By King                                               H.B. No. 1765
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to the regulation of the fitting and dispensing of hearing
    1-3  instruments.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  Section 1, Chapter 366, Acts of the 61st
    1-6  Legislature, Regular Session, 1969 (Article 4566-1.01, Vernon's
    1-7  Texas Civil Statutes), is amended by amending Subdivisions (3) and
    1-8  (13) and adding Subdivisions (14) and (15) to read as follows:
    1-9              (3)  "Temporary training permit" means a permit issued
   1-10  by the committee to persons authorized to fit and dispense hearing
   1-11  instruments only under the direct or indirect supervision, as
   1-12  appropriate, of a person who holds a license under this Act.
   1-13              (13)  "Direct supervision" means the requirement of the
   1-14  <physical> presence of the supervisor on the premises and the
   1-15  availability of the supervisor for prompt consultation <any time a
   1-16  temporary permit holder is engaged in services related to the
   1-17  fitting, dispensing, and sales of hearing instruments>.
   1-18              (14)  "Indirect supervision" means the daily review by
   1-19  a supervisor of a temporary training permit holder's patient
   1-20  contact and daily work.
   1-21              (15)  "Contact hour" means a period of time equal to 55
   1-22  minutes.
   1-23        SECTION 2.  Section 2(a), Chapter 366, Acts of the 61st
   1-24  Legislature, Regular Session, 1969 (Article 4566-1.02, Vernon's
    2-1  Texas Civil Statutes), is amended to read as follows:
    2-2        (a)  The State Committee of Examiners in the Fitting and
    2-3  Dispensing of Hearing Instruments is within the Texas Department of
    2-4  Health and is composed of nine members appointed by the governor
    2-5  with the advice and consent of the senate.  Appointments shall be
    2-6  made without regard to the race, creed, sex, religion, or national
    2-7  origin of the appointees.  The committee members must have the
    2-8  following qualifications:
    2-9              (1)  six committee members must possess a hearing
   2-10  instrument dispenser's license under this Act and have been
   2-11  residents of this state actually engaged in fitting and dispensing
   2-12  hearing instruments for at least five years preceding their
   2-13  appointment; not <no> more than one person <two persons> licensed
   2-14  under Chapter 381, Acts of the 68th Legislature, Regular Session,
   2-15  1983 (Article 4512j, Vernon's Texas Civil Statutes), is <and its
   2-16  subsequent amendments, are> eligible to serve as a member
   2-17  <members> of the committee;
   2-18              (2)  two committee members must be members of the
   2-19  general public, each of whom is eligible for appointment as a
   2-20  public member only if the person and the person's spouse are not
   2-21  licensed by an occupational regulatory agency in the field of
   2-22  health care; are not employed by and do not participate in the
   2-23  management of a business entity or other organization that provides
   2-24  health-care services or that sells, manufactures, or distributes
   2-25  health-care supplies or equipment; and do not own, control, or
   2-26  have, directly or indirectly, an interest in a business entity or
   2-27  other organization that provides health-care services or that
    3-1  sells, manufactures, or distributes health-care supplies or
    3-2  equipment; and
    3-3              (3)  one committee member must be a citizen of the
    3-4  United States and a resident of this state for at least two years
    3-5  preceding the person's appointment, be an active practicing
    3-6  physician or surgeon licensed to practice in this state by the
    3-7  Texas State Board of Medical Examiners, and specialize in the
    3-8  practice of otolaryngology and may not have a financial interest in
    3-9  a hearing instrument manufacturing company or a wholesale or retail
   3-10  hearing instrument company.
   3-11        SECTION 3.  Section 6(b), Chapter 366, Acts of the 61st
   3-12  Legislature, Regular Session, 1969 (Article 4566-1.06, Vernon's
   3-13  Texas Civil Statutes), is amended to read as follows:
   3-14        (b)  The applicant shall:
   3-15              (1)  apply <must make application> to the committee on
   3-16  forms to be furnished by the committee, including sworn evidence
   3-17  that the applicant has attained the age of majority and has
   3-18  graduated from an accredited high school or equivalent and
   3-19  providing other information as the committee may deem necessary for
   3-20  the enforcement of this Act; and
   3-21              (2)  pay any required fees for application and
   3-22  examination.
   3-23        SECTION 4.  Section 9, Chapter 366, Acts of the 61st
   3-24  Legislature, Regular Session, 1969 (Article 4566-1.09, Vernon's
   3-25  Texas Civil Statutes), is amended by amending Subsections (a), (e),
   3-26  (f), and (h) and adding Subsection (l) to read as follows:
   3-27        (a)(1)  The committee shall grant a temporary training permit
    4-1  to fit and dispense hearing instruments to any person applying to
    4-2  the committee who has never taken the examination provided in the
    4-3  Act and who possesses the qualifications in Subsection (b) of
    4-4  Section 6 of this Act, on written application to the committee.
