BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 1535|
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THIRD READING
Bill No: AB 1535
Author: Jones (D)
Amended: 9/2/09 in Senate
Vote: 21
SENATE BUS., PROF. & ECON. DEVEL. COMM. : 4-3, 7/6/09
(Fail)
AYES: Corbett, Correa, Florez, Romero
NOES: Aanestad, Walters, Yee
NO VOTE RECORDED: Negrete McLeod, Wyland, Oropeza
SENATE BUS., PROF. & ECON. DEVEL. COMMITTEE : 6-2, 7/13/09
AYES: Negrete McLeod, Wyland, Corbett, Florez, Romero,
Walters
NOES: Aanestad, Yee
NO VOTE RECORDED: Correa, Oropeza
SENATE APPROPRIATIONS COMMITTEE : 12-0, 8/27/09
AYES: Kehoe, Cox, Corbett, Denham, Hancock, Leno, Oropeza,
Price, Runner, Walters, Wolk, Wyland
NO VOTE RECORDED: Yee
ASSEMBLY FLOOR : 70-5, 5/28/09 - See last page for vote
SUBJECT : Audiologists: hearing aids
SOURCE : The California Academy of Audiology
DIGEST : This bill revises the definition of the practice
of audiology to include the selling of hearing aids, and
CONTINUED
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specifies certain requirements for the sale of hearing
aids. Specifically, this bill provides that on and after
January 1, 2010, in addition to satisfying the licensure
and examination requirements, as specified, no licensed
audiologists shall sell hearing aids unless he/she passed
an examination, approved by the Speech-Language Pathology
and Audiology Board (SLPAB) relating to selling hearing
aids, and eliminates the Hearing Aid Dispensers Bureau and
consolidates its functions into the SLPAB, changes the
composition of the SLPAB, and renames it the
Speech-Language Pathology and Audiology and Hearing Aid
Dispensers Board.
ANALYSIS :
Existing law:
1. Establishes the Speech-Language Pathologists and
Audiologists Licensure Act to regulate the practice of
speech-language pathology and audiology. Establishes
the SLPAB to license and regulate speech-language
pathologists and audiologists.
2. States that the nine-member SLPAB includes three
licensed speech-language pathologists, three licensed
audiologists, and three public members, one of whom is a
licensed physician and surgeon, board certified in
otolaryngology, and the remaining two public members who
shall be licentiates of the SLPAB, as specified.
Provides that the Governor appoints the physician and
surgeon public member and the other six licensed
members, and the Senate Rules Committee and the Speaker
of the Assembly each appoint a public member.
3. States that the practice of audiology means the
application of principles, methods, and procedures of
measurement, testing, appraisal, prediction,
consultation, counseling, instruction related to
auditory, vestibular, and related functions and the
modification of communicative disorders involving
speech, language, auditory behavior or other aberrant
behavior resulting from auditory dysfunction; and the
planning, directing, conducting, supervising, or
participating in programs of identification of auditory
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disorders, hearing conservation, cerumen removal, aural
habilitation, and rehabilitation, including, hearing aid
recommendation and evaluation procedures including, but
not limited to, specifying amplification requirements
and evaluation of the results thereof, auditory
training, and speech reading.
4. Establishes within the Department of Consumer Affairs
(DCA) the Hearing Aid Dispensers Bureau (HAD) to
regulate the practice of hearing aid dispensers.
Establishes the Hearing Aid Dispensers Advisory
Committee, consisting of seven members; three of whom
shall be licensed hearing aid dispensers and four of
whom are public members. States that only one of the
licensed members may also be a licensed audiologist.
This bill:
1. Eliminates the HAD and consolidates its functions into
the SLPAB. Eliminates the HAD Fund and places those
funds into the SLPAB Fund. Renames SLPAB the
Speech-Language Pathology and Audiology and Hearing Aid
Dispensers Board (Board).
2. Revises the definition of the practice of audiology to
include the selling of hearing aids.
3. Revises the composition of the Board, and instead
requires that the six non-public members be made up of
the following: two licensed speech-language
pathologists, two licensed audiologists, one of whom
shall be a dispensing audiologist, and two hearing aid
dispensers.
