For Purchase of Hearing Aids

1. Assist the client in completing the Communication Assessment Form (CAF) if not already completed.
2. Review the CAF information with the client to determine employment needs and identify any comparable resources.
3. Refer client to an audiologist for a hearing assessment if the client has not already had one in the last year. Provide the client a copy of the CAF to give to the audiologist. If the client has already seen an audiologist within the past year, consult with the audiologist to determine if another assessment is necessary.
4. Authorize, if needed, for an assessment with an audiologist. The audiologist should recommend hearing aids that meet Nebraska Medicaid Allowable rates and addresses the hearing issues of the client based on his/her employment needs. If the client's unique condition and/or employment situation require aid(s) above the Medicaid rate, recommendations of two hearing aid models are required. The recommendation should include the brand, model and needed features. VR can fund the lowest cost aid(s) that will meet the client’s employment needs.
5. Authorize for the recommended aid at Medicaid rates or the lower cost aid when two models are recommended models. If the client would like additional features or prefers the higher priced aid(s), then he/she will be responsible for the difference. Use the Standard Text in the body of authorization.
6. Address with the client the importance of going through aural rehabilitation services to adjust to the hearing aid(s). Should additional aural rehabilitation services be needed outside of the trial period, the cost should be authorized at the same rate as a visit with an audiologist per Medicaid rate.
7. Consider along with the client, the need for assistive listening devices based on the Communication Assessment Form, Employment Discussion and Audiology Report. If it is determined there is a need, refer to the Assistive Technology Partnership.

   • VR is responsible for determining the need for and arranging the purchase of any hearing aids.
   • ATP is responsible for arranging the purchase of any Assistive Listening Devices determined to be needed except when an audiologist recommends a specific model ALD device that is paired with the current or recommended hearing aid. See ATP/VR Partnership Chapter.

8. Review the client their responsibilities regarding the warranty and maintenance on hearing aids.
9. Review and evaluate the progress of client within 30-60 days to see how he/she is adjusting and if aids are meeting his/her needs.

For Purchase or Acquisition of an Assistive Listening Device

1. Refer client to the Assistive Technology Partnership, Commission for the Deaf and Hard of Hearing or to an audiologist to determine what assistive listening devices are appropriate to assist with meeting the clients needs.
2. Authorize for assistive listening devices at the Medicaid rate if one is available. Use Standard Text in body of authorization.
3. Review client responsibilities regarding warranties and maintenance on assistive listening devices.
4. Review and evaluate the progress of client within 30-60 days to assess how he/she is adjusting and if ADL are meeting his/her needs.

The Communication Assessment Form must be completed prior to a decision to purchase hearing aids or ALDs. In some cases, the individual may only have need of an assistive listening device.

The purchase of a hearing aid or aids and any Assistive Listening Devices is allowable if the individual’s hearing loss meets the hearing loss criteria used to determine eligibility regardless of whether the hearing loss is the primary, secondary, tertiary, etc. impairment.

Two hearing aid recommendations are required from the audiologist in the rare instance when the type and level of hearing loss and/or client's work environment can only be addressed by a hearing aid that exceeds the Medicaid Rate.

VR is responsible for determining the need for and arranging the purchase of any hearing aids.

ATP is responsible for arranging the purchase of any Assistive Listening Devices (ALD) determined to be needed except when an audiologist recommends a specific model ALD device that is paired with the current or recommended hearing aid. See ATP/VR Partnership Chapter.

Hearing aids and ALDs can be purchased as an assessment or planned service. Purchasing of hearing aids or ALDs in assessment should only be done when the aid or device is needed in order to effectively engage in assessment services and the development of the IPE.

Community Resources


Nebraska Commission for the Deaf and Hard of Hearing

Lincoln Office:
4600 Valley Road, Ste. #420
Lincoln, Nebraska 68510-4844
Local: (402) 471-3593 TTY/V
Statewide Toll Free: 1-800-545-6244 v/tty
Fax: (402) 471-3067
Email:ncdhh.@nebraska.gov
Website: www.ncdhh.ne.gov


Omaha Office:
1313 Farnam On-The-Mall
Omaha, NE 68102-1836
Local: (402) 595-3991 v/tty
Statewide Toll Free: 1-800-545-6244 v/tty
Fax: (402) 595-2509


North Platte Office:
200 South Silber, Room 207
North Platte, NE 69101-4298
Local: (308) 535-6600 v/tty
Statewide Toll Free: 1-800-545-6244 v/tty
Fax: (308) 535-8175


NCDHH is dedicated to improving the quality of life for deaf and hard of hearing people of all ages by providing assistance, advocacy, and access to services and information.


