Drew Wilson
Hearing loss is an issue that millions of Americans struggle with daily, and one that is particularly important for the over 4 million seniors living here in Florida. Currently, only 15% of people who have hearing problems end up addressing the issue with a hearing aid.
Unfortunately, in Florida, there are obsolete regulations on the books that reduce access to treatment for those with hearing difficulties.
Florida is currently one of only two states in the nation, along with New York, that places a blanket restriction on delivering hearing aids by mail.
Thankfully, a bill this session, HB 957, would address this issue.
If signed into law, the bill would undo the prohibition of the distribution of hearing aids through the mail. In a state that has as many seniors as Florida does, it makes little sense to restrict more access to treatment. Especially in today’s times with the COVID-19 pandemic, it also makes no sense to force our most vulnerable residents to take unnecessary trips to a hearing professional.
This method of providing hearing aids is not a new concept. Throughout the country those with hearing problems are able to purchase aids cost-effectively and safely from licensed providers and sent directly to their homes; indeed, there is a growing body of research evidence that supports the effectiveness of providing hearing devices and have them sent directly to the consumer.
Moreover, these regulations are archaic. The restrictions on mailing hearing aids currently in place were put into law over 30 years ago and predate the invention of modern hearing aid technology which allows for remote hearing aid fitting and adjustments.
The bill sponsors have adjusted the legislation in response to objections to ensure a balance of both safety and access. This bill in no way removes the licensed hearing care professional from the process. Floridians would still need to have their device dispensed by a locally licensed professional. Importantly, the language that was in the Senate version of the bill (SB 700), and is supported by all parties, would not permit deliveries of hearing aids by mail for children, who need special attention and protection.
One hopes the Legislature will take a long, careful look at this bill, and at the possibility that Florida can join the 48 other states that don’t have overly restrictive and outdated regulations that potentially put our seniors at risk.
5 comments
Julia P. Andrews, Au.D.
April 21, 2021 at 9:50 pm
Thank you, Mr. Wilson, for your interest in this legislation. As an audiologist in Florida, I felt it is important to clarify some of the statements made in your article that may be misleading and/or incomplete.
Currently Florida is one of six states that have restrictions on delivering hearing aids by mail. The other states are California, Illinois, Nebraska, New York, and Washington (per their state statutes).
HB 957 proposes to eliminate all restriction on mail order of hearing aids in Florida. If this bill passes, there would be nothing remaining in the statutes that would require a hearing aid to be dispensed by a locally licensed professional which means the following statements you made are wholly false: “This bill in no way removes the licensed hearing care professional from the process. Floridians would still need to have their device dispensed by a locally licensed professional.” It would be wonderful if the proponents of the bill would add language that would make your statements true.
Additionally, the statement made regarding the body of research evidence you shared (one research article) does not provide the whole conclusion the authors made. The researchers concluded that while being fit with hearing aids by a professional and being fit by oneself via mail (over-the-counter type model) are both efficacious delivery models, those that fit themselves (OTC type model) “had a significantly (p < .05) lower satisfaction and percentage (CD: 55%; AB: 81%; P: 36%) likely to purchase hearing aids after the trial.”
Lastly, the bill language that was amended to SB 700 regarding hearing aid dispensing has since been deleted and as of this post does not exist on any Senate bill. All the consumer groups and professional organizations testified against HB 957 and the corresponding amendments to SB 700. They traveled from all over the state to oppose it. Only one company stood in support of this change.
Please include retractions and clarifications in your article to reflect proper reporting of the facts. I appreciate your consideration of this request.
Kim Cavitt, AuD
April 29, 2021 at 4:17 pm
Illinois allows for the mail order and online hearing aid sales in Section 6 of https://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1305&ChapAct=225%C2%A0ILCS%C2%A050/&Chap%09terID=24&ChapterName=PROFESSIONS%20AND%20OCCUPATIONS&ActName=Hearing%20Instru%09ment%20Consumer%20Protection%20Act.
Robert Fifer, Ph.D.
April 21, 2021 at 11:55 pm
Your interest in this legislation is interesting because the information you published is both incomplete and misleading. The “research” that you reference focuses on Over-the Counter (OTC) hearing aids intended for individuals with primarily mild or no worse than moderate hearing loss. OTC hearing aids are not a panacea that some advocates of mail order hearing aids have tried to promote. They are primarily for one purpose – individuals who need simply a boost in loudness to have a conversation with a friend in a relatively quiet place or to watch TV more comfortably.
