Vocational Rehabilitation: A Possible Route to Hearing-Device Funding Your state’s vocational rehabilitation program can help you better serve patients and grow your practice. All Ears on Audiology
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All Ears on Audiology  |   February 01, 2017
Vocational Rehabilitation: A Possible Route to Hearing-Device Funding
Author Notes
  • Laura Smith-Olinde, PhD, CCC-A, is an associate professor of audiology and director of the Educators Academy at the University of Arkansas for Medical Sciences. She is also a contributor to VR4Hearing Loss, a website that provides training resources for vocational rehabilitation professionals. She is an affiliate of ASHA Special Interest Groups 6, Hearing and Hearing Disorders: Research and Diagnostics; and 10, Issues in Higher Education. lso@uams.edu
    Laura Smith-Olinde, PhD, CCC-A, is an associate professor of audiology and director of the Educators Academy at the University of Arkansas for Medical Sciences. She is also a contributor to VR4Hearing Loss, a website that provides training resources for vocational rehabilitation professionals. She is an affiliate of ASHA Special Interest Groups 6, Hearing and Hearing Disorders: Research and Diagnostics; and 10, Issues in Higher Education. lso@uams.edu×
  • Steven E. Boone, PhD, is the associate provost for teaching and learning support at the University of Arkansas for Medical Sciences and the primary investigator and founder of VR4HearingLoss. He is also the former director of research for a federally funded research and training center for vocational rehabilitation and hearing loss. seboone@uams.edu
    Steven E. Boone, PhD, is the associate provost for teaching and learning support at the University of Arkansas for Medical Sciences and the primary investigator and founder of VR4HearingLoss. He is also the former director of research for a federally funded research and training center for vocational rehabilitation and hearing loss. seboone@uams.edu×
Article Information
Hearing Aids, Cochlear Implants & Assistive Technology / All Ears on Audiology
All Ears on Audiology   |   February 01, 2017
Vocational Rehabilitation: A Possible Route to Hearing-Device Funding
The ASHA Leader, February 2017, Vol. 22, 18-19. doi:10.1044/leader.AEA.22022017.18
The ASHA Leader, February 2017, Vol. 22, 18-19. doi:10.1044/leader.AEA.22022017.18
Access to hearing-assistive technologies is often limited by a person’s ability to pay. But by participating in programs run by state-based vocational rehabilitation (VR) programs, audiologists may be able to better help those with hearing loss fund their treatment.
The hearing aid adoption rate in the U.S. has risen in recent years to about 30 percent in people with “hearing difficulty,” but varies with age and degree of hearing loss. About 25 percent of working-age people with hearing loss use hearing aids, while 40 percent of people older than 65 with hearing loss use them. People with mild loss adopt at less than 10 percent, but the rate increases to about 40 percent in people with moderate to severe loss (see sources below).
There are several reasons for the low adoption rate, and we know cost is one. Half of hearing aid non-adopters say they “definitely” cannot afford hearing aids and 15 percent say they “somewhat” cannot afford them (see sources).
Only recently have some insurance companies begun covering hearing aids, and audiologists and patients have long looked for alternative funding sources. For working-age patients, your state’s VR system may provide that alternative funding.

Federal guidelines mandate the program components that vocational rehabilitation in each state must follow, although implementation and service delivery models vary by state.

