When do I set the rocker cover for either Open/Weapons Fire or Closed/Constant Protection?
If you are firing a weapon (in training or in combat) and you have to maintain situational awareness and hear verbal communication, set the rocker cover in the Open/Weapons Fire mode. For steady/continuous noise, like in a helicopter or tracked vehicle, set the rocker cover in the Closed/Constant Protection mode. You will be protected from weapons fire in either mode, but only from steady/continuous noise in the Closed mode.

How does the CAE protect my hearing from weapons fire or explosions in the Open/Weapons Fire mode?
The blast energy (impulse noise) must pass through two calibrated holes that filter the more hazardous sound energy. Think of the reduction of this sound energy as sound friction which increases as the impulse noise becomes louder. Me- anwhile, lower level sounds like conversation get through the filter relatively unchanged.

How protective is the CAE in the Open/Weapons Fire mode?
When properly inserted, Army studies found the plug protective for impulse noise (weapons fire and explosions) up to 193 dBP. That covers the loudest weapons in the inventory at the firer’s position.

Why does weapons fire sound louder in the Open/Weapons Fire mode than the Closed/Constant Protection mode?
More low-frequency sound energy, which is not as hazardous to hearing as high-frequency sound, gets through in the Open position.

How do I determine the correct size?
It is essential that someone with the appropriate training fits you with the correct size. Sizes are color-coded – small (olive drab), medium (tan) and large (brown). An ear gage will provide an approximation of the correct size, but the insertion of a trial earplug is needed to confirm. A recommended sizing distribution for a military population would be 25% small, 60% medium and 15% large. Approximately 1% will require a different size in each ear. There will be a shift toward the smaller sizes for females, African Americans and younger personnel. Conversely, there is a shift toward the larger sizes for Caucasian males.

As long as it stays in my ear, will any size work? What’s the problem if the size is a little off?
You want these earplugs to be tough on noise, not your ears. For you own comfort and maximum protection, you want the size that fits best. The correct size also keeps the ear sealed without having to constantly reinsert the plug.

How do I insert the earplug properly and know when it is in correctly?
Reach behind your head and pull your ear out to straighten the earcanal; insert the earplug with your free hand. Gently tug on the earplug for a required tension. Your own voice will also sound low-toned, muffled even more so in the Closed mode. If the plugs do not appear to be blocking any sound, try again to reinsert them. If they still do not appear to be working, have a person trained in earplug fitting recheck you for the correct size. Remember, if you don’t have them in correctly, you might as well not have them in at all.

What is the best way to clean the earplug?
Use plain soap and water only, no harsh chemicals or detergents. Ensure the soap is thoroughly rinsed off so no holes are clogged. For best results, separate the plug from the plastic housing and clean the plug separately.

When do I know when to replace the Combat Arms earplug?
Replace if the plug flanges become torn, harden or cannot be cleaned, or if the plastic housing is damaged.

How should I store the earplug?
When not in use, keep in the plastic case provided or tie the cords to the helmet webbing for quick access.

Can I remove the cord?
Yes, it just snaps off. Note: the cord cannot be re-attached.

Are any other modifications to the CAE recommended?
None are recommended. Any other modifications could degrade the ability of the earplug to protect you from hazardous noise and/or interfere with your ability to maintain situational awareness and hear verbal communications.

For further information contact 3M Occupational Safety at:
Sales Assistance: 1-800-328-1667 Technical Assistance: 1-800-243-4630 or via their Website.

The three measures currently available to audiologists in 2010 include:

• Referral for Otologic Evaluation for Patients with Congenital or Traumatic Deformity of the Ear
• Referral for Otologic Evaluation for Patients with a History of Active Drainage from the Ear within the Previous 90 Days
• Referral for Otologic Evaluation for Patients with a History of Sudden or Rapidly Progressive Hearing Loss

The Audiology Quality Consortium (AQC), a coalition of 10 audiology organizations formed to collaborate on the development of these measures, has created educational resources in order to facilitate their use by audiologists that are available on the AQC website.

Resources include detailed specifications on the quality measures available to be used by audiologists and how to use them, a list of Frequently Asked Questions, a step-by-step guide on reporting PQRI measures, as well as links to additional information about the PQRI from the Centers of Medicare and Medicaid Services (CMS).

Beginning January 1, 2010 audiologists that bill Medicare Part B will have the opportunity to participate in the Medicare Physician Quality Reporting Initiative (PQRI) program. PQRI is a voluntary program designed to improve the quality of care to Medicare beneficiaries. Audiologists who participate in PQRI by reporting on approved quality measures are eligible for a 2% incentive payment after the yearly reporting period.

There are three measures that audiologists can report on for 2010. Each measure has a numerator, a denominator, and denominator exclusions.