    4-5  The applicant must pay the temporary training permit fee and make
    4-6  application on forms to be furnished by the committee furnishing
    4-7  sworn evidence that the applicant possesses the qualifications
    4-8  contained in Subsection (b), Section 6, of this Act, that the
    4-9  applicant has never taken the examination provided in this Act, and
   4-10  that the applicant has never previously been issued in this state a
   4-11  temporary training permit to fit and dispense hearing instruments.
   4-12              (2)  Students of audiology in an accredited college or
   4-13  university program are exempt from the provisions of this Act,
   4-14  provided that their activities and services constitute a part of
   4-15  their supervised course of study or practicum experience.  Such
   4-16  students are subject to the provisions of Chapter 381, Acts of the
   4-17  68th Legislature, Regular Session, 1983 (Article 4512j, Vernon's
   4-18  Texas Civil Statutes)<, and its subsequent amendments>.
   4-19        (e)  The committee shall establish educational guidelines,
   4-20  both formal and practical, for the training of temporary training
   4-21  permit holders.  The training guidelines must include directions to
   4-22  the training supervisor about the subject matter to be taught,
   4-23  length of the training, extent of a trainee's contact with the
   4-24  public, and responsibility of the training supervisor for direct
   4-25  and indirect supervision of all aspects of the training.  A trainee
   4-26  shall be required to have at least 150 hours of directly supervised
   4-27  practicum that shall include the following:
    5-1              (1)  25 contact hours of pure tone air conduction, bone
    5-2  conduction, and speech audiometry, recorded and live voice with 15
    5-3  of the required hours being with actual clients;
    5-4              (2)  25 client contact hours of hearing instrument
    5-5  evaluations including sound field measurements with recorded and
    5-6  live voice;
    5-7              (3)  20 contact hours of instrument fittings with
    5-8  actual clients;
    5-9              (4)  10 contact hours of earmold orientation types,
   5-10  uses, and terminology;
   5-11              (5)  5 contact <15> hours of earmold impressions and
   5-12  otoscopic examinations of the ear;
   5-13              (6)  15 contact hours of troubleshooting of defective
   5-14  hearing instruments;
   5-15              (7)  20 contact hours of case history with actual
   5-16  clients;
   5-17              (8)  10 contact hours of the laws governing the
   5-18  licensing of persons fitting and dispensing hearing instruments and
   5-19  federal Food and Drug Administration and Federal Trade Commission
   5-20  regulations relating to the fitting and dispensing of hearing
   5-21  instruments; and
   5-22              (9)  20 contact <10> hours of supplemental work in one
   5-23  or more of the above areas.
   5-24        (f)  <The length of the training may not be shorter than 200
   5-25  days.>  The training period begins on the date of the issuance of
   5-26  the temporary permit.  On completion of the 150 hours of directly
   5-27  supervised practicum under Subsection (e) of this section, a
    6-1  temporary training permit holder shall complete the permit holder's
    6-2  training under the indirect supervision of the permit holder's
    6-3  supervisor.
    6-4        (h)  A supervisor of a temporary training permit holder must
    6-5  be licensed under this Act.  Supervision of a permit holder shall
    6-6  entail direct and indirect supervision by the supervisor as
    6-7  appropriate.  A supervisor may not supervise more than two trainees
    6-8  at any one time.  A supervisor shall maintain a log of the contact
    6-9  hours by practicum category on a form supplied by the committee.
   6-10  On completion of the 150 contact hours, the form shall be signed by
   6-11  the supervisor and the temporary training permit holder, notarized,
   6-12  and mailed to the committee.
   6-13        (l)  A temporary training permit holder may provide routine
   6-14  fitting and dispensing that has been ordered by the permit holder's
   6-15  supervisor.  The supervisor is the sole judge of whether the
   6-16  temporary training permit holder has the qualifications necessary
   6-17  for the performance of routine fitting and dispensing.  A
   6-18  supervisor is accountable to the committee for the actions and
   6-19  misdeeds of a temporary training permit holder acting at the
   6-20  supervisor's discretion.
   6-21        SECTION 5.  Sections 9A(a) and (c), Chapter 366, Acts of the
   6-22  61st Legislature, Regular Session, 1969 (Article 4566-1.09A,
   6-23  Vernon's Texas Civil Statutes), are amended to read as follows:
   6-24        (a)  A temporary training permit holder who has taken all
   6-25  parts of the examination given by the committee and has passed all
   6-26  parts of the examination with a score of 70 percent or greater and
   6-27  paid the required fees shall be issued an apprentice permit to fit
    7-1  and dispense hearing instruments.  An apprentice permit remains
    7-2  valid for one year unless it is extended by the committee for an
    7-3  additional period not to exceed six months.
