Category: Army

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.

Technology for the Warfighter

The Auditory Research Agenda centers around the needs of the warfighter: survivability, decreased response time, intelligence gathering, C3, safety, situational awareness. Audiologists know that hearing offers many advantages to the soldier, yet these advantages are often taken for granted. For example, hearing is fully operational 24 hr/day; sound (unlike vision) is not blocked by obstacles; operational in a full spherical range; operational without visual cues at night or in smoke; full attentional focus is not required; often the only warning signal available. The Army research team will exploit these hearing abilities to benefit the warfighters needs and integrate auditory needs and considerations into capstone requirements documents and mission needs statements. Basic and applied research efforts at the US Army Research Lab, Walter Reed, and USA Aeromedical Research Lab and battlelabs will increase our understanding of soldier auditory capabilities and limitations.

Research initiatives are focused in the following categories: speech communication, situational awareness, hearing enhancement, and combat sound training (detection and identification).

Highlights!

US Army Research Lab and USA CHPPM are investigating hearing loss which may occur as a result of deploying airbags. Drs. Richard Price and Doug Ohlin are the primary investigators and need your help! Please ask all soldiers, sailors and seamen (during their annual hearing tests) if they have been involved in a car accident since their last test. Get their name, phone number and SSN and USARL and Dr. Joan Besing will do the rest. Fax those names attn: Dr. Richard Price, 410-278-3587 (DSN 298).

Ongoing research experiments includes:

3D audio displays for a prototype command and control vehicle (C2V) at Ft. Knox Virtual Mounted Maneuver Battlelab system evaluation, auditory signal design, and auditory training for the hand held stationary mine detection system (HSTAMIDS), Mine and Countermines, Ft. Belvoir Landwarrior helmet design, Ft Benning Battlelab feasibility of bone conduction transducers in hands free radio operations an ARL initative audio displays in the Army Battle Command System for the TRADOC Program Integration Office, Ft. Leavenworth. ARL is delighted to assist any audiologist who may identify a field requirement, but requires experimental design or analysis consultation. Additionally, ARL often needs soldier input or unit participation to test new equipment and products. If you care to volunteer your soldiers or need help with a field experiment, just call (DSN 298-5999; 410-278-5999).

By: CPT Marjorie Grantham, USA

Promotions

• LTC Clyde Byrne to COL
• MAJ Lynn Henselman to LTC
• LTC David Chandler to LTC(P)
• CPT Jennifer Johnson to MAJ
• 1LT Kristen Casto to CPT
• 1LT Rhonda Fleener to CPT

Awards

CPT Rosemary Jacobs – Post Volunteer of the Year, Seoul, Korea, ARCOM

Announcements

MAJ Kathy Gates was married to David Bolgiano on May 30, 1998. MAJ Gates will continue to go by Gates for Army purposes.

Fort Stewart, Georgia, Audiology is seeking a full-time GS11 Government Civilian Audiologist. This position is 45 minutes from Savannah, Georgia. Ft Stewart is also seeking a 91BP2 for both its Hearing Conservation and Audiology sections.

John Ribera will is now at the House Clinic. He would be happy to correspond with old friends. His new address is:

Dr. John E. Ribera
House Ear Clinic
2100 West Third St.
Los Angeles, CA 90057

CPT Eric Peterson and Cyndi Allen were married on 9 June 1998 in San Antonio, TX. CPT Peterson also received the ARCOM July 1997.

Welcome to MAJ Vickie Tuten, returning to active duty from the reserves. She is the new Chief of Audiology at BAMC.

A big welcome to 1LT Catina S. Green who graduated from the AMEDD Officer’s Basic Course in March 1998. She received her undergraduate degree from Xavier University of Louisiana and her Masters degree in Audiology from the University of Northern Iowa in 1997. She is currently completing her CFY while assigned at Ft. Benning, GA. While attending UNI, 1LT Green’s research was published in the Educational Audiology Monograph. She completed a graduate internship at William Beaumont Army Medical Center in El Paso, TX. 1LT Green is from New Orleans, LA. She is engaged and plans to marry sometime this fall.

The US Army audiologists now have [had] a web page. It is just getting started and will be changing as time goes on. You can find it at http://www.wramc.amedd.army.mil/audio/ Please take time to look it over and periodically recheck it for new information. All Army Audiologists should apply for a password to the bulletin board if you have access to the internet. This will be another way to keep in touch with each other since few of us work in a place with multiple audiologists.

Getting the Message

The staff of the Army Audiology & Speech Center (AASC) recently produced a short videotape entitled “Getting the Message” for use in our aural rehabilitation program. The 12 minute tape depicts seven typical communication challenges and potential strategies that might be used to overcome these challenges. Our staff has found that our hearing impaired patients identify strongly with these situations and that they better understand the concepts of communication strategies when this tape is used. We encourage active participation from the AR group members when using this video: A “challenge” is presented in each scenario; the tape is stopped, and the patients discuss possible resolutions. The tape continues with one or two possible resolutions for each scenario. Often the class will offer solutions that didn’t occur to us at the time of the scripting and taping! A few weeks ago we mailed a copy of this videotape to audiologists at Army MEDCEN’s and MEDDAC’s. We attached an instruction sheet which included the names of the cast members (many of whom you will recognize – all “local talent.”) If you did not receive a copy and are interested, please contact me via cc:mail or phone. The tape may be reproduced locally.

Charlene K. Scherr, Coordinator, Rehabilitative Audiology AASC, WRAMC 202-782-8588 (DSN:662)