2023 -- H 6489
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LC003146
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S TATE OF RHODE IS LAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2023
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A N A C T
RELATING TO BUSINESSES AND PROFESSIONS -- PROFESSIONAL LICENSING AND
REGULATION OF SPEECH-LANGUAGE PATHOLOGIST S AND AUDIOLOGISTS
Introduced By: Representatives Handy, and Corvese
Date Introduced: June 07, 2023
Referred To: House Health & Human Services
It is enacted by the General Assembly as follows:
SECTION 1. Title 5 of the General Laws entitled "BUSINESSES AND PROFESSIONS" 1
is hereby amended by adding thereto the following chapter: 2
CHAPTER 48.2 3
PROFESSIONAL LICENSING AND REGULATION OF SPEECH -LANGUAGE 4
PATHOLOGISTS AND AUDIOLOGISTS 5
5-48.2-1. Purpose. 6
The purpose of this chapter is to establish and codify prevailing standards and procedures 7
for licensing speech-language pathologists and audiologists in Rhode Island. 8
5-48.2-2. Incorporated materials. 9
This chapter hereby adopts and incorporates the American Speech-Language-Hearing 10
Association’s "American Speech-Language-Hearing Association Code of Ethics" (2016) by 11
reference, not including any further editions or amendments thereof and only to the extent that the 12
provisions therein are not inconsistent with these regulations. 13
5-48.2-3. Definitions. 14
(a) As used in this chapter, the following words and terms shall have the following 15
meanings, except where the context clearly indicates otherwise. 16
(1) "Accredited/approved" means that an institution/program holds regional accreditation 17
from one of six (6) regional accrediting bodies: Middle States Association of Colleges and Schools, 18
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New England Association of Schools and Colleges, North Central Association of Colleges and 1
Schools, Northwest Association of Schools and Colleges, Southern Association of Colleges and 2
Schools, and Western Association of Schools and Colleges. 3
(2) "Act" means chapter 48 of title 5 entitled, "speech-language pathology and audiology," 4
as well as the provisions of this chapter, where the context so indicates. 5
(3) "Audiologist" means an individual who is licensed by the board to practice audiology 6
either in person or via telepractice. 7
(4) "Audiology" means the audiologist applies the principles, methods, and procedures 8
related to hearing and the disorders of the hearing and balance systems, to related language and 9
speech disorders, and to aberrant behavior related to hearing loss. A hearing disorder is defined as 10
altered sensitivity, acuity, function, processing, and/or damage to the integrity of the physiological 11
auditory/vestibular systems, in individuals or groups of individuals who have or are suspected of 12
having such disorders. 13
(5) "Audiology support personnel" shall operate under the title "audiometric aide" or 14
"audiology assistant" and means an individual who meets minimum qualifications established by 15
the board, which are less than those established by the act as necessary for licensing as an 16
audiologist; does not act independently; is limited to hearing screening with pass/fail criteria, and 17
works under the direction and supervision of an audiologist licensed under the act who has been 18
actively working in the field for twenty-four (24) months after completion of the postgraduate 19
professional experience and who accepts the responsibility for the acts and performances of the 20
audiometric aide or audiology assistant while working under the act . 21
(6) "Board" means the state board of examiners for speech-language pathology and 22
audiology established pursuant to § 5-48-2. 23
(7) "Clinical fellowship or traineeship" means the direct clinical work, consultation or other 24
duties relevant to clinical speech-language pathology work with individuals presenting disorders in 25
communication, for a cumulative or equivalent total of nine (9) months of full-time employment 26
following completion of professional speech-language pathology education under supervision 27
pursuant to § 5-48-7 and the provisions of this chapter. 28
(8) "Clinical fellow" means the person who is practicing speech-language pathology under 29
the supervision of a licensed speech-language pathologist while completing the postgraduate 30
professional experience as required by the act and who holds a current provisional license in 31
accordance with the requirements described in this chapter. 32
(9) "Department" means the Rhode Island department of health. 33
(10) "Director" means the director of the Rhode Island department of health. 34
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(11) "Graduate program" means a post-baccalaureate accredited program leading to a 1
master’s or doctoral degree, including a professional doctoral degree, whether offered through an 2
accredited graduate or professional school. 3
(12) "Newborn hearing screener" means an audiometric aide or audiology assistant 4
working in a hospital-based newborn hearing screening program under the direction of the 5
