License Requirement for Credentialed Clinicians (DoD Directive 6025.13)
COL Richard Danielson
USAMEDCOM has alerted us that that the Department of Defense will be directing that audiologists and speech-language pathologists working in a military MTF must have a license by 30 SEP 99. This action is related to broad issues of accreditation, clinical quality assurance, and some issues that are, in part, related to some articles in the press that military physicians do not have to meet the same standards as their civilian colleagues. As a result, DOD has directed that health care providers possess a license in order to work in the military.
WHEN officially mandated:
The requirement applies to military (ADTY and USAR) and civilian personnel (Civil Service and providers working under contractual or similar arrangement) who are granted privileges to diagnose, initiate, alter, or terminate healthcare treatment regimens.
We have contended for a long time that a CCC was an acceptable alternative document, since licenses were not available in all states. This position appears to be no longer accepted by DoD, due to the increased scrutiny of health care providers (and the fact that more states have license regulations. Forty-seven states now regulate audiology (not ID, MI, VT) and 44 regulate SLP (not AK, CO, MI, ID, SD, VT).
COL Dennis will be responsible to assist audiologists in locating states for licensure if the MTF is in a state that does not license (e.g., overseas and D.C.). He has tasked me to develop this strategy. I have an audiology officer assisting me in the field as the POC for the many questions that will play in the notification and follow-up stage. There is no consultant in SLP, so I will handle what I can for the AMEDD.
We will be required to ‘provide documentation of active pursuit of a license by 1 JAN 99’, if not licensed in a state at this time. That can be expected to be possessing an application and moving on.
Dr. Lu Beck has, I’ve learned, required clinicians at the Washington VA to have licenses for a couple of years. This supported their recognition as independent health care providers in their MTF. The VA does not, however, routinely require state licenses at other MTF’s.
You can check out your own state requirements at the ASHA website… look under “state regulations” on the home page.
Army Audiology and Hearing Conservation Consultant Update
COL Richard A. Dennis, Jr.
Medical Service Corps, U.S. Army
As the military downsizes the need for sharing resources, systems, and ideas grow more important. In an effort to explore all the possibilities for sharing, the three military Audiology consultants are working towards the full implementation of the Tri-service Strategic Plan. This document was developed at a meeting in April of 1997. Slowly but surely we are working the issues that our work group decided were the most important for the survival of military Audiology. One of the decisions made at this meeting was to regionalize our mentoring. With the departure of senior leaders it is becoming increasingly necessary to depend on each other for support. The Military Audiology Consultants have distributed mentoring responsibilities according to the following:
One very important issue that will impact Army Audiology in the next six months is the Optimization study. The intent is to allow major subordinate commanders (MSC) to shape the structure of the AMEDD for the future. This is not the first time they have been given this opportunity. MSC’s response will determine the size, mix, and distribution of commissioned, warrant, and enlisted corps within the MEDCOM for FY 01. Stay tuned. There is much more to come on this issue.
Recently, I was made aware of a Department of Defense (DoDI) Instruction that requires many health care providers to posses a valid state license for the practice of Audiology. As COL Danielson and I investigated the number of 72C’s who held a state license we were surprised to learn that almost 60% of our officers were not currently licensed. I have appointed Maj Bill Fanning to investigate access to and cost of licensure in an effort to make obtaining a license accessible to all our officers. In the near future all Army Audiologists will receive a letter from Maj Fanning regarding this issue. We expect our colleagues in the Navy and Air Force will have to participate in a similar drill.
The Executive Committee of the distance learning initiative has been working very hard to insure that all military audiologists avail themselves of the opportunity to attain the Doctor of Audiology (AuD.) through distance learning. Now that Army, Navy, and Air Force money has been committed to the Central Michigan University and Vanderbilt University consortium many decisions are still to be made. Dr. Walden will be visiting the CMU Campus on the 17th and 18th of December to talk with the staff. Issues such as access, faculty assignments, capstone experiences are on his agenda for discussion. I will make more information available as the program develops.
I hope that everyone has had a great holiday. I hope you come to the New Year well rested. We have a great deal of work to do in the coming year. I will be asking many of the Army Junior Officers to help me in 1999.
You can reach me at 703-681-3156 or FAX me at 703-681-3163.
TRICARE/CHAMPUS Hearing Aid Problems
Donna MacNeil
Tricare/CHAMPUS complaints regarding non-payment or underpayment for hearing aids may be referred to Anna Reilly at (202) 224-2023 or fax (202) 224-6295. Ms. Reilly has been appointed by Senator John Warner to investigate Tricare complaints.