4028S.04F
1
SENATE SUBSTITUTE
FOR
HOUSE BILL NO. 2149
AN ACT
To repeal sections 197.400, 197.445, 327.312,
327.313, 327.314, 327.331, 334.036, 334.530, 334.655,
345.015, and 345.050, RSMo, and to enact in lieu
thereof sixteen new sections relating to professional
licensing, with an emergency clause for a certain
section.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Sections 197.400, 197.445, 327.312, 327.313, 1
327.314, 327.331, 334.036, 334.530, 334.655, 345.015, and 2
345.050, RSMo, are repealed and sixteen new sections enacted in 3
lieu thereof, to be known as sections 197.400, 197.445, 324.005, 4
327.312, 327.313, 327.314, 327.331, 332.325, 334.036, 334.530, 5
334.655, 345.015, 345.022, 345.050, 345.052, and 345.085, to 6
read as follows:7
197.400. As used in sections 197.400 to 197.475, 1
unless the context otherwise requires, the following terms 2
mean: 3
(1) "Council", the home health services advisory 4
council created by sections 197.400 to 197.475; 5
(2) "Department", the department of health and senior 6
services; 7
(3) "Home health agency", a public agency or private 8
organization or a su bdivision or subunit of an agency or 9
organization that provides two or more home health services 10
at the residence of a patient according to a [physician's] 11
written [and signed] plan of treatment signed by a 12
physician, nurse practitioner, clinical nurse specialist, or 13
physician assistant; 14
2
(4) "Home health services", any of the following items 15
and services provided at the residence of the patient on a 16
part-time or intermittent basis: nursing, physical therapy, 17
speech therapy, occupational thera py, home health aid, or 18
medical social service; 19
(5) "Nurse practitioner, clinical nurse specialist", a 20
person recognized by the state board of nursing pursuant to 21
the provisions of chapter 335 to practice in this state as a 22
nurse practitioner or clinical nurse specialist; 23
(6) "Part-time or intermittent basis", the providing 24
of home health services in an interrupted interval sequence 25
on the average of not to exceed three hours in any twenty - 26
four-hour period; 27
[(6)] (7) "Patient's residence", the actual place of 28
residence of the person receiving home health services, 29
including institutional residences as well as individual 30
dwelling units; 31
[(7)] (8) "Physician", a person licensed by the state 32
board of registration for the heali ng arts pursuant to the 33
provisions of chapter 334 to practice in this state as a 34
physician and surgeon; 35
(9) "Physician assistant", a person licensed by the 36
state board of registration for the healing arts pursuant to 37
the provisions of chapter 334 to practice in this state as a 38
physician assistant; 39
[(8)] (10) "Plan of treatment", a plan reviewed and 40
signed as often as [medically] necessary by a physician 41
[or], podiatrist, nurse practitioner, clinical nurse 42
specialist, or a physician assis tant, not to exceed sixty 43
days in duration, and reviewed by a physician at least once 44
every six months, prescribing items and services for an 45
individual patient's condition; 46
3
[(9)] (11) "Podiatrist", a person licensed by the 47
state board of podiatr y pursuant to the provisions of 48
chapter 330 to practice in this state as a podiatrist; 49
[(10)] (12) "Subunit" or "subdivision", any 50
organizational unit of a larger organization which can be 51
clearly defined as a separate entity within the larger 52
structure, which can meet all of the requirements of 53
sections 197.400 to 197.475 independent of the larger 54
organization, which can be held accountable for the care of 55
patients it is serving, and which provides to all patients 56
care and services meeting th e standards and requirements of 57
sections 197.400 to 197.475. 58
197.445. 1. The department may adopt reasonable rules 1
and standards necessary to carry out the provisions of 2
sections 197.400 to 197.477. The rules and standards 3
adopted shall not be less than the standards established by 4
the federal government for home health agencies under Title 5
XVIII of the Federal Social Security Act. The reasonable 6
rules and standards shall be initially promulgated within 7
one year of September 28, 1983. 8
2. The rules and standards adopted by the department 9
pursuant to the provisions of sections 197.400 to 197.477 10
shall apply to all health services covered by sections 11
197.400 to 197.477 rendered to any patient being served by a 12
home health agency regardless of source of payment for the 13
service, patient's condition, or place of residence, at 14
which the home health services are ordered by the physician 15
[or], podiatrist, nurse practitioner, clinical nurse 16
specialist, or physician assista nt. No rule or portion of a 17
rule promulgated pursuant to the authority of sections 18
197.400 to 197.477 shall become effective unless it has been 19
promulgated pursuant to the provisions of section 536.024. 20
4
324.005. 1. Notwithstanding any requirements for 1
licensure for all professional boards, commissions, 2
committees, and offices within the division of professional 3
registration to the contrary, a professional who has a 4
current license to practice from another state, 5
commonwealth, territory, or the District of Columbia shall 6
be exempt from the licensure requirements of his or her 7
respective licensure board in this state if: 8
(1) The professional is an active duty or reserve 9
member of the Armed Forces of the United States, a member of 10
the National Guard, a civilian employee of the United States 11
Department of Defense, an authorized services contractor 12
under 10 U.S.C. Section 1091, or a professional otherwise 13
authorized by the United States Department of Defense; 14
(2) The professional practices the same occupation or 15
profession at the same practice level for which he or she 16
holds a current license; and 17
(3) The professional is engaged in the practice of a 18
professional through a partnership with the federal 19
Innovative Readiness Training program within the United 20
States Department of Defense. 21
2. The exemption provided in this section shall not 22
permit a professional to engage in practice except as part 23
of the federal Innovative Readiness Training program w ithin 24
the United States Department of Defense. The exemption 25
shall only apply while: 26
(1) The professional's practice is required by the 27
program pursuant to military orders; and 28
(2) The services provided by the professional are 29
within the scope of practice for the individual's respective 30
profession in this state. 31
327.312. 1. Prior to January 1, 2024, any person may 1
apply to the board for enrollment as a land surveyor -in- 2
5
training who is a high school graduate, or who holds a 3
Missouri certificate of high school equivalence (GED), and 4
either: 5
(1) Has graduated and received a baccalaureate degree 6
in an approved curriculum as defined by board regulation 7
which shall include at least twelve semester hours of 8
approved surveying course work as defined by board 9
regulation of which at least two semester hours shall be in 10
the legal aspects of boundary surveying; or 11
(2) Has passed at least sixty hours of college credit 12
which shall include credit for at least tw enty semester 13
hours of approved surveying course work as defined by board 14
regulation of which at least two semester hours shall be in 15
legal aspects of boundary surveying and present evidence 16
satisfactory to the board that in addition thereto such 17
person has at least one year of combined professional office 18
and field experience in land surveying projects under the 19
immediate personal supervision of a professional land 20
surveyor; or 21
(3) Has passed at least twelve semester hours of 22
approved surveying course work as defined by board 23
regulation of which at least two semester hours shall be in 24
legal aspects of land surveying and in addition thereto has 25
at least two years of combined professional office and field 26
experience in land surveying projec ts under the immediate 27
personal supervision of a professional land surveyor. 28
Pursuant to this provision, not more than one year of 29
satisfactory postsecondary education work shall count as 30
equivalent years of satisfactory land surveying work as 31
aforementioned. 32
2. The board shall issue a certificate of completion 33
to each applicant who satisfies the requirements of the 34
aforementioned land surveyor -in-training program and passes 35
6
such examination or examinations as shall be required by the 36
board. 37
3. Beginning January 1, 2024, any person may apply to 38
the board for enrollment as a land surveyor -intern who is a 39
high school graduate, or who holds a certificate of high 40
school equivalence (GED), and has passed any examination 41
required by the board pursuant to section 327.331. 42
327.313. Applications for enrollment as a land 1
[surveyor-in-training] surveyor-intern shall be typewritten 2
on prescribed forms furnished to the applicant. The 3
application shall contain applicant's statements showing the 4
applicant's education, experience, and such other pertinent 5
information as the board may require. Each application 6
shall contain a statement that it is made under oath or 7
affirmation and that the representations are true and 8
correct to the best knowledge and belief of the applicant, 9
subject to the penalties of making a false affidavit or 10
declaration and shall be accompanied by the required fee. 11
327.314. 1. Prior to January 1, 2024, any person may 1
apply to the board for licensure as a professional land 2
surveyor who has been enrolled as a land surveyor -in- 3
training and has presented evidence to the satisfaction of 4
the board that said person has acquired at least four years 5
of satisfactory professional field and office experience in 6
land surveying from the date of enrollment as a land 7
surveyor-in-training. This experience shall have been under 8
the immediate personal supervision of a professional land 9
surveyor. 10
2. Beginning January 1, 2024, any person may apply to 11
the board for licensure who presents evidence satisfactory 12
to the board that the applicant has met the requirements as 13
provided in this subsection: 14
7
(1) An applicant shall be a high school graduate or 15
hold a certificate of hig h school equivalence (GED), and 16
either: 17
(a) Has graduated and received a baccalaureate degree 18
in an approved curriculum, as defined by the board, which 19
shall include at least fifteen semester hours of approved 20
surveying course work, as defined by the board, of which at 21
least six semester hours shall be in the legal aspects of 22
boundary surveying; or 23
(b) Has passed at least sixty hours of college credit 24
which shall include at least fifteen semester hours of 25
approved surveying course work, as defined by the board, of 26
which at least six semester hours shall be in legal aspects 27
of boundary surveying; or 28
(c) Has passed at least fifteen semester hours of 29
approved surveying coursework, as defined by the board, of 30
which at least six seme ster hours shall be in legal aspects 31
of land surveying; 32
(d) An applicant meeting the requirements of paragraph 33
(a) of this subdivision shall have acquired at least four 34
years of satisfactory field and office experience in land 35
surveying under the immediate personal supervision of a 36
professional land surveyor; 37
(e) An applicant meeting the requirements of paragraph 38
(b) of this subdivision shall have acquired at least five 39
years of satisfactory field and office experience in land 40
surveying under the immediate personal supervision of a 41
professional land surveyor; 42
(f) An applicant meeting the requirements of paragraph 43
(c) of this subdivision shall have acquired at least six 44
years of satisfactory field and office experience in land 45
surveying under the immediate personal supervision of a 46
professional land surveyor. Pursuant to this provision, up 47
8
to one year of post-secondary education, approved by the 48
board, may count as equivalent work experience; 49
(2) An applicant shall pass any examinations required 50
by the board pursuant to section 327.331; 51
(3) Any person enrolled as a land surveyor -in-training 52
prior to January 1, 2024, shall only be required to meet the 53
requirements in place pursuant to their enrollment. 54
327.331. 1. After it has been determined that an 1
applicant possesses the qualifications entitling the 2