4. Retains the three public members, one of whom shall be a
physician certified in otolaryngology of SLPAB.
5. Makes other clarifying and conforming changes in the
Hearing Aid Dispensers Licensing Law and the
Speech-Language Pathologists and Audiologists Licensure
Act.
6. Creates within the Board, the Hearing Aid Dispensing
Committee to review and research the practice of fitting
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and selling hearing aids.
7. Specifies the fee and renewal fee for dispensing
audiologists shall not exceed $280.
This bill, similar to requirements for hearing aid
dispensers:
1. States that on and after January 1, 2010, in addition to
satisfying existing licensure and examination
requirements, no licensed audiologists shall sell
hearing aids unless he/she has completed an application,
paid all applicable fees, and passed an examination,
approved by the Board relating to selling hearing aids.
2. Provides that on and after January 1, 2010, a licensed
audiologist, with an unexpired license, to sell hearing
aids pursuant to the Hearing Aid Dispensers Licensing
Law, may continue to sell hearing aids pursuant to that
license until that license expires, and upon expiration
the licensee shall be deemed to have satisfied the
requirements specified in # 1) above and may continue to
sell hearing aids pursuant to his/her audiology license
pursuant to the provisions of the Speech-Language
Pathologists and Audiologists Licensure Act. Requires
the Board provide the same exam provided by HAD until
the next examination validation and occupational
analysis is completed by DCA.
3. States that an audiologist whose license to sell hearing
aids, issued pursuant to the Hearing Aid Dispensers
Licensing Law is suspended or revoked is not authorized
to sell hearing aids and shall be subject to the
examination requirements specified in # 1) above and
other provisions of the Speech-Language Pathologists and
Audiologists Licensure Act
4. Provides that hearing aids may be sold by catalog or
direct mail provided that:
A. The seller is licensed as an audiologist in this
state.
B. There is no fitting, selection, or adaptation of
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the instrument and no advice is given with respect
to fitting, selection, or adaptation of the
instrument and no advice is given with respect to
the taking of an ear impression for an earmold by
the seller.
C. The seller has received a statement which is
signed by a physician and surgeon, audiologist, or
a hearing aid dispenser, licensed by the State of
California which verifies that consultation for the
conditions specified in item #11) below has been
complied with.
5. Requires a copy of the statement referred to in item #
4) c) above, to be retained by the seller for a
seven-year period.
6, Requires a licensed audiologist, upon the consummation
of a sale of a hearing aid, deliver to the purchaser a
written receipt, signed by or on behalf of the licensed
audiologist, containing all of the following:
A. The date of consummation of the sale.
B. Specifications as to the make, serial number,
and model number of the hearing aid or aids sold.
C. The address of the principal place of business
of the licensed audiologist, and the address and
office hours at which the licensed audiologist
shall be available for fitting or postfitting
adjustments and servicing of the hearing aid or
aids sold.
D. A statement to the effect that the aid or aids
delivered to the purchaser are used or
reconditioned, as the case may be, if that is the
fact.
E. The number of the licensed audiologist's license
and the name and license number of any other
hearing aid dispenser, temporary licensee, or
audiologist who provided any recommendation or
consultation regarding the purchase of the hearing
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aid.
F. The terms of any guarantee or written warranty,
as specified, made to the purchaser with respect to
the hearing aid or hearing aids.
7. States that whenever any of the following conditions are
found to exist (as specified in a) to f), above), either
from observations by the licensed audiologist, or on the
basis of information furnished by the prospective
hearing aid user, a licensed audiologist shall, prior to
fitting or selling a hearing aid to any individual,
suggest to that individual in writing that his/her best
interests would be served if he/she would consult a
licensed physician specializing in diseases of the ear,
or if no licensed physician is available in the
community, then to a duly licensed physician:
A. Visible congenital or traumatic deformity of the
ear.
B. History of, or active, drainage from the ear
within the previous 90 days.
C. History of sudden or rapidly progressive hearing
loss within the previous 90 days.
D. Acute or chronic dizziness.
E. Unilateral hearing loss of sudden or recent
onset within the previous 90 days.
