Prefiled 12/04/13. Read first time 01/13/14.   Referred to Committee on Health Care & Wellness.

     AN ACT Relating to hearing instrument fitter/dispensers; amending RCW 18.35.010, 18.35.020, 18.35.040, 18.35.050, 18.35.070, 18.35.090, 18.35.095, 18.35.100, 18.35.105, 18.35.110, 18.35.120, 18.35.140, 18.35.150, 18.35.161, 18.35.172, 18.35.185, 18.35.190, 18.35.195, 18.35.205, 18.35.230, 18.35.240, 18.35.250, and 18.35.260; adding new sections to chapter 18.35 RCW; and providing an effective date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   A new section is added to chapter 18.35 RCW to read as follows:
     (1) The department shall issue an interim work-based learning permit to any applicant who meets the following requirements:
     (a) Either:
     (i) Possession of a two-year or four-year degree in a field of study approved by the board from an accredited institution of higher education; or
     (ii) Current enrollment in a two-year or four-year degree program in a field of study approved by the board in an accredited institution of higher education with no more than one full-time academic year remaining in his or her course of study; and
     (b) Designation of a board-approved licensed hearing aid specialist or board-approved licensed audiologist who has agreed to act as the applicant's supervisor under sections 2 and 3 of this act.
     (2) The applicant shall complete an application form designated by the department and pay an application fee set by the secretary under RCW 43.70.250. The application form must be signed by both the applicant and the licensed hearing aid specialist or licensed audiologist who has agreed to act as the applicant's supervisor.
     (3) An interim work-based learning permit issued under this section expires twelve months after issuance and may be renewed once for a period of twelve months.

NEW SECTION.  Sec. 2   A new section is added to chapter 18.35 RCW to read as follows:
     (1) A holder of an interim work-based learning permit may engage in the fitting and dispensing of hearing instruments in a board-approved work-based learning pathway. Except as provided in subsection (2) of this section, a holder of an interim work-based learning permit may engage in the fitting and dispensing of hearing instruments only under the direct supervision of a board-approved licensed hearing aid specialist or board-approved licensed audiologist.
     (2) A holder of an interim work-based learning permit may engage in the fitting and dispensing of hearing instruments under the indirect supervision of a board-approved licensed hearing aid specialist or board-approved licensed audiologist only after the holder of the interim work-based learning permit has successfully completed the work-based learning pathway. The board shall approve learning pathways established in partnership with private business or pathways established in partnership with accredited institutions of higher education and sponsoring private businesses through work-based learning agreements. The holder of the interim work-based learning permit has successfully completed a work-based learning pathway if:
     (a) For a board-approved, work-based learning pathway established in partnership with private business, the supervising hearing aid specialist or audiologist notifies the department and the board that the holder of the work-based learning permit has completed at least five hundred twenty hours of practical training under the direct supervision of the hearing aid specialist or audiologist. The training must include at least the following:
     (i) Audiometric testing;
     (ii) Counseling regarding hearing examinations;
     (iii) Hearing instrument selection;
     (iv) Ear mold impressions;
     (v) Hearing instrument fitting and follow-up care; and
     (vi) Business practices, including ethics, regulations, and sanitation and infection control; or
     (b) For a board-approved, work-based learning pathway established in partnership with an institution of higher education and a sponsoring private business through a work-based learning agreement, the holder of the interim work-based learning permit has completed all of the requirements of the pathway, which must be consistent with the requirements in (a) of this subsection.

NEW SECTION.  Sec. 3   A new section is added to chapter 18.35 RCW to read as follows:
     (1) A hearing aid specialist or audiologist may supervise an interim work-based learning permit holder only if he or she:
     (a) Has been licensed in good standing under this chapter for at least two years;
     (b) Practices in an established place of business;
     (c) Is responsible for all activities and training of the interim work-based learning permit holder under this chapter; and
     (d) Is approved to supervise interim work-based learning permit holders by the board.
     (2) A hearing aid specialist or audiologist may supervise no more than three interim work-based learning permit holders at any one time.
     (3) An interim work-based learning permit holder shall notify the department and the board within ten working days if:
     (a) His or her relationship with his or her existing supervisor is terminated; or
     (b) He or she designates a new supervisor who meets the requirements of this section.