applicant to be examined, each applicant for examination and 3
enrollment as a land surveyor -in-training and for 4
examination and licensure as a professional land surveyor in 5
Missouri shall appear before the board or its 6
representatives for examination at the time and place 7
specified. 8
2. The examination or examinations shall be of such 9
form, content and duration as shall b e determined by the 10
board to thoroughly test the qualifications of each 11
applicant to become enrolled as a land [surveyor-in- 12
training] surveyor-intern or to become licensed as a 13
professional land surveyor in Missouri. 14
3. Any applicant to be eligib le for enrollment or for 15
license must make a grade on the applicable examination of 16
at least seventy percent. 17
4. Any person who passes the examination hereinabove 18
specified shall be entitled to be enrolled as a land 19
[surveyor-in-training] surveyor-intern or licensed as a 20
professional land surveyor, as the case may be, in Missouri 21
and shall receive a certificate of enrollment or a license, 22
as the case may be. 23
332.325. 1. The Missouri dental board may collaborate 1
with the department of health and senior services and the 2
office of dental health within the department of health and 3
9
senior services to approve pilot projects designed to 4
examine new methods of extending care to medically 5
underserved populations, as defined in 42 U.S.C. Section 6
300e-1(7). These pilot projects may employ techniques or 7
approaches to care that may necessitate a waiver of the 8
requirements of this chapter and regulations promulgated 9
thereunder; provided: 10
(1) The project plan has a clearly stated objective of 11
serving a specific underserved population that warrants, in 12
the opinion of a majority of the board, granting approval 13
for a pilot project; 14
(2) The project has a finite start date and 15
termination date; 16
(3) The project clearly defines the new techniques or 17
approaches it intends to examine to determine if it results 18
in an improvement in access or quality of care; 19
(4) The project plan identifies specific and limited 20
locations and populations to participate in the pi lot 21
project; 22
(5) The project plan clearly establishes minimum 23
guidelines and standards for the pilot project, including, 24
but not limited to, provisions for protecting safety of 25
participating patients; 26
(6) The project plan clearly defines th e measurement 27
criteria it will use to evaluate the outcomes of the pilot 28
project on access and quality of care; and 29
(7) The project plan identifies reporting intervals to 30
communicate interim and final outcomes to the board. 31
2. The board may promulgate rules and regulations to 32
implement the provisions of this section. Any rule or 33
portion of a rule, as that term is defined in section 34
536.010, that is created under the authority delegated in 35
this section shall become effective only if it co mplies with 36
10
and is subject to all of the provisions of chapter 536 and, 37
if applicable, section 536.028. This section and chapter 38
536 are nonseverable and if any of the powers vested with 39
the general assembly pursuant to chapter 536 to review, to 40
delay the effective date, or to disapprove and annul a rule 41
are subsequently held unconstitutional, then the grant of 42
rulemaking authority and any rule proposed or adopted after 43
August 28, 2022, shall be invalid and void. 44
3. The provisions of this sec tion shall expire on 45
August 28, 2026. The board shall provide a final report on 46
approved projects and related data or findings to the 47
general assembly on or before December 31, 2025. The name, 48
location, approval dates, and general description of an 49
approved pilot project shall be deemed a public record 50
pursuant to chapter 610. 51
334.036. 1. For purposes of this section, the 1
following terms shall mean: 2
(1) "Assistant physician", any graduate of a medical 3
school [graduate] accredited by the Liaison Committee on 4
Medical Education, the Commission on Osteopathic College 5
Accreditation, or the Educational Commission for Foreign 6
Medical Graduates who: 7
(a) Is a resident and citizen of the United States or 8
is a legal resident alien; 9
(b) Has successfully completed Step 2 of the United 10
States Medical Licensing Examination or the equivalent of 11
such step of any other board -approved medical licensing 12
examination within the three -year period immediately 13
preceding application for licensure as an assistant 14
physician, or within three years after graduation from a 15
medical college or osteopathic medical college, whichever is 16
later; 17
11
(c) Has not completed an approved postgraduate 18
residency and has successfully comple ted Step 2 of the 19
United States Medical Licensing Examination or the 20
equivalent of such step of any other board -approved medical 21
licensing examination within the immediately preceding three - 22
year period unless when such three -year anniversary occurred 23
he or she was serving as a resident physician in an 24
accredited residency in the United States and continued to 25
do so within thirty days prior to application for licensure 26
as an assistant physician; and 27
(d) Has proficiency in the English language. 28
Any graduate of a medical school [graduate] who could have 29
applied for licensure and complied with the provisions of 30
this subdivision at any time between August 28, 2014, and 31
August 28, 2017, may apply for licensure and shall be deemed 32
in compliance with the provisions of this subdivision; 33
(2) "Assistant physician collaborative practice 34
arrangement", an agreement between a physician and an 35
assistant physician that meets the requirements of this 36
section and section 334.037 [; 37
(3) "Medical school graduate", any person who has 38
graduated from a medical college or osteopathic medical 39
college described in section 334.031 ]. 40
2. (1) An assistant physician collaborative practice 41
arrangement shall limit the assistant physician to providing 42
only primary care services and only in medically underserved 43
rural or urban areas of this state [or in any pilot project 44
areas established in which assistant physicians may 45
practice]. 46
(2) For a physician-assistant physician team working 47
in a rural health clinic under the federal Rural Health 48
Clinic Services Act, P.L. 95 -210, as amended: 49
12
(a) An assistant physician shall be considered a 50
physician assistant for purposes of regulations of the 51
Centers for Medicare and Medicaid Services (CMS); and 52
(b) No supervision requirements in addition to the 53
minimum federal law shall be required. 54
3. (1) For purposes of this section, the licensure of 55
assistant physicians shall take place within processes 56
established by rules of the state boa rd of registration for 57
the healing arts. The board of healing arts is authorized 58
to establish rules under chapter 536 establishing licensure 59
and renewal procedures, supervision, collaborative practice 60
arrangements, fees, and addressing such other matt ers as are 61
necessary to protect the public and discipline the 62
profession. No licensure fee for an assistant physician 63
shall exceed the amount of any licensure fee for a physician 64
assistant. An application for licensure may be denied or 65
the licensure of an assistant physician may be suspended or 66
revoked by the board in the same manner and for violation of 67
the standards as set forth by section 334.100, or such other 68
standards of conduct set by the board by rule. No rule or 69
regulation shall require an assistant physician to complete 70
more hours of continuing medical education than that of a 71
licensed physician. 72
(2) Any rule or portion of a rule, as that term is 73
defined in section 536.010, that is created under the 74
authority delegated in this section shall become effective 75
only if it complies with and is subject to all of the 76
provisions of chapter 536 and, if applicable, section 77
536.028. This section and chapter 536 are nonseverable and 78
if any of the powers vested with the general assembl y under 79
chapter 536 to review, to delay the effective date, or to 80
disapprove and annul a rule are subsequently held 81
unconstitutional, then the grant of rulemaking authority and 82
13
any rule proposed or adopted after August 28, 2014, shall be 83
invalid and void. 84
(3) Any rules or regulations regarding assistant 85
physicians in effect as of the effective date of this 86
section that conflict with the provisions of this section 87
and section 334.037 shall be null and void as of the 88
effective date of this sect ion. 89
4. An assistant physician shall clearly identify 90
himself or herself as an assistant physician and shall be 91
permitted to use the terms "doctor", "Dr.", or "doc". No 92
assistant physician shall practice or attempt to practice 93
without an assistant physician collaborative practice 94
arrangement, except as otherwise provided in this section 95
and in an emergency situation. 96
5. The collaborating physician is responsible at all 97
times for the oversight of the activities of and accepts 98
responsibility for primary care services rendered by the 99
assistant physician. 100
6. The provisions of section 334.037 shall apply to 101
all assistant physician collaborative practice 102
arrangements. Any renewal of licensure under this section 103
shall include verific ation of actual practice under a 104
collaborative practice arrangement in accordance with this 105
subsection during the immediately preceding licensure period. 106
7. Each health carrier or health benefit plan that 107
offers or issues health benefit plans that are delivered, 108
issued for delivery, continued, or renewed in this state 109
shall reimburse an assistant physician for the diagnosis, 110
consultation, or treatment of an insured or enrollee on the 111
same basis that the health carrier or health benefit plan 112
covers the service when it is delivered by another 113
comparable mid-level health care provider including, but not 114
limited to, a physician assistant. 115
14
334.530. 1. A candidate for license to practice as a 1
physical therapist shall furnish evidence of such person's 2
educational qualifications by submitting satisfactory 3
evidence of completion of a program of physical therapy 4
education approved as reputable by the board or eligibility 5
to graduate from such a program within ninety days . A 6
candidate who presents satisfactory evidence of the person's 7
graduation from a school of physical therapy approved as 8
reputable by the American Medical Association or, if 9
graduated before 1936, by the American Physical Therapy 10
Association, or if gradu ated after 1988, the Commission on 11
Accreditation for Physical Therapy Education or its 12
successor, is deemed to have complied with the educational 13
qualifications of this subsection. 14
2. Persons desiring to practice as physical therapists 15
in this state shall appear before the board at such time and 16
place as the board may direct and be examined as to their 17
fitness to engage in such practice. Applicants shall meet 18
the qualifying standards for such examinations, including 19
any requirements establish ed by any entity contracted by the 20
board to administer the board -approved examination. 21
Applications for examination shall be in writing, on a form 22
furnished by the board and shall include evidence 23
satisfactory to the board that the applicant possesses the 24
qualifications set forth in subsection 1 of this section and 25
meets the requirements established to qualify for 26
examination. Each application shall contain a statement 27
that it is made under oath or affirmation and that its 28
representations are tru e and correct to the best knowledge 29
and belief of the applicant, subject to the penalties of 30
making a false affidavit or declaration. 31
3. The examination of qualified candidates for 32
licenses to practice physical therapy shall test entry -level 33
15
competence as related to physical therapy theory, 34
examination and evaluation, physical therapy diagnosis, 35
prognosis, treatment, intervention, prevention, and 36
consultation. 37
4. The examination shall embrace, in relation to the 38
human being, the subjects of anatomy, chemistry, 39
kinesiology, pathology, physics, physiology, psychology, 40
physical therapy theory and procedures as related to 41
medicine, surgery and psychiatry, and such other subjects, 42
including medical ethics, as the board deems useful to test 43
