WSR 03-15-106

PROPOSED RULES

DEPARTMENT OF HEALTH


[ Filed July 21, 2003, 11:26 a.m. ]

     Original Notice.

     Exempt from preproposal statement of inquiry under RCW 34.05.310(4).

     Title of Rule: Chapter 246-828 WAC, Hearing and speech.

     Purpose: Housekeeping amendments are necessary to implement 2002 legislation creating mandatory licensure for audiologists and speech-language pathologists and the elimination of the permit and apprenticeship requirement for hearing instrument fitter/dispensers.

     Other Identifying Information: This proposal is the result of chapter 310, Laws of 2002 which passed during the 2002 legislative session.

     Statutory Authority for Adoption: RCW 18.35.161.

     Statute Being Implemented: Chapter 18.35 RCW.

     Summary: The proposed amendments will change references from certificate to license for audiologists and speech language pathologists, the word hearing "aid" to "instrument," references to the "Board on fitting and dispensing of hearing aids" to the "Board of Hearing and Speech," removes duplicate listing of fees, and repeals rules specifically relating to the eliminated apprenticeship requirement.

     Reasons Supporting Proposal: Changes are needed to implement new legislative requirements.

     Name of Agency Personnel Responsible for Drafting and Implementation: Diane Young, 310 Israel Road S.E., P.O. Box 47869, Olympia, WA 98504-7869, (360) 236-4950; and Enforcement: Katherine Slater, 310 Israel Road S.E., P.O. Box 47869, Olympia, WA 98504-7869, (360) 236-4950.

     Name of Proponent: Board of Hearing and Speech, governmental.

     Rule is not necessitated by federal law, federal or state court decision.

     Explanation of Rule, its Purpose, and Anticipated Effects: The proposed amendments will change references to "certification" to "licensure," eliminate references to the hearing instrument fitter/dispenser permit and apprenticeship requirement. These changes are intended to bring the rules into compliance with the statute and to provide clarification regarding the credentialing requirements for audiologists, speech-language pathologists and hearing instrument fitter/dispensers.

     Proposal Changes the Following Existing Rules: WAC 246-828-045, 246-828-095 and 246-828-105, replaces the word "certified" with the word "licensed"; WAC 246-828-075, replaces the words "certified and certificate holder" with the words "licensed and licensee"; WAC 246-828-090, replaces the words "certificate holder" with the word "licensee"; WAC 246-828-100, adds "or audiologist" to the section requiring the licensee to afford the prospective hearing instrument user the opportunity to sign a statement regarding that they have been advised that their best health interest would be served if they had a medical evaluation before purchasing hearing instruments; WAC 246-828-220 and 246-828-500, replaces the word "aid" with the word "instrument"; WAC 246-828-270, replaces the words "certificate holder and certificate" with the words "licensee and license"; WAC 246-828-290, 246-828-320, 246-828-330 and 246-828-350, replaces the word "certificate holder" with the word "licensee"; WAC 246-828-550, replaces the words "on fitting and dispensing of hearing aids" with "of hearing and speech"; and WAC 246-828-990, removes duplicate listing of fees.

     No small business economic impact statement has been prepared under chapter 19.85 RCW. RCW 19.85.025(3) indicates that a small business economic impact statement is not necessary for rules identified under RCW 34.05.310(4). Specifically, these rules adopt or incorporate by reference, without material change, Washington state statutes, and only correct typographical errors, make address or name changes, or clarify language of a rule without changing its effect.

     RCW 34.05.328 does not apply to this rule adoption. The proposed amendments are not significant and are exempt under RCW 34.05 328 (5)(b)(v). The content of the rule is explicitly and specifically dictated by statute.

     Hearing Location: 310 Israel Road S.E., Room 139, Tumwater, WA 98501, on October 3, 2003, at 9:00 a.m.

     Assistance for Persons with Disabilities: Ericka Brown by September 15, 2003, TDD (800) 833-6388 or (360) 236-4925.

     Submit Written Comments to: Diane Young, Board of Hearing and Speech, 310 Israel Road S.E., P.O. Box 47869, Olympia, WA 98504-7869, fax (360) 236-2406, by September 15, 2003.

     Date of Intended Adoption: October 3, 2003.

July 10, 2003

Robert Nicoloff

Executive Director

OTS-6226.2


AMENDATORY SECTION(Amending WSR 99-08-102, filed 4/6/99, effective 5/7/99)

WAC 246-828-045   Interim permit.   Interim permit requirements.

     (1) The department will issue an interim permit to any applicant who has shown to the satisfaction of the department that the applicant:

     (a) Is supervised by a speech-language pathologist or audiologist ((certified)) licensed under chapter 18.35 RCW, in good standing for at least two years unless otherwise approved by the board.

     (((i) Supervision includes the personal and direct involvement of the supervisor. The supervisor must directly observe diagnostic and therapeutic procedures.

     (ii) All purchase agreements for the sale of hearing instruments must be signed by the supervisor and the permit holder.

     (iii) No certified audiologist or speech-language pathologist under chapter 18.35 RCW may assume the responsibility for more than one permit holder.

     (iv) The supervisor is responsible for all acts of the interim permit holder in connection with audiology or speech-language pathology services during the duration of the permit.))

