FOI-3 23/24-0648
DOCUMENT 3
The contents of this document are OFFICIAL. Guide – Hearing supports
This article provides guidance for a planner delegate, internal review delegate, complex support needs (CSN) planner, national reassessment delegate and local area coordinator to understand: • an overview of hearing supports • funding responsibilities • when the NDIS will typically fund a new hearing device • delegate considerations when planning with participants who need hearing supports in their plan.
For participants younger than 7 years, refer to article EC Hearing. Note: In this article we have used the terms ‘Deaf, hard of hearing, hearing loss or hearing impairment’. We understand this is not the preferred language for many participants in the Deaf community. We have used these terms to make sure this article is consistent with our Operational Guidelines and PACE. You should always check with the participant how they identify and what their preferred terminology is. Recent updates October 2023 This guidance comes from the Practice Guide – Hearing supports We’ve made minor updates to change any NDIS Business System language to PACE language. We’ll make improvements to this guidance in the future. Before you start You have read and understood: • Our Guideline – Reasonable and necessary support (external) • Our Guideline – Assistive technology (external) • article Guide – Assisting communication.
Hearing loss Hearing loss can be described as:
Page 66 of 103
FOI-3 23/24-0648
• congenital, which is present at birth or soon after birth • acquired, when hearing loss occurs or develops during a person’s life but was not present at birth.
Types of hearing loss: • Sensorineural hearing loss is considered permanent affecting the inner ear, this is called the cochlea. • Conductive hearing loss may be considered a temporary condition if it’s associated with a middle ear pathology. For example, ear infections which are also known as otitis media. A conductive hearing loss would be considered permanent if there is sufficient medical evidence that the hearing loss is permanent, or is likely to be permanent. This means evidence there are no known available and appropriate evidenced-based medical treatments that would remedy the hearing loss. This may include evidence from an Ear, Nose & Throat (ENT) specialist. For more information refer to S5.4 National Disability Insurance Scheme (Becoming a Participant) Rules 2016. • Mixed hearing loss is a combination of a sensorineural (permanent) hearing loss with a conductive overlay. • Auditory Neuropathy Spectrum Disorder (ANSD) is sometimes called auditory neuropathy or auditory dys-synchrony. It is a “neural” hearing condition which impacts on the ability of the hearing (auditory) nerve to send sounds from the inner ear (cochlear) to the brain.
Levels of hearing loss Hearing severity level and decibel ranges: • Normal Hearing: 0-20dBHL • Mild Hearing Loss: 21 – 40dBHL • Moderate Hearing Loss: 41 – 60dBHL • Severe Hearing Loss: 61 – 80dBHL • Severe or Profound Hearing Loss: 81 – 90dBHL • Profound Hearing Loss: >90dBHL
Page 67 of 103
FOI-3 23/24-0648
Hearing Supports If the participant is Deaf or hard of hearing, their ability to hear conversational speech and environmental sounds may be impacted. They may need hearing support to communicate, learn and socially interact. This will be different for each person based on different factors, including: • age of onset • severity • type of hearing loss • early intervention support received, and • other factors affecting the person such as whether they also have a secondary disability.
NDIS and the Hearing Services Program (HSP) From 1 July 2020 hearing services in Australia will continue to be funded by both the Hearing Services Program (HSP) and the NDIS. The HSP is available for participants who are: • under the age of 26 or • aged 26 years and over and meet the Hearing Services Program eligibility criteria.
The HSP has two components: • voucher (voucher program) delivers general hearing services and devices to eligible people • community service obligations (CSO program) deliver Specialist Hearing Services and devices to eligible people. The Community Services Obligations program is solely delivered by Hearing Australia.
Under a previous in-kind arrangement participants who weren’t normally eligible for the HSP were issued a voucher. This voucher will remain valid until it expires, or, when the participant has a plan change and chooses to cancel their voucher. This means all their hearing needs will be funded in their NDIS plan. Plan developers need to understand the participant’s current and future eligibility for the HSP to determine how a participant will receive their hearing supports. If the participant is eligible for the HSP they will fund some supports. This includes:
Page 68 of 103
FOI-3 23/24-0648
• audiology assessments • fittings • devices and upgrades. This doesn’t include cochlear implant speech processors.
