Accommodations for Hard of Hearing Residents in Long Term Care - - PowerPoint PPT Presentation

NCDHHS, Division of Services for the Deaf and Hard of Hearing

1

Accommodations for Hard of Hearing Residents in Long Term Care

Tony

• ny D

Davis is, , MSW SW, , Har Hard d of

• f H

Hear earing ing Ser Service ices Coor

• ordin

dinator

• r

N.C N.C. . Divis Division ion of

• f Se

Servic vices es for the

• r the Dea

Deaf an and t d the he Ha Hard d of

• f He

Hearin aring

July, 2019

NCDHHS, Division of Services for the Deaf and Hard of Hearing

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Hearing Aids

NCDHHS, Division of Services for the Deaf and Hard of Hearing

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Hearing Aids

Bene Benefits of fits of using he using hear aring ing aids aids in in long long-te term car m care e set setting tings

• Reside

esident nt a able ble to to mor more full e fully y par participa ticipate te in: in:

• Act

Activi ivities ties

• Mealt

Mealtime ime group con

• up conver

ersa sations tions

• Car

Care planning meetings e planning meetings

• Dail

Daily y inter interactions actions wi with s th staf taff and and

• ther
• ther residen

esidents ts

• Doct

Doctor

• r and nur

and nurse se vis visits its

• Unt

Untrea eate ted d he hear aring ing loss loss lead leads s to to

• Inc

Increased r eased risk isk of

• f
• Demen

Dementia tia

• Fal

alls s

• Isola

solation tion and and dep depress ession

• n

NCDHHS, Division of Services for the Deaf and Hard of Hearing

4

Funding Hearing Aids

• Med

Medica icare

• Par

art t A A and B: No co and B: No cover erage ge

• Med

Medica icare Su e Supp pplem lemen enta tal l Plan Plans s

• i.e. Unit

i.e. United Health ed Health Car Care Plan NC e Plan NC

• Med

Medica icaid id

• Adult

Adults: s: no co no cover erage ge in Nor in North C th Car arolina

• lina
• Twenty

enty-Fiv Five e st states tes co cover er one or t

• ne or two hearing aids
• hearing aids
• On

One st state covers for nu nursing ing home me r reside idents

• Priva

Private te Ins Insur uran ance ce Comp Compan anies ies

• May

May contr contribute ibute to towar ards ds tot total cost al costs s e.g. $500 e.g. $500-$1, $1,000 000

• May

May giv give allo e allowance to pur ance to purchase hase hearing aids hearing aids

• Of

Offer dis er discounts counts to to specific pr specific provider viders s e.g. 30 per e.g. 30 percent cent of

• ff
• Veteran’s Administration
• Co

Cover ers s hea hearing aid ring aids and a s and acce ccess ssories

• ries
• Veterans Be

Benefi fits Ad Admi minist istration ion ( (based on percent of disa isabil ility ity)

• Veterans He

Health lth Ad Admi minist istration ion (Hea (Health lth Car Care)

Healthcare and hearing Aids Presentation, Coleman June 2019, Navigating the VA’s Hearing Services Presentation, Ingrao, June 2019

NCDHHS, Division of Services for the Deaf and Hard of Hearing

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Funding Hearing Aids

• Nor

North th Car Carolina

• lina Sta

Statewid tewide R e Res esou

• urce

ces s

• Equipmen

Equipment D t Dist istribut ribution ion Ser Services vices Pr Prog

• gram thr

am through the

• ugh the

Div Divisi ision

• n of
• f Ser

Services vices for

• r the

the Deaf Deaf and Har and Hard d of

• f Heari

Hearing ng

• Pr

Provide ides one hearing ing aid id wi with a te telec lecoil il for pe people le to comm mmunica icate on th the telep lephone

• Se

Serves those that mee meet sp specif ific ic audiol iologica ical l need and ar are belo low 2 w 250 pe percent of poverty l line ine

• NC Independent Living

NC Independent Living Pr Prog

• gram

am

• Char

Charlott lotte e Speec Speech and Hearing C h and Hearing Center enter (discounted (discounted hearing aids hearing aids)

