Florida Senate - 2023                        COMMITTEE AMENDMENT
       Bill No. SB 1506
       
       
       
       
       
       
                                Ì9741286Î974128                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  03/28/2023           .                                
                                       .                                
                                       .                                
                                       .                                
       —————————————————————————————————————————————————————————————————




       —————————————————————————————————————————————————————————————————
       The Committee on Health Policy (Rodriguez) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete lines 1269 - 1890
    4  and insert:
    5         Section 18. Section 468.1115, Florida Statutes, is amended
    6  to read:
    7         468.1115 Exemptions.—
    8         (1) No provision of This part may not shall be construed to
    9  limit the practice of persons licensed in this state from
   10  engaging in the professions for which they are licensed, so long
   11  as they do not hold themselves out to the public as possessing a
   12  license or certificate issued pursuant to this part or use a
   13  title protected by this part.
   14         (2) This part may not be construed to prohibit audiologists
   15  from fitting, selling, dispensing, servicing, marketing,
   16  providing customer support for, or distributing over-the-counter
   17  hearing aids to persons 18 years of age or older.
   18         (3)The provisions of This part does shall not apply to:
   19         (a) Students actively engaged in a training program, if
   20  such persons are acting under the direct supervision of a
   21  licensed speech-language pathologist or a licensed audiologist.
   22         (b) Persons practicing a licensed profession or operating
   23  within the scope of their profession, such as doctors of
   24  medicine, clinical psychologists, nurses, or hearing aid
   25  specialists, who are properly licensed under the laws of this
   26  state.
   27         (c) Persons certified in the areas of speech-language
   28  impairment or hearing impairment in this state under chapter
   29  1012 when engaging in the profession for which they are
   30  certified, or any person under the direct supervision of such a
   31  certified person, or of a licensee under this chapter, when the
   32  person under such supervision is performing hearing screenings
   33  in a school setting for prekindergarten through grade 12.
   34         (d) Laryngectomized individuals, rendering guidance and
   35  instruction to other laryngectomized individuals, who are under
   36  the supervision of a speech-language pathologist licensed under
   37  this part or of a physician licensed under chapter 458 or
   38  chapter 459 and qualified to perform this surgical procedure.
   39         (e) Persons licensed by another state as speech-language
   40  pathologists or audiologists who provide services within the
   41  applicable scope of practice set forth in s. 468.1125(10) or
   42  (11) s. 468.1125(6) or (7) for no more than 5 calendar days per
   43  month or 15 calendar days per year under the direct supervision
   44  of a Florida-licensed speech-language pathologist or
   45  audiologist. A person whose state of residence does not license
   46  speech-language pathologists or audiologists may also qualify
   47  for this exemption, if the person holds a certificate of
   48  clinical competence from the American Speech-Language and
   49  Hearing Association and meets all other requirements of this
   50  paragraph. In either case, the board shall hold the supervising
   51  Florida licensee fully accountable for the services provided by
   52  the out-of-state licensee.
   53         (f) Nonlicensed persons working in a hospital setting who
   54  provide newborn infant hearing screenings, so long as training,
   55  clinical interpretation of the screenings, and the protocol for
   56  followup of infants who fail in-hospital screenings are provided
   57  by a licensed audiologist.
   58         (g)An audiologist while engaged in fitting, selling,
   59  dispensing, servicing, marketing, providing customer support
   60  for, or distributing over-the-counter hearing aids.
   61         (h)Any person who fits, sells, dispenses, services,
   62  markets, provides customer support for, or distributes
   63  exclusively over-the-counter hearing aids.
   64         Section 19. Section 468.1125, Florida Statutes, is
   65  reordered and amended to read:
   66         468.1125 Definitions.—As used in this part, the term:
   67         (1) “Air-conduction hearing aid” means a hearing aid that
   68  conducts sound to the ear through the air.
   69         (2) “Audiologist” means a person licensed under this part
   70  to practice audiology.
   71         (3)(2) “Board” means the Board of Speech-Language Pathology
   72  and Audiology.
   73         (4)(3) “Certified audiology assistant” means a person who
   74  is certified under this part to perform audiology services under
   75  the direct supervision of an audiologist.
   76         (5)(4) “Certified speech-language pathology assistant”
   77  means a person who is certified under this part to perform
   78  speech pathology services under the direct supervision of a
   79  speech pathologist.
   80         (6)(5) “Department” means the Department of Health.
   81         (8)“Hearing aid” means any wearable device designed for,
   82  offered for the purpose of, or represented as aiding persons
   83  with, or compensating for, impaired hearing, to be worn by a
   84  hearing-impaired person to improve hearing.
   85         (9)Over-the-counter hearing aid means an air-conduction
   86  hearing aid that does not require implantation or other surgical
   87  intervention and is intended for use only by a person 18 years
   88  of age or older to compensate for perceived mild to moderate
   89  hearing impairment. The device, through tools, tests, or
   90  software, allows the user to control the hearing aid and
   91  customize it to the user’s hearing needs. The device may use
   92  wireless technology or may include tests for self-assessment of
   93  hearing loss. The device is available over-the-counter, without
   94  the supervision, prescription, or other order, involvement, or
   95  intervention of a licensed person, to consumers through in
   96  person transactions, by mail, or online, provided that the
   97  device satisfies the requirements of 21 C.F.R. parts 800, 801,
   98  and 874 (2022), which are specifically incorporated by reference
   99  herein.
  100         (10)(a)(6)(a) “Practice of audiology” means the application
  101  of principles, methods, and procedures for the prevention,
  102  identification, evaluation, consultation, habilitation,
  103  rehabilitation, instruction, treatment, and research, relative
  104  to hearing and the disorders of hearing, and to related language
  105  and speech disorders. “Disorders” are defined to include any and
  106  all conditions, whether of organic or nonorganic origin,
  107  peripheral or central, that impede the normal process of human
  108  communication, including, but not limited to, disorders of
  109  auditory sensitivity, acuity, function, or processing, or damage
  110  to the integrity of the physiological system.
