PURPOSE: This rule clarifies the process by which an individual may apply for a permit to practice as a hearing instrument specialist in training, and defines time limit and supervision requirements for the temporary permit holder.

1. (1) Any individual seeking to develop the skills and training necessary to obtain a license 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 shall not be considered proper and final until qualifications of the supervisor match the criteria as prescribed in 20 CSR 2165- 2.020.

2. (2) An approved temporary permit shall entitle 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.

   1. (A) If a person holding a permit has not passed the examination 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.
   2. (B) The six (6)-month renewal term shall commence immediately following the expiration of the temporary permit, regardless of when the renewal application is received by the board, such that 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. (3) The hearing instrument specialist in training shall accrue no less than one hundred
4. (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.
5. (4) If the hearing instrument specialist in training ceases to practice under an approved supervisor and/or changes supervision, s/he 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. The change of supervision is subject to review pursuant to 20 CSR 2165-2.010(2).
6. (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.
7. (6) The practice of fitting hearing instruments by a hearing instrument specialist in training shall be performed according to the registered supervisor’s order, control, guidance, and professional responsibility.

8. (7) A hearing instrument specialist in training shall be trained in the following procedures during his/her training period:

   1. (A) Air conduction thresholds, with masking where appropriate;
   2. (B) Bone conduction thresholds, with masking where appropriate;
   3. (C) Speech reception thresholds, with masking where appropriate, utilizing test equipment with a calibrated circuit;
   4. (D) Word recognition scores, with masking where appropriate, utilizing test equipment with a calibrated circuit;
   5. (E) A verification of hearing instrument benefit;
   6. (F) Ear impressions; and
   7. (G) Visual otoscopy.

9. (8) As a part of the training of a hearing instrument specialist in training, s/he shall attend classes that would be approved for a licensee to renew his/her license under 20 CSR 2165-2.050.

   1. (A) Three (3) hours of such training shall be completed every six (6) months.
   2. (B) A person in training less than six (6) months need not complete such training.
   3. (C) Proof of completion of such training shall be attached to the attestation form completed by the registered supervisor.
10. (9) 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.
11. (10) The hearing instrument specialist in training must be identified by a temporary permit number and use one of the following 20 CSR 2165-2

titles: “hearing instrument specialist in training,” “trainee,” or “temporary permit holder” in any sales contract or other documents available to the consumer, and referring to the temporary permit holder. Initials or acronyms representing these titles shall not be used.

1. (11) A temporary permit is not required for students attending a hearing sciences program at an accredited college or university that are participating in a practicum to complete that program. The student must be under the direct supervision of a registered supervisor. Direct supervision shall mean 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 at such times as acceptable hearing instrument specialist practice requires. 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 346.115.1(7), RSMo 2000.* 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. *Original authority: 346.070, RSMo 1973, amended 1995; 346.075, RSMo 1973, amended 1981, 1995; 346.080, RSMo 1973, amended 1981, 1995; and 346.115, RSMo 1973, amended 1981, 1993, 1995.