GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1991

H	1 

HOUSE BILL 566

Short Title:  Hearing Aid Board Changes.	(Public)
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Sponsors: Representatives Hightower; Balmer, Beall, Gray, Jeffus, and Lilley.
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Referred to:  State Government.
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April 1, 1991

A BILL TO BE ENTITLED
AN ACT TO REVISE AND UPDATE THE LAWS RELATING TO THE NORTH CAROLINA STATE HEARING AID DEALERS AND FITTERS BOARD.
The General Assembly of North Carolina enacts:
Section 1.  G.S. 93D-1 reads as rewritten:
"§ 93D-1. Definitions.
For the purposes of this Chapter:
(1)	'Board' shall mean the North Carolina State Hearing Instrument Dispensers  Board.
(2)	 
(2)	' Hearing instrument' shall mean any wearable instrument or device designed for, offered for the purpose of or represented as aiding, improving, or otherwise benefitting persons with or compensating for impaired hearing hearing and any parts, attachments or accessories of such instrument or device.
	(3)	'Hearing instrument dispensing' shall include: the testing of the peripheral auditory system including the use of commercially available auditory test equipment and standardized evaluation procedures as they realte to identifying persons with impaired hearing who may be candidates for hearing instrument amplification; the selection, fitting, adaptation, modification, maintenance and demonstration of hearing amplification systems; the taking of ear impressions to facilitate hearing instrument use; the post-dispensing counseling of individuals to facilitate adjustment or orientation to hearing instrument amplification; or the selling, leasing or renting of hearing instruments.
(4)	'Hearing instrument dispenser' shall mean any person licensed under the provisions who engages in hearing instrument dispensing."
Sec. 2.  G.S. 93D-2 reads as rewritten:
"§ 93D-2. Dispensing Without license or Registration unlawful.
(a)	It shall be unlawful for any person to fit or sell hearing instruments unless he has first obtained a license from the North Carolina State Hearing Instrument Dispensers Board or has passed the minimum competency examination administered by the Board and is a registered apprentice under the provisions of this Chapter.
(b)	Hearing instruments may be offered for sale, lease or rental to persons located in North Carolina by catalog, direct mail, television radio, and all such mass media strategic provided that:
(1)	The seller holds a license issued pursuant to the provisions of this Chapter;
(2)	There is no fitting, selection or adaptation of the instrument and no advice is given with respect to fitting, selection or adaption of the instrument and no advice is given with respect to the taking of an ear impression for an earmold by the seller; and
(3)	The seller has received an audiogram and a statement signed by a physician audiologist or a hearing instrument dispenser which verifies that the provisions of this Chapter have been met.  A copy of this audiogram and statement shall be retained by the seller for a period of time as required under federal law of the provisions of this Chapter or rules adopted pursuant thereto, whichever is longer."
Sec. 3.  G.S. 93D-3 reads as rewritten:
"§ 93D-3. North Carolina Hearing Instrument Dispensers Board; composition, organization, duties and compensation.
(a)	There is hereby created a board whose duty it shall be to carry out the purposes and enforce the provisions of this Chapter, and which shall be known as the "North Carolina Hearing Instrument Dispensers Board." The duty of this board is to provide training, evaluation of qualifications, and regulation of persons engaged in dispensing hearing instruments in order to safeguard the public of North Carolina.  No person shall deny to the recipients or beneficiaries of their aid or service, their freedom to choose a duly licensed hearing instrument dispenser as the provider of care or service which are within the scope of this Chapter.
(b)	The Board shall be composed of seven members. Four members who have been actively engaged in the licensed dispensing of hearing aids for three years shall be appointed by the Governor. 
One member shall be appointed by the Governor and shall be a physician practicing in North Carolina, preferably specializing in the field of otolaryngology. 
One member shall be appointed by the Governor from a list of two audiologists residing in North Carolina, which list shall be compiled  by the North Carolina Speech and Hearing Association. 
One member shall be appointed by the Governor to represent the interest of the public at large. This member shall have no ties to the hearing instrument business nor shall he be an audiologist. 