• The numerator describes the action required by the measure for reporting and performance.
• A denominator describes all the eligible patients for a measure.
• Denominator exclusions are those patients that fit in the denominator but are not eligible for the measure for specific reasons.

Each audiology measure requires the audiologists to refer a patient to a physician after an audiologic evaluation finds a certain condition, unless the patient fits into an exclusion.

The Audiology Quality Consortium (AQC), a coalition of 10 audiology organizations, developed these measures based on the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guidelines for “Red Flags–Warning of Ear Disease” and FDA regulations (21 C.F.R. § 801.420(c)(2)) requiring referral when there are signs of ear disease. AQC submitted eight “red flag” measures to the Centers for Medicare and Medicaid Services (CMS) for consideration and three were chosen for 2010. These measures, which came within a year of audiologists becoming eligible to participate in PQRI, will assist audiologists in documenting referral for warning signs. The three measures also directly benefit audiologists, rather than physicians who use audiology services.

The measures are as follows:

1. Referral for Otologic Evaluation for Patients with Congenital or Traumatic Deformity of the Ear
Description: Percentage of patients aged birth and older referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation subsequent to an audiologic evaluation after presenting with a visible congenital or traumatic deformity of the ear.

Numerator (action required): Patients referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation subsequent to an audiologic evaluation who present with visible congenital or traumatic deformity of the ear.

Denominator (eligible patients): Patients aged birth and older who present with visible congenital or traumatic deformity of the ear.

Denominator Exclusions: Patients not eligible for the “Referral for Otologic Evaluation for Patients with Congenital or Traumatic Deformity of the Ear” measure (e.g. Patients for whom an assessment of the visible congenital or traumatic deformity of the ear has been performed by a physician within the past 6 months; patients who are already under the care of a physician for congenital or traumatic deformity of the ear.)

2. Referral for Otologic Evaluation for Patients with a History of Active Drainage from the Ear within the Previous 90 Days

Description: Percentage of patients aged birth and older who have disease of the ear and mastoid processes referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation subsequent to an audiologic evaluation after presenting with a history of active drainage from the ear within the previous 90 days.

Numerator (action required): Patients referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation subsequent to an audiologic evaluation who present with a history of active drainage from the ear within the previous 90 days.

Denominator (eligible patients): Patients aged birth and older who have disease of the ear and mastoid processes who present with active drainage from the ear within the previous 90 days.

Denominator Exclusions: Patients not eligible for the “Referral for Otologic Evaluation for Patients with a History of Active Drainage” measure (e.g. Patients who are already under the care of a physician for active ear drainage.)

3. Referral for Otologic Evaluation for Patients with a History of Sudden or Rapidly Progressive Hearing Loss

Description: Percentage of patients aged birth and older referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation immediately following an audiologic evaluation that verifies and documents sudden or rapidly progressive hearing loss.

Numerator (action required): Patients referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation immediately following an audiologic evaluation that verifies and documents sudden or rapidly progressive hearing loss.

Denominator (eligible patients): Patients aged birth and older with verification and documentation of sudden or rapidly progressive hearing loss.

Denominator Exclusions: Patients not eligible for the “Referral for Otologic Evaluation for Sudden or Rapidly Progressive Hearing Loss” measure (e.g. patients who are under current care of a physician for sudden or rapidly progressive hearing loss.)

The full specifications for each measure can be found on the AQC website. CMS also provides general information on PQRI and measures in its PQRI Implementation Guide (.pdf download).

These measures are reported in the following ways:

• The measures are reportable via the CMS 1500 claim form.
  • The audiologist would add Medicare directed codes to the claim form to report the measures to CMS.
  • These codes are specific to both the numerator and denominator. The audiology measure codes will be released by CMS later in November.
• CMS requires that PQRI participants report on at least three measures, and on 80% patients seen that would fit into a measure. Therefore, an audiologist would need to report on 80% of the patients they see with the above three conditions.

The AQC will be providing more detailed information on reporting in the future.

Further information, including frequently asked questions, is available on the AQC website.

This is the first in a series of PQRI informational resources for audiologists that will be published by the AQC.

What is the Physician Quality Reporting Initiative (PQRI)?
The PQRI is a voluntary program through the Centers for Medicare and Medicaid Services (CMS) designed to improve the quality of care to Medicare beneficiaries through tracking of practice patterns. Medicare enrolled health care professionals who participate in PQRI by reporting on approved quality measures are eligible for a 2% incentive payment at year end.

Can an audiologist participate in PQRI?
Yes, if the audiologist is enrolled as a Medicare provider. PQRI is for Medicare Part B only, but does not apply to Part B settings for hospitals and skilled nursing facilities.

When can audiologists participate in PQRI?
Beginning January 1, 2010 and through December 31, 2010.

