California Academy of Audiology Licensing Board Update 2018 Paul R. Sanchez, Executive Officer

Who are we? Part of the Department of Consumer Affairs Responsible for regulating the practices of speech-language pathology, audiology, and hearing aid dispensing Composition of the Board 2 Speech-Language Pathologists 2 Audiologists 2 Hearing Aid Dispensers 3 Public Members Board Office staff – 10 employees Partnership with Attorney General’s Office, Division of Investigation, DCA, and other contracted experts

Why do we need a Licensing Board? § 2530.1. Legislative findings The Legislature finds and declares that the practice of speech-language pathology and audiology and hearing aid dispensing in California affects the public health, safety, and welfare and there is a necessity for those professions to be subject to regulation and control. Added to B&P Stats 1972 § 2531.02. Priority of board; Protection of the public Protection of the public shall be the highest priority for the Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board in exercising its licensing, regulatory, and disciplinary functions. Whenever the protection of the public is inconsistent with other interests sought to be promoted, the protection of the public shall be paramount. Added to Statutes 2002

What does a Licensing Board do? License Develop, approve, and conduct examinations Promote standards through legislative and regulatory processes Enforcement

Licensure Authorizes the individual to practice his or her profession Privilege that must be earned and maintained Required to maintain a minimum standard Governed by state laws and regulations- administered and enforced by the Board

Maintaining your License Audiologist license renews every 2 years. Expires on the last day of birth month. Dispensing audiology license renews every year. Expires on the last day of date- issued month. See Board website table explaining CE requirements for licensees at speechandhearing.ca.gov. Under “Licensee/Continuing Education” DCA sends courtesy renewal form approximately 90 days prior to license expiration date. Renew at this time – do not wait! Keep your address current with the Board, to ensure that you receive a renewal by mail.

Maintaining your License Complete the renewal application (allow at least 6-8 weeks for processing the renewal application) Certify completion of the CE. Answer the conviction declaration question. Complete an address change if necessary. Pay the appropriate renewal fee by check or money order. Renewals are processed by “Central Cashiering.” Your license is deemed active and current when the renewal application is processed, check has cleared, and status of your license is updated on the Board’s website.

CE Requirements Non-Dispensing Audiologists California Code of Regulations 1399.160.3-4 TWO YEAR - License Renewal Requirements: 24 hours every 2-year license renewal 6 hours may be obtained through self-study Self-Study is defined as viewing pre-recorded courses, listening to audiotapes, and/or online courses which are non-participatory (recorded courses that include a live chat or test upon completion are still considered self-study.) Live online courses are not self- study and are considered the equivalent to sitting in a class. 4 hours may be obtained through related or indirect client care courses Not more than 50% of the CE hours required of a licensed non-dispensing audiologist, may be in hearing aid courses, but  shall not be obtained from courses where the content focuses on equipment, devices, or other products of a particular publisher, company or corporation. CCR§ 1399.160.3.(e)

CE Requirements Dispensing Audiologists California Code of Regulations 1399.160.3-4 ONE YEAR - License Renewal Requirements: 12 hours of CE per annual renewal 50% of the CE hours shall be in courses related to hearing aid dispensing, but shall not be obtained from courses where the content focuses on the equipment, devices, or other products of a particular manufacturer. 50% of the CE hours shall be relevant to the practice of audiology and shall not be coursework focused on hearing aid dispensing. 1.5 hours may be obtained through self-study, 1.5 hours may be obtained through related or indirect client care courses.

CE Requirements CE Compliance: Applies to both DAUs & AUDs All courses related to the dispensing of hearing aids offered by hearing aid manufacturers are reviewed and approved by the Board as an applicable course offering. CE courses for DAUs, unlike HADs, do not require individual approval unless the courses are provided by a manufacturer. Provider of the course must be an “approved” provider such as AAA, ASHA, etc. See Board website table explaining CE requirements for licensees at speechandhearing.ca.gov under “Licensee - Continuing Education”

CE Audits Resuming A total of 733 licensees from all license types were randomly selected and audited for compliance during their last renewal cycle. The initial pass rate was 79 percent (579). Audiologist pass rate was 89 percent. Approximately, 17 percent (126) failed the initial audit and approximately 4 percent (28) did not respond. As of July 1, 2018, of those who failed the initial audit, 81 licensees corrected their deficiency.