Nebraska Public Service Commission for the Equipment Distribution Program (NSTEP)

1200 N Street
Suite 300
Lincoln, NE 68508
Local: (402) 471-3101
TDD: (402) 471-0213
Statewide Toll Free: 1-800-526-0017 (Nebraska only)
Fax: (402) 471-0254
Website: http://www.psc.ne.gov


The Public Service Commission funds the Nebraska Equipment Distribution Program. This program is designed to offer monetary assistance to Nebraskans who are dear, hard of hearing, deaf/blind, or speech impaired in purchasing specialized telecommunications equipment, such as TTY/TTDs, phone amplifiers, and signaling devices. The application package, available online from the Public Service Commission, is submitted to the Nebraska Commission for the Deaf and Hard of Hearing.

Easter Seals Nebraska Alternative Financing Program
12565 W. Center Road, Suite 100
Omaha, NE 68144
Local: (402) 345-2200
Statewide Toll Free: (800) 650-9880
Fax: (402) 345-2500
Website: www.ne.easterseals.com


Hotline for Disability Services:
Client Assistance Program
301 Centennial Mall South
P O Box 94987
Lincoln NE 68509-4987
Local: (402) 471-0801
Statewide Toll Free: 1-800-742-7594
Fax: (402) 471-0117
Email: CAP.AllStaff@nebraska.gov


Provides information and resources for people with disabilities (Not a funding source).


Assistive Technology Partnership:

Lincoln Office
3901 N. 27th Street, Suite 5
Lincoln, Nebraska 68521
Local: (402) 471-0734
Statewide Toll Free: 1-888-806-6287
Fax: (402) 471-6052
Website: www.atp.ne.gov
Email: atp@nebraska.gov


Omaha Office
1313 Farnam on the Mall
Omaha, Nebraska 68102
Local: (402) 595-1923
Statewide Toll Free: 1-877-201-4141
Fax: 402) 595-1919


Kearney Office
315 W 60th Street, Suite 300
Kearney, Nebraska 68845-1504
Local: (308) 865-5349
Statewide Toll Free: 1-800-683-6699
Fax: (308) 865-5322


Scottsbluff Office
505A Broadway, Suite 500
Scottsbluff, Nebraska 69361-4939
Local: (308) 632-1332
Statewide Toll Free: 1-888-806-6287
Fax: (308) 632-1392


Fremont
827 North D Street
Fremont, NE 68025
Local: (402) 727-2961
Fax: (402) 727-29900


A resource for individuals with disabilities, family, friends, health care, professionals, employers, case managers, etc., provides information on assistive and accessibility devices, including location, funding, and training sources. Sponsors demonstration centers and peer volunteers across the state. Provides assessments for assistive technology and independent living (Not a funding source).

Nebraska Relay:
7-1-1
Voice: 1-800-833-0920
TTY/ASCII: 1-800-833-7352
Cap Tel: 1-877-243-2823
Spanish to Spanish: 1-888-272-5528
Spanish to English: 1-877-564-3503
Customer Service: 1-800-676-3777 (TTY/Voice/ASCII
Customer Service: 1-800-787-1989 (Español – TTY/VOZ/ASCII)
Website: Nebraska Relay 711


Nebraska Relay Service is designed to enable persons who are deaf, hard of hearing or speech disabled to communicate on the telephone with the general public The relay services include TTY, Voice Carry Over (VCO), Hearing Carry Over (HCO), Speech-to-Speech ((STS), Spanish-to-Spanish, and CAPTEL. (Not a funding source).

Sertoma International:
Toll Free: 1-816-333-8300
Fax: (816) 333-4320
Website: www.sertoma.org
Email: infosertoma@sertoma.org (if no local club to contact)


Assists persons who are deaf, hard of hearing, or speech disabled with equipment, information, grants, or scholarships.