  111         (b) Any audiologist who has complied with the provisions of
  112  this part may:
  113         1. Offer, render, plan, direct, conduct, consult, or
  114  supervise services to individuals or groups of individuals who
  115  have or are suspected of having disorders of hearing, including
  116  prevention, identification, evaluation, treatment, consultation,
  117  habilitation, rehabilitation, instruction, and research.
  118         2. Participate in hearing conservation, evaluation of noise
  119  environment, and noise control.
  120         3. Conduct and interpret tests of vestibular function and
  121  nystagmus, electrophysiologic auditory-evoked potentials,
  122  central auditory function, and calibration of measurement
  123  equipment used for such purposes.
  124         4. Habilitate and rehabilitate, including, but not limited
  125  to, prescription hearing aid evaluation, prescription,
  126  preparation, fitting and dispensing prescription hearing aids,
  127  assistive listening device selection and orientation, auditory
  128  training, aural habilitation, aural rehabilitation, speech
  129  conservation, and speechreading.
  130         5. Fabricate earmolds.
  131         6. Evaluate tinnitus.
  132         7. Include speech and language screening, limited to a
  133  pass/fail determination for identifying individuals with
  134  disorders of communication.
  135         (11)(a)(7)(a) “Practice of speech-language pathology” means
  136  the application of principles, methods, and procedures for the
  137  prevention, identification, evaluation, treatment, consultation,
  138  habilitation, rehabilitation, instruction, and research,
  139  relative to the development and disorders of human
  140  communication; to related oral and pharyngeal competencies; and
  141  to behavior related to disorders of human communication.
  142  “Disorders” are defined to include any and all conditions,
  143  whether of organic or nonorganic origin, that impede the normal
  144  process of human communication, including, but not limited to,
  145  disorders and related disorders of speech, phonology,
  146  articulation, fluency, voice, accent, verbal and written
  147  language and related nonoral/nonverbal forms of language,
  148  cognitive communication, auditory and visual processing, memory
  149  and comprehension, interactive communication, mastication,
  150  deglutition, and other oral, pharyngeal, and laryngeal
  151  sensorimotor competencies.
  152         (b) Any speech-language pathologist who has complied with
  153  the provisions of this part may:
  154         1. Offer, render, plan, direct, conduct, and supervise
  155  services to individuals or groups of individuals who have or are
  156  suspected of having disorders of human communication, including
  157  identification, evaluation, treatment, consultation,
  158  habilitation, rehabilitation, amelioration, instruction, and
  159  research.
  160         2. Determine the need for personal alternatives or
  161  augmentative systems, and recommend and train for the
  162  utilization of such systems.
  163         3. Perform a hearing screening, limited to a pass/fail
  164  determination, for the purpose of initial identification of
  165  communication disorders.
  166         (12)“Prescription hearing aid” means a hearing aid or
  167  sound amplifying device that is not an over-the-counter hearing
  168  aid. Hearing aids intended for use by persons younger than 18
  169  years of age must be prescription hearing aids.
  170         (13)(8) “Speech-language pathologist” means a person
  171  licensed under this part to practice speech pathology.
  172         (7)(9) “Direct supervision” means responsible supervision
  173  and control by a licensed speech-language pathologist who shall
  174  assume legal liability for the services rendered by any
  175  certified speech-language pathology assistant under the
  176  licensee’s supervision, or responsible supervision and control
  177  by a licensed audiologist who shall assume legal liability for
  178  the services rendered by any certified audiology assistant under
  179  the licensee’s supervision. Direct supervision shall require the
  180  physical presence of the licensed speech-language pathologist
  181  for consultation and direction of the actions of the certified
  182  speech-language pathology assistant, or the physical presence of
  183  the licensed audiologist for consultation and direction of the
  184  actions of the certified audiology assistant, unless the
  185  assistant is acting under protocols established by the board.
  186  The board shall establish rules further defining direct
  187  supervision of a certified speech-language pathology assistant
  188  or a certified audiology assistant.
  189         Section 20. Section 468.1225, Florida Statutes, is amended
  190  to read:
  191         468.1225 Procedures, equipment, and protocols.—
  192         (1) The following minimal procedures shall be used when a
  193  licensed audiologist fits and sells a prescription hearing aid:
  194         (a) Pure tone audiometric testing by air and bone to
  195  determine the type and degree of hearing deficiency when
  196  indicated.
  197         (b) Effective masking when indicated.
  198         (c) Appropriate testing to determine speech reception
  199  thresholds, speech discrimination scores, the most comfortable
  200  listening levels, uncomfortable loudness levels, and the
  201  selection of the best fitting arrangement for maximum hearing
  202  aid benefit when indicated.
  203         (2) The following equipment shall be used:
  204         (a) A wide range audiometer that which meets the
  205  specifications of the American National Standards Institute for
  206  diagnostic audiometers when indicated.
  207         (b) A speech audiometer or a master hearing aid in order to
  208  determine the most comfortable listening level and speech
  209  discrimination when indicated.
  210         (3) A final fitting ensuring physical and operational
  211  comfort of the prescription hearing aid shall be made when
  212  indicated.
  213         (4) A licensed audiologist who fits and sells prescription
  214  hearing aids shall obtain the following medical clearance: If,
  215  upon inspection of the ear canal with an otoscope in the common
  216  procedure of fitting a prescription hearing aid and upon
  217  interrogation of the client, there is any recent history of
  218  infection or any observable anomaly, the client shall be
  219  instructed to see a physician, and a prescription hearing aid
  220  may shall not be fitted until medical clearance is obtained for
  221  the condition noted. If, upon return, the condition noted is no
  222  longer observable and the client signs a medical waiver, a
  223  prescription hearing aid may be fitted. Any person with a
  224  significant difference between bone conduction hearing and air
  225  conduction hearing must be informed of the possibility of
  226  medical or surgical correction.
  227         (5)(a) A licensed audiologist’s office must have available,
  228  or have access to, a selection of prescription hearing aid
  229  models, hearing aid supplies, and services complete enough to
  230  accommodate the various needs of the hearing aid wearers.
