A Successful Model for Hearing Aid Reuse Wednesday, August 14, 2019 3:00 PM to 4:00 PM EST www.at3center.net | www.passitoncenter.org

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Our Facilitators Carolyn Phillips, M.Ed., CPAAC | Interim Director, Services and Education, Director and Principal Investigator, Tools for Life and Pass It On Center, Center for Inclusive Design & Innovation, College of Design, Georgia Institute of Technology Liz Persaud | Program and Outreach Manager, Tools for Life and Pass It On Center, Center for Inclusive Design & Innovation, Georgia Institute of Technology Identify and add bio sketches

Our Guest Speaker Today Jimmy Brown Kentucky’s Statewide Hearing Aid Reuse Program (SHARP): A Model for Replication KATS Network Statewide Hearing Aid Assistance & Reuse Program

Today’s Webinar and Objectives Access to hearing aids is severely limited by affordability. Aging populations and the absence of insurance coverage are just two factors that make the reuse of hearing aids a high-impact opportunity to expand into a new facet of reuse. The webinar will address three objectives: To explain the critical need for expanded reuse of hearing aids; To provide an overview of an established hearing aid reuse program that can be replicated; and, To understand key operational and financial issues in hearing aid reuse to facilitate the acquisition of appropriate devices for customers in need of assistance.

The Need for Hearing Aid Reuse Carolyn Phillips

Incidence of Hearing Loss 1 in 8 in U.S. (13% or 30 million) age 12 and older has hearing loss in both ears1 Age: Greatest hearing loss in 60-69 age group2 Gender: Men twice as likely as women to have hearing loss among adults 20-692 Ethnic/racial groups: Non-Hispanic white group more likely to experience loss; non-Hispanic black adults have lowest prevalence2 Increasing incidence of disabling loss by age:3 2% age 45-54 8.5% age 55-64 25% age 65-74 50% of those 75 and older 1- Lin, Niparko, Ferruci. Archives of Internal Medicine, 2011 Nov 14; 171(20): 1851-1852. 2- Hoffman et al. JAMA Otolaryngology – Head 7 neck Surgery. Dec. 2016 online. 3- Calculations performed by NIDCD Epidemiology and Statistics Program staff.

Impact of Hearing Loss on Individuals Individuals with hearing loss without remediation may experience: Communication difficulties that affect: Education Workplace performance Safety in emergencies and disasters Societal interaction Health impact: Untreated, over 10 years, resulting in greater risk for*: Dementia (50% greater risk) Depression (40% greater risk) Falls (30% greater risk) *Untreated Hearing Loss and higher health care costs. Johns Hopkins University Bloomberg School of Public Health. Science Daily 8 Nov 2018

Economic Impact Hearing loss without remediation has a macroeconomic impact: Overall, healthcare costs resulting from hearing loss, exclusive of devices, are significantly increased. Educational costs are increased. Productivity is diminished by impaired performance, sometimes unemployment, and perhaps early retirement.

Barriers to Access Affordability is the major barrier to access to hearing aids. Very few insurance plans (private or employer) cover therapeutic medical services for hearing loss. (Medicare, the provider for the age group most heavily impacted, does not.) Prior to 2017, the FDA required individuals to be evaluated by qualified medical doctor to acquire hearing aids. Prescription hearing aids are expensive: The average cost of a single device was $2,400 in 2016. Affordability of the testing and fitting (access to an audiologist) is an barrier for the uninsured. NOTE: The Over the Counter Hearing Aid Act of 2017 permits the direct sale of hearing aids for perceived mild to moderate hearing loss without a medical evaluation. However, without professional evaluation, the individual risks not having the appropriate device. And, even devices that cost hundreds instead of thousands of dollars each are unaffordable to some.

Types of Hearing Aid Technology Older analog technology simply amplifies all sounds in the same manner. “Programmable” analog devices permit the user to select settings (different programs) for different environments. New digital devices with microchips can analyze both speech and environmental sounds.

Organizations Engaged in Hearing Aid Reuse Lion’s Clubs have recycling centers. Rules for individuals in need differ by club area. Sertoma’s Hearing Aid Project collects donated devices for refurbishing. Starkey Hearing Foundation’s Hear Now Project offers a partnership with a different model. Jimmy Brown from Kentucky’s Statewide Hearing Aid Reuse Program (SHARP) will describe their path to creating a program, how it works, and how it can be replicated in your state.

Statewide Hearing Aid Assistance & Reuse Program (SHARP) Jimmy Brown KATS Network 08/14/2019

Mission To make it easier for Kentuckians with hearing loss to acquire hearing aids.

