HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/HB 957 Hearing Aid Consultations and Sales
SPONSOR(S): Professions & Public Health Subcommittee, Mooney and others
TIED BILLS: IDEN./SIM. BILLS:
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY
CHIEF
1) Professions & Public Health Subcommittee 9 Y, 7 N, As CS Guzzo McElroy
SUMMARY ANALYSIS
A person who is not able to hear as well as someone with normal hearing, hearing thresholds of 20 decibels or
better in both ears, has hearing loss. In the United States, approximately 15% of adults (37.5 million) report
some difficulty hearing and 29 million adults could benefit from hearing aids. In 2019, there were 372,111
people with a hearing disability in Florida.
The Board of Speech-Language Pathology & Audiology within the Department of Health (DOH) is responsible
for licensing, monitoring, disciplining and educating audiologists. The practice of audiology includes the
application of principles, methods, and procedures for the prevention, identification, evaluation, consultation,
habilitation, rehabilitation, instruction, treatment, and research, relative to hearing and the disorders of hearing.
The Board of Hearing Aid Specialists within DOH is responsible for licensing, monitoring, disciplining and
educating hearing aid specialists. A licensed hearing aid specialist may practice the dispensing of hearing aids,
which includes: conducting and interpreting hearing tests for purposes of selecting suitable hearing aids;
making ear molds or ear impressions; providing appropriate counseling; and all acts pertaining to the selling,
renting, leasing, pricing, delivery, and warranty of hearing aids.
Audiologists and hearing aid specialists are authorized to conduct and interpret hearing tests and to dispense
hearing aids if necessary. Both audiologists and hearing aid specialists are authorized to utilize telehealth to
provide audiology services. However, current law prohibits any person from selling or distributing hearing aids
through the mail to the ultimate consumer. A violation of the mailing prohibition constitutes a second-degree
misdemeanor which is punishable by up to 60 days imprisonment and carries a fine of up to $500. This creates
a barrier for audiologists and hearing aid specialists to utilize telehealth to provide audiology services.
PCS for HB 957 repeals sections of law, s. 468.1265, F.S., and s. 484.054, F.S., that prohibit individuals from
selling or distributing hearing aids through the mail to the ultimate consumer. This removes a key barrier for
audiologists and hearing aid specialists to utilize telehealth to provide audiology services to individuals with
hearing loss.
The bill has no fiscal impact on state or local government.
The bill provides an effective date of July 1, 2021.
This document does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h0957.PPH
DATE: 4/1/2021
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Hearing Loss
A person who is not able to hear as well as someone with normal hearing – hearing thresholds of 20
decibels or better in both ears – is said to have hearing loss.1 There are four types of hearing loss:2
Conductive Hearing Loss – Occurs when something prevents sounds from getting through the
outer or middle ear.
Sensorineural Hearing Loss - Occurs when there is a problem in the way the inner ear or
hearing nerve works.
Mixed Hearing Loss - Hearing loss that includes both a conductive and a sensorineural
hearing loss.
Auditory Neuropathy Spectrum Disorder - Hearing loss that occurs when sound enters the
ear normally, but because of damage to the inner ear or the hearing nerve, sound is not
organized in a way that the brain can understand.
In the United States, approximately 15% of adults (37.5 million) report some difficulty hearing and 29
million adults could benefit from hearing aids.3 In 2019, there were 372,111 people with a hearing
disability in Florida.4
Audiologists
The Board of Speech-Language Pathology & Audiology within the Department of Health (DOH) is
responsible for licensing, monitoring, disciplining and educating audiologists.5 The practice of audiology
includes the application of principles, methods, and procedures for the prevention, identification,
evaluation, consultation, habilitation, rehabilitation, instruction, treatment, and research, relative to
hearing and the disorders of hearing.
In addition to conducting and interpreting hearing tests and dispensing hearing aids a licensed
audiologist may also:6
Offer, render, plan, direct, conduct, consult, or supervise certain services to individuals who
have or are suspected of having hearing disorders, including:
o Identification;
o Evaluation;
o Treatment;
o Consultation;
o Habilitation;
1 World Health Organization, Deafness and Hearing Loss, Mar. 2, 2021, available at https://www.who.int/news-room/fact-
sheets/detail/deafness-and-hearing-loss (last visited Mar. 29, 2021). “Disabling hearing loss” refers to hearing loss greater than 35
decibels in the better hearing ear.
2 Centers for Disease Control and Prevention, Types of Hearing Loss, available at https://www.cdc.gov/ncbddd/hearingloss/types.html
(last visited on March 30, 2021).
3 United States Department of Health and Human Services, National Institute of Deafness and Other Communication Disorders, Quick
Statistics About Hearing, available at https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing (last visited on March 30, 2021).
A hearing aid is a small electronic device that goes in or behind an individual’s ear to make sounds louder so the person can listen,
communicate, and participate more fully in daily activities.