Sec. 4   RCW 18.35.010 and 2009 c 301 s 2 are each amended to read as follows:
     The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
     (1) "Assistive listening device or system" means an amplification system that is specifically designed to improve the signal to noise ratio for the listener, reduce interference from noise in the background, and enhance hearing levels at a distance by picking up sound from as close to source as possible and sending it directly to the ear of the listener, excluding hearing instruments as defined in this chapter.
     (2) "Audiology" means the application of principles, methods, and procedures related to hearing and the disorders of hearing and to related language and speech disorders, whether of organic or nonorganic origin, peripheral or central, that impede the normal process of human communication including, but not limited to, disorders of auditory sensitivity, acuity, function, processing, or vestibular function, the application of aural habilitation, rehabilitation, and appropriate devices including fitting and dispensing of hearing instruments, and cerumen management to treat such disorders.
     (3) "Board" means the board of hearing and speech.
     (4) "Department" means the department of health.
     (5) "Direct supervision" means the supervising speech-language pathologist, hearing aid specialist, or audiologist is on-site and in view during the procedures or tasks. The board shall develop rules outlining the procedures or tasks allowable under direct supervision.
     (6) "Establishment" means any permanent site housing a person engaging in the practice of fitting and dispensing of hearing instruments by a hearing ((instrument fitter/dispenser)) aid specialist or audiologist; where the client can have personal contact and counsel during the firm's business hours; where business is conducted; and the address of which is given to the state for the purpose of bonding.
     (7) "Facility" means any permanent site housing a person engaging in the practice of speech-language pathology and/or audiology, excluding the sale, lease, or rental of hearing instruments.
     (8) "Fitting and dispensing of hearing instruments" means the sale, lease, or rental or attempted sale, lease, or rental of hearing instruments together with the selection and modification of hearing instruments and the administration of nondiagnostic tests as specified by RCW 18.35.110 and the use of procedures essential to the performance of these functions; and includes recommending specific hearing instrument systems, specific hearing instruments, or specific hearing instrument characteristics, the taking of impressions for ear molds for these purposes, the use of nondiagnostic procedures and equipment to verify the appropriateness of the hearing instrument fitting, and hearing instrument orientation. The fitting and dispensing of hearing instruments as defined by this chapter may be equally provided by a licensed hearing ((instrument fitter/dispenser)) aid specialist or licensed audiologist.
     (9) "Good standing" means a licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, licensed speech-language pathologist, or certified speech-language pathology assistant whose license or certification has not been subject to sanctions pursuant to chapter 18.130 RCW or sanctions by other states, territories, or the District of Columbia in the last two years.
     (10) "Hearing aid specialist" means a person who is licensed to engage in the practice of fitting and dispensing of hearing instruments and meets the qualifications of this chapter.
     (11) "Hearing health care professional" means an audiologist or hearing ((instrument fitter/dispenser)) aid specialist licensed under this chapter or a physician specializing in diseases of the ear licensed under chapter 18.71 RCW.
     (((11))) (12) "Hearing instrument" means any wearable prosthetic instrument or device designed for or represented as aiding, improving, compensating for, or correcting defective human hearing and any parts, attachments, or accessories of such an instrument or device, excluding batteries and cords, ear molds, and assistive listening devices.
     (((12) "Hearing instrument fitter/dispenser" means a person who is licensed to engage in the practice of fitting and dispensing of hearing instruments and meets the qualifications of this chapter.))
     (13) "Indirect supervision" means the procedures or tasks are performed under the speech-language pathologist(('s)), the hearing aid specialist, or the audiologist's overall direction and control, but the speech-language pathologist(('s)), hearing aid specialist, or audiologist's presence is not required during the performance of the procedures or tasks. The board shall develop rules outlining the procedures or tasks allowable under indirect supervision.
     (14) "Interim permit holder" means a person who holds the permit created under RCW 18.35.060 and who practices under the supervision of a licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed speech-language pathologist, or licensed audiologist.
     (15) "Licensed audiologist" means a person who is licensed by the department to engage in the practice of audiology and meets the qualifications in this chapter.
     (16) "Licensed speech-language pathologist" means a person who is licensed by the department to engage in the practice of speech-language pathology and meets the qualifications of this chapter.
     (17) "Secretary" means the secretary of health.
     (18) "Speech-language pathology" means the application of principles, methods, and procedures related to the development and disorders, whether of organic or nonorganic origin, that impede oral, pharyngeal, or laryngeal sensorimotor competencies and the normal process of human communication including, but not limited to, disorders and related disorders of speech, articulation, fluency, voice, verbal and written language, auditory comprehension, cognition/communication, and the application of augmentative communication treatment and devices for treatment of such disorders.
     (19) "Speech-language pathology assistant" means a person who is certified by the department to provide speech-language pathology services under the direction and supervision of a licensed speech-language pathologist or speech-language pathologist certified as an educational staff associate by the superintendent of public instruction, and meets all of the requirements of this chapter.

Sec. 5   RCW 18.35.020 and 2006 c 263 s 801 are each amended to read as follows:
     (1) No person shall engage in the fitting and dispensing of hearing instruments or imply or represent that he or she is engaged in the fitting and dispensing of hearing instruments unless he or she is a licensed hearing ((instrument fitter/dispenser)) aid specialist, an interim work-based learning permit holder, or a licensed audiologist or holds an interim permit issued by the department as provided in this chapter and is an owner or employee of an establishment that is bonded as provided by RCW 18.35.240. The owner or manager of an establishment that dispenses hearing instruments is responsible under this chapter for all transactions made in the establishment name or conducted on its premises by agents or persons employed by the establishment engaged in fitting and dispensing of hearing instruments. Every establishment that fits and dispenses shall have in its employ at least one licensed hearing ((instrument fitter/dispenser)) aid specialist or licensed audiologist at all times, and shall annually submit proof that all testing equipment at that establishment that is required by the board to be calibrated has been properly calibrated.
     (2) Effective January 1, 2003, no person shall engage in the practice of audiology or imply or represent that he or she is engaged in the practice of audiology unless he or she is a licensed audiologist or holds an audiology interim permit issued by the department as provided in this chapter. Audiologists who are certified as educational staff associates by the Washington professional educator standards board are excluded unless they elect to become licensed under this chapter. However, a person certified by the state board of education as an educational staff associate who practices outside the school setting must be a licensed audiologist.
     (3) Effective January 1, 2003, no person shall engage in the practice of speech-language pathology or imply or represent that he or she is engaged in the practice of speech-language pathology unless he or she is a licensed speech-language pathologist or holds a speech-language pathology interim permit issued by the department as provided in this chapter. Speech-language pathologists who are certified as educational staff associates by the state board of education are excluded unless they elect to become licensed under this chapter. However, a person certified by the state board of education as an educational staff associate who practices outside the school setting must be a licensed speech-language pathologist.

