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SB-198 Hearing aid dispensers: cerumen: management: tympanometry.(2017-2018)

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Date Published: 04/17/2017 02:45 PM
SB198:v98#DOCUMENT

Amended  IN  Senate  April 17, 2017

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Senate Bill No. 198


Introduced by Senator Galgiani

January 30, 2017


An act to amend Section 2538.11 of the Business and Professions Code, relating to healing arts.


LEGISLATIVE COUNSEL'S DIGEST


SB 198, as amended, Galgiani. Hearing aid dispensers: cerumen management. cerumen: management: tympanometry.
Existing law, the Speech-Language Pathologists and Audiologists and Hearing Aid Dispensers Licensure Act, provides for the licensure and regulation of hearing aid dispensers by the Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board. A violation of the act is a crime. Under existing law, an applicant for a hearing aid dispenser license is required to take and pass a written examination and a practical examination. Existing law requires hearing aid licensees to complete at least 12 hours of continuing education, as provided. Existing law defines the “practice of fitting or selling hearing aids” as those practices used for the purpose of selection and adaptation of hearing aids, including direct observation of the ear, testing of hearing in connection with the fitting and selling of hearing aids, taking of ear mold impressions, fitting or sale of hearing aids, and any necessary postfitting counseling. Under existing law, hearing tests conducted are required to include those that are in compliance with the Food and Drug Administration Guidelines for Hearing Aid Devices and those that are specifically covered in the licensing examination prepared and administered by the board.
This bill would include cerumen management and tympanometry for patients 18 years of age and older in the practice of fitting or selling hearing aids. The bill would make a licensed hearing aid dispenser who has passed his or her licensing examinations eligible to sit for a board-approved examination assessing techniques and patient safety measures in cerumen management or tympanometry. The bill would require the board to apply board-approved courses in cerumen management and tympanometry to the continuing education requirement. The bill would require the administration of cerumen management by a licensed hearing aid dispenser to occur under physician and surgeon supervision. The bill would require a licensed hearing aid dispenser to immediately refer a patient to an appropriate physician or surgeon under certain circumstances in the process of cerumen management.
Because a violation of these requirements would be a crime, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.

This bill would authorize that practice to include cerumen management, as defined, subject to specified requirements, including that the hearing aid dispenser demonstrates specified proficiency in cerumen management and that cerumen management only occur under physician and surgeon supervision. The bill would additionally authorize tympanometry as an allowable hearing test if it is only used for further referral to a physician and surgeon for diagnosis or treatment.

Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NOYES  

The people of the State of California do enact as follows:


SECTION 1.

 (a) The Legislature finds and declares all of the following:
(1) There are currently over 1,100 licensed hearing aid dispensers in the State of California, who must pass a rigorous written and practical exam to obtain a license to practice in the state.
(2) Licensed hearing aid dispensers are required to complete 12 hours of continuing education annually, with all courses approved by the Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board (board).
(3) Above and beyond California’s licensing standards, many hearing aid dispensers obtain additional accreditation, known as the Board-Certified Hearing Instrument Specialist designation, which requires a separate examination and course study that advances the healing aid dispensers’s knowledge and skills.
(b) It is the intent of the Legislature to allow licensed hearing aid dispensers to practice at the highest levels of their training in order to better serve their patients, as well as provide the board with enforceable regulations to protect the public.

SECTION 1.SEC. 2.

 Section 2538.11 of the Business and Professions Code is amended to read:

2538.11.
 (a) “Practice of fitting or selling hearing aids,” as used in this article, means those practices used for the purpose of selection and adaptation of hearing aids, including direct observation of the ear, testing of hearing in connection with the fitting and selling of hearing aids, taking of ear mold impressions, fitting or sale of hearing aids, and any necessary postfitting counseling. This may include cerumen management. For management and tympanometry for patients 18 years of age and older.
(1) For the purposes of this section, cerumen management means the removal of cerumen for the sole purpose of inspecting the ears, making impressions, or fitting and maintaining hearing aids.
(2) For the purposes of this section, tympanometry means the administration of the test for the sole purposes of fitting and maintaining hearing aids or referring a patient to a specialist physician and surgeon.

(1)Cerumen management shall only be performed by a hearing aid dispenser who has demonstrated proficiency of this skill in his or her licensing examination.

(2)Cerumen management shall only occur under physician and surgeon supervision, which shall be subject to all of the following:

(A)The hearing aid dispenser and physician and surgeon shall collaborate to develop a written standardized protocol. The protocol shall include, but not be limited to, a requirement that the supervised hearing aid dispenser immediately refer to an appropriate physician and surgeon any trauma, including skin tears, bleeding, or other pathology of the ear discovered in the process of cerumen management.

(B)Approval by the supervising physician and surgeon of the written standardized protocol.

(C)The supervising physician and surgeon shall be within the general vicinity, as provided by the written standardized protocol, of the supervised hearing aid dispenser and shall be available by telephone at the time of cerumen management.

(b) (1) A licensed hearing aid dispenser who has passed his or her examinations described in Section 2538.25 is eligible to sit for a board-approved examination assessing techniques and patient safety measures in cerumen management or tympanometry. An examination approved by the board shall be an examination sufficient to demonstrate proficiency in cerumen management or tympanometry and the knowledge, skills, and abilities needed to perform those techniques safely.
(2) Notwithstanding any other law, the board shall apply board-approved courses in cerumen management and tympanometry to the continuing education requirement described in Section 2538.18. In order to be board-approved, a course shall cover the knowledge, skills, and abilities needed to perform cerumen management and tympanometry safely.
(3) The administration of cerumen management by a licensed hearing aid dispenser shall occur under physician and surgeon supervision. Physician and surgeon supervision shall not be construed to require the physical presence of the physician and surgeon, but does include (A) collaboration on the development of the standardized procedure, (B) approval of the standardized procedure, and (C) availability by telephonic contact at the time of patient examination by the licensed hearing aid dispenser.
(4) A licensed hearing aid dispenser shall immediately refer a patient to an appropriate physician or surgeon if the patient demonstrates any trauma, including tears, bleeding, or other pathology of the ear discovered in the process of cerumen management.

(D)

(5) A physician and surgeon may not simultaneously supervise more than two hearing aid dispensers for purposes of cerumen management.

The

(c) The practice of fitting or selling hearing aids does not include the act of concluding the transaction by a retail clerk.

When

(d) When any audiometer or other equipment is used in the practice of fitting or selling hearing aids, it shall be kept properly calibrated and in good working condition, condition and the calibration of the audiometer or other equipment shall be checked at least annually.

(b)

(e) A hearing aid dispenser shall not conduct diagnostic hearing tests when conducting tests in connection with the practice of fitting or selling hearing aids.

(c)

(f) Hearing tests conducted pursuant to this article shall include those that are in compliance with the Food and Drug Administration Guidelines for Hearing Aid Devices and those that are specifically covered in the licensing examination prepared and administered by the board. Tympanometry shall be considered an allowable hearing test for purposes of this section and shall only be used for further referral to a physician and surgeon for diagnosis or treatment.

SEC. 3.

 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.