All appointments shall be for terms of three years.  No member shall serve more than two complete consecutive terms.
Vacancies on the Board shall be filled by appointment of the Governor. Appointees shall serve the unexpired terms of their predecessors in office and must be appointed from the same category as their predecessors in office. The members of the Board, before entering their duties, shall respectively take all oaths taken and prescribed for other State officers, in the manner provided by law, which oaths shall be filed in the office of the Secretary of State, and the Board  shall have a common seal.
(b)	The Board shall meet quarterly or on the call of the president, the executive secretary, or a majority of the members of the Board.  The Board shall elect annually the president and the secretary-treasurer.  A majority of the Board shall constitute a quorum.  The secretary and treasurer of the Board shall keep a full record of its proceedings, including a current list of all licensees and apprentices, which shall at all reasonable times be open to public inspection. 
	(c) The Board is authorized to employ an executive secretary, office personnel, investigator, and legal representation in order to provide such assistance as may be necessary for said Board to perform its duties.
	(d) The Board is authorized to:
(1)	Authorize all disbursements necessary to carry out the provisions of this Chapter;
(2)	Establish, administer, and supervise the licensing examinations to test and determine the knowledge and proficiency of applicants for licenses, minimum competency examinations required for apprentice registration, and minimum competency examinations as described in G.S. 93D-5.
(3)	Issue registrations and licenses to persons qualified under the provisions of this Chapter who apply to the Board;
(4)	Obtain audiometric equipment and facilities necessary to carry out the examination of applicants for licenses and the minimum competency examination;
(5)	To issue and reissue, deny to issue or reissue with cause, to renew or to deny to renew with cause, and to suspend or revoke licenses and apprentice registrations pursuant to the provisions of this Chapter;
(6)	Make and publish rules and regulations (including a code of ethics) which are necessary and proper to regulate the dispensing of hearing instruments to carry out the provisions of this Chapter;
(7)	Exercise jurisdiction over the hearing of complaints, charges of malpractice including corrupt or unprofessional conduct, and allegations of violations of the Board's rules or regulations, which are made against any licensed hearing instrument dispenser or registered apprentice in North Carolina;
(8)	Require the annual calibration of audiometric testing equipment of persons who are dispensing hearing instruments;
(9)	In connection with any matter within the jurisdiction of the  Board, summon and subpoena and examine witnesses under oath and to compel their attendance and the production of books, papers, or other documents or writings deemed by the Board to be necessary or material to the inquiry. Each summons or subpoena shall be issued under the hand of the secretary and treasurer or the president of the Board and shall have the force and effect of a summons or subpoena issued by a court of record. Any witness who shall refuse or neglect to appear in obedience thereto or to testify or produce books, papers, or other documents or writings required shall be liable to contempt charges. The Board shall pay to any witness subpoenaed before it the fees and per diem as paid witnesses in civil actions in the superior court of the county where such hearing is held;
(10)	Inform the Attorney General of any information or knowledge it acquires regarding any "price-fixing" activity whatsoever in connection with the dispensing and servicing of hearing instruments;
			(14)	Establish the subject matter of minimum competency examinations and licensing examinations and provide for instructional training materials and classes for the purpose of preparing persons to be qualified as registered apprentices or to be issued licenses in accordance with the provisions of this Chapter;
(15)	Provide annual continuing education programs as requirements for registration and license renewal as established by the Board and published in the Board's rules;
(16)	Set where not established by this Chapter and collect fees for the minimum competency examinations and the licensing examinations; training classes for apprentices; annual continuing education programs; issuance and renewal of licenses, registrations, and replacement licenses and registrations; reproduction of documents; and for processing continuing education program approval and verification of attendance.
(d)	Out of the funds coming into the possession of said Board, each member thereof may receive as reimbursement for each day he is actually engaged in the assigned duties of his office in accordance with G.S. 93B-5. 
The secretary-treasurer and the executive secretary shall each give a bond to the Board to be approved by the Board, in a sum equal to the annual budget conditioned upon the faithful performance of the duties of his office.