We’ll fund other supports that meet the NDIS funding criteria which the HSP does not fund. If the participant isn’t eligible for the HSP, we’ll fund all supports that meet the NDIS funding criteria.
Confirm who should fund hearing supports The hearing supports the participant can access will depend on the type of funding the participant may be eligible for. The below list includes the different groups. Participant older than 7 and younger than 25 • Hearing services provided by the CSO program. • We’ll fund hearing supports that meet the NDIS funding criteria which the CSO program does not fund.
If the participant is turning 26 during plan duration, think about their future hearing support needs. Current NDIS participant older than 26 and eligible for the HSP with a current HSP voucher The participant’s eligibility to the Hearing Services Program may change and should be checked at each check-in. • Hearing services provided by the HSP. • We’ll fund hearing supports that meet the NDIS funding criteria which the HSP does not fund.
Current NDIS participant older than 26 not eligible for the HSP, with a current HSP voucher who would like to have NDIS fund their hearing supports This may include participants who received their HSP under the previous in-kind arrangement. HSP vouchers are valid for 3 years from the date of issue. • We’ll fund hearing supports that meet the NDIS funding criteria.
Current NDIS participant older than 26 not eligible for the HSP, but would like to remain with the HSP while their HSP voucher is valid This may include participants who received their HSP under the previous in-kind arrangement. HSP vouchers are valid for 3 years from the date of issue.
Page 69 of 103
FOI-3 23/24-0648
• Hearing services provided by the HSP until the participant’s HSP voucher expires. • We’ll fund hearing supports that meet the NDIS funding criteria which the HSP does not fund.
New NDIS participant older than 26, eligible for the HSP • Hearing services provided by HSP. • We’ll fund hearing supports that meet the NDIS funding criteria which the HSP does not fund.
New NDIS participant older than 26, not eligible for the HSP • We’ll fund hearing supports that meet the NDIS funding criteria.
Participant who is Aboriginal or Torres Strait Islander older than 50 • Hearing services provided by the CSO program. • We’ll fund hearing supports that meet the NDIS funding criteria which the CSO program does not fund.
To learn more about who is responsible for funding supports, refer to article Guide – Hearing supports appendix A – Funding responsibilities. To create a referral or check if the participant is still eligible for the HSP, refer to article Add or update low-cost assistive technology (AT) in a plan approval case.
HSP repairs, maintenance and replacement devices We’ll fund the co-payment towards the annual maintenance fee and the administration fee for replacement of lost or damaged beyond repair device. The annual maintenance fee for repairs and replacing a lost or damaged device includes: • batteries • repairs • spare parts • replacing a lost or damaged device.
If the participant has a hearing device from the partially subsidised category, there may be additional fee. The hearing services provider will advise if any additional fees apply to the participant. To include funding for HSP repairs, maintenance and replacement devices, refer to article Add or update hearing supports in a plan approval case.
Page 70 of 103
FOI-3 23/24-0648
NDIS funded hearing supports We’ll fund hearing supports that meet the NDIS funding criteria. This may include: • assessments, fittings and devices where they are not available through the Hearing Services Program • assistive technology, other than Low Cost AT, for example vibrating alerting systems or smoke alarms • Auslan interpreting services and training • repairs, maintenance and consumables for hearing devices • capacity building supports.
To learn more about these supports refer to articles: • Guide – Hearing supports appendix A – Funding responsibilities • Guide – Hearing supports appendix B – Capacity building supports • Guide – Hearing supports appendix C – Capital supports • Guide – Hearing supports appendix D – Core supports.
Glossary Audiometrist Audiometrists have met the relevant membership and clinical competency requirements for audiometrists set by the Australian Practitioner Professional Bodies. Audiometrists are: • Full or ordinary members of ACAud with a Hearing Rehabilitation Specialist (HRS) competency • Full members of HAASA. They have completed an Australian Diploma-level Technical and Further Education (TAFE) vocational qualification in audiometry or a Bachelor of Audiometry from an Australian university.