department of health newborn hearing screening program, or its appointee. 6
(13) "Person" means an individual, partnership organization or corporation, except that 7
only individuals can be licensed under this chapter. 8
(14) "The practice of audiology" means an audiologist rendering or offering to render any 9
service in audiology either in person or via telepractice as defined in § 5-48-1 and in this section. 10
(15) "The practice of speech-language pathology" means rendering or offering to render 11
any service in speech-language pathology either in person or via telepractice as defined in this 12
section. 13
(16) "Regionally accredited" means the official guarantee that a college or university or 14
other educational institution is in conformity with the standards of education prescribed by a 15
regional accrediting commission recognized by the United States Secretary of Education. 16
(17) "School hearing screener" means an audiometric aide or audiology assistant working 17
in a school-based hearing screening program under the direction of the Rhode Island department 18
of elementary and secondary education or its appointee. 19
(18) "Speech-language pathologist" means an individual who is licensed by the board to 20
practice speech-language pathology either in person or via telepractice. 21
(19) " Speech-language pathology" means the activities defined in § 5-48-1 and in this 22
section. 23
(20) "Speech-language pathology assistant (SLPA) support personnel" means an individual 24
who meets minimum qualifications established by the board, which are less than those established 25
by the act as necessary for licensing as a speech-language pathologist; does not act independently; 26
and works under the direction and supervision of a speech-language pathologist licensed under the 27
act who has been actively working in the field for twenty-four (24) months after completion of the 28
postgraduate professional experience and who accepts the responsibility for the acts and 29
performances of the speech language speech-language pathology assistant while working under 30
this chapter. 31
(21) "Telepractice" means the use of telecommunication technology to deliver speech-32
language pathology and audiology services remotely. Other terms such as teleaudiology, telespeech 33
and speech teletherapy are also used in addition to telepractice. Use of telepractice should be of 34
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equal quality to services provided in person and consistent with adherence to ASHA’s Code of 1
Ethics (ASHA, 2016a), Scope of Practice in Audiology (ASHA, 2018), Scope of Practice in 2
Speech-Language Pathology (ASHA, 2016b), and Assistants Code of Conduct (ASHA, 2020) 3
5-48.2-4. License requirements. 4
(a) No person shall practice as, advertise as, or use the title of speech-language pathologist 5
or audiologist unless licensed in accordance with the provisions of the act and this section. The 6
provisions of the act and this section shall not apply to individuals specifically exempt from the 7
provisions thereof by § 5-48-10. 8
(b) A provisional license for the clinical fellow as defined in this chapter shall be required 9
in speech-language pathology for that period of postgraduate professional experience as required 10
in §§ 5-48-7 and 5-48.2-5. A provisional license shall authorize an individual to practice speech-11
language pathology solely in connection with the completion of the supervised postgraduate 12
professional experience. 13
(c) Any person residing in and/or licensed in another state who provides telepractice 14
services in the area of speech-language pathology and audiology within the State of Rhode Island 15
regardless of their legal residence must be licensed in the state in accordance with the provisions 16
of the act and this chapter. The provisions of the act and this chapter shall not apply to individua ls 17
specifically exempt from the provisions thereof by § 5-48-10. 18
5-48.2-5. Qualifications for licensure. 19
(a) Audiologists. 20
(1) In addition to the requirements set forth in § 5-48-7.2, persons seeking initial licensure 21
as an audiologist providing in-person or telepractice services shall meet the following requirements: 22
(i) Submit an official transcript indicating possession of an earned doctorate degree in 23
audiology from a regionally accredited educational institution or other national accrediting 24
organization as may be approved by the board; 25
(ii) Pass a national examination in audiology approved by the board; 26
(iii) Present evidence of practicum experience that is equivalent to a minimum of twelve 27
(12) months of full-time, supervised experience, that may be completed as part of the graduate 28
degree, as delineated in this chapter; 29
(iv) Applicants with a master’s degree holding licensure from another state must present 30
verification of a Certificate of Clinical Competence from the American Speech-Language-Hearing 31
Association (ASHA) or other national accrediting association as may be approved by the board. 32
(b) Qualifications for audiologists licensed in alternate jurisdictions. 33