The Board shall make an annual report of its proceedings to the Governor on the first Monday in June of each year, which report shall contain an account of all moneys received and disbursed by the Board and a complete listing of names and addresses of all licensees and apprentices. Copies of the report and list of licensees and apprentices shall be filed in the office of the State Auditor, the Secretary of State, and Attorney General."
Sec. 4.  G.S. 93D-4 reads as rewritten:
"§ 93D-4. Board may enjoin illegal practices.
The Board may, if it finds that any person is violating any of the provisions of this Chapter, apply to superior court for a temporary or permanent restraining order or injunction to restrain such persons from continuing such illegal practices. If upon application, it appears to the court that such person has violated or is violating the provisions of this Chapter, the court shall issue an order restraining the dispensing of hearing instruments or other conduct in violation of this Chapter.  All such actions by the Board for injunctive relief shall be governed by the Rules of Civil Procedure and Article 37, Chapter 1 of the General Statutes; provided, that injunctive relief may be granted regardless of whether criminal prosecution has been or may be instituted under the provisions of this Chapter. Actions under this section shall be commenced in the superior court district or set of districts as defined in G.S. 7A-41.1 in which the respondent resides or has his principal place of business."
Sec. 5. G.S. 93D-5 reads as rewritten:
"§ 93D-5. Requirements for registration; examinations; apprentice licenses.
(a)	No person shall dispense of hearing instruments in this State after the effective date of this Chapter until he is issued a license by the Board or is an registered apprentice working under the supervision of a licensee. Except as hereinafter provided, each applicant for a license shall pay a fee of one hundred dollars ($100.00) and shall show to the satisfaction of the Board that he:
(1)	Is a person of good moral character,
(2)	Is 18 years of age or older,
(3)	Has an education equivalent to graduation from a four-year course in an accredited high school,
(4)	Certifies by signed statement that he is free of contagious or infectious disease.
(b)	(1)	All applicants for apprentice registration must first register and pass a minimum competency examination before such registration is granted under supervision of a licensee.  The requirements for supervision by a licensee are to be determined by the Board.   No person can engage in the dispensing of hearing instruments until he is issued an apprentice registration.
(2)	All applicants for apprentice registration must take a minimum competency examination which will be offered at least quarterly at the discretion of the Board.  The examination will have two sections:
(i)	The written section will test knowledge of State and federal laws concerning the practice of hearing instrument dispensing and sponsors' training responsibilities; and
(ii)	The practicum section will consist of taking ear impressions and performing basic audiometric procedures.
(3)	Upon receiving an application accompanied by a fee set by the Board and successful completion of a minimum competency examination, the Board may register the applicant as an apprentice which shall entitle the applicant to dispense hearing instruments under the supervision of a licensee.
(c)	No apprentice shall be registered by the Board under this section unless the applicant has passed a minimum competency examination and shows to the satisfaction of the Board that he is or will be supervised and trained by a licensee.  No applicant for apprentice registration shall be allowed to sit for the minimum competency examination more than three times under the same sponsor.
(d)	If an apprentice does not take the next succeeding examination given after the completion of his apprenticeship period as required under this Chapter, his apprentice registration shall not be renewed except for good cause shown to the satisfaction of the Board.  A registered apprentice is eligible to and must take the licensing examination for licensure after a period of two years of supervised training as a registered apprentice.
(e)	If a registered apprentice takes and fails to pass the next succeeding examination given after two full years of apprenticeship, the Board may renew the apprenticeship registration for a period of time to end 30 days after the results of the examination given next after the date of renewal of said registration.  The fee for renewal of apprenticeship registration shall be set by the Board.
	All requirements for licensure including successfully passing the licensing examination must be completed within 12 months of initially sitting for the licensing examination.  No license shall be issued to a person until he has successfully passed a qualifying examination administered by the Board.
	No license shall be issued to any person until he has served as an apprentice as set forth in G.S. 93D-9 for a period of at least two years; provided, that this subsection shall not apply to those persons holding masters degrees in Audiology who have attended a pre-examination workshop sponsored and approved by the Board, passed a minimum competency examination administered by the Board, been registered as an apprentice, and have completed the Board-specified supervised activity of dispensing hearing instruments under the direct supervision of a licensee approved by the Board for a period of one year, or have met the licensure requirements under Article 22 of Chapter 90 of the General Statutes, have attended a pre-examination workshop sponsored and approved by the Board, and have passed a licensing examination. 