Sec. 6   RCW 18.35.040 and 2009 c 301 s 3 are each amended to read as follows:
     (1) An applicant for licensure as a hearing ((instrument fitter/dispenser)) aid specialist must have the following minimum qualifications and shall pay a fee determined by the secretary as provided in RCW 43.70.250. An applicant shall be issued a license under the provisions of this chapter if the applicant has not committed unprofessional conduct as specified by chapter 18.130 RCW, and:
     (a)(i) Satisfactorily completes the hearing ((instrument fitter/dispenser)) aid specialist examination required by this chapter; and
     (ii) Satisfactorily completes:
     (A) A minimum of a two-year degree program in hearing ((instrument fitter/dispenser)) aid specialist instruction. The program must be approved by the board;
     (B) A two-year or four-year degree in a field of study approved by the board from an accredited institution of higher education, a work-based learning pathway under sections 1 through 3 of this act, and a practical examination approved by the board. The practical examination must be given at least quarterly, as determined by the board. The department may hire licensed industry experts approved by the board to proctor the examination; or
     (C) A nine-month board-approved certificate program offered by a board-approved hearing aid specialist program and the practical examination in (a)(ii)(B) of this subsection; or
     (b) Holds a current, unsuspended, unrevoked license from another jurisdiction if the standards for licensing in such other jurisdiction are substantially equivalent to those prevailing in this state as provided in (a) of this subsection; or
     (c)(i) Holds a current, unsuspended, unrevoked license from another jurisdiction, has been actively practicing as a licensed hearing aid ((fitter/dispenser)) specialist in another jurisdiction for at least forty-eight of the last sixty months, and submits proof of completion of advance certification from either the international hearing society or the national board for certification in hearing instrument sciences; and
     (ii) Satisfactorily completes the hearing ((instrument fitter/dispenser)) aid specialist examination required by this chapter or a substantially equivalent examination approved by the board.
     The applicant must present proof of qualifications to the board in the manner and on forms prescribed by the secretary and proof of completion of a minimum of four clock hours of AIDS education and training pursuant to rules adopted by the board.
     (2)(a) An applicant for licensure as a speech-language pathologist or audiologist must have the following minimum qualifications:
     (i) Has not committed unprofessional conduct as specified by the uniform disciplinary act;
     (ii) Has a master's degree or the equivalent, or a doctorate degree or the equivalent, from a program at a board-approved institution of higher learning, which includes completion of a supervised clinical practicum experience as defined by rules adopted by the board; and
     (iii) Has completed postgraduate professional work experience approved by the board.
     (b) All qualified applicants must satisfactorily complete the speech-language pathology or audiology examinations required by this chapter.
     (c) The applicant must present proof of qualifications to the board in the manner and on forms prescribed by the secretary and proof of completion of a minimum of four clock hours of AIDS education and training pursuant to rules adopted by the board.
     (3) An applicant for certification as a speech-language pathology assistant shall pay a fee determined by the secretary as provided in RCW 43.70.250 and must have the following minimum qualifications:
     (a) An associate of arts or sciences degree, or a certificate of proficiency, from a speech-language pathology assistant program from an institution of higher education that is approved by the board, as is evidenced by the following:
     (i) Transcripts showing forty-five quarter hours or thirty semester hours of speech-language pathology coursework; and
     (ii) Transcripts showing forty-five quarter hours or thirty semester hours of general education credit; or
     (b) A bachelor of arts or bachelor of sciences degree, as evidenced by transcripts, from a speech, language, and hearing program from an institution of higher education that is approved by the board.

Sec. 7   RCW 18.35.050 and 2002 c 310 s 5 are each amended to read as follows:
     Except as otherwise provided in this chapter an applicant for license shall appear at a time and place and before such persons as the department may designate to be examined by written or practical tests, or both. Examinations in hearing ((instrument fitting/dispensing)) aid specialist, speech-language pathology, and audiology shall be held within the state at least once a year. The examinations shall be reviewed annually by the board and the department, and revised as necessary. The examinations shall include appropriate subject matter to ensure the competence of the applicant. Nationally recognized examinations in the fields of fitting and dispensing of hearing instruments, speech-language pathology, and audiology may be used to determine if applicants are qualified for licensure. An applicant who fails an examination may apply for reexamination upon payment of a reexamination fee. The hearing ((instrument fitting/dispensing)) aid specialist reexamination fee for hearing ((instrument fitter/dispensers)) aid specialists and audiologists shall be set by the secretary under RCW 43.70.250.

Sec. 8   RCW 18.35.070 and 1996 c 200 s 8 are each amended to read as follows:
     The hearing ((instrument fitter/dispenser)) aid specialist written or practical examination, or both, provided in RCW 18.35.050 shall consist of:
     (1) Tests of knowledge in the following areas as they pertain to the fitting of hearing instruments:
     (a) Basic physics of sound;
     (b) The human hearing mechanism, including the science of hearing and the causes and rehabilitation of abnormal hearing and hearing disorders; and
     (c) Structure and function of hearing instruments.
     (2) Tests of proficiency in the following areas as they pertain to the fitting of hearing instruments:
     (a) Pure tone audiometry, including air conduction testing and bone conduction testing;
     (b) Live voice or recorded voice speech audiometry, including speech reception threshold testing and speech discrimination testing;
     (c) Effective masking;
     (d) Recording and evaluation of audiograms and speech audiometry to determine hearing instrument candidacy;
     (e) Selection and adaptation of hearing instruments and testing of hearing instruments; and
     (f) Taking ear mold impressions.
     (3) Evidence of knowledge regarding the medical and rehabilitation facilities for children and adults that are available in the area served.
     (4) Evidence of knowledge of grounds for revocation or suspension of license under the provisions of this chapter.
     (5) Any other tests as the board may by rule establish.