(1) Persons licensed as an audiologist in alternate jurisdictions on or before January 1, 34
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2008, shall meet the requirements of Rhode Island that were in effect at the time of initial licensure 1
in the alternate jurisdiction. 2
(c) Speech-language pathologists. 3
(1) In addition to the requirements set forth in § 5-48-7, an applicant seeking licensure to 4
practice as a speech-language pathologist who provides in person or telepractice services in Rhode 5
Island must: 6
(i) Have attained a master's degree or a doctoral degree or equivalent in speech-language 7
pathology from an accredited educational institution accredited by the Council on Academic 8
Accreditation (CAA) of the American Speech-Language-Hearing Association (ASHA) or other 9
national accrediting association as may be approved by the board. The degree shall consist of course 10
work in accordance with the current minimum requirements for the Certificate of Clinical 11
Competence issued by the American Speech-Language-Hearing Association (ASHA) or other 12
national accrediting association as may be approved by the board. 13
(d) Qualifications for a provisional license for speech-language pathologists. 14
(1) To be eligible for provisional licensure by the department, the speech-language 15
pathologist must submit an application with the required application fee and be in compliance with 16
the requirements of this chapter and § 5-48-7.1. 17
5-48.2-6. Issuance and renewal of license and fee. 18
(a) The department shall issue a license as an audiologist or speech-language pathologist, 19
or renewal thereof, for a period of two (2) years. The license, unless sooner suspended or revoked, 20
shall expire on the first day of July, two (2) years following its issuance, and may be renewed 21
biennially (in even years); provided the applicant meets the requirements of this chapter and the 22
statutory provisions of the act. The licensee must maintain their certificate of clinical competence 23
in their practicing area (speech-language pathology or audiology) in order to renew their license. 24
(b) A license may be renewed by submission of the renewal application and renewal fee as 25
set forth in the fee structure for licensing, laboratory and administrative services provided by the 26
department of health in their regulations payable before July 1 of even years (biennially). 27
(c) A provisional license may be renewed annually from the date of issue, if the post-28
graduate professional experience has exceeded one year, by submission of the renewal application 29
and renewal fee as set forth in the fee structure for licensing, laboratory and administrative services 30
provided by the department of health. A provisional license shall not exceed thirty-six (36) months 31
past the initiation of the professional experience and will expire ninety (90) days after the end of 32
the postgraduate professional experience. 33
(d) Any licensee who allows his or her license to lapse by failing to renew it on or before 34
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the thirtieth day of June of even years (biennially), may have the license renewed by submitting to 1
the department an application and renewal fee plus an additional late fee as set forth in the fee 2
structure for licensing, laboratory and administrative services provided by the department of health. 3
(1) Any person who allows his or her license to lapse longer than two (2) consecutive 4
licensing periods may be reinstated by the department, upon the filing of: 5
(i) A reinstatement application for licensure; 6
(ii) Payment of the current licensure renewal fee plus an additional late fee as set forth in 7
the fee structure for licensing, laboratory and administrative services provided by the department 8
of health; and 9
(iii) Documentation of completion of CEUs as required in this chapter taken during the 10
previous two (2) years. 11
(e) Inactive status. 12
(1) An individual licensed as a speech-language pathologist and/or audiologist in Rhode 13
Island, not in the active practice of speech-language pathology or audiology within Rhode Island 14
during any year, may upon request to the department, have his or her name transferred to an inactive 15
status and shall not be required to register biennially or pay any fee as long as he or she remains 16
inactive. 17
(2) Inactive status may be maintained for no longer than two (2) consecutive licensing 18
periods, after which period licensure will be terminated and a reinstatement application submitted 19
to the department will be required to resume practice. 20
(3) Any individual whose name has been transferred to an inactive status may be restored 21
to active status within two (2) licensing periods to practice speech-language pathology or audiology 22
without a penalty fee, upon the filing of: 23
(i) An application for licensure renewal with a licensure renewal fee as set forth in the fee 24
structure for licensing, laboratory and administrative services provided by the department of health; 25
and 26
(ii) Such other information as may be requested by the board. 27
5-48.2-7. Denial, suspension and revocation of license. 28