History Project CARAT – Assistive Technology/Durable Medical Equipment Refurbishing program (est. 2012) Ed Schickel – expand CARAT to include hearing aids (general exchange between consumers) Lexington Lions Club Hearing Aid Distribution Program

History (cont’d) Statewide HA workgroup KATS Network, OVR, Office for the Blind, Commission for the Deaf/Hard of Hearing, KY School for the Deaf, Hearing Loss Association, Lexington Lions Club, HHP’s, Individuals w/ Hearing Loss Explore what hearing aid programs exist across the country and what one would look like in KY

Lexington Lions Club Hearing Aid Distribution Program Funded at $12,000/yr by Lexington Lions Club Partnered with a single local Audiologist Shares cost of Hear Now application fee (currently $125/hearing aid) with applicant, OR Purchase one (1) new hearing aid per individual. Currently works with 30-40 individuals/yr Collects used hearing aids, which are sent to Starkey All Make Repair Program for cash credit. 19

SHARP Using the Lexington Lions program as a Model, SHARP will: Provide Information & Referral services to help identify potential funding sources, locate peer counseling, other related AT needs, etc. Collect used hearing aids statewide Provide financial assistance for: Hear Now Applicants; Recipients of refurbished hearing aids through Starkey All Make Repair Repair of existing hearing aids through Starkey All Make Repair

Information & Referral Help individuals identify existing funding sources SHARP not to replace existing programs Locate peer counseling services Provide literature – “Tips for new hearing aid users”, “What to ask your Hearing Health Professional”, etc. Identify related AT – ex: Telecommunications Access Program (TAP), iCanConnect, etc.

Collecting Used Hearing Aids Used HA’s sent directly to KATS coordinating center KATS can provide SASE (padded) to send in HA’s – or can be dropped off at any VR office, IL center, or KATS regional office. HA’s (and remotes) only – no batteries, cases, manuals, brushes, etc. All makes, all models, any condition Donation receipt provided upon request 22

Collecting Used Hearing Aids, cont’d 23

Hear Now Application based Charitable program – Starkey Hearing Foundation (income/asset guidelines) Hearing Health Professional (HHP) waives fees for fitting and follow-up for first year can charge for initial evaluation Funds 8-9,000 applicants per year (capacity to serve 20-25k/yr) Refundable application fee ($125/HA) MSRP – approx $3,500/HA

Starkey All Make Repair Repairs/Refurbishes all makes and models of hearing aids. 1 year warranty included with repairs and refurbished hearing aids Typical cost for refurbished hearing aid: $100-$500; Repair of existing hearing aids: $150 (est.) 25

How Does It Work? Hear Now Contact Hear Now to discuss eligibility Complete application (patient info pp. 4-6; HHP info pp 8-10) SHARP can help locate an HHP if needed Contact SHARP to obtain payment code SHARP can provide partial financial assistance towards application fee if needed Write this code on the top of Page 4 Submit application directly to Hear Now 26

How Does It Work? – Process Refurbished Hearing Aids Must be prescribed/authorized by HHP HHP places order directly with Starkey HHP can select from current inventory of reconditioned HA’s available through Starkey All Make Repair Program SHARP will provide up to $250 per individual Patient responsible for cost above $250 in addition to HHP fees (exam, fitting, follow-up)

How Does It Work? cont’d Hearing Aid Repair Must be approved/authorized by HHP HHP places order directly with Starkey SHARP will provide up to $250 per individual Patient responsible for cost above $250 in addition to HHP fees (exam, fitting, follow-up)

How Are We Doing? As of March, 2019, we have: Hear Now Assisted 496 individuals acquire 954 hearing aids. Cost to SHARP: $75,500 in application fees Cost Savings (compared to purchasing new hearing aids) – approx: $3.3 million Recondition and Repair Assisted 70 individuals Cost to SHARP ($0) – donated hearing aids have covered cost of these activities Cost savings (compared to purchasing new hearing aids) – approx: $245,000 29

SHARP GOALS (Sustainability) KATS will fund SHARP for 2 years ($30k/yr) Search for outside funding to support Hear Now portion of program Minimal investment (financial or time) required KATS can still provide oversight of program and assist with locating HHP’s Continue to collect hearing aids to assist with repair and refurbished hearing aids. 30

Thank You! KATS Network Statewide Hearing Aid Assistance & Reuse Program (800) 327-5287 katsnet.org/funding/sharp/ Jimmy Brown – JamesA.Brown@ky.gov

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Contact Information Liz Persaud Program and Outreach Manager liz.persaud@gatfl.gatech.edu Trish Redmon Special Projects Consultant trishredmon@bellsouth.net Kathy Laurin AT3, ATAP kathy.laurin@ataporg.org Carolyn Phillips Director and PI carolyn.phillips@gatfl.gatech.edu