Sec. 9   RCW 18.35.090 and 2002 c 310 s 8 are each amended to read as follows:
     Each person who engages in practice under this chapter shall comply with administrative procedures and administrative requirements established under RCW 43.70.250 and 43.70.280 and shall keep the license, interim work-based learning permit, or interim permit conspicuously posted in the place of business at all times. The secretary may establish mandatory continuing education requirements and/or continued competency standards to be met by licensees or interim permit holders as a condition for license or interim permit renewal.

Sec. 10   RCW 18.35.095 and 2009 c 301 s 4 are each amended to read as follows:
     (1) A hearing ((instrument fitter/dispenser)) aid specialist licensed under this chapter and not actively practicing may be placed on inactive status by the department at the written request of the licensee. The board shall define by rule the conditions for inactive status licensure. In addition to the requirements of RCW 43.24.086, the licensing fee for a licensee on inactive status shall be directly related to the costs of administering an inactive license by the department. A hearing ((instrument fitter/dispenser)) aid specialist on inactive status may be voluntarily placed on active status by notifying the department in writing, paying the remainder of the licensing fee for the licensing year, and complying with subsection (2) of this section.
     (2) Hearing ((instrument fitter/dispenser)) aid specialist inactive licensees applying for active licensure shall comply with the following: A licensee who has not fitted or dispensed hearing instruments for more than five years from the expiration of the licensee's full fee license shall retake the practical or the written, or both, hearing ((instrument fitter/dispenser)) aid specialist examinations required under this chapter and other requirements as determined by the board. Persons who have inactive status in this state but who are actively licensed and in good standing in any other state shall not be required to take the hearing ((instrument fitter/dispenser)) aid specialist practical examination, but must submit an affidavit attesting to their knowledge of the current Washington Administrative Code rules and Revised Code of Washington statutes pertaining to the fitting and dispensing of hearing instruments.
     (3) A speech-language pathologist or audiologist licensed under this chapter, or a speech-language pathology assistant certified under this chapter, and not actively practicing either speech-language pathology or audiology may be placed on inactive status by the department at the written request of the license or certification holder. The board shall define by rule the conditions for inactive status licensure or certification. In addition to the requirements of RCW 43.24.086, the fee for a license or certification on inactive status shall be directly related to the cost of administering an inactive license or certification by the department. A person on inactive status may be voluntarily placed on active status by notifying the department in writing, paying the remainder of the fee for the year, and complying with subsection (4) of this section.
     (4) Speech-language pathologist, speech-language pathology assistant, or audiologist inactive license or certification holders applying for active licensure or certification shall comply with requirements set forth by the board, which may include completion of continuing competency requirements and taking an examination.

Sec. 11   RCW 18.35.100 and 2002 c 310 s 10 are each amended to read as follows:
     (1) Every hearing ((instrument fitter/dispenser)) aid specialist, audiologist, speech-language pathologist, interim work-based learning permit holder, or interim permit holder, who is regulated under this chapter, shall notify the department in writing of the regular address of the place or places in the state of Washington where the person practices or intends to practice more than twenty consecutive business days and of any change thereof within ten days of such change. Failure to notify the department in writing shall be grounds for suspension or revocation of the license, interim work-based learning permit, or interim permit.
     (2) The department shall keep a record of the places of business of persons who hold licenses, interim work-based learning permits, or interim permits.
     (3) Any notice required to be given by the department to a person who holds a license, interim work-based learning permit, or interim permit may be given by mailing it to the address of the last establishment or facility of which the person has notified the department, except that notice to a licensee, interim work-based learning permit, or interim permit holder of proceedings to deny, suspend, or revoke the license, interim work-based learning permit, or interim permit shall be by certified or registered mail or by means authorized for service of process.

Sec. 12   RCW 18.35.105 and 2002 c 310 s 11 are each amended to read as follows:
     Each licensee, interim work-based learning permit holder, and interim permit holder under this chapter shall keep records of all services rendered for a minimum of three years. These records shall contain the names and addresses of all persons to whom services were provided. Hearing ((instrument fitter/dispensers)) aid specialists, audiologists, interim work-based learning permit holders, and interim permit holders shall also record the date the hearing instrument warranty expires, a description of the services and the dates the services were provided, and copies of any contracts and receipts. All records, as required pursuant to this chapter or by rule, shall be owned by the establishment or facility and shall remain with the establishment or facility in the event the licensee changes employment. If a contract between the establishment or facility and the licensee provides that the records are to remain with the licensee, copies of such records shall be provided to the establishment or facility.