(f)	The Board shall adopt rules implementing initial and renewal registration of apprentices; dates of examination; pre-examination workshops; and instructional programs which may be required of apprentices.  These rules shall also detail the duties of the licensee supervising an apprentice and of the apprentice during the entire apprenticeship period."
Sec. 6. G.S. 93D-7 reads as rewritten:
"§ 93D-7. Statements of sale.
Every person dispensing a hearing instrument, be it new or used, in the State of North Carolina, no later than at the time of delivery of the hearing instrument shall render to the user and/or purchaser a statement of sale to include the following:
(1)	Date of sale;
(2)	Condition of the hearing instrument;  new, used, reconditioned;
(3)	Name of manufacturer and model of the instrument;
(4)	Hearing instrument serial number and year manufactured;
(5)	Total price of all products and services;
(6)	Name and North Carolina address of the dispenser;
(7)	Name of the person who sold the instrument and his license or apprentice registration number;
(8)	Signature of customer;
(9)	Name of person who delivered the instrument and his license or apprentice registration number;
(10)	Name of purchasing party if different than customer; and
(11)	Information required to conform with all current federal and state laws."
Sec. 7. G.S. 93D-7 reads as rewritten:
"§ 93D-8. Licensing Examination. 
(a)	Every applicant for a license who is notified by the Board that he has fulfilled the requirements of G.S. 93D-5(a) shall appear at a time, place and before such persons as the Board may designate, to be  examined by written and practical tests in order to demonstrate that he is qualified for the dispensing of hearing instruments. The Board shall give two licensing examinations of the type prescribed herein each year at a duly prescribed time and place, which shall be publicized for at least 90 days in advance. Additional licensing examinations may be given at the discretion of the Board. The licensing examinations provided in this section shall not include questions requiring a medical or surgical education but shall consist of:
(1)	Tests of knowledge in the following areas as they pertain to the fitting of hearing instruments:
a.	The basic physics of sound,
b.	The human hearing mechanism, including the science of hearing and the cause and rehabilitation of abnormal hearing and hearing disorders, and
c.	The structure and function of hearing âinstruments.
(2)	Tests of proficiency in the following techniques as they  pertain to the fitting of hearing instruments:
a.	Pure tone audiometry, including air conduction testing and bone conduction testing, and the appropriate use of masking.
b.	Live voice and recorded voice speech audiometry, including speech reception threshold testing and speech discrimination testing,
	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 in the opinion of the Board.
(3)	Knowledge of the state and federal laws and rules that govern the dispensing of hearing instruments.
(b)	Upon payment of five dollars ($5.00) and upon successful completion of the licensing examination and all other requirements set forth in this Chapter, the Board shall issue a license certificate to each applicant who successfully passes the licensing examination.
	(c)	No applicant shall be allowed to sit for the licensing examination more than three times under the same apprentice registration."
Sec. 8. G.S. 93D-10 reads as rewritten:
"§ 93D-10.  Registration and notice.
The Board shall register each apprentice and each person to whom it grants a license. The secretary-treasurer of the Board shall keep a record of the place of business of all licensees and apprentices. Any notice required to be given by the Board to a person holding a license or registration may be given by mailing to him at the last address received by the Board from him."
Sec. 9. G.S. 93D-11 reads as rewritten:
"§ 93D-11.  Annual fees; failure to pay; expiration of license; occupational instruction courses.