  231         (b) At the time of the initial examination for fitting and
  232  sale of a prescription hearing aid, the attending audiologist
  233  must notify the prospective purchaser of the benefits of
  234  telecoil, also known as “t” coil or “t” switch, technology,
  235  including increased access to telephones and noninvasive access
  236  to assistive listening systems required under the Americans with
  237  Disabilities Act of 1990.
  238         (6) Unless otherwise indicated, each audiometric test
  239  conducted by a licensee or a certified audiology assistant in
  240  the fitting and selling of prescription hearing aids must shall
  241  be made in a testing room that has been certified by the
  242  department, or by an agent approved by the department, not to
  243  exceed the following sound pressure levels at the specified
  244  frequencies: 250Hz-40dB, 500Hz-40dB, 750Hz-40dB, 1000Hz-40dB,
  245  1500Hz-42dB, 2000Hz-47dB, 3000Hz-52dB, 4000Hz-57dB, 6000Hz-62dB,
  246  and 8000Hz-67dB. An exception to this requirement shall be made
  247  in the case of a client who, after being provided written notice
  248  of the benefits and advantages of having the test conducted in a
  249  certified testing room, requests that the test be conducted in a
  250  place other than the licensee’s certified testing room. Such
  251  request must shall be documented by a waiver that which includes
  252  the written notice and is signed by the licensee and the client
  253  before prior to the testing. The waiver must shall be executed
  254  on a form provided by the department. The executed waiver must
  255  shall be attached to the client’s copy of the contract, and a
  256  copy of the executed waiver must shall be retained in the
  257  licensee’s file.
  258         (7) The board may shall have the power to prescribe the
  259  minimum procedures and equipment used in the conducting of
  260  hearing assessments and for the fitting and selling of
  261  prescription hearing aids. The board shall adopt and enforce
  262  rules necessary to implement carry out the provisions of this
  263  subsection and subsection (6).
  264         (8) Any duly authorized officer or employee of the
  265  department may shall have the right to make such inspections and
  266  investigations as are necessary in order to determine the state
  267  of compliance with the provisions of this section and the
  268  applicable rules and may enter the premises of a licensee and
  269  inspect the records of same upon reasonable belief that a
  270  violation of this law is being or has been committed or that the
  271  licensee has failed or is failing to comply with the provisions
  272  of this part.
  273         (9)Any hearing aid provided to a person younger than 18
  274  years of age must be a prescription hearing aid and may not be
  275  an over-the-counter hearing aid.
  276         Section 21. Section 468.1245, Florida Statutes, is amended
  277  to read:
  278         468.1245 Itemized listing of prices; delivery of
  279  prescription hearing aid; receipt; guarantee; packaging;
  280  disclaimer.—
  281         (1) Before Prior to delivery of services or products to a
  282  prospective purchaser, a licensee must shall disclose, upon
  283  request by the prospective purchaser, an itemized listing of
  284  prices, which must listing shall include separate price
  285  estimates for each service component and each product. Provision
  286  of such itemized listing of prices may shall not be predicated
  287  on the prospective purchaser’s payment of any charge or
  288  agreement to purchase any service or product.
  289         (2) Any licensee who fits and sells a prescription hearing
  290  aid shall, at the time of delivery, provide the purchaser with a
  291  receipt containing the seller’s signature, the address of his or
  292  her regular place of business, and his or her license or
  293  certification number, if applicable, together with the brand,
  294  model, manufacturer or manufacturer’s identification code, and
  295  serial number of the prescription hearing aid furnished and the
  296  amount charged for the prescription hearing aid. The receipt
  297  must also shall specify whether the prescription hearing aid is
  298  new, used, or rebuilt, and shall specify the length of time and
  299  other terms of the guarantee, and by whom the prescription
  300  hearing aid is guaranteed. When the client has requested an
  301  itemized list of prices, the receipt must shall also provide an
  302  itemization of the total purchase price, including, but not
  303  limited to, the cost of the aid, ear mold, batteries, and other
  304  accessories, and the cost of any services. Notice of the
  305  availability of this service must be displayed in a conspicuous
  306  manner in the office. The receipt must also shall state that any
  307  complaint concerning the prescription hearing aid and its
  308  guarantee, if not reconciled with the licensee from whom the
  309  prescription hearing aid was purchased, should be directed by
  310  the purchaser to the department. The address and telephone
  311  number of such office must shall be stated on the receipt.
  312         (3) A prescription No hearing aid may not be sold to any
  313  person unless both the packaging containing the prescription
  314  hearing aid and the contract provided pursuant to subsection (2)
  315  carry the following disclaimer in 10-point or larger type: “A
  316  hearing aid will not restore normal hearing, nor will it prevent
  317  further hearing loss.”
  318         Section 22. Section 468.1246, Florida Statutes, is amended
  319  to read:
  320         468.1246 Thirty-day trial period; purchaser’s right to
  321  cancel; notice; refund; cancellation fee.—
  322         (1) A person selling a prescription hearing aid in this
  323  state must provide the buyer with written notice of a 30-day
  324  trial period and money-back guarantee. The guarantee must permit
  325  the purchaser to cancel the purchase for a valid reason as
  326  defined by rule of the board within 30 days after receiving the
  327  prescription hearing aid, by returning the prescription hearing
  328  aid or mailing written notice of cancellation to the seller. If
  329  the prescription hearing aid must be repaired, remade, or
  330  adjusted during the 30-day trial period, the running of the 30
  331  day trial period is suspended 1 day for each 24-hour period that
  332  the prescription hearing aid is not in the purchaser’s
  333  possession. A repaired, remade, or adjusted prescription hearing
  334  aid must be claimed by the purchaser within 3 working days after
  335  notification of availability. The running of the 30-day trial
  336  period resumes on the day the purchaser reclaims a repaired,
  337  remade, or adjusted prescription hearing aid or on the 4th day
  338  after notification of availability.
  339         (2) The board, in consultation with the Board of Hearing
  340  Aid Specialists, shall prescribe by rule the terms and
  341  conditions to be contained in the money-back guarantee and any
  342  exceptions thereto. Such rule must shall provide, at a minimum,
  343  that the charges for earmolds and service provided to fit the
  344  prescription hearing aid may be retained by the licensee. The
  345  rules must shall also set forth any reasonable charges to be
  346  held by the licensee as a cancellation fee. Such rule shall be
  347  effective on or before December 1, 1994. Should the board fail
  348  to adopt such rule, a licensee may not charge a cancellation fee
  349  which exceeds 5 percent of the total charge for a hearing aid
  350  alone. The terms and conditions of the guarantee, including the
  351  total amount available for refund, must shall be provided in
  352  writing to the purchaser before prior to the signing of the
  353  contract.