F. Significant air-bone gap (when generally
acceptable standards have been established).
8. Provides that no referral for medical opinion need be
made by any licensed audiologist in the instance of
replacement only of a hearing aid that has been lost or
damaged beyond repair within one year of the date of
purchase. Requires a copy of the written recommendation
to be retained by the licensed audiologist for a
seven-year period.
9. Requires that a person receiving the written
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recommendation who elects to purchase a hearing aid to
sign a receipt, and the receipt shall be kept with the
other papers retained by the licensed audiologist for a
seven-year period.
10.States that nothing that is required to be performed by
a licensed audiologist for the sale of a hearing aid
shall mean that the licensed audiologist is engaged in
the diagnosis of illness or the practice of medicine or
any other activity prohibited by the provisions of the
Business and Professions Code.
11.Prohibits the sale by of a hearing aid by an individual
licensed as an audiologist to a person 16 years of age
or younger, unless within the preceding 6 months a
recommendation for a hearing aid has been made by both a
board-certified, or a board-eligible physician
specializing in otolaryngology, and by a state licensed
audiologist. States that a replacement of an identical
hearing aid within one year shall be an exception to
this requirement.
12.Requires a licensed audiologist to, upon the
consummation of a sale of a hearing aid, keep and
maintain records in his/her office or place of business
at all times and each such record shall be kept and
maintained for a seven-year period. These records
include:
A. Results of test techniques as they pertain to
fitting of the hearing aid.
B. A copy of the written receipt required by item #
6) above, and the written recommendation and
receipt as specified in item # 8) and # 9) above.
13.Requires a licensed audiologist who is the owner,
manager, or franchisee at a location where hearing aids
are fit or sold, to be responsible for the adequacy of
the fitting or selling of any hearing aid fit and sold
by any licensee or licensees at that location.
14.States legislative intent that the license fees for
audiologists who sell hearing aids and the license fees
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for hearing aid dispensers will need to be adjusted to
reflect the transfer of duties, powers, purposes and
responsibilities from the Hearing Aid Dispensers Board.
15.Requires the Board, no later than January 1, 2011,
review the license fees paid by audiologists and hearing
aid dispensers in order to assess whether the revenue is
adequate to support the new functions.
Background
The Practice of Audiology . The SLPAB sets licensing
standards and enforces the laws governing the practices of
speech-language pathology and audiology. SLPAB
investigates complaints against licensed and unlicensed
practioners and takes disciplinary action whenever
appropriate. There are roughly 1650 licensed audiologists
in California and approximately 50 percent of them are
licensed to dispense hearing aids. Current law provides
that to be eligible for licensure as an audiologist, the
applicant must possess at least a master's degree in
audiology from an educational institution approved by the
SPLAB, complete at least 60 units of courses related to the
normal development, function, and use of speech, hearing,
and language; and courses that provide information about,
and training in, the management of speech, hearing, and
language disorders, and at least 24 of the 60 required
units be related to language resulting from hearing
disorders, completion of supervised clinical practice,
completion of no less than 36 weeks of supervised
professional full-time experience or 72 weeks of
professional part-time experience obtained under the
supervision of a licensed audiologist, and pass an
examination approved by the SLPAB. The examination
includes test items on evaluating of hearing, identifying
medical conditions requiring referral, fitting hearing
aids, and ethics. A minimum of 375 hours of supervised
clinical practice is also required of audiologists. Under
current law, the practice of audiology does not include the
selling of hearing aids, and audiologists may not sell
hearing aids unless they have obtained a license from the
HAD. SB 821 (Senate Business, Professions and Economic
Development Committee) revises the educational and
curriculum standards for audiologists to require a doctoral
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level in audiology. The doctoral level in audiology
provides for another full-year of classroom instruction and
a full-year externship to be completed under the auspices
of the university training program prior to the issuance of
the doctorate degree.