When can an audiologist participating in PQRI anticipate receiving the incentive payment?
After the reporting is calculated for the year.

Are there quality measures that audiologists can report on in 2010?
Yes. Audiologists will be able to report on three quality measures that call for referral of patients of any age to a physician after an audiologic assessment determines one of three conditions and the patient is not currently under the care of a physician for that condition:

• Congenital or traumatic deformity of the ear
• A history of active drainage from the ear within the previous 90 days (for patients who have disease of the ear and mastoid processes)
• A history of sudden or rapidly progressive hearing loss

How would an audiologist report on these three measures?
These measures are reportable via the CMS 1500 claim form. The audiologist would add Medicare directed codes to the claim form to report the measures to CMS.

Why is PQRI important for audiology?
The three audiology PQRI measures were developed by the Audiology Quality Consortium (AQC), a coalition of 10 audiology organizations. By participating in PQRI, audiologists will be providing support for the efficacy of audiology services as part of the patient continuum of care. Participating audiologists are eligible for a 2% incentive payment at year end for performing specific procedures that improve the quality of healthcare.

Where can I find more information?
Further information is available on the Audiology Quality Consortium’s website. Additional information about Medicare the Physician Quality Reporting Initiative can be found on the Centers for Medicare and Medicaid Services (CMS) website.

ASHA has convened a committee called the Audiology Quality Consortium (AQC) that consists of members of 10 audiology organizations (including Military Audiology Association) to provide input for the PQRI. The PQRI is a voluntary program through the Centers for Medicare and Medicaid Services (CMS) designed to improve the quality of Care to Medicare beneficiaries. Providers who see medicare enrollees can participate in PQRI by reporting on approved quality measures. Those who report are eligible for a 2% incentive payment.

Of course, this does not directly apply to us in military audiology settings, as we do not bill medicare or medicaid for services in our military hospitals. However, ASHA’s interest was in gathering a group of audiologists from a variety of diverse employment settings to discuss these measures and to make recommendations for future indicators to report on. I appreciate the fact that they included MAA in the group, but I do not want to confuse our members into thinking that this is something they should be reporting on, because, at present, it is not.

PQRI reporting begins 1 JAN 2010. The committee is in the process of developing a series of e-mail and informational messages that they request that each agency post on their website. Each week, the committee meets via conference call to discuss the next message.

The first messages follow.

More messages will follow, approximately weekly until the end of Dec 2009.

Rochester, N.Y. – A college specializing in technical education for students with hearing loss is reaching out to U.S. troops who have suffered significant hearing loss as a result of exposure to gunfire and explosions during their military service.

The National Technical Institute for the Deaf, a college of Rochester Institute of Technology, has established the Military Veterans with Hearing Loss Project at RIT/NTID and plans to admit recent veterans with hearing loss. Those veterans can earn bachelor or graduate-level degrees at RIT with access services – such as real-time captioning and notetaking in the classroom – from NTID.

A Web site for the initiative has been created to offer prospective students more information about the college and details the services available.

Nearly 1,300 deaf and hard-of-hearing students attend NTID. They receive access services as needed in classrooms throughout the RIT campus, including live captioning and note-taking services as well as sign language interpreting.

“It makes sense for us to welcome the men and women serving our country who could benefit from the education and access services we offer,” says NTID President Alan Hurwitz. “Our talented faculty and staff have experience helping those who have suffered a sudden hearing loss. RIT/NTID would be a perfect option for veterans seeking to continue their educations. We are happy to help serve the men and women who have already sacrificed so much to serve our country.”

The Department of Veterans Affairs reports hearing damage is the most common disability for veterans. More than 46,700 veterans from Operation Enduring Freedom and Operation Iraqi Freedom have reported hearing loss. That damage is permanent for many veterans.

Exposure to more than 85 decibels continuously or 140 decibels for any length of time can damage hearing. A rifle can produce 160 decibels of sound. On average, the men and women serving in Afghanistan and Iraq have served longer time in combat than any other U.S. military conflict.

NTID is a federally-funded college with more than 40 years of experience providing services to students with a wide range of hearing loss, including students whose loss may be sudden or progressive. NTID provides comprehensive, unmatched services for those using hearing aids and for cochlear implant users. There are 250 students at RIT/NTID this year with cochlear implants.

The access services provided to college students with hearing loss are unparalleled at RIT/NTID. More than 50 classroom captionists provide real-time captioning to students on campus. There are also more than 120 sign language interpreters employed at the college for those students who benefit from interpreting.

Congressional staff members and veterans groups are excited about this opportunity for returning veterans.

• “Hats off to RIT and NTID for offering this great program to the brave men and women who have served our country,” says New York Sen. Chuck Schumer. “There are many veterans who will benefit from the world-class services available for deaf and hard-of-hearing students at NTID and RIT.”