     (b) Has paid the application and permit fee.

     (c) Has not committed unprofessional conduct as specified by the Uniform Disciplinary Act or chapter 18.35 RCW.

     (2) The provisions of RCW 18.35.030, 18.35.110, 18.35.120 ((shall)) apply to ((any person issued an interim)) permit holders. A person issued an audiology interim permit may engage in the fitting and dispensing of hearing instruments.

     (3) The interim permit shall contain the name and title of the ((certified)) supervisor licensed under chapter 18.35 RCW ((who is supervising the permit holder. The supervisor shall execute and submit to the department acknowledgment of responsibility for all acts of the permit holder in connection with audiology or speech-language pathology services)).

     Interim permit period.

     (4) The interim permit period is divided into three equal segments. The supervisor must complete a minimum of:

     (a) ((No less than)) At least thirty-six supervisory activities spaced uniformly throughout the year.

     (b) At least eighteen on-site observations (one hour equals one on-site observation). At least six on-site observations must be accrued during each segment (up to six hours may be accrued in one day).

     (c) Eighteen other monitoring activities, at least six per segment.

     (d) Upon the completion of each segment the supervisor must submit documentation of completion to the department on a form provided by the department.

     (e) A review of all purchase agreements in the fitting and dispensing of hearing instruments prior to signing. All purchase agreements ((will)) must be signed by the supervisor.

     (5) The interim permit is valid for one year or for the duration of the postgraduate experience. The interim permit ((will)) expires one year from the date ((of its issuance)) it is issued. The board may extend the permit an additional six months.

     Supervisor delegation.

     (6) Portions of the supervisory activities including the supervision in hearing instrument fitting and dispensing may be obtained in another facility and may be under the supervision of another ((certified)) licensed speech-language pathologist or audiologist as delegated by the supervisor of record.

     (a) The audiologist supervisor of record may delegate the supervision of hearing instrument fitting and dispensing to a licensed hearing instrument fitter/dispenser who has been licensed in good standing for at least two years.

     (b) Delegation of the responsibility of supervision must be approved by the department.

     (7) The department may approve transfer of a permit holder to another eligible supervisor upon the written request of either the supervisor or the permit holder.

     (8) ((It is the responsibility of)) The permit holder ((to)) must immediately report the termination of the supervisor to the department in writing, by certified mail.

     (9) The supervisor of a permit holder who desires to terminate the responsibility as supervisor must immediately notify the department in writing, by certified mail, of the termination. The supervisor is responsible for the permit holder until ((such time as)) the notification of termination to the department is deposited in the United States mail.

[Statutory Authority: RCW 18.35.161(3) and 18.35.060(6). 99-08-102, § 246-828-045, filed 4/6/99, effective 5/7/99.]


AMENDATORY SECTION(Amending WSR 98-06-079, filed 3/3/98, effective 4/3/98)

WAC 246-828-075   Student supervisors -- Scope and definitions.   (((1))) Students enrolled in an accredited education or training program may perform the duties of a hearing instrument fitter/dispenser in the course of their training if under the supervision of a Washington state licensed hearing instrument fitter/dispenser or ((certified)) audiologist.

     (1) Supervision ((shall)) means ((that)) the licensee((/certificate holder)) is physically present on the premises at all times.

     (a) Supervision includes the personal and direct involvement of the supervisor. The supervisor must:

     (i) Directly observe diagnostic and therapeutic procedures; and

     (ii) Cosign all purchase agreements for the sale of hearing instruments.

     (b) A licensed audiologist or speech-language pathologist under chapter 18.35 RCW may not assume the responsibility for more than one permit holder.

     (c) The supervisor is responsible for all acts of the permit holder in connection with audiology or speech-language pathology services through the duration of the permit. The supervisor shall execute and submit to the department acknowledgment of responsibility for all acts of the permit holder in connection with audiology or speech-language pathology services.

     (2) An accredited education or training program ((shall be defined as)) means any course of study in the field of fitting and dispensing hearing instruments that is offered by a school or program recognized by the state of Washington.

     (3) The student shall at all times wear an identification badge readily visible to the public ((which)) that identifies him or her as a student.

     (((4) The licensed/certified supervisor shall be responsible for all acts of the student.))

[Statutory Authority: RCW 18.35.161. 98-06-079, § 246-828-075, filed 3/3/98, effective 4/3/98. Statutory Authority: RCW 18.35.161 (1) and (3). 95-19-017 § 246-828-075, filed 9/7/95, effective 10/8/95.]


AMENDATORY SECTION(Amending WSR 98-06-079, filed 3/3/98, effective 4/3/98)

WAC 246-828-090   Standards for equipment calibration.   (1) All electronic equipment utilized by licensees((/certificate holders)) for the determination of audiometric thresholds for pure tones and for speech shall conform to all current standards of the American National Standards Institute. Licensees((/certificate holders)) shall insure that all such audiometric equipment has been evaluated electrically and acoustically at least once each year, adjusted or repaired if necessary, and that conformity with such standards was determined at that time. Licensees must maintain calibration records ((of such calibration shall be)) permanently ((maintained by licensees/certificate holders)) and licensees shall ((be)) make the records available for inspection by the department at any time ((by the department)). No licensee((/certificate holder shall be permitted to)) may certify ((as to)) the calibration of his or her own equipment unless authorized to do so by the department. In addition, all licensees((/certificate holders shall utilize)) must use routine procedures for the daily inspection of audiometric equipment, or prior to use if used less often than on a daily basis, to generally determine that it is in normal working order.

