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(1) Any individual seeking to develop the skills and training necessary to obtain a temporary permit under section 346.075, RSMo, shall register supervision and apply for a temporary permit to engage in the practice of fitting hearing instruments as defined by section 346.010(11), RSMo. An application for registration of supervision shall be made on a form provided by the board and must be accompanied by the appropriate fee as prescribed in 20 CSR 2165-1.020. The application is not considered complete until qualifications of the supervisor match the criteria as prescribed in 20 CSR 2165-2.020. (2) An approved temporary permit entitles the hearing instrument specialist in training to engage in the practice of fitting hearing instruments as defined by section 346.010(11), RSMo, for a period of one (1) year. (A) If a person holding a permit is not licensed within the one- (1-) year period, the hearing instrument specialist in training may renew the permit once for a period of six (6) months upon payment of the applicable fee as prescribed in 20 CSR 2165-1.020. (B) The six- (6-) month permit extension will immediately follow the expiration of the temporary permit, regardless of when the application is received by the board. A hearing instrument specialist in training shall not hold a temporary permit beyond eighteen (18) months from the date the temporary permit was originally issued. (3) The hearing instrument specialist in training shall accrue no less than one hundred (100) hours of supervision from a licensed hearing instrument specialist registered as a supervisor pursuant to 20 CSR 2165-2.020 prior to becoming eligible for licensure by examination. (4) If the hearing instrument specialist in training ceases to practice under an approved supervisor and/or changes supervision, the specialist in training shall notify the board by filing a change of supervision form and paying the change of supervision fee as defined in 20 CSR 2165-1.020. (5) Each applicant for a hearing instrument specialist in training permit as provided in section 346.075, RSMo, must indicate on the application form the name, business address and license number of the registered supervisor. (6) Upon completion of any registered supervised experience, the hearing instrument specialist in training shall request an attestation form from the board to be completed by the registered supervisor and returned to the board. (7) The hearing instrument specialist in training must be identified by a temporary permit number and the words “hearing instrument specialist in training,” on any sales contract or other documents available to the consumer, including marketing and referring to the temporary permit holder. Initials or acronyms representing these titles shall not be used. (8) A temporary permit is not required for students attending a hearing sciences program at an accredited college or university who are participating in a practicum to complete that program. The student must be under the direct supervision of a registered supervisor. Direct supervision means the licensed hearing instrument specialist is on the premises where the patient is being treated and is quickly and easily available and the patient has been examined by a licensed hearing instrument specialist. Such students shall not identify themselves as a “hearing instrument specialist,” “hearing instrument specialist in training,” or a “temporary permit holder.” AUTHORITY: sections 346.070, 346.075, 346.080, and 346.125, RSMo 2016.* This rule originally filed as 4 CSR 165-2.010. Emergency rule filed March 18, 1996, effective March 28, 1996, expired Sept. 23, 1996. Emergency rule filed Oct. 28, 1996, effective Nov. 7, 1996, expired May 5, 1997. Original rule filed Oct. 16, 1996, effective May 30, 1997. Amended: Filed June 22, 1999, effective Dec. 30, 1999. Amended: Filed April 1, 2003, effective Sept. 30, 2003. Amended: Filed March 15, 2004, effective Sept. 30, 2004. Moved to 20 CSR 2165-2.010, effective Aug. 28, 2006. Amended: Filed June 27, 2008, effective Dec. 30, 2008. Amended: Filed Dec. 30, 2008, effective July 30, 2009. Amended: Filed May 18, 2022, effective Nov. 30, 2022. *Original authority: 346.070, RSMo 1973, amended 1995, 2009; 346.075, RSMo 1973, amended 1981, 1995, 2009; 346.080, RSMo 1973, amended 1981, 1995, 2009; and 346.125, RSMo 1973, amended 1981, 1995, 2009. 