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Early Hearing Detection and Intervention in Mississippi
EHDI-M
Overcoming Barriers to Timely Diagnosis of Hearing Loss
Mississippi’s Strengths
Legislation Low referral rates EHDI-M housed in Part C program Well organized Infant & Toddler Services EHDI-M & First Steps assist with tracking First Steps will act as payer of last resort for
evaluation of hearing
Mississippi’s limitations
Rural /Access to audiology services 35 % of babies in MS are on Medicaid/CHIP Some centers will not accept Medicaid for
hearing evaluations Fewer audiology centers will accept Medicaid
for hearing aids At this point, Part C is not paying for HA’s
EHDI-M Data- Referrals for Diagnostics
0
100
200
300
400
500
600
700
1999 2000 2001
# ReferredSeen for audioLost or TrackingConfirmed
Outpatient Screen Data
0
100
200
300
400
500
600
700
2000 2001
Referred to OP
# Screened
Referred
Passed
No shows
Outpatient Screen Data
2000 2001
Referred to 3rd 660 540
Screened 642 522
Referred (418) (320)
Passed 224 202
No Shows 28 18
Overcoming Barriers
Purchase of Equipment Tracking and Follow-up trainingMentoring and Hands-on workshopsResolving Funding issues
Overcoming Geographic Barriers
Equipment purchased for four different centers
Contracts established that allow for “no-charge” options in various regions of the state
Audiologist training
Tracking and Follow-up Overview
Hospitals report all referrals, high risk, and NS for outpatient screen to EHDI-M
Hospitals schedule appointments to the diagnostic centers
Diagnostic Centers provide feedback to EHDI-M for all referrals from hospitals and for all babies 0-3 with confirmed permanent hearing loss, regardless of referral source
Tracking and Follow-up (cont.)
EHDI-M initiates tracking procedures when hearing loss is confirmed or when family fails to show for appointments
EHDI-M and local First Steps staff work together to contact the family and determine needs/confusion about the test results, transportation issues, funding questions
Important- Ongoing Procedures Training
Regular visits by EHDI staff to hospitals Regular visits to audiology centers District level First Steps staff receive training
regarding their responsibilities in tracking and service coordination
Hearing Resource Coordinators meet regularly to update knowledge, materials and procedures
Audiology Survey
54 surveys mailed to audiology centers in and out-of-state
31 returned 4 dropped due to lack of interest in 0-36 mo. 2 were not interested in receiving referrals for
diagnostics but did want referral for HA’s N=27
Interested in Receiving Referrals from Hospitals
0
5
10
15
20
25
30
Yes No
In-state
Out-of-state
Total
Interest in receiving referrals for hearing aid evaluations
0
5
10
15
20
25
Yes No Manageonly
In-state
Out-of-State
Total
Accept Medicaid Reimbursement
0
5
10
15
20
25
Diagnostics HearingAids
In-state
Out-of-state
Total
Types of Services offered
0
5
10
15
20
25
30
0-6 month 6-36 mos HA's CI Audtraining
Yes
No
Equipment and Use of Equipment
0
5
10
15
20
25
30
Don't use
Have equipment
Mentoring and Hands-on Workshops Survey results
Workshops—17 indicated interest in hands-on workshops
Mentorships---12 indicated interest in being a mentor for one or more areas of evaluation or management
Mentoring- Areas of Expertise
Behavioral assessment
Hearing aid fitting
Immittance
CI management
ABR
Aural Habilitation
CAPD
Counseling
Types of training audiologists were most interested in receiving
ABR OAEHearing aids fittingAll areas of evaluation for 0-6 mo
Resolving Funding Issues
Notifying parents in the hospital of “no charge” options
Locate families who may not understand that funding is available (tracking procedures)
EHDI-M taskforce is meeting to develop legislation for insurance coverage of hearing aids
Quarterly meetings with Medicaid to improve reimbursement
Consider developing procedures for using Part C funds for hearing aids after careful analysis of current situation