Hearing Aid Dispensers . The HAD oversees the licensing and
regulation of hearing aid dispensers. HAD informs
consumers of their legal rights and obligations when
purchasing or returning hearing aids. It also protects
consumers by maintaining advertising standards as well as
evaluating the competence of individual dispensers. HAD
mediates complaints and enforces statutory and regulatory
requirements related to the practice of hearing aid
dispensers. HAD licenses more than 2,200 hearing aid
dispensers. Current law makes it unlawful for an
individual to fit or sell hearing aids, or to display a
sign or to advertise to be engaged in the business of
fitting or selling hearing aids without t a license. To be
eligible to be a hearing aids dispenser, an applicant must
be at least 18 years of age, and who possess a high school
diploma or its equivalent. An applicant must also pass
written and practical examinations as prescribed by the
HAD. The practical examination contains three stations,
and an applicant moves from one station to another in no
particular order. Station A is a 30 minutes examination
that involves audiometric assessment or the inspection of
the ear and an electronic hearing assessment. Station B is
a twenty minutes examination which involves taking an ear
impression and evaluating hearing instruments. Finally,
Station C is a 25 minutes examination that involves fitting
and orientation and post-fitting care.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee analysis:
Fiscal Impact (in thousands)
Major Provisions 2009-10 2010-11 2011-12
Fund
Bureau and board $142 savings one
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time Special*
Consolidation
Licensure requirement $320 annual
loss of licensing revenue
Special**
Exemption
*Savings to the Hearing Aid Dispensers Fund; all monies in
this fund will be transferred to the Speech-Language
Pathology and Audiology Board Fund
**Speech-Language Pathology and Audiology Board Fund.
SUPPORT : (Verified 9/1/09)
California Academy of Audiology (source)
American Academy of Audiology
California Senior Legislature
California Speech-Language Hearing Association
Kaiser Permanente
ARGUMENTS IN SUPPORT : According to the author's office
states, this bill allows licensed audiologists to sell
hearing aids under their audiology licenses, rather than
requiring them to also have a dispenser's (sales) license
administered by a second state licensing entity. The
author's office points out that this bill increases the
accessibility of hearing aids for hearing impaired patients
by allowing the purchase of a hearing aid directly through
their audiologist, and does not affect the ability of
non-audiologist dispensers to sell hearing aids. Consumers
may go to an audiologist or a dispenser elsewhere if they
wish to purchase a hearing aid device. The California
Academy of Audiology, which is the sponsor of this bill,
argues that this limitation dates back 37 years ago when
hearing aid options were quite limited and thought to be
"unprofessional" at that time for audiologists to sell the
devices. As a result, a dispenser's license was
established to license non-audiologists who sell the
devices, and it required some basic knowledge about
"fitting" a hearing aid. Over the years, hearing treatment
and hearing aid technology has become more advanced,
particularly within the pediatric population as a result of
the Universal Newborn Hearing Screening Programs in
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California and other states, and many audiologists have had
to get a dispenser's license in order to vend the new
hearing aids and fully serve their patients. Currently, 52
percent of the audiology licensees now have a dispenser's
license. This Sponsor points out that this bill removes
the unnecessary dual licensing requirement for audiologists
to sell hearing aids.
ASSEMBLY FLOOR
AYES: Adams, Ammiano, Arambula, Beall, Bill Berryhill, Tom
Berryhill, Blakeslee, Block, Blumenfield, Brownley,
Buchanan, Caballero, Charles Calderon, Carter, Chesbro,
Conway, Coto, Davis, De La Torre, De Leon, Eng, Evans,
Feuer, Fletcher, Fong, Fuentes, Fuller, Furutani,
Galgiani, Garrick, Gilmore, Hagman, Hall, Hayashi,
Hernandez, Hill, Huber, Huffman, Jones, Knight,
Krekorian, Lieu, Logue, Bonnie Lowenthal, Ma, Mendoza,
Miller, Monning, Nava, Niello, John A. Perez, V. Manuel
Perez, Portantino, Price, Ruskin, Salas, Saldana, Silva,
Skinner, Smyth, Solorio, Audra Strickland, Swanson,
Torlakson, Torres, Torrico, Tran, Villines, Yamada, Bass
NOES: Anderson, Emmerson, Gaines, Jeffries, Nielsen
NO VOTE RECORDED: Cook, DeVore, Duvall, Harkey, Nestande
JJA:do 9/2/09 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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