(a) The board is authorized to suspend or revoke any license to practice speech-language 29
pathology and/or audiology upon finding by the board that the person is guilty of conduct as set 30
forth in § 5-48-11, and in addition: 31
(1) Violating any provision of the act, any lawful order given, or rule or regulation adopted 32
by the board or departure from or failure to conform to the current standards of acceptable 33
prevailing practice and code of ethics of speech-language pathology or audiology as adopted by the 34
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board and as contained in the "American Speech-Language-Hearing Association Code of Ethics" 1
as incorporated in this chapter. The board need not establish actual injury to clients in order to 2
adjudge a speech-language pathologist or audiologist of the above named conduct. 3
(2) The procedure for denial, revocation or suspension shall be as that set forth § 5-48-13. 4
5-48.2-8. Support personnel. 5
(a) A speech-language pathology assistant (SLPA) for speech-language pathologists shall 6
meet the following requirements: 7
(1) Hold a bachelor's degree from an accredited college or university and have successfully 8
completed no less than eighteen (18) hours of graduate credit in the areas of speech-language 9
pathology to include the following: 10
(i) Normal processes in speech, language and hearing three (3) hours; 11
(ii) Disorders of speech, language and hearing nine (9) hours; 12
(iii) Equipment, materials, procedures and data collection used in assessment and/or 13
management of speech, language and hearing disorders six (6) hours; and 14
(iv) Completion of twenty-five percent (25%) of those practicum hours required for 15
professional personnel by the American Speech-Language-Hearing Association. 16
(2) A speech-language pathology assistant (SLPA) shall be registered at the department 17
and be required to re-register every two (2) years. 18
(b) Support personnel for audiologists (audiometric aide) or audiology assistants must meet 19
the following requirements: 20
(1) Hold a high school diploma; 21
(2) Receive intensive on-the-job training in accordance with the American Speech-22
Language-Hearing Association (ASHA) or American Academy of Audiology (AAA) guidelines 23
for support personnel by the supervising licensed audiologist prior to providing services. Any 24
subsequent supervising licensed audiologist may require retraining of an audiometric aide or 25
audiology assistants under his/her supervision. 26
(3) Audiometric aides or audiology assistants shall be registered at the department and be 27
required to re-register every two (2) years. 28
5-48.2-9. Supervision and responsibility. 29
(a) A supervising professional must be a speech-language pathologist or audiologist who 30
is licensed under the act and this chapter, has attained and maintained their certificate of clinical 31
competency and who has been actively working in the field for twenty-four (24) months after 32
completion of the postgraduate professional experience, and must be responsible for the acts and 33
performances, patient screening, and specific tasks assigned by the licensee to the speech-language 34
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pathology assistant (SLPA)/audiometric aide or audiology assistant. 1
(1) A licensee who supervises support personnel must: 2
(i) Utilize the services of only those who meet the minimum requirements enumerated 3
under this chapter; 4
(ii) Ensure that the support personnel are assigned only those duties and responsibilities for 5
which the person has been specifically trained and which the assistant is qualified to perform; 6
(iii) Ensure that persons who will be receiving services from support personnel, or the 7
person's legal representative, are informed that services are being rendered by support personnel; 8
(iv) Provide supervision of the support personnel (other than newborn hearing screeners 9
and school hearing screeners); and 10
(v) Complete of a minimum of two (2) hours of professional development in clinical 11
instruction/supervision. 12
(b) A speech-language pathologist supervisor may only supervise one full-time equivalent 13
speech-language pathology assistant (SLPA) support personnel and an audiologist supervisor may 14
only supervise three (3) full-time equivalent audiometric aides or audiology assistants unless 15
otherwise approved by the board. 16
(c) Observations of support audiometric aides must be completed and documented as to 17
date, amount of time, and accuracy and efficacy of service according to the following: Direct on-18
site observations of the first ten (10) hours of direct client contact; and five percent (5%) of all 19
clinical sessions after the first ten (10) hours for every forty (40) consecutive hours worked; and 20
Indirect supervision (e.g. home, interactive television, audio/video review or patient record review) 21
of five percent (5%) of each forty (40) consecutive hours worked. 22
5-48.2-10. Supervision of the support personnel -- newborn hearing screeners and 23
school hearing screeners. 24