  354         Section 23. Section 468.1255, Florida Statutes, is amended
  355  to read:
  356         468.1255 Cancellation by medical authorization; purchaser’s
  357  right to return.—
  358         (1) In addition to any other rights and remedies the
  359  purchaser of a prescription hearing aid may have, the purchaser
  360  has shall have the right to rescind the transaction if the
  361  purchaser for whatever reason consults a licensed physician with
  362  specialty board certification in otolaryngology or internal
  363  medicine or a licensed family practice physician, subsequent to
  364  purchasing a prescription hearing aid, and the physician
  365  certifies in writing that the purchaser has a hearing impairment
  366  for which a prescription hearing aid will not provide a benefit
  367  or that the purchaser has a medical condition which
  368  contraindicates the use of a prescription hearing aid.
  369         (2) The purchaser of a prescription hearing aid has shall
  370  have the right to rescind as provided in subsection (1) only if
  371  the purchaser gives a written notice of the intent to rescind
  372  the transaction to the seller at the seller’s place of business
  373  by certified mail, return receipt requested, which notice shall
  374  be posted not later than 60 days following the date of delivery
  375  of the prescription hearing aid to the purchaser, and the
  376  purchaser returns the prescription hearing aid to the seller in
  377  the original condition less normal wear and tear.
  378         (3) If the conditions of subsections (1) and (2) are met,
  379  the seller must shall, without request, refund to the purchaser,
  380  within 10 days after of the receipt of notice to rescind, a full
  381  and complete refund of all moneys received, less 5 percent. The
  382  purchaser does not shall incur any no additional liability for
  383  rescinding the transaction.
  384         Section 24. Section 468.1265, Florida Statutes, is amended
  385  to read:
  386         468.1265 Sale or distribution of prescription hearing aids
  387  through mail; penalty.—It is unlawful for any person to sell or
  388  distribute prescription hearing aids through the mail to the
  389  ultimate consumer. Any person who violates this section commits
  390  a misdemeanor of the second degree, punishable as provided in s.
  391  775.082 or s. 775.083.
  392         Section 25. Section 468.1275, Florida Statutes, is amended
  393  to read:
  394         468.1275 Place of business; display of license.—Each
  395  licensee who fits and sells a prescription hearing aid shall
  396  declare and establish a regular place of business, at which his
  397  or her license shall be conspicuously displayed.
  398         Section 26. Section 484.0401, Florida Statutes, is amended
  399  to read:
  400         484.0401 Purpose.—The Legislature recognizes that the
  401  dispensing of prescription hearing aids requires particularized
  402  knowledge and skill to ensure that the interests of the hearing
  403  impaired public will be adequately served and safely protected.
  404  It recognizes that a poorly selected or fitted prescription
  405  hearing aid not only will give little satisfaction but may
  406  interfere with hearing ability and, therefore, deems it
  407  necessary in the interest of the public health, safety, and
  408  welfare to regulate the dispensing of prescription hearing aids
  409  in this state. Restrictions on the fitting and selling of
  410  prescription hearing aids shall be imposed only to the extent
  411  necessary to protect the public from physical and economic harm,
  412  and restrictions shall not be imposed in a manner which will
  413  unreasonably affect the competitive market.
  414         Section 27. Section 484.041, Florida Statutes, is reordered
  415  and amended to read:
  416         484.041 Definitions.—As used in this part, the term:
  417         (1) “Air-conduction hearing aid” means a hearing aid that
  418  conducts sound to the ear through the air.
  419         (2) “Board” means the Board of Hearing Aid Specialists.
  420         (3)(2) “Department” means the Department of Health.
  421         (4)(3) “Dispensing prescription hearing aids” means and
  422  includes:
  423         (a) Conducting and interpreting hearing tests for purposes
  424  of selecting suitable prescription hearing aids, making earmolds
  425  or ear impressions, and providing appropriate counseling.
  426         (b) All acts pertaining to the selling, renting, leasing,
  427  pricing, delivery, and warranty of prescription hearing aids.
  428         (7)(4) “Hearing aid specialist” means a person duly
  429  licensed in this state to practice the dispensing of
  430  prescription hearing aids.
  431         (5) “Hearing aid” means any wearable an amplifying device
  432  designed for, offered for the purpose of, or represented as
  433  aiding persons with, or compensating for, impaired hearing to be
  434  worn by a hearing-impaired person to improve hearing.
  435         (11)(6) “Trainee” means a person studying prescription
  436  hearing aid dispensing under the direct supervision of an active
  437  licensed hearing aid specialist for the purpose of qualifying
  438  for certification to sit for the licensure examination.
  439         (6)(7) “Hearing aid establishment” means any establishment
  440  in this the state which employs a licensed hearing aid
  441  specialist who offers, advertises, and performs hearing aid
  442  services for the general public.
  443         (8) “Over-the-counter hearing aid” means an air-conduction
  444  hearing aid that does not require implantation or other surgical
  445  intervention and is intended for use only by a person 18 years
  446  of age or older to compensate for perceived mild to moderate
  447  hearing impairment. The device, through tools, tests, or
  448  software, allows the user to control the hearing aid and
  449  customize it to the user’s hearing needs. The device may use
  450  wireless technology or may include tests for self-assessment of
  451  hearing loss. The device is available over-the-counter, without
  452  the supervision, prescription, or other order, involvement, or
  453  intervention of a licensed person, to consumers through in
  454  person transactions, by mail, or online, provided that the
  455  device satisfies the requirements of 21 C.F.R. parts 800, 801,
  456  and 874 (2022), which are specifically incorporated by reference
  457  herein.
  458         (9) “Prescription hearing aid” means a hearing aid or sound
  459  amplifying device that is not an over-the-counter hearing aid.
  460  Hearing aids intended for use by persons younger than 18 years
  461  of age must be prescription hearing aids.