     (2) Hearing instruments, assistive listening devices, and electronic equipment used for assessment and/or monitoring of auditory and vestibular function ((shall)) must be maintained according to manufacturer's specifications.

     (3) All instrumental technology used to diagnose and/or treat disorders of communication, swallowing and hearing shall be maintained in proper working order and be properly calibrated according to accepted standards.

[Statutory Authority: RCW 18.35.161. 98-06-079, § 246-828-090, filed 3/3/98, effective 4/3/98. Statutory Authority: RCW 18.35.161 (1) and (3). 95-19-017 § 246-828-090, filed 9/7/95, effective 10/8/95. Statutory Authority: RCW 18.35.161. 91-11-031 (Order 165B), recodified as § 246-828-090, filed 5/8/91, effective 6/8/91; 84-08-062 (Order PL 463), § 308-50-120, filed 4/4/84; Order PL 159, § 308-50-120, filed 2/8/74.]


AMENDATORY SECTION(Amending WSR 98-14-055, filed 6/26/98, effective 7/27/98)

WAC 246-828-095   Audiology minimum standards of practice.   ((Certified)) Licensed audiologists are independent practitioners who provide a comprehensive array of services related to the identification, assessment, habitation/rehabilitation and prevention of auditory and vestibular impairments.

     Audiologists serve in a number of roles including but not limited to clinician, therapist, teacher, consultant, researcher, and administrator. Audiologists provide services in hospitals, clinics, schools, nursing facilities, care centers, private practice and other settings in which audiological services are relevant. Audiologists provide services to individuals of all ages.

     Audiologists must engage in and supervise only those aspects of the profession that are within the scope of their education, training and experience.

     Standard procedures for providing audiology services may include one or more of the following:

     (1) Case history ((to include)) including:

     (a) Documentation of referrals.

     (b) Historical review of the nature, onset, progression and stability of the hearing problem, and associated otic and/or vestibular symptoms.

     (c) Review of communication difficulties.

     (d) Review of medical, pharmacology, vocational, social and family history pertinent to the etiology, assessment and management of the underlying hearing disorder.

     (2) Physical examination of the external ear ((includes)) including:

     (a) Otoscopic examination of the external auditory canal to detect:

     (i) Congenital or traumatic abnormalities of the external canal or tympanic membrane.

     (ii) Inflammation or irritation of the external canal or tympanic membrane.

     (iii) Perforation of the tympanic membrane and/or discharge from the external canal.

     (iv) A foreign body or impacted cerumen in the external canal.

     (b) Cerumen management to clean the external canal and to remove excess cerumen for the preservation of hearing.

     (c) Referral for otologic evaluation and/or treatment when ((indicated)) necessary.

     (3) Identification of audiometry:

     (a) Hearing screening administered as needed, requested, or mandated for those persons who may be identified as at risk for hearing impairment.

     (b) Referral of persons who fail the screening for rescreening, audiologic assessment and/or for medical or other examination and services.

     (c) Audiologists may perform speech and language screening measures for initial identification and referral.

     (4) Assessment of auditory function ((includes)) including:

     (a) The administration of behavioral and/or objective measures of the peripheral and central auditory system to determine the presence, degree and nature of hearing loss or central auditory impairment, the effect of the hearing impairment on communication, and/or the site of the lesion within the auditory system. Assessment may also include procedures to detect and quantify nonorganic hearing loss.

     (i) When traditional audiometric techniques cannot be employed as in infants, children or multiple impaired clients, developmentally appropriate behavioral and/or objective measures may be employed.

     (ii) Assessment and intervention of central auditory processing disorders in which there is evidence of communication disorders may be provided in collaboration with other professionals.

     (b) Interpretation of measurement recommendations for habilitative/rehabilitative management and/or referral for further evaluation and the counseling of the client and family.

     (5) Assessment of vestibular function ((includes)) including administration and interpretation of behavioral and objective measures of equilibrium to detect pathology within the vestibular system, to determine the site of lesion, to monitor changes in balance and to determine the contribution of visual, vestibular and proprioceptive systems to balance.

     (6) Habilitation/rehabilitation of auditory and vestibular disorders ((may include)) including:

     (a) Aural rehabilitation therapy.

     (b) Fitting and dispensing of hearing instruments and assistive listening devices.

     (c) Habilitative and rehabilitative nonmedical management of disorders of equilibrium.

     (7) Industrial and community hearing conservation programs.

     (8) Intraoperative neurophysiologic monitoring.

     (9) Standardized and nonstandardized procedures may be employed for assessment, habilitation/rehabilitation of auditory and vestibular disorders. When standardized procedures are employed they must be conducted according to the standardized procedure or exception documented. Nonstandardized measures must be conducted according to established principles and procedures of the profession.

[Statutory Authority: RCW 18.35.161 (3) and (10). 98-14-055, § 246-828-095, filed 6/26/98, effective 7/27/98.]


