BILL ANALYSIS Ó
SENATE COMMITTEE ON
BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
Senator Jerry Hill, Chair
2015 - 2016 Regular
Bill No: AB 1950 Hearing Date: June 27,
2016
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|Author: |Maienschein |
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|Version: |April 25, 2016 |
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|Urgency: |No |Fiscal: |Yes |
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|Consultant|Sarah Mason and Natalie Diaz Mondragon |
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Subject: Hearing aids: audio switch
SUMMARY: Requires the Speech-Language Pathology and Audiology and
Hearing Aid Dispensers Board (SLPAHADB) to develop a consumer
hearing aid disclosure that includes information on a telecoil,
t-coil, or t-switch and, beginning July 1, 2017 and requires a
licensed hearing aid dispenser and a licensed dispensing
audiologist to provide a purchaser of a hearing aid with a copy
of the disclosure at the time of purchase.
Existing law:
1) Establishes the SLPAHADB within the Department of Consumer
Affairs and provides the SLPAHADB with licensing, regulatory
and disciplinary functions for the professions of
speech-language pathology, audiology, and hearing aid
dispensing. (Business and Professions Code (BPC) § 2530 et
seq.)
2) Defines the obligations of retail sellers of assistive
devices and provides warranty/right of return provisions for
consumers of assistive devices including exact language to be
included in the notice to consumers. (Civil Code (CC) §
1793.02)
3) Provides definitions of assistive devices, hearing aids and
hearing aid dispensers:
AB 1950 (Maienschein) Page 2
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a) Assistive Device is defined as: "Any instrument,
apparatus, or contrivance, including any component or part
thereof or accessory thereto, that it used or intended to
be used, to assist an individual with a disability in the
mitigation or treatment of an injury or disease or to
assist or affect or replace the structure or any function
of the body or an individual with a disability, except that
this term does not include lenses and ophthalmic goods
unless they are sold or dispensed to a blind person and
unless they are intended to assist the limited vision of
the person so disabled." (CC 1791 § (o))
b) A hearing aid is defined as any wearable instrument or
device designed for or offered for the purpose of aiding or
compensating for impaired human hearing. (BPC § 2538.10
(d))
c) A hearing aid dispenser is a person engaged in the
practice of fitting or selling hearing aids to an
individual with impaired hearing. (BPC § 2538.14)
d) A hearing aid dispenser who is the owner, manager, or
franchisee at a location where hearing aids are fit or
sold, shall 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. (BPC § 2538.39)
4)Provides that the practice of fitting or selling hearing aids
includes 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. (BPC § 2538.11(a))
5)Provides that it is unlawful for a licensed hearing aid
dispenser to fit or sell a hearing aid unless he or she first
does all of the following: (BPC § 2538.49)
a) Complies with all provisions of state laws and
regulations relating to the fitting or selling of hearing
aids.
b) Conducts a direct observation of the purchaser's ear
AB 1950 (Maienschein) Page 3
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canals.
c) Informs the purchaser of the address and office hours at
which the licensee shall be available for fitting or
postfitting adjustments and servicing of the hearing aid or
aids sold.
6)Requires that a hearing aid dispenser shall, upon the
consummation of a sale of a hearing aid, deliver to the
purchaser a written receipt, signed by or on behalf of the
dispenser, containing all of the following: (BPC § 2538.35)
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
dispenser, and the address and office hours at which the
dispenser 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 dispenser's license and the name and
license number of any other hearing aid dispenser or
temporary licensee who provided any recommendation or
consultation regarding the purchase of the hearing aid.
f) The terms of any guarantee or written warranty, required
by CC § 1793.02, made to the purchaser with respect to the
hearing aid or hearing aids.
7) States that it is unlawful for a licensed hearing aid
dispenser to fit or sell a hearing aid unless he or she first
does all of the following: (BPC § 2538.49)
a) Complies with all provisions of state laws and
regulations relating to the fitting or selling of a hearing
aid;
b) Conducts a direct observation of the purchaser's ear
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canals; and,
c) Informs the purchaser of the address and office hours at
which the licensee is available for fitting or post-fitting
adjustments and servicing of the hearing aid or aids sold.