  462         (10) “Sponsor” means an active, licensed hearing aid
  463  specialist under whose direct supervision one or more trainees
  464  are studying prescription hearing aid dispensing for the purpose
  465  of qualifying for certification to sit for the licensure
  466  examination.
  467         Section 28. Subsection (2) of section 484.042, Florida
  468  Statutes, is amended to read:
  469         484.042 Board of Hearing Aid Specialists; membership,
  470  appointment, terms.—
  471         (2) Five members of the board shall be hearing aid
  472  specialists who have been licensed and practicing the dispensing
  473  of prescription hearing aids in this state for at least the
  474  preceding 4 years. The remaining four members, none of whom
  475  shall derive economic benefit from the fitting or dispensing of
  476  hearing aids, shall be appointed from the resident lay public of
  477  this state. One of the lay members shall be a prescription
  478  hearing aid user but may not neither be nor have been a hearing
  479  aid specialist or a licensee of a closely related profession.
  480  One lay member shall be an individual age 65 or over. One lay
  481  member shall be an otolaryngologist licensed pursuant to chapter
  482  458 or chapter 459.
  483         Section 29. Subsection (2) of section 484.044, Florida
  484  Statutes, is amended to read:
  485         484.044 Authority to make rules.—
  486         (2) The board shall adopt rules requiring that each
  487  prospective purchaser of a prescription hearing aid be notified
  488  by the attending hearing aid specialist, at the time of the
  489  initial examination for fitting and sale of a hearing aid, of
  490  telecoil, “t” coil, or “t” switch technology. The rules shall
  491  further require that hearing aid specialists make available to
  492  prospective purchasers or clients information regarding
  493  telecoils, “t” coils, or “t” switches. These rules shall be
  494  effective on or before October 1, 1994.
  495         Section 30. Subsection (2) of section 484.0445, Florida
  496  Statutes, is amended to read:
  497         484.0445 Training program.—
  498         (2) A trainee shall perform the functions of a hearing aid
  499  specialist in accordance with board rules only under the direct
  500  supervision of a licensed hearing aid specialist. The term
  501  “direct supervision” means that the sponsor is responsible for
  502  all work being performed by the trainee. The sponsor or a
  503  hearing aid specialist designated by the sponsor shall give
  504  final approval to work performed by the trainee and shall be
  505  physically present at the time the prescription hearing aid is
  506  delivered to the client.
  507         Section 31. Subsection (2) of section 484.045, Florida
  508  Statutes, is amended to read:
  509         484.045 Licensure by examination.—
  510         (2) The department shall license each applicant who the
  511  board certifies meets all of the following criteria:
  512         (a) Has completed the application form and remitted the
  513  required fees.;
  514         (b) Is of good moral character.;
  515         (c) Is 18 years of age or older.;
  516         (d) Is a graduate of an accredited high school or its
  517  equivalent.;
  518         (e)1. Has met the requirements of the training program; or
  519         2.a. Has a valid, current license as a hearing aid
  520  specialist or its equivalent from another state and has been
  521  actively practicing in such capacity for at least 12 months; or
  522         b. Is currently certified by the National Board for
  523  Certification in Hearing Instrument Sciences and has been
  524  actively practicing for at least 12 months.;
  525         (f) Has passed an examination, as prescribed by board
  526  rule.; and
  527         (g) Has demonstrated, in a manner designated by rule of the
  528  board, knowledge of state laws and rules relating to the fitting
  529  and dispensing of prescription hearing aids.
  530         Section 32. Section 484.0501, Florida Statutes, is amended
  531  to read:
  532         484.0501 Minimal procedures and equipment.—
  533         (1) The following minimal procedures shall be used in the
  534  fitting and selling of prescription hearing aids:
  535         (a) Pure tone audiometric testing by air and bone to
  536  determine the type and degree of hearing deficiency.
  537         (b) Effective masking when indicated.
  538         (c) Appropriate testing to determine speech reception
  539  thresholds, speech discrimination scores, the most comfortable
  540  listening levels, uncomfortable loudness levels, and the
  541  selection of the best fitting arrangement for maximum hearing
  542  aid benefit.
  543         (2) The following equipment shall be used:
  544         (a) A wide range audiometer that which meets the
  545  specifications of the American National Standards Institute for
  546  diagnostic audiometers.
  547         (b) A speech audiometer or a master hearing aid in order to
  548  determine the most comfortable listening level and speech
  549  discrimination.
  550         (3) A final fitting ensuring physical and operational
  551  comfort of the prescription hearing aid shall be made.
  552         (4) The following medical clearance shall be obtained: If,
  553  upon inspection of the ear canal with an otoscope in the common
  554  procedure of a prescription hearing aid fitter and upon
  555  interrogation of the client, there is any recent history of
  556  infection or any observable anomaly, the client must shall be
  557  instructed to see a physician, and a prescription hearing aid
  558  may shall not be fitted until medical clearance is obtained for
  559  the condition noted. If, upon return, the condition noted is no
  560  longer observable and the client signs a medical waiver, a
  561  prescription hearing aid may be fitted. Any person with a
  562  significant difference between bone conduction hearing and air
  563  conduction hearing must be informed of the possibility of
  564  medical correction.
  565         (5)(a) A prescription hearing aid establishment office must
  566  have available, or have access to, a selection of prescription
  567  hearing aid models, hearing aid supplies, and services complete
  568  enough to accommodate the various needs of the prescription
  569  hearing aid wearers.
  570         (b) At the time of the initial examination for fitting and
  571  sale of a prescription hearing aid, the attending hearing aid
  572  specialist shall must notify the prospective purchaser or client
  573  of the benefits of telecoil, “t” coil, or “t” switch technology,
  574  including increased access to telephones and noninvasive access
  575  to assistive listening systems required under the Americans with
  576  Disabilities Act of 1990.
  577         (6) Each audiometric test conducted by a licensee or
  578  authorized trainee in the fitting and selling of prescription
  579  hearing aids must shall be made in a testing room that has been
  580  certified by the department, or by an agent approved by the
  581  department, not to exceed the following sound pressure levels at
  582  the specified frequencies: 250Hz-40dB, 500Hz-40dB, 750Hz-40dB,
  583  1000Hz-40dB, 1500Hz-42dB, 2000Hz-47dB, 3000Hz-52dB, 4000Hz-57dB,
  584  6000Hz-62dB, and 8000Hz-67dB. An exception to this requirement
  585  shall be made in the case of a client who, after being provided
  586  written notice of the benefits and advantages of having the test
  587  conducted in a certified testing room, requests that the test be
  588  conducted in a place other than the licensee’s certified testing
  589  room. Such request must shall be documented by a waiver which
  590  includes the written notice and is signed by the licensee and
  591  the client before prior to the testing. The waiver must shall be
  592  executed on a form provided by the department. The executed
  593  waiver must shall be attached to the client’s copy of the
  594  contract, and a copy of the executed waiver must shall be
  595  retained in the licensee’s file.
