Rule-Making Notices (Hearing Notices)

Summary of, and comparison with, existing or proposed federal regulation: None. Checked the U.S. Code and Federal Register.

Comparison with rules in adjacent states: The following is a summary of the requirements to obtain and maintain a license in Illinois, Iowa, Michigan and Minnesota.

The states of Illinois and Minnesota require an individual to obtain a temporary license prior to completing a postgraduate clinical fellowship in speech-language pathology. Minnesota also requires an individual to obtain a temporary license prior to completing a postgraduate clinical fellowship in audiology.

None of the states authorize audiologists to supervise hearing instrument specialist trainees.

None of the states permit applicants to claim “hardship" for failure to take the required examinations.

The state of Illinois exempts audiologists and speech-language pathologists from the continuing education requirements during the first renewal period following initial licensure. The state of Minnesota exempts certified dispensers, who have been licensed less than one year, from the continuing education requirements.

All of the states have adopted a provision that authorizes disciplinary action based upon unprofessional conduct, unethical conduct or similar language.

Summary of factual date and analytical methodologies: The Hearing and Speech Examining Board considered its past experience as the credentialing and enforcement authority overseeing hearing instrument specialists, audiologists and speech-language pathologists in drafting the rules. The board also researched proposed national licensure standard changes to ensure Wisconsin license application requirements will remain current notwithstanding new standards that may be imposed, and to ensure a continuing role for the board in deciding on the adequacy of training to protect public health and safety. The board reviewed license applications in cooperation with department staff to clarify and amend where needs have been identified. Enforcement provisions were modified slightly to allow the board to act where its authority was less than clear in the past and to improve the overall structure of the enforcement rules.

Determination of significant fiscal effect on the private sector: The department finds that this rule has no significant fiscal effect on the private sector.

Fiscal Effect

The proposed rules will have no impact on the department's funds.

Effect on Small Business

These proposed rules will be reviewed by the Department's Small Business Review Advisory Committee to determine whether there will be a significant economic impact on a substantial number of small businesses, as defined in s. 227.114 (1) (a), Stats. The Department's Regulatory Review Coordinator may be contacted by email at [e-mail], or by calling [phone].

Agency Contact Person

Pamela Haack, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, Room 171, P.O. Box 8935, Madison, Wisconsin 53708-8935. Telephone: [phone].
Email: [e-mail].

Place where comments are to be submitted and deadline for submission: Comments may be submitted to the addresses listed above. Comments must be received on or before May 13, 2005 to be included in the record of rule-making proceedings.

TEXT OF RULE

SECTION 1. HAS 2.01 (2) is amended to read:

HAS 2.01 (2) A trainee permit issued by the board entitles the trainee to practice fitting hearing instruments, make ear impressions and make measurements of human hearing, for the purpose of fitting hearing instruments, for a period of one year and only while under the direct supervision of a hearing instrument specialist or an audiologist who holds a license issued under ch. 459, Stats. The licensee is liable for the trainee's negligent acts and omissions in the fitting of hearing instruments.

SECTION 2. HAS 5.02 (2) (g) (intro.) and 2. are amended to read:

HAS 5.02 (2) (g) (intro.) Failing to clearly state the full terms of sale on a receipt, as required in s. 459.03, Stats., and failing to comply with those terms. The full terms of sale shall include all of the following:

2. The date, and place and method of delivery.

SECTION 3. HAS 6.02 (1m) is amended to read:

HAS 6.02 (1m) “Au.D." means a doctor of audiology degree granted by a college or university approved by the board.

SECTION 4. HAS 6.02 (4g), (4m), (5g) and (6b) are repealed.

SECTION 5. HAS 6.03 (7) is renumbered HAS 6.03 (7) (intro.) and is amended to read:

HAS 6.03 (7) (intro.) Evidence satisfactory to the board that the applicant has completed a postgraduate clinical fellowship in speech-language pathology approved by the board. satisfied one of the following:

SECTION 6. HAS 6.03 (7) (a) and (b) are created to read:

HAS 6.03 (7) (a) Completed a postgraduate clinical fellowship in speech-language pathology approved by the board.

(b) Completed education or training that the board determines is substantially equivalent to the completion of a postgraduate clinical fellowship in speech-language pathology.

SECTION 7. HAS 6.09 (1) is renumbered HAS 6.09 (1m).

SECTION 8. HAS 6.09 (1) is created to read:

HAS 6.09 (1) “Hardship" means serious illness or some other personal adversity, as determined by the board.

SECTION 9. HAS 6.10 (title), (1) (intro.) and (2) are amended to read:

HAS 6.10 (title) Application for licensure temporary license. (1) (intro.) Before commencing a postgraduate clinical fellowship in speech-language pathology or audiology, an individual shall obtain a temporary license under s. 459.24 (6), Stats. The applicant shall submit all of the following:

(2) A temporary license granted by the board to practice speech-language pathology is valid for a period designated by the board, not to exceed 9 18 months. A temporary license granted by the board to practice speech-language pathology and may be renewed once for 18 months or longer, at the discretion of the board. A temporary license granted to practice audiology may be renewed once by the board if the applicant fails an examination for audiologist licensure under s. 459.26 (2) (a) or (b), Stats., and applies to take the next available examination or if the applicant shows, to the satisfaction of the board, sufficient cause for the renewal.

SECTION 10. HAS 6.10 (3) is renumbered HAS 6.10 (6).

SECTION 11. HAS 6.10 (3), (4) and (5) are created to read:

HAS 6.10 (3) Except as provided in sub. (5), a temporary license granted to practice audiology is valid for a period designated by the board, not to exceed 12 months.

