Welcome everyone to IHS's first ever half-day virtual event. I'm Kathleen Manillo, the Executive Director of International Hearing Society. Whether you are continuing on from our first webinar this morning, or you're just tuning in, we're so glad you could join us. This spring has provided us with quite a bit of uncertainty, and IHS is committed to helping you navigate this new journey. We have heard from so many of you that with stay-at-home orders in place, and with the cancellation of face-to-face events, there's a great need for professional development opportunities, and we want to answer that need for you. I want to send a big thank you to our sponsor, CareCredit. Their support is allowing us to offer a free CE credit for each webinar you attend today. And with 500 registrants for today, and over 410 people on the wait list to receive the link to the recording, together we're able to meet a great need. Thank you so much, CareCredit. I also want to share with you that IHS has created a COVID-19 resource webpage to provide you with pertinent information. Please visit ihsinfo.org to access this content. Now it's time to get back to learning, and to do so, I'll turn it over to Diana Cherubo, IHS's Associate Director of Marketing. Diana? Thanks, Kathleen. Welcome back, everybody, and if you're still here from the first one, and if not, thanks for joining us. This hour's topic is IHS Policy Perspectives and Updates for the Hearing Health Professional. You'll get a review of relevant legislative, regulatory, and other activities being undertaken by Congress, agencies, workgroups, and organizations that seek to address hearing healthcare policy, and learn about resources and news that affect the role and advancement of hearing health professionals. Speaking today, we have none other than our very own Alyssa Paradis, Director of Government and Chapter Affairs at IHS. Alyssa oversees IHS's international, federal, state, and provincial policy, as well as payer advocacy programs, and engages with the society's 51 chapters. Prior to joining IHS in 2011, she served as State Legislative Affairs Manager for the American Academy of Otolaryngology Head and Neck Surgery for five years, which builds off her experience working for a healthcare system, as staff for the Connecticut General Assembly, and on various political campaigns. Alyssa earned her BA from the University of Connecticut in Political Science. We're excited to have Alyssa as our presenter today, but before we get started, a few housekeeping items to keep in mind. Note that we're recording today's presentation so that we may offer it on demand through the IHS website in the future. And as mentioned, this webinar is available for one free CE credit. To earn that credit, you'll have to take and pass a quiz online. You'll find a link to today's quiz on this slide, right there, that bit.ly link. If you take and pass with a 70% or higher, IHS will process and send you a certificate of completion within the next couple of weeks. The links and instructions for the quiz are also found in a downloadable handout, found in the handout section of your webinar dashboard. You may access it at any time. And for a copy of today's presentation, that can also be found in that handout section of the dashboard. Go ahead and access that now. All the links for the quiz, information about receiving CE credit, and today's presentation are also on our website, IHSinfo.org. Just click on the webinar banner on the homepage, or choose webinars from the navigation menu. Lastly, tomorrow, you'll receive an email with a link to a survey about this webinar. It's brief, and your feedback will help us create valuable content for you moving forward. Now today, we're gonna be covering U.S. and international advocacy updates, as well as business tools and professional development for the hearing health professional. Afterwards, we'll move on to a Q&A session. You can submit a question for Alyssa at any time by entering your question in the question box on your webinar dashboard, usually located at the right or top of your screen. We'll take as many questions as we can in the time we have available. And now I'm gonna turn it over to Alyssa, who'll take us through today's presentation. Alyssa? Well, thank you so much. I'm so pleased to be here. Usually it's in person at one of our chapter meetings, but I'm so glad to be able to come to all of you in your homes and workplaces. I'm gonna be giving you just a glimpse into our policy work. There's a whole lot more. But first, before I do that, I know we've got a lot of members on the line, and then maybe we have some folks who aren't really familiar with IHS. And so, just wanted to take a quick step back and let you know who we are and what we do, and why we would love to have you be a part. First of all, we're an organization that provides protection to the hearing aid dispensing practice through establishing tools and guidance that relate to best practices and business standards. We provide hearing healthcare professionals a network where you can interact with each other. And as Kathleen has mentioned, there's been a lot going on on our hearing hub right now around infection control and COVID response. And that's been really a great way for individuals to connect when we really need that connection. We also, in my wheelhouse, we are the only organization internationally and at the federal level in the US that represents hearing aid dispensing professionals. And then finally, we work very hard to contribute to the growth of the profession through our training programs, developing education, and other really exciting opportunities. So I'm gonna speak to some of those things today. But first, what I'd like to do is just take a little bit of a step back and let you know kind of what our track record is here. There's been so much that's happened at IHS just in the last 10 years. And I'm just gonna throw out a couple of these, some that we've worked on in the Government Affairs Department and some in our other departments, including establishing our first federal bill, which was signed into law and I'll be talking about. We also had our first federal training standards adopted, which is really incredibly exciting. We've been appointed to international work groups. We launched an entire new training course and new testing platform and modernization. And we've been just doing so very much more, but