For more information, refer to Audiology Australia (external). Auslan Auslan is the recognised language of the Australian Deaf Community. Auslan has its own syntax, grammar and uses a combination of handshapes, movements and facial expression. Audiologist
Page 71 of 103
FOI-3 23/24-0648
Audiologists have met the relevant membership and clinical competency requirements set by the Australian Practitioner Professional Bodies. This means that audiologists are: • Full members of Audiology Australia with a Certificate of Clinical Practice (CCP) • Full or ordinary members of the Australian College of Audiology (ACAud) with Hearing Rehabilitation Specialist (HRS) and Diagnostic Rehabilitation Specialist (DRS) competencies.
Audiologists must have completed at least the equivalent of an Australian university Masters level degree in clinical audiology. For more information, refer to Audiology Australia (external). Cochlear Implant A surgically implanted device which enables the person to experience sounds by sending signals to the nerve endings in the inner ear (cochlea). Deaf, hard of hearing, hearing impaired and hearing loss A person who has problems with their ability to hear or cannot hear. When referring to individuals in general, it is considered appropriate to use the term ‘deaf’. However, an individual is referred to as ‘Deaf’ if they are involved in the signing community. Sometimes signing individuals are referred to as ‘culturally Deaf’. For more information, refer to National Association for the Deaf (external) or International Federation of Hard of Hearing People (external). Fully Subsidised Hearing Device Fully subsidised devices are free to NDIS participants receiving hearing supports through the Hearing Services Program. Hearing Australia Hearing Australia is the contracted provider who receives government funding (Community Services Obligation) to deliver specialist hearing services to children and young adults younger than 26. Mild hearing loss A person with a mild hearing loss may have difficulties hearing soft speech sounds. Moderate hearing loss A person with a moderate hearing loss will have difficulties understanding conversational speech, particularly in the presence of background noise. Non-standard device
Page 72 of 103
FOI-3 23/24-0648
An NDIS funded device that offers specific technology to meet a particular functional requirement, which cannot be met by a standard, intermediate or advanced hearing device. Partially subsidised hearing device The NDIS participant has opted to purchase a partially subsidised hearing device through the HSP, which may have more technological features to suit individual lifestyle choices. In this case, the HSP contributes the amount that would have been paid for a fully subsidised hearing device to the service provider, and the participant has paid the additional amount quoted for the hearing device for example the “gap”. Severe or profound hearing loss A person with a severe or profound hearing loss cannot hear normal conversational speech. many people with a profound hearing loss are now fitted with a cochlear implant. Speech Processor The part of a cochlear implant that converts speech sound into electrical impulses to stimulate the auditory nerve, allowing a person to understand sound and speech. Unilateral hearing loss A person with a unilateral hearing loss has their hearing in one ear only affected. Next steps
- Add NDIS funded hearing supports to the participant plan, refer to article Add or update hearing supports in a plan approval case. Article topics and case names – internal use only
Topics This article relates to the following topics: • Add: t_assistivetechnology • Add: t_communication • Add: t_hearing • Add: t_implementation • Add: t_planchanges • Add: t_providers • Add: t_reasonableandnecessary • Add: t_therapysupports
Page 73 of 103
FOI-3 23/24-0648
Case names You can use this guidance for the: e Add: dc_case_checkin e Add: dc_case_earlysupports e Add: dc_case_internalreview e Add: dc_case_participantbudgetupdate e Add: dc_case_planapproval e Add: dc_case_planchange e Add: dc_case_planimplementation e Add: dc_case_requestforservice
e Add: dc_case_technicaladvice
Version control
Version Amended Brief Description of Change Status by 1.0 CS0074 |Class 1 approval APPROVED | 2022-11-18 1.1 MGC723 | Updated to make sure content is DRAFT 2023-09-14 transferred from PG — Hearing supports 1.2 BTM847 |Peer review DRAFT 2023-09-28 1.3 MGC723 |Action peer review and add links DRAFT 2023-09-28 2.0 JS0082 |Class 1 Approval APPROVED | 2023-09-28
Page 74 of 103