Louisiana Initiates Hearing Aid Program Qualified, older Louisiana residents may begin to receive basic hearing aids, at no charge, later this fall from the Louisiana Commission for the Deaf (LCD). The original plan was to provide hearing aids free of charge to all Louisiana citizens who are not already eligible for other state or federal ... News in Brief
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News in Brief  |   November 01, 2002
Louisiana Initiates Hearing Aid Program
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Hearing Aids, Cochlear Implants & Assistive Technology / News in Brief
News in Brief   |   November 01, 2002
Louisiana Initiates Hearing Aid Program
The ASHA Leader, November 2002, Vol. 7, 1-34. doi:10.1044/leader.NIB.07202002.1
The ASHA Leader, November 2002, Vol. 7, 1-34. doi:10.1044/leader.NIB.07202002.1
Qualified, older Louisiana residents may begin to receive basic hearing aids, at no charge, later this fall from the Louisiana Commission for the Deaf (LCD).
The original plan was to provide hearing aids free of charge to all Louisiana citizens who are not already eligible for other state or federal hearing assistance programs, such as Medicaid or the Veterans Administration.
After drawing concerns from around the state, over 40 audiologists wrote in and suggested guidelines to the qualification parameters, including the following:
  • The applicant must have a documented hearing loss of 40 dB or greater and be age 50 or older. Younger individuals may be considered on an individual basis.

  • The applicant’s household income cannot exceed 250% of the federal poverty guidelines. This means that the cutoff point will be about $22,000 for an individual and about $29,000 for a couple.

  • The hearing aids will be limited to behind-the-ear, in-the-ear, and in-the-canal instruments. LCD will pay up to $400 of the invoice cost and reimburse the dispenser a fee of $325 for a monaural fitting and $500 for binaural fitting.

  • A 30-day trial is mandated by state licensure, rather than the initial 60-day trial period.

  • Provisions have been added to pay for custom earmolds and two follow-up hearing aid checks. A $65 fee will be paid for a diagnostic audiological evaluation; however, the same fee is allocated for both audiologists and hearing aid dispensers.

“The proposed program by the Louisiana Commission for the Deaf has a great deal of merit in that it would provide hearing aids to individuals of low income who have no other means of obtaining amplification,” says Glenn Waguespack, a Shreveport, LA, audiologist in private practice and chair of the state licensing board. “At the same time, audiologists may suffer financially due to the low reimbursement rates and the ethical need to inform patients of the program.” Waguespack estimated that about 50% of his clients would qualify for the LCD’s program, and that this is common across the state.
Initial Concerns
Problems with the initial plan included reimbursement rates for hearing aids that were lower than Medicaid rates. Concerns also were cited that the same type of program and reimbursement rates will be in place for audiologists as for hearing aid dispensers who possess a different level of training and expertise.
Waguespack also says that the initial plan could potentially result in abuse of consumers. “With no economic restrictions, the potential existed for the dispensing of unnecessary and/or inappropriate hearing aids,” he says. “Hearing aid dispensers often fit hearing aids in patient’s homes, and nothing would stop them from fitting all residents of nursing homes.”
The program does not provide any parameters for audiometric testing. “The diagnostic battery includes pure-tone-air and bone-conduction testing, speech-reception thresholds, speech-discrimination testing, and MCL and UCL measurements,” Waguespack says. “However, there are no specifications for the test environment. This means that some hearing aid dispensers will be paid for a diagnostic evaluation that was not conducted in a sound-treated room under controlled conditions.”
The initial legislation passed last July is currently in the legislative rules promulgation process, which mandates a period of publicizing the new guidelines and receiving comments. The deadline for these new guidelines to be submitted was Sept. 6. Waguespack says that the executive director of LCD contacted audiologists by phone for suggestions on how to revise the plan.
Once the promulgation process is completed, and if the committee approves the rules in their revised form, they may become effective in 60 days. The LCD says it plans to begin implementation this month.
Organized in 1980, the LCD aims to ensure that Louisiana’s public and private services are accessible to citizens who are deaf, deaf-blind, hard of hearing, and speech impaired. The program is designed to be a statewide resource on issues related to the welfare and inclusion of these citizens. LCD, which is under state rehabilitative services, received its funding for this program through a phone program that provides assistive listening devices.
According to the July 2002 Hearing Journal, the state will pay for the program largely from the LCD Telecommunications Fund for the Deaf, which, since 1988, has been receiving the proceeds from a 5-cents-per-month tax on every telephone line in Louisiana. Originally, the fund paid only for devices designed to give people with hearing loss equal access to the public telephone network. However, money began accumulating in the fund, so the 2001 law expanded the permissible uses. Last year, it became available for assistive devices. This year, the fund—supplemented by a $750,000 appropriation by the legislature—will start paying for hearing aids.
Audiologists first learned of the LCD’s program this spring when the LCD sent vendor applications to all licensed audiologists and licensed hearing aid dispensers informing them that July 2001 legislation had authorized the LCD to provide hearing aids as well as assistive listening devices to citizens of Louisiana.
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November 2002
Volume 7, Issue 20