CASLPO News

ADP and Practice Standards Advisory

Since January 2024, CASLPO has focused on clarifying the standards of practice for audiologists when prescribing hearing aids. This focus has been heightened by changes to the Ministry of Health’s Assistive Devices Program (ADP) hearing devices funding application process.

Over the past year, we have spent considerable time and effort consulting and communicating with various interested and affected parties on these issues, including post graduate academic programs, professional advocacy organizations, the Ministry of Health, ADP staff, other health professional regulators, and individual registrants.

In 2024, the College released two key resources for audiologists:

1. Frequently Asked Questions (April 17, 2024): This document addressed the ADP’s changes, highlighted the legislation on the controlled act of prescribing a hearing aid, discussed conflict of interest standards, and provided guidance on prescribing hearing aids when working with hearing instrument practitioners.
2. An E-Forum on the Practice Standards for the Controlled Act of Prescribing Hearing Aids (August 14th, 2024): This forum offered additional information on relevant legislation, the risk of harm associated with the controlled act, standards of practice for prescription, how audiologists can work with HIPs, and regulatory principles around record keeping and charging fees for prescriptions.

Both resources remain relevant and reflect CASLPO’s current guidance on how audiologists can meet standards of practice in this changing environment.

We encourage you to review these resources if you haven’t already. Any time you spend doing this can be counted towards Continuous Learning Activity Credits (CLACs) in your Quality Assurance Self-Assessment Tool (SAT).

Based on recent questions, we are offering the following additional points of clarification:

• Establishing a patient relationship: Audiologists must establish a professional relationship with the patient when prescribing hearing aids. The type, length, and method of the interaction must be sufficient for patients to understand the audiologist’s role in their hearing health care and to recognize that the audiologist is the regulated professional responsible for the hearing aid prescription (Code of Ethics Principle 1a, Principle 2d, g, Principle 3g, j, l).
• Prescription Checklist and Form: The Prescription Checklist and Prescription Form that were provided with the April 17th FAQs do not replace the prescriptive process carried out by audiologists in collaboration with patients. These tools are intended to help audiologists ensure they meet standards for the prescriptive process (Practice Standards for the Provision of Hearing Aid Services by Audiologists, Standards H1 to H6, Code of Ethics Principles 1a, Principle 2b, g, Principles 3d, e, f).
• Accepting recommendations from HIPs: Audiologists may choose to accept recommendations from hearing instrument practitioners regarding the make, model, or style of hearing aids to prescribe. However, the final decision on the prescription, including the selection of the device, must be decided and documented by the audiologist, based on a patient-centred prescriptive process (Practice Standards for the Provision of Hearing Aid Services, Standard H4, Code of Ethics Principle 2d, g, Principle 3 d,e,f,g).
• Regulatory obligations and declining requests: Audiologists must inform those they work with of their regulatory obligations. If asked to prescribe hearing aids in a way that does not meet the standards or ensure quality patient service, the audiologist can decline the prescription request. Reasons for declining must be clearly documented, with the patient’s best interest as the priority (Code of Ethics Principle 2 d,e,g, Principle 3 d i, 4d, f).

CASLPO’s role is to regulate audiologists in the public interest, and this is the primary consideration that informs our focus on these issues. Requiring that hearing aids cannot be dispensed without a prescription protects the public by ensuring that only professionals with knowledge, skills, and judgement are able to prescribe hearing aids (RHPA, Section 31). The involvement of audiologists as regulated health professionals who have met educational criteria and are held accountable to meet standards when caring for this vulnerable population is important for public protection. This is particularly true for a needed health care service that is complex for the public to understand, and where significant public funds are expended.

The College will continue to monitor trends and developments within the profession and update our guidance as necessary to ensure it reflects current practice and addresses patient risk of harm.