Background: A hearing instrument fitter/dispenser is authorized to sell, lease, or rent hearing instruments; modify hearing instruments; administer non-diagnostic tests; and use other procedures essential to these functions. The practice of fitting and dispensing hearing instruments includes the following:

recommending specific hearing instrument systems, specific hearing instruments, or specific hearing instrument characteristics;
taking impressions for ear molds;
using non-diagnostic procedures and equipment to verify the appropriateness of the hearing instrument fitting; and
performing hearing instrument orientation.

To be licensed as a hearing instrument fitter/dispenser, a person must:

complete a two-year degree program in hearing instrument fitter/dispenser education approved by the Board of Hearing and Speech (Board) and pass an examination;
hold a current license from another jurisdiction whose standards are substantially equivalent to Washington's; or
hold a current license from another jurisdiction; demonstrate that the person has actively practiced in the other jurisdiction for at least 48 of the past 60 months; achieve active certification from the International Hearing Society or the National Board for Certification in Hearing Instrument Sciences; and pass an examination.

Summary of Bill: Hearing instrument fitters/dispensers are re-named hearing aid specialists, and two alternate paths to certification are created for hearing aid specialists: a nine-month certificate program and a work-based learning pathway.

Nine-Month Certificate Program. A person may be certified as a hearing aid specialist if the person satisfactorily completes the following:

a Board-approved, nine-month certificate program offered by a Board-approved hearing aid specialist program;
a practical examination approved by the Board, which must be given at least quarterly and may be proctored by industry experts hired by the Board; and
the hearing aid specialist examination.

Work-based Learning Pathway. A person may be certified as a hearing aid specialist if the person successfully completes the following:

a two-year or four-year degree in a Board-approved field of study from an institution of higher education;
a work-based learning pathway;
a practical examination approved by the Board, which must be given at least quarterly and may be proctored by industry experts hired by the Board; and
the hearing aid specialist examination.

In order to begin a work-based learning pathway, an applicant must obtain an interim work-based learning permit. The applicant must be issued a permit if the applicant has completed a two-year or four-year degree in a Board-approved field of study from an institution of higher education, or is a current enrollee in such a degree program with no more than one full-time academic year remaining, and is under the direct supervision of a licensed hearing aid specialist or licensed audiologist. The interim work-based learning permit expires after 12 months and may be renewed only once for a period of 12 months.

The holder of an interim work-based learning permit may fit and dispense hearing aids in a work-based learning pathway approved by the Board. The Board must approve two types of work-based learning pathways: ones established in partnership with private businesses, and ones established in partnership with accredited institutions of higher education and sponsoring private businesses through work-based learning agreements.

A permit holder of the work-based learning pathway must complete at least 520 hours of training in the following:

audiometric testing;
counseling regarding hearing examinations;
hearing instrument selection;
ear-mold impressions;
hearing instrument fitting and follow-up care; and
business practices including ethics, regulations, and sanitation and infection control.

A participant in a work-based learning pathway must be directly supervised by a Board-approved licensed hearing aid specialist or a licensed audiologist until the participant completes the requirements of the pathway, after which the participant may be indirectly supervised. A supervising hearing aid specialist or audiologist must be licensed in good standing for at least two years; practice in an established place of business; and be responsible for all activities and training of the apprentice hearing aid specialist. A hearing aid specialist or audiologist may supervise no more than three apprentice hearing aid specialists at one time. An apprentice hearing aid specialist must notify the Department of Health and the Board if the apprentice's relationship with the apprentice's supervisor is terminated or if the apprentice designates a new supervisor.

Staff Summary of Public Testimony: PRO: We made considerable changes to the bill on the House floor that reflect active participation from stakeholders. Washington is the only state that requires a two-year specific degree to be a hearing aid specialist. This will help make more people eligible to provide hearing aids to be prepared for the silver tsunami, or growth in the aging population that will need hearing aids. When the Legislature first put the two-year degree requirement in place, we anticipated 60 graduates per year. We have only two schools offering programs and have only 15–20 graduates per year. We need to add to the supply so we can fill our needs to offer the services. This bill offers an option for those that have a four-year degree to allow them to use the nine-month certificate rather than go back to school for two more years. We have an amendment to clarify the nine-month certificate is supposed to be tied to a degree program. It also offers two worksite options with the industry or with higher education agreements that allow permit holders to get work-based learning and meet specific training requirements. There is a growing industry need to add more licensed providers. Costco has been adding providers at a rapid rate.

CON: We appreciate the floor amendments that added the Board into approval of the program but we have concerns about the work-based sites. There may be quality of care concerns with the interim permit holders. We have concerns with the pathway linked with industry without a clear educational component. The nine-month certification should meet the needs without the worksite pathway. We do not believe there is a shortage of hearing aid specialists. The technical college is producing future professionals and the school in Portland anticipates 21 graduates in 2014. There are 400 audiologists that could dispense and fit hearing aids as well. We think this needs more work and discussion over the interim. The technology is getting more complex, not less.

OTHER: We had many concerns with the original bill that there was a lack of oversight by the Board, but that has been corrected. We have one remaining issue with the nine-month certificate that it be tied to the degree programs.