  596         (7) The board may shall have the power to prescribe the
  597  minimum procedures and equipment which must shall be used in the
  598  conducting of hearing assessments, and for the fitting and
  599  selling of prescription hearing aids, including equipment that
  600  will measure the prescription hearing aid’s response curves to
  601  ensure that they meet the manufacturer’s specifications. These
  602  procedures and equipment may differ from those provided in this
  603  section in order to take full advantage of devices and equipment
  604  which may hereafter become available and which are demonstrated
  605  to be of greater efficiency and accuracy. The board shall adopt
  606  and enforce rules necessary to implement carry out the
  607  provisions of this subsection and subsection (6).
  608         (8) Any duly authorized officer or employee of the
  609  department may shall have the right to make such inspections and
  610  investigations as are necessary in order to determine the state
  611  of compliance with the provisions of this section and the
  612  applicable rules and may enter the premises of a licensee and
  613  inspect the records of same upon reasonable belief that a
  614  violation of this law is being or has been committed or that the
  615  licensee has failed or is failing to comply with the provisions
  616  of this part act.
  617         (9)A licensed hearing aid specialist may fit, sell,
  618  dispense, service, market, provide customer support for, and
  619  distribute prescription and over-the-counter hearing aids.
  620  However, over-the-counter hearing aids may be provided only to
  621  persons 18 years of age or older.
  622         Section 33. Section 484.051, Florida Statutes, is amended
  623  to read:
  624         484.051 Itemization of prices; delivery of prescription
  625  hearing aid; receipt, packaging, disclaimer, guarantee.—
  626         (1) Before Prior to delivery of services or products to a
  627  prospective purchaser, any person who fits and sells
  628  prescription hearing aids must shall disclose on request by the
  629  prospective purchaser an itemized listing of prices, which must
  630  listing shall include separate price estimates for each service
  631  component and each product. Provision of such itemized listing
  632  of prices may shall not be predicated on the prospective
  633  purchaser’s payment of any charge or agreement to purchase any
  634  service or product.
  635         (2) Any person who fits and sells a prescription hearing
  636  aid must shall, at the time of delivery, provide the purchaser
  637  with a receipt containing the seller’s signature, the address of
  638  her or his regular place of business, and her or his license or
  639  trainee registration number, if applicable, together with the
  640  brand, model, manufacturer or manufacturer’s identification
  641  code, and serial number of the prescription hearing aid
  642  furnished and the amount charged for the prescription hearing
  643  aid. The receipt must also shall specify whether the
  644  prescription hearing aid is new, used, or rebuilt, and shall
  645  specify the length of time and other terms of the guarantee, and
  646  by whom the prescription hearing aid is guaranteed. If When the
  647  client has requested an itemized list of prices, the receipt
  648  must shall also provide an itemization of the total purchase
  649  price, including, but not limited to, the cost of the aid,
  650  earmold, batteries and other accessories, and any services.
  651  Notice of the availability of this service shall be displayed in
  652  a conspicuous manner in the office. The receipt must also shall
  653  state that any complaint concerning the prescription hearing aid
  654  and guarantee therefor, if not reconciled with the licensee from
  655  whom the prescription hearing aid was purchased, should be
  656  directed by the purchaser to the Department of Health. The
  657  address and telephone number of such office must shall be stated
  658  on the receipt.
  659         (3) A prescription No hearing aid may not be sold to any
  660  person unless both the packaging containing the prescription
  661  hearing aid and the itemized receipt provided pursuant to
  662  subsection (2) carry the following disclaimer in 10-point or
  663  larger type: “A hearing aid will not restore normal hearing, nor
  664  will it prevent further hearing loss.”
  665         Section 34. Section 484.0512, Florida Statutes, is amended
  666  to read:
  667         484.0512 Thirty-day trial period; purchaser’s right to
  668  cancel; notice; refund; cancellation fee; criminal penalty.—
  669         (1) A person selling a prescription hearing aid in this
  670  state must provide the buyer with written notice of a 30-day
  671  trial period and money-back guarantee. The guarantee must permit
  672  the purchaser to cancel the purchase for a valid reason, as
  673  defined by rule of the board rule, within 30 days after
  674  receiving the prescription hearing aid, by returning the
  675  prescription hearing aid or mailing written notice of
  676  cancellation to the seller. If the prescription hearing aid must
  677  be repaired, remade, or adjusted during the 30-day trial period,
  678  the running of the 30-day trial period is suspended 1 day for
  679  each 24-hour period that the prescription hearing aid is not in
  680  the purchaser’s possession. A repaired, remade, or adjusted
  681  prescription hearing aid must be claimed by the purchaser within
  682  3 working days after notification of availability. The running
  683  of the 30-day trial period resumes on the day the purchaser
  684  reclaims the repaired, remade, or adjusted prescription hearing
  685  aid or on the fourth day after notification of availability,
  686  whichever occurs earlier.
  687         (2) The board, in consultation with the Board of Speech
  688  Language Pathology and Audiology, shall prescribe by rule the
  689  terms and conditions to be contained in the money-back guarantee
  690  and any exceptions thereto. Such rules must rule shall provide,
  691  at a minimum, that the charges for earmolds and service provided
  692  to fit the prescription hearing aid may be retained by the
  693  licensee. The rules must shall also set forth any reasonable
  694  charges to be held by the licensee as a cancellation fee. Such
  695  rule shall be effective on or before December 1, 1994. Should
  696  the board fail to adopt such rule, a licensee may not charge a
  697  cancellation fee which exceeds 5 percent of the total charge for
  698  a hearing aid alone. The terms and conditions of the guarantee,
  699  including the total amount available for refund, must shall be
  700  provided in writing to the purchaser before prior to the signing
  701  of the contract.