Sec. 13   RCW 18.35.110 and 2002 c 310 s 12 are each amended to read as follows:
     In addition to causes specified under RCW 18.130.170 and 18.130.180, any person licensed or holding an interim permit or an interim work-based learning permit under this chapter may be subject to disciplinary action by the board for any of the following causes:
     (1) For unethical conduct in dispensing hearing instruments. Unethical conduct shall include, but not be limited to:
     (a) Using or causing or promoting the use of, in any advertising matter, promotional literature, testimonial, guarantee, warranty, label, brand, insignia, or any other representation, however disseminated or published, which is false, misleading or deceptive;
     (b) Failing or refusing to honor or to perform as represented any representation, promise, agreement, or warranty in connection with the promotion, sale, dispensing, or fitting of the hearing instrument;
     (c) Advertising a particular model, type, or kind of hearing instrument for sale which purchasers or prospective purchasers responding to the advertisement cannot purchase or are dissuaded from purchasing and where it is established that the purpose of the advertisement is to obtain prospects for the sale of a different model, type, or kind than that advertised;
     (d) Falsifying hearing test or evaluation results;
     (e)(i) Whenever any of the following conditions are found or should have been found to exist either from observations by the licensee, interim work-based learning permit holder, or interim permit holder or on the basis of information furnished by the prospective hearing instrument user prior to fitting and dispensing a hearing instrument to any such prospective hearing instrument user, failing to advise that prospective hearing instrument user in writing that the user should first consult a licensed physician specializing in diseases of the ear or if no such licensed physician is available in the community then to any duly licensed physician:
     (A) Visible congenital or traumatic deformity of the ear, including perforation of the eardrum;
     (B) History of, or active drainage from the ear within the previous ninety days;
     (C) History of sudden or rapidly progressive hearing loss within the previous ninety days;
     (D) Acute or chronic dizziness;
     (E) Any unilateral hearing loss;
     (F) Significant air-bone gap when generally acceptable standards have been established as defined by the food and drug administration;
     (G) Visible evidence of significant cerumen accumulation or a foreign body in the ear canal;
     (H) Pain or discomfort in the ear; or
     (I) Any other conditions that the board may by rule establish. It is a violation of this subsection for any licensee or that licensee's employees and putative agents upon making such required referral for medical opinion to in any manner whatsoever disparage or discourage a prospective hearing instrument user from seeking such medical opinion prior to the fitting and dispensing of a hearing instrument. No such referral for medical opinion need be made by any licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work-based learning permit holder, or interim permit holder in the instance of replacement only of a hearing instrument which has been lost or damaged beyond repair within twelve months of the date of purchase. The licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work-based learning permit holder, or interim permit holder or their employees or putative agents shall obtain a signed statement from the hearing instrument user documenting the waiver of medical clearance and the waiver shall inform the prospective user that signing the waiver is not in the user's best health interest: PROVIDED, That the licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work-based learning permit holder, or interim permit holder shall maintain a copy of either the physician's statement showing that the prospective hearing instrument user has had a medical evaluation within the previous six months or the statement waiving medical evaluation, for a period of three years after the purchaser's receipt of a hearing instrument. Nothing in this section required to be performed by a licensee, interim work-based learning permit holder, or interim permit holder shall mean that the licensee, interim work-based learning permit holder, or interim permit holder is engaged in the diagnosis of illness or the practice of medicine or any other activity prohibited under the laws of this state;
     (ii) Fitting and dispensing a hearing instrument to any person under eighteen years of age who has not been examined and cleared for hearing instrument use within the previous six months by a physician specializing in otolaryngology except in the case of replacement instruments or except in the case of the parents or guardian of such person refusing, for good cause, to seek medical opinion: PROVIDED, That should the parents or guardian of such person refuse, for good cause, to seek medical opinion, the licensed hearing ((instrument fitter/dispenser)) aid specialist or licensed audiologist shall obtain from such parents or guardian a certificate to that effect in a form as prescribed by the department;
     (iii) Fitting and dispensing a hearing instrument to any person under eighteen years of age who has not been examined by an audiologist who holds at least a master's degree in audiology for recommendations during the previous six months, without first advising such person or his or her parents or guardian in writing that he or she should first consult an audiologist who holds at least a master's degree in audiology, except in cases of hearing instruments replaced within twelve months of their purchase;
     (f) Representing that the services or advice of a person licensed to practice medicine and surgery under chapter 18.71 RCW or osteopathic medicine and surgery under chapter 18.57 RCW or of a clinical audiologist will be used or made available in the selection, fitting, adjustment, maintenance, or repair of hearing instruments when that is not true, or using the word "doctor," "clinic," or other like words, abbreviations, or symbols which tend to connote a medical or osteopathic medicine and surgery profession when such use is not accurate;
     (g) Permitting another to use his or her license, interim work-based learning permit, or interim permit;
     (h) Stating or implying that the use of any hearing instrument will restore normal hearing, preserve hearing, prevent or retard progression of a hearing impairment, or any other false, misleading, or medically or audiologically unsupportable claim regarding the efficiency of a hearing instrument;
     (i) Representing or implying that a hearing instrument is or will be "custom-made," "made to order," "prescription made," or in any other sense specially fabricated for an individual when that is not the case; or
     (j) Directly or indirectly offering, giving, permitting, or causing to be given, money or anything of value to any person who advised another in a professional capacity as an inducement to influence that person, or to have that person influence others to purchase or contract to purchase any product sold or offered for sale by the hearing ((instrument fitter/dispenser)) aid specialist, audiologist, interim work-based learning permit holder, or interim permit holder, or to influence any person to refrain from dealing in the products of competitors.
     (2) Engaging in any unfair or deceptive practice or unfair method of competition in trade within the meaning of RCW 19.86.020.
     (3) Aiding or abetting any violation of the rebating laws as stated in chapter 19.68 RCW.

Sec. 14   RCW 18.35.120 and 2002 c 310 s 13 are each amended to read as follows:
     A licensee, interim work-based learning permit holder, or interim permit holder under this chapter may also be subject to disciplinary action if the licensee, interim work-based learning permit holder, or interim permit holder:
     (1) Is found guilty in any court of any crime involving forgery, embezzlement, obtaining money under false pretenses, larceny, extortion, or conspiracy to defraud and ten years have not elapsed since the date of the conviction; or
     (2) Has a judgment entered against him or her in any civil action involving forgery, embezzlement, obtaining money under false pretenses, larceny, extortion, or conspiracy to defraud and five years have not elapsed since the date of the entry of the final judgment in the action, but a license shall not be issued unless the judgment debt has been discharged; or
     (3) Has a judgment entered against him or her under chapter 19.86 RCW and two years have not elapsed since the entry of the final judgment; but a license shall not be issued unless there has been full compliance with the terms of such judgment, if any. The judgment shall not be grounds for denial, suspension, nonrenewal, or revocation of a license unless the judgment arises out of and is based on acts of the applicant, licensee, or employee of the licensee; or
     (4) Commits unprofessional conduct as defined in RCW 18.130.180 of the uniform disciplinary act.