(a) Hospital-based newborn hearing screeners and school-based hearing screeners shall be 25
trained by a licensed audiologist working in the newborn hearing or school screening program 26
according to training guidelines established by the programs. 27
(b) Supervision shall include a method of evaluation and documenting the competency of 28
each screener upon completion of the initial training and at least annually thereafter by a licensed 29
audiologist working in the newborn hearing or school screening program. 30
(c) Observations of a speech-language pathology assistant (SLPA) pathology support 31
personnel must be completed and documented as to date, amount of time, and accuracy and efficacy 32
of service according to the following: 33
(1) Direct on-site observations of the first ten (10) hours of direct client contact; and ten 34
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percent (10%) of clinical sessions after the first ten (10) hours of each forty (40) consecutive hours 1
worked; and 2
(2) Indirect supervision (e.g. phone, interactive television, audio/video review) of ten 3
percent (10%) of each forty (40) consecutive hours worked. 4
(d) Supervisors must observe all provisions of the ASHA policy regarding support 5
personnel unless a specific policy is addressed in this chapter, including, but not limited to, that the 6
licensee must maintain records which document the frequency and type of supervision of support 7
personnel, such records to be available for audit upon request by the board. 8
5-48.2-11. Continuing education requirements. 9
(a) On or before the thirtieth day of June of even years, every person licensed to practice 10
speech-language pathology and/or audiology within Rhode Island shall complete not less than 11
twenty (20) clock hours of continuing education within the preceding two (2) years and be able to 12
present satisfactory evidence of completion to the department. 13
(1) Course descriptions, proof of attendance, or other documentation of completion shall 14
be retained by the licensee for a minimum of four (4) years and is subject to random audit by the 15
department. 16
(2) Activities approved by the board for continuing education credit are those sponsored 17
by the American Speech-Language Hearing Association (ASHA), the American Academy of 18
Audiology (AAA), a state department of education, other International Association for Continuing 19
Education and Training (IACET)-authorized providers, and/or continuing medical education units 20
(CMEs) from the Accreditation Council for Continuing Medical Education (ACCME). Approved 21
activities may include conferences, seminars, self-study programs, courses, or workshops 22
sponsored by the organizations noted above, or course work from an accredited institution. 23
(b) Those persons holding licensure in both speech-language pathology and audiology must 24
have completed and have evidence of completion of not less than thirty (30) clock hours of 25
continuing education within the preceding two (2) years. 26
(c) Continuing education hours may not be carried over from one renewal period to the 27
next. 28
(d) Continuing education hours must be in accordance with the American-Speech-29
Language-Hearing Association's requirements including at least two (2) hours in cultural 30
competency, cultural humility, culturally responsive practice or diversity, equity, and inclusion 31
(DEI) and at least one hour in the area of ethics. 32
(1) If the licensee is acting as a clinical supervisor a minimum of two (2) hours of 33
professional development in clinical instruction/supervision is required. 34
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(e) Speech-language pathologists or audiologists initially licensed by examination after the 1
July 1 renewal date shall be exempt from the continuing education requirements stated in this 2
section until the date of the next renewal cycle (i.e., June 30 of the second year following its 3
issuance). 4
(f) The board, at its discretion, may extend, reduce, or waive for a person the requirement 5
for continuing education for hardship or other extenuating circumstances as the board deems 6
appropriate. 7
5-48.2-12. Rules governing the dispensing and/or selling of hearing aids. 8
An audiologist who engages in the dispensing and/or selling of hearing aids shall comply 9
with any and all federal and state laws and regulations governing the sale of hearing aids. 10
5-48.2-13. Rules governing practices and procedures. 11
All hearings and reviews required under the provisions of the act shall be held in 12
accordance with the provisions of the rules and regulations regarding practices and procedures 13
before the department of health. 14
SECTION 2. This act shall take effect upon passage. 15
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO BUSINESSES AND PROFESSIONS -- PROFESSIONAL LICENSING AND
REGULATION OF SPEECH-LANGUAGE PATHOLOGIST S AND AUDIOLOGISTS
***
This act would establish prevailing standards and procedures for licensing speech-language 1
pathologists and audiologists in Rhode Island. 2
This act would take effect upon passage. 3
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