we know that there's a lot coming your way in the profession. We know there's a lot coming to the industry. And so we're very cognizant of that. And a lot of the work that we do really is to this end. So we know that strategically, we need to be considering the fact that demand for hearing healthcare is continuing to rise, without a doubt. And I think a lot of you who are operating on a part-time basis right now, you're feeling that. There's people reaching out looking for help who maybe never have done that before. We also know that there's an increased awareness amongst consumers about the importance of hearing loss as a critical health and wellness function. And of course, there's hearing devices hanging off of a lot of ears these days. There's an increased use, which we know can contribute to noise exposure, but it also leads to a better acceptance of actually having ear-worn devices. Then of course, we know that the delivery models have been changing, expanding. We know that over-the-counter hearing aids is coming. So not to say we haven't had mail order for a long time, but internet is playing a bigger role in the delivery of hearing aids. Telehealth is a hot topic. And of course, we've got big box and drug store like Walmart, CVS, Sam's, Costco, et cetera, who are now in this space. We also know that the difference in insurance coverage has dramatically changed even over the last six or seven years, and that we were seeing these discount plans coming into the marketplace trying to play a role. One of the things I'm gonna be talking about is discussion around potential Medicare expansion to include hearing aid coverage, and that would be a really big deal for us. And then finally, there's several groups that are developing new research that we expect will help drive policy and best practices. So I'm gonna jump into our advocacy report first by just touching back on the issue of the COVID-19 that's going on right now, because there's a congressional component to that. As Kathleen, I think, mentioned, IHS launched a little over a month ago, I think, our new COVID-19 Resource Center, and you can see there's a link right there. And I'll just say that, as you see, links through the presentation. Don't worry about writing that down. You can download the presentation, and you'll be able to get access to all of those, but there are some peppered throughout. So the Resource Center really is a tremendous landing place to access information on what the government has been doing, access small business loan information, and much, much more. So we encourage you to visit that. Obviously, we know that hearing health care offices, hearing aid dispensing offices have been heavily affected. And so from onset, IHS has been reaching out to and communicating with congressional leaders and key committees who oversee funding to let them know about that effect. Obviously, we know that the patient population you're caring for is amongst those that are most vulnerable. And so we were very pleased when CARES Act, and of course, we've had the subsequent funding through the Paycheck Protection Program and Health Care Enhancement Act, which provided small business loans and funding. And I know many of you were able to get access to that, which is wonderful, and hopefully with this new influx of funds, anybody who wasn't able to now will be able to. We're also continuing to monitor additional action that Congress and the White House may be taking as it relates to small business loans and assistance. And then one of the other things that we're doing right now is we've been meeting virtually on a weekly basis with other hearing organizations, including manufacturers, providers, consumers, to just share information and identify opportunities to coordinate with each other as we need to. What I'm gonna do now is I'm gonna transition into our Fit to Serve initiative. Many of you are likely familiar with this. Fit to Serve is kind of our internal name for an initiative that we launched back around 2011, aimed at helping veterans gain better access to hearing health care. We knew that they were coming into hearing aid specialist offices looking for help. And so we began this endeavor, which led to passage of legislation in 2016, which is really the first step. Our ultimate goal is to help veterans get access to hearing health care, both in the VA clinics and then also through hearing aid specialists as community care providers. That first bill, which was Public Law 114-256, did four things. One is it specifically added hearing aid specialists to the list of professions in the law that the VA can hire in their staff clinics. It also requires an annual report to Congress on what the wait times are for hearing health care services, including staffing numbers of audiologists and hearing aid specialists both in, I'm sorry, in VA facilities, and then how many they're actually using the contract size. And that report is due every five years. And so we've been tracking those. And as expected right now, unfortunately, there's no hearing aid specialist being used. I'll be talking about that in a second. So, and then the third thing that it required was for the Department of Veterans Affairs to pull together stakeholders at a meeting to talk about what qualifications should look like for hearing aid specialists to work for the VA. So where are we now? The bill passed. Ultimately, the VA has not chosen to use its authority. It did hold the stakeholders meeting. But beyond that, they have not begun hiring. They have not developed those qualifications. So we gave them ample time. And in 2019, we launched a very robust effort to reengage our congressional champions to help them push the VA to take action. And I won't read through all of these. You can certainly do that at your own time. But this just gives you a sense as to the level of activity, which was high, high, high. We had questions asked during public hearings. We had letters going into the VA. And we still find ourselves, and our congressional champions find themselves seeing no action on behalf of the VA. So, we are back at it in 2020. And building upon that momentum, we had a couple of exciting changes happen, developments happen. The first one being in January, and one exciting thing happened that we're thrilled about. The other one, it led to that. So, Senator Jerry Moran, he's been working with us since the get-go. He's a Republican