Sec. 15   RCW 18.35.140 and 2002 c 310 s 14 are each amended to read as follows:
     The powers and duties of the department, in addition to the powers and duties provided under other sections of this chapter, are as follows:
     (1) To provide space necessary to carry out the examination set forth in RCW 18.35.070 of applicants for hearing ((instrument fitter/dispenser)) aid specialist licenses or audiology licenses.
     (2) To authorize all disbursements necessary to carry out the provisions of this chapter.
     (3) To require the periodic examination of testing equipment, as defined by the board, and to carry out the periodic inspection of facilities or establishments of persons who are licensed under this chapter, as reasonably required within the discretion of the department.
     (4) To appoint advisory committees as necessary.
     (5) To keep a record of proceedings under this chapter and a register of all persons licensed or holding interim permits or interim work-based learning permits under this chapter. The register shall show the name of every living licensee or interim permit holder for hearing ((instrument fitting/dispensing)) aid specialist, every living interim work-based learning permit holder, every living licensee or interim permit holder for speech-language pathology, and every living licensee or interim permit holder for audiology, with his or her last known place of residence and the date and number of his or her license or interim permit.

Sec. 16   RCW 18.35.150 and 2009 c 301 s 5 are each amended to read as follows:
     (1) There is created hereby the board of hearing and speech to govern the three separate professions: Hearing ((instrument fitting/dispensing)) aid specialist, audiology, and speech-language pathology. The board shall consist of eleven members to be appointed by the governor.
     (2) Members of the board shall be residents of this state. Three members shall represent the public and shall have an interest in the rights of consumers of health services, and shall not be or have been a member of, or married to a member of, another licensing board, a licensee of a health occupation board, an employee of a health facility, nor derive his or her primary livelihood from the provision of health services at any level of responsibility. Two members shall be hearing ((instrument fitter/dispensers)) aid specialists who are licensed under this chapter, have at least five years of experience in the practice of hearing instrument fitting and dispensing, and must be actively engaged in fitting and dispensing within two years of appointment. Two members of the board shall be audiologists licensed under this chapter who have at least five years of experience in the practice of audiology and must be actively engaged in practice within two years of appointment. Two members of the board shall be speech-language pathologists licensed under this chapter who have at least five years of experience in the practice of speech-language pathology and must be actively engaged in practice within two years of appointment. One advisory nonvoting member shall be a speech-language pathology assistant certified in Washington. One advisory nonvoting member shall be a medical physician licensed in the state of Washington.
     (3) The term of office of a member is three years. Of the initial appointments, one hearing ((instrument fitter/dispenser)) aid specialist, one speech-language pathologist, one audiologist, and one consumer shall be appointed for a term of two years, and one hearing ((instrument fitter/dispenser)) aid specialist, one speech-language pathologist, one audiologist, and two consumers shall be appointed for a term of three years. Thereafter, all appointments shall be made for expired terms. No member shall be appointed to serve more than two consecutive terms. A member shall continue to serve until a successor has been appointed. The governor shall either reappoint the member or appoint a successor to assume the member's duties at the expiration of his or her predecessor's term. A vacancy in the office of a member shall be filled by appointment for the unexpired term.
     (4) The chair shall rotate annually among the hearing ((instrument fitter/dispensers)) aid specialists, speech-language pathologists, audiologists, and public members serving on the board. In the absence of the chair, the board shall appoint an interim chair. In event of a tie vote, the issue shall be brought to a second vote and the chair shall refrain from voting.
     (5) The board shall meet at least once each year, at a place, day and hour determined by the board, unless otherwise directed by a majority of board members. The board shall also meet at such other times and places as are requested by the department or by three members of the board. A quorum is a majority of the board. A hearing ((instrument fitter/dispenser)) aid specialist, speech-language pathologist, and audiologist must be represented. Meetings of the board shall be open and public, except the board may hold executive sessions to the extent permitted by chapter 42.30 RCW.
     (6) Members of the board shall be compensated in accordance with RCW 43.03.240 and shall be reimbursed for their travel expenses in accordance with RCW 43.03.050 and 43.03.060.
     (7) The governor may remove a member of the board for cause at the recommendation of a majority of the board.

Sec. 17   RCW 18.35.161 and 2010 c 65 s 4 are each amended to read as follows:
     The board shall have the following powers and duties:
     (1) To establish by rule such minimum standards and procedures in the fitting and dispensing of hearing instruments as deemed appropriate and in the public interest;
     (2) To adopt any other rules necessary to implement this chapter and which are not inconsistent with it;
     (3) To develop, approve, and administer or supervise the administration of examinations to applicants for licensure under this chapter;
     (4) To require a licensee, interim work-based learning permit holder, or interim permit holder to make restitution to any individual injured by a violation of this chapter or chapter 18.130 RCW, the uniform disciplinary act. The authority to require restitution does not limit the board's authority to take other action deemed appropriate and provided for in this chapter or chapter 18.130 RCW;
     (5) To pass upon the qualifications of applicants for licensure, interim work-based learning permits, or interim permits and to certify to the secretary;
     (6) To recommend requirements for continuing education and continuing competency requirements as a prerequisite to renewing a license or certification under this chapter;
     (7) To keep an official record of all its proceedings. The record is evidence of all proceedings of the board that are set forth in this record;
     (8) To adopt rules, if the board finds it appropriate, in response to questions put to it by professional health associations, hearing ((instrument fitter/dispensers or)) aid specialists, audiologists, speech-language pathologists, interim permit holders, interim work-based learning permit holders, and consumers in this state; and
     (9) To adopt rules relating to standards of care relating to hearing ((instrument fitter/dispensers)) aid specialists or audiologists, including the dispensing of hearing instruments, and relating to speech-language pathologists, including dispensing of communication devices.