7)Requires a licensed audiologist to obtain a dispensing
audiologist license in order to sell hearing aids, as
specified. (BPC § 2539.1)
8)Permits a hearing aid to be sold by catalog or direct mail
provided that:
(BPC § 2539.2)
a) The seller is a licensed audiologist and authorized to
sell hearing aids;
b) There is no fitting, selection, or adaptation of 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; and,
c) The seller has received a statement which is signed by a
physician and surgeon, audiologist, or a licensed hearing
aid dispenser to verify proper referral protocols.
9)Requires a licensed audiologist, upon to consummation of a
sale of a hearing aid, to deliver to the purchaser a written
receipt signed by or on behalf of the licensed audiologist,
containing specified information including, but not limited
to, the date of the sale, specifications as to the make,
serial number, and model number of the hearing aid or aids
sold, and 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. (BPC § 2539.4)
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This bill:
1) Requires the SLPAHADB, before July 1, 2017, to develop a
consumer hearing aid disclosure that provides information for
the benefit of hearing aid purchasers, including, but not
limited to, information on a telecoil, t-coil, or t-switch
and requires SLPAHADB to make the disclosure available on the
SLPAHADB website. Authorizes SLPAHADB to solicit and receive
public comments during the development of the disclosure and
requires that the SLPAHADB update the disclosure as often as
it deems necessary.
2) Requires, on and after July 1, 2017, a licensed hearing aid
dispenser and a licensed dispensing audiologist, upon the
sale of a hearing aid, to provide the purchaser with a copy
of the consumer hearing aid disclosure made available by the
board pursuant to Item #1), above.
FISCAL EFFECT: This bill is keyed "fiscal" by Legislative
Counsel. According to the Assembly Committee on Appropriations
analysis dated May 18, 2016, this bill will result in estimated
costs to the SLPAHADB of approximately $100,000 in fiscal year
2016-17 and $70,000 in fiscal year 2017-18. The analysis notes
that ongoing costs related to ensuring the disclosure is updated
should be minor.
COMMENTS:
1. Purpose. The Sponsors of this bill are Roger that Consulting
and The Hearing Well Club . According to the Author,
"telecoils remain a little-known aspect of the hearing aid,
but are of great value to the hearing impaired. They can be
found in most hearing aids and cochlear implants and can help
improve a person's ability to hear in noisy environments.
With the price of hearing aids reaching thousands of dollars,
it is critical that we educate consumers on how best to use
their hearing aids in the most efficient way."
2. Background. According to the U.S. Department of Health and
Human Services' National Institute on Deafness and Other
Communication Disorders, a hearing aid is an electronic
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device that makes some sounds louder. There are three
different styles of hearing aids: behind-the-ear, in-the-ear,
and canal aid. These hearing aids are composed of three
basic parts: a microphone, amplifier, and speaker. The
hearing aid receives sound through a microphone, which
converts the sound waves to electrical signals and sends them
to an amplifier, which then increases the power of the
signals and sends them to the ear through a speaker.
Certain hearing aids also include a telecoil, which is a
small copper wire located inside the hearing aid that expands
functionality. The telecoil functions as a way to increase
the clarity of sounds and connects the listener directly to
the sounds source while eliminating most background noise.
Telecoils pair with Hearing Assistive Technology (HAT), which
is becoming increasingly available in public spaces. HAT
typically comes in two forms: the hearing loop and an
infrared system. The hearing loop is a wire that circles a
room and transmits sound electro-magnetically, and then the
electromagnetic signal is picked up by the telecoil in the
hearing aid. To use a hearing loop, the user flips a
t-switch on the hearing aid. The infrared system uses
invisible light beams to carry sound from the source to a
personal receiver- this receiver can be a neckloop or a
behind the ear silhouette inductor - in which the telecoil
then picks up sounds from the receiver via the attachment.