the fitness of the candidate to practice physical therapy. 44
5. No person who has failed on six or more occasions 45
to achieve a passing score on the examination required by 46
this section shall be eligible for licensure by examination 47
under this section. 48
6. The applicant shall pass a test administered by the 49
board on the laws and rules related to the practice of 50
physical therapy in Missouri. 51
334.655. 1. A candidate for licensure to practice as 1
a physical therapist assis tant shall furnish evidence of the 2
person's educational qualifications. The educational 3
requirements for licensure as a physical therapist assistant 4
are: 5
(1) A certificate of graduation from an accredited 6
high school or its equivalent; and 7
(2) Satisfactory evidence of completion of an 8
associate degree program of physical therapy education 9
accredited by the commission on accreditation of physical 10
therapy education or eligibility to graduate from such a 11
program within ninety days . 12
2. Persons desiring to practice as a physical 13
therapist assistant in this state shall appear before the 14
board at such time and place as the board may direct and be 15
16
examined as to the person's fitness to engage in such 16
practice. Applicants shall meet th e qualifying standards 17
for such examinations, including any requirements 18
established by any entity contracted by the board to 19
administer the board -approved examination. Applications for 20
examination shall be on a form furnished by the board and 21
shall include evidence satisfactory to the board that the 22
applicant possesses the qualifications provided in 23
subsection 1 of this section and meets the requirements 24
established to qualify for examination . Each application 25
shall contain a statement that the statement is made under 26
oath of affirmation and that its representations are true 27
and correct to the best knowledge and belief of the person 28
signing the statement, subject to the penalties of making a 29
false affidavit or declaration. 30
3. The examination of qualified candidates for 31
licensure to practice as physical therapist assistants shall 32
embrace an examination which shall cover the curriculum 33
taught in accredited associate degree programs of physical 34
therapy assistant education. Such examination shall be 35
sufficient to test the qualification of the candidates as 36
practitioners. 37
4. The examination shall include, as related to the 38
human body, the subjects of anatomy, kinesiology, pathology, 39
physiology, psychology, physical therapy theor y and 40
procedures as related to medicine and such other subjects, 41
including medical ethics, as the board deems useful to test 42
the fitness of the candidate to practice as a physical 43
therapist assistant. 44
5. No person who has failed on six or more occasions 45
to achieve a passing score on the examination required by 46
this section shall be eligible for licensure by examination 47
under this section. 48
17
6. The applicant shall pass a test administered by the 49
board on the laws and rules related to the practice as a 50
physical therapist assistant in this state. 51
[6.] 7. The board shall license without examination 52
any legally qualified person who is a resident of this state 53
and who was actively engaged in practice as a physical 54
therapist assistant on August 28, 1993. The board may 55
license such person pursuant to this subsection until ninety 56
days after the effective date of this section. 57
[7.] 8. A candidate to practice as a physical 58
therapist assistant who does not meet the educational 59
qualifications may submit to the board an application for 60
examination if such person can furnish written evidence to 61
the board that the person has been employed in this state 62
for at least three of the last five years under the 63
supervision of a licensed phys ical therapist and such person 64
possesses the knowledge and training equivalent to that 65
obtained in an accredited school. The board may license 66
such persons pursuant to this subsection until ninety days 67
after rules developed by the state board of heali ng arts 68
regarding physical therapist assistant licensing become 69
effective. 70
345.015. As used in sections 345.010 to 345.080, the 1
following terms mean: 2
(1) "Audiologist", a person who is licensed as an 3
audiologist pursuant to sections 345.010 to 345.080 to 4
practice audiology; 5
(2) "Audiology aide", a person who is registered as an 6
audiology aide by the board, who does not act independently 7
but works under the direction and supervision of a licensed 8
audiologist. Such person assists the audiologist with 9
activities which require an understanding of audiology but 10
do not require formal training in the relevant academics. 11
18
To be eligible for registration by the board, each applicant 12
shall submit a registration fee and: 13
(a) Be at least eighteen years of age; 14
(b) Furnish evidence of the person's educational 15
qualifications which shall be at a minimum: 16
a. Certification of graduation from an accredited high 17
school or its equivalent; and 18
b. On-the-job training; 19
(c) Be employed in a setting in which direct and 20
indirect supervision are provided on a regular and 21
systematic basis by a licensed audiologist. 22
However, the aide shall not administer or interpret hearing 23
screening or diagnostic tests, fi t or dispense hearing 24
instruments, make ear impressions, make diagnostic 25
statements, determine case selection, present written 26
reports to anyone other than the supervisor without the 27
signature of the supervisor, make referrals to other 28
professionals or agencies, use a title other than audiology 29
aide, develop or modify treatment plans, discharge clients 30
from treatment or terminate treatment, disclose clinical 31
information, either orally or in writing, to anyone other 32
than the supervising audiologist, or perform any procedure 33
for which he or she is not qualified, has not been 34
adequately trained or both; 35
(3) "Board", the state board of registration for the 36
healing arts; 37
(4) "Clinical fellowship", the supervised professional 38
employment period following completion of the academic and 39
practicum requirements of an accredited training program 40
under this chapter; 41
(5) "Commission", the advisory commission for speech - 42
language pathologists and audiologists; 43
19
[(5)] (6) "Hearing instrument" or "hearing aid", any 44
wearable device or instrument designed for or offered for 45
the purpose of aiding or compensating for impaired human 46
hearing and any parts, attachments or accessories, including 47
ear molds, but excluding batteries, cords, recei vers and 48
repairs; 49
[(6)] (7) "Person", any individual, organization, or 50
corporate body, except that only individuals may be licensed 51
pursuant to sections 345.010 to 345.080; 52
[(7)] (8) "Practice of audiology": 53
(a) The application of acce pted audiologic principles, 54
methods and procedures for the measurement, testing, 55
interpretation, appraisal and prediction related to 56
disorders of the auditory system, balance system or related 57
structures and systems; 58
(b) Provides consultation or counseling to the 59
patient, client, student, their family or interested parties; 60
(c) Provides academic, social and medical referrals 61
when appropriate; 62
(d) Provides for establishing goals, implementing 63
strategies, methods and techniques, for h abilitation, 64
rehabilitation or aural rehabilitation, related to disorders 65
of the auditory system, balance system or related structures 66
and systems; 67
(e) Provides for involvement in related research, 68
teaching or public education; 69
(f) Provides for rendering of services or participates 70
in the planning, directing or conducting of programs which 71
are designed to modify audition, communicative, balance or 72
cognitive disorder, which may involve speech and language or 73
education issues; 74
(g) Provides and interprets behavioral and 75
neurophysiologic measurements of auditory balance, cognitive 76
20
processing and related functions, including intraoperative 77
monitoring; 78
(h) Provides involvement in any tasks, procedures, 79
acts or practices that are necessary for evaluation of 80
audition, hearing, training in the use of amplification or 81
assistive listening devices; 82
(i) Provides selection, assessment, fitting, 83
programming, and dispensing of hearing instruments, 84
assistive listening devices, and other amplification systems; 85
(j) Provides for taking impressions of the ear, making 86
custom ear molds, ear plugs, swim molds and industrial noise 87
protectors; 88
(k) Provides assessment of external ear and cerumen 89
management; 90
(l) Provides advising, fitting, mapping assessment of 91
implantable devices such as cochlear or auditory brain stem 92
devices; 93
(m) Provides information in noise control and hearing 94
conservation including education, equipment selection, 95
equipment calibration, site evaluation and employee 96
evaluation; 97
(n) Provides performing basic speech -language 98
screening test; 99
(o) Provides involvement in social aspects of 100
communication, including challenging behavior and 101
ineffective social skills, lack of communicat ion 102
opportunities; 103
(p) Provides support and training of family members 104
and other communication partners for the individual with 105
auditory balance, cognitive and communication disorders; 106
(q) Provides aural rehabilitation and related services 107
to individuals with hearing loss and their families; 108
21
(r) Evaluates, collaborates and manages audition 109
problems in the assessment of the central auditory 110
processing disorders and providing intervention for 111
individuals with central auditory processi ng disorders; 112
(s) Develops and manages academic and clinical 113
problems in communication sciences and disorders; 114
(t) Conducts, disseminates and applies research in 115
communication sciences and disorders; 116
[(8)] (9) "Practice of speech-language pathology": 117
(a) Provides screening, identification, assessment, 118
diagnosis, treatment, intervention, including but not 119
limited to prevention, restoration, amelioration and 120
compensation, and follow -up services for disorders of: 121
a. Speech: articulation, fluency, voice, including 122
respiration, phonation and resonance; 123
b. Language, involving the parameters of phonology, 124
morphology, syntax, semantics and pragmatic; and including 125
disorders of receptive and expressive communication in ora l, 126
written, graphic and manual modalities; 127
c. Oral, pharyngeal, cervical esophageal and related 128
functions, such as dysphagia, including disorders of 129
swallowing and oral functions for feeding; orofacial 130
myofunctional disorders; 131
d. Cognitive aspects of communication, including 132
communication disability and other functional disabilities 133
associated with cognitive impairment; 134
e. Social aspects of communication, including 135
challenging behavior, ineffective social skills, lack of 136
communication opportunities; 137
(b) Provides consultation and counseling and makes 138
referrals when appropriate; 139
22
(c) Trains and supports family members and other 140
communication partners of individuals with speech, voice, 141
language, communication and swallowi ng disabilities; 142
(d) Develops and establishes effective augmentative 143
and alternative communication techniques and strategies, 144
including selecting, prescribing and dispensing of 145
augmentative aids and devices; and the training of 146
individuals, their families and other communication partners 147
in their use; 148
(e) Selects, fits and establishes effective use of 149
appropriate prosthetic/adaptive devices for speaking and 150
swallowing, such as tracheoesophageal valves, 151
electrolarynges, or speaking valves ; 152
(f) Uses instrumental technology to diagnose and treat 153
disorders of communication and swallowing, such as 154
videofluoroscopy, nasendoscopy, ultrasonography and 155
stroboscopy; 156
(g) Provides aural rehabilitative and related 157
counseling services t o individuals with hearing loss and to 158
their families; 159
(h) Collaborates in the assessment of central auditory 160
processing disorders in cases in which there is evidence of 161
speech, language or other cognitive communication disorders; 162
provides intervention for individuals with central auditory 163
processing disorders; 164