AMENDATORY SECTION(Amending WSR 98-06-079, filed 3/3/98, effective 4/3/98)

WAC 246-828-100   Hearing instrument fitting dispensing -- Minimal standards of practice.   Minimum procedures in the fitting and dispensing of hearing instruments ((shall)) include:

     (1) ((Obtain)) Obtaining case history ((to include the following)) including:

     (a) As required by WAC 246-828-280, documentation of referrals, or as otherwise required by this chapter.

     (b) Historical evaluation ((to include)) including inquiry regarding hearing loss, onset of loss, and any associated symptoms including significant noise in the ears, vertigo, acute or chronic dizziness, nausea, earaches, or other such discomfort which may indicate the presence of medical illness. Specific inquiry should be made to determine if hearing loss has been sudden or rapidly progressive in the past ninety days, if there has been any active drainage or infection in ears during the past ninety days, and if there are any specific physical problems ((which)) that may relate to the use of a hearing instrument.

     (2) ((Examination of)) Examining the ears ((should be done)) to reasonably determine if any of the following conditions exist:

     (a) Impacted ear wax.

     (b) Foreign body within the ear canal.

     (c) Discharge in the ear canal.

     (d) Presence of inflammation or irritation of the ear canal.

     (e) Perforation of the ear drum.

     (f) Any other abnormality.

     (3) Hearing testing ((shall be performed)) to include the following:

     (a) Hearing loss, or residual hearing, shall be established for each ear using pure tone threshold audiometry by air and bone conduction with effective masking as required.

     (b) Appropriate live voice or recorded speech audiometry by ear phones to determine the following: Speech reception threshold, most comfortable level, uncomfortable level, and the speech discrimination percent.

     (c) Hearing testing shall be conducted in the appropriate environment as required by WAC 246-828-080, minimum standards of equipment, or as otherwise required by this chapter.

     (d) When pure tone audiometry indicates an air-bone gap of 15db or more, 500, 1000, and 2000 Hz, the presence of unilateral hearing loss, or any inconsistent audiometric findings, the client shall be advised of the potential help available through medical treatment. ((Should)) If the client declines ((to consider such methods, or if the client has previously)) medical treatment, has been appropriately treated previously, or has been advised against ((such procedures,)) medical treatment, the licensee shall make an appropriate notation ((shall be made)) in the client's record.

     (e) In the event a client is referred to a licensee by an M.A. audiologist, otologist, otolaryngologist, or by a fitter/dispenser duly licensed under chapter 18.35 RCW, and the audiometric results obtained within the previous six months are provided to the licensee as a part of this referral, the applicable provisions of WAC 246-828-100 shall not be required. However, a confirmatory audiometric examination is recommended.

     (4) Medical evaluation requirements:

     (a) If the prospective hearing instrument user is eighteen years of age or older, the hearing instrument dispenser may afford the prospective user an opportunity to waive the medical evaluation requirements of (b) of this subsection ((provided that)) if the hearing instrument dispenser:

     (i) Informs the prospective user that the exercise of the waiver is not in the user's best health interest;

     (ii) Does not in any way actively encourage the prospective user to waive ((such a)) the medical evaluation;

     (iii) ((Affords)) Offers the prospective user the opportunity to sign the following statement:

     I have been advised by (hearing instrument fitter/dispenser or audiologist name) that the Food and Drug Administration has determined that my best health interest would be served if I had a medical evaluation before purchasing a hearing instrument; and

     (iv) Provides the prospective user with a copy of the signed waiver statement.

     (b) Except as provided in (a) of this subsection, a hearing instrument dispenser shall not sell a hearing instrument unless the prospective user has presented to the hearing instrument dispenser a written statement signed by a licensed physician that states that the patient's hearing loss has been medically evaluated and the patient may be considered a candidate for a hearing instrument. The medical evaluation must have taken place within the preceding six months.

     (5) Selection and fitting of the hearing instrument ((shall include the following)) includes providing the client:

     (a) ((Provide)) Information regarding the selection of the most appropriate method and model for amplification for the needs of the client.

     (b) ((Provide the user with)) The cost of the recommended instruments and services.

     (c) ((Provide for or have available)) An appropriate custom made ear mold.

     (d) ((Provide)) Final fitting of the hearing instrument to ensure physical and operational comfort.

     (e) ((Provide)) Adequate instructions and appropriate post-fitting adjustments to ensure the most successful use of the hearing instrument.

     (6) Keeping records on every client to whom the licensee/certificate holder renders service in connection with the dispensing of a hearing instrument. ((Such)) These records ((shall)) must be preserved for at least three years after the dispensing of the first hearing instrument to the client. If other hearing instruments are subsequently dispensed to that client, cumulative records must be maintained for at least three years after the ((latest)) most recent dispensing of an instrument to that client. The records must be available for the department inspection and ((will)) must include:

     (a) Client's case history.

     (b) Source of referral and appropriate documents.

     (c) Medical clearance for the hearing instrument user or the waiver set forth in subsection (4)(a)(iii) of this section which has been signed after being fully informed that it is in the best health interest to seek medical evaluation.

     (d) Copies of any contracts and receipts executed in connection with the fitting and dispensing of each hearing instrument provided.

