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28	28	STATE OF OKLAHOMA
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30	30	1st Session of the 60th Legislature (2025)
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32	32	HOUSE BILL 2188 By: Blancett
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38	38	AS INTRODUCED
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40	40	An Act relating to schools; requiring hearing
41	41	screening for certain students within certain
42	42	timeframe; specifying screenings be conduct ed by
43	43	certain personnel; providing for notification of
44	44	certain information; directing advisory committee to
45	45	make certain suggestions; providing composition;
46	46	directing State Board of Health to adopt certain
47	47	rules; requiring State Department of Health to
48	48	maintain a statewide registry; recommending certain
49	49	students receive certain hear ing examination;
50	50	requiring certain person to forward written report to
51	51	certain parties; specifying contents of report;
52	52	allowing school attendance in event of failure of
53	53	certain parties to furnish certain report; providing
54	54	for school districts to notify certain parents of
55	55	certain requirements; directing the State Board of
56	56	Education to adopt certain rules; directing the State
57	57	Department of Education to issue certain annual
58	58	report; providing for codification; and providing an
59	59	effective date.
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66	66	BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
67	67	SECTION 1. NEW LAW A new section of law to be codified
68	68	in the Oklahoma Statutes as Section 1210.286 of Ti tle 70, unless
69	69	there is created a duplication in numbering, reads as follows:
70	70
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96	96	1. "Audiologist" means a person licensed by the State of
97	97	Oklahoma to practice audiology under Section 1603 of Title 59 of the
98	98	Oklahoma Statutes;
99	99	2. "Board" means the State Boar d of Health;
100	100	3. "Commissioner" means the State Commissioner of Health of the
101	101	State of Oklahoma;
102	102	4. "Comprehensive hearing exam" means a clinical assessment and
103	103	tests administered by a licensed audiologist to assess a person 's
104	104	level of hearing as well as detect any abnormality or diseases;
105	105	5. "Department" means the State Department of Health;
106	106	6. "Draining ear" means an ear is not able to be screened due
107	107	to a postulant drainage from the ear canal;
108	108	7. "Equipment" means the necessary items needed to carry out a
109	109	hearing screening pursuant to this act and consists of the
110	110	following:
111	111	a. a properly calibrated pure tone audiometer,
112	112	b. a properly calibrated tympanometer,
113	113	c. an otoacoustic emission device (DPOAE and/or TPOAE),
114	114	or
115	115	d. a tablet computer with audio por t; a clinically
116	116	validated auditory assessment tablet -based software
117	117	that uses both high-frequency tones and speech
118	118	screening; high-resolution headphones that provide
119	119	ambient noise attenuation ;
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146	146	8. "Hearing screening" means the process or system used to
147	147	identify students who may be at risk of having or developing hearing
148	148	problems that may adversely affect their ability to acquire
149	149	knowledge, skill or learning, for the purpose of recommending
150	150	further evaluation by an audiologist;
151	151	9. "A hearing screening app " means a software application that
152	152	determines relative auditory pathway integrity for speech
153	153	understanding using speech -in-quiet, speech-in-noise, and tones-in-
154	154	noise methods, in addition to pure tones at 6000Hz and 8000Hz;
155	155	10. "Hard-of-hearing" (HOH) means having some residual hearing
156	156	and therefore not considered deaf;
157	157	11. "Hearing screening provider" means a person who has
158	158	successfully completed hearing screening training using curricula
159	159	approved by the Department, submitted an application to the
160	160	Department, and has been approved by the Department as being a
161	161	hearing screening provider;
162	162	12. "Hearing screening registry" is a system for collecting and
163	163	maintaining in a structured manner the names of individuals that
164	164	have been approved by the Department as hea ring screening providers;
165	165	13. "Hearing screening trainer " is a person who has been
166	166	approved as a hearing screening provider approved by the Department
167	167	to provide training to potential hearing screening providers;
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194	194	14. "Infant and Children's Health Advisory Council" means the
195	195	advisory council to the Board and Department in the area of infant
196	196	and child health issues including vision and audiology screening;
197	197	15. "Middle ear pathology" refers to the presence of either
198	198	outer ear obstructions by a foreign objec t and/or middle ear
199	199	pressure and/or fluid and/or deformation of middle ear oss icles;
200	200	16. "Noise induced hearing loss" referred to as NIHL is the
201	201	loss of hearing sensitivity due to excessive exposure at damaging
202	202	levels of noise;
203	203	17. "Pure tone" means a hearing screening that determines
204	204	relative hearing sensitivity for pure tone frequencies; and
205	205	18. "Referral" means parent or guardian notification that the
206	206	student's screening results indicate a need for a comprehensive
207	207	hearing exam by an audiologist.