• Easter

Easter Seals NC Seals NC

• Self

Self Help Cr Help Credit U edit Union ass nion assist istiv ive e tec technolog hnology l y loan

• an
• Pot
• ten

ential Bar tial Barrier riers

• A per

A person son wi will ll not financiall not financially qualify f y qualify for as

• r assis

sistance tance

• A per

A person son wi will ll not kno not know w about t bout these r hese resour esources ces availa vailable ble

NCDHHS, Division of Services for the Deaf and Hard of Hearing

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Funding Hearing Aids

Healthcare and Hearing Aids Presentation Coleman, June 2019

• Some Na

Some Nation tional al Reso esour urce ces s

• AARP:

: of

• ffer

ers s disc discou

• unts

nts on

• n ce

certain tain he hearing aring aids aids an and d accessor accessories es

• Aud

udient: ient: Provide vides s he hearing aring aids aids at t pa partial tial co cost st to to lo low w inco income me America mericans ns

• Na

Nationa tional l Hearing Hearing Aid Pr id Projec

• ject

t

• Gi

Gift ft of

• f H

Hea earing ring Fou

• und

ndation tion

• Star

tarkey ey Hearing Hearing Aid F id Fou

• und

ndation: tion: Hear Hear No Now w Prog

• gram

am

• Fou
• und

ndation tion for

• r Sight

ight & & Sou

• und

nd: : Help Help America merica Hear Hear

• Hearing

earing Chariti harities es of

• f A

Ameri merica ca

• Mir

Mirac acle le-Ear ar Fou

• und

ndation tion

• Lion

Lions s Club lub inter interna nationa tional l

• Poten
• tential

tial Bar Barrier riers

• A per

A person son wi will ll not financiall not financially qualify f y qualify for as

• r assis

sistance tance

• A per

A person son wi will ll not kno not know w about t bout the r he resour esources ces availa vailable ble

NCDHHS, Division of Services for the Deaf and Hard of Hearing

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Recommendations to Consider Related to Hearing Aids

• Whe

hen n ad adult ults with s with he hear aring ing loss loss ca cann nnot

• t af

affor

• rd

d he hear aring ing aid aids o s on t n the heir o ir own wn

• Med

Medicaid icaid

• Bo

Both Di Direct Me Medica icaid id and Ma Managed Ca Care: :

• DHB or PHP’s purchase binaural hearing aids every four years for

recipients ts wi with th hearing ring loss ss regardless ss of age if me medically y necessa ssary

• Purchase

se drying ying/sto storage syste system m for r hearing ring aids s th that t wi will prolong th the life of a hearing ring aid and provide vide a sa safe and identifi tifiable sto storage syste system m

• Acc

cces ess s to: to:

• Na

Naviga igators th that t can can ass assist st th those

• se in

n long

• ng te

term m car care e set settings tings wit with a applying ing for he hearing ing aids ids f from v m variou ious resources

• So

Social ial workers f for bo both hospita ital l systems ms an and lon long te term m care facil ilities ities

• Provide

vide NC NC and nation tional hearing ring aid bank reso sources s th that ar t are continu tinuousl sly y kept up t up to to date te

• Assi

Assist st reside sidents/ ts/patien tients ts wi with th applying ying for th r the DS DSDHH DHH EDS DS program m and or ot r other r hearing ring aid reso sources s

• Training

aining for

• r long

long-ter term m car care e staf staff on hearing

• n hearing aid

aid car care e i. i.e. e. clean leaning, ing, sto storage ge, , tes testing ting an and c d cha hang nging ing ba batteries tteries

NCDHHS, Division of Services for the Deaf and Hard of Hearing

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Personal Amplifiers

NCDHHS, Division of Services for the Deaf and Hard of Hearing

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Personal Amplifiers

A multi-use solution for those who do not use hearing aids and some that do

• Use with headphones
• r earbuds, neckloop
• Often rechargeable
• Often $100-$200
• Easy to use for most

patients

• Can use with hearing

aids that have t-coil

• Can have several sets

available for multiple use during activities

NCDHHS, Division of Services for the Deaf and Hard of Hearing

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Funding Hearing Personal Amplifiers

