Interview with Bernice Dinner Ph.D., Founder, Hear Now
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AO/Beck: Dr. Dinner, thanks for joining me this evening. Would you please tell me about your education?
Dinner: I received my Ph.D. in Communication Disorders in 1981 from the University of Colorado at Boulder.
AO/Beck: OK, let's jump right in -- what is HearNow?
Dinner: HearNow USA is the domestic program of the Starkey Hearing Foundation. HearNow and Starkey merged in October, 1999 to create HearNow USA and the new programs is headquartered in Minneapolis. The HearNow USA program provides hearing aids and cochlear implants to people who cannot afford them. We serve children and adults and we serve patients with all degrees of hearing loss. There is also an international division of the Starkey Hearing Foundation which funds and conducts missions overseas for children in third world countries.
AO/Beck: What was it that inspired you to initiate HearNow?
Dinner: HearNow officially started in November, 1988. I was working on clinical trials with cochlear implant patients for a group in Colorado for some three years. Time and time again I realized there was a tremendous need for cochlear implants but the cost of the devices (hardware and services) was simply prohibitive for many people. This was very disturbing to me because I saw so many successes and so many people who could potentially benefit from this technology, but again, financial issues very often separated patients from benefits. I thought we needed to find a way for patients to obtain implants back in the middle to late 1980s. Back then, Medicare and Medicaid did not routinely cover implants, nor did the Veterans Administration, so it was very difficult for even well-insured patients to get cochlear implant coverage.
AO/Beck: When did Medicare and Medicaid switch over to actually covering cochlear implants on a routine basis?
Dinner: I think that was around 1992, maybe 1993.
AO/Beck: Tell me what happens to hearing aids donated to HearNow?
Dinner: When we get a donated hearing aid, we send the donor a combined 'Thank You' card and a receipt. We do not determine the value of the hearing aid. The donor sets the value of the donation. We take the BTEs which are in good shape and we hold them aside for distribution to people for whom they may be appropriate after they are cleaned up. The BTEs which are not in good shape and all of the custom devices are essentially sold as 'salvage' for the value of their parts. Whatever monies we get for those salvage instruments (approximately 25,000 units per year) is available to support the purchase of new instruments. So, in essence, about 90 percent of the hearing aids we provide are new units and the vast majority of those are provided by Starkey.
AO/Beck: If I may ask this, when HearNow USA purchases hearing aids for their patients, do they pay retail, wholesale or is it a special reduced contract price?
Dinner: We get an amazing price through Starkey. In essence, they charge us the cost of supplies and plastic and labor is provided at no charge. I believe Starkey gave us some three million dollars worth of donations last year. Starkey and Bill Austin have been the single largest supporters of our program over the years.
AO/Beck: How many hearing aids did HearNow USA provide in calendar year 1999?
Dinner: I believe it was about 4000 units which were provided last year.
AO/Beck: How many hearing aids have been dispensed through HearNow since the very beginning?
Dinner: I would guess the number is about 12,000 total at this time. I'm not sure of the exact number but I'd guess I'm fairly close.
AO/Beck: So roughly one-third of all the hearing aids dispensed were dispensed in the last calendar year?
Dinner: Yes, the growth pattern has been dynamic. I think we provided 24 hearing aids the first year, then 56 the second year, then over 900 in the third year and so on.
AO/Beck: What do the numbers look like for cochlear implants?
Dinner: In calendar year 1999, we helped about 27 people get implants, but we only provided full support for four of them. That is, sometimes we can get an awful lot of services donated, sometimes we can get product donated. Each situation is different. On some occassions we will donate up to 5000 dollars to the patient for non-reimburseable medical expenses. We spend a lot of time getting fees waived!
AO/Beck: What are the eligibility criteria for patients applying to HearNow?
Dinner: The current criteria for hearing aids is the patient's direct family has to earn less than 125 percent of federal poverty level guidelines. So in other words, since the federal poverty guideline for a family of four is $17,050 per year, 125% means they can earn up to $21,300 and still be eligible for our assistance. Additionally, we will consider candidates who do not have access to funding elsewhere and we will consider people who have medical expenses greater than 15 percent of the family income.
AO/Beck: What about cochlear implants? How does the funding work for implants?
Dinner: In essence, no one can afford cochlear implants! The total bill can run from $45,000 to $50,000. Just the implant itself might cost $20,000 to $25,000 each, so these are extremely expensive procedures and products. Sometimes we ask patients to pay a portion and then we pay a portion. Again, every case is different and we are flexible so we'll consider all sorts of requests for cochlear implants. In most states, children can be covered for cochlear implants through the various Medicaid programs. Adults may actually have quite a few less options, particularly the working poor.
AO/Beck: If any of the readers have patients they would like to refer to HearNow, how do they go about it?
Dinner: The best thing to do is to have the patient contact us. Of course the audiologist can call us too, but generally it's the patient that contacts us. Generally, our first efforts are to work with the patient to find a funding source. Sometimes there are no other options and we'll get involved. The toll free number is 1-800-648-4327. Jonita Stelter will answer the phone and once she figures out the best course of action, she'll get the information to me, or whomever the right person or group is depending on whether the candidate is a hearing aid or a cochlear implant candidate.
AO/Beck: Dr. Dinner, thanks for all of your fine work on behalf of the patients. You have had an extraordinary impact on the lives of thousands of people and it's marvelous to meet people like you who are willing and able to volunteer so much of your time and abilities. Congratulations on your fine efforts and many accomplishments.
