SB-0206, As Passed Senate, April 20, 2004                                   

HOUSE SUBSTITUTE FOR

SENATE BILL NO. 206

                                                                             A bill to amend 1978 PA 368, entitled                                             

"Public health code,"                                                       

by amending sections 16131 and 16263 (MCL 333.16131 and                     

333.16263), as amended by 2004 PA 3, and by adding section 16323a           

and part 168.                                                               

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

1       Sec. 16131.  The terms of office of individual members of                   

2   the boards and task forces, except those appointed to fill                  

3   vacancies, expire 4 years after appointment as follows:                     

4   Audiologists                                  June 30

5     Nursing                                       June 30                     

6     Nursing home administrator                    June 30                     

7     Optometry                                     June 30                     

8     Pharmacy                                      June 30                     

1     Podiatric medicine and surgery                June 30                     

2     Dentistry                                     June 30                     

3     Chiropractic                                  December 31                 

4     Counseling                                    June 30                     

5     Marriage and family therapy                   June 30                     

6     Medicine                                      December 31                 

7     Occupational therapists                       December 31                 

8     Osteopathic medicine and surgery              December 31                 

9     Physical therapy                              December 31                 

10    Psychology                                    December 31                 

11    Respiratory care                              December 31                 

12    Social work                                   December 31                 

13    Veterinary medicine                           December 31                 

14      Sec. 16263.  (1) Except as provided in subsection (2), the                  

15  following words, titles, or letters or a combination thereof,               

16  with or without qualifying words or phrases, are restricted in              

17  use only to those persons authorized under this article to use              

18  the terms and in a way prescribed in this article:                          

19      (a) "Chiropractic", "doctor of chiropractic", "chiropractor",               

20  "d.c.", and "chiropractic physician".                                       

21      (b) "Dentist", "doctor of dental surgery", "oral and                        

22  maxillofacial surgeon", "orthodontist", "prosthodontist",                   

23  "periodontist", "endodontist", "oral pathologist", "pediatric               

24  dentist", "dental hygienist", "registered dental hygienist",                

25  "dental assistant", "registered dental assistant", "r.d.a.",                

26  "d.d.s.", "d.m.d.", and "r.d.h.".                                           

27      (c) "Doctor of medicine" and "m.d.".                                        

1       (d) "Physician's assistant" and "p.a.".                                     

2       (e) "Registered professional nurse", "registered nurse",                    

3   "r.n.", "licensed practical nurse", "l.p.n.", "nurse midwife",              

4   "nurse anesthetist", "nurse practitioner", "trained attendant",             

5   and "t.a.".                                                                 

6       (f) "Doctor of optometry", "optometrist", and "o.d.".                       

7       (g) "Osteopath", "osteopathy", "osteopathic practitioner",                  

8   "doctor of osteopathy", "diplomate in osteopathy", and "d.o.".              

9       (h) "Pharmacy", "pharmacist", "apothecary", "drugstore",                    

10  "druggist", "medicine store", "prescriptions", and "r.ph.".                 

11      (i) "Physical therapy", "physical therapist",                               

12  "physiotherapist", "registered physical therapist", "licensed               

13  physical therapist", "physical therapy technician", "p.t.",                 

14  "r.p.t.", "l.p.t.", and "p.t.t.".                                           

15      (j) "Chiropodist", "chiropody", "chiropodical", "podiatry",                 

16  "podiatrist", "podiatric", "doctor of podiatric medicine", "foot            

17  specialist", "podiatric physician and surgeon", and "d.p.m.".               

18      (k) "Consulting psychologist", "psychologist", "psychological               

19  assistant", "psychological examiner", "licensed psychologist",              

20  and "limited licensed psychologist".                                        

21                                                                               (l) "Licensed professional counselor", "licensed counselor",                        

22  "professional counselor", and "l.p.c.".                                     

23      (m) "Sanitarian", "registered sanitarian", and "r.s.".                      