from Kansas, and he's been on the Senate VA Committee for many years. He was actually named chairman of the committee back in January, which is fantastic. And within just a couple of weeks, we worked with him to incorporate into a mental health bill, Senate 785, language that would help move forward our objectives. And I'll talk about what that was in a second. And then the other thing that happened just last week was the same language that was included in that mental health bill. We worked with the committee chair of the House VA Committee, Mark Takano, and the ranking member, which is the top Republican on committee, Dr. Phil Rowe, to introduce a House companion, and it contains just our language. It's just a unique bill to us. The language that's included in the bill, both in the House and Senate bill, it's actually very simple, but it's very direct. The first thing is that it would require the VA within six months of the bill's enactment to establish qualifications for hearing aid specialists to work for the VA. That's one thing that they've been pushing back on. That's really an impediment to hiring. You need those qualifications. Then by September 30th, 2022, the VA is required to appoint at least one hearing aid specialist at all of the VA medical centers, and there's 170. That's pretty phenomenal. And then the last piece is that the VA would be required to submit an annual report to Congress, just letting them know where they're at at the hiring, whether or not there's any problems that has affected hiring. Seems pretty simple. So in terms of where we're going now, we are going to be working towards obtaining passage this year. This is the second of a two-year Congress, so we have until the end of December, and the bills will be viable up until that point. We're also, we've provided to the VA back at the stakeholders meeting in 2018, our suggestions on what technical qualifications for hearing aid specialists should look like, and so we're gonna continue to work with them as they provide us the opportunity and as we can engage through our congressional champions. We are also using our congressional champions and friends and doing direct outreach to the VA, suggesting that they need to change the audiology directive which currently lives in a handbook. The audiology directive presently has some restrictions on when the VA can use hearing aid specialists, and so we wanna see those changed. And then we also wanna take advantage of the opportunity to weigh in on the Mission Act. The Mission Act is the newer version of the, oh my gosh, I'm sorry. The bill that, the new delivery of community-based care began in 2014, and so Mission Act was the recent revision of that bill. And so they have sought to make improvements to the delivery of community-based care, and so we wanna use the Mission Act to identify ways in which we can actually participate. And one of the big challenges of the way that community-based care is being delivered right now is that hearing aids are not actually being delivered through that. So you have to go through a brick and mortar VA building and the audiology team there. So we need to be able to open that up so that community care providers can actually be providing the types of services that our veterans are looking for. So if you go to our fit2serve.us site, you can stay connected to what we're working on, and there's a link to our online action alert that you can fill out and send off to your house number and ask them to co-sponsor our bill. So now I'm gonna transition to the hot topic of Medicare coverage of hearing aids. I'm sure everybody's heard about this and is tracking the fact that there have been several national policy groups and consumers that have been pushing for expanded coverage of Medicare to cover hearing aids. We are very pleased back at the beginning of last year, we knew this was coming and we began gathering facts and meeting with key stakeholders in early 2019. And in September of last year, the IHS Board of Governors adopted four guiding principles for its Medicare policy approach. These include that hearing aid specialists must be added to the list of Medicare providers to provide hearing evaluations and hearing aid dispensing services, including oral rehabilitation. That coverage should not be limited just to hearing aids, that they need to include, it needs to include hearing aid dispensing services, including those services that are consistent with the standard of care. We also are recommending that hearing aids be defined to at a minimum include capability for assistive device connectivity and operability, and that beneficiaries be able to top up basic technology that doesn't work for everyone, then it's not going to be as valuable as intended. And then, finally, if there is going to be some sort of an order from a physician in order to get hearing aids, that if that exists, that hearing aid specialists and audiologists be treated equally. If there's no order and a Medicare beneficiary can go straight to a provider, then it should be the same for hearing aid specialists and audiologists. So typically, it wouldn't be a surprise to see legislation introduced in Congress that would expand Medicare to cover hearing aids. Typically, we see several every year. And at first glance, in October 2019, when we saw HR 4618 introduced, we didn't give it a whole lot of thought right away until we started to understand that this was part of more of a plan to move a package. And so, just briefly, the bill that was introduced by Representative Lucy McBath, HR 4618, sought to expand the services audiologists could provide for Medicare reimbursement to include oral rehabilitation and treatment services and expand the Medicare Part B coverage to include non-over-the-counter hearing aids and examinations, therefore, for adults who've been diagnosed with severe to profound loss, the benefit would be available every five years, and the intended beginning date would be in January 2022. So what happened, though, as we heard about the bill, was House Speaker Pelosi was out in the press talking about how she was intending to package that bill along with expanded vision and dental services under Medicare into a drug pricing bill. The drug pricing bill, HR 3, offered up significant savings that they could then put towards Medicare expansion. So what happened very quickly was not only was the drug pricing bill passed