20 CSR 2165-2.020 Supervisors PURPOSE: This rule outlines and explains the responsibilities and requirements of a registered supervisor. (1) A licensed hearing instrument specialist may obtain a certificate of registration as a registered supervisor by completing an application from the board and paying the fee as defined in 20 CSR 2165-1.020. (2) A registered supervisor must be licensed in Missouri as a hearing instrument specialist for a minimum of two (2) years. (A) A licensed hearing instrument specialist who holds any professional license which is or has ever been subject to any form of discipline may be prohibited from serving as a supervisor; and (B) A licensed hearing instrument specialist shall be credentialed as a Board Certified Hearing Instrument Specialist (BC-HIS) or the American Conference of Audioprosthology (ACA) or be a licensed audiologist pursuant to Chapter 345, RSMo, and licensed as a hearing instrument specialist in order to qualify as a registered supervisor. (3) The registered supervisor shall exercise full order, control, guidance, and professional responsibility involved in the practice of fitting hearing instruments by a hearing instrument specialist in training. (4) The registered supervisor shall meet with the hearing instrument specialist in training at least once per workweek, face-to-face, to review all audiometric evaluations, whether a purchase is made or not, purchase agreements, instrument orders, ear impressions, and all hearing instrument fittings. The registered supervisor must affix his/her signature and license number to purchase agreements and audiometric evaluation results. (5) Within thirty (30) days of completion of registered supervision, pursuant to 20 CSR 2165-2.010(5) the registered supervisor shall document the supervision and training on an attestation form provided by the board. (6) Upon termination of registered supervision, the registered supervisor shall submit both the attestation form and temporary permit to the board within thirty (30) days. AUTHORITY: sections 346.075.2 and 346.125, RSMo 2016.* This rule originally filed as 4 CSR 165-2.020. Emergency rule filed March 18, 1996, effective March 28, 1996, expired Sept. 23, 1996. Emergency rule filed Oct. 28, 1996, effective Nov. 7, 1996, expired May 5, 1996. Original rule filed Oct. 16, 1996, effective May 30, 1997. Moved to 20 CSR 2165-2.020, effective Aug. 28, 2006. Amended: Filed June 27, 2008, effective Dec. 30, 2008. Amended: Filed Sept. 25, 2019, effective March 30, 2020. *Original authority: 346.075, RSMo 1973, amended 1981, 1995, 2009 and 346.125, RSMo 1973, amended 1981, 1995, 2009. 20 CSR 2165-2.025 Application Procedures PURPOSE: This rule outlines the procedure for applying for licensure as a hearing instrument specialist and/or a hearing instrument specialist in training. (1) Application forms must be obtained by requesting them from the Board of Examiners for Hearing Instrument Specialists, PO Box 1335, Jefferson City, MO 65102 or on the board’s website www.pr.mo.gov/hearing.asp. (2) The following documents must be on file for an application to be considered complete: (A) Completed original application that must be legible (printed or typed), signed, and notarized; (B) Appropriate fee; (C) An official transcript sent directly to the board by the school showing proof of educational requirements pursuant to section 346.055, RSMo; (D) A current, standard passport photo, attached to the application; and (E) Verification of licensure submitted by each state where the applicant has ever been licensed. (3) For an applicant who elects to apply for a license and completes the written and/or practical examinations prior to the completion of his/her educational program, the board will not issue a license until such time as the applicant completes his/her education and an official transcript verifying a conferred degree is sent directly to the board by the school and all other licensure requirements are met. (4) Applications for licensure are valid for a period of three (3) years from the date the application is received in the board’s office. If an applicant has not completed the application process within the three- (3-) year period, the application will be void. If an applicant must reapply for licensure, all current licensure requirements must be met. AUTHORITY: section 346.055, RSMo Supp. 2022, and sections 346.115 and 346.125, RSMo 2016.* Original rule filed Sept. 8, 2008, effective March 30, 2009. Amended: Filed Jan. 10, 2013, effective July 30, 2013. Amended: Filed May 18, 2022, effective Nov. 30, 2022. *Original authority: 346.055, RSMo 1973, amended 1981, 1995, 2007, 2013, 2014, 2018, 2020; 346.115, RSMo 1973, amended 1981, 1993, 1995, 2009; and 346.125, RSMo 1973, amended 1981, 1995, 2009. 