Sec. 18   RCW 18.35.172 and 2002 c 310 s 17 are each amended to read as follows:
     The uniform disciplinary act, chapter 18.130 RCW, governs unlicensed practice, the issuance and denial of licenses, interim work-based learning permits, and interim permits, and the discipline of licensees and permit holders under this chapter.

Sec. 19   RCW 18.35.185 and 2002 c 310 s 19 are each amended to read as follows:
     (1) In addition to any other rights and remedies a purchaser may have, the purchaser of a hearing instrument shall have the right to rescind the transaction for other than the licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work-based learning permit holder, or interim permit holder's breach if:
     (a) The purchaser, for reasonable cause, returns the hearing instrument or holds it at the licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work-based learning permit holder, or interim permit holder's disposal, if the hearing instrument is in its original condition less normal wear and tear. "Reasonable cause" shall be defined by the board but shall not include a mere change of mind on the part of the purchaser or a change of mind related to cosmetic concerns of the purchaser about wearing a hearing instrument; and
     (b) The purchaser sends notice of the cancellation by certified mail, return receipt requested, to the establishment employing the licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work-based learning permit holder, or interim permit holder at the time the hearing instrument was originally purchased, and the notice is posted not later than thirty days following the date of delivery, but the purchaser and the licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work-based learning permit holder, or interim permit holder may extend the deadline for posting of the notice of rescission by mutual, written agreement. In the event the hearing instrument develops a problem which qualifies as a reasonable cause for recision or which prevents the purchaser from evaluating the hearing instrument, and the purchaser notifies the establishment employing the licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work-based learning permit holder, or interim permit holder of the problem during the thirty days following the date of delivery and documents such notification, the deadline for posting the notice of rescission shall be extended by an equal number of days as those between the date of the notification of the problem to the date of notification of availability for redeliveries. Where the hearing instrument is returned to the licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work-based learning permit holder, or interim permit holder for any inspection for modification or repair, and the licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work-based learning permit holder, or interim permit holder has notified the purchaser that the hearing instrument is available for redelivery, and where the purchaser has not responded by either taking possession of the hearing instrument or instructing the licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work-based learning permit holder, or interim permit holder to forward it to the purchaser, then the deadline for giving notice of the recision shall extend no more than seven working days after this notice of availability.
     (2) If the transaction is rescinded under this section or as otherwise provided by law and the hearing instrument is returned to the licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work-based learning permit holder, or interim permit holder, the licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work- based learning permit holder, or interim permit holder shall refund to the purchaser any payments or deposits for that hearing instrument. However, the licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work-based learning permit holder, or interim permit holder may retain, for each hearing instrument, fifteen percent of the total purchase price or one hundred twenty-five dollars, whichever is less. After December 31, 1996, the recision amount shall be determined by the board. The licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work-based learning permit holder, or interim permit holder shall also return any goods traded in contemplation of the sale, less any costs incurred by the licensed hearing ((instrument fitter/dispenser)) aid specialist, licensed audiologist, interim work-based learning permit holder, or interim permit holder in making those goods ready for resale. The refund shall be made within ten business days after the rescission. The buyer shall incur no additional liability for such rescission.
     (3) For the purposes of this section, the purchaser shall have recourse against the bond held by the establishment entering into a purchase agreement with the buyer, as provided by RCW 18.35.240.

Sec. 20   RCW 18.35.190 and 2002 c 310 s 20 are each amended to read as follows:
     In addition to remedies otherwise provided by law, in any action brought by or on behalf of a person required to be licensed or to hold an interim work-based learning permit or an interim permit under this chapter, or by any assignee or transferee, it shall be necessary to allege and prove that the licensee, interim work-based learning permit holder, or interim permit holder at the time of the transaction held a valid license, interim work-based learning permit, or interim permit as required by this chapter, and that such license, interim work-based learning permit, or interim permit has not been suspended or revoked pursuant to RCW 18.35.110, 18.35.120, or 18.130.160.

Sec. 21   RCW 18.35.195 and 2006 c 263 s 802 are each amended to read as follows:
     (1) This chapter shall not apply to military or federal government employees.
     (2) This chapter does not prohibit or regulate:
     (a) Fitting or dispensing by students enrolled in a board-approved program who are directly supervised by a licensed hearing ((instrument fitter/dispenser)) aid specialist, a licensed audiologist under the provisions of this chapter, or an instructor at a two-year hearing ((instrument fitter/dispenser)) aid specialist degree program that is approved by the board;
     (b) Hearing ((instrument fitter/dispensers)) aid specialists, speech-language pathologists, or audiologists of other states, territories, or countries, or the District of Columbia while appearing as clinicians of bona fide educational seminars sponsored by speech-language pathology, audiology, hearing ((instrument fitter/dispenser)) aid specialist, medical, or other healing art professional associations so long as such activities do not go beyond the scope of practice defined by this chapter; and
     (c) The practice of audiology or speech-language pathology by persons certified by the Washington professional educator standards board as educational staff associates, except for those persons electing to be licensed under this chapter. However, a person certified by the board as an educational staff associate who practices outside the school setting must be a licensed audiologist or licensed speech-language pathologist.