24      (n)  "Social Until July 1, 2005, "social worker", "certified               

25  social worker", "social work technician", "s.w.", "c.s.w.", and             

26  "s.w.t.".  Beginning July 1, 2005, "social worker", "licensed               

27  master's social worker", "licensed bachelor's social worker",               

1   "registered social service technician", "social service                     

2   technician", "l.m.s.w.", "l.b.s.w.", and "r.s.s.t.".

3       (o) "Veterinary", "veterinarian", "veterinary doctor",                      

4   "veterinary surgeon", "doctor of veterinary medicine", "v.m.d.",            

5   "d.v.m.", "animal technician", or "animal technologist".                    

6       (p) "Occupational therapist", "occupational therapist                       

7   registered", "certified occupational therapist", "o.t.",                    

8   "o.t.r.", "c.o.t.", "certified occupational therapy assistant",             

9   "occupational therapy assistant", or "c.o.t.a.".                            

10      (q) "Marriage advisor" or "marriage consultant"; "family                    

11  counselor", "family advisor", "family therapist", or "family                

12  consultant"; "family guidance counselor", "family guidance                  

13  advisor", or "family guidance consultant"; "marriage guidance               

14  counselor", "marriage guidance advisor", or "marriage guidance              

15  consultant"; "family relations counselor"; "marriage relations              

16  counselor", "marriage relations advisor", or "marriage relations            

17  consultant"; "marital counselor" or "marital therapist"; "limited           

18  licensed marriage and family therapist" or "limited licensed                

19  marriage counselor"; "licensed marriage and family therapist" or            

20  "licensed marriage counselor"; and "l.m.f.t.".                              

21      (r) "Nursing home administrator".                                           

22      (s) "Respiratory therapist", "respiratory care practitioner",               

23  "licensed respiratory therapist", "licensed respiratory care                

24  practitioner", "r.t.", "r.c.p.", "l.r.t.", and "l.r.c.p.".                  

25  (t) "Audiometrist", "audiologist", "hearing therapist",                     

26  "hearing aid audiologist", "educational audiologist", "industrial           

27  audiologist", and "clinical audiologist".

1       (2) Notwithstanding section 16261, a person who was specially               

2   trained at an institution of higher education in this state to              

3   assist a physician in the field of orthopedics and upon                     

4   completion of training, received a 2-year associate of science              

5   degree as an orthopedic physician's assistant before January 1,             

6   1977, may use the title "orthopedic physician's assistant"                  

7   whether or not the person is licensed under this article.                   

8   Sec. 16323a.  Fees for a person licensed or seeking                         

9   licensure as an audiologist under part 168 are as follows:                  

10       (a) Application processing fee......................$ 120.00           

11       (b) License fee, per year...........................  150.00

12  PART 168.  AUDIOLOGY

13  Sec. 16801.  (1) As used in this part:                                      

14      (a) "Audiologist" means an individual licensed under this                   

15  article to engage in the practice of audiology.                             

16      (b) "Practice of audiology" means the nonmedical and                        

17  nonsurgical application of principles, methods, and procedures              

18  related to disorders of hearing, including all of the following:            

19                                                                               (i) Facilitating the conservation of auditory system                                

20  function.                                                                   

21      (ii) Developing and implementing hearing conservation                        

22  programs.                                                                   

23  (iii) Preventing, identifying, and assessing hearing                         

24  disorders of the peripheral and central auditory system.                    

25      (iv) Selecting, fitting, and dispensing of amplification                     

26  systems, including hearing aids and related devices, and                    

27  providing training for their use.                                           

1       (v) Providing auditory training, consulting, education, and                 

2   speech reading to individuals with hearing disorders.                       

3       (vi) Administering and interpreting tests of vestibular                      

4   function and tinnitus in compliance with section 16809 and in               

5   adherence to the mandate of subsection (2).                                 