out, but the vision, hearing, and dental also moved through committees incredibly fast. They didn't have public hearings. They just took the votes and moved forward. And there really was no opportunity for comments or amendments. It was quite an unusual process. And what we know is that on December 12th, the House passed that drug pricing bill, and that included the hearing language. It was a party-line vote. So by the time we got to that part, there were two amendments that were added to the bill. The first would reclassify audiologists as practitioners under Medicare. The audiology groups say that that is necessary so that they could deliver the intended services. And then the second requires a report every two years from the enactment that would evaluate whether or not that physician order that currently exists for audiology services to be provided under Medicare could potentially disappear without affecting the program integrity or affecting utilization. So there were two things that IHS was quite focused on. We do have all of our priorities that we were sharing, and we also were suggesting that covering only those with severe to profound loss was certainly not enough. But the two primary focuses in terms of potential amendments that we thought were possibly palatable was obviously adding hearing needs specialists as providers of treatment and oral rehabilitation services under Medicare consistent with their state scope of practice, and also looking at this potential for some sort of a report or a study that would help us make the case as an alternative to just simply adding hearing aid specialists. We wanted to direct a report on access problems that might stem from not having hearing aid specialists in Medicare. We obviously know in more rural areas, hearing aid specialists fill a great need, and that would have been very obvious. So we did get great support and agreement from staff as we were meeting with them, but ultimately their hands were tied, and I'll talk about in a second the potential impact on cost, but timing was also very much an issue. And so any changes to the language would have slowed down the process, and they were very uncomfortable with that. And we were also told, you know, this is not the last time we're going to be talking about Medicare policy, so let's continue having conversations. The cost impact, I just wanted to bring up really briefly, is the net of the bill, once it was passed through the House, including the hearing benefit, had just a $5, I'm sorry, a $5 billion savings over 10 years. Now, if you look at just the piece related to hearing care, and that piece only covers individuals who have severe to profound loss, that estimate for the cost is $89 billion. So if you were to add those with mild to moderate loss, or even just those with moderate loss, that cost would have gone way up and they couldn't have covered it. The other issue is, and as we were talking with congressional staff, they said, well, we can't add hearing aid specialists because it will increase the cost. And we said, well, that doesn't make any sense. How is that possible? You're just giving access. And the answer is, no, we would be giving more access because we're basing this off of limited access to only audiologists, which was all disappointing to hear that that was the perspective, but that's what they were able to do. So what's next? So overall, we know that the reaction to COVID has sucked up a lot of time and energy, rightfully so. Do we expect anything that's going to pass this year? No, we don't. There's a few drug pricing bills in the Senate right now that could be potential vehicles. None of them have any sort of expanded coverage of hearing aids. If there were a drug pricing bill that passed the Senate, then that bill and the House bill, H.R. 3, would have to be resolved and that would be an area where we can try to influence that outcome. But ultimately, we don't really see this happening. There is a health extenders package that reauthorizes and grants additional monies to existing programs that was seen as a potential vehicle. It was reauthorized and will have to be considered again in November, so we're watching that. But should nothing happen this year, we are still very mindful that House passage was incredibly significant and that depending on how the elections turn out in November, this could be a much larger conversation going forward. But either way, we are ready. So we're going to keep monitoring potential action and we've been meeting with the Friends of the Congressional Hearing Health Caucus, which again is organizations who are related to the hearing health care field, consumers, providers, industry, and we're talking about whether or not there might be some shared priorities going forward. Something that's interesting that came out of the discussion around coronavirus actually led to six organizations sending a letter just a couple weeks ago to the Center for Medicare and Medicaid Services related to the delivery of Medicare telehealth services by speech-language pathologists and audiologists specifically during this crisis. But fortunately, we were able to work together with our partners at HIA and HLAA to incorporate into that letter support for expanded coverage for hearing care under Medicare and specifically support for the use of hearing aid specialists as Medicare providers. So it's great to have that on policy. So now what I'm going to do is I'm going to transition over to the topic of over-the-counter hearing aids, which is still actively happening, even though we've been diverted on a couple of other different policy issues. Specifically, this is the year when we're anticipating seeing the proposed over-the-counter rules. The proposed rules are due no later than August 2020. There was a suggestion by the FDA that they were going to have the proposed rules out in November 2019, but that review process has slowed down. And so whether or not there's any impact on the timeline because of the coronavirus, that we don't know, but it's certainly plausible. But presuming that the FDA is going to follow the directive from Congress, then the latest that we should expect to see those proposed rules would be August 2020. So when we do see those, we will be communicating with members with our calls for action, concerns that we want to make sure that folks are raising. And then that comment period congressionally is mandated