department of labor hearing aid apprenticeship

Department of Labor Withdraws Apprenticeship Program for Hearing Instrument Specialists

As announced on November 18, the US Congress passed the Fit to Serve bill, allowing hearing instrument specialists to work directly with American veterans. Although the Fit to Serve legislation passed, it was not without substantial modifications. The bill, which is expected to be signed in the near future by President Obama, contains considerable patient protections and maintains the important role of the audiologist in the delivery of care.

On the heels of this legislation, the U.S. Department of Labor (DOL) announced they have rescinded the proposed apprenticeship program for hearing aid dispensers, citing the need to seek additional input from audiology stakeholders before creating such a program.

In June, 2015, the U.S. Department of Labor established National Apprenticeship Standards for hearing aid specialists that would expand their scope of practice beyond what is authorized by many state licensing laws. This proposal came under scrutiny by the three professional audiology organizations: ASHA, AAA and ADA.

Given the Department of Labor’s decision and the passage of the Fit to Serve compromise legislation, audiologists can proclaim a victory of sorts, as these recent rulings essentially recognize and preserve audiology’s scope of practice.


“The DOL decision and the passage of the compromise legislation represent the culmination of efforts by the American Academy of Audiology (AAA), the American Speech-Language-Hearing Association (ASHA), and the Academy of Doctors of Audiology (ADA), collectively the Audiology Organizations, to prevent hearing aid dispensers from expanding their scope of practice both on the state level and within the VA system. Today marks a great victory for audiologists as we continue to ensure our patients receive access to high quality audiological care.”

–Excerpt from AAA notice sent to members last week, obtained by HHTM


  1. Rather than disputing where scope of practice begins and ends, we should be much more concerned as allied professionals about the marked decline in market penetration with which we are faced today. Accessibility, pricing options, etc, are decidedly not the culprits, but instead consumer education as to the nature and effects of hearing loss, which span a wide range of human function and wellness.

    Scopes of practice overlap in every healthcare field, including in hearing health and in autonomous private practice dispensing. Knowing when to refer and for what is part of our universal education. A non-dispensing physician, for instance, is just as egregious in their practice by not referring a hearing impaired patient for a hearing aid evaluation as a dispenser or audiologist that does not refer clearly medical issues to the physician. In both cases, being ready to refer when indicated should be our principal concern.

    Hence, in continuing education, we often see all three branches of the allied professions sitting in on the same courses, studying from the same publications, and taking similar exams for the practical skills we are respectively expected to know. Understanding and appreciating what each branch has to offer, realizing that there is some overlap as their should be where training and licensing standards verify it, should be our mutual goal–not treating each other as adversarial competitors, but as colleagues focused on the well-being of the hearing impaired population.

    Tinnitus cannot be separated from hearing loss, and yet at least 77% of those with longstanding sensorineural losses will exhibit some degree of longterm tinnitus. An appropriately fitted hearing aid has been said to be the single most universal answer to most of these cases, as documented over and over in the literature. Where other approaches can be used and be more effective, our goal should be in learning from each other as to when to refer without impugning on the veracity of the other.

    I implore all involved in hearing healthcare to work as a team, respect that all three can dispense hearing aids and assistive technologies if they so choose and are trained to do so, and to exhibit trust that with our focus on the well-being on the patient that they can and will be referred where they can be better served.

    But a larger consideration to this discussion lies in historical practice. There is nothing in the aforesaid apprentice program that has not already been in common practice for decades. In many cases, the licensed dispenser was performing these procedures before any other branch of hearing care. Going back more than 60 years, hearing aid dispensers were pioneers to many of the common practices of our day today.

    The FDA 8 Red Flag conditions were established in 1977 with subsequent updates thereafter to assure that dispensers receive the needed training to know when to refer. That, in reality, means it is crucial that they receive the training to meet expectations and needs of consumers. They must understanding the intricate implications of diseases of the ear, congential malformations, related pathologies, and the resources available to help in each case. Training and education has been in the forefront of dispensing activities at least since the 1970s.

    These factors need consideration in any discussion such as this, and then we should turn our focus back to working together for the common purpose of serving the hearing impaired market to the best our industry has to offer. Teamwork is the answer if we really want what is best for hearing impaired consumers.

  2. FYI below find the whole story, it is truly unfortunate that mis-information is often reported as fact.

    It has come to our attention that inaccurate information is being spread in the audiology community regarding the U.S. Department of Labor Hearing Aid Specialist Apprenticeship Program guidelines. IHS values transparency; therefore, we want to address the misstatements and share with you some facts.

    1) The DOL guidelines were not “rescinded” as the audiology organizations have stated. The DOL has temporarily suspended the program. This action comes partially as a result of objections made by the audiology groups that they should have been consulted in the DOL’s approval process and their unfounded belief that the program impacts hearing aid specialists’ scope of practice, which is in no way true. IHS could not idly stand by and have organized audiology dictate our hearing aid specialist training program, and therefore we agreed with the Department of Labor to suspend and resubmit the program. In doing so, the DOL can revise the review process as needed to move the program towards active status again.
    2) The audiology organizations pushed back on the guidelines with comments IHS couldn’t accept. For example, they took issue with hearing aid specialists learning how to “interpret” audiometric tests, hearing aid evaluations, and validation testing; hearing aid specialists learning about aural rehabilitation and tympanometry; and even learning tasks such as tracking changes in a patient’s hearing and health. They took issue with the use of books that have been the core of IHS’ Distance Learning program for years. And they took issue with portions of a non-binding “Description” of the profession, which has no bearing on the lawful practice of hearing aid specialists.

    IHS supports hearing aid specialists having well-rounded education and training experiences that best prepare them for independent practice. Nothing contained within the guidelines breaks new ground; it simply establishes the gold-standard learning for apprentices based on existing standards. More importantly, the guidance is just that. State apprenticeship agencies are expected to work with licensing boards to ensure the program is consistent with state licensing laws and standards.

    Please note that the DOL program being suspended is not new news. The DOL notice was released in July – four months ago. Rather it appears the audiology organizations may be trying to drum up controversial news to divert attention away from IHS’ recent win on Fit to Serve. What it most certainly is, however, is an attempt to diminish the role of the hearing aid specialist in the provision of hearing healthcare, and we will not stand by and let that happen.

    We welcome your questions.

    Richard Giles, President Elect, International Hearing Society.

    1. I neglected to mention this post is taken from the IHS blog site “the hearing hub” and was originally submitted by Alissa Parady, IHS Director of Government Affairs, I have edited it for this post, my apologies.
      Richard Giles

  3. When we as a healthcare group only provide for 1/7th of those with the condition, just maybe we should consider fighting the lack of care together instead ??

  4. Well states license barbers too.

    At least with a barber you know what you’ve gotten. Can’t say that for this industry

  5. How does any group proclaim victory when it is at the expense of their patients. Someday when certain groups get off their high horse and look back they will be ashamed at this proclamation .

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