6       (vii) Routine cerumen removal from the cartilaginous portion                 

7   of the external ear in otherwise healthy ears except that if the            

8   audiologist, while engaged in routine cerumen removal, discovers            

9   any trauma, including, but not limited to, continuous                       

10  uncontrolled bleeding, lacerations, or other traumatic injuries,            

11  he or she shall, as soon as practically possible, refer the                 

12  patient to a person licensed in the practice of medicine or                 

13  osteopathic medicine and surgery.                                           

14      (viii) Speech and language screening limited to a pass-fail                   

15  determination for the purpose of identification of individuals              

16  with disorders of communication.                                            

17      (2) Practice of audiology does not include the practice of                  

18  medicine or osteopathic medicine and surgery or medical diagnosis           

19  or treatment.                                                               

20      (3) In addition to the definitions in this part, article 1                  

21  contains general definitions and principles of construction                 

22  applicable to all articles in this code and part 161 contains               

23  definitions applicable to this part.

24  Sec. 16803.  Beginning 120 days after the effective date of                 

25  this part and except as otherwise provided in section 16807, an             

26  individual shall not engage in the practice of audiology unless             

27  licensed or otherwise authorized by this article.

1   Sec. 16805.  The Michigan board of audiology is created                     

2   within the department.  The board consists of the following 9               

3   voting members who meet the requirements of part 161:                       

4       (a) Five audiologists.  The members initially appointed under               

5   this subdivision shall meet the requirements of section 16135.              

6       (b) Two members shall be persons licensed to practice                       

7   medicine or osteopathic medicine and surgery who hold a                     

8   certificate of qualification from the American board of                     

9   otolaryngology.                                                             

10      (c) Two public members, neither of whom is an audiologist or                

11  physician or has family or financial ties to an audiologist or              

12  physician.

13  Sec. 16807.  This part does not limit any of the following:                 

14      (a) An individual employed by a regionally accredited college               

15  or university and involved with research or the teaching of                 

16  communication disorders from performing those duties for which he           

17  or she is employed by that institution, as long as the individual           

18  does not engage in the practice of audiology or hold himself or             

19  herself out as licensed or otherwise authorized under this                  

20  article as an audiologist.                                                  

21  (b) An individual who is employed by the department of                      

22  community health in 1 of its approved hearing screening training            

23  programs from conducting screening of hearing sensitivity.                  

24      (c) An individual certified by an agency acceptable to the                  

25  occupational health standards commission from engaging in hearing           

26  screening as part of a hearing conservation program in compliance           

27  with standards adopted under the Michigan occupational safety and           

1   health act, 1974 PA 154, MCL 408.1001 to 408.1094.                          

2       (d) A certified, licensed, registered, or otherwise                         

3   statutorily recognized member of another profession, including a            

4   person licensed in the practice of medicine or osteopathic                  

5   medicine and surgery and an unlicensed or licensed person to whom           

6   tasks have been delegated under his or her supervision, and                 

7   including a person licensed under article 13 of the occupational            

8   code, 1980 PA 299, MCL 339.1301 to 339.1309, from practicing his            

9   or her profession as authorized by law, so long as the individual           

10  does not hold himself or herself out to the public as possessing            

11  a license issued or title protected under this article.

12  Sec. 16809.  (1) An audiologist shall administer tests of                   

13  vestibular function only to patients who have been referred to              

14  him or her by a person licensed to practice medicine or                     

15  osteopathic medicine and surgery.                                           

16      (2) If an audiologist administers an audiometric test for                   

17  tinnitus and his or her examination of the patient reflects the             

18  presence of otologic or systemic diseases, the audiologist shall            

19  promptly refer the patient to a person licensed to practice                 

20  medicine or osteopathic medicine and surgery.                               