20 CSR 2165-2.030 Licensure by Examination PURPOSE: This rule outlines and explains the requirements and procedures for obtaining a hearing instrument specialist license by examination. (1) Applications for the written examination shall be received by the board prior to the written examination. Applications for the practical examination shall be received by the board at least thirty (30) days prior to the next scheduled practical examination. (2) Applicants with special needs addressed by the Americans with Disabilities Act must notify the board office or its approved vendor at least thirty (30) days prior to the examination to ensure that reasonable accommodations are made. Notification may be forwarded in writing and mailed to the Board of Examiners for Hearing Instrument Specialists, PO Box 1335, Jefferson City, MO 65102 or by calling (573) 751-0240. The TDD number for the hearing impaired is (800) 735-2966. (3) The practical examination will be administered at least every six (6) months. The written and practical examinations may be administered on different days. (4) The written and practical portions of the examination may be administered by the board or its approved vendor utilizing a national testing service or other examination at the board’s discretion. (5) The applicant shall pass the written examination to be eligible for the practical portion of the examination. The written examination scores shall be received by the board at least thirty (30) days prior to the next scheduled practical examination. (6) The following procedures and requirements apply to the practical examination: (A) It shall be the responsibility of the applicant to furnish all equipment needed. In order to ensure the integrity of the practical portion of the examination and that it adequately tests the applicant’s abilities, the board or its approved vendor may determine what equipment an applicant is permitted to use and may prohibit the use of any particular equipment containing memory storage or automated testing procedures, unless it can be demonstrated and verified that the memory can be erased or the feature deactivated. Equipment shall be in good working order as evidenced by a receipt of annual calibration of the audiometer. Failure to have the necessary equipment will be sufficient reason to disallow the applicant the opportunity to take the practical portion of the examination and cause forfeiture of the examination fee. If the applicant wishes to take the next scheduled practical portion of the examination, the applicant must reapply and pay the practical examination fee; and (B) The practical portion of the examination may be conducted at the discretion of the board or its approved vendor either using simulators or live subjects for all or part of the examination, except that all persons taking the examination on a specific date shall be tested in the same manner. A time limit may be imposed for any part of the practical portion of the examination provided that: 1) this time limit is established by the board or its approved vendor prior to the examination; and 2) that it is applied uniformly. (7) Requirements for Passing the Written Examination. (A) The board or its approved vendor shall determine the passing score according to the standards of the examination. (B) If the applicant fails the written portion of the examination, the applicant shall retake the entire written examination. (8) If the applicant fails one (1) or more portions of the practical examination, the applicant shall retake the entire practical examination upon payment of the practical examination fee. (9) An applicant who fails the practical examination and two (2) subsequent re-examinations shall be disqualified from retaking the examination a fourth time, until meeting with the board, presenting a written plan for passing the examination, and obtaining the board’s approval for retaking the examination. In the case of a hearing instrument specialist in training, the current registered supervisor, as defined in section 346.010(15), RSMo, must be present at the meeting with the board. AUTHORITY: sections 346.060, 346.085, 346.115, and 346.125, RSMo 2016.* This rule originally filed as 4 CSR 165-2.030. Emergency rule filed March 18, 1996, effective March 28, 1996, expired Sept. 23, 1996. Original rule filed Oct. 16, 1996, effective May 30, 1997. Amended: Filed June 22, 1999, effective Dec. 30, 1999. Amended: Filed April 1, 2003, effective Sept. 30, 2003. Moved to 20 CSR 2165-2.030, effective Aug. 28, 2006. Amended: Filed Dec. 30, 2008, effective July 30, 2009. Amended: Filed Jan. 10, 2013, effective July 30, 2013. Amended: Filed Sept. 13, 2013, effective Feb. 28, 2014. Amended: Filed Sept. 25, 2019, effective March 30, 2020. *Original authority: 346.060, RSMo 1973, amended 1995, 2007; 346.085, RSMo 1973, amended 1995, 2013; 346.115, RSMo 1973, amended 1981, 1993, 1995, 2009; and 346.125, RSMo 1973, amended 1981, 1995, 2009. 20 CSR 2165-2.035 Issuance of Temporary Courtesy License to Nonresident Military Spouse (Rescinded June 30, 2022) Authority: sections 324.008 and 346.125, RSMo 2016. Original rule filed Sept. 25, 2019, effective March 30, 2020. Rescinded: Filed Dec. 15, 2021, effective June 30, 2022. 20 CSR 2165-2.040 Licensure by Reciprocity (Rescinded November 30, 2022) AUTHORITY: section 346.115.1(7), RSMo 2000. This rule originally filed as 4 CSR 165-2.040. Original rule filed Oct. 16, 1996, effective May 30, 1997. Moved to 20 CSR 2165-2.040, effective Aug. 28, 2006. Amended: Filed Dec. 30, 2008, effective July 30, 2009. Rescinded: Filed May 18, 2022, effective Nov. 30, 2022. 