4 Florida Department of Health – FLHealthCHARTS Community Health Assessment Resource Tool Set, Census Population Under 18
with Hearing Disability, Census Population 18-64 with Hearing Disability, Hearing Disability 65-74, and Hearing Disability 75+, available
at http://www.flhealthcharts.com/charts/SearchResult.aspx (last visited Mar. 29, 2021).
5 S. 468.1185, F.S.
6 S. 468.1125(6)(b), F.S.
STORAGE NAME: h0957.PPH PAGE: 2
DATE: 4/1/2021
o Rehabilitation;
o Instruction; and
o Research.
Participate in hearing conservation, evaluation of noise environments, and noise control.
Habilitate and rehabilitate, including, but not limited to, hearing aid evaluation, prescription,
preparation, fitting, assistive listening device selection and orientation, auditory training, aural
habilitation and rehabilitation, speech conservation, and speechreading;
Fabricate ear molds;
Evaluate tinnitus; and
Provide speech and language screening, limited to a pass/fail determination for identifying
individuals with disorders of communication.
Audiologists are required to follow certain minimum procedures and conduct certain tests when fitting a
patient for a hearing aid, including:7
Pure tone audiometric testing by air and bone to determine the type and degree of hearing
deficiency when indicated;
Effective masking when indicated; and
Appropriate testing to determine speech reception thresholds, speech discrimination scores, the
most comfortable listening levels, uncomfortable loudness levels, and the selection of the best
fitting arrangement for maximum hearing aid benefit when indicated.
All audiometric tests must be conducted in a testing room that has been certified by DOH not to exceed
certain sound pressure levels and specified frequencies.8 An audiologist is required to perform a final
fitting for a patient to ensure the physical and operational comfort of the hearing aid when indicated.9
Hearing Aid Specialists
The Board of Hearing Aid Specialists within DOH is responsible for licensing, monitoring, disciplining
and educating hearing aid specialists. A licensed hearing aid specialist may practice the dispensing of
hearing aids, which includes:10
Conducting and interpreting hearing tests for purposes of selecting suitable hearing aids.
Making ear molds or ear impressions;
Providing appropriate counseling; and
All acts pertaining to the selling, renting, leasing, pricing, delivery, and warranty of hearing aids.
Hearing aid specialists are required to follow certain minimum procedures and conduct certain tests
when fitting a patient for a hearing aid, including:11
Pure tone audiometric testing by air and bone to determine the type and degree of hearing
deficiency;
Effective masking when indicated; and
Appropriate testing to determine speech reception thresholds, speech discrimination scores, the
most comfortable listening levels, uncomfortable loudness levels, and the selection of the best
fitting arrangement for maximum hearing aid benefit.
All audiometric tests must be conducted in a testing room that has been certified by DOH not to exceed
certain sound pressure levels and specified frequencies.12 A hearing aid specialist is required to
perform a final fitting for a patient to ensure the physical and operational comfort of the hearing aid.13
7 S. 468.1225(1), F.S.
8 S. 468.1225(6), F.S.
9 S. 468.1225(3), F.S.
10 S. 484.045, F.S.
11 S. 484.0501(1), F.S.
12 S. 484.0501(6), F.S.
13 S. 484.0501(3), F.S.
STORAGE NAME: h0957.PPH PAGE: 3
DATE: 4/1/2021
Telehealth for Audiologists and Hearing Aid Specialists
Florida licensed and Florida registered out-of-state audiologists and hearing aid specialists are
authorized to utilize telehealth to provide audiology services.14 However, current law prohibits any
person from selling or distributing hearing aids through the mail to the ultimate consumer.15 A violation
of the mailing prohibition constitutes a second-degree misdemeanor which is punishable by up to 60
days imprisonment and carries a fine of up to $500.16 This creates a barrier for audiologists and hearing
aid specialists to utilize telehealth to provide audiology services.
Effect of the Bill
PCS for HB 957 repeals the sections of law, s. 468.1265, F.S., and s. 484.054, F.S., that prohibit
individuals from selling or distributing hearing aids through the mail to the ultimate consumer. This
removes a key barrier for audiologists and hearing aid specialists to utilize telehealth to provide
audiology services to individuals with hearing loss.
The bill provides an effective date of July 1, 2021.
B. SECTION DIRECTORY:
Section 1: Repeals ss. 468.1265 and 484.054, F.S.
Section 2: Provides an effective date of July 1, 2021.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
None.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
It is possible that allowing audiologists and hearing aid specialists to sell and distribute hearing aids
through the mail will result in an indeterminate increase in their sales and revenue.
D. FISCAL COMMENTS:
None.
14 S. 456.47(1)(b), F.S.
15 SS. 468.1265, F.S., and 484.054, F.S.
16 Id., and ss. 775.082(4)(b), F.S., and 775.083(1)(e), F.S.
STORAGE NAME: h0957.PPH PAGE: 4
DATE: 4/1/2021
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not applicable. The PCS does not appear to affect county or municipal governments.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
No rule-making authority is necessary to implement the provisions of the bill.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/ COMMITTEE SUBSTITUTE CHANGES
STORAGE NAME: h0957.PPH PAGE: 5
DATE: 4/1/2021