Dinner: Thank you Doug and Audiology Online for helping spread the word about HearNow.
Dinner: I received my Ph.D. in Communication Disorders in 1981 from the University of Colorado at Boulder.
AO/Beck: OK, let's jump right in -- what is HearNow?
Dinner: HearNow USA is the domestic program of the Starkey Hearing Foundation. HearNow and Starkey merged in October, 1999 to create HearNow USA and the new programs is headquartered in Minneapolis. The HearNow USA program provides hearing aids and cochlear implants to people who cannot afford them. We serve children and adults and we serve patients with all degrees of hearing loss. There is also an international division of the Starkey Hearing Foundation which funds and conducts missions overseas for children in third world countries.
AO/Beck: What was it that inspired you to initiate HearNow?
Dinner: HearNow officially started in November, 1988. I was working on clinical trials with cochlear implant patients for a group in Colorado for some three years. Time and time again I realized there was a tremendous need for cochlear implants but the cost of the devices (hardware and services) was simply prohibitive for many people. This was very disturbing to me because I saw so many successes and so many people who could potentially benefit from this technology, but again, financial issues very often separated patients from benefits. I thought we needed to find a way for patients to obtain implants back in the middle to late 1980s. Back then, Medicare and Medicaid did not routinely cover implants, nor did the Veterans Administration, so it was very difficult for even well-insured patients to get cochlear implant coverage.
AO/Beck: When did Medicare and Medicaid switch over to actually covering cochlear implants on a routine basis?
Dinner: I think that was around 1992, maybe 1993.
AO/Beck: Tell me what happens to hearing aids donated to HearNow?
Dinner: When we get a donated hearing aid, we send the donor a combined 'Thank You' card and a receipt. We do not determine the value of the hearing aid. The donor sets the value of the donation. We take the BTEs which are in good shape and we hold them aside for distribution to people for whom they may be appropriate after they are cleaned up. The BTEs which are not in good shape and all of the custom devices are essentially sold as 'salvage' for the value of their parts. Whatever monies we get for those salvage instruments (approximately 25,000 units per year) is available to support the purchase of new instruments. So, in essence, about 90 percent of the hearing aids we provide are new units and the vast majority of those are provided by Starkey.
AO/Beck: If I may ask this, when HearNow USA purchases hearing aids for their patients, do they pay retail, wholesale or is it a special reduced contract price?
Dinner: We get an amazing price through Starkey. In essence, they charge us the cost of supplies and plastic and labor is provided at no charge. I believe Starkey gave us some three million dollars worth of donations last year. Starkey and Bill Austin have been the single largest supporters of our program over the years.
AO/Beck: How many hearing aids did HearNow USA provide in calendar year 1999?
Dinner: I believe it was about 4000 units which were provided last year.
AO/Beck: How many hearing aids have been dispensed through HearNow since the very beginning?
Dinner: I would guess the number is about 12,000 total at this time. I'm not sure of the exact number but I'd guess I'm fairly close.
AO/Beck: So roughly one-third of all the hearing aids dispensed were dispensed in the last calendar year?
Dinner: Yes, the growth pattern has been dynamic. I think we provided 24 hearing aids the first year, then 56 the second year, then over 900 in the third year and so on.
AO/Beck: What do the numbers look like for cochlear implants?
Dinner: In calendar year 1999, we helped about 27 people get implants, but we only provided full support for four of them. That is, sometimes we can get an awful lot of services donated, sometimes we can get product donated. Each situation is different. On some occassions we will donate up to 5000 dollars to the patient for non-reimburseable medical expenses. We spend a lot of time getting fees waived!
AO/Beck: What are the eligibility criteria for patients applying to HearNow?
Dinner: The current criteria for hearing aids is the patient's direct family has to earn less than 125 percent of federal poverty level guidelines. So in other words, since the federal poverty guideline for a family of four is $17,050 per year, 125% means they can earn up to $21,300 and still be eligible for our assistance. Additionally, we will consider candidates who do not have access to funding elsewhere and we will consider people who have medical expenses greater than 15 percent of the family income.
AO/Beck: What about cochlear implants? How does the funding work for implants?
Dinner: In essence, no one can afford cochlear implants! The total bill can run from $45,000 to $50,000. Just the implant itself might cost $20,000 to $25,000 each, so these are extremely expensive procedures and products. Sometimes we ask patients to pay a portion and then we pay a portion. Again, every case is different and we are flexible so we'll consider all sorts of requests for cochlear implants. In most states, children can be covered for cochlear implants through the various Medicaid programs. Adults may actually have quite a few less options, particularly the working poor.
AO/Beck: If any of the readers have patients they would like to refer to HearNow, how do they go about it?
Dinner: The best thing to do is to have the patient contact us. Of course the audiologist can call us too, but generally it's the patient that contacts us. Generally, our first efforts are to work with the patient to find a funding source. Sometimes there are no other options and we'll get involved. The toll free number is 1-800-648-4327. Jonita Stelter will answer the phone and once she figures out the best course of action, she'll get the information to me, or whomever the right person or group is depending on whether the candidate is a hearing aid or a cochlear implant candidate.
AO/Beck: Dr. Dinner, thanks for all of your fine work on behalf of the patients. You have had an extraordinary impact on the lives of thousands of people and it's marvelous to meet people like you who are willing and able to volunteer so much of your time and abilities. Congratulations on your fine efforts and many accomplishments.
Dinner: Thank you Doug and Audiology Online for helping spread the word about HearNow.