• “Our veterans deserve the full support of their community and I am proud to help RIT announce its plan to welcome returning veterans with hearing loss,” says Rep. Eric Massa, (D-Corning), a retired Navy commander whose district includes RIT. “Programs that address the needs of our returning veterans such as this deserve support from their representatives in Washington, and I look forward to helping strengthen this effort.”

• “Our brave men and women in uniform have sacrificed much and deserve our gratitude and support when they return home,” said Rep. Louise Slaughter, (D-Fairport). “I am proud to support RIT/NTID’s initiative and applaud their commitment to ensuring that our service members with hearing loss can attend school and successfully begin the next chapter of their lives.”

• “RIT is to be commended for making NTID’s first-rate program available to the brave men and women who were reunited with their loved ones, but not without making a lasting sacrifice,” said Rep. Chris Lee (R-Clarence). “This program provides vital leadership at a critical juncture in the fight to improve care for our wounded warriors.”

• “The dedicated men and women of our armed services make tremendous sacrifices abroad,” says Rep. Dan Maffei (D-DeWitt). “Some unfortunately sustain injuries that, even after they return home, have permanently changed their lives. I am so pleased that RIT/NTID is making the effort to include returning service men and women.”

• Jim McDonough, Director of the New York State Division of Veterans’ Affairs, says: “I applaud the RIT/NTID initiative to tailor its educational programs so that our returning Operation Iraqi Freedom and Operation Enduring Freedom veterans with hearing loss can attend college ‘barrier free.’ We look forward to working with the school’s leaders to help serve these veterans as they continue their education and move from soldier to student.”

The first veterans may attend an orientation program this summer and begin classes this fall. As many as 10 veterans could be admitted each year, growing up to 50 veterans over time. The same standard academic requirements for admission to RIT/NTID would be applied to veterans.

RIT recently announced it will become a “Yellow Ribbon” college, offering significant discounted tuition for recent veterans pursuing their educations at RIT. More than 300 RIT students are currently receiving veterans’ benefits. The amount of the discount depends on their length of service.

NTID was established by Congress in 1965 to offer deaf and hard-of-hearing students a technical college education. Students from every state attend RIT/NTID. Students live, study and socialize with more than 15,000 hearing students on the RIT campus. For more information, visit the NTID website.

The following aspects of the test are discussed:

• Background
• Test Development
• Test Administration
• Test Procedures
• Recommendations
• Reliability

The document includes the test items and scoring sheet which are in the Microsoft Word® format.

SPRINT Audio Files

The following FLAC or WMA Lossless files will need to be converted to wav/aiff and “burned” to a blank CD prior to use.

FLAC format:
1000 Hz Calibration Tone
Lists 1-2
Lists 3-4
md5 file verification
Read Me

WMA Lossless format:
1000 Hz Calibration Tone
Lists 1-2
Lists 3-4

Who can Benefit? Any Military Retiree or Family Member of a Military Retiree may take advantage of this opportunity.

How to Buy: Purchases may be made directly with Williams Sound Corp.’s headquarters by calling, faxing, mailing, or, e-mailing your order. Please see below for contact information. This is also available on your order form.

What is an Assistive Listening Device? An ALD is a device designed to pick up sounds from the sound source (or what you want to hear) and bring it directly to your ear. This eliminates the need to struggle to hear in various situational settings. ALDs can provide a cost effective solution for those with temporary or permanent hearing loss depending upon the type and severity of loss. An ALD can also provide situational relief for hearing loss allowing the isolation often associated with hearing impairment to become a thing of the past.

The two product descriptions below outline a few of the many opportunities and possible applications that our wide variety of ALDs can provide:
The SoundPlus TV Listening System allows users to listen to the TV or stereo at a comfortable volume without disturbing others. This innovative system provides for relaxed at home television viewing or can be used for television/stereo listening on base where a quiet environment may be imperative. Williams Sound also has large area infrared listening systems that can be used for movie viewing–accommodating an unlimited number of users. Infrared offers NO interference to RF equipment!

The Pocketalker personal amplifier is a small simple to use product designed to help individuals hear more clearly in one on one situations, at the dinner table, in the car, at a restaurant, playing cards etc. Ideal for use in doctor/patient interviews, this simple amplifier allows for comfortable private communication. In the field immediate communication can be provided to those returning from combat, with temporary or permanent hearing loss, allowing contact and communication to be provided in critical situations.

Our team at Williams Sound would be happy to discuss your needs at length and tell you more about the variety of products we offer. You can reach a RALD customer service agent toll free at 1-800-843-3544. We look forward to hearing from you soon and improving the qualify of life for our military service members and their families!

Contact information:

Williams Sound Corp
10300 Valley View Rd
Eden Prairie, MN 55344
Phone: 800-328-6190 ext. 740
Fax: 952-943-2252