Licenses Issued Annually FY12/13 FY13/14 FY14/15 FY15/16 FY16/17 FY17/18 AU 76 57 89 48 53 77 DAU 19 UA 26 24 30 SLP 1056 974 1143 1352 1457 1482 SLPA 407 325 550 606 501 558 RPE 727 702 836 834 897 945 HAD Permanent 84 49 92 140 120 137 HAD Trainee 95 139 145 180 152 169 HAD Temp (Out-of-State) 7 5 9 16 20 TOTAL LICENSES ISSUED 2532 2306 2929 3268 3285 3473

Licensee Population LICENSEE POPULATION FY12/13 FY13/14 FY14/15 AU 609 584 612 556 698 720 DAU 942 971 988 1,045 1,211 1,246 Both License Types 1,551 1,555 1,600 1,601 1,909 1,966 SLP 12,696 13,285 13,967 14,860 18,024 19,161 SLPA 1,771 1,969 2,343 2,795 3,752 4,118 RPE 682 768 802 806 1,174 1,232 AIDE 120 119 124 133 235 216 HAD 946 913 948 996 1,179 1,266 HAD Trainees 95 145 160 158 238 204 HAD Temp (Out-of-State) 9 8 7 18 28 TOTAL LICENSEES 17,870 18,762 19,951 21,367 26,529 28,191

Board Enforcement We will investigate all violations of the Board’s laws and regulations, including: Sexual misconduct Conviction of a criminal offense related to the profession Any practice outside the scope of the speech-language pathologist, audiologist, dispensing audiologist, and hearing aid dispenser's license or below accepted professional standards Deceptive or misleading advertising Unlicensed practice

How to file a Complaint Web address: speechandhearing.ca.gov

How to file a Complaint

Complaint Process Written complaint received at Board office. Complaint file opened and a case number is issued. Acknowledgment letter sent to complainant. Complainant information is confidential. In some cases, licensee may be advised of complainant's specific concerns. In that event, the licensee is advised of the complaint and asked to respond. Investigation - Depending on the seriousness of the allegations or number of complaints received, cases may be referred to investigator.

Complaint Process Board may issue a citation and fine as a corrective action against licensee. If investigation results warrant formal discipline, report is forwarded to the Attorney General's Office with request to initiate legal proceedings seeking revocation, probation, or other discipline. Complainant informed of the final disposition of the case. Citations and formal discipline are public information. Citation remains on licensing record for five years Formal discipline remains on licensing record permanently

Enforcement Statistics Fiscal Year 2017-18 License Type Population Complaints Received* Citation Formal Discipline Audiologists 1,966 (1,246 DAUs) 38 3 SLPs 19,161 69 6 5 SLPAs 4,118 47 RPEs 1,232 21 2 1 Aides 216 HADs 1,266 84 7 4 HAD Trainees 204 17 HAD Temp (Out-of-State) 28 Total 28,191 278 20 13 *Includes convictions/subsequent arrest reports.

Audiologist Complaint Issues 2017-18 Board received 38 complaints against audiologists 17 – Advertising 6 – Criminal charges/Convictions 6 – Unprofessional conduct 3 – Fraud 3 – Unlicensed activity 1 – Discipline by another state agency 1 – Negligence/incompetence 1 – Refund/Warranty Issues

Audiologist Complaint Outcomes Since 2011, the Board has received 15-20 complaints annually against audiologists 33% - No action taken Non-jurisdiction, no violation, record on file 24% - Educational letter 15% - Duplicate Less than 10% - Formal discipline Probation, revocation, surrender, etc. Less than 10% - Citation and fine