(i) Conducts pure-tone air conduction hearing 165
screening and screening tympanometry for the purpose of the 166
initial identification or referral; 167
(j) Enhances speech and language proficiency and 168
communication effectiveness, including but not limited to 169
accent reduction, collaboration with teachers of English as 170
a second language and improvement of voice, performance and 171
singing; 172
23
(k) Trains and supervises support personne l; 173
(l) Develops and manages academic and clinical 174
programs in communication sciences and disorders; 175
(m) Conducts, disseminates and applies research in 176
communication sciences and disorders; 177
(n) Measures outcomes of treatment and conducts 178
continuous evaluation of the effectiveness of practices and 179
programs to improve and maintain quality of services; 180
[(9)] (10) "Speech-language pathologist", a person who 181
is licensed as a speech -language pathologist pursuant to 182
sections 345.010 to 345.080; who engages in the practice of 183
speech-language pathology as defined in sections 345.010 to 184
345.080; 185
[(10)] (11) "Speech-language pathology aide", a person 186
who is registered as a speech -language aide by the board, 187
who does not act indepe ndently but works under the direction 188
and supervision of a licensed speech -language pathologist. 189
Such person assists the speech -language pathologist with 190
activities which require an understanding of speech -language 191
pathology but do not require formal training in the relevant 192
academics. To be eligible for registration by the board, 193
each applicant shall submit a registration fee and: 194
(a) Be at least eighteen years of age; 195
(b) Furnish evidence of the person's educational 196
qualifications which shall be at a minimum: 197
a. Certification of graduation from an accredited high 198
school or its equivalent; and 199
b. On-the-job training; 200
(c) Be employed in a setting in which direct and 201
indirect supervision is provided on a regular and sy stematic 202
basis by a licensed speech -language pathologist. 203
However, the aide shall not administer or interpret hearing 204
screening or diagnostic tests, fit or dispense hearing 205
24
instruments, make ear impressions, make diagnostic 206
statements, determine case s election, present written 207
reports to anyone other than the supervisor without the 208
signature of the supervisor, make referrals to other 209
professionals or agencies, use a title other than speech - 210
language pathology aide, develop or modify treatment plans, 211
discharge clients from treatment or terminate treatment, 212
disclose clinical information, either orally or in writing, 213
to anyone other than the supervising speech -language 214
pathologist, or perform any procedure for which he or she is 215
not qualified, has n ot been adequately trained or both; 216
[(11)] (12) "Speech-language pathology assistant", a 217
person who is registered as a speech -language pathology 218
assistant by the board, who does not act independently but 219
works under the direction and supervision o f a licensed 220
speech-language pathologist practicing for at least one year 221
or speech-language pathologist practicing under subdivision 222
(1) or (6) of subsection 1 of section 345.025 for at least 223
one year and whose activities require both academic and 224
practical training in the field of speech -language pathology 225
although less training than those established by sections 226
345.010 to 345.080 as necessary for licensing as a speech - 227
language pathologist. To be eligible for registration by 228
the board, each applicant shall submit the registration fee, 229
supervising speech-language pathologist information if 230
employment is confirmed, if not such information shall be 231
provided after registration, and furnish evidence of the 232
person's educational qualifications whic h meet the following: 233
(a) Hold a bachelor's level degree from an institution 234
accredited or approved by a regional accrediting body 235
recognized by the United States Department of Education or 236
its equivalent; and 237
25
(b) Submit official transcripts from one or more 238
accredited colleges or universities presenting evidence of 239
the completion of bachelor's level course work and 240
requirements in the field of speech -language pathology as 241
established by the board through rules and regulations; 242
(c) Submit proof of completion of the number and type 243
of clinical hours as established by the board through rules 244
and regulations. 245
345.022. 1. Any person in the person's clinical 1
fellowship shall hold a provisional license to practice 2
speech-language pathology or audiology. The board may issue 3
a provisional license to an applicant who: 4
(1) Has met the requirements for practicum and 5
academic requirements from an accredited training program 6
under this chapter; 7
(2) Submits an application to the board on a form 8
prescribed by the board. Such form shall include a plan for 9
the content and supervision of the clinical fellowship, as 10
well as evidence of good moral and ethical character; and 11
(3) Submits to the board an a pplication fee, as set by 12
the board, for the provisional license. 13
2. A provisional license is effective for one year and 14
may be extended for an additional twelve months only for 15
purposes of completing the postgraduate clinical experience 16
portion of the clinical fellowship; provided, that the 17
applicant has passed the national examination and shall hold 18
a master's degree from an approved training program in his 19
or her area of application. 20
3. Within twelve months of issuance of the provision al 21
license, the applicant shall pass an examination promulgated 22
or approved by the board. 23
4. Within twelve months of issuance of a provisional 24
license, the applicant shall complete the requirements for 25
26
the master's or doctoral degree from a progr am accredited by 26
the Council on Academic Accreditation of the American Speech - 27
Language-Hearing Association or other accrediting agency 28
approved by the board in the area in which licensure is 29
sought. 30
345.050. [1.] To be eligible for licensure by the 1
board by examination, each applicant shall submit the 2
application fee and shall furnish evidence of such person's 3
current competence and shall: 4
(1) Hold a master's or a doctoral degree from a 5
program that was awarded "accredit ation candidate" status or 6
is accredited by the Council on Academic Accreditation of 7
the American Speech-Language-Hearing Association or other 8
accrediting agency approved by the board in the area in 9
which licensure is sought; 10
(2) Submit official transcripts from one or more 11
accredited colleges or universities presenting evidence of 12
the completion of course work and clinical practicum 13
requirements equivalent to that required by the Council on 14
Academic Accreditation of the American Speech -Language- 15
Hearing Association or other accrediting agency approved by 16
the board; [and] 17
(3) Present written evidence of completion of a 18
clinical fellowship from supervisors. The experience 19
required by this subdivision shall follow the completion of 20
the requirements of subdivisions (1) and (2) of this 21
subsection. This period of employment shall be under the 22
direct supervision of a person who is licensed by the state 23
of Missouri in the profession in which the applicant seeks 24
to be licensed. Persons applying with an audiology clinical 25
doctoral degree are exempt from this provision; and 26
27
(4) Pass an examination promulgated or approved by the 27
board. The board shall determine the subject and scope of 28
the examinations. 29
[2. To be eligible for licensure by the board without 30
examination, each applicant shall make application on forms 31
prescribed by the board, submit the application fee, submit 32
an activity statement and meet one of the following 33
requirements: 34
(1) The board shall issue a license to any speech - 35
language pathologist or audiologist who is licensed in 36
another country and who has had no violations, suspension or 37
revocations of a license to practice speech -language 38
pathology or audiology in any jurisdiction; provided that, 39
such person is licensed in a country whose requirements are 40
substantially equal to, or greater than, Missouri at the 41
time the applicant applies for licensure; or 42
(2) Hold the certificate of clinical competence issued 43
by the American Speech -Language-Hearing Association in the 44
area in which licensure is sought. ] 45
345.052. 1. For purposes of this section, the 1
following terms mean: 2
(1) "Board", the Missouri board of registration for 3
the healing arts; 4
(2) "Commission", the advisory commission for speech - 5
language pathologists and audiologists; 6
(3) "License", a license, certificate, registration, 7
permit, accreditation, or military occupational specialty 8
that enables a person to legally practice an occupation or 9
profession in a particular jurisdiction; 10
(4) "Military", the Armed Forces of the United States 11
including the Air Force, Army, Coast Guard, Marine Corps, 12
Navy, Space Force, National Guard, and any other military 13
branch that is designated by Congr ess as part of the Armed 14
28
Forces of the United States, and all reserve components and 15
auxiliaries. Such term also includes the military reserves 16
and militia of the United States territory or state; 17
(5) "Nonresident military spouse", a nonresident 18
spouse of an active duty member of the Armed Forces of the 19
United States who has been transferred or is scheduled to be 20
transferred to an adjacent state and is or will be domiciled 21
in the state of Missouri, or has moved to the state of 22
Missouri on a permanent change-of-station basis; 23
(6) "Resident military spouse", a spouse of an active 24
duty member of the Armed Forces of the United States who has 25
been transferred or is scheduled to be transferred to the 26
state of Missouri, who is domiciled in t he state of 27
Missouri, or who has Missouri as his or her home of record. 28
2. Any person who holds a valid current speech - 29
language pathologist or audiologist license issued by 30
another state, a branch or unit of the military, a territory 31
of the United States, or the District of Columbia, and who 32
has been licensed for at least one year in the other 33
jurisdiction, may submit an application for a speech - 34
language pathologist or audiologist license in Missouri 35
along with proof of current licensure and p roof of licensure 36
for at least one year in the other jurisdiction, to the 37
board. 38
3. The board shall: 39
(1) Within six months of receiving an application 40
described in subsection 2 of this section, waive any 41
examination, educational, or experie nce requirements for 42
licensure in this state for the applicant if it determines 43
that there were minimum education requirements and, if 44
applicable, work experience and clinical supervision 45
requirements in effect and the other state verifies that the 46
person met those requirements in order to be licensed or 47
29
certified in that state. The board may require an applicant 48
to take and pass an examination specific to the laws of this 49
state; or 50
(2) Within thirty days of receiving an application 51
describe in subsection 2 of this section from a nonresident 52
military spouse or a resident military spouse, waive any 53
examination, educational, or experience requirements for 54
licensure in this state for the applicant and issue such 55
applicant a license under thi s section if such applicant 56
otherwise meets the requirements of this section. 57
4. (1) The board shall not waive any examination, 58
educational, or experience requirements for any applicant 59
who has had his or her license revoked by a board outside 60
the state; who is currently under investigation, who has a 61
complaint pending, or who is currently under disciplinary 62
action, except as provided in subdivision (2) of this 63
subsection, with a board outside the state; who does not 64
hold a license in good st anding with a board outside the 65
state; who has a criminal record that would disqualify him 66
or her for licensure in Missouri; or who does not hold a 67
valid current license in the other jurisdiction on the date 68
the board receives his or her application un der this section. 69
(2) If another jurisdiction has taken disciplinary 70
action against an applicant, the board shall determine if 71