to be, I'm sorry, the FDA typically is allowing for 30 to 60 days. We don't know exactly what that comment period is going to look like, but once that comment period closes, then the FDA will have six months to finalize the rules. So if that timeline all falls together, then we can see the final rules in March or April 2021, again, based on how long that comment period is. So as a reminder, IHS joined with the three national audiology groups to release recommendations for the FDA on the over-the-counter hearing aid classification. We've met with the FDA, we met with congressional offices, we've secured some support letters, and some other supporters within the hearing healthcare space, and you can certainly check out the recommendations and updates we have. That was really significant, by the way, that we had these joint recommendations. I don't think in our history we've been able to do anything like that with the three audiology groups, so it really was a turning point for us. So now I'm going to transition briefly to some international activity. We are an international organization. We value our international members. Globally, there is a significant deal of activity that can and will filter down to the U.S., Canada, and other jurisdictions where IHS members are present, and so just to tell you a little bit about this, the International Organization for Standardization, ISO, that's not a typo, that's what they call themselves, just finalized a brand-new international standard for hearing aid fitting management, and we were thrilled to have past IHS President Rick Giles participate on the workgroup on behalf of ANSI and the Acoustical Society of America. It's really significant that we were a part of that, because that allowed Rick and the U.S. representative to ensure that the final standard that was released reflects the U.S. and the Canadian practice standards and recognizes the types of providers that dispense hearing aids in our areas. So there's going to be more to come on that. They were just released in the last couple of weeks. The other thing that's happening in the international space right now is the World Health Organization is following through on a directive from 2017 to develop a world hearing forum, release a world report on hearing. They have been developing standards, safe listening standards, which are being integrated into our smartphone devices, and actually I came across mine the other day, and fortunately I'm listening safely. And so IHS was actually appointed to be a part of the world hearing forum, and we are participating on a committee related to public awareness activities, so that's really exciting. The world report on hearing is going to pull together research from around the world to help make the case for increased prevention, identification, and treatment of hearing. Now it was due out in May. I just got a notice that it's on delay because of the coronavirus, which is, of course, unfortunate. But there will be more information coming out from IHS on that and some coverage in the upcoming edition of the Hearing Professional. So coming back into the States, a couple of other work groups have some active activity there, including the National Academies of Science, Engineering, and Medicine. NASM, as it's called, was previously the Institute of Medicine, and you may remember that back in 2016 the NASM released its hearing report, which included a series of 12 recommendations, which included the creation of an over-the-counter hearing aid category. Specifically what they're doing now in light of the incoming over-the-counter hearing category is they're intending to host a workshop on the potential tie between insurance and over-the-counter hearing aids, which, of course, IHS is incredibly concerned about. We've been concerned about from the get-go, and so we've been in touch with the workshop organizers, provided them a good deal of feedback to help them as they develop the session, and we're going to be pursuing opportunities to play a continuing role in that. I also wanted to mention on the research side of things the U.S. Preventative Services Task Force, which is a national body that looks at developing recommendations for various areas of medicine and delivery of health care. They are presently looking at whether or not they want to make a recommendation that asymptomatic adults aged 50 and over would obtain hearing screenings in primary settings. They looked at this in 2012. There was not enough research at the time. Now there's definitely more research in the area, and we're very hopeful that their ultimate recommendation would suggest that hearing screenings are valuable because that really is a trigger for physicians to understand the value of hearing screenings and hearing loss. And then, finally, on the federal side of things, I just wanted to mention, now that Tax Day has been extended to July 15, if you have not yet filed your taxes, IHS several years ago worked to ensure that a brand-new tax deduction, 20% tax deduction, for business owners could potentially apply to hearing-aid business owners. This is part of President Trump's Tax Cuts and Jobs Act, and so if you're not familiar with that, members can go to our website and download our member advisory and share that with your tax counsel. Before I do transition, again, I just want to mention, this is just a brief glimpse into the work that we do. We also work closely with our 51 chapters in the U.S. and Canada to help them with state and provincial regulatory and legislative issues to include defeating deregulation. This year in Iowa, we partnered there for a win, advocating for fair licensing rules, ensuring hearing-aid providers are all included in insurance mandates that cover hearing aids and you can certainly learn more about what we do through our advocacy webpages. I know that this is a time when folks are working on themselves professionally, while businesses may be a little bit closed, so I do want to let you know, though, that all the work that I've talked about and much, much more on the advocacy side is funded through voluntary donations. We're very grateful to our members who donate and our chapters who donate on an annual basis. If you are interested in supporting the work that we do, we would certainly appreciate that. And if that's not today, which I understand it may not be, if it's in a couple months when things are back on track