Age-Related Hearing Loss

With a rapidly growing population of older Minnesotans, age-related hearing loss has become a public health issue. We must support healthy aging by increasing early identification of hearing loss and providing access to needed services and products. It is imperative to provide this support in order to prevent physical and cognitive decline so older adults can continue to be an active part of their workplaces, families and communities.

Age-Related Hearing Loss Task Force (2014-2015)
A piece of the Commission of Deaf, DeafBlind and Hard of Hearing Minnesotans’ strategic plan is a goal to: Recognize hearing loss as a public health issue to support healthy aging.

How will the Commission work towards this goal?
One of the strategies for achieving this goal is to create a Task Force of agencies and organizations that address aging and hearing loss to set direction for this work.

When did the Task Force meet?
The Age Related Hearing Loss Task Force met from September 2014 to June 2015.

Who was on the Task Force?
The Task Force was made up of health care professionals, representatives of consumer organizations, state agencies, representatives of the insurance industry and policy makers. Specifically it included:

Health Care Professionals

  • Dr. James Pacala, Associate Head, U of MN Department of Family Medicine and Community Health
  • Dr. Bevan Yueh, Department Chair, U of MN Otolaryngology
  • Dr. Mark DeRuiter, Associate Dept. Director, U of MN Speech-Language-Hearing Sciences
  • Juliana Milhofer, Minnesota Medical Association

Consumer Organizations

  • Monique Hammond, Hearing Loss Association of America, Twin Cities
  • Lyle Hoxtell, Deaf & Hard of Hearing Services Division Regional Advisory Board
  • Rick Nelson, Loop Minnesota

State Agencies/Divisions

  • John Wodele, Commission of Deaf, DeafBlind & Hard of Hearing Minnesotans
  • Mary Hartnett, Commission of Deaf, DeafBlind & Hard of Hearing Minnesotans
  • Brad Lindsay, Department of Veterans Affairs
  • Jim Miller, Department of Veterans Affairs
  • Darcy Miner, Department of Health
  • Don Bishop, Department of Health
  • David Rosenthal, Deaf & Hard of Hearing Services Division, Department of
    Human Services
  • Jan Radatz, Deaf & Hard of Hearing Services Division, Department of Human Services
  • Marie Koehler, Deaf & Hard of Hearing Services Division, Department of Human Services
  • Sherilyn Moe, Office of Ombudsman for Long-Term Care
  • Jean Wood, Board on Aging
  • Mark Schulz, Board on Aging

Insurance Industry

  • Kathryn Kmit, Minnesota Council of Health Plans

Policy Makers

  • Rep. Tom Huntley, Former Minnesota House of Representatives
  • Kari Thurlow, Leading Age

What was the goal of the Task Force’s work?
To create an action plan with timelines, measurable goals, and assigned responsibilities that will create a framework the state can use to support healthy aging for seniors with hearing loss in Minnesota.

Who did the Task Force determine was their target population?
Minnesotans aged 55 and older who have age related hearing loss

What did the Task Force set as the desired outcomes?

  1. Knowledge that “there’s help and there’s hope”. This means that Minnesotans would know what options (technology and resources) are available to them and have choices in the treatment and care they receive. It also means that there would be awareness among professionals, people with age related hearing loss, their families and the general public about hearing loss and its consequences.
  2. Affordable, accessible and effective healthcare. This includes screening, which supports healthy aging for people with age-related hearing loss. Minnesotans and health care providers would know what they need to know related to hearing loss screening and identification. Policy makers would allocate money for screening and devices.
  3. The environment supports people with age related hearing loss.

What are the Task Force’s recommendations?
These recommendations will require action from many sectors, including state government agencies, and those who serve and are affected by those with age related hearing loss, between 2015 and 2018:

