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STATE OF OKLAHOMA
1st Session of the 60th Legislature (2025)
HOUSE BILL 2188 By: Blancett
AS INTRODUCED
An Act relating to schools; requiring hearing
screening for certain students within certain
timeframe; specifying screenings be conducted by
certain personnel; providing for notification of
certain information; directing advisory committee to
make certain suggestions; providing composition;
directing State Board of Health to adopt certain
rules; requiring State Department of Health to
maintain a statewide registry; recommending certain
students receive certain hearing examination;
requiring certain person to forward written report to
certain parties; specifying contents of report;
allowing school attendance in event of failure of
certain parties to furnish certain report; providing
for school districts to notify certain parents of
certain requirements; directing the State Board of
Education to adopt certain rules; directing the State
Department of Education to issue certain annual
report; providing for codification; and providing an
effective date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1210.286 of Title 70, unless
there is created a duplication in numbering, reads as follows:
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1. "Audiologist" means a person licensed by the State of
Oklahoma to practice audiology under Section 1603 of Title 59 of the
Oklahoma Statutes;
2. "Board" means the State Board of Health;
3. "Commissioner" means the State Commissioner of Health of the
State of Oklahoma;
4. "Comprehensive hearing exam" means a clinical assessment and
tests administered by a licensed audiologist to assess a person's
level of hearing as well as detect any abnormality or diseases;
5. "Department" means the State Department of Health;
6. "Draining ear" means an ear is not able to be screened due
to a postulant drainage from the ear canal;
7. "Equipment" means the necessary items needed to carry out a
hearing screening pursuant to this act and consists of the
following:
a. a properly calibrated pure tone audiometer,
b. a properly calibrated tympanometer,
c. an otoacoustic emission device (DPOAE and/or TPOAE),
or
d. a tablet computer with audio port; a clinically
validated auditory assessment tablet-based software
that uses both high-frequency tones and speech
screening; high-resolution headphones that provide
ambient noise attenuation;
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8. "Hearing screening" means the process or system used to
identify students who may be at risk of having or developing hearing
problems that may adversely affect their ability to acquire
knowledge, skill or learning, for the purpose of recommending
further evaluation by an audiologist;
9. "A hearing screening app" means a software application that
determines relative auditory pathway integrity for speech
understanding using speech-in-quiet, speech-in-noise, and tones-in-
noise methods, in addition to pure tones at 6000Hz and 8000Hz;
10. "Hard-of-hearing" (HOH) means having some residual hearing
and therefore not considered deaf;
11. "Hearing screening provider" means a person who has
successfully completed hearing screening training using curricula
approved by the Department, submitted an application to the
Department, and has been approved by the Department as being a
hearing screening provider;
12. "Hearing screening registry" is a system for collecting and
maintaining in a structured manner the names of individuals that
have been approved by the Department as hearing screening providers;
13. "Hearing screening trainer" is a person who has been
approved as a hearing screening provider approved by the Department
to provide training to potential hearing screening providers;
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14. "Infant and Children's Health Advisory Council" means the
advisory council to the Board and Department in the area of infant
and child health issues including vision and audiology screening;
15. "Middle ear pathology" refers to the presence of either
outer ear obstructions by a foreign object and/or middle ear
pressure and/or fluid and/or deformation of middle ear ossicles;
16. "Noise induced hearing loss" referred to as NIHL is the
loss of hearing sensitivity due to excessive exposure at damaging
levels of noise;
17. "Pure tone" means a hearing screening that determines
relative hearing sensitivity for pure tone frequencies; and
18. "Referral" means parent or guardian notification that the
student's screening results indicate a need for a comprehensive
hearing exam by an audiologist.
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1210.287 of Title 70, unless
there is created a duplication in numbering, reads as follows:
A. 1. The State Department of Health, in coordination with the
State Department of Education, shall require hearing screenings of
all children in pre-kindergarten, kindergarten, first, second,
third, fifth, seventh, and eleventh grades, or children in
comparable age groups referred for testing. This includes any child
in any grade being recommended for a hearing screening by a parent
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and/or educator. The timing of screenings shall be followed as set
forth in paragraph 1, 3, and 4 of subsection G in this section.
2. Exemption criteria for a school hearing screening is as
follows:
a. a child entering public school or public charter
school in this state shall provide certification to
school personnel that the student passed a hearing
screening meeting the criteria set forth by this act
as a minimum, within the previous six (6) months or
during the school year. Such screening shall be
conducted by personnel listed on the statewide
registry as maintained by the State Department of
Health, which may include, but not be limited to,
Oklahoma-licensed audiologists,
b. a student enrolled in pre-kindergarten, kindergarten,
first, second, third, seventh, and eleventh grade at a
public school or public charter school, in this state
shall provide, within thirty (30) days of the
beginning of the school year, certification to school
personnel that the student passed a hearing screening
within the previous six (6) months. Such screening
shall be conducted by personnel listed on the
statewide registry as maintained by the State
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Department of Health; which may include, but not be
limited to, Oklahoma-licensed audiologists, or
c. the parent or guardian of a deaf or hard-of-hearing
student, who provides within thirty (30) days of the
beginning of the school year, certification to school
personnel the most recent hearing test by a licensed
audiologist which is within the last six (6) months.