     (e) A complete record of tests, test results, and services provided except for minor services.

     (f) All correspondence specifically related to the service given the client or the hearing instrument or instruments dispensed to the client.

[Statutory Authority: RCW 18.35.161. 98-06-079, § 246-828-100, filed 3/3/98, effective 4/3/98. Statutory Authority: RCW 18.35.161 (1) and (3). 95-19-017 § 246-828-100, filed 9/7/95, effective 10/8/95. Statutory Authority: RCW 18.35.161. 91-11-031 (Order 165B), recodified as § 246-828-100, filed 5/8/91, effective 6/8/91; 89-04-017 (Order PM 818), § 308-50-130, filed 1/23/89; 84-19-018 (Order PL 478), § 308-50-130, filed 9/12/84; Order PL 159, § 308-50-130, filed 2/8/74.]


AMENDATORY SECTION(Amending WSR 99-19-058, filed 9/15/99, effective 10/16/99)

WAC 246-828-105   Speech-language pathology -- Minimum standards of practice.   ((Certified)) Licensed speech-language pathologists are independent practitioners who provide a comprehensive array of services related to the identification, assessment, habilitation/rehabilitation, of communication disorders and dysphagia. Speech-language pathologists serve in a number of roles including but not limited to clinician, therapist, teacher, consultant, researcher, and administrator. Speech-language pathologists provide services in hospitals, clinics, schools, nursing facilities, care centers, private practice, and other settings in which speech-language pathology services are relevant. Speech-language pathologists provide services to individuals of all ages.

     Services must be provided and products dispensed only when benefit can reasonably be expected. All services provided and products dispensed must be evaluated for effectiveness. A certified speech-language pathologist must engage in and supervise only those aspects of the profession that are within the scope of their education, training, and experience. Speech-language pathologists must provide services appropriate to each individual in his or her care, which may include one or more of the following standard procedures:

     (1) Case history, ((to include the following)) including:

     (a) Documentation of referral.

     (b) Review of the communication, cognitive and/or swallowing problem.

     (c) Review of pertinent medical, pharmacological, social and educational status.

     (2) Examination of the oral mechanism for the purposes of determining adequacy for speech communication and swallowing.

     (3) Screening to include: Speech and language.

     (a) Hearing screening, limited to pure-tone air conduction and screening tympanometry.

     (b) Swallowing screening. Children under the age of three years who are considered at risk are assessed, not screened;

     (4) Assessment may include the following:

     (a) Language may include parameters of phonology, morphology, syntax, semantics, and pragmatics; and include receptive and expressive communication in oral, written, graphic and manual modalities;

     (b) Speech may include articulation, fluency, and voice (including respiration, phonation and resonance). Treatment shall address appropriate areas;

     (c) Swallowing;

     (d) Cognitive aspects of communication may include communication disability and other functional disabilities associated with cognitive impairment;

     (e) Central auditory processing disorders in collaboration with other qualified professionals;

     (f) Social aspects of communication may include challenging behaviors, ineffective social skills, lack of communication opportunities;

     (g) Augmentative and alternative communication include the development of techniques and strategies that include selecting, and dispensing of aids and devices (excluding hearing instruments) and providing training to individuals, their families, and other communication partners in their use.

     (5) Habilitation/rehabilitation of communication and swallowing ((to include the following)) including:

     (a) Treatment of speech disorders including articulation, fluency and voice.

     (b) Treatment of language disorders including phonology, morphology, syntax, semantics, and pragmatics; and include receptive and expressive communication in oral, written, graphic and manual modalities.

     (c) Treatment of swallowing disorders.

     (d) Treatment of the cognitive aspects of communication.

     (e) Treatment of central auditory processing disorders in which there is evidence of speech, language, and/or other cognitive communication disorders.

     (f) Treatment of individuals with hearing loss, including aural rehabilitation and related counseling.

     (g) Treatment of social aspects of communication, including challenging behaviors, ineffective social skills, and lack of communication opportunities.

     (6) All services must be provided with referral to other qualified resources when appropriate.

[Statutory Authority: RCW 18.35.161 (3) and (10). 99-19-058, § 246-828-105, filed 9/15/99, effective 10/16/99; 98-14-055, § 246-828-105, filed 6/26/98, effective 7/27/98.]


AMENDATORY SECTION(Amending Order 165B, filed 5/8/91, effective 6/8/91)

WAC 246-828-220   Unfair or deceptive practices, unethical conduct and unfair methods of competition -- Used or rebuilt products.   (1) A licensee may not represent, directly or indirectly, that any industry product or part thereof is new, unused, or rebuilt, ((when such)) if it is not ((the fact)).

     (2) In the marketing of a hearing ((aid)) instrument which has been used, or which contains used parts, a licensee ((shall make full and nondeceptive disclosure of such fact)) must fully and nondeceptively disclose that the product or its parts are used in all advertising and promotional literature relating to the product, on the container, box or package in which ((such)) the product is packed or enclosed and, if the product has the appearance of being new, on the product itself. The required disclosure may be made by use of ((such)) words such as "used," "secondhand," "repaired," or "rebuilt," whichever most accurately describes the product involved.

