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Oklahoma Legislature· HB 2188Referred to Public Health

An act relating to schools, the official text

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1                            STATE OF OKLAHOMA

2   1st Session of the 60th Legislature (2025)

3 HOUSE BILL 2188            By: Blancett

4

5

6                            AS INTRODUCED

7   An Act relating to schools; requiring hearing

    screening for certain students within certain

8   timeframe; specifying screenings be conducted by

    certain personnel; providing for notification of

9   certain information; directing advisory committee to

    make certain suggestions; providing composition;

10  directing State Board of Health to adopt certain

    rules; requiring State Department of Health to

11  maintain a statewide registry; recommending certain

    students receive certain hearing examination;

12  requiring certain person to forward written report to

    certain parties; specifying contents of report;

13  allowing school attendance in event of failure of

    certain parties to furnish certain report; providing

14  for school districts to notify certain parents of

    certain requirements; directing the State Board of

15  Education to adopt certain rules; directing the State

    Department of Education to issue certain annual

16  report; providing for codification; and providing an

    effective date.

17

18

19

20 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:

21  SECTION 1.      NEW LAW  A new section of law to be codified

22 in the Oklahoma Statutes as Section 1210.286 of Title 70, unless

23 there is created a duplication in numbering, reads as follows:

24

    Req. No. 12220                                                 Page 1
1   1. "Audiologist" means a person licensed by the State of

2 Oklahoma to practice audiology under Section 1603 of Title 59 of the

3 Oklahoma Statutes;

4   2. "Board" means the State Board of Health;

5   3. "Commissioner" means the State Commissioner of Health of the

6 State of Oklahoma;

7   4. "Comprehensive hearing exam" means a clinical assessment and

8 tests administered by a licensed audiologist to assess a person's

9 level of hearing as well as detect any abnormality or diseases;

10  5. "Department" means the State Department of Health;

11  6. "Draining ear" means an ear is not able to be screened due

12 to a postulant drainage from the ear canal;

13  7. "Equipment" means the necessary items needed to carry out a

14 hearing screening pursuant to this act and consists of the

15 following:

16  a. a properly calibrated pure tone audiometer,

17  b. a properly calibrated tympanometer,

18  c. an otoacoustic emission device (DPOAE and/or TPOAE),

19             or

20  d. a tablet computer with audio port; a clinically

21             validated auditory assessment tablet-based software

22             that uses both high-frequency tones and speech

23             screening; high-resolution headphones that provide

24             ambient noise attenuation;

    Req. No. 12220                                                 Page 2
1   8. "Hearing screening" means the process or system used to

2 identify students who may be at risk of having or developing hearing

3 problems that may adversely affect their ability to acquire

4 knowledge, skill or learning, for the purpose of recommending

5 further evaluation by an audiologist;

6   9. "A hearing screening app" means a software application that

7 determines relative auditory pathway integrity for speech

8 understanding using speech-in-quiet, speech-in-noise, and tones-in-

9 noise methods, in addition to pure tones at 6000Hz and 8000Hz;

10  10. "Hard-of-hearing" (HOH) means having some residual hearing

11 and therefore not considered deaf;

12  11. "Hearing screening provider" means a person who has

13 successfully completed hearing screening training using curricula

14 approved by the Department, submitted an application to the

15 Department, and has been approved by the Department as being a

16 hearing screening provider;

17  12. "Hearing screening registry" is a system for collecting and

18 maintaining in a structured manner the names of individuals that

19 have been approved by the Department as hearing screening providers;

20  13. "Hearing screening trainer" is a person who has been

21 approved as a hearing screening provider approved by the Department

22 to provide training to potential hearing screening providers;

23

24

    Req. No. 12220                                                 Page 3
1   14. "Infant and Children's Health Advisory Council" means the

2 advisory council to the Board and Department in the area of infant

3 and child health issues including vision and audiology screening;

4   15. "Middle ear pathology" refers to the presence of either

5 outer ear obstructions by a foreign object and/or middle ear

6 pressure and/or fluid and/or deformation of middle ear ossicles;

7   16. "Noise induced hearing loss" referred to as NIHL is the

8 loss of hearing sensitivity due to excessive exposure at damaging

9 levels of noise;

10  17. "Pure tone" means a hearing screening that determines

11 relative hearing sensitivity for pure tone frequencies; and

12  18. "Referral" means parent or guardian notification that the

13 student's screening results indicate a need for a comprehensive

14 hearing exam by an audiologist.