How VR works
The state-federal VR program provides a broad range of services to people with hearing loss who experience functional limitations at work—for example, when someone’s telephone use is restricted or the ability to participate in meetings is compromised. Federal guidelines mandate the program components that VR in each state must follow, although implementation and service delivery models vary by state. Some states hire audiologists who assess and dispense devices to their clients; other states use private vendors for these services and underwrite the costs.
Private vendors might refer clients to VR for evaluation and development of a rehabilitation plan that could potentially pay for hearing aids and hearing-assistive technologies. If you are unfamiliar with the VR process in your state, go to bit.ly/state-vr to find your state’s VR director. In many states, the director can provide contact information to the state coordinator for services for deaf or hard-of-hearing consumers.
Unlike entitlement programs such as the Americans With Disabilities Act, VR is an eligibility program for which “an applicant must be determined eligible based on specific criteria that the individual have a physical or mental impairment that is a substantial impediment to employment, requires VR services to become employed and can benefit from these VR services in terms of an employment outcome” (see sources).
Because the need is often greater than available resources, people considered the “most significantly disabled”—a determination made by each state—must be served first. People with hearing loss and who experience severe functional limitations across life domains are often determined to be eligible for services. For example, many people with hearing loss experience communication challenges that make it difficult to find or maintain work, as well as to communicate at home and in social situations. The more areas affected, the more likely a person will be eligible for services from VR.
If someone does not directly receive services, most VR counselors will make appropriate referrals to other state and federal programs, such as state employment agencies and independent-living centers.
Because all aspects of a client’s needs must be considered in the eligibility process, VR counselors may request a number of evaluations—for example, audiologic, otologic, communication assessment, psychosocial state or coping skills, among others. If necessary evaluations have not been completed to make an eligibility decision, VR providers typically contract to have those evaluations performed.

This partnership is a win-win situation for consumers who need services, as well as a potential source of income for audiologists providing these services.

Audiologists’ role
The VR counselor will then work with clients to develop an Individual Plan for Employment (IPE). The IPE lists the client’s employment goals and services needed to achieve them. Examples of services that are funded by VR and might be needed include vocational assessment, post-secondary education, job-readiness training, worksite assessments, hearing-assistive technologies and communication-skills training. Audiologists are a key provider of these latter two services, and they can also perform a worksite assessment for communication technology needs.
Although VR counselors are informed about hearing-assistive technologies, audiologists can augment this with visits to their local VR offices to provide in-services on these technologies. Highlighting new applications of wireless technologies in hearing-assistive and access devices may be especially useful.
Audiologists can disseminate information and market their services to VR counselors, who then can refer clients to the audiologist for needed services. Given the availability of funding, VR could pay for the services.
Many people with hearing loss could benefit from assistance and services provided by audiologists. By working closely with VR agencies, audiologists can help meet these individuals’ needs. This partnership is a win-win situation for consumers who need services, as well as a potential source of income for audiologists providing these services.
Abrams, H. B., & Kihm, J. (2015). An introduction to MarkeTrak IX: A new baseline for the hearing aid market. Hearing Review, 22(6), 16.
Abrams, H. B., & Kihm, J. (2015). An introduction to MarkeTrak IX: A new baseline for the hearing aid market. Hearing Review, 22(6), 16.×
Kochkin, S. (2007). MarkeTrak VII: Obstacles to adult non-use adoption of hearing aids. The Hearing Journal, 60(4), 24–51. [Article]
Kochkin, S. (2007). MarkeTrak VII: Obstacles to adult non-use adoption of hearing aids. The Hearing Journal, 60(4), 24–51. [Article] ×
Kochkin, S. (2012). MarkeTrak VIII: The key influencing factors in hearing aid purchase intent. Hearing Review, 19(3), 12–25.
Kochkin, S. (2012). MarkeTrak VIII: The key influencing factors in hearing aid purchase intent. Hearing Review, 19(3), 12–25.×
Watson, D., Jennings, T., Tomlinson, P., Boone, S., & Anderson, G. (Eds.) (2008). Model state plan for VR services for individuals who are deaf, deaf-blind, hard of hearing, and late deafened. Little Rock, AR: University of Arkansas Rehabilitation Research and Training Center for Persons Who Are Deaf or Hard of Hearing.
Watson, D., Jennings, T., Tomlinson, P., Boone, S., & Anderson, G. (Eds.) (2008). Model state plan for VR services for individuals who are deaf, deaf-blind, hard of hearing, and late deafened. Little Rock, AR: University of Arkansas Rehabilitation Research and Training Center for Persons Who Are Deaf or Hard of Hearing.×
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FROM THIS ISSUE
February 2017
Volume 22, Issue 2