With regard to the legislation that you reference, a group of advocates tried to convince a number of us that hearing aids are very much like glasses. Only a simple test, listening to some tones, will be sufficient to know how to program a hearing aid. They stated that all could be accomplished via “telehealth” services: the hearing test and the hearing aid programming and dispensing. As part of their advocacy, this group sent to us research articles that, if they had bothered to read what they sent, showed just the opposite. These articles concluded that a thorough diagnostic evaluation had to be done face to face in order to assess fully the degree of hearing loss and the functional impact of the loss. The initial hearing aid programming and dispensing also had to be done face to face. Here is why: in order to show any degree of hearing loss on the audiogram, more than 60% of a sensory cell group in the inner ear must be effectively destroyed. This means that for any hearing loss that is worse than “mild”, significant damage and compromise to how the inner ear processes sound has occurred. There are also other changes in the inner ear function that may not be reflected in the pure tone audiogram (the pure tone audiogram records the lowest level a person can hear a series of individual tones). All of these inner ear changes, taken together, affect how the person hears and understands speech, especially in the presence of background noise. As a result, two identical hearing losses on the pure tone audiogram can be very different in their impact – one person mildly bothered, the other person devastated, especially in noise. This is why much more than listening to tones must be done to evaluate hearing abilities. This is also the reason that the initial hearing aid programming and dispensing must be done face to face. The initial program, based on the audiogram, may not be appropriate for that particular hearing loss and must be modified based on the person’s speech understanding ability in quiet and also in noise. More often than not, the audiogram is the starting place for a hearing aid’s program but not the ending place.
The research that they sent to us did highlight the use of telehealth for the aftercare. Checking with the person to adjust the hearing aid remotely if/when necessary. Providing guidance and counseling to maximize benefit with the hearing aids. Answering questions and resolving listening problems. Hearing aids are not like glasses where you can put them on, and all is well. It is important to recognize that you are putting amplified sound into a severely compromised inner ear that doesn’t work anymore the way it used to work.
And with regard to your statement about Florida and New York being the only states to prohibit mail delivery of hearing aids. That too is false as detailed by my colleague. I went to the state statutes of numerous states and found the ones she mentioned that prohibit direct mail delivery of hearing aids. A number of other states’ statutes I examined were silent on the issue. I did not take the time to look at regulations of all states which means there may be more that prohibit direct mail delivery of hearing aids.
Lastly, be aware that OTC hearing aids are not yet available pending the publication of FDA regulations. When they do become available, advanced information indicates that they will be of mild amplification gain and not necessarily appropriate for the general public depending on the degree of hearing loss and other related factors. The moral of this story is that there is much more to hearing loss than what the pure tone audiogram, performed without additional testing, will show.
Robert Fifer, Ph.D.
Lisa Tanner, Au.D.
April 22, 2021 at 12:23 am
Mr. Wilson, The article you wrote concerning the bill, HB 957, supporting delivering hearing aids by mail, is very disturbing, I have worked in the hearing healthcare field for many years. I have a doctorate in Audiology and own a private audiology practice in the state of Florida. I have had the opportunity of fitting thousands of hearing aid devices. I would like to point two key factors that would be missing and could be disastrous to an individual purchasing a hearing aid by mail:
1. No visual examination of the ear canal nor eardrum has taken place. (i.e. Wax, foreign object, boney growths, or other issues that could be addressed with no need for a hearing device)
2. No hearing evaluation has been completed to properly diagnose a hearing loss. (e.g. some hearing losses can be corrected by surgical intervention)
This bill was not drafted for the good of the people. This bill was drafted for the good of a hearing aid manufacturer or a third-party hearing aid supplier. This bill is about financial gain for companies not for the well-being of a person with hearing loss.
Theresa Bulger
April 22, 2021 at 12:04 pm
There are a number of inaccuracies in this article. The greatest one is of course that no protections for children exist in Hb # 0957.
It seems negligent to me that the reporter did not avail himself of lobbyist disclosure for HB # 0957 and/or reach out to the opposition.
Nor did the reporter reach out to consumer groups listed in opposition, such as: the 100 year old Sertoma Speech and Hearing Foundation, the Fl Chapter of A G Bell Association for the Deaf, the Fl Coalition and several other entities.
The legislation as written may have been well intended, but as written could have put children who are deaf, senior citizens and adults with hearing loss at physical and financial risk.
The organizations that ensure professional credentialing also opposed HB #0957.
In fact one company alone appeared to drive this legislation. Laws should be focused on citizens not profit centers of industry.
Perhaps, there is a way that the company’s interests and citizens could be both met. That would surely be ideal? Yet this news item seems to ignore the valid concerns of consumer groups, deaf individuals and professionals practicing in Florida? That surprised me. I hope the excellent reporter will dive back in and give a fuller, perhaps more accurate view?
Even more I hope that this encourages a dialogue focused on a robust, safe, free- market for folks who like me – have hearing loss. However, unintended consequences are currently throughout HB#0957 . Let’s hope all parties can work together this summer to the greatest good.
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