Lion’s Hearing Aid Bank Nebraska
Audient – An Alliance for Accessible Hearing Care
Website: www.audientalliance.org
Hearing Aid Bank: Nebraska Commission for the Deaf and Hard of Hearing.
Website: www.ncdhh.ne.gov/lions_hab.html
Local Lion’s Club Directory
Website: Lions Club Locator


Lions’ Club conducts screening programs for children and adults, provides and repairs hearing aid (s) for low income and supports a variety of rehabilitation services. Auditory equipment is furnished to schools with hearing-impaired students, and scholarships are issued to youngsters with this disability.

HLAA – Hearing Loss Association of America (Nebraska Chapter)
(Formerly SHHH – Self Help for Hard of Hearing People)
Nebraska Information: http://www.ncdhh.ne.gov/hearing_loss_mtg_omaha.html
National Website: www.hearingloss.org


The Hearing Loss Association of America is the nation’s largest organization for people with hearing loss. The Hearing Loss Association of America exists to open the world of communication for people with hearing loss through information, education, advocacy, and support.

Definitions


Analog hearing aid: A hearing aid based on traditional electronics similar to that used in stereo systems and television sets. Analog hearing aids simply makes the sound wave larger to amplify the sounds.

Assistive Listening Devices (ALD): Hearing instruments other than hearing aids used to improve listening to speech in noisy environments. These devices may include telephone amplifiers, TV listeners, or personal amplifiers and may or may not be used in conjunction with a hearing aid.

Audiogram: A graphic representation of audiometric findings showing the lowest volume that an individual can hear pure tone signals at different frequencies for each ear.

Audiologist: An individual with a graduate degree in audiology and is qualified to conduct a thorough hearing evaluation in addition to dispensing hearing aids.

Aural Training: This is the re-education of an individual that is required if an individual is to receive the most, or any benefit, from hearing aids. This re-education can include learning about the residual hearing, general attitudes; receive information or instruction about hearing loss, assistive devices, expectations, coping strategies, speech reading and auditory training. For new users this training is usually scheduled during the trial period.

Behind-The-Ear (BTE) hearing aid: A hearing aid that fits up over the ear and is connected to an ear mold that directs the amplified sound into the ear canal.

Binaural: Two hearing instruments, one for each ear.

Completely-In-The-Canal hearing aid (CIC): The smallest and most discrete of the common hearing aid styles. A CIC is custom designed fits to fit entirely in the ear canal, improving sound quality and reducing feedback. CICs are appropriate for mild to moderate hearing losses and for sloping high-frequency hearing losses, but not for infants or young children.

Decibel (dB): A unit that characterizes the magnitude of sound.

• 
Degree of Hearing Loss: A qualification of hearing loss
• None 0 to 25dB HL
• Mild26-39 dB HL
• Moderate40-55dB HL
• Moderate-Severe56-70 dB HL
• Severe71-90 dB HL Profound > 91 dB HL


Digital hearing aids: A hearing aid based on microprocessor technology that performs most device functions digitally.

ENT: Otolaryngologists are sometimes referred to as an Ear, Nose, and Throat Specialists.

Monaural: One hearing instrument fits in one ear.

Multi-channel aids: These aids have frequencies divided into two or more channels. The advantage is you can more adequately fit a hearing loss that varies greatly from frequency to frequency, and for individuals with reverse slope losses. Those who hear high frequency sounds better than the low. This gives the audiologist more flexibility in setting the aid correctly to the loss. Some are programmable.

Otolaryngologist: A physician who specializes in the ear (also known as an Otologist).

Programmable aids: A hearing aid whose sound characteristics are able to be altered and adjusted with the use of a hand-held programmer or computer. May be either analog or digital.

Rehabilitation Audiology: The process of improving the communication ability of an individual with a hearing impairment through the use of a variety of procedures that include speech reading, auditory training, hearing aid fitting, counseling and teaching of strategies that improve communication ability.

Speech Reception Threshold: The Speech Reception Threshold is the softest point at which the individual with a hearing impairment is able to repeat words correctly fifty percent of the time. The Speech Reception Threshold test indicates the level of sound the individual will need before he/she can hear and understand words.

Communication Assessment - English