15  SECTION 2.      NEW LAW  A new section of law to be codified

16 in the Oklahoma Statutes as Section 1210.287 of Title 70, unless

17 there is created a duplication in numbering, reads as follows:

18  A. 1. The State Department of Health, in coordination with the

19 State Department of Education, shall require hearing screenings of

20 all children in pre-kindergarten, kindergarten, first, second,

21 third, fifth, seventh, and eleventh grades, or children in

22 comparable age groups referred for testing. This includes any child

23 in any grade being recommended for a hearing screening by a parent

24

    Req. No. 12220                                                  Page 4
1 and/or educator. The timing of screenings shall be followed as set

2 forth in paragraph 1, 3, and 4 of subsection G in this section.

3   2. Exemption criteria for a school hearing screening is as

4 follows:

5           a. a child entering public school or public charter

6           school in this state shall provide certification to

7           school personnel that the student passed a hearing

8           screening meeting the criteria set forth by this act

9           as a minimum, within the previous six (6) months or

10          during the school year. Such screening shall be

11          conducted by personnel listed on the statewide

12          registry as maintained by the State Department of

13          Health, which may include, but not be limited to,

14          Oklahoma-licensed audiologists,

15          b. a student enrolled in pre-kindergarten, kindergarten,

16          first, second, third, seventh, and eleventh grade at a

17          public school or public charter school, in this state

18          shall provide, within thirty (30) days of the

19          beginning of the school year, certification to school

20          personnel that the student passed a hearing screening

21          within the previous six (6) months. Such screening

22          shall be conducted by personnel listed on the

23          statewide registry as maintained by the State

24

    Req. No. 12220                                                 Page 5
1               Department of Health; which may include, but not be

2               limited to, Oklahoma-licensed audiologists, or

3   c. the parent or guardian of a deaf or hard-of-hearing

4               student, who provides within thirty (30) days of the

5               beginning of the school year, certification to school

6               personnel the most recent hearing test by a licensed

7               audiologist which is within the last six (6) months.

8   B. Hearing screenings shall, at a minimum, utilize the

9 equipment and procedures specified under Title 70 of the Oklahoma

10 Statutes and comply with the following criteria based on the

11 methodology used:

12  1. For a pure tone audiometer, perform a four-frequency, pure

13 tone hearing screening on each of the student's ears with response

14 recorded at each of the following frequencies and intensities:

15  a. 1000 Hz at 20 dB HL,

16  b. 2000 Hz at 20 dB HL,

17  c. 4000 Hz at 20 dB HL, and

18  d. 6000 Hz at 20 dB HL;

19  2. For a combination of a tympanometer and a pure tone

20 audiometer:

21  a. produce a tympanogram showing the probability of

22              middle ear fluid by using a tympanometer and/or any

23              new middle ear screening tool determined by the

24

    Req. No. 12220                                                 Page 6
1       Department to be a comparable screening tool. A

2       tympanometer will show the following results:

3       (1) peak acoustic immittance in mmho, ml, or

4                   compliance for a 226 Hz probe tone, or

5       (2) tympanometric width in daPa, and

6       b. obtain the results of a four-frequency, pure tone

7       hearing screening on each of the student's ears with

8       response recorded at each of the following frequencies

9       and intensities:

10      (1) 1000 Hz at 20 dB HL,

11      (2) 2000 Hz at 20 dB HL, and

12      (3) 4000 Hz at 20 dB HL; 6000 Hz at 20dB; or

13      3. For an otoacoustic emissions device (OAE) device:

14      a. measure responses of the cochlea to no less than four

15      test frequencies, and

16      b. device display screen indicates pass for all four

17      frequencies;

18      4. All equipment must meet the American National Standards

19 Institute (ANSI) standards and manufacturer specifications. This

20 equipment must be calibrated annually to ensure accuracy. The

21 equipment model and calibration date must be on all screening forms;

22 and

23      5. Schools opting to use speech screenings must use a tablet

24 meeting the same ANSI standards as an audiometer and an evidence-

    Req. No. 12220                                                  Page 7
1 based, clinically validated assessment software using pure tones and

2 speech software, or any new hearing screening tool determined by the

3 Department to be a comparable screening tool that utilizes both

4 methods.

5   C. The following hearing acuity criteria shall be used as a

6 basis for referring a child for further evaluation by an

7 audiologist:

8   1. Refer on a clinically validated tablet-based auditory

9 assessment software using both high-frequency pure tones and speech

10 testing for two screenings and/or referring the pure tone

11 frequencies at any frequency in one or both ears;

12  2. A draining ear; or

13  3. A refer on OAEs in one or both ears at any frequency.