    7-4        (c)  A hearing instrument dispenser's license shall be issued
    7-5  to an apprentice permit holder when the committee has received
    7-6  sufficient evidence that the apprentice permit holder has met all
    7-7  the requirements of this Act for a hearing instrument dispenser's
    7-8  license.  <Audiologists and audiology interns licensed under
    7-9  Chapter 381, Acts of the 68th Legislature, Regular Session, 1983
   7-10  (Article 4512j, Vernon's Texas Civil Statutes), and its subsequent
   7-11  amendments, are exempt from the provisions of this Act.>
   7-12        SECTION 6.  Section 12, Chapter 366, Acts of the 61st
   7-13  Legislature, Regular Session, 1969 (Article 4566-1.12, Vernon's
   7-14  Texas Civil Statutes), is amended to read as follows:
   7-15        Sec. 12.  Fees and expenses.  (a)  The committee by rule
   7-16  shall adopt reasonable and necessary fees so that the fees, in the
   7-17  aggregate, produce sufficient revenue to cover the costs of
   7-18  administering this Act.  The fees adopted by the committee under
   7-19  this section may include a license fee, license renewal fee,
   7-20  examination fee, temporary training permit fee, apprentice license
   7-21  fee, duplicate document fee, and other fees as necessary to
   7-22  administer this Act.  <The fees for administering this Act shall be
   7-23  as follows:>
   7-24              <1.  Temporary Training Permit               $200>
   7-25              <2.  Examination Fee                          250>
   7-26              <3.  Apprentice License Fee                   300>
   7-27              <4.  License Fee                              220>
    8-1              <5.  License Renewal Fee                      440>
    8-2              <6.  Duplicate Document Fee                    50>
    8-3        (b)  The hearing instrument dispensers licensing account is
    8-4  created in the general revenue fund.  Funds in the account may be
    8-5  used by the committee and department only for the administration of
    8-6  this Act.  Fees received under this Act shall be deposited in the
    8-7  general revenue fund to the credit of the account.  <The committee
    8-8  shall, every third work day, remit to the state treasurer all of
    8-9  the fees collected by the committee during the preceding month for
   8-10  deposit in the general revenue fund.>
   8-11        (c)  <Funds for the administration of this Act shall be
   8-12  provided by the General Appropriations Act from the general revenue
   8-13  fund.>  The financial transactions of the committee are subject to
   8-14  audit by the state auditor in accordance with Chapter 321,
   8-15  Government Code.
   8-16        SECTION 7.  Sections 16A(a), (b), and (d), Chapter 366, Acts
   8-17  of the 61st Legislature, Regular Session, 1969 (Article 4566-1.16A,
   8-18  Vernon's Texas Civil Statutes), are amended to read as follows:
   8-19        (a)  A sole proprietor, partnership, corporation, or other
   8-20  legal entity engaged in the fitting and dispensing of hearing
   8-21  instruments <A license holder> shall file a bond or a surety in
   8-22  lieu of a bond in the amount of $10,000 with the committee
   8-23  conditioned on the <license holder's> promise to pay all:
   8-24              (1)  taxes and contributions due to the state and
   8-25  political subdivisions of the state by the sole proprietor,
   8-26  partnership, corporation, or other legal entity; and
   8-27              (2)  judgments that the sole proprietor, partnership,
    9-1  corporation, or other legal entity <license holder>  may be
    9-2  required to pay for negligently or improperly dispensing hearing
    9-3  instruments or for breaching a contract relating to the dispensing
    9-4  of hearing instruments.
    9-5        (b)  A sole proprietor, partnership, corporation, or other
    9-6  legal entity subject to Subsection (a) of this section <A license
    9-7  holder> may file with the committee a cash deposit or other
    9-8  negotiable security acceptable to the committee in the amount
    9-9  required in Subsection (a) of this section in lieu of a bond.