Board Enforcement We do not investigate: Fee or billing disputes Personality conflicts Anything outside of the Board’s legal jurisdiction General business practices

Licensing Fees Update License Type Current Fees (2002) Proposed Fee Renewal (24 months) - Audiologist (non-dispensing) - Speech-Language Pathologist $110 $150 Initial Application Audiologist Speech-Language Pathologist $60 -Speech-Language Pathology Assistant $75 $100 Audiology Aide $10 $30 California Code of Regulations, Section 1399.157 and 1399.170.13 list current, affected licensing board fees, effective January 1, 2002. Board regulations to be updated to reflect fee increase for initial and renewal fees.

We Need Subject Matter Experts Subject matter experts assist the Board in any of the following areas: Examination development Serving as “Examiners” for Hearing Aid Dispenser practical Assisting the Board with enforcement case review Interested in Serving as an subject matter expert? Please visit speechandhearing.ca.gov for more information

2017 Occupational Analysis At the May 2018 Board meeting, the Office of Professional Examination Services (OPES), presented the 2017 Occupational Analysis (OA) of the Audiology profession.   The analysis included dispensing audiology exam and licensing requirements. Based OA, OPES determined that audiologists wishing to dispense hearing aids should not have to take the hearing aid dispensers’ practical exam. Doctoral level of education Training/supervised clinical experience Performance-based assessment on hearing aid dispensing Taking of ear impressions, assessing and fitting patients for hearing aids, and programming and troubleshooting hearing aids.

2017 Occupational Analysis Current law, BPC Section 2539.1(a) requires that audiologists “pass an examination, approved by the Board, relating to selling hearing aids” to sell hearing aids in California. This section of the law was enacted during the 2010 merger of the HAD Bureau and the Speech-Language Pathology and Audiology Board. BPC Section 2391.1 (d) further directs the Board to require the exam provided at the time by the Hearing Aid Dispensers Bureau until DCA completes an exam validation and OA and a determination is made that a different exam is to be administered. At August 2018, the Board voted in favor of accepting OPES’ recommendations. NEXT STEPS: Proposed language changing dispensing audiologist exam requirements in regulations.

Changes to Self-Study CE Hours for Licensure Renewal California Code of Regulations Section 1399.160.3. Continuing Professional Development Requirements state audiologists can complete a maximum of 6 hours of self-study every two years. Board approved an increase in self-study hours from a maximum of 6 hours to a maximum of 12 hours (out of the minimum of 24 hours) at the November 2015 Board meeting. New regulations to increase allowable self-study hours should become effective 2018/2019.

New Notice to Consumers Requirement California Code of Regulations Section 1399.157. Notice to Consumers approved by the Board at its May 2017 meeting. Regulation requires practitioners to display a consumer notice at the practitioner’s point of service regarding the roles and responsibilities of the Board similar to other healing arts boards consumer notices. Regulation will apply to all Board licensees, including those licensed professionals working in school settings. Effective date will be approximately 2019/2020.

New Fingerprinting Requirements Language in California Code of Regulations Section 1399.112 Requirements for Renewal of License updated and approved at the May 2017 licensing board meeting. Licenses expiring after June 30, 2018 and those not previously electronically fingerprinted, as a condition of renewal, must get provide a full set of electronic fingerprints to Department of Justice for the purpose of conducting and successfully completing a criminal history record check through the Department of Justice.

Coming Soon: Online License Renewal Online renewal by Spring of 2019 Will update daily Limited to renewals Interim solution until we upgrade our database Board has begun work on database conversion

Connect with the Board Future Board Meetings: November 8-9 or 29-30, 2018, Sacramento February 7-8, 2019, Los Angeles May 2-3, 2019, Northern California Web address: speechandhearing.ca.gov Address: 2005 Evergreen Street, Suite 2100, Sacramento, CA 95815 Email: speechandhearing@dca.ca.gov Telephone: 916-263-2666