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Rhode Island House Bill H6489

Rhode Island 2023 Regular Session

Rhode Island House Bill H6489 Compare Versions

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55 2023 -- H 6489
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77 LC003146
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99 S TATE OF RHODE IS LAND
1010 IN GENERAL ASSEMBLY
1111 JANUARY SESSION, A.D. 2023
1212 ____________
1313
1414 A N A C T
1515 RELATING TO BUSINESSES AND PROFESSIONS -- PROFESSIONAL LICENSING AND
1616 REGULATION OF SPEECH-LANGUAGE PATHOLOGIST S AND AUDIOLOGISTS
1717 Introduced By: Representatives Handy, and Corvese
1818 Date Introduced: June 07, 2023
1919 Referred To: House Health & Human Services
2020
2121
2222 It is enacted by the General Assembly as follows:
2323 SECTION 1. Title 5 of the General Laws entitled "BUSINESSES AND PROFESSIONS" 1
2424 is hereby amended by adding thereto the following chapter: 2
2525 CHAPTER 48.2 3
2626 PROFESSIONAL LICENSING AND REGULATION OF SPEECH -LANGUAGE 4
2727 PATHOLOGISTS AND AUDIOLOGISTS 5
2828 5-48.2-1. Purpose. 6
2929 The purpose of this chapter is to establish and codify prevailing standards and procedures 7
3030 for licensing speech-language pathologists and audiologists in Rhode Island. 8
3131 5-48.2-2. Incorporated materials. 9
3232 This chapter hereby adopts and incorporates the American Speech-Language-Hearing 10
3333 Association’s "American Speech-Language-Hearing Association Code of Ethics" (2016) by 11
3434 reference, not including any further editions or amendments thereof and only to the extent that the 12
3535 provisions therein are not inconsistent with these regulations. 13
3636 5-48.2-3. Definitions. 14
3737 (a) As used in this chapter, the following words and terms shall have the following 15
3838 meanings, except where the context clearly indicates otherwise. 16
3939 (1) "Accredited/approved" means that an institution/program holds regional accreditation 17
4040 from one of six (6) regional accrediting bodies: Middle States Association of Colleges and Schools, 18
4141
4242
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4444 New England Association of Schools and Colleges, North Central Association of Colleges and 1
4545 Schools, Northwest Association of Schools and Colleges, Southern Association of Colleges and 2
4646 Schools, and Western Association of Schools and Colleges. 3
4747 (2) "Act" means chapter 48 of title 5 entitled, "speech-language pathology and audiology," 4
4848 as well as the provisions of this chapter, where the context so indicates. 5
4949 (3) "Audiologist" means an individual who is licensed by the board to practice audiology 6
5050 either in person or via telepractice. 7
5151 (4) "Audiology" means the audiologist applies the principles, methods, and procedures 8
5252 related to hearing and the disorders of the hearing and balance systems, to related language and 9
5353 speech disorders, and to aberrant behavior related to hearing loss. A hearing disorder is defined as 10
5454 altered sensitivity, acuity, function, processing, and/or damage to the integrity of the physiological 11
5555 auditory/vestibular systems, in individuals or groups of individuals who have or are suspected of 12
5656 having such disorders. 13
5757 (5) "Audiology support personnel" shall operate under the title "audiometric aide" or 14
5858 "audiology assistant" and means an individual who meets minimum qualifications established by 15
5959 the board, which are less than those established by the act as necessary for licensing as an 16
6060 audiologist; does not act independently; is limited to hearing screening with pass/fail criteria, and 17
6161 works under the direction and supervision of an audiologist licensed under the act who has been 18
6262 actively working in the field for twenty-four (24) months after completion of the postgraduate 19
6363 professional experience and who accepts the responsibility for the acts and performances of the 20
6464 audiometric aide or audiology assistant while working under the act . 21
6565 (6) "Board" means the state board of examiners for speech-language pathology and 22
6666 audiology established pursuant to § 5-48-2. 23
6767 (7) "Clinical fellowship or traineeship" means the direct clinical work, consultation or other 24
6868 duties relevant to clinical speech-language pathology work with individuals presenting disorders in 25
6969 communication, for a cumulative or equivalent total of nine (9) months of full-time employment 26
7070 following completion of professional speech-language pathology education under supervision 27
7171 pursuant to § 5-48-7 and the provisions of this chapter. 28
7272 (8) "Clinical fellow" means the person who is practicing speech-language pathology under 29
7373 the supervision of a licensed speech-language pathologist while completing the postgraduate 30
7474 professional experience as required by the act and who holds a current provisional license in 31
7575 accordance with the requirements described in this chapter. 32
7676 (9) "Department" means the Rhode Island department of health. 33
7777 (10) "Director" means the director of the Rhode Island department of health. 34
7878
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8181 (11) "Graduate program" means a post-baccalaureate accredited program leading to a 1
8282 master’s or doctoral degree, including a professional doctoral degree, whether offered through an 2
8383 accredited graduate or professional school. 3
8484 (12) "Newborn hearing screener" means an audiometric aide or audiology assistant 4
8585 working in a hospital-based newborn hearing screening program under the direction of the 5
8686 department of health newborn hearing screening program, or its appointee. 6
8787 (13) "Person" means an individual, partnership organization or corporation, except that 7
8888 only individuals can be licensed under this chapter. 8
8989 (14) "The practice of audiology" means an audiologist rendering or offering to render any 9
9090 service in audiology either in person or via telepractice as defined in § 5-48-1 and in this section. 10
9191 (15) "The practice of speech-language pathology" means rendering or offering to render 11
9292 any service in speech-language pathology either in person or via telepractice as defined in this 12
9393 section. 13
9494 (16) "Regionally accredited" means the official guarantee that a college or university or 14
9595 other educational institution is in conformity with the standards of education prescribed by a 15
9696 regional accrediting commission recognized by the United States Secretary of Education. 16