• Medi

edicar care e

• No

No co cover erage ge

• Medi

Medicaid caid

• No

No co cover erage ge

• MN

N do does co es cover by er by using M using Med edicaid W icaid Waiv aiver ers s (c (con

• nsi

side dered ed a a du durable med ble medical ical supp supply) y)

• Pr

Priv ivate Ins e Insur uranc ance e Comp

• mpani

anies es

• No

No co cover erage ge

• Veteran’s Administration
• Wil

ill l co cover er

• May

ay req equir uire r e residen esident t to to self self-advocate te

• Equi

Equipme pment nt D Dis istribu ibution ion Ser Service ices Pr Prog

• gram

am thr hroug

• ugh t

h the he Di Divi visi sion

• n of
• f Ser

Servi vices ces for

• r the

he Deaf Deaf and H and Har ard d of

• f Hear

Hearing ing

• Can

an cho hoose

• se amp

ampli lifier fier instead instead of

• f he

hearing aring aid aid or

• r amp

ampli lified fied ph phon

• ne

e

• Acce

ccessibi ibili lity: : Shoul Should d ha have s e sever eral on ha al on hand nd at ea each l h long

• ng

ter erm m car care s e set etting ing

• Depe

ependi nding ng on

• n br

brand and, , can can us use w e wit ith h ind induct uctiv ive e loo loop s p system em

NCDHHS, Division of Services for the Deaf and Hard of Hearing

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Recommendations to Consider Related to Personal Amplifiers

• Long

Long-ter term m car care e settings, settings, medical medical cent center ers and s and sma small ll pr prac actic tices es pr provid vide e pe perso sona nal am l amplifie plifiers s to to res eside ident nts a s and nd pa patie tient nts

• Number of

Number of amplifier amplifiers s pr provided fits vided fits the need of the need of f facilit acility

• Ex

Examp mple: le:

• Med

Medical cente ter: tw two amp mplifi fiers s per w r waiting ting room m area

• Long te

term m care se sett tting ing: : fiv five amp mpli lifier fiers s for r each te ten resid sidents ts

• Physician

ysician offi fices: s: tw two amp mplifi fiers s per of r offi fice

• Headphones and earbuds

Headphones and earbuds st stor

• red

ed for

• r eac

each r h resident esident in in long long-ter term car m care set e settings tings

• Amplifier

Amplifiers s ar are c e char harged and sanit ged and sanitiz ized ed after us after use

• Signa

Signage ge tha that pr t promotes

• motes cultur

culture of e of use use and acceptance and acceptance

• Med

Medica icaid id

• Ut

Utiliz ilize w e waiv aiver er fun funding ding

• Cr

Crea eate new te new waiv aiver f er for per

• r persons

sons wi with th hearing los hearing loss s

• Civil

Civil Mon Money ey P Pen enalt alty y Rein einves estm tmen ent t Pr Prog

• gram

am fu fund nds s

NCDHHS, Division of Services for the Deaf and Hard of Hearing

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Wide Area Listening Systems

NCDHHS, Division of Services for the Deaf and Hard of Hearing

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Wide Area Listening Systems

FM Syste FM System, Infr m, Infra a Red ed, , Ind Induc uctiv tive loo e loop

• Use

Uses s tr tran ansmitter an smitter and r d rec eceiv eiver er(s) (s)

• Can

Can co conn nnec ect t dir direc ectl tly y into into sou sound nd syste system

• Gr

Group

• up
• Activ

ctivit ities ies

• Pr

Presen esenta tations tions

• Perf

erfor

• rman

mance ces

• Movi

vies es

• Ind

Induc uctiv tive L e Loo

• ops

ps

• Con

Confer eren ence ce roo

• oms

ms

• Activity

Activity roo

• oms

ms

• Cha

Chape pels ls

• The

heatr tres es

NCDHHS, Division of Services for the Deaf and Hard of Hearing

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Funding Assistive Listening Systems

• Fac

acil ilities ities sh shou

• uld

ld pr provide vide sy syst stems ems as as an an AD ADA A ac acco commoda mmodation tion

• AD

ADA-219 219

• Ther

here need to be as e need to be assis sistiv tive e lis listening tening sy syst stems ems pr provided vided

• For assembl
• r assembly

y ar area w ea wher here e “audible communication is integral to the use of space”