     (3) A licensee shall not misrepresent the identity of the rebuilder of a hearing ((aid)) instrument. If the rebuilding of a hearing ((aid)) instrument was done by other than the original manufacturer, a licensee shall disclose ((such)) this fact wherever the original manufacturer is identified.

[Statutory Authority: RCW 18.35.161. 91-11-031 (Order 165B), recodified as § 246-828-220, filed 5/8/91, effective 6/8/91; Readopted by 84-14-100 (Order PL 469), § 308-50-260, filed 7/3/84; Order PL 159, § 308-50-260, filed 2/8/74.]


AMENDATORY SECTION(Amending WSR 98-06-079, filed 3/3/98, effective 4/3/98)

WAC 246-828-270   Personal disclosure.   A licensee((/certificate holder)) who contacts a prospective purchaser away from the licensee's((/certificate holder's)) place of business must:

     (1) When the contact is in person, present the prospective purchaser with written notice of:

     (a) His or her name, the name of his or her business firm, his or her business address and telephone number;

     (b) The number of his or her license((/certificate)).

     (2) Telephone contact with prospective purchasers must disclose the name of the licensee((/certificate holder)), name and location of his or her principal establishment and purpose of call.

     (3) When the contact is through a direct mail piece or other advertising initiated by the licensee((/certificate holder)), clearly show on all promotional items the business/establishment name, the principal establishment address and telephone number, not just the address or telephone number where he/she will be on given days.

     (4) A principal establishment is one which is bonded ((pursuant to)) under RCW 18.35.240.

[Statutory Authority: RCW 18.35.161. 98-06-079, § 246-828-270, filed 3/3/98, effective 4/3/98; 91 -11-032 (Order 166B), § 246-828-270, filed 5/8/91, effective 6/8/91; 91-11-031 (Order 165B), recodified as § 246-828-270, filed 5/8/91, effective 6/8/91; 85-23-065 (Order PL 563), § 308-50-310, filed 11/19/85; Order PL 159, § 308-50-310, filed 2/8/74.]


AMENDATORY SECTION(Amending WSR 02-14-052, filed 6/27/02, effective 7/28/02)

WAC 246-828-290   Purchaser recision rights.   In addition to the receipt and disclosure information required by RCW 18.35.030, 18.35.185, 63.14.040 and 63.14.120, every retail agreement for the sale of hearing instruments shall contain or have attached the following notice to buyer in twelve point type or larger. The language in part 1 under "Notice to Buyer" is intended to have the same legal effect as the notices required in RCW 63.14.040(2) and 63.14.120(3) and may be substituted for those notices.

     The rights summarized in the "Notice to Buyer" must be made known to the purchaser before the contract is executed. The licensee ((or certificate holder)) must provide this "Notice to Buyer" in writing to the purchaser. The purchaser must demonstrate knowledge of these rights by initialing each numbered section of the "Notice to Buyer" and by signing his or her name in the appropriate space following the "Notice to Buyer."


Notice to Buyer

     Do not sign this agreement before you read it or if any spaces intended for the agreed terms are blank.

     You are entitled to receive a copy of this agreement at the time you sign it.

     The seller's business address must be shown on the agreement.


Section 1 CANCELLATION - WITHIN THREE DAYS

Purchaser's Initial . . . . . . . . . . . .


     You may cancel this agreement within three days, without explaining your reasons, if the seller solicited it in person and you signed it at a place other than the seller's business address.

     To cancel this agreement without explaining your reasons, you must notify the seller in writing that you are canceling the agreement. You may deliver the written notice to the seller at the seller's business address. Alternatively, you may send the written notice by certified mail, return receipt requested, to the seller at the seller's business address.

     Your written notice must be mailed or delivered by midnight of the third business day after you signed this agreement.

     Any merchandise you received under this agreement must be in its original condition. You must return it to the seller or make it available to the seller at the same place it was delivered to you.

     The seller must refund to you all deposits, including any down payment, and must return to you all goods traded in as part of the agreement.

     You will incur no additional liability for canceling the agreement.


Section 2 RECISION - WITHIN THIRTY DAYS

Purchaser's Initial . . . . . . . . . . . .


     You may rescind (or terminate) the agreement within thirty days, for reasonable cause. This thirty-day period is called the "recision period."

     To rescind this agreement, you must notify the seller in writing that you are rescinding the agreement for reasonable cause pursuant to RCW 18.35.185(1). (Reasonable cause does not include cosmetic concerns or a mere change of mind.) You may deliver the written notice to the seller at the seller's business address. Alternatively, you may send the written notice by certified mail, return receipt requested, to the seller at the seller's business address.

     Your written notice must be mailed or delivered by midnight of the thirtieth day after delivery of the hearing instrument.

     Any merchandise you received under this agreement must be in its original condition, except for normal wear and tear. You must return it to the seller or make it available to the seller at the same place it was delivered to you.

     The seller must refund to you all deposits, including any down payment, and must return to you all goods traded in as part of the agreement. However, for each hearing instrument you return, the seller may keep either one hundred fifty dollars or fifteen percent of the total purchase price, whichever is less. The seller also may deduct any costs incurred in making traded-in goods ready for resale.

     The seller must refund your money and return your traded goods, or have them postmarked and in the mail to you, within ten business days after receiving your notice of recision.

