Mark Takano

From the office of:

Mark Takano

Sending Office: Honorable Mark Takano
Sent By:

Dear Colleague:

Please join me in a letter to Department of Veterans Affairs (VA) Secretary Robert Wilkie, advocating for better access to quality hearing health services for our veterans – particularly those in rural and underserved communities.

Audiologist/health technician staffing within the VA has decreased for the past two years while the need for these services has increased.  The VA was given authority in the Veterans Mobility Safety Act of 2016 to hire additional hearing aid specialists,
yet has failed move beyond the minimum requirements of this statute to fully utilize hearing aid specialists within the VA.  The VA can and must do more to ensure that our veterans have access to vital hearing health services.

Thank you for your appreciation for and dedication to our veterans.  Should you have any questions or would like to sign onto this letter, please contact on my staff.


                        MARK TAKANO

                        Member of Congress


May XX, 2019


Dear Secretary Wilkie:

Ensuring our veterans have the best access to hearing healthcare services they require is both necessary and urgent.  Untreated hearing loss contributes to myriad conditions including but not limited to depression, falls, isolation, and cognitive decline.
Nonetheless, access to quality hearing health services remains an issue for veterans across the country, especially in rural and undeserved communities.  We and our colleagues regularly hear from veterans in our districts who are seeking answers as to why
they are often being directed to travel hours away, sometimes hundreds of miles across state lines, for hearing health services, or report that they opt to pursue help from non-VA contracted local hearing aid specialists because they received hearing aids
from the VA but still needed assistance with programming and counseling. 

According to VHA’s 2017 & 2018 annual reports to Congress, Department of Veterans Affairs (VA) audiologist/health technician staffing decreased by .5% while total patient encounters increased over 20%. The percent of veterans exceeding 30 days processing
time was about 24% for VA audiologists and about 30% for contracted audiologists. The Veterans Mobility Safety Act of 2016, now PL 114-256, authorizes the VA to hire hearing aid specialists, after proper consultation with the stakeholder community on qualifications
for hire by the Veterans Health Administration (VHA). It is our understanding that, to date, the VA has complied with required annual reports and held the stakeholder meeting, however, it seems that the bare minimum is being done in accordance with this statute,
and the VA is simply running through the motions as a formality. I urge you to go beyond these minimum requirements and expedite this now two-year old authorization, so that hearing aid specialists can be fully utilized by the VA, performing services consistent
with their training and licensure in VHA clinics as part of their audiology teams.  Doing so will help build VHA’s internal capacity to efficiently and effectively deliver hearing healthcare services to veterans.

The fact that after two years since enactment, the VA has not even established qualifications for the hiring of hearing aid specialists, is simply unacceptable. At this point, Congress would have expected VA had finalized qualifications so presently it would
be actively hiring and employing hearing aid specialists to assist veterans as VA providers on the audiology team. In addition to prioritizing efforts to finalize qualifications and begin hearing aid specialist hiring, another step forward would be to resolve
impediments to care in the VA audiology handbook that presently require VA clinics to exhaust options to utilize audiologists before veterans can receive care from hearing aid specialists. There is no question audiologists play a vital role at the VA, but
why there seems to be an insistence on stretching their work so thin to deliver services that could be performed by hearing aid specialists is puzzling.


Please provide an update to the following questions:

1.         Does the VA plan to utilize its authority under PL114-256, and if not, please provide a thorough and detailed analysis as to your reasoning, and a justification for this failure to act.

2.         We know VHA has not established qualifications for hearing aid specialist hiring, which would ultimately be captured in a future VA audiology handbook revision or directive, so we ask, when does VA plan to update the Audiology Handbook, will the
update include hearing aid specialist qualifications, and will impediments to hearing aid specialist use in contracting be resolved?  If the answers to the latter two actions are no, please provide a thorough and detailed analysis as to your reasoning and
future plans on these actions.

3.         We understand that the qualifications for state licensure of hearing aid specialists vary from state to state. What prevents the VA, and its vast resources as the largest health care provider in the United States and legal authorities, from reviewing
these various professional standards and establishing national standard qualifications for the hiring of hearing aid specialists?


We appreciate your attention to these issues and look forward to reviewing a timely response.


Related Legislative Issues

Selected legislative information: HealthCare, Veterans

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