the cause for the action was corrected and the matter 72
resolved. If the matter has not been resolved by that 73
jurisdiction, the board may deny a license until the matter 74
is resolved. 75
5. Nothing in this section shall prohibit the board 76
from denying a license to an applicant under this section 77
for any reason described in section 345.065. 78
6. Any person who is li censed under the provisions of 79
this section shall be subject to the board's jurisdiction 80
30
and all rules and regulations pertaining to the practice as 81
a speech-language pathologist or audiologist in this state. 82
7. This section shall not be construed to waive any 83
requirement for an applicant to pay any fees. 84
345.085. SECTION 1. PURPOSE 1
The purpose of this Compact is to facilitate interstate 2
practice of audiology and speech -language pathology with the 3
goal of improving pu blic access to audiology and speech - 4
language pathology services. The practice of audiology and 5
speech-language pathology occurs in the state where the 6
patient/client/student is located at the time of the 7
patient/client/student encounter. The Compact preserves the 8
regulatory authority of states to protect public health and 9
safety through the current system of state licensure. 10
This Compact is designed to achieve the following 11
objectives: 12
1. Increase public access to audiology and speech - 13
language pathology services by providing for the mutual 14
recognition of other member state licenses; 15
2. Enhance the states' ability to protect the public's 16
health and safety; 17
3. Encourage the cooperation of member states in 18
regulating multistate audiology and speech -language 19
pathology practice; 20
4. Support spouses of relocating active duty military 21
personnel; 22
5. Enhance the exchange of licensure, investigative 23
and disciplinary information between member states; 24
6. Allow a remote state to hold a provider of services 25
with a compact privilege in that state accountable to that 26
state's practice standards; and 27
31
7. Allow for the use of telehealth technology to 28
facilitate increased access to audiology and speech -language 29
pathology services. 30
SECTION 2. DEFINITIONS 31
As used in this Compact, and except as otherwise 32
provided, the following definitions shall apply: 33
A. "Active duty military" means full -time duty status 34
in the active uniformed service of the United States, 35
including members of the National Guard and Reserve on 36
active duty orders pursuant to 10 U.S.C. Chapter 1209 and 37
1211. 38
B. "Adverse action" means any administrative, civil, 39
equitable or criminal action permitted by a state's laws 40
which is imposed by a licensing board or other authority 41
against an audiologist or speech -language pathologist, 42
including actions against an individual's license or 43
privilege to practice such as revocation, suspension, 44
probation, monitoring of the licensee, o r restriction on the 45
licensee's practice. 46
C. "Alternative program" means a non -disciplinary 47
monitoring process approved by an audiology or speech - 48
language pathology licensing board to address impaired 49
practitioners. 50
D. "Audiologist" means a n individual who is licensed 51
by a state to practice audiology. 52
E. "Audiology" means the care and services provided by 53
a licensed audiologist as set forth in the member state's 54
statutes and rules. 55
F. "Audiology and Speech -Language Pathology C ompact 56
Commission" or "Commission" means the national 57
administrative body whose membership consists of all states 58
that have enacted the Compact. 59
32
G. "Audiology and speech -language pathology licensing 60
board," "audiology licensing board," "speech -language 61
pathology licensing board," or "licensing board" means the 62
agency of a state that is responsible for the licensing and 63
regulation of audiologists and/or speech -language 64
pathologists. 65
H. "Compact privilege" means the authorization granted 66
by a remote state to allow a licensee from another member 67
state to practice as an audiologist or speech -language 68
pathologist in the remote state under its laws and rules. 69
The practice of audiology or speech -language pathology 70
occurs in the member stat e where the patient/client/student 71
is located at the time of the patient/client/student 72
encounter. 73
I. "Current significant investigative information" 74
means investigative information that a licensing board, 75
after an inquiry or investigation that i ncludes notification 76
and an opportunity for the audiologist or speech -language 77
pathologist to respond, if required by state law, has reason 78
to believe is not groundless and, if proved true, would 79
indicate more than a minor infraction. 80
J. "Data system" means a repository of information 81
about licensees, including, but not limited to, continuing 82
education, examination, licensure, investigative, compact 83
privilege and adverse action. 84
K. "Encumbered license" means a license in which an 85
adverse action restricts the practice of audiology or speech - 86
language pathology by the licensee and said adverse action 87
has been reported to the National Practitioners Data Bank 88
(NPDB). 89
L. "Executive Committee" means a group of directors 90
elected or appointed to act on behalf of, and within the 91
powers granted to them by, the Commission. 92
33
M. "Home state" means the member state that is the 93
licensee's primary state of residence. 94
N. "Impaired practitioner" means individuals whose 95
professional practice is adversely affected by substance 96
abuse, addiction, or other health -related conditions. 97
O. "Licensee" means an individual who currently holds 98
an authorization from the state licensing board to practice 99
as an audiologist or speech -language pathologist. 100
P. "Member state" means a state that has enacted the 101
Compact. 102
Q. "Privilege to practice" means a legal authorization 103
permitting the practice of audiology or speech -language 104
pathology in a remote state. 105
R. "Remote state" means a member state other than the 106
home state where a licensee is exercising or seeking to 107
exercise the compact privilege. 108
S. "Rule" means a regulation, principle or directive 109
promulgated by the Commission that has the force of law. 110
T. "Single-state license" means an audiology or speech - 111
language pathology license issued by a member state that 112
authorizes practice only within the issuing state and does 113
not include a privilege to practice in any other member 114
state. 115
U. "Speech-language pathologist" means an individual 116
who is licensed by a state to practice speech -language 117
pathology. 118
V. "Speech-language pathology" means the care and 119
services provided by a licensed speech -language pathologist 120
as set forth in the member state's sta tutes and rules. 121
W. "State" means any state, commonwealth, district or 122
territory of the United States of America that regulates the 123
practice of audiology and speech -language pathology. 124
34
X. "State practice laws" means a member state's laws, 125
rules and regulations that govern the practice of audiology 126
or speech-language pathology, define the scope of audiology 127
or speech-language pathology practice, and create the 128
methods and grounds for imposing discipline. 129
Y. "Telehealth" means the appl ication of 130
telecommunication technology to deliver audiology or speech - 131
language pathology services at a distance for assessment, 132
intervention and/or consultation. 133
SECTION 3. STATE PARTICIPATION IN THE COMPACT 134
A. A license issued to an audiolo gist or speech- 135
language pathologist by a home state to a resident in that 136
state shall be recognized by each member state as 137
authorizing an audiologist or speech -language pathologist to 138
practice audiology or speech -language pathology, under a 139
privilege to practice, in each member state. 140
B. A state must implement or utilize procedures for 141
considering the criminal history records of applicants for 142
initial privilege to practice. These procedures shall 143
include the submission of fingerprints or oth er biometric- 144
based information by applicants for the purpose of obtaining 145
an applicant's criminal history record information from the 146
Federal Bureau of Investigation and the agency responsible 147
for retaining that state's criminal records. 148
1. A member state must fully implement a criminal 149
background check requirement, within a time frame 150
established by rule, by receiving the results of the Federal 151
Bureau of Investigation record search on criminal background 152
checks and use the results in making l icensure decisions. 153
2. Communication between a member state, the 154
Commission and among member states regarding the 155
verification of eligibility for licensure through the 156
Compact shall not include any information received from the 157
35
Federal Bureau of Investigation relating to a federal 158
criminal records check performed by a member state under 159
Public Law 92-544. 160
C. Upon application for a privilege to practice, the 161
licensing board in the issuing remote state shall ascertain, 162
through the data sys tem, whether the applicant has ever 163
held, or is the holder of, a license issued by any other 164
state, whether there are any encumbrances on any license or 165
privilege to practice held by the applicant, whether any 166
adverse action has been taken against any license or 167
privilege to practice held by the applicant. 168
D. Each member state shall require an applicant to 169
obtain or retain a license in the home state and meet the 170
home state's qualifications for licensure or renewal of 171
licensure, as well as, al l other applicable state laws. 172
E. For an audiologist: 173
1. Must meet one of the following educational 174
requirements: 175
a. On or before, Dec. 31, 2007, has graduated with a 176
master's degree or doctorate in audiology, or equivalent 177
degree regardless of degree name, from a program that is 178
accredited by an accrediting agency recognized by the 179
Council for Higher Education Accreditation, or its 180
successor, or by the United States Department of Education 181
and operated by a college or university ac credited by a 182
regional or national accrediting organization recognized by 183
the board; or 184
b. On or after, Jan. 1, 2008, has graduated with a 185
Doctoral degree in audiology, or equivalent degree, 186
regardless of degree name, from a program that is accre dited 187
by an accrediting agency recognized by the Council for 188
Higher Education Accreditation, or its successor, or by the 189
United States Department of Education and operated by a 190
36
college or university accredited by a regional or national 191
accrediting organization recognized by the board; or 192
c. Has graduated from an audiology program that is 193
housed in an institution of higher education outside of the 194
United States (a) for which the program and institution have 195
been approved by the authorized accre diting body in the 196
applicable country and (b) the degree program has been 197
verified by an independent credentials review agency to be 198
comparable to a state licensing board -approved program. 199
2. Has completed a supervised clinical practicum 200
experience from an accredited educational institution or its 201
cooperating programs as required by the Commission; 202
3. Has successfully passed a national examination 203
approved by the Commission; 204
4. Holds an active, unencumbered license; 205
5. Has not been convicted or found guilty, and has not 206
entered into an agreed disposition, of a felony related to 207
the practice of audiology, under applicable state or federal 208
criminal law; 209
6. Has a valid United States Social Security or 210
National Practitione r Identification number. 211
F. For a speech-language pathologist: 212
1. Must meet one of the following educational 213
requirements: 214
a. Has graduated with a master's degree from a speech - 215
language pathology program that is accredited by an 216
organization recognized by the United States Department of 217
Education and operated by a college or university accredited 218
by a regional or national accrediting organization 219
recognized by the board; or 220
b. Has graduated from a speech -language pathology 221
program that is housed in an institution of higher education 222
outside of the United States (a) for which the program and 223