     You will incur no additional liability for rescinding the agreement.


Section 3 EXTENSION OF RECISION PERIOD

Purchaser's Initial . . . . . . . . . . . .


     If you notify the seller within the thirty-day recision period that your hearing instrument has developed a problem that constitutes reasonable cause to rescind the agreement or that prevents you from evaluating your hearing instrument, the seller must extend the recision period. The recision period stops running on the date you notify the seller of the problem and starts running again on the date the seller notifies you that your hearing instrument is ready for redelivery.

     You and the seller may agree to a recision period longer than thirty days.

     Whenever the recision period is extended, the seller must provide you written notice of the last date upon which you may demand a refund and return of traded goods.


Signature of Purchaser Date
Signature of Seller Date
Delivery Acknowledgment - Signature of Purchaser Date

[Statutory Authority: RCW 18.35.161. 02-14-052, § 246- 828-290, filed 6/27/02, effective 7/28/02. Statutory Authority: RCW 18.35.161 and 18.35.185(2). 99-08-103, § 246-828-290, filed 4/6/99, effective 7/5/99. Statutory Authority: RCW 18.35.161. 91-11-031 (Order 165B), recodified as § 246-828-290, filed 5/8/91, effective 6/8/91; 86-09-064 (Order PL 586), § 308-50-330, filed 4/17/86; Order PL 190, § 308-50-330, filed 5/23/75; Order PL 159, § 308-50-330, filed 2/8/74.]


AMENDATORY SECTION(Amending WSR 98-06-079, filed 3/3/98, effective 4/3/98)

WAC 246-828-320   Minimum standards for fitting and dispensing locations.   (1) The hours of business of each hearing instrument establishment shall be prominently and continuously displayed and visible to the public at each regular place or places of business owned or operated by that establishment.

     (2) ((All such)) Any regular place or places of business or any activities ((emanating therefrom shall)) resulting from these locations must meet the minimum standards for facilities and equipment essential for the testing of hearing and the fitting and dispensing of hearing instruments ((as set forth)) in WAC 246-828-080.

     (3) The term "place or places of business" means a location where a licensee((/certificate holder)) engages or intends to engage in the fitting and dispensing of hearing instruments at a permanent address(es) open to the public on a regular basis.

[Statutory Authority: RCW 18.35.161. 98-06-079, § 246-828-320, filed 3/3/98, effective 4/3/98. Statutory Authority: RCW 18.35.161 (1) and (3). 95-19-017 § 246-828-320, filed 9/7/95, effective 10/8/95. Statutory Authority: RCW 18.35.161. 91-11-031 (Order 165B), recodified as § 246-828-320, filed 5/8/91, effective 6/8/91; 85-10-024 (Order PL 526), § 308-50-390, filed 4/24/85.]


AMENDATORY SECTION(Amending WSR 98-06-079, filed 3/3/98, effective 4/3/98)

WAC 246-828-330   Notice of availability and location of follow-up services.   Every licensee((/certificate holder)) shall provide to a hearing instrument purchaser, in writing prior to the signing of the contract, notice of availability of services. The notice shall include the specific location of the follow-up service, including date and time if applicable.

[Statutory Authority: RCW 18.35.161. 98-06-079, § 246-828-330, filed 3/3/98, effective 4/3/98; 91-11-031 (Order 165B), recodified as § 246-828-330, filed 5/8/91, effective 6/8/91; 85-10-024 (Order PL 526), § 308-50-400, filed 4/24/85.]


AMENDATORY SECTION(Amending WSR 98-06-079, filed 3/3/98, effective 4/3/98)

WAC 246-828-350   Reasonable cause for recision.   RCW 18.35.190(2) allows the purchaser of the hearing instrument(s) ((may)) to rescind the purchase and recover moneys ((in accordance with RCW 18.35.190(2))) for reasonable cause. The term "reasonable cause" ((is defined to include the following)) includes:

     (1) Any material misstatement of fact or misrepresentation by the licensee((/certificate holder)) regarding the hearing instrument(s) or fitting and dispensing services to be provided which the purchaser relied on or which induced the purchaser into making the agreement;

     (2) Failure by the licensee((/certificate holder)) to provide the purchaser with the hearing instrument(s) and fitting and dispensing services which conform to those specified in the purchase agreement between the parties;

     (3) Diagnosis of a medical condition unknown to the purchaser at the time of purchase, which precludes the purchaser from using the hearing instrument(s);

     (4) Failure by the licensee((/certificate holder)) to remedy a significant material defect of the hearing instrument(s) within a reasonable period of time in accordance with RCW 18.35.190 (2)(c);

     (5) The hearing instrument(s) and/or fitting and dispensing services would not be in accordance with accepted practices of the industry; and

     (6) Failure by the licensee((/certificate holder fails)) to meet any standard of conduct prescribed in the laws regarding the fitting and dispensing of hearing instruments and this failure adversely affects in any way the transaction which the purchaser seeks to rescind.

[Statutory Authority: RCW 18.35.161. 98-06-079, § 246-828-350, filed 3/3/98, effective 4/3/98; 91-11-031 (Order 165B), recodified as § 246-828-350, filed 5/8/91, effective 6/8/91; 89-04-017 (Order PM 818), § 308-50-420, filed 1/23/89; 86-09-064 (Order PL 586), § 308-50-420, filed 4/17/86.]


