1. Early Hearing Detection and Intervention in Mississippi EHDI-M Overcoming Barriers to Timely Diagnosis of Hearing Loss

2. Mississippis 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

3. Mississippis 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 HAs

4. EHDI-M Data- Referrals for Diagnostics

5. Outpatient Screen Data

6. 20002001 Referred to 3rd660540 Screened642522 Referred(418)(320) Passed224202 No Shows2818

7. Overcoming Barriers Purchase of Equipment Tracking and Follow-up training Mentoring and Hands-on workshops Resolving Funding issues

8. 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

9. 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

10. 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

11. 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

12. 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 HAs N=27

13. Interested in Receiving Referrals from Hospitals

14. Interest in receiving referrals for hearing aid evaluations

15. Accept Medicaid Reimbursement

16. Types of Services offered

17. Equipment and Use of Equipment

18. Mentoring and Hands-on Workshops Survey results Workshops17 indicated interest in hands- on workshops Mentorships---12 indicated interest in being a mentor for one or more areas of evaluation or management

19. Mentoring- Areas of Expertise Behavioral assessment Hearing aid fitting Immittance CI management ABR Aural Habilitation CAPD Counseling

20. Types of training audiologists were most interested in receiving ABR OAE Hearing aids fitting All areas of evaluation for 0-6 mo

21. 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