• Laws

Laws about r bout receiv eceiver r er ratios tios

ADA Compliance Directory, July 2019

NCDHHS, Division of Services for the Deaf and Hard of Hearing

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Recommendations to Consider Related to Assistive Listening Systems

• Si

Sign gnage ge th that pr t promo

• mote

tes s cu cultur lture of e of use use and and acceptance acceptance

• Hear

Hearing ing aid pr aid provider viders s wor

• rking w

king with ith residents esidents inf infor

• rmed

med of

• f assistiv

assistive e li liste stening ning systems systems

• Civi

Civil l Mone Money P y Pen enalty alty Rein einvest estmen ment t Pr Prog

• gram

am fund funds s ca can n be be used used to to

• “to aid nursing home teams in reducing adverse events,

improving staffing quality and improving dementia care”

• Un

Untreated hearing ing los loss l leads i increases risk isk of

• f
• Deme

Dementia tia

• Adv

Adverse se events ts

• Long

Long-te term m ca care e set setting tings s co cont ntac act t DSD DSDHH HH to to get get exp xper ert t gu guidan idance ce an and d reso esour urce ces s

Civil Money Penalty Reinvestment Program, July 2019

NCDHHS, Division of Services for the Deaf and Hard of Hearing

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Thank y hank you

• u
• Ques

Questions? tions?

• Conta

Contact ct Inf Infor

• rma

mation tion

Ton

• ny

y Davi vis s Ha Hard d of

• f Hea

Hearing ring Ser Servi vice ces s Coo

• ordina

dinator tor Div ivis ision ion of

• f S

Ser ervi vices ces for t

• r the

he Deaf eaf and Har and Hard d of

• f Heari

Hearing ng NC NC Dep epar artmen tment t of

• f Hea

Health lth an and Hu d Human man Ser Servi vice ces Of Office fice: : 91 919-351 351-22 2206 06 (VP) (VP) Voice

• ice/TTY

/TTY: : 80 800-851 851-6099 6099 Fax ax: : 91 919-855 855-6873 6873 Tony

• ny.D

.Davi vis@ s@dhh dhhs. s.nc.go nc.gov

NCDHHS, Division of Services for the Deaf and Hard of Hearing

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Wor

• rks

ks Cit Cited ed

• Hear

earing ing Lo Loss Lin Linked ed to to Ac Accel celer erated ted Br Brain ain Tis issue ue Los Loss (John

• hns H

Hopk

• pkins

ins Medicine, edicine, 2017) 2017)

• Incr

ncreas eased ris ed risk k of

• f depr

depres ession in ion in pa patients tients w with ith acquir acquired s ed sens ensor

• ry hearing los

hearing loss: : A A 12 12-year f ear follo

• llow-up

up study tudy ( (Wei ei-Ting, ing, Chih Chih-Chao Chao, , Ming ing-Hsun un et al. et al. (2016) 2016)

• Ada

Ada-Compliance Compliance Dir Director ectory, , https https:/ ://www.ada .ada-compliance.com/ compliance.com/ada ada- compliance/ compliance/219 219-and and-706 706-as assis istiv tive-li listening tening-systems tems.html html (Acces Accessed, ed, Jul uly 2019) 2019)

• Civ

Civil il Money

• ney P

Penalty enalty R Rein einves estment tment Prog

• gram CM

am CMS.go .gov, , https https:/ ://www.cms .cms.go .gov/Medicar edicare/ e/Provider ider-Enr Enrollm

• llment

ent-and and- Cer Certif tifica ication/ tion/Sur urvey eyCer Certif tifica icationG tionGenI enInf nfo/

• /LTC-CM

CMP-Rei einves estment.html tment.html (Acces Accessed, ed, Jul uly 2019) 2019)

• HLAA

LAA Webs bsite, ite, Medicaid H edicaid Hearing earing Aid Aid Co Cover erage f ge for

• r Adults

Adults, , https https:/ ://www.hearing .hearinglos loss.or .org/ g/hearing hearing-help/ help/financial nancial-as assis istance/ tance/medicaid/ edicaid/ (Acces Accessed, ed, Jul uly 2019) 2019)