Every licensed person who engages in the dispensing of hearing instruments shall pay to the Board an annual license renewal fee of one hundred dollars ($100.00). Such payment shall be made prior to the first day of April in each year. In case of default in payment the license shall expire 30 days after notice by the secretary-treasurer or executive secretary to the last known address of the licensee by registered mail. The Board may reinstate an expired license upon the showing of good cause for late payment of fees, upon payment of said fees within 60 days after expiration of the license, and upon the further payment of a late penalty of ten dollars ($10.00). After 60 days after the expiration date, the Board may reinstate the license for good cause shown upon application for reinstatement and payment of the late penalty of ten dollars ($10.00) and renewal fee. The Board may require all licensees to successfully attend and complete a course or courses of occupational instruction funded, conducted or approved or sponsored by the Board on an annual basis as a condition to any license renewal and evidence of satisfactory attendance and completion of any such course or courses shall be provided the Board by the licensee."
Sec. 10. G.S. 93D-12 reads as rewritten:
"§ 93D-12.  License to be displayed at office.
Every person to whom a license or apprenticeship registration is granted shall display the same in a conspicuous part of his office wherein the dispensing of hearing instruments is conducted, or shall have a copy of such license or apprenticeship registration on his person and exhibit the same upon request when dispensing hearing instruments outside of his office."
Sec. 11. G.S. 93D-13 reads as rewritten:
"§ 93D-13.  Discipline, suspension, revocation of licenses.
(a)	The Board may in its discretion administer the punishment of private reprimand, suspension of license or registration for a fixed period, or revocation of license or registration as the case may warrant in their discretion for any violation of the rules and regulations of the Board or for any of the following causes:
(1) Habitual drunkenness;
(2)	Gross incompetence;
(3)	Knowingly dispensing hearing instruments while suffering with a contagious or infectious disease;
(4)	Commission of a criminal offense indicating professional unfitness;
(5)	The use of a false name or alias in his business;
(6)	Conduct involving willful deceit;
(7)	Conduct involving fraud or any other business conduct involving moral turpitude;
(8)	Advertising of a character or nature tending to deceive or mislead the public;
(9)	The use of advertising declared to be unethical by the Board or prohibited by the code of ethics established by the Board;
(10)	Permitting another person to use his license or registration;
   (11)	Failure by a licensee to properly supervise an apprentice or trainee under his supervision;
(12)	Knowingly employing or contracting with any person to dispense hearing instruments in North Carolina who does not hold a valid North Carolina hearing instrument dispenser license or a valid apprentice registration; and
   (13)	For violating any of the provisions of this Chapter.
(b)	Board action in revoking or suspending a license or registration shall be in accordance with the provisions of Chapter 150A of the General Statutes. Any person whose license or registration has been suspended for any of the grounds or reasons herein set forth, may, after the expiration of 90 days but within two years, apply to the Board to have the same reissued; upon a showing satisfactory to the Board that such reissuance will not endanger the public health and welfare, the Board may reissue a license or registration to such person for a fee of one hundred dollars ($100.00) plus five dollars ($5.00) for a certificate of license. If application is made subsequent to two years from date of suspension, reissuance shall be in accordance with the provisions of G.S. 93D-8."
Sec. 12.  G.S. 93D-14 reads as rewritten:
"§ 93D-14.  Persons not affected.
(a)	This Chapter shall not prevent any person from engaging in the measuring of human hearing for the purpose of selection of hearing instruments, provided such person or organization employing such person does not sell hearing instruments or accessories thereto, nor shall this Chapter apply to any physician licensed to practice medicine or surgery in the State of North Carolina. Nothing in this Chapter shall permit a licensee hereunder to perform any practices or services set forth in Article 17 of Chapter 90 of the General Statutes of North Carolina.
(b)	The purchase of auditory trainers by a school or other educational institution for the purpose of communicating with and educating individuals with hearing impairments is exempt from the provisions of this Chapter."
Sec. 13.  G.S. 93D-15 reads as rewritten:
"§ 93D-15.  Violation of Chapter.
Any person who violates any of the provisions of this Chapter and any person who holds himself out to the public as a dispenser of hearing instruments without having first obtained a license or apprenticeship registration as provided for herein shall be deemed guilty of a misdemeanor and upon conviction shall be punished by a fine of not more than one thousand dollars ($1,000) nor less than five hundred dollars ($500.00) or imprisonment for not more than six months, or both, in the discretion of the court."
Sec. 14.  This act shall become effective October 1, 1991.