and you're feeling really good about business, we would really appreciate that. We also have some great corporate partners like NBC who help us every year, so we appreciate them. So the remainder of my time, I'm going to just talk about some of the business tools and professional development tools that we have that could be helpful, and really, this is a great time for you to be putting these into practice right away while coronavirus is forcing everyone to just slow down a bit. I was talking to one of our members just a couple days ago, and he was talking about how the slowdown has actually helped him identify some areas where they weren't always acting efficiently, and in identifying those efficiencies, they're going to be able to put that into practice going forward. So I hope everybody else is finding some of those enlightening moments. But quickly, let's just look at the data. Specifically, the census projections point to there being a major shift in the next few decades that will suggest that there will be more adults 65 and over than children, and that's going to happen around 2034. So if you look at 2016 to 2034, that's an increase of 25 million adults right in that population that is going to be needing hearing aids. And then beyond that, 2060, maybe for those young professionals on the line, that goes up to 95 million adults. And that sounds like a ways off, but we're going to be feeling that trend. So how is it that you can plan to grow your practice to meet the demand? I'm going to talk about some of these in my remaining slides, not all of them, just for sake of time. But there's several things that you could be considering doing, including looking at the Tinnitus Care Provider Program, which we'll be offering our next course in 2021, and things are a little bit back to normal. Maybe you want to look at best practices in hearing aid dispensing and see how you can make sure that you're complying. Can you look at expanding your participation in managed care, making sure that you're following all those legal requirements to make sure that you're protecting your practice? Maybe you want to look at elevating your professional brand through becoming an IHS member or becoming board certified if you're not already. So I know it's hard to think about hiring right now. Few, if any, businesses are actually hiring, and possibly we're going to be going through some sort of a shift or a reset when things get back to normal, but we know that we do need more hearing aid specialists in the normal world to fill the need. There's just not enough. So if you do expect to be hiring in the next say year or two years, we do encourage you to learn more about the National Department of Labor Training Program, which will help you recruit new apprentices, teach them to the gold standard, and be able to access incentive programs that the states offer, which can turn into savings on books and testing fees, and it's really an exciting opportunity also for reciprocity. So it's a really great program and I encourage you to learn more. For those who are training or who are trainees themselves, I did want to highlight we've got this amazing new tool called ILE Test Prep, and it's really just taken off. Trainees are using the ILE Test Prep to refine their knowledge before they take the test. So they spend time with the distance learning course, and then before they take their their licensing exam, which they're spending money on, they can get access to a paid monthly online service where they can go in and they can answer test questions that have been used in the past on the international licensing exam, and then find out where they might have some deficiencies and find out where they need to be working a little bit more on. So that's been great and we've seen really we've seen positive effects on the test. Great. I also wanted to just highlight that the trainer manual that many of you are familiar with continues to grow and expand and get better and better. We just released a new trainer toolbox, which one of our members described as, wow, this is like hearing aid specialist university. I've never seen anything like this before. So that accompanies the text that we've used in the past to help somebody who's been in the field for a long time, maybe who has a trainee and they're not really sure, where do I even begin? I didn't take this test. They don't really remember what they need. This is really your tool. We also have professional practice guidelines. I think a lot of folks aren't really familiar with this, but these practice guidelines, including sitting and dispensing hearing aids, bridge and brace techniques for patient safety, verification and validation, provide a really great overview of the standards that you really want to make sure that you're practicing in your business, validated by our International Institute for Hearing Instrument Sciences. This really will comply with the national standards and they're defensible and they set a really great measure for your staff and your business. So please check those out. We encourage everybody to get familiar with those and make sure that you're using those in your practice. We also released in 2017 a new tool related to managed care. It's our Hearing Health Care Professionals Guide to Third-Party Participation, which we also call the Insurance Guide. Everybody calls it the Insurance Guide. This is a really great resource for either getting started in insurance. It's really like a play-by-play. Here's where you get started. Here's what you need to do. Or if you've been participating in managed care, you can use this guide to really refine the way that you're doing it and find new efficiencies and make sure you're doing it the right way. Now I'll tell you that this guide right now is available free to IHS members. For non-members, it's $325, which is exactly the same cost as becoming an IHS member. So it all pays for itself. The Managed Care and Compliance Committee, which developed this fantastic tool, is in the process of doing the next edition, which is going to be bigger and beefier and better than ever. And when that gets released, we do expect that will be a for-cost product. So if you want to get the early edition and get a little flavor as to what it might look like later on, this would be a great time to do that because it is free. But we want you to make sure that you understand that this new one is going to