37
institution have been approved by the authorized accrediting 224
body in the applicable country and (b) the degree program 225
has been verified by an independent credentials review 226
agency to be comparable to a state licensing board -approved 227
program. 228
2. Has completed a supervised clinical practicum 229
experience from an educational institution or its 230
cooperating programs as required by the Commission; 231
3. Has completed a supervised postgraduate 232
professional experience as required by the Commission; 233
4. Has successfully passed a national examination 234
approved by the Commission; 235
5. Holds an active, unencumbered license; 236
6. Has not been convicted or found guilty, and has not 237
entered into an agreed disposition, of a felony related to 238
the practice of speech -language pathology, under applicable 239
state or federal criminal law; 240
7. Has a valid United States Social Secur ity or 241
National Practitioner Identification number. 242
G. The privilege to practice is derived from the home 243
state license. 244
H. An audiologist or speech -language pathologist 245
practicing in a member state must comply with the state 246
practice laws of the state in which the client is located at 247
the time service is provided. The practice of audiology and 248
speech-language pathology shall include all audiology and 249
speech-language pathology practice as defined by the state 250
practice laws of the member state in which the client is 251
located. The practice of audiology and speech -language 252
pathology in a member state under a privilege to practice 253
shall subject an audiologist or speech -language pathologist 254
to the jurisdiction of the licensing board, the courts and 255
38
the laws of the member state in which the client is located 256
at the time service is provided. 257
I. Individuals not residing in a member state shall 258
continue to be able to apply for a member state's single - 259
state license as provided under t he laws of each member 260
state. However, the single-state license granted to these 261
individuals shall not be recognized as granting the 262
privilege to practice audiology or speech -language pathology 263
in any other member state. Nothing in this Compact shall 264
affect the requirements established by a member state for 265
the issuance of a single -state license. 266
J. Member states may charge a fee for granting a 267
compact privilege. 268
K. Member states must comply with the bylaws and rules 269
and regulations of the Commission. 270
SECTION 4. COMPACT PRIVILEGE 271
A. To exercise the compact privilege under the terms 272
and provisions of the Compact, the audiologist or speech - 273
language pathologist shall: 274
1. Hold an active license in the home state; 275
2. Have no encumbrance on any state license; 276
3. Be eligible for a compact privilege in any member 277
state in accordance with Section 3; 278
4. Have not had any adverse action against any license 279
or compact privilege within the previous 2 years from date 280
of application; 281
5. Notify the Commission that the licensee is seeking 282
the compact privilege within a remote state(s); 283
6. Pay any applicable fees, including any state fee, 284
for the compact privilege; 285
7. Report to the Commission adve rse action taken by 286
any non-member state within 30 days from the date the 287
adverse action is taken. 288
39
B. For the purposes of the compact privilege, an 289
audiologist or speech -language pathologist shall only hold 290
one home state license at a time. 291
C. Except as provided in Section 6, if an audiologist 292
or speech-language pathologist changes primary state of 293
residence by moving between two -member states, the 294
audiologist or speech -language pathologist must apply for 295
licensure in the new home state, and the license issued by 296
the prior home state shall be deactivated in accordance with 297
applicable rules adopted by the Commission. 298
D. The audiologist or speech -language pathologist may 299
apply for licensure in advance of a change in primary state 300
of residence. 301
E. A license shall not be issued by the new home state 302
until the audiologist or speech -language pathologist 303
provides satisfactory evidence of a change in primary state 304
of residence to the new home state and satisfies all 305
applicable requirements to obtain a license from the new 306
home state. 307
F. If an audiologist or speech -language pathologist 308
changes primary state of residence by moving from a member 309
state to a non-member state, the license issued by the prior 310
home state shall convert to a single-state license, valid 311
only in the former home state. 312
G. The compact privilege is valid until the expiration 313
date of the home state license. The licensee must comply 314
with the requirements of Section 4A to maintain the compact 315
privilege in the remote state. 316
H. A licensee providing audiology or speech -language 317
pathology services in a remote state under the compact 318
privilege shall function within the laws and regulations of 319
the remote state. 320
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I. A licensee providing audiology or speech-language 321
pathology services in a remote state is subject to that 322
state's regulatory authority. A remote state may, in 323
accordance with due process and that state's laws, remove a 324
licensee's compact privilege in the remote state for a 325
specific period of time, impose fines, and/or take any other 326
necessary actions to protect the health and safety of its 327
citizens. 328
J. If a home state license is encumbered, the licensee 329
shall lose the compact privilege in any remote state until 330
the following occur: 331
1. The home state license is no longer encumbered; and 332
2. Two years have elapsed from the date of the adverse 333
action. 334
K. Once an encumbered license in the home state is 335
restored to good standing, the licensee must m eet the 336
requirements of Section 4A to obtain a compact privilege in 337
any remote state. 338
L. Once the requirements of Section 4J have been met, 339
the licensee must meet the requirements in Section 4A to 340
obtain a compact privilege in a remote state. 341
SECTION 5. COMPACT PRIVILEGE TO PRACTICE TELEHEALTH 342
Member states shall recognize the right of an 343
audiologist or speech -language pathologist, licensed by a 344
home state in accordance with Section 3 and under rules 345
promulgated by the Commission, to practice audiology or 346
speech-language pathology in any member state via telehealth 347
under a privilege to practice as provided in the Compact and 348
rules promulgated by the Commission. 349
SECTION 6. ACTIVE DUTY MILITARY PERSONNEL OR THEIR 350
SPOUSES 351
Active duty military personnel, or their spouse, shall 352
designate a home state where the individual has a current 353
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license in good standing. The individual may retain the 354
home state designation during the period the service member 355
is on active duty. Subsequent to designating a home state, 356
the individual shall only change their home state through 357
application for licensure in the new state. 358
SECTION 7. ADVERSE ACTIONS 359
A. In addition to the other powers conferred by state 360
law, a remote state shall have the authority, in accordance 361
with existing state due process law, to: 362
1. Take adverse action against an audiologist's or 363
speech-language pathologist's privilege to practice within 364
that member state. 365
2. Issue subpoenas for both hea rings and 366
investigations that require the attendance and testimony of 367
witnesses as well as the production of evidence. Subpoenas 368
issued by a licensing board in a member state for the 369
attendance and testimony of witnesses or the production of 370
evidence from another member state shall be enforced in the 371
latter state by any court of competent jurisdiction, 372
according to the practice and procedure of that court 373
applicable to subpoenas issued in proceedings pending before 374
it. The issuing authority shall pay any witness fees, 375
travel expenses, mileage and other fees required by the 376
service statutes of the state in which the witnesses or 377
evidence are located. 378
3. Only the home state shall have the power to take 379
adverse action against a audiologist' s or speech-language 380
pathologist's license issued by the home state. 381
B. For purposes of taking adverse action, the home 382
state shall give the same priority and effect to reported 383
conduct received from a member state as it would if the 384
conduct had occurred within the home state. In so doing, 385
42
the home state shall apply its own state laws to determine 386
appropriate action. 387
C. The home state shall complete any pending 388
investigations of an audiologist or speech -language 389
pathologist who changes primary state of residence during 390
the course of the investigations. The home state shall also 391
have the authority to take appropriate action(s) and shall 392
promptly report the conclusions of the investigations to the 393
administrator of the data system. The administrator of the 394
coordinated licensure information system shall promptly 395
notify the new home state of any adverse actions. 396
D. If otherwise permitted by state law, the member 397
state may recover from the affected audiologist or speech - 398
language pathologist the costs of investigations and 399
disposition of cases resulting from any adverse action taken 400
against that audiologist or speech -language pathologist. 401
E. The member state may take adverse action based on 402
the factual findings of the rem ote state, provided that the 403
member state follows the member state's own procedures for 404
taking the adverse action. 405
F. Joint Investigations: 406
1. In addition to the authority granted to a member 407
state by its respective audiology or speech -language 408
pathology practice act or other applicable state law, any 409
member state may participate with other member states in 410
joint investigations of licensees. 411
2. Member states shall share any investigative, 412
litigation, or compliance materials in furth erance of any 413
joint or individual investigation initiated under the 414
Compact. 415
G. If adverse action is taken by the home state 416
against an audiologist's or speech -language pathologist's 417
license, the audiologist's or speech -language pathologist's 418
43
privilege to practice in all other member states shall be 419
deactivated until all encumbrances have been removed from 420
the state license. All home state disciplinary orders that 421
impose adverse action against an audiologist's or speech - 422
language pathologist' s license shall include a statement 423
that the audiologist's or speech -language pathologist's 424
privilege to practice is deactivated in all member states 425
during the pendency of the order. 426
H. If a member state takes adverse action, it shall 427
promptly notify the administrator of the data system. The 428
administrator of the data system shall promptly notify the 429
home state of any adverse actions by remote states. 430
I. Nothing in this Compact shall override a member 431
state's decision that participation in an alternative 432
program may be used in lieu of adverse action. 433
SECTION 8. ESTABLISHMENT OF THE AUDIOLOGY AND SPEECH - 434
LANGUAGE PATHOLOGY COMPACT COMMISSION 435
A. The Compact member states hereby create and 436
establish a joint public agency known as the Audiology and 437
Speech-Language Pathology Compact Commission: 438
1. The Commission is an instrumentality of the Compact 439
states. 440
2. Venue is proper and judicial proceedings by or 441
against the Commission shall be brought solely and 442
exclusively in a court of competent jurisdiction where the 443
principal office of the Commission is located. The 444
Commission may waive venue and jurisdictional defenses to 445
the extent it adopts or consents to participate in 446
alternative dispute resolution proceeding s. 447
3. Nothing in this Compact shall be construed to be a 448
waiver of sovereign immunity. 449
B. Membership, Voting and Meetings: 450
44
1. Each member state shall have two (2) delegates 451
selected by that member state's licensing board. The 452
delegates shall be current members of the licensing board. 453
One shall be an audiologist and one shall be a speech - 454
language pathologist. 455