  1. Collect and analyze data to better understand the needs of the aging population experiencing hearing loss, and to better understand what does and does not work regarding treatment, technology, protocols, and policy. Specific actions include:
    i. Participate in the Baltimore Hearing Equality through Accessible Research and Solutions (HEARS) project, headed by Dr. Frank Lin, Johns Hopkins University. This study will test the use of low cost hearing devices in a pilot setting, and test and review protocols for screening and distribution of the devices. Minnesota would be the second pilot site. Results would indicate if the low cost hearing devices are effective, and the project would results in a replicable protocol for application beyond the pilot population.
    ii. Create a data development agenda (DDA) examining information from the pilot project and from other sources, including demographic data on Minnesotans and the possible impacts of various treatment approaches. Collect and analyze existing data or create a pilot study to collect new data. Collaborate across agency lines and sectors to create a comprehensive view of the hearing loss implications to Minnesotans, and the efficacy of approaches to address the issue.
  2. Educate stakeholders about hearing loss, its implications, and hearing loss identification and treatment. Specific actions include:
    i. Partner with TPT to create an age related hearing loss awareness campaign, including a video production to air on TPT and for use in subsequent showings. The TPT effort will results in a set of materials for use in communicating to the broader community, including policy makers, as a part of a communications and education campaign.
    ii. Review and revise existing public sector consumer materials to incorporate key messages. Provide training for key staff such as Senior Linkage Line specialists, and track information on hearing loss related questions received.
    iii. Develop key messages and data points for use in presentations and other communications, and make this available to all stakeholders (public, private, non-profit, providers) for use. Have targeted messages for people 50–65 years old; 65–80 years old; and 80 and beyond. Also target messages towards work situations with higher likelihood for hearing loss (e.g. farmers, baristas, and construction workers).
  3. Improve professional hearing loss care and standards of care, by developing protocols that lead to best practices and improved standards of care. Specific actions include:
    i. Develop hearing screening protocols for people 65 and older as mandated by the legislature. Review the data to determine if other protocols are needed at younger ages (50, 55 or 60).
    ii. Research and create best practices to assure all dispensers are highly qualified, and consider legislation in the future if appropriate. The best practice should include telling consumers about all options available, including hearing aids, other hearing devices, and environmental access options such as T coils. In addition, best practice should include early identification, early treatment, and combined hearing/vision loss standards. As a part of this research, investigate what insurance covers and best practices regarding coverage of follow-up visits. Communicate best practices to stakeholders.
    iii. Encourage increased training for service providers, and add information about age related hearing loss to service providers’ training curriculum. These providers include nurses, certified nursing assistants (particularly those in nursing homes, hospitals, and adult day programs), and mental health professionals.
    iv. Use the DHS performance-based incentive payment program grants to provide financial incentives to improve care. In addition, explore development of a pilot project with the Minnesota Department of Veterans Affairs to build on existing MDVA protocols and screening. Use this pilot to study low cost solutions and evaluate efficacy compared to higher cost options.
  4. Establish partnerships to bring about change.
    i. Establish partnerships and coalitions to set priorities, develop messages, and develop and implement strategies to build capacity of the existing organizations that advocate in this area. A key message for these partners is that hearing loss is a state public health issue and major condition with personal, social, economic, and health care costs.
  5. Improve financial and other access to age related hearing loss care.
    i. Engage Minnesota’s congressional delegation to address Medicare coverage of hearing aid tests and hearing aids.
    ii. Improve insurance coverage for hearing care. Compile data that supports expansion of coverage, including: medical research data tying hearing loss to physical and cognitive issues; cost data; estimates of people who would benefit from proper hearing loss care; and a cost benefit analysis examining if increased costs for coverage would be offset by lowered costs for other avoided health issues. Develop a standard of care with input from consumers.
    iii. Compile information on low cost solutions and their effectiveness for various applications. Educate audiologists, physicians, other providers, and the general public about low cost solutions. Possibly review the hearing loss industry and engage device manufacturers in offering or finding solutions to make hearing devices affordable.
    iv. Enact legislation or use bonding requirements to improve hearing access, especially in public buildings, including: requirements that public places have T Coil loops installed; universal design elements such as visual alarms are required in new home construction; visual indicators are in use at rail stations; and acoustic standards are required in public buildings.
    v. Pursue legislative funding for untreated age related hearing loss.
    vi. Provide transportation to medical appointments or develop alternative approaches, such as in- home assistance with hearing screening and hearing aid adjustments, to address the needs of Minnesotans who lack transportation alternatives.

What are members of the Task Force doing right now to advance these goals?
Four things:

  1. Developing hearing screening standards for older adults. The Commission is paying the Minnesota Department of Health to convene a group to do this work. The group has developed recommendations for standardized screening and is working on next steps.
  2. Producing a documentary on age-related hearing loss. The Commission is working with Twin Cities Public Television (TPT) to produce the documentary and to develop training and advocacy tools to educate older adults and their families about the impact of age related hearing loss.
  3. Participating in a national pilot using cutting-edge, affordable hearing devices. It is a community-delivered intervention to provide affordable, accessible and effective hearing healthcare to seniors-of-color and low-income seniors. The research is conducted by Johns Hopkins University. (attached)
  4. Testing low cost hearing aids from World Sound Solutions (the same company that the John Hopkins University study is using). The Commission is working with the Minnesota Department of Health to design a pre and post survey to measure outcomes and the Deaf and Hard of Hearing Services Division will distribute the devices.