  702         (3) Within 30 days after the return or attempted return of
  703  the prescription hearing aid, the seller shall refund all moneys
  704  that must be refunded to a purchaser pursuant to this section. A
  705  violation of this subsection is a misdemeanor of the first
  706  degree, punishable as provided in s. 775.082 or s. 775.083.
  707         (4) For purposes of this section, the term “seller” or
  708  “person selling a prescription hearing aid” includes:
  709         (a) Any natural person licensed under this part or any
  710  other natural person who signs a sales receipt required by s.
  711  484.051(2) or s. 468.1245(2) or who otherwise fits, delivers, or
  712  dispenses a prescription hearing aid.
  713         (b) Any business organization, whether a sole
  714  proprietorship, partnership, corporation, professional
  715  association, joint venture, business trust, or other legal
  716  entity, that which dispenses a prescription hearing aid or
  717  enters into an agreement to dispense a prescription hearing aid.
  718         (c) Any person who controls, manages, or operates an
  719  establishment or business that dispenses a prescription hearing
  720  aid or enters into an agreement to dispense a prescription
  721  hearing aid.
  722         Section 35. Section 484.0513, Florida Statutes, is amended
  723  to read:
  724         484.0513 Cancellation by medical authorization; purchaser’s
  725  right to return.—
  726         (1) In addition to any other rights and remedies the
  727  purchaser of a prescription hearing aid may have, the purchaser
  728  has shall have the right to rescind the transaction if the
  729  purchaser for whatever reason consults a licensed physician with
  730  specialty board certification in otolaryngology or internal
  731  medicine or a licensed family practice physician, subsequent to
  732  purchasing a prescription hearing aid, and the physician
  733  certifies in writing that the purchaser has a hearing impairment
  734  for which a prescription hearing aid will not provide a benefit
  735  or that the purchaser has a medical condition which
  736  contraindicates the use of a prescription hearing aid.
  737         (2) The purchaser of a prescription hearing aid has shall
  738  have the right to rescind as provided in subsection (1) only if
  739  the purchaser gives a written notice of the intent to rescind
  740  the transaction to the seller at the seller’s place of business
  741  by certified mail, return receipt requested, which must notice
  742  shall be posted within not later than 60 days after following
  743  the date of delivery of the prescription hearing aid to the
  744  purchaser, and the purchaser returns the prescription hearing
  745  aid to the seller in the original condition less normal wear and
  746  tear.
  747         (3) If the conditions of subsections (1) and (2) are met,
  748  the seller must shall, without request, refund to the purchaser,
  749  within 10 days after of the receipt of the notice to rescind, a
  750  full and complete refund of all moneys received, less 5 percent.
  751  The purchaser does not shall incur any no additional liability
  752  for rescinding the transaction.
  753         Section 36. Section 484.053, Florida Statutes, is amended
  754  to read:
  755         484.053 Prohibitions; penalties.—
  756         (1) A person may not:
  757         (a) Practice dispensing prescription hearing aids unless
  758  the person is a licensed hearing aid specialist;
  759         (b) Use the name or title “hearing aid specialist” when the
  760  person has not been licensed under this part;
  761         (c) Present as her or his own the license of another;
  762         (d) Give false, incomplete, or forged evidence to the board
  763  or a member thereof for the purposes of obtaining a license;
  764         (e) Use or attempt to use a hearing aid specialist license
  765  that is delinquent or has been suspended, revoked, or placed on
  766  inactive status;
  767         (f) Knowingly employ unlicensed persons in the practice of
  768  dispensing prescription hearing aids; or
  769         (g) Knowingly conceal information relative to violations of
  770  this part.
  771         (2) Any person who violates any provision of the provisions
  772  of this section is guilty of a felony of the third degree,
  773  punishable as provided in s. 775.082 or s. 775.083.
  774         (3) If a person licensed under this part allows the sale of
  775  a prescription hearing aid by an unlicensed person not
  776  registered as a trainee or fails to comply with the requirements
  777  of s. 484.0445(2) relating to supervision of trainees, the board
  778  must shall, upon determination of that violation, order the full
  779  refund of moneys paid by the purchaser upon return of the
  780  prescription hearing aid to the seller’s place of business.
  781         Section 37. Section 484.054, Florida Statutes, is amended
  782  to read:
  783         484.054 Sale or distribution of prescription hearing aids
  784  through mail; penalty.—It is unlawful for any person to sell or
  785  distribute prescription hearing aids through the mail to the
  786  ultimate consumer. Any violation of this section constitutes a
  787  misdemeanor of the second degree, punishable as provided in s.
  788  775.082 or s. 775.083.
  789         Section 38. Section 484.059, Florida Statutes, is amended
  790  to read:
  791         484.059 Exemptions.—
  792         (1) The licensure requirements of this part do not apply to
  793  any person engaged in recommending prescription hearing aids as
  794  part of the academic curriculum of an accredited institution of
  795  higher education, or as part of a program conducted by a public
  796  charitable institution supported primarily by voluntary
  797  contribution, provided this organization does not dispense or
  798  sell prescription hearing aids or accessories.
  799         (2) The licensure requirements of this part do not apply to
  800  any person licensed to practice medicine in this the state,
  801  except that such physician must shall comply with the
  802  requirement of periodic filing of the certificate of testing and
  803  calibration of audiometric equipment as provided in this part. A
  804  No person employed by or working under the supervision of a
  805  person licensed to practice medicine may not shall perform any
  806  services or acts which would constitute the dispensing of
  807  prescription hearing aids as defined in s. 484.041 s.
  808  484.041(3), unless such person is a licensed hearing aid
  809  specialist.
  810         (3) The licensure requirements of this part do not apply to
  811  an audiologist licensed under pursuant to part I of chapter 468.
  812         (4) Section The provisions of s. 484.053(1)(a) does shall
  813  not apply to registered trainees operating in compliance with
  814  this part and board rules of the board.
