health care benefits. Meet with the appropriate individuals and explain why you or someone in your family needs hearing aids. Be sure to discuss how hearing aids enhance your ability to function at work.
Job Qualification Testing
Can an employer lawfully require its employees and applicants for jobs to take a hearing test and screen out those who fail to pass? Does an employee or applicant who has a hearing loss have the right to use hearing aids while taking such a test?
Medicare Coverage of Hearing Aids and Aural Rehabilitation
Medicare covers hearing evaluation only if a physician orders the tests, and the purpose of the test is largely diagnostic, that is, to select the type of medical or surgical treatment needed for a hearing loss or other medical issues. Medicare explicitly excludes “hearing aids or examinations for the purposes of prescribing, fitting, or changing hearing aids.” Because hearing aids are statutorily excluded under Medicare, any coverage for Medicare beneficiaries will require amending Title 18 of the Social Security Act.
The Hearing Loss Association of America (HLAA) supports amending Title 18 of the Social Security Act to include coverage of hearing examinations for the purposes of prescribing, fitting or changing hearing aids, coverage of the hearing instruments themselves and aural rehabilitation.
Newborn Hearing Screening
There are psychosocial, linguistic, and educational advantages for children who receive appropriate management for their hearing condition at an early age (Ross, l998). Studies completed over ten years ago have shown that the English language and auditory skill development is superior for these children compared to those whose hearing loss is detected and managed at a later date (Watkins, 1987; White & White, l987; Levitt, McGarr, & Geffner, l987).
Optional Hearing Aid Delivery Systems
In October 2011 United Healthcare® the largest health insurance company with ten million subscribers introduced a direct online hearing health service to consumers. Through its subsidiary hi HealthInnovations, they offer their Medicare Advantage plan subscribers a hearing health benefit – hearing aids free or at very low co-payment.
Executive Director Brenda Battat explained the UnitedHealthcare® hi HealthInnovations program to Hearing Loss Association members in her Hearing Loss Magazine column (January/February 2012). Read her column.
Battat also appeared before the National Institute on Deafness and Other Communication Disorders, National Institutes of Health (NIDCD-NIH), Advisory Council of which she is a member to explain where the Hearing Loss Association stands on the issue. Read her comments.
Mark Ross, Ph.D., also wrote on the topic for the March/April 2012 Hearing Loss Magazine in his article “Direct-to-Consumer Services: Comments on the hi HealthInnovations Hearing Aid Dispensing Program.” Read his article.
Hearing loss is not an all or nothing phenomenon: People with hearing losses are not usually completely deaf, but ordinarily, show varying degrees of hearing loss at different frequencies in one or both ears. Although this fact is obvious, its implications are often overlooked.
Screening for Hearing Loss in Primary Health Care Settings
According to the National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health, more than 36 million Americans report that they have hearing loss, 10 percent of the U.S. population. A study by researchers at Johns Hopkins University School of Medicine, which based its statistics on audiometric testings, found that one in five Americans age 12 and over, approximately 48 million people in the U.S. has a hearing loss. It is also well documented that hearing loss adversely affects quality of life and is linked to other serious health conditions, including falls, depression, and cognitive decline. At the same time, access to hearing health care and the technology that could help people with hearing loss is hindered because consumers face multiple barriers which include a complex and confusing system. One such barrier is lack of screening in primary care. Reports indicate that hearing screening in primary care is uncommon, occurring approximately 17-30 percent of the time even in elderly individuals who are at risk for hearing loss.
The Hearing Loss Association of America (HLAA) supports the inclusion of a standardized approach to screening for hearing loss in primary health care settings that includes both a subjective and objective component in all adults during routine physicals; the “Welcome to Medicare” assessment; and Medicare annual risk assessments, that are accomplished in primary care settings.
All hearing aids contain three basic components: the microphone, amplifier, and loudspeaker (called a "receiver" in hearing aid terminology). The microphone picks up sound waves and converts these into a tiny electrical current. This current is then amplified and changed back into sound by the hearing aid receiver.
The Doctor of Audiology Degree
It is generally accepted that the profession of audiology had its genesis during and immediately after World War II. Servicemen deafened by war injury required aural rehabilitation services, and various types of health care professionals joined forces to provide such programs. After the war, these programs became the basis for the creation of formal academic programs in colleges and universities designed to train "speech and hearing therapists".
Vocational Rehabilitation and People Who Are Hard of Hearing
The United States government operates an extensive vocational rehabilitation (VR) program that provides a wide range of services and job training to people with disabilities who want to work.
Wider Access to the Full Spectrum of Hearing Technology Benefiting People with Hearing Loss
According to the National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health, access to devices and emerging technologies that could help people with hearing loss is limited because consumers face multiple barriers, including a system that is confusing and involves competing interests. This thwarts the ability of the individual to find the best and most affordable options to address his or her particular situation. The Hearing Loss Association of America (HLAA) supports a hearing health care system that provides consumers access to the full spectrum of safe and effective hearing technology to meet their individual needs. This model should include:
- Easy access to the full spectrum of hearing technology based on individual need and ability to pay. Hearing technologies include hearing aids and the full range of assistive listening devices including personal sound amplification products (PSAPs).
- To the greatest degree possible, hearing technology should not be proprietary and should be usable by consumers of all brands of hearing devices.
- Access to appropriate hearing technology through multiple points of entry, including: hearing health care specialists (audiologists, hearing aid specialists, otolaryngologists); direct website access; pharmacies; and retail outlets.
- Creation of functional performance standards for all hearing technology.
Utilization of multiple platforms – websites, informational brochures, product labeling and in-store information – to provide the information and education needed to ensure informed consumer decision making, including, but not limited to:
- expected performance of the hearing technology;
- means of comparison to other similar hearing technology; and,
- limitations of the hearing technology.