20 CSR 2165-2.050 Continuing Education Requirements PURPOSE: This rule provides the requirements for continuing education for a licensed hearing instrument specialist. (1) The following guidelines govern the attendance and approval of educational programs for biennial license renewal: (A) The licensee shall provide certificates of completion upon request of the board. Every licensee shall maintain full and complete records of all approved continuing education hours earned for the two (2) previous reporting periods in addition to the current reporting period. Such records shall include all certificates of completion of approved continuing education hours. The board may conduct an audit of licensees to verify compliance with the continuing education requirements. Licensees shall provide all approved continuing education certificates to the board within fifteen (15) days of the board’s request of such documentation; (B) Certificates of completion must demonstrate that the licensee attended a minimum of twenty-four (24) hours of approved educational hearing instrument programs during the current reporting period; and (C) The continuing education reporting period shall consist of a two- (2-) year period. It shall begin on January 1 of even-numbered years and end on December 31 of the following year. (2) The first twelve (12) hours of the continuing education requirements will be waived during the initial year of licensure as a hearing instrument specialist. The new licensee will be required to obtain the remaining twelve (12) hours of the twenty-four- (24-) hour continuing education requirement should the licensee become licensed in the first year of the continuing education reporting period. If the new licensee becomes licensed in the second year of the continuing education reporting period, the continuing education requirement shall be waived for that reporting period. (3) The board may approve individual educational programs whose curriculum provides training which enhances the licensee’s ability to dispense hearing instruments and which benefits the hearing impaired. Documentation supporting the educational program’s relevance is required. The board will automatically approve continuing education programs that are approved by the following organizations without requiring documentation supporting the educational program’s relevance: (A) International Institute for Hearing Instrument Studies (IIHIS); (B) American Speech and Hearing Association (ASHA); and (C) American Academy of Audiology (AAA); (4) Any group or individual that wishes to sponsor an educational program to meet the standard for annual license renewal in Missouri that is not approved by the organizations listed in section (3) of this rule shall submit a copy of the program schedule and outline to the board. The outline shall indicate the program subject, the number of hours required for its presentation, and the identity and qualifications of the speakers and instructors and shall be submitted to the board no less than thirty (30) days prior to the presentation of the program. (5) The licensee may submit the information outlined in 20 CSR 2165-2.050(4) to the board for review and approval of a particular class. (6) The board, for good cause shown, may approve continuing education hours or waive continuing education hours required for an individual licensee in lieu of satisfying the requirements of 20 CSR 2165-2.050(3) and 20 CSR 2165-2.060. The board may make such approval or waiver conditional. A request for approval or waiver of continuing education hours shall be submitted in writing to the board no less than thirty (30) days prior to the continuing education requirement deadline for which the approval or waiver is sought. (7) Each licensee shall be provided with evidence of attendance from the sponsoring organization. This evidence shall be in the form of documentation received from the sponsoring organization, showing the name of the course, date, place, and hours of attendance. All licensees shall maintain full and complete records of all approved continuing education hours earned for the two (2) previous reporting periods in addition to the current reporting period. AUTHORITY: sections 346.095 and 346.115, RSMo 2016.* This rule originally filed as 4 CSR 165-2.050. Original rule filed Oct. 16, 1996, effective May 30, 1997. Amended: Filed June 22, 1999, effective Dec. 30, 1999. Amended: Filed July 30, 2001, effective March 30, 2002. Amended: Filed June 28, 2002, effective Dec. 30, 2002. Moved to 20 CSR 2165-2.050, effective Aug. 28, 2006. Amended: Filed June 27, 2008, effective Dec. 30, 2008. Amended: Filed Dec. 2, 2011, effective June 30, 2012. Amended: Filed Dec. 26, 2023, effective June 30, 2024. *Original authority: 346.095, RSMo 1973, amended 1981, 1995, 2009, and 346.115, RSMo 1973, amended 1981, 1993, 1995, 2009. 