AMENDATORY SECTION(Amending Order 342B, filed 3/5/93, effective 4/5/93)

WAC 246-828-500   Citation and purpose.   The purpose of these rules is to require licensed hearing ((aid)) instrument fitters and dispensers to continue their professional education as a condition of maintaining a license to practice the fitting and dispensing of hearing ((aids)) instruments in this state.

[Statutory Authority: RCW 18.35.161(3). 93-07-007 (Order 342B), § 246-828-500, filed 3/5/93, effective 4/5/93.]


AMENDATORY SECTION(Amending WSR 95-19-017, filed 9/7/95, effective 10/8/95)

WAC 246-828-550   Programs approved by the board ((on fitting and dispensing of hearing aids)) of hearing and speech.   Completion of the following ((are deemed to)) qualify an individual for continuing education credit:

     (1) Attendance at a continuing education program having a featured speaker(s) or panel which has been approved by an industry-recognized local, state, national, or international organization.

     (2) Participation as a speaker or panel member in a continuing education program which has been approved by an industry-recognized local, state, national, or international organization. A maximum of two hours of such participation may be applied towards the total ten hours required.

     (3) Completion as a student, of a written, video, or audio continuing education program which has been approved by an industry-recognized local, state, national, or international organization. Only ((such)) programs ((which)) that have accompanying required comprehension tests ((of comprehension)) upon completion ((and)) that are independently graded ((shall)) may be accepted.

[Statutory Authority: RCW 18.35.161 (1) and (3). 95-19-017, § 246-828-550, filed 9/7/95, effective 10/8/95. Statutory Authority: RCW 18.35.161(3). 93-07-007 (Order 342B), § 246-828-550, filed 3/5/93, effective 4/5/93.]


AMENDATORY SECTION(Amending WSR 98-05-060, filed 2/13/98, effective 3/16/98)

WAC 246-828-990   Hearing ((aid)) instrument fitter/dispenser, audiologist and speech language pathologists fees and renewal cycle.   (1) Licenses ((and certificates)) must be renewed every year on the practitioner's birthday as provided in chapter 246-12 WAC, Part 2.

     (2) Licensees must pay the following nonrefundable fees ((will be charged for fitter/dispensers)):


Title of Fee Fee
     ((Fitter/dispenser:))
     License application $125.00
     Initial license 100.00
     Interim permit 100.00
     Renewal 200.00
     ((Written Exam 100.00
     Practical Exam 200.00
     Apprentice permit 85.00))
     Inactive license 75.00
     Late renewal penalty 100.00
     Expired license reissuance 100.00
     Expired inactive license reissuance 50.00
     License verification 15.00
     Wall certificate 15.00
     Duplicate license 15.00

     (((3) The following nonrefundable fees will be charged for audiologists:
     Certificate application 125.00
     Initial certificate 100.00
     Renewal 200.00
     Written Examination 100.00
     Practical Examination     200.00
     Interim permit 100.00
     Inactive certificate 75.00
     Late renewal penalty 100.00
     Expired certificate reissuance     100.00
     Expired inactive certificate reissuance 50.00
     Certificate verification 15.00
     Wall certificate 15.00
     Duplicate certificate 15.00

     (4) The following nonrefundable fees will be charged for speech/language pathologist:
     Certificate application 125.00
     Initial certificate 100.00
     Renewal 200.00
     Written Examination 100.00
     Practical Examination 200.00
     Interim permit 100.00
     Inactive certificate 75.00
     Late renewal penalty 100.00
     Expired certificate reissuance 100.00
     Expired inactive certificate reissuance 50.00
     Certificate verification 15.00
     Wall certificate 15.00
     Duplicate certificate 15.00))

[Statutory Authority: RCW 43.70.280. 98-05-060, § 246-828-990, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 18.35.090 and 43.70.250. 97-04-043, § 246-828-990, filed 1/31/97, effective 1/31/97. Statutory Authority: RCW 18.35.161 (1) and (3). 95-19-017, § 246-828-990, filed 9/7/95, effective 10/8/95. Statutory Authority: RCW 43.70.250. 94-08-038, § 246-828-990, filed 3/31/94, effective 5/1/94; 93-14-011, § 246-828-990, filed 6/24/93, effective 7/25/93; 91-13-002 (Order 173), § 246-828-990, filed 6/6/91, effective 7/7/91. Statutory Authority: RCW 43.70.040. 91-11-030 (Order 139), recodified as § 246-828-990, filed 5/8/91, effective 6/8/91. Statutory Authority: RCW 43.70.250. 90-04-094 (Order 029), § 308-50-440, filed 2/7/90, effective 3/10/90. Statutory Authority: RCW 43.24.086. 87-18-031 (Order PM 667), § 308-50-440, filed 8/27/87.]


REPEALER

     The following sections of the Washington Administrative Code are repealed:
WAC 246-828-030 Reexaminations.
WAC 246-828-055 Apprenticeship program -- Definitions.
WAC 246-828-061 Requirements for apprenticeship training waiver.
WAC 246-828-070 Apprenticeship program -- Minimum training requirements.

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