   9-10        (d)  The purchaser of a hearing instrument may rescind the
   9-11  purchase and recover as provided by this section for:
   9-12              (1)  a material misstatement of fact or
   9-13  misrepresentation by a <the> license holder employed by the sole
   9-14  proprietor, partnership, corporation, or other legal entity
   9-15  regarding the hearing instrument or services to be provided by the
   9-16  license holder that were relied on by the purchaser or that induced
   9-17  the purchaser to purchase the instrument;
   9-18              (2)  the failure by the sole proprietor, partnership,
   9-19  corporation, or other legal entity <license holder> to provide the
   9-20  purchaser with an instrument or with fitting and dispensing
   9-21  services that conform to the specifications of the purchase
   9-22  agreement;
   9-23              (3)  the diagnosis of a medical condition unknown to
   9-24  the purchaser at the time of the purchase that precludes the
   9-25  purchaser's use of the instrument;
   9-26              (4)  the failure by the sole proprietor, partnership,
   9-27  corporation, or other legal entity <license holder> to remedy a
   10-1  significant material defect of the hearing instrument within a
   10-2  reasonable time;
   10-3              (5)  the provision by the sole proprietor, partnership,
   10-4  corporation, or other legal entity <license holder  of a hearing
   10-5  instrument> of fitting and dispensing services that are not in
   10-6  accordance with accepted industry practices; or
   10-7              (6)  the failure by a <the> license holder employed by
   10-8  the sole proprietor, partnership, corporation, or other legal
   10-9  entity to meet the standards of conduct prescribed under this Act
  10-10  or by rules adopted under this Act that adversely affects the
  10-11  transactions between the purchaser and  the license holder or the
  10-12  sole proprietorship, partnership, corporation, or other legal
  10-13  entity.
  10-14        SECTION 8.  Section 16B, Chapter 366, Acts of the 61st
  10-15  Legislature, Regular Session, 1969 (Article 4566-1.16B, Vernon's
  10-16  Texas Civil Statutes), is amended to read as follows:
  10-17        Sec. 16B.  Ownership of dispensing practice.  (a)  A person
  10-18  who owns, maintains, or operates an office or place of business
  10-19  where the person employs or engages under contract a person who
  10-20  practices the fitting and dispensing of hearing instruments shall
  10-21  be considered also to be engaged in the practice of fitting and
  10-22  dispensing of hearing instruments under this Act.  If the person
  10-23  who owns, maintains, or operates an office or place of business
  10-24  under this subsection is a partnership, each partner must be
  10-25  licensed as provided by this section.  If the person who owns,
  10-26  maintains, or operates an office or place of business under this
  10-27  subsection is a corporation or other legal entity, the chief
   11-1  executive officer of the corporation or entity must be licensed as
   11-2  provided by this section.
   11-3        (b)  A person who is considered to be practicing the fitting
   11-4  and dispensing of hearing instruments under this section shall be
   11-5  required to be licensed under this Act or licensed under Chapter
   11-6  381, Acts of the 68th Legislature, Regular Session, 1983 (Article
   11-7  4512j, Vernon's Texas Civil Statutes), <and its subsequent
   11-8  amendments,> as an audiologist.
   11-9        SECTION 9.  Section 19, Chapter 366, Acts of the 61st
  11-10  Legislature, Regular Session, 1969 (Article 4566-1.19, Vernon's
  11-11  Texas Civil Statutes), is amended to read as follows:
  11-12        Sec. 19.  EXCEPTIONS.  Nothing in this Act shall be construed
  11-13  to apply to the following:
  11-14              (1)  Persons engaged in the practice of measuring human
  11-15  hearing as a part of the academic curriculum of an accredited
  11-16  institution of higher learning, provided such persons or their
  11-17  employees do not sell hearing aids.
  11-18              (2)  Physicians and surgeons duly licensed by the Texas
  11-19  State Board of Medical Examiners and qualified to practice in the
  11-20  State of Texas.
  11-21              (3)  An individual with a master's or doctorate degree
  11-22  in audiology from an accredited college or university may engage in
  11-23  the measurement of human hearing by the use of an audiometer or by
  11-24  any means for the purpose of making selections and adaptations of
  11-25  or recommendations for a hearing aid and the making of impressions
  11-26  for earmolds to be used as part of a hearing aid, provided such
  11-27  persons do not sell hearing aids.
   12-1              (4)  An audiologist or an audiology intern licensed
   12-2  under Chapter 381, Acts of the 68th Legislature, Regular Session,
   12-3  1983 (Article 4512j, Vernon's Texas Civil Statutes), is exempt from
   12-4  the provisions of this Act.
   12-5        SECTION 10.  This Act takes effect September 1, 1995.
   12-6        SECTION 11.  The change in law made by this Act to Section
   12-7  9(f), Chapter 366, Acts of the 61st Legislature, Regular Session,
   12-8  1969 (Article 4566-1.09, Vernon's Texas Civil Statutes), regarding
   12-9  the requirements for a person holding a temporary training permit
  12-10  applies only to a person holding a temporary training permit issued
  12-11  on or after the effective date of this Act.  A person holding a
  12-12  temporary training permit issued before that date is governed by
  12-13  the law in effect at the time the permit was issued, and the former
  12-14  law is continued in effect for that purpose.
  12-15        SECTION 12.  The importance of this legislation and the
  12-16  crowded condition of the calendars in both houses create an
  12-17  emergency and an imperative public necessity that the
  12-18  constitutional rule requiring bills to be read on three several
  12-19  days in each house be suspended, and this rule is hereby suspended.