be fantastic and well worth it. The last thing I'm going to be talking about in terms of new tools is the IHS Compliance Plan Development Guide. So what is a Compliance Plan Development Guide? I know we've had a lot of members recently downloading them. They're identifying, hey, this is a great time for me to take advantage of this and do some work on my business. So a compliance plan is a formalized statement of a business's intent to act ethically and legally in its operations following state, federal, and any local laws to deliver patient care and services. And to be participate in health plans, this is actually a requirement for some to participate. So it was released in February. This really came from requests from members. They were finding that they needed these. So why would you do this? Like I said, maybe because it's required for a health plan. There's several reasons. This can help if you use it effectively, if you customize it for your business, and if you follow the plan, you can use it to minimize organizational and individual risk. It can help you avoid serious sanctions and very hefty fines through implementing it and observing it. It can help a business owner or the compliance officer within the business prevent and detect unethical and illegal conduct. And this includes knowingly or not, intentionally or not, it's going to help you identify those through different auditing mechanisms. And then it allows you to establish a uniform process and procedures which helps your staff and business associates know how they need to act. So this is exclusive for IHS members. Our attorney was telling us like, wow, we do compliance plans in my practice and we charge tens of thousands of dollars for that. So this is really a starting point that naturally would cost anywhere from three to five thousand dollars just to get. And then again, this is a starting point. There's an explanation internally about the why, the how, what are the key terms. It gives you a starting point and then you customize that to make it work for you. It is free for IHS members. We're so excited to be able to offer it free for IHS members. So you can visit the resources section of the IHS website to get access to that. So finally, I want to just thank the volunteer members of IHS for the contributions to the resources that I've talked about and the work that we do. Thank you to our board for the leadership during this time and their commitment to IHS. And I encourage you, if you don't know who your regional governor is, I really encourage you to get to know them. You can find them on our website. Thank you for the opportunity to be a part of this and I will turn it back over to the moderators. Thanks, Alyssa. This is Diana. That was great. So much information and so many things happening. So you're doing a great job over there. For all of you on the webinar today, we do have some time for questions. So go ahead and enter your question for Alyssa, if you have any, in the question box on your webinar dashboard. Our first question is from Renee. And Renee wants to know, what justification has the VA given as to why they haven't started hiring hearing aid specialists? Thank you for that. Yes, so the VA most recently has suggested that because the states have a non-uniform licensing standard, that it would be too difficult to establish a national standard and they don't want to establish a standard that is different than what a state might have on the books. And so we specifically responded to that question in the language that was introduced in our bills from January and April and specifically directing the VA to establish qualifications based on what a majority of states require. And so that should help overcome that particular challenge. I think also it's a bit of a bias and they just don't want to hire us. But we are addressing that question in our underlying legislation. Thank you. Okay, I got it. And Alyssa, I know you mentioned this earlier, just touched upon it in terms of something to prepare you for the future, but Gregory wants to know if the board certification credential, CCHIS, which is offered through the National Board for Certification in Hearing Instrument Sciences, is that credential suggested to the VA as a qualification for non-audiologist HISs to provide services to vets? Would we recommend that? Yep, so I understand the question. So to work for the VA, we were very clear early on and in the legislation that passed in 2016, that licensure is adequate. Licensure shows competency. It has the mechanisms built in if there's a problem. So from the basis of participating in VA should be licensure. However, board certification can play a role as you look at the GS levels. So one of the, as we were providing input to the VA, we did suggest, you know, this GS level, this could be the requirement for entry, this GS level, etc. And it's consistent with how they handle GS levels. So board certification could certainly play a role as you look at various roles for, you know, supervision or doing more services. But we don't want that to be the baseline because licensure is adequate, but board certification can certainly play a helpful role. This next question here is from Timothy, and Timmy wants to know, he wants to support the advocacy work that IHS is doing, but can't afford to make a large donation right now. Are there any other ways that he can help? Oh, I love that question so much. Thank you. Yes, we actually, large donations are not necessary. We appreciate them, but we have donors who will give us $10 or $20, and that matters just as much as any other donation. We also have many individuals who have opted to provide monthly donations, so they might say, you know what, I'm not going to feel the effects of $10 or $20 per month, so go ahead and just charge me, you know, every month for a smaller amount. So we can certainly work with you, but we welcome support at any level. Thank you. Awesome. This next question comes from Granville, and the question is, how has the proliferation of audiologists that can dispense without taking a license exam impacted IHS's projection of the future for future needs of the hearing instrument specialist? Hi, Granville. Nice to hear from you. Audiologists being able to dispense without a license, I know in some states it's a little bit different issue because there are maybe registration requirements, there may be a required test that