ODSP: Two quote policy unfair to patients, audiologists

The Ontario government says it has a clear policy on how it will pay for hearing aids for people on disability. Too bad the bureaucrats aren’t listening.

According to the Ministry of Community and Social Services, there is no new policy requiring individuals on the Ontario Disability Support Program (ODSP) to get two quotes for everything from hearing devices to batteries. Yet audiologists are being told by their clients with disabilities that they must get at least a second opinion, in writing and at their own expense, before they can obtain hearing services and devices.

This is hard on people who are physically and mentally challenged who have trouble sitting through hearing evaluations, which require a great deal of concentration. Many people with autism don’t like being touched. Other persons with disabilities have difficulty with health professionals working around their faces so they take some comfort in using familiar health care providers.

Petawawa resident Donald Cole is one of those people. A mentally-challenged man in his 60s, Donald gets agitated around new people. So it is no wonder that Donald became distraught when he was told he might have to give up his audiologist, a woman who has treated him for more than 13 years.

That’s because his caseworker wants a second opinion and if the quote is lower, Donald has been told, he will have to change audiologists.

As a result of this directive, which shocked Donald and his caregiver, Ellen McMillan, the pair must make a round trip of more than 80 kilometres to Pembroke at their own expense to have a second hearing evaluation performed. Donald has to do the same thing to get his corrective lenses and the batteries for his hearing aids.

To Donald, this makes no sense.

“I feel like I’m doing duplication,” he says. “I find it’s too hard on my nerves.”

According to those working in hearing health care, the unofficial two quote policy is costing unnecessary time and money to be spent by both patients and their health care providers. The average hearing evaluation takes between 60 and 90 minutes and audiologists are unclear whether they will be paid for their time. Some rural patients have to be transported long distances, often to other communities, and try to work around the policy by sharing their quotes. As one provider put it, they have no intention of using the services of the second audiologist.

The implications of the unofficial two-quote policy go much farther than getting the best bang for the public buck.

Fitting hearing aids, pocket talkers and other devices is a specialized field which requires years of training and an understanding of physiology and cognition. Choosing appropriate hearing solutions for seniors and the disabled is not as simple as choosing a piece of hardware.

Audiologists from across Ontario are complaining to their association that caseworkers, who are not regulated health professionals, are making medical decisions on behalf of patients. They are playing fast and loose with privacy information and sharing quotes. They are also violating the rights of patients who are guaranteed, under the Canada Health Act, the ability to choose their health care providers.

According to Rex Banks, Director of Hearing Healthcare at The Canadian Hearing Society: “ there has been quite a bit of confusion regarding the two quote process and our clients have been the ones caught in the middle. The Canada Health Act guarantees the right to choose one’s healthcare provider along with recognizing individual needs and preferences. I am hopeful that ODSP will find an equitable way of addressing costs related to hearing healthcare without compromising the rights of those involved.”

In the meantime, in the words of Mary Cook, the executive director of the Ontario Speech Language Pathologists and Audiologists Association (OSLA), “the whole thing is a mess”.

More than 60 audiologists in Ontario have signed a petition urging the government to put an end to the practice. Members of OSLA want the Ontario government to work with audiologists to establish a fee schedule, an idea that the government is now considering. But by the time that happens, it may be too late for Donald Cole and other people with disabilities who are caught in the system right now.