208	208	SECTION 2. NEW LAW A new section of law to be codified
209	209	in the Oklahoma Statutes as Section 1210.287 of Title 70, unless
210	210	there is created a duplication in numbering, reads as follows:
211	211	A. 1. The State Department of Health, in coordinatio n with the
212	212	State Department of Education, shall require hearing screenings of
213	213	all children in pre-kindergarten, kindergarten, first, second,
214	214	third, fifth, seventh, and eleventh grades, or children in
215	215	comparable age groups referred for testing. This includes any child
216	216	in any grade being recommended for a hearing screening by a paren t
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243	243	and/or educator. The timing of screenings shall be followed as set
244	244	forth in paragraph 1, 3, and 4 of subsection G in this section.
245	245	2. Exemption criteria for a school hearing screening is as
246	246	follows:
247	247	a. a child entering public school or public charter
248	248	school in this state shall provide certification to
249	249	school personnel that the student passed a hearing
250	250	screening meeting the criteria set forth by this act
251	251	as a minimum, within th e previous six (6) months or
252	252	during the school year. Such screening shall be
253	253	conducted by personnel listed on the statewide
254	254	registry as maintained by the State Department of
255	255	Health, which may include, but not be limited to,
256	256	Oklahoma-licensed audiologists,
257	257	b. a student enrolled in pre-kindergarten, kindergarten,
258	258	first, second, third, seventh, and eleventh grade at a
259	259	public school or public charter school, in this state
260	260	shall provide, within thirty (30) days of the
261	261	beginning of the school year, certification to school
262	262	personnel that the student passed a hearing screening
263	263	within the previous six (6) months. Such screening
264	264	shall be conducted by personnel listed on the
265	265	statewide registry as maintained by the State
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292	292	Department of Health; which may include, but no t be
293	293	limited to, Oklahoma -licensed audiologists, or
294	294	c. the parent or guardian of a deaf or hard-of-hearing
295	295	student, who provides within thirty (30) days of the
296	296	beginning of the school year, certification to school
297	297	personnel the most recent hearing test by a licensed
298	298	audiologist which is within the last six (6) months.
299	299	B. Hearing screenings shall, at a minimum, utilize the
300	300	equipment and procedures specified under Title 70 of the Oklahoma
301	301	Statutes and comply with the following criteria based on the
302	302	methodology used:
303	303	1. For a pure tone audiometer, perform a four -frequency, pure
304	304	tone hearing screening on each of the student 's ears with response
305	305	recorded at each of the following frequencies and intensities:
306	306	a. 1000 Hz at 20 dB HL,
307	307	b. 2000 Hz at 20 dB HL,
308	308	c. 4000 Hz at 20 dB HL, and
309	309	d. 6000 Hz at 20 dB HL;
310	310	2. For a combination of a tympa nometer and a pure tone
311	311	audiometer:
312	312	a. produce a tympanogram showing the probability of
313	313	middle ear fluid by using a tympanometer and/or any
314	314	new middle ear screening tool determin ed by the
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341	341	Department to be a comparable screening tool. A
342	342	tympanometer will show the following results:
343	343	(1) peak acoustic immittance in mmho, ml, or
344	344	compliance for a 226 Hz probe tone , or
345	345	(2) tympanometric width in daPa , and
346	346	b. obtain the results of a fou r-frequency, pure tone
347	347	hearing screening on each of the student 's ears with
348	348	response recorded at each of the following frequencies
349	349	and intensities:
350	350	(1) 1000 Hz at 20 dB HL,
351	351	(2) 2000 Hz at 20 dB HL, and
352	352	(3) 4000 Hz at 20 dB HL; 6000 Hz at 20dB; or
353	353	3. For an otoacoustic emissions device (OAE) device:
354	354	a. measure responses of the cochlea to no less than four
355	355	test frequencies, and
356	356	b. device display screen indicates pass for all four
357	357	frequencies;
358	358	4. All equipment must meet the American National Standards
359	359	Institute (ANSI) standards and manufacturer specifications. This
360	360	equipment must be calibrated annually to ensure accuracy. The
361	361	equipment model and calibration date must be on all screening forms ;
362	362	and
363	363	5. Schools opting to use speech screenings must use a table t
364	364	meeting the same ANSI standards as an audiometer and an evidence -
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391	391	based, clinically validated assessment software using pure tones and
392	392	speech software, or any new hearing screening tool determined by the
393	393	Department to be a comparable screening tool that u tilizes both
394	394	methods.
395	395	C. The following hearing acuity criteria shall be used as a
396	396	basis for referring a child for further evaluation by an
397	397	audiologist:
398	398	1. Refer on a clinically validated tablet-based auditory
399	399	assessment software using both high -frequency pure tones and speech
400	400	testing for two screenings and/or referring the pure tone
401	401	frequencies at any frequency in one or both ears;
402	402	2. A draining ear; or
403	403	3. A refer on OAEs in one or both ears at any frequency.
404	404	D. Training for performing hearing screenin gs in schools shall
405	405	be provided by the Department and at a minimum, include ho w to
406	406	perform a hearing screening, criteria for passing, the various
407	407	methods to screen hearing, and resources to use when a child is
408	408	referred twice.