9797 (17) "School hearing screener" means an audiometric aide or audiology assistant working 17
9898 in a school-based hearing screening program under the direction of the Rhode Island department 18
9999 of elementary and secondary education or its appointee. 19
100100 (18) "Speech-language pathologist" means an individual who is licensed by the board to 20
101101 practice speech-language pathology either in person or via telepractice. 21
102102 (19) " Speech-language pathology" means the activities defined in § 5-48-1 and in this 22
103103 section. 23
104104 (20) "Speech-language pathology assistant (SLPA) support personnel" means an individual 24
105105 who meets minimum qualifications established by the board, which are less than those established 25
106106 by the act as necessary for licensing as a speech-language pathologist; does not act independently; 26
107107 and works under the direction and supervision of a speech-language pathologist licensed under the 27
108108 act who has been actively working in the field for twenty-four (24) months after completion of the 28
109109 postgraduate professional experience and who accepts the responsibility for the acts and 29
110110 performances of the speech language speech-language pathology assistant while working under 30
111111 this chapter. 31
112112 (21) "Telepractice" means the use of telecommunication technology to deliver speech-32
113113 language pathology and audiology services remotely. Other terms such as teleaudiology, telespeech 33
114114 and speech teletherapy are also used in addition to telepractice. Use of telepractice should be of 34
115115
116116
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118118 equal quality to services provided in person and consistent with adherence to ASHA’s Code of 1
119119 Ethics (ASHA, 2016a), Scope of Practice in Audiology (ASHA, 2018), Scope of Practice in 2
120120 Speech-Language Pathology (ASHA, 2016b), and Assistants Code of Conduct (ASHA, 2020) 3
121121 5-48.2-4. License requirements. 4
122122 (a) No person shall practice as, advertise as, or use the title of speech-language pathologist 5
123123 or audiologist unless licensed in accordance with the provisions of the act and this section. The 6
124124 provisions of the act and this section shall not apply to individuals specifically exempt from the 7
125125 provisions thereof by § 5-48-10. 8
126126 (b) A provisional license for the clinical fellow as defined in this chapter shall be required 9
127127 in speech-language pathology for that period of postgraduate professional experience as required 10
128128 in §§ 5-48-7 and 5-48.2-5. A provisional license shall authorize an individual to practice speech-11
129129 language pathology solely in connection with the completion of the supervised postgraduate 12
130130 professional experience. 13
131131 (c) Any person residing in and/or licensed in another state who provides telepractice 14
132132 services in the area of speech-language pathology and audiology within the State of Rhode Island 15
133133 regardless of their legal residence must be licensed in the state in accordance with the provisions 16
134134 of the act and this chapter. The provisions of the act and this chapter shall not apply to individua ls 17
135135 specifically exempt from the provisions thereof by § 5-48-10. 18
136136 5-48.2-5. Qualifications for licensure. 19
137137 (a) Audiologists. 20
138138 (1) In addition to the requirements set forth in § 5-48-7.2, persons seeking initial licensure 21
139139 as an audiologist providing in-person or telepractice services shall meet the following requirements: 22
140140 (i) Submit an official transcript indicating possession of an earned doctorate degree in 23
141141 audiology from a regionally accredited educational institution or other national accrediting 24
142142 organization as may be approved by the board; 25
143143 (ii) Pass a national examination in audiology approved by the board; 26
144144 (iii) Present evidence of practicum experience that is equivalent to a minimum of twelve 27
145145 (12) months of full-time, supervised experience, that may be completed as part of the graduate 28
146146 degree, as delineated in this chapter; 29
147147 (iv) Applicants with a master’s degree holding licensure from another state must present 30
148148 verification of a Certificate of Clinical Competence from the American Speech-Language-Hearing 31
149149 Association (ASHA) or other national accrediting association as may be approved by the board. 32
150150 (b) Qualifications for audiologists licensed in alternate jurisdictions. 33
151151 (1) Persons licensed as an audiologist in alternate jurisdictions on or before January 1, 34
152152
153153
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155155 2008, shall meet the requirements of Rhode Island that were in effect at the time of initial licensure 1
156156 in the alternate jurisdiction. 2
157157 (c) Speech-language pathologists. 3
158158 (1) In addition to the requirements set forth in § 5-48-7, an applicant seeking licensure to 4
159159 practice as a speech-language pathologist who provides in person or telepractice services in Rhode 5
160160 Island must: 6
161161 (i) Have attained a master's degree or a doctoral degree or equivalent in speech-language 7
162162 pathology from an accredited educational institution accredited by the Council on Academic 8
163163 Accreditation (CAA) of the American Speech-Language-Hearing Association (ASHA) or other 9
164164 national accrediting association as may be approved by the board. The degree shall consist of course 10
165165 work in accordance with the current minimum requirements for the Certificate of Clinical 11
166166 Competence issued by the American Speech-Language-Hearing Association (ASHA) or other 12
167167 national accrediting association as may be approved by the board. 13
168168 (d) Qualifications for a provisional license for speech-language pathologists. 14
169169 (1) To be eligible for provisional licensure by the department, the speech-language 15
170170 pathologist must submit an application with the required application fee and be in compliance with 16
171171 the requirements of this chapter and § 5-48-7.1. 17
172172 5-48.2-6. Issuance and renewal of license and fee. 18
173173 (a) The department shall issue a license as an audiologist or speech-language pathologist, 19
174174 or renewal thereof, for a period of two (2) years. The license, unless sooner suspended or revoked, 20
175175 shall expire on the first day of July, two (2) years following its issuance, and