(4) A temporary license granted under sub. (3) may be renewed once for 12 months or longer, at the discretion of the board, if the applicant fails an examination for licensure under s. 459.26 (2) (a) or (b), Stats., and applies to take the next available examination or if the applicant shows, to the satisfaction of the board, sufficient cause for the renewal.

(5) If an individual who is granted a temporary license under sub. (3) to practice audiology fails to take the next available examination under s. 459.26 (2) (a) or (b), Stats., for reasons other than inaction by the board or hardship, the temporary license granted under sub. (3) automatically expires on the one-hundredth calendar day following the date the individual failed to take the examination.

SECTION 12. HAS 6.175 is created to read:

HAS 6.175 Definitions. In this subchapter and in subchapter II of ch. 459, Stats.:

(1) “Cerumen management" means the removal of cerumen from the external auditory canal by the utilization of methods and techniques performed in accordance with minimum standards and procedures established in the audiological profession.

(2) “Full terms of sale" means the conditions of a sale agreed to by an audiologist and the purchaser of a hearing instrument.

(3) “Personal guarantee" means a promise made by an audiologist to a hearing instrument purchaser to provide the minimum product warranty offered by a manufacturer.

(4) “Sell" or “sale" has the meaning given in s. 459.20 (3t), Stats.

(5) “Unprofessional conduct" means the violation of any standard of professional behavior, which through experience, state statute or administrative rule has become established in the practice of speech-language pathology or audiology.

SECTION 13. HAS 6.18 (1) (h) is repealed and recreated to read:

HAS 6.18 (1) (h) Engaged in unprofessional conduct.

SECTION 14. HAS 6.18 (2) is renumbered HAS 6.18 (3) and is amended to read:

HAS 6.18 (3) (intro.) In addition to the grounds bases for discipline unprofessional conduct set forth in under sub. (1) (2), the board may reprimand an audiologist, or deny, limit, suspend or revoke a license or permit, if it finds that the applicant, licensee or permittee has done any of engaged in the following unprofessional conduct:

(a) Violated any federal or state statute, rule or regulation that relates to the practice of fitting and dealing in hearing aids.

(b) Failed to conduct a direct observation of the ear canal of a purchaser of person for whom a hearing aid is purchased.

(c) Sold a hearing aid to for use by a person who was not given tests by a hearing instrument specialist or an audiologist licensed under ch. 459, Stats., or in another state using appropriate procedures and instrumentation and without proper measurement of the functional intensity and range of the person's hearing.

(d) Failed to calibrate audiometric equipment at least once every 12 months.

(e) Failed to maintain adequate records of certification of calibrations of audiometric equipment for a period of 5 years or failed to provide access to those records when requested by the board or its representative.

(f) (intro.) Failed to clearly state the full terms of sale on a receipt, as required in s. 459.24 (3m), Stats., or failed to comply with those terms. The full terms of sale shall include all of the following:

1. The amount and method of payment.

2. The date, and place and method of delivery.

3. The terms of any personal guarantee.

4. The nature and duration of the trial period and extension, if any.

5. The refund policy and amount, if any.

6. The product return and exchange policy, if any.

7. The product repair policy, if any.

(g) Failed to perform cerumen management in a competent manner.

SECTION 15. HAS 6.18 (3) is renumbered HAS 6.18 (2) and is amended to read:

HAS 6.18 (2) (intro.) In this section, “conduct in the practice of speech-language pathology or audiology which evidences a lack of knowledge or ability to apply professional principles or skills" includes subchapter and in s. 459.34 (2) (h), Stats., the following, without limitation because of enumeration, are violations of standards of professional behavior that constitute unprofessional conduct:

(a) Subject to ss. 111.321, 111.322 and 111.34, Stats., practicing or attempting to practice speech-language pathology or audiology while the person's ability to practice is impaired by a mental or emotional disorder.

(b) Using the title “speech-language pathologist," “audiologist" or any similar title unless the individual holds a current speech-language pathologist or audiologist license granted under s. 459.24 (2) or (3), Stats.

(c) Violating the conditions or limitations placed upon a license or permit by the board.

(d) Engaging in conduct likely to deceive, defraud, or harm an individual or the public in the course of the practice of speech-language pathology or audiology.

(e) Having a license, certificate, permit or registration issued by another jurisdiction to practice as a speech-language pathologist or audiologist limited, suspended or revoked.

(f) Aiding or abetting an unlicensed person, knowingly conspiring with an unlicensed person, or allowing one's license to be used by an unlicensed person to evade the use of a title prohibited under s. 459.24 (1) or (1m), Stats.

(g) Engaging in sexual intimacies in connection with the practice of speech-language pathology or audiology.

(h) Failing to fully inform persons served of the nature and possible adverse effects of services rendered and products dispensed.

(i) Failing to evaluate the effectiveness of services rendered or products dispensed.

(j) Providing services or dispensing products when benefits cannot reasonably be expected.

(k) Guaranteeing the results of any treatment or procedure, directly or by implication, except that a reasonable statement of prognosis may be made.

(L) Evaluating or treating speech, language, or hearing disorders except in a professional relationship.

(m) Treating solely by correspondence.

(n) Failing to maintain adequate records of professional services rendered and products dispensed for a period of 5 years.

Note: Speech-language pathologists and audiologists are also required to maintain patient health care records in accordance with ss. 146.81 to 146.84, Stats.

(o) Failing to provide access to records of professional services rendered and products dispensed when requested by the board or its representative in connection with an investigation of a complaint filed against the applicant, licensee or permittee.

(p) Failing to record all of the following information in each client record:

1. The name of the licensee.

2. The date of entry of pertinent information.

3. Information sufficiently legible to allow interpretation by other individuals for the benefit of the client.

(q) Misrepresenting diagnostic information, services rendered, or products dispensed or engaging in any scheme to defraud in connection with obtaining reimbursement.