409	409	E. The statewide registry will maintain a list of individuals
410	410	who have been trained to screen hearing using all methods. This
411	411	training is good for three (3) years. The registry will also
412	412	maintain a list of pediatric audiologists who can provide services
413	413	to schools who need further t esting for referred students.
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440	440	F. Licensed audiologists are exempt from traini ng but will be
441	441	included on the statewide registry and referral list at their
442	442	request.
443	443	G. This section shall recognize the need to use a gradient
444	444	method to allow schools to learn , adapt, and implement hearing
445	445	screenings in the schools. The gradient method is listed as
446	446	follows:
447	447	1. First year hearing screenings for children may include any
448	448	of the methods listed therein . Any child being evaluated for
449	449	special education services, an d/or is referred by a parent/educator ,
450	450	shall be screened using speech and high -frequency pure tones ;
451	451	2. The second year hearing screenings for children may include
452	452	any of the methods listed therein with the exception of special
453	453	education students. Any child who is being evaluated/reevaluated
454	454	for special education services and/or is referred by a
455	455	parent/educator shall be screened using speech and high -frequency
456	456	pure tones; and
457	457	3. The third year hearing screenings for all children being
458	458	evaluated for or are in special education services, and/or is
459	459	referred by a parent/educator shall use speech and high-frequency
460	460	pure tones.
461	461	H. 1. The Department shall make recommendations on:
462	462	a. qualifications for initial recognition and renewal of
463	463	recognition of hearing s creeners, and
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490	490	b. qualifications for initial recognition and renewal of
491	491	recognition of hearing screener trainers ; provided,
492	492	Oklahoma licensed audiologists shall be exempt from
493	493	any training requirements ;
494	494	2. The Department shall:
495	495	a. establish and thereafter maintain a statewide
496	496	registry, available via the Internet, which shall
497	497	contain a list of approved hearing screeners and
498	498	audiologists who seek to be listed to provide
499	499	services, and
500	500	b. maintain a list of approved hearing screener trainers ;
501	501	3. After notice and hearing, the Department may deny, refuse,
502	502	suspend, or revoke approval to an applicant who has a history of:
503	503	a. noncompliance or incomplete or partial compliance with
504	504	the provisions of this section or the rules adopted by
505	505	the Board to implement the provi sions of this section,
506	506	b. referring persons to a business in which the applica nt
507	507	has a financial interest or a business which is owned
508	508	or operated by someone within the third degree of
509	509	consanguinity or affinity of the applicant, or
510	510	c. conduct which demonst rates that the applicant is
511	511	providing services in a manner which does not warrant
512	512	public trust; and
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539	539	4. The Board, giving consideration to the recommendations of
540	540	the Council, shall promulgate rules to implement the provisions of
541	541	this section.
542	542	I. 1. The parent or guardian of each student who fails the
543	543	hearing screening required in subsection A of this section shall
544	544	receive a recommendation to undergo a comprehensive hearing
545	545	examination performed by an Oklahoma -licensed audiologist .
546	546	2. The Oklahoma-licensed audiologist shall forward a written
547	547	report of the results of the comprehensive hearing examination to
548	548	the Department, the student 's school, parent or guardian, and
549	549	primary health care provider designated by the parent or guardian.
550	550	The report shall includ e, but not be limited to:
551	551	a. date of report,
552	552	b. name, address, and date of bir th of the student,
553	553	c. name of the student's school,
554	554	d. type of examination,
555	555	e. a summary of significant findings, including
556	556	diagnoses, medication used, duration of action of
557	557	medication, treatment, prognosis, whether or not a
558	558	return visit is recommended and, if so, when,
559	559	f. recommended educational adjustments for the child, if
560	560	any, which may include: preferential seating in the
561	561	classroom, the use of hearing aids, specific
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588	588	interventions, FM systems, and any other
589	589	recommendations, and
590	590	g. name, address, credent ials, and signature of the
591	591	examiner.
592	592	J. No student shall be prohibited from attending school for a
593	593	parent's or guardian's failure to furnish a report of the student 's
594	594	hearing screening or an examiner 's failure to furnish the results of
595	595	a student's comprehensive hearing examination required by this
596	596	section.
597	597	K. School districts shall notify parents or guardians of
598	598	students who enroll in kindergarten, first, second, third, seventh,
599	599	and eleventh grade for the 202 6-2027 school year and each year
600	600	thereafter of the requirements of this section.
601	601	L. The State Board of Education shall adopt rules for the
602	602	implementation of this section except as provided in subsection B of
603	603	this section. The State Department of Education shall issue a
604	604	report annually on the impact and effectiveness of this act.
605	605	SECTION 3. This act shall become effective June 1, 2025.
606	606
607	607	60-1-12220 TJ 01/15/25

Oklahoma 2025 Regular Session

Oklahoma House Bill HB2188 Compare Versions