2. An additional five (5) delegates, who are either a 456
public member or board administrator from a state licensing 457
board, shall be chosen by the Executive Committee from a 458
pool of nominees provided by the Commission at Large. 459
3. Any delegate may be removed or suspended from 460
office as provided by the law of the state from which the 461
delegate is appointed. 462
4. The member state board shall fill any vacancy 463
occurring on the Commission, within 90 days. 464
5. Each delegate shall be entitled to one (1) vote 465
with regard to the promulgation of rules and creation of 466
bylaws and shall otherwise have an opportunity to 467
participate in the business and affairs of the Commission. 468
6. A delegate shall vote in person or by other means 469
as provided in the bylaws. The bylaws may provide for 470
delegates' participation in meetings by telephone or other 471
means of communicati on. 472
7. The Commission shall meet at least once during each 473
calendar year. Additional meetings shall be held as set 474
forth in the bylaws. 475
C. The Commission shall have the following powers and 476
duties: 477
1. Establish the fiscal year of the C ommission; 478
2. Establish bylaws; 479
3. Establish a Code of Ethics; 480
4. Maintain its financial records in accordance with 481
the bylaws; 482
45
5. Meet and take actions as are consistent with the 483
provisions of this Compact and the bylaws; 484
6. Promulgate uniform rules to facilitate and 485
coordinate implementation and administration of this 486
Compact. The rules shall have the force and effect of law 487
and shall be binding in all member states; 488
7. Bring and prosecute legal proceedings or act ions in 489
the name of the Commission, provided that the standing of 490
any state audiology or speech -language pathology licensing 491
board to sue or be sued under applicable law shall not be 492
affected; 493
8. Purchase and maintain insurance and bonds; 494
9. Borrow, accept, or contract for services of 495
personnel, including, but not limited to, employees of a 496
member state; 497
10. Hire employees, elect or appoint officers, fix 498
compensation, define duties, grant individuals appropriate 499
authority to carry out the purposes of the Compact, and to 500
establish the Commission's personnel policies and programs 501
relating to conflicts of interest, qualifications of 502
personnel, and other related personnel matters; 503
11. Accept any and all appropriate donations an d 504
grants of money, equipment, supplies, materials and 505
services, and to receive, utilize and dispose of the same; 506
provided that at all times the Commission shall avoid any 507
appearance of impropriety and/or conflict of interest; 508
12. Lease, purchase, accept appropriate gifts or 509
donations of, or otherwise to own, hold, improve or use, any 510
property, real, personal or mixed; provided that at all 511
times the Commission shall avoid any appearance of 512
impropriety; 513
46
13. Sell, convey, mortgage, pledge, lease, exchange, 514
abandon, or otherwise dispose of any property real, 515
personal, or mixed; 516
14. Establish a budget and make expenditures; 517
15. Borrow money; 518
16. Appoint committees, including standing committees 519
composed of members, and oth er interested persons as may be 520
designated in this Compact and the bylaws; 521
17. Provide and receive information from, and 522
cooperate with, law enforcement agencies; 523
18. Establish and elect an Executive Committee; and 524
19. Perform other functions as may be necessary or 525
appropriate to achieve the purposes of this Compact 526
consistent with the state regulation of audiology and speech - 527
language pathology licensure and practice. 528
D. The Executive Committee 529
The Executive Committee shall have the power to act on 530
behalf of the Commission according to the terms of this 531
Compact: 532
1. The Executive Committee shall be composed of ten 533
(10) members: 534
a. Seven (7) voting members who are elected by the 535
Commission from the current memb ership of the Commission; 536
b. Two (2) ex-officios, consisting of one nonvoting 537
member from a recognized national audiology professional 538
association and one nonvoting member from a recognized 539
national speech-language pathology association; and 540
c. One (1) ex-officio, nonvoting member from the 541
recognized membership organization of the audiology and 542
speech-language pathology licensing boards. 543
E. The ex-officio members shall be selected by their 544
respective organizations. 545
47
1. The Commission may remove any member of the 546
Executive Committee as provided in bylaws. 547
2. The Executive Committee shall meet at least 548
annually. 549
3. The Executive Committee shall have the following 550
duties and responsibilities: 551
a. Recommend to the entire Commission changes to the 552
rules or bylaws, changes to this Compact legislation, fees 553
paid by Compact member states such as annual dues, and any 554
commission Compact fee charged to licensees for the compact 555
privilege; 556
b. Ensure Compact admin istration services are 557
appropriately provided, contractual or otherwise; 558
c. Prepare and recommend the budget; 559
d. Maintain financial records on behalf of the 560
Commission; 561
e. Monitor Compact compliance of member states and 562
provide compliance reports to the Commission; 563
f. Establish additional committees as necessary; and 564
g. Other duties as provided in rules or bylaws. 565
4. Meetings of the Commission 566
All meetings shall be open to the public, and public 567
notice of meetings shall be given in the same manner as 568
required under the rulemaking provisions in Section 10. 569
5. The Commission or the Executive Committee or other 570
committees of the Commission may convene in a closed, non - 571
public meeting if the Commission or Exec utive Committee or 572
other committees of the Commission must discuss: 573
a. Non-compliance of a member state with its 574
obligations under the Compact; 575
b. The employment, compensation, discipline or other 576
matters, practices or procedures related to specific 577
48
employees or other matters related to the Commission's 578
internal personnel practices and procedures; 579
c. Current, threatened, or reasonably anticipated 580
litigation; 581
d. Negotiation of contracts for the purchase, lease, 582
or sale of goods, services, or real estate; 583
e. Accusing any person of a crime or formally 584
censuring any person; 585
f. Disclosure of trade secrets or commercial or 586
financial information that is privileged or confidential; 587
g. Disclosure of information of a personal nature 588
where disclosure would constitute a clearly unwarranted 589
invasion of personal privacy; 590
h. Disclosure of investigative records compiled for 591
law enforcement purposes; 592
i. Disclosure of information related to any 593
investigative reports prepared by or on behalf of or for use 594
of the Commission or other committee charged with 595
responsibility of investigation or determination of 596
compliance issues pursuant to the Compact; or 597
j. Matters specifically exempted from disclosure by 598
federal or member state statute. 599
6. If a meeting, or portion of a meeting, is closed 600
pursuant to this provision, the Commission's legal counsel 601
or designee shall certify that the meeting may be closed and 602
shall reference each relevant exempting pro vision. 603
7. The Commission shall keep minutes that fully and 604
clearly describe all matters discussed in a meeting and 605
shall provide a full and accurate summary of actions taken, 606
and the reasons therefore, including a description of the 607
views expressed. All documents considered in connection 608
with an action shall be identified in minutes. All minutes 609
and documents of a closed meeting shall remain under seal, 610
49
subject to release by a majority vote of the Commission or 611
order of a court of competent jurisdiction. 612
8. Financing of the Commission: 613
a. The Commission shall pay, or provide for the 614
payment of, the reasonable expenses of its establishment, 615
organization, and ongoing activities. 616
b. The Commission may accept any and all appr opriate 617
revenue sources, donations, and grants of money, equipment, 618
supplies, materials, and services. 619
c. The Commission may levy on and collect an annual 620
assessment from each member state or impose fees on other 621
parties to cover the cost of the operations and activities 622
of the Commission and its staff, which must be in a total 623
amount sufficient to cover its annual budget as approved 624
each year for which revenue is not provided by other 625
sources. The aggregate annual assessment amount shall be 626
allocated based upon a formula to be determined by the 627
Commission, which shall promulgate a rule binding upon all 628
member states. 629
9. The Commission shall not incur obligations of any 630
kind prior to securing the funds adequate to meet the same; 631
nor shall the Commission pledge the credit of any of the 632
member states, except by and with the authority of the 633
member state. 634
10. The Commission shall keep accurate accounts of all 635
receipts and disbursements. The receipts and disbursements 636
of the Commission shall be subject to the audit and 637
accounting procedures established under its bylaws. 638
However, all receipts and disbursements of funds handled by 639
the Commission shall be audited yearly by a certified or 640
licensed public accountant, and the re port of the audit 641
shall be included in and become part of the annual report of 642
the Commission. 643
50
F. Qualified Immunity, Defense, and Indemnification: 644
1. The members, officers, executive director, 645
employees and representatives of the Commission shall be 646
immune from suit and liability, either personally or in 647
their official capacity, for any claim for damage to or loss 648
of property or personal injury or other civil liability 649
caused by or arising out of any actual or alleged act, error 650
or omission that occurred, or that the person against whom 651
the claim is made had a reasonable basis for believing 652
occurred within the scope of Commission employment, duties 653
or responsibilities; provided that nothing in this paragraph 654
shall be construed to pro tect any person from suit and/or 655
liability for any damage, loss, injury, or liability caused 656
by the intentional or willful or wanton misconduct of that 657
person. 658
2. The Commission shall defend any member, officer, 659
executive director, employee or re presentative of the 660
Commission in any civil action seeking to impose liability 661
arising out of any actual or alleged act, error, or omission 662
that occurred within the scope of Commission employment, 663
duties, or responsibilities, or that the person against whom 664
the claim is made had a reasonable basis for believing 665
occurred within the scope of Commission employment, duties, 666
or responsibilities; provided that nothing herein shall be 667
construed to prohibit that person from retaining his or her 668
own counsel; and provided further, that the actual or 669
alleged act, error, or omission did not result from that 670
person's intentional or willful or wanton misconduct. 671
3. The Commission shall indemnify and hold harmless 672
any member, officer, executive director, employee, or 673
representative of the Commission for the amount of any 674
settlement or judgment obtained against that person arising 675
out of any actual or alleged act, error or omission that 676
51
occurred within the scope of Commission employment, duties, 677
or responsibilities, or that person had a reasonable basis 678
for believing occurred within the scope of Commission 679
employment, duties, or responsibilities, provided that the 680
actual or alleged act, error, or omission did not result 681
from the intentional or willf ul or wanton misconduct of that 682
person. 683
SECTION 9. DATA SYSTEM 684
A. The Commission shall provide for the development, 685
maintenance, and utilization of a coordinated database and 686
reporting system containing licensure, adverse action, and 687
investigative information on all licensed individuals in 688
member states. 689
B. Notwithstanding any other provision of state law to 690
the contrary, a member state shall submit a uniform data set 691
to the data system on all individuals to whom this Compact 692
is applicable as required by the rules of the Commission, 693
including: 694
1. Identifying information; 695