  815         (5)The licensure requirements of this part do not apply to
  816  a person who fits, sells, dispenses, services, markets, provides
  817  customer support for, or distributes exclusively over-the
  818  counter hearing aids.
  819         Section 39. Paragraph (b) of subsection (4) of section
  820  1002.394, Florida Statutes, is amended to read:
  821         1002.394 The Family Empowerment Scholarship Program.—
  822         (4) AUTHORIZED USES OF PROGRAM FUNDS.—
  823         (b) Program funds awarded to a student with a disability
  824  determined eligible pursuant to paragraph (3)(b) may be used for
  825  the following purposes:
  826         1. Instructional materials, including digital devices,
  827  digital periphery devices, and assistive technology devices that
  828  allow a student to access instruction or instructional content
  829  and training on the use of and maintenance agreements for these
  830  devices.
  831         2. Curriculum as defined in subsection (2).
  832         3. Specialized services by approved providers or by a
  833  hospital in this state which are selected by the parent. These
  834  specialized services may include, but are not limited to:
  835         a. Applied behavior analysis services as provided in ss.
  836  627.6686 and 641.31098.
  837         b. Services provided by speech-language pathologists as
  838  defined in s. 468.1125 s. 468.1125(8).
  839         c. Occupational therapy as defined in s. 468.203.
  840         d. Services provided by physical therapists as defined in
  841  s. 486.021(8).
  842         e. Services provided by listening and spoken language
  843  specialists and an appropriate acoustical environment for a
  844  child who has a hearing impairment, including deafness, and who
  845  has received an implant or assistive hearing device.
  846         4. Tuition or fees associated with full-time or part-time
  847  enrollment in a home education program, an eligible private
  848  school, an eligible postsecondary educational institution or a
  849  program offered by the postsecondary educational institution, a
  850  private tutoring program authorized under s. 1002.43, a virtual
  851  program offered by a department-approved private online provider
  852  that meets the provider qualifications specified in s.
  853  1002.45(2)(a), the Florida Virtual School as a private paying
  854  student, or an approved online course offered pursuant to s.
  855  1003.499 or s. 1004.0961.
  856         5. Fees for nationally standardized, norm-referenced
  857  achievement tests, Advanced Placement Examinations, industry
  858  certification examinations, assessments related to postsecondary
  859  education, or other assessments.
  860         6. Contributions to the Stanley G. Tate Florida Prepaid
  861  College Program pursuant to s. 1009.98 or the Florida College
  862  Savings Program pursuant to s. 1009.981 for the benefit of the
  863  eligible student.
  864         7. Contracted services provided by a public school or
  865  school district, including classes. A student who receives
  866  services under a contract under this paragraph is not considered
  867  enrolled in a public school for eligibility purposes as
  868  specified in subsection (6).
  869         8. Tuition and fees for part-time tutoring services
  870  provided by a person who holds a valid Florida educator’s
  871  certificate pursuant to s. 1012.56, a person who holds an
  872  adjunct teaching certificate pursuant to s. 1012.57, a person
  873  who has a bachelor’s degree or a graduate degree in the subject
  874  area in which instruction is given, a person who has
  875  demonstrated a mastery of subject area knowledge pursuant to s.
  876  1012.56(5), or a person certified by a nationally or
  877  internationally recognized research-based training program as
  878  approved by the department. As used in this paragraph, the term
  879  “part-time tutoring services” does not qualify as regular school
  880  attendance as defined in s. 1003.01(13)(e).
  881         9. Fees for specialized summer education programs.
  882         10. Fees for specialized after-school education programs.
  883         11. Transition services provided by job coaches.
  884         12. Fees for an annual evaluation of educational progress
  885  by a state-certified teacher under s. 1002.41(1)(f), if this
  886  option is chosen for a home education student.
  887         13. Tuition and fees associated with programs offered by
  888  Voluntary Prekindergarten Education Program providers approved
  889  pursuant to s. 1002.55 and school readiness providers approved
  890  pursuant to s. 1002.88.
  891         14. Fees for services provided at a center that is a member
  892  of the Professional Association of Therapeutic Horsemanship
  893  International.
  894         15. Fees for services provided by a therapist who is
  895  certified by the Certification Board for Music Therapists or
  896  credentialed by the Art Therapy Credentials Board, Inc.
  897  
  898  ================= T I T L E  A M E N D M E N T ================
  899  And the title is amended as follows:
  900         Delete lines 72 - 96
  901  and insert:
  902         examination; amending s. 468.1115, F.S.; providing
  903         construction and applicability; conforming a cross
  904         reference; reordering and amending s. 468.1125, F.S.;
  905         providing and revising definitions; amending ss.
  906         468.1225 and 468.1245, F.S.; revising the scope of
  907         practice for audiologists, as it relates to hearing
  908         aids to apply to prescription hearing aids only;
  909         requiring that hearing aids provided to persons
  910         younger than 18 years of age be prescription hearing
  911         aids and not over-the-counter hearing aids; amending
  912         s. 468.1246, F.S.; conforming provisions to changes
  913         made by the act; deleting obsolete language; amending
  914         ss. 468.1255, 468.1265, and 468.1275, F.S.; conforming
  915         provisions to changes made by the act; amending s.
  916         484.0401, F.S.; revising legislative findings and
  917         intent to conform to changes made by the act;
  918         reordering and amending s. 484.041, F.S.; providing
  919         and revising definitions; amending s. 484.042, F.S.;
  920         revising membership requirements for members of the
  921         Board of Hearing Aid Specialists; amending s. 484.044,
  922         F.S.; revising the board’s rulemaking authority;
  923         deleting obsolete language; amending ss. 484.0445,
  924         484.045, 484.0501, and 484.051, F.S.; revising the
  925         scope of practice for hearing aid specialists and
  926         making conforming changes to licensure and practice
  927         requirements; amending s. 484.0512, F.S.; conforming
  928         provisions to changes made by the act; deleting
  929         obsolete language; amending ss. 484.0513, 484.053, and
  930         484.054, F.S.; conforming provisions to changes made
  931         by the act; amending s. 484.059, F.S.; conforming
  932         provisions to changes made by the act; providing
  933         applicability; amending s. 1002.394, F.S.; conforming
  934         a cross-reference; providing a