20 CSR 2165-2.060 License Renewal PURPOSE: This rule clarifies the license renewal requirements and procedures. (1) Every licensed hearing instrument specialist must notify the Board of Examiners for Hearing Instrument Specialists of every change in their office address(es) within fifteen (15) working days. (2) Every licensed hearing instrument specialist shall display his/her current license in a conspicuous place in his/her office. A hearing instrument specialist working outside of the office shall have available for review his/her current official wallet license at all times. (3) Each person who engages in the fitting and selling of hearing instruments shall, on or before the renewal date, pay the required fees, present annual receipts of calibration of all audiometers, and obtain satisfactory evidence that continuing education requirements have been completed pursuant to 20 CSR 2165-2.050. (4) When an organization owns or leases all or a portion of the audiometers utilized by the hearing instrument specialist employed, the organization must submit annual receipt of calibration pursuant to 20 CSR 2165-2.060(3). A hearing instrument specialist employed with such an organization who utilizes only this equipment may reference this annual receipt as evidence of compliance with his/her annual calibration requirements. (5) Reactivation of Non-Current License. (A) Any hearing instrument specialist license that is not renewed prior to the expiration date of the license shall become non-current. Persons with non-current licenses shall not engage in the fitting of hearing instruments. (B) In order to reactivate a non-current license the hearing instrument specialist must submit the following: 1. Renewal application; 2. Renewal fee; 3. Reactivation fee; 4. Annual calibration receipt; 5. Proof of the required continuing education hours pursuant to 20 CSR 2165-2.050. These hours must have been obtained during the preceding twenty-four (24) months from the date of application for reactivation. (C) Hearing instrument specialists may reactivate a non-current license within two (2) years of its expiration date without submitting to an examination. Any hearing instrument specialist license not reactivated within two (2) years of the expiration date must complete a new application for licensure, submit all required documentation, and pay all applicable fees. (6) Inactive License. (A) A hearing instrument specialist may choose to place his/her license on an inactive status by signing an affidavit stating that s/he will not engage in the practice of fitting hearing instruments in Missouri, which would include serving as a supervisor of a hearing instrument specialist in training, and submitting that affidavit with the renewal application and the appropriate fee to the board office. The license issued to all these applicants shall be stamped “inactive.” (B) In order for a hearing instrument specialist to activate an inactive license, the licensee shall submit to the board office— 1. The renewal application; 2. The balance of the active renewal fee. No fee will be prorated; 3. Evidence that the licensee has completed the required continuing education credits pursuant to 20 CSR 2165-2.050 for each renewal cycle that the license is inactive; 4. Annual calibration receipt; 5. The license stamped “inactive”; and 6. Registered supervisors must submit proof of current board certification. (C) The board will issue an inactive license, which shall be effective until the next regular renewal date. No penalty fee shall apply. AUTHORITY: sections 346.095 and 346.125, RSMo 2016.* This rule originally filed as 4 CSR 165-2.060. Emergency rule filed Oct. 28, 1996, effective Nov. 7, 1996, expired May 5, 1997. Original rule filed Nov. 6, 1996, effective May 30, 1997. Amended: Filed July 30, 2001, effective March 30, 2002. Amended: Filed April 1, 2003, effective Sept. 30, 2003. Moved to 20 CSR 2165-2.060, effective Aug. 28, 2006. Amended: Filed June 27, 2008, effective Jan. 30, 2009. Amended: Filed May 18, 2022, effective Nov. 30, 2022. *Original authority: 346.095, RSMo 1973, amended 1981, 1995, 2009, and 346.125, RSMo 1973, amended 1981, 1995, 2009. 20 CSR 2165-2.065 Renewal of Licenses for Military Members PURPOSE: This rule sets forth the procedure for renewal of a license held by a licensee on active military duty and for discipline of a license held by a licensee on active military duty. (1) Any individual holding a current hearing instrument specialist license that is engaged in the performance of active military duty who has their license lapse while performing such military service, may renew or reinstate such license without penalty by— (A) Filing with the board a Notice of Active Military Duty on a form provided by the board or by written communication accepted by the board that shall be signed and dated by the licensee and shall contain the licensee’s name, address, the type of license or