Sec. 22   RCW 18.35.205 and 2009 c 301 s 6 are each amended to read as follows:
     The legislature finds that the public health, safety, and welfare would best be protected by uniform regulation of hearing ((instrument fitter/dispensers)) aid specialists, speech-language pathologists, speech-language pathology assistants, audiologists, interim work-based learning permit holders, and interim permit holders throughout the state. Therefore, the provisions of this chapter relating to the licensing of hearing ((instrument fitter/dispensers)) aid specialists, speech-language pathologists, and audiologists, the certification of speech-language pathology assistants, and regulation of interim work-based learning permit holders and interim permit holders and their respective establishments or facilities is exclusive. No political subdivision of the state of Washington within whose jurisdiction a hearing ((instrument fitter/dispenser)) aid specialist, audiologist, or speech-language pathologist establishment or facility is located may require any registrations, bonds, licenses, certificates, interim work-based learning permits, or interim permits of the establishment or facility or its employees or charge any fee for the same or similar purposes: PROVIDED, HOWEVER, That nothing herein shall limit or abridge the authority of any political subdivision to levy and collect a general and nondiscriminatory license fee levied on all businesses, or to levy a tax based upon the gross business conducted by any firm within the political subdivision.

Sec. 23   RCW 18.35.230 and 2002 c 310 s 23 are each amended to read as follows:
     (1) Each licensee, interim work-based learning permit holder, or interim permit holder shall name a registered agent to accept service of process for any violation of this chapter or rule adopted under this chapter.
     (2) The registered agent may be released at the expiration of one year after the license, interim work-based learning permit, or interim permit issued under this chapter has expired or been revoked.
     (3) Failure to name a registered agent for service of process for violations of this chapter or rules adopted under this chapter may be grounds for disciplinary action.

Sec. 24   RCW 18.35.240 and 2002 c 310 s 24 are each amended to read as follows:
     (1) Every individual engaged in the fitting and dispensing of hearing instruments shall be covered by a surety bond of ten thousand dollars or more, for the benefit of any person injured or damaged as a result of any violation by the licensee or permit holder, or their employees or agents, of any of the provisions of this chapter or rules adopted by the secretary.
     (2) In lieu of the surety bond required by this section, the licensee or permit holder may deposit cash or other negotiable security in a banking institution as defined in chapter 30.04 RCW or a credit union as defined in chapter 31.12 RCW. All obligations and remedies relating to surety bonds shall apply to deposits and security filed in lieu of surety bonds.
     (3) If a cash deposit or other negotiable security is filed, the licensee or permit holder shall maintain such cash or other negotiable security for one year after discontinuing the fitting and dispensing of hearing instruments.
     (4) Each invoice for the purchase of a hearing instrument provided to a customer must clearly display on the first page the bond number covering the licensee or interim permit holder responsible for fitting/dispensing the hearing instrument.
     (5) All licensed hearing ((instrument fitter/dispensers)) aid specialists, licensed audiologists, and permit holders must verify compliance with the requirement to hold a surety bond or cash or other negotiable security by submitting a signed declaration of compliance upon annual renewal of their license or permit. Up to twenty-five percent of the credential holders may be randomly audited for surety bond compliance after the credential is renewed. It is the credential holder's responsibility to submit a copy of the original surety bond or bonds, or documentation that cash or other negotiable security is held in a banking institution during the time period being audited. Failure to comply with the audit documentation request or failure to supply acceptable documentation within thirty days may result in disciplinary action.

Sec. 25   RCW 18.35.250 and 2002 c 310 s 25 are each amended to read as follows:
     (1) In addition to any other legal remedies, an action may be brought in any court of competent jurisdiction upon the bond, cash deposit, or security in lieu of a surety bond required by this chapter, by any person having a claim against a licensee, interim work-based permit holder, or interim permit holder, agent, or employee for any violation of this chapter or any rule adopted under this chapter. The aggregate liability of the surety, cash deposit, or other negotiable security to all claimants shall in no event exceed the sum of the bond. Claims shall be satisfied in the order of judgment rendered.
     (2) An action upon the bond, cash deposit, or other negotiable security shall be commenced by serving and filing a complaint.

Sec. 26   RCW 18.35.260 and 2009 c 301 s 7 are each amended to read as follows:
     (1) A person who is not a licensed hearing ((instrument fitter/dispenser)) aid specialist may not represent himself or herself as being so licensed and may not use in connection with his or her name the words "licensed hearing instrument fitter/dispenser," "hearing instrument specialist," or "hearing aid fitter/dispenser," or a variation, synonym, word, sign, number, insignia, coinage, or whatever expresses, employs, or implies these terms, names, or functions of a licensed hearing ((instrument fitter/dispenser)) aid specialist.
     (2) A person who is not a licensed speech-language pathologist may not represent himself or herself as being so licensed and may not use in connection with his or her name the words including "licensed speech-language pathologist" or a variation, synonym, word, sign, number, insignia, coinage, or whatever expresses, employs, or implies these terms, names, or functions as a licensed speech-language pathologist.
     (3) A person who is not a certified speech-language pathology assistant may not represent himself or herself as being so certified and may not use in connection with his or her name the words including "certified speech-language pathology assistant" or a variation, synonym, word, sign, number, insignia, coinage, or whatever expresses, employs, or implies these terms, names, or functions as a certified speech-language pathology assistant.
     (4) A person who is not a licensed audiologist may not represent himself or herself as being so licensed and may not use in connection with his or her name the words "licensed audiologist" or a variation, synonym, letter, word, sign, number, insignia, coinage, or whatever expresses, employs, or implies these terms, names, or functions of a licensed audiologist.
     (5) Nothing in this chapter prohibits a person credentialed in this state under another act from engaging in the practice for which he or she is credentialed.

NEW SECTION.  Sec. 27   This act takes effect July 1, 2015.