B. Hearing screenings shall, at a minimum, utilize the
equipment and procedures specified under Title 70 of the Oklahoma
Statutes and comply with the following criteria based on the
methodology used:
1. For a pure tone audiometer, perform a four-frequency, pure
tone hearing screening on each of the student's ears with response
recorded at each of the following frequencies and intensities:
a. 1000 Hz at 20 dB HL,
b. 2000 Hz at 20 dB HL,
c. 4000 Hz at 20 dB HL, and
d. 6000 Hz at 20 dB HL;
2. For a combination of a tympanometer and a pure tone
audiometer:
a. produce a tympanogram showing the probability of
middle ear fluid by using a tympanometer and/or any
new middle ear screening tool determined by the
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Department to be a comparable screening tool. A
tympanometer will show the following results:
(1) peak acoustic immittance in mmho, ml, or
compliance for a 226 Hz probe tone, or
(2) tympanometric width in daPa, and
b. obtain the results of a four-frequency, pure tone
hearing screening on each of the student's ears with
response recorded at each of the following frequencies
and intensities:
(1) 1000 Hz at 20 dB HL,
(2) 2000 Hz at 20 dB HL, and
(3) 4000 Hz at 20 dB HL; 6000 Hz at 20dB; or
3. For an otoacoustic emissions device (OAE) device:
a. measure responses of the cochlea to no less than four
test frequencies, and
b. device display screen indicates pass for all four
frequencies;
4. All equipment must meet the American National Standards
Institute (ANSI) standards and manufacturer specifications. This
equipment must be calibrated annually to ensure accuracy. The
equipment model and calibration date must be on all screening forms;
and
5. Schools opting to use speech screenings must use a tablet
meeting the same ANSI standards as an audiometer and an evidence-
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based, clinically validated assessment software using pure tones and
speech software, or any new hearing screening tool determined by the
Department to be a comparable screening tool that utilizes both
methods.
C. The following hearing acuity criteria shall be used as a
basis for referring a child for further evaluation by an
audiologist:
1. Refer on a clinically validated tablet-based auditory
assessment software using both high-frequency pure tones and speech
testing for two screenings and/or referring the pure tone
frequencies at any frequency in one or both ears;
2. A draining ear; or
3. A refer on OAEs in one or both ears at any frequency.
D. Training for performing hearing screenings in schools shall
be provided by the Department and at a minimum, include how to
perform a hearing screening, criteria for passing, the various
methods to screen hearing, and resources to use when a child is
referred twice.
E. The statewide registry will maintain a list of individuals
who have been trained to screen hearing using all methods. This
training is good for three (3) years. The registry will also
maintain a list of pediatric audiologists who can provide services
to schools who need further testing for referred students.
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F. Licensed audiologists are exempt from training but will be
included on the statewide registry and referral list at their
request.
G. This section shall recognize the need to use a gradient
method to allow schools to learn, adapt, and implement hearing
screenings in the schools. The gradient method is listed as
follows:
1. First year hearing screenings for children may include any
of the methods listed therein. Any child being evaluated for
special education services, and/or is referred by a parent/educator,
shall be screened using speech and high-frequency pure tones;
2. The second year hearing screenings for children may include
any of the methods listed therein with the exception of special
education students. Any child who is being evaluated/reevaluated
for special education services and/or is referred by a
parent/educator shall be screened using speech and high-frequency
pure tones; and
3. The third year hearing screenings for all children being
evaluated for or are in special education services, and/or is
referred by a parent/educator shall use speech and high-frequency
pure tones.
H. 1. The Department shall make recommendations on:
a. qualifications for initial recognition and renewal of
recognition of hearing screeners, and
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b. qualifications for initial recognition and renewal of
recognition of hearing screener trainers; provided,
Oklahoma licensed audiologists shall be exempt from
any training requirements;
2. The Department shall:
a. establish and thereafter maintain a statewide
registry, available via the Internet, which shall
contain a list of approved hearing screeners and
audiologists who seek to be listed to provide
services, and
b. maintain a list of approved hearing screener trainers;
3. After notice and hearing, the Department may deny, refuse,
suspend, or revoke approval to an applicant who has a history of:
a. noncompliance or incomplete or partial compliance with
the provisions of this section or the rules adopted by
the Board to implement the provisions of this section,
b. referring persons to a business in which the applicant
has a financial interest or a business which is owned
or operated by someone within the third degree of
consanguinity or affinity of the applicant, or
c. conduct which demonstrates that the applicant is
providing services in a manner which does not warrant
public trust; and
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4. The Board, giving consideration to the recommendations of
the Council, shall promulgate rules to implement the provisions of
this section.
I. 1. The parent or guardian of each student who fails the
hearing screening required in subsection A of this section shall
receive a recommendation to undergo a comprehensive hearing
examination performed by an Oklahoma-licensed audiologist.
2. The Oklahoma-licensed audiologist shall forward a written
report of the results of the comprehensive hearing examination to
the Department, the student's school, parent or guardian, and
primary health care provider designated by the parent or guardian.
The report shall include, but not be limited to:
a. date of report,
b. name, address, and date of birth of the student,
c. name of the student's school,
d. type of examination,
e. a summary of significant findings, including
diagnoses, medication used, duration of action of
medication, treatment, prognosis, whether or not a
return visit is recommended and, if so, when,
f. recommended educational adjustments for the child, if
any, which may include: preferential seating in the
classroom, the use of hearing aids, specific
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interventions, FM systems, and any other
recommendations, and
g. name, address, credentials, and signature of the
examiner.
J. No student shall be prohibited from attending school for a
parent's or guardian's failure to furnish a report of the student's
hearing screening or an examiner's failure to furnish the results of
a student's comprehensive hearing examination required by this
section.
K. School districts shall notify parents or guardians of
students who enroll in kindergarten, first, second, third, seventh,
and eleventh grade for the 2026-2027 school year and each year
thereafter of the requirements of this section.
L. The State Board of Education shall adopt rules for the
implementation of this section except as provided in subsection B of
this section. The State Department of Education shall issue a
report annually on the impact and effectiveness of this act.
SECTION 3. This act shall become effective June 1, 2025.
60-1-12220 TJ 01/15/25