2. Licensure data; 696
3. Adverse actions against a license or compact 697
privilege; 698
4. Non-confidential information related to alternative 699
program participation; 700
5. Any denial of application for licensure, and the 701
reason(s) for denial; and 702
6. Other information that may facilitate the 703
administration of this Compact, as determined by the rules 704
of the Commission. 705
C. Investigative information pertaining to a licensee 706
in any member state shall only be available to other member 707
states. 708
52
D. The Commission shall promptly notify all member 709
states of any adverse action taken against a licensee or an 710
individual applying for a lic ense. Adverse action 711
information pertaining to a licensee in any member state 712
shall be available to any other member state. 713
E. Member states contributing information to the data 714
system may designate information that may not be shared with 715
the public without the express permission of the 716
contributing state. 717
F. Any information submitted to the data system that 718
is subsequently required to be expunged by the laws of the 719
member state contributing the information shall be removed 720
from the data system. 721
SECTION 10. RULEMAKING 722
A. The Commission shall exercise its rulemaking powers 723
pursuant to the criteria set forth in this Section and the 724
rules adopted thereunder. Rules and amendments shall become 725
binding as of the date specified in each rule or amendment. 726
B. If a majority of the legislatures of the member 727
states rejects a rule, by enactment of a statute or 728
resolution in the same manner used to adopt the Compact 729
within 4 years of the date of adoption of the rule, the rule 730
shall have no further force and effect in any member state. 731
C. Rules or amendments to the rules shall be adopted 732
at a regular or special meeting of the Commission. 733
D. Prior to promulgation and adoption of a final rule 734
or rules by the Commiss ion, and at least thirty (30) days in 735
advance of the meeting at which the rule shall be considered 736
and voted upon, the Commission shall file a Notice of 737
Proposed Rulemaking: 738
1. On the website of the Commission or other publicly 739
accessible platform; and 740
53
2. On the website of each member state audiology or 741
speech-language pathology licensing board or other publicly 742
accessible platform or the publication in which each state 743
would otherwise publish proposed rules. 744
E. The Notice of Propos ed Rulemaking shall include: 745
1. The proposed time, date, and location of the 746
meeting in which the rule shall be considered and voted upon; 747
2. The text of the proposed rule or amendment and the 748
reason for the proposed rule; 749
3. A request for comments on the proposed rule from 750
any interested person; and 751
4. The manner in which interested persons may submit 752
notice to the Commission of their intention to attend the 753
public hearing and any written comments. 754
F. Prior to the adoptio n of a proposed rule, the 755
Commission shall allow persons to submit written data, 756
facts, opinions and arguments, which shall be made available 757
to the public. 758
G. The Commission shall grant an opportunity for a 759
public hearing before it adopts a rule or amendment if a 760
hearing is requested by: 761
1. At least twenty-five (25) persons; 762
2. A state or federal governmental subdivision or 763
agency; or 764
3. An association having at least twenty -five (25) 765
members. 766
H. If a hearing is held on the proposed rule or 767
amendment, the Commission shall publish the place, time, and 768
date of the scheduled public hearing. If the hearing is 769
held via electronic means, the Commission shall publish the 770
mechanism for access to the electronic hearing. 771
1. All persons wishing to be heard at the hearing 772
shall notify the executive director of the Commission or 773
54
other designated member in writing of their desire to appear 774
and testify at the hearing not less than five (5) business 775
days before the schedul ed date of the hearing. 776
2. Hearings shall be conducted in a manner providing 777
each person who wishes to comment a fair and reasonable 778
opportunity to comment orally or in writing. 779
3. All hearings shall be recorded. A copy of the 780
recording shall be made available on request. 781
4. Nothing in this section shall be construed as 782
requiring a separate hearing on each rule. Rules may be 783
grouped for the convenience of the Commission at hearings 784
required by this section. 785
I. Following the scheduled hearing date, or by the 786
close of business on the scheduled hearing date if the 787
hearing was not held, the Commission shall consider all 788
written and oral comments received. 789
J. If no written notice of intent to attend the public 790
hearing by interested parties is received, the Commission 791
may proceed with promulgation of the proposed rule without a 792
public hearing. 793
K. The Commission shall, by majority vote of all 794
members, take final action on the proposed rule and shall 795
determine the effective date of the rule, if any, based on 796
the rulemaking record and the full text of the rule. 797
L. Upon determination that an emergency exists, the 798
Commission may consider and adopt an emergency rule without 799
prior notice, opportunity for comment, or hearing, provided 800
that the usual rulemaking procedures provided in the Compact 801
and in this section shall be retroactively applied to the 802
rule as soon as reasonably possible, in no event later than 803
ninety (90) days after the effective date of the ru le. For 804
the purposes of this provision, an emergency rule is one 805
that must be adopted immediately in order to: 806
55
1. Meet an imminent threat to public health, safety, 807
or welfare; 808
2. Prevent a loss of Commission or member state funds; 809
or 810
3. Meet a deadline for the promulgation of an 811
administrative rule that is established by federal law or 812
rule. 813
M. The Commission or an authorized committee of the 814
Commission may direct revisions to a previously adopted rule 815
or amendment for purpo ses of correcting typographical 816
errors, errors in format, errors in consistency, or 817
grammatical errors. Public notice of any revisions shall be 818
posted on the website of the Commission. The revision shall 819
be subject to challenge by any person for a pe riod of thirty 820
(30) days after posting. The revision may be challenged 821
only on grounds that the revision results in a material 822
change to a rule. A challenge shall be made in writing and 823
delivered to the chair of the Commission prior to the end of 824
the notice period. If no challenge is made, the revision 825
shall take effect without further action. If the revision 826
is challenged, the revision may not take effect without the 827
approval of the Commission. 828
SECTION 11. OVERSIGHT, DISPUTE RESOLUTION, A ND 829
ENFORCEMENT 830
A. Dispute Resolution 831
1. Upon request by a member state, the Commission 832
shall attempt to resolve disputes related to the Compact 833
that arise among member states and between member and non - 834
member states. 835
2. The Commission shall promulgate a rule providing 836
for both mediation and binding dispute resolution for 837
disputes as appropriate. 838
B. Enforcement 839
56
1. The Commission, in the reasonable exercise of its 840
discretion, shall enforce the provisions and rules of this 841
Compact. 842
2. By majority vote, the Commission may initiate legal 843
action in the United States District Court for the District 844
of Columbia or the federal district where the Commission has 845
its principal offices against a member state in default to 846
enforce compliance with the provisions of the Compact and 847
its promulgated rules and bylaws. The relief sought may 848
include both injunctive relief and damages. In the event 849
judicial enforcement is necessary, the prevailing member 850
shall be awarded all co sts of litigation, including 851
reasonable attorney's fees. 852
3. The remedies herein shall not be the exclusive 853
remedies of the Commission. The Commission may pursue any 854
other remedies available under federal or state law. 855
SECTION 12. DATE OF IMPLEMENTATION OF THE INTERSTATE 856
COMMISSION FOR AUDIOLOGY AND SPEECH -LANGUAGE PATHOLOGY 857
PRACTICE AND ASSOCIATED RULES, WITHDRAWAL, AND AMENDMENT 858
A. The Compact shall come into effect on the date on 859
which the Compact statute is enacted into law in th e 10th 860
member state. The provisions, which become effective at 861
that time, shall be limited to the powers granted to the 862
Commission relating to assembly and the promulgation of 863
rules. Thereafter, the Commission shall meet and exercise 864
rulemaking powers necessary to the implementation and 865
administration of the Compact. 866
B. Any state that joins the Compact subsequent to the 867
Commission's initial adoption of the rules shall be subject 868
to the rules as they exist on the date on which the Compact 869
becomes law in that state. Any rule that has been 870
previously adopted by the Commission shall have the full 871
57
force and effect of law on the day the Compact becomes law 872
in that state. 873
C. Any member state may withdraw from this Compact by 874
enacting a statute repealing the same. 875
1. A member state's withdrawal shall not take effect 876
until six (6) months after enactment of the repealing 877
statute. 878
2. Withdrawal shall not affect the continuing 879
requirement of the withdrawing state's audiology or speech- 880
language pathology licensing board to comply with the 881
investigative and adverse action reporting requirements of 882
this act prior to the effective date of withdrawal. 883
D. Nothing contained in this Compact shall be 884
construed to invalidate or p revent any audiology or speech - 885
language pathology licensure agreement or other cooperative 886
arrangement between a member state and a non -member state 887
that does not conflict with the provisions of this Compact. 888
E. This Compact may be amended by the member states. 889
No amendment to this Compact shall become effective and 890
binding upon any member state until it is enacted into the 891
laws of all member states. 892
SECTION 13. CONSTRUCTION AND SEVERABILITY 893
This Compact shall be liberally construed so as to 894
effectuate the purposes thereof. The provisions of this 895
Compact shall be severable and if any phrase, clause, 896
sentence or provision of this Compact is declared to be 897
contrary to the constitution of any member state or of the 898
United States or the applicability thereof to any 899
government, agency, person or circumstance is held invalid, 900
the validity of the remainder of this Compact and the 901
applicability thereof to any government, agency, person or 902
circumstance shall not be affected thereby. If this Compact 903
shall be held contrary to the constitution of any member 904
58
state, the Compact shall remain in full force and effect as 905
to the remaining member states and in full force and effect 906
as to the member state affected as to all severable matters . 907
SECTION 14. BINDING EFFECT OF COMPACT AND OTHER LAWS 908
A. Nothing herein prevents the enforcement of any 909
other law of a member state that is not inconsistent with 910
the Compact. 911
B. All laws in a member state in conflict with the 912
Compact are superseded to the extent of the conflict. 913
C. All lawful actions of the Commission, including all 914
rules and bylaws promulgated by the Commission, are binding 915
upon the member states. 916
D. All agreements between the Commission and the 917
member states are binding in accordance with their terms. 918
E. In the event any provision of the Compact exceeds 919
the constitutional limits imposed on the legislature of any 920
member state, the provision shall be ineffective to the 921
extent of the conflict with the constitutional provision in 922
question in that member state. 923
Section B. Because of the urgent need of low -income 1
Missouri residents for access to quality health care 2
services, the enactment of section 324.005 of this act is 3
deemed necessary for the immediate preservation of the 4
public health, welfare, peace, and safety, and is hereby 5
declared to be an emergency act within the meaning of the 6
constitution, and the enactment of section 324.005 of this 7
act shall be in full force and effect upon its passage and 8
approval. 9