According to the Hearing Loss Association of America, pairing
telecoils with HAT creates a way to bridge the physical space
between the listener and the sound source.
3. Arguments in Support. Supporters state that while hearing
aids are a necessity for users, sometimes they are not
enough, as problems such as background noise may occur.
Supporters note that the use of a telecoil remedies loss of
clarity due to background noise. According to supporters,
telecoils can improve clarity on the telephone. Supporters
believe that "when spending up to $4,000 per hearing aid,
consumers should be informed about the universal and
versatile features of telecoils." According to supporters of
this bill, Californians with hearing loss will be
able to make an informed decision about what features they want
and need in their hearing aids, including telecoil.
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4. Arguments in Opposition. The California Academy of Audiology
(CAA) is opposed to this bill, noting that the type of device
that is the focus of this bill has many enthusiastic users
but may not be the best type of device for all patients.
According to CAA, today's hearing aids can use audio switches
for activating t-coils but there are also more modern items
like streamers. CAA states t-coils create an additional cost
and would thus increase the cost of hearing aids and notes
that the bill does not acknowledge that physicians also
dispense hearing aids. CAA proposes amending the bill to
strike the current provisions and instead require the
SLPAHADB could produce a consumer fact sheet on its website
outlining current hearing aid options, including the types of
devices available to consumers like those with t-coils or
audio switches.
Hearing Healthcare Providers (HHP) writes "we have seen
technology move away from traditional copper wire telecoils.
The telecoil posited in this bill has been in use since the
1970's and requires high amounts of energy to operate." HHP
believes that the creation of an additional document for HHP
members, small business with small budgets, payrolls and
office staff, requires them to print at their own cost is
another cost to bear. HHP states that it would be willing to
include a link to a document like that proposed in this bill
on the written purchase order every patient receives or
proposes the same fact sheet production and posting by
SLPAHADB as CAA above.
SLPAHADB notes that the Federal Trade Commission requires
that a patient-education insert be included with all new
hearing aids at the time of sale. According to SLPAHADB,
this insert fully describes the function of the hearing aid
telecoil. SLPAHADB writes that this bill would create a
duplication of information that is already mandated by the
federal government and adds that emphasizing telecoil over
other technologies to all hearing aid purchasers is not
appropriate, as telecoils are just one of many hearing aid
features available to consumers.
5. Should the Legislature Mandate Information About One Specific
Technology? This bill intends to increase awareness about
one technological component of hearing aids. Typically,
consumer outreach and public information provided by a
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licensing board to licensees and the public is broad and
comprehensive, offering information that can assist
practitioners in their work while at the same time informing
patients of issues impacting a particular practice. In the
case of SLPAHADB, the hope would be that the board is
providing information to its licensees, as well as hearing
impaired patients, to ensure that licensees are performing
services that utilize the most appropriate and available
means of serving their patients. It is unclear how adding a
consumer information sheet specific to one technology,
telecoils, will assist in the delivery of services to hearing
impaired patients. Additionally, the delivery of material
that could be for a different type of technology than that
received by the patient may lead consumers to question the
judgment of a licensee and could have the unintended
consequence of driving decisions about the most appropriate
type of hearing aid away from the licensed audiologist.
SUPPORT AND OPPOSITION:
Support:
Hearing Loss Association of America
Hearing Loss Association of America California State Association
Hearing Loss Association of America Chapters throughout the
state, including the
Central Coast Chapter, Diablo Valley Chapter, Long
Beach/Lakewood Chapter, Mission Viejo Chapter, San Diego
Chapter and Santa Barbara Chapter
Hearing Well Club
Roger That Consulting
Numerous individuals
Opposition:
California Academy of Audiology
Hearing Healthcare Providers California
Speech-Language Pathology and Audiology and Hearing Aid
Dispensers Board
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