14  D. Training for performing hearing screenings in schools shall

15 be provided by the Department and at a minimum, include how to

16 perform a hearing screening, criteria for passing, the various

17 methods to screen hearing, and resources to use when a child is

18 referred twice.

19  E. The statewide registry will maintain a list of individuals

20 who have been trained to screen hearing using all methods. This

21 training is good for three (3) years. The registry will also

22 maintain a list of pediatric audiologists who can provide services

23 to schools who need further testing for referred students.

24

    Req. No. 12220                                                 Page 8
1   F. Licensed audiologists are exempt from training but will be

2 included on the statewide registry and referral list at their

3 request.

4   G. This section shall recognize the need to use a gradient

5 method to allow schools to learn, adapt, and implement hearing

6 screenings in the schools. The gradient method is listed as

7 follows:

8   1. First year hearing screenings for children may include any

9 of the methods listed therein. Any child being evaluated for

10 special education services, and/or is referred by a parent/educator,

11 shall be screened using speech and high-frequency pure tones;

12  2. The second year hearing screenings for children may include

13 any of the methods listed therein with the exception of special

14 education students. Any child who is being evaluated/reevaluated

15 for special education services and/or is referred by a

16 parent/educator shall be screened using speech and high-frequency

17 pure tones; and

18  3. The third year hearing screenings for all children being

19 evaluated for or are in special education services, and/or is

20 referred by a parent/educator shall use speech and high-frequency

21 pure tones.

22  H. 1. The Department shall make recommendations on:

23          a. qualifications for initial recognition and renewal of

24              recognition of hearing screeners, and

    Req. No. 12220                                                  Page 9
1   b. qualifications for initial recognition and renewal of

2   recognition of hearing screener trainers; provided,

3   Oklahoma licensed audiologists shall be exempt from

4   any training requirements;

5   2. The Department shall:

6   a. establish and thereafter maintain a statewide

7   registry, available via the Internet, which shall

8   contain a list of approved hearing screeners and

9   audiologists who seek to be listed to provide

10  services, and

11  b. maintain a list of approved hearing screener trainers;

12  3. After notice and hearing, the Department may deny, refuse,

13 suspend, or revoke approval to an applicant who has a history of:

14  a. noncompliance or incomplete or partial compliance with

15  the provisions of this section or the rules adopted by

16  the Board to implement the provisions of this section,

17  b. referring persons to a business in which the applicant

18  has a financial interest or a business which is owned

19  or operated by someone within the third degree of

20  consanguinity or affinity of the applicant, or

21  c. conduct which demonstrates that the applicant is

22  providing services in a manner which does not warrant

23  public trust; and

24

    Req. No. 12220                                       Page 10
1   4. The Board, giving consideration to the recommendations of

2 the Council, shall promulgate rules to implement the provisions of

3 this section.

4   I. 1. The parent or guardian of each student who fails the

5 hearing screening required in subsection A of this section shall

6 receive a recommendation to undergo a comprehensive hearing

7 examination performed by an Oklahoma-licensed audiologist.

8   2. The Oklahoma-licensed audiologist shall forward a written

9 report of the results of the comprehensive hearing examination to

10 the Department, the student's school, parent or guardian, and

11 primary health care provider designated by the parent or guardian.

12 The report shall include, but not be limited to:

13  a. date of report,

14  b. name, address, and date of birth of the student,

15  c. name of the student's school,

16  d. type of examination,

17  e. a summary of significant findings, including

18               diagnoses, medication used, duration of action of

19               medication, treatment, prognosis, whether or not a

20               return visit is recommended and, if so, when,

21  f. recommended educational adjustments for the child, if

22               any, which may include: preferential seating in the

23               classroom, the use of hearing aids, specific

24

    Req. No. 12220                                                Page 11
1           interventions, FM systems, and any other

2           recommendations, and

3           g. name, address, credentials, and signature of the

4           examiner.

5   J. No student shall be prohibited from attending school for a

6 parent's or guardian's failure to furnish a report of the student's

7 hearing screening or an examiner's failure to furnish the results of

8 a student's comprehensive hearing examination required by this

9 section.

10  K. School districts shall notify parents or guardians of

11 students who enroll in kindergarten, first, second, third, seventh,

12 and eleventh grade for the 2026-2027 school year and each year

13 thereafter of the requirements of this section.

14  L. The State Board of Education shall adopt rules for the

15 implementation of this section except as provided in subsection B of

16 this section. The State Department of Education shall issue a

17 report annually on the impact and effectiveness of this act.

18  SECTION 3. This act shall become effective June 1, 2025.

19

20  60-1-12220      TJ  01/15/25

21

22

23

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    Req. No. 12220                                                 Page 12
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