registration, license number, and the date of active duty activation, and shall be accompanied by a copy of the licensee’s active duty orders or other evidence sufficient for the board to determine the dates of active military duty; and (B) Filing such Notice of Active Military Duty or accepted written communication with the board no later than sixty (60) days after completion of the active duty military service. (2) Upon receipt and approval of the Notice of Active Military Duty or accepted written communication, the board shall reinstate the individual’s license with no further requirements. (3) If a licensee fails to take any required action or fails to meet any required obligation of the board while the licensee is on active military duty, the licensee shall have at least one hundred eighty (180) days after the end of his or her active military duty to take those actions or fulfill those obligations before any administrative action can be taken by the board. (4) If the board desires to initiate disciplinary action, administrative action, or any other proceeding where the licensee is a necessary party and the licensee is on active military duty, the board shall stay such action or proceeding until at least sixty (60) days after the licensee returns from active duty. AUTHORITY: sections 41.950, 324.008, and 346.125, RSMo 2016.* Original rule filed Sept. 25, 2019, effective March 30, 2020. *Original authority: 41.950, RSMo 1991, amended 2007, 2009, 2011; 324.008, RSMo 2011; and 346.125, RSMo 1973, amended 1981, 1995, 2009. 20 CSR 2165-2.070 Public Complaint Handling and Disposition Procedure PURPOSE: This rule establishes a procedure for the receipt, handling, and disposition of public complaints by the board. (1) The office will receive and process each complaint made against any licensee or hearing instrument specialist in training when a complaint alleges certain acts or practices which may constitute one (1) or more violations of the provisions of Chapter 346, RSMo. Any member of the public or the profession, or any federal, state, or local official may make and file a complaint with the department. Complaints from sources outside Missouri will be received and processed in the same manner as those originating within Missouri. No member of the board shall file a complaint with this division while they hold that office, unless the member excuses him/herself from further board deliberations or activity concerning matters alleged within that complaint. Any executive director or any staff member within the division may file a complaint pursuant to this rule in the same manner as any member of the public. (2) Complaints should be sent to the board at: Board of Examiners for Hearing Instrument Specialists, PO Box 1335, Jefferson City, MO, 65102-1335 or [email protected]. Complaints may be made based upon personal knowledge or upon information and belief reciting information received from other sources. (3) All complaints shall be made in writing and fully identify the complainant by name and address. Complaints shall be made on forms provided by the board. Oral or telephone communication will not be considered or processed as complaints. However, the person making this communication will be provided with a complaint form and requested to complete it in writing and return it to the office. (4) Each complaint received under this rule shall be acknowledged in writing. The licensee or subject of the complaint shall be informed as to whether the complaint is being investigated. Both the licensee and the complainant shall be notified of the ultimate disposition of the complaint, excluding judicial appeals and be provided with copies of the ultimate disposition (if any) of the Administrative Hearing Commission and the board. The provisions of this section shall not apply to complaints filed by staff members of the board based on information and belief, acting in reliance on third-party information received by the division. (5) Both the complaint and any information obtained as a result of the investigation shall be considered a closed record and not be available for inspection by the general public. However, a copy of the complaint and any attachments shall be provided to any licensee who is the subject of that complaint or their legal counsel. (6) This rule shall not be deemed to limit the board’s authority to file a complaint with the Administrative Hearing Commission charging a licensee or hearing instrument specialist in training with any actionable conduct or violation, whether or not any public complaint has been filed with the board. AUTHORITY: section 346.125, RSMo 2016.* This rule originally filed as 4 CSR 165-2.070. Emergency rule filed Oct. 18, 1996, effective Nov. 1, 1996, expired April 29, 1997. Original rule filed Nov. 6, 1996, effective May 30, 1997. Moved to 20 CSR 2165-2.070, effective Aug. 28, 2006. 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