Australian Government - Department of Health - Office of Hearing Services
Hearing Services Program

Hearing Rehabilitation Outcomes

Hearing Rehabilitation Outcomes (HRO's) for Voucher-Holders 1 July 2015

Outcome 1 Assessment
Outcome 2 Referrals
Outcome 3 Hearing Rehabilitation
Outcome 4 Fitting of Hearing Devices
Outcome 5 Follow- up
Outcome 6 Aftercare
Outcome 7 Service Management Systems
Glossary

Introduction

The aim of the voucher component of the Australian Government’s Hearing Services Program is to

Assist people with hearing loss to maximize their potential for independent communication and improve their quality of life.

This is achieved through contracting hearing services providers to provide a range of hearing services to eligible clients

  • Hearing assessment.
  • Identification of communication goals.
  • Identification of client attitude and motivation towards hearing rehabilitation.
  • Provision of rehabilitation services.
  • Fitting of hearing devices, where appropriate.
  • Education about the effects of hearing loss.
  • Communication tactics and strategies.
  • Referral to medical practitioners and/or support organisations.
  • Follow-up services, including evaluation of outcomes and long term support.

This Hearing Rehabilitation Outcomes for Voucher Holders documents the outcomes to be achieved by contracted service providers in delivering services to voucher holders.  

Note terms marked with an * are defined in the glossary.

  • Compliance with these Hearing Rehabilitation Outcomes is periodically reviewed and action is taken to remedy identified non compliance.

Outcome 1 Assessment

This outcome requires that

  • Practitioners establish the nature and extent of a client’s hearing and communication problems.
  • The focus of this outcome is understanding the client’s communication and hearing goals.

Results

The contracted service provider must demonstrate that

  • An accurate and complete assessment of the client’s clinical history, hearing, and communication concerns has been conducted by a qualified practitioner or a provisional practitioner under the supervision of a qualified practitioner.
  • The client's hearing goals and expectations have been discussed.
  • Compliance with these Hearing Rehabilitation Outcomes is periodically reviewed and action is taken to remedy identified non compliance.

Outcome 2 Referrals

This outcome requires that

  • Clients are referred for medical evaluation where appropriate
  • The focus of this outcome is safety for clients. 

Results

The contracted service provider must demonstrate that

  • Clients are referred to a medical practitioner for evaluation where clinically appropriate.
  • Audiometrists have liaised with an audiologist about the management of non-routine clients* or referred such clients to a medical practitioner for assessment.
  • Compliance with these Hearing Rehabilitation Outcomes is periodically reviewed and action is taken to remedy identified non compliance.

Outcome 3 Hearing Rehabilitation

This outcome requires that

  • The practitioner provides rehabilitation to clients to better manage their life with hearing loss. This may include device fitting.
  • The focus of this outcome is supporting clients decision making in the management of their communication and hearing goals. 

Results

The contracted service provider must demonstrate that

  • The hearing rehabilitation program that has been agreed with the client takes into account the client’s attitude and motivation towards rehabilitation and reflects the client’s communication and hearing goals.
  • The client has been informed about appropriate communication strategies, rehabilitation programs, and technological options available to assist them to manage their hearing loss and enhance communication.
  • They have assisted clients who require a device to make an informed choice about the type and configuration of device that they are fitted with.
  • They have advised the Office about clients who are considered to be complex*.
  • Where a client with 3FAHLs ≤ 23dB is fitted, the client meets both exemption criteria identified for the Minimum Hearing Loss Threshold (MHLT)*.
  • Compliance with these Hearing Rehabilitation Outcomes is periodically reviewed and action is taken to remedy identified non compliance.

Outcome 4 Fitting of Hearing Devices

This outcome requires that

  • Where appropriate, clients are provided with hearing devices to help manage life with hearing loss.
  • The focus of this outcome is providing appropriate hearing technology for clients.