21  (3) An audiologist shall comply with the federal food and                   

22  drug administration medical referral guidelines for fitting and             

23  dispensing hearing instruments, 21 CFR 801.621, incorporated by             

24  reference.                                                                  

25      (4) A licensed audiologist may not sell a hearing instrument                

26  to a person under 18 years of age unless the person or the parent           

27  or guardian of the person presents to the audiologist a written             

1   statement signed by a licensed physician who specializes in                 

2   diseases of the ear stating that both of the following exist:               

3       (a) The person's hearing loss has been medically evaluated                  

4   during the 6-month period preceding the date the statement is               

5   presented.                                                                  

6       (b) The person may be considered a candidate for a hearing                  

7   instrument.                                                                 

8       Sec. 16811.  (1) The department shall require an individual                 

9   granted a license under this article as an audiologist to meet              

10  either of the following requirements:                                       

11      (a) Possess a master's degree in audiology from a regionally                

12  accredited college or university approved by the board; have                

13  completed at least 9 months of supervised clinical experience in            

14  audiology; and have successfully completed an examination in                

15  audiology as described in subsection (2) or (3).                            

16      (b) Possess a doctoral degree in audiology from a regionally                

17  accredited college or university approved by the board; have                

18  completed at least 9 months of supervised clinical experience in            

19  audiology; and have successfully completed an examination in                

20  audiology as described in subsection (2) or (3).                            

21  (2) The department, in consultation with the board, shall                   

22  provide that applicants pass an examination dealing with all                

23  aspects of the practice of audiology before issuance of a license           

24  under this part.  The department, in consultation with the board,           

25  may develop its own examination and may promulgate rules to                 

26  establish standards for that examination or for the adoption by             

27  reference of an examination, or parts of an examination,                    

1   developed by an outside entity that it determines offers an                 

2   appropriate examination.  If the department adopts all or part of           

3   an examination developed by an outside entity, the department may           

4   promulgate rules to adopt by reference any supplement or update             

5   to the examination.                                                         

6       (3) Beginning on the effective date of this part and until 1                

7   or more examinations are developed or adopted under subsection              

8   (2), the PRAXIS examination in audiology, developed by                      

9   educational testing services, in existence on the effective date            

10  of this part is adopted by reference and considered acceptable              

11  for qualification of applicants under this part.  Not later than            

12  June 30, 2005, the department, in consultation with the board,              

13  shall make a recommendation on whether to develop its own exam,             

14  adopt an examination developed by an outside entity, or continue            

15  to accept the PRAXIS examination and any update pursuant to rule            

16  as further described in subsection (2).  The department shall               

17  notify the house and senate standing committees on health policy            

18  matters of its recommendation.                                              

19      (4) Notwithstanding subsections (2) and (3), the department                 

20  shall grant a license to a person who, on the effective date of             

21  this part, has been engaged in the practice of audiology, who               

22  meets the requirements of subsection (1), who applies for                   

23  licensure under this part, and who presents to the department               

24  proof of passing any past or present version of the PRAXIS                  

25  examination in audiology or any past or present version of its              

26  predecessor, the national teachers examination on speech and                

27  language pathology and audiology, both of which were developed by           

Senate Bill No. 206 (H-6) as amended March 18, 2004

1   educational testing services.  Passage of those examinations is             

2   considered fulfillment of the examination requirement of this               

3   subsection.  The past and present versions of the PRAXIS                    

4   examination in audiology and all versions of its predecessor, the           

5   national teachers examination on speech and language pathology              

6   and audiology, both of which were developed by educational                  

7   testing services, are adopted by reference for purposes of this             

8   subsection.                                                                 

9       (5) Beginning the license year after the effective date of                  

10  the rules promulgated under this subsection, an individual shall            

11  meet the continuing education requirements of this subsection.

12  The department, in consultation with the board, shall promulgate

13  Rules to require licensees seeking renewal to furnish evidence

14  Acceptable to the department and board of the successful

15  Completion, during the preceding license year, of at least 10

16  clock hours of countinuing education [courses or programs related to the

17  practice of audiology and designed to further educate licensees.]

18  (6) The [department] shall ensure that all approved continuing              

19  education courses described in subsection (5) include defined               

20  measurements of preknowledge and postknowledge or skill                     

21  improvements, or both, as a result of the continuing education              

22  program.  [                                                     

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Senate Bill No. 206 (H-6) as amended March 18, 2004

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