October 2022

UNT audiology faculty instrumental in providing evidence that led to expanded Medicare coverage for cochlear implants

Dr. Sharon Miller, assistant professor in the College of Health and Public Service Department of Audiology and Speech-Language Pathology, was part of a team of researchers whose work led the Centers for Medicare & Medicaid Services (CMS) to update their cochlear implant candidacy criteria to provide coverage for a broader spectrum of hearing loss.

DENTON (UNT), Texas – Dr. Miller was part of the CMS National Coverage Analysis that led to the recommendation that older individuals who receive Medicare benefits with speech test scores of greater than 40% and less than or equal to 60% qualify for cochlear implantation. Previously, only those whose score was below 40% could qualify. The change became effective Sept. 26 and will drastically expand care for older adults with a broader spectrum of hearing loss. Prior to this decision, cochlear implantation was only covered by Medicare for patients who did not meet candidacy criteria when they were enrolled in either a specific type of FDA-approved clinical trial, a trial under the CMS Clinical Trial Policy, or a prospective, controlled comparative trial approved by CMS.

The current decision specifically states: Cochlear implants are an appropriate treatment of bilateral pre- or post-linguistic, sensorineural, moderate-to-profound hearing loss in individuals who demonstrate limited benefit from amplification defined by test scores of less than or equal to 60% correct in the best-aided listening condition on recorded tests of open-set sentence recognition.

“Along with my UNT colleague Dr. Erin Schafer, our research has shown that older adults who receive a cochlear implant obtain significant improvement in speech recognition in quiet and in background noise,” Dr. Miller said. “More importantly, we have also documented significant improvements in overall quality of life because of access to cochlear implants.”

Patients do need to meet other criteria defined by the CMS, such as having limited benefit from appropriate hearing aids, no ear infections or other impediments to the implantation, and no contradictions to surgery.

“Increasing access to cochlear implants is crucial to reduce health disparities related to untreated hearing loss,” Dr. Miller said. “This new change in CMS coverage removes a significant barrier to obtaining a cochlear implant for older adults who can significantly benefit from the technology.”


UNT social work faculty receives $1.865M grant to fund substance use disorder Community Health Worker (CHW) training program

Dr. Dhru Mukherjee, associate professor in the College of Health and Public Service Department of Social Work, will use the funds to address health disparities and the shortage in the healthcare workforce in DFW who are skilled in handling opioid and other substance use disorders in underserved communities. 

DENTON (UNT), Texas – With the 3-year funding from the Health Resources & Services Administration (HRSA), Dr. Mukherjee, the principal investigator, will be collaborating with faculty in the college’s Department of Rehabilitation & Health Services and UNT’s Center for Racial and Ethnic Equity in Health and Society (CREEHS) to develop much-needed curriculum and training to develop Community Health Worker workforce focusing on substance use disorder. Undergraduate students and healthcare workers also can participate in the program.

“The program will create a state-recognized certificate and federally recognized apprenticeship program for the community health worker participants,” said Dr. Mukherjee. “This initiative will bolster the shortage of behavioral health workforce in the Dallas/Fort-Worth area.”

According to the American Public Health Association (APHA), a community health worker is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. In this case, in addition to UNT students, Dr. Mukherjee hopes to encourage CHWs without credentials who have been in treatment/recovery for substance use themselves who can work toward their Licensed Chemical Dependency Counselor (LCDC) credential without having to earn a degree.

There are four goals for the program:

  • Establish and expand an internship-based Community Health Worker certification program (they will seek state certification) from the existing addiction studies and social work courses, and provide stipends to offset expenses that would prevent success in training
  • Establish and expand a CHW apprenticeship program that will be registered with the Texas Workforce Commission (TWC) and provide job placement services and on-the-job training to new CHW-substance use disorder workers
  • Develop a new CHW-substance use disorder training curriculum by creating collaborative, participatory community-based partner networks in DFW
  • Strategically recruit diverse populations to include underserved and underrepresented communities to join the CHW workforce

The curriculum will be tested on undergraduate students, and the team will work with Texoma Community Centers, Denton County MHMR and The Stress and Trauma Treatment Center to recruit community members. Once it’s fully implemented, the program will also provide continuing education opportunities, and online and in-person workshops for the CHW workforce and others wanting to work towards earning or renewing their LCDC credentials.

As the program progresses, Mukherjee said he plans to form an advisory board of experts in these fields to continuously evaluate the curriculum to keep it relevant and marketable for employment. He also plans to advocate for the program to become part of the education, training, or credentialing approved by the state for CHWs to receive reimbursement from insurance providers.