Amends TCA Title 63, Chapter 17.

This bill adds "cerumen management by a person who has completed a cerumen management course approved by the International Hearing Society" within the definition of the practice of dispensing and fitting hearing instruments, as discussed below. Generally under present law, a person must be licensed in order to engage in the sale of or practice of dispensing and fitting hearing instruments or display a sign or in any other way advertise or hold out to be a hearing instrument specialist. The person must also provide direct hands-on testing and follow-up services to persons to whom the hearing instrument specialist has dispensed and/or sold a hearing instrument. Under present law, the "practice of dispensing and fitting hearing instruments” includes the evaluation or measurement of the powers or range of human hearing by means of an audiometer for the consequent selection or adaptation for sale of hearing instruments intended to compensate for hearing loss, including the appropriate instructions, consultations, suggestions, recommendations or opinions related to this practice, including the making of an impression of the ear, or an ear mold. This bill adds the following to be considered the practice of dispensing and fitting hearing instruments, and accordingly, requires licensure for such service: cerumen management in the course of examining ears by a person who holds a certification of completion of a cerumen management course approved by the International Hearing Society. "Cerumen management" involves the removal of wax-like secretions from the ear. ON APRIL 29, 2021, THE HOUSE ADOPTED AMENDMENT #1 AND PASSED HOUSE BILL 920, AS AMENDED. AMENDMENT #1 changes the approving entity for the required course (see item (10) below) and adds multiple provisions to this bill, as follows: (1) Defines "cerumen" as a wax like secretion from glands in the external auditory canal; (2) Requires a licensed hearing instrument specialist to comply with the certain cerumen management principles, as set out in detail in the bill; (3) Requires the licensed hearing instrument specialist to refer a patient who exhibits certain contraindications to cerumen removal for medical consultation or medical intervention to an otolaryngologist or a licensed physician. Those contraindications include being less than 12 years of age, ear surgery within the last six months, and cerumen impaction that totally occludes the ear canal, among others as specified in this bill; (4) Specifies the instruments that the specialist may use in performing cerumen removal; (5) Sets out circumstances under which the specialist must immediately stop a procedure and refer the patient to an otolaryngologist or a licensed physician; (6) Sets out specific infection control practices to be followed; (7) Requires a licensed hearing instrument specialist who performs cerumen management to maintain a case history for every patient and informed consent signed by the patient as part of the patient's records; (8) Requires a licensed hearing instrument specialist to carry appropriate professional liability insurance before performing cerumen removal; (9) Prohibits a licensed hearing instrument specialist from requiring patients to sign any form that eliminates liability if patient is harmed; and (10) Requires that a licensed hearing instrument specialist who engages in cerumen management must have completed a cerumen management course approved by the International Hearing Society, the American Academy of Otolaryngology-Head and Neck Surgery, or another organization approved by the board. This amendment sets out in detail certain requirements for the course. ON FEBRUARY 3, 2022, THE SENATE SUBSTITUTED HOUSE BILL 920 FOR SENATE BILL 665, ADOPTED AMENDMENT #1, AND PASSED HOUSE BILL 920, AS AMENDED. AMENDMENT #1 incorporates the changes made by House Amendment #1 but changes the authority responsible for approving a cerumen management course described in (10) of the Summary of House Amendment #1 from the board to the council for licensing hearing instrument specialists, and changes this bill's effective date, for purposes other than rules promulgation, from July 1, 2021, to July 1, 2022.