Results

The contracted service provider must demonstrate that

  • The device(s) fitted to the client has been
    • appropriately programmed, with the aid(s) response verified against a prescriptive target; and 
    • optimised according to the client’s needs and preferences.
    • checked for comfort.
  • The client or carer has been assisted to effectively manage the device,
  • The client has been informed about options for maintenance of the device, including battery provision, and ongoing services available under the voucher program.
  • Compliance with these Hearing Rehabilitation Outcomes is periodically reviewed and action is taken to remedy identified non compliance.

Outcome 5 Follow-Up

This outcome requires that

  • The practitioner evaluates outcomes of the client’s rehabilitation program.
  • The focus of this outcome is evaluation of results for clients.

Results

The contracted service provider must demonstrate that

  • Timely face-to-face follow-up is provided to clients.
  • The short term outcome(s) of the client’s rehabilitation program have been evaluated.
  • Action has been taken to assist the client to address any issues or concerns identified through client initiated contact or through monitoring activities implemented by the Contracted Service Provider.
  • Compliance with these Hearing Rehabilitation Outcomes is periodically reviewed and action is taken to remedy identified non compliance.

Outcome 6 Aftercare

This outcome requires that

  • The client’s hearing and communications needs are reviewed.
  • The focus of this outcome is ongoing client support for the management of their hearing loss. 

Results

The contracted service provider must demonstrate that

  • Regular review of the client’s communication and hearing goals is undertaken and adequate support or referral is offered to the client where needed.
  • Criteria used by practitioners to determine refitting eligibility are consistent with the Eligibility Criteria for Refitting published by the Hearing Services Program.
  • Compliance with these Hearing Rehabilitation Outcomes is periodically reviewed and action is taken to remedy identified non compliance.

Outcome 7 Service Management Systems

This outcome requires that

  • The service provider has management systems in place to support compliance with their obligations under the Hearing Services Program.
  • The focus of this outcome is continuous quality improvement. 

Results

The contracted service provider must demonstrate that

  • Internal policies and procedures are in place to support service delivery and compliance with Hearing Services Program obligations.
  • Staff are aware of, and have access to, current versions of policies, procedures, instructions, documents or forms relevant to the requirements of the Hearing Services Program.
  • Policies and procedures are in place to manage complaints or disputes.
  • Service delivery is continuously monitored and improved.
  • Compliance with these Hearing Rehabilitation Outcomes is periodically reviewed and action is taken to remedy identified non compliance.

Glossary

Complex Client as defined in the Declared Hearing Services Determination 1997, a complex client is an eligible person who has

  1. profound hearing loss (a hearing loss where the average hearing threshold level for 0.5, 1 and 2 kilohertz ((kHz) in the person’s better ear is greater than, or equal to, 80 decibels.); or
  2. hearing loss and severe communication impairment.  Severe communication impairment means communication difficulty that prevents the person from communicating effectively in his or her daily environment; or is caused or aggravated by significant physical, intellectual, mental, emotional or social disability.

MHLT  Minimum Hearing Loss Threshold

Where a client has 3FAHLs ≤ 23dB the client can only be fitted under the legislative exemptions to the MHLT.

Exemptions to the minimum hearing loss threshold

A participant meets the exception from the minimum hearing loss threshold if

  1. the participant receives a score of 5 or greater on the Wishes and Needs Tool with a score of 2 or greater for each response and
  2. the participant has
    1. high frequency hearing loss averaging 40 decibels or greater when tested at 2, 3 and 4 kilohertz in the ear in which the hearing device is for fitting or
    2. tinnitus, the symptoms of which can be reduced through the use of the device or
    3.  previously used a voucher to obtain a hearing device and can demonstrate  to the satisfaction of a contracted service provider use of that device or
    4.  a visual impairment that reduces the ability to see mouth movements and is not able to be corrected by medical or optometrical treatment.

Non-Routine Client a client found to have one or more of the following audiometric presentations.

  1. An air bone gap of 20dB or greater at 500Hz, 1kHz or 2kHz.
  2. Speech discrimination poorer than expected given HTLs.
  3. Evidence of fluctuation in audiometric thresholds.

WANT Wishes and Needs Tool (developed by Harvey Dillon, NAL).

 

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