an audiologist has to take to dispense, so it really ends up being sort of a case-by-case basis, but by and large, if competency is shown, you know, we need everybody. We need audiologists, we need hearing aid specialists, as long as they've proven competency, then obviously, you know, we need them in the marketplace. I don't know if that answers your question, but that's really our philosophy on it. We need more everybody. Thanks, Alyssa. This next question here is from Laura, and she'd like to know, are there any other types of resources related to insurance and managed care that IHS has to offer? Oh my goodness, yes, there are. The Managed Care and Compliance Committee has been such an active committee. I staff the committee, and starting last January, they started doing a standing article in the Hearing Professional that's been so incredibly well received. They've been delivering webinars and seminars at the convention. There was a webinar that was recorded back in, I think it was November or December of 2019, so if you're looking for like the basics of managed care, you can go back and watch that at your leisure, and we're working on other exciting projects, like I said, coming up a revamp to the insurance guide. I would also add that for IHS members, if you get into the IHS website, it's sort of indirect through advocacy, and then we have a payer advocacy site. You can actually ask your questions direct to our committee, which is a really fantastic and free service that you really can't get anywhere else, so I encourage you, if you do have questions about billing or coding, you can reach out to me, and I can pass it along, or you can find that Ask a Question that we have and tap into this amazing resource of this committee. Awesome, thank you. Christy wants to know, is there any push to have hearing instrument specialist education standardized, since it varies so much? Well, that would be great. You know, we are subject, at least in the United States, we're subject to 50 different rules about how it's handled. The National Apprenticeship Program that I mentioned through the Department of Labor offers a really tremendous standard that can be used in any of the states right now, whether or not that makes its way into the licensure standards, that's on the states, and we certainly advocate for that. We also have a Model Licensure Act that defines what the training and licensure standards should be, but really, if you have somebody, say, who you want to be able to work in, you know, two or more states, that Apprenticeship Training Program is a very valuable tool that should meet the requirements of any state, because it's very robust, and a trainee who goes to the program will actually get a Certificate of Completion from their State Department of Labor that they can certainly show to another licensing body. Thank you, Alyssa. This next question here, and we've only got just a few minutes left, comes from Tina. Tina is wondering, she's hearing a lot of important things that IHS has been doing internationally and federally, but what is it doing in the states? Oh, thank you. Yes, as I began to mention, we work very closely with our state associations, and we also work with our Canadian chapters to monitor what is being introduced, both in their legislatures and through their regulatory bodies, that could potentially impact the work that you all do. As I said, in Iowa, there was an attempt to deregulate the profession. We've seen that in multiple states over the last several years. In fact, if there's anybody from Indiana on the line, they know that we've been through this three times and successfully fought it off. Every, like, three to four years, the governor introduces a bill through a member of the legislature to deregulate. So the deregulation right alone is incredibly important that we've been fighting, but also those licensing standards, making sure that entry into the profession is not overly onerous, and one of those hot topics right now is insurance coverage, and we've seen several bills that would mandate insurance coverage, but it doesn't incorporate hearing aid specialists into that process, and so we're actively out there fighting to make sure that hearing aid specialists and audiologists both can help individuals get access to hearing aids through these insurance benefits. So there's so much actively happening in that space. Obviously, not enough time to get through here, and again, on the Canadian side as well, we provide support to our Canadian chapters. It's amazing how much is happening, and well, we are coming up to the top of the hour here, and that's about all the time that we have today for Q&A. Thank you so much, Alyssa, for your excellent presentation and all the information that you have shared in your presentation, IHS Policy Perspectives and Updates for the Hearing Health Professional. If you would like to get in touch with Alyssa, you can do so by emailing her at advocacy at IHSinfo.org. And as a reminder, to receive a continuing education credit for this webinar through IHS, be sure to take and pass the quiz online by following the URL on your screen or accessing it from the downloadable handout in your handout section on the dashboard. You'll also find links to the quiz, information about receiving CE credit, and today's presentation on our website, IHSinfo.org. Just click on our webinar banner on the home page or choose webinars from the navigation menu. And lastly, keep an eye out for the feedback survey you'll receive tomorrow via email. We ask for just a few moments of your time to answer the quality of today's presentation. Now I'm going to turn it over to Kathleen to close us out. Thank you, Diana, and thank you, Alyssa. Excellent information and efforts here. Thank you so much. I'd like to take a moment to say thank you once again to our generous sponsor, CareCredit. Without them, today's complimentary CEs just would not be possible. Please be sure to visit them by clicking the link in the presentation here or visiting them on the web at carecredit.com forward slash sound strategies. And thank you all for joining us. We're going to take a quick 15-minute break before our final and exciting speaker of the day. If you're already on and plan to join us or you're just logged on, we'll be back at 2.30 Eastern with Dr. Keith Darrow. Thank you so much.

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Alyssa Paradis