TVR_106-3

Viehweg, 1985; Brookhouser, Worthington, & Kelly, 1991; Culbertson & Gilbert,
1986).
When DHH children are not identified early and provided with appropriate
access to auditory input and early intervention programs, there are also
significant costs to society in terms of direct medical costs, special education
expenditures and lost productivity. According to Chambers, Shkolnik, &
Perez (2003), DHH children required more than twice the annual per student
educational expenditure as children without disabilities ($15,992 versus
$6,556) in the year 2000. Another study (Schroeder et al., 2006) found that the
average economic costs per year for children with bilateral moderate, severe
or profound hearing loss were nearly four times those for hearing children
($26,207 versus $7,823). Many of the negative outcomes DHH children have
historically experienced can be minimized or avoided completely if they are
provided with appropriate amplification and early intervention that focuses
on teaching language (Yoshinaga-Itano, 1998; Moeller, 2000; Kennedy et al.,
2006).
In spite of the consensus among professionals about the importance of
fitting hearing aids as early as possible, data from various sources suggests
that it is quite difficult for many DHH children to obtain hearing aids. For
example, most private health insurance plans explicitly exclude coverage for
hearing aids (Nemes, 2004). A recent survey of hearing aid users found that
only 16% of children had any coverage of hearing aids through their private
health insurance plan (Rhoades & Powell, 2002, No. 35). Fox, McManus, &
Reichman (2002) reported that only 7% of the most commonly sold private
health insurance plans offered hearing aid coverage.
More than half of all children in the United States are covered by Medicaid,
which generally does provide coverage for hearing aids. Unfortunately, reimbursement
rates are so low that most children do not obtain the type of
hearing aids they need. McManus et al. (2004) found in a 15-state region that
average Medicaid fees for hearing aids and other auditory audiology services
were only 38% of those paid by private health insurers. Furthermore, in many
states, “medical necessity” guidelines require that Medicaid provide the
“least costly alternative.” Consequently, analog aids, rather than digital aids,
are often provided to children despite clear evidence that digital aids would
be more beneficial (AAA, 2003).
At the present time, Part C programs seldom pay for hearing aids, It would
seem however, that Part C should be a source of funding to provide appropriate
hearing aid technology to DHH children when other sources are unavailable.
According to IDEA, funds from Part C cannot be used to pay for
services that would otherwise have been paid for from another public or
private source (34 CFR 303.520). However, because both Medicaid and private
insurance plans are unlikely to cover the type of hearing aids needed for
DHH children to make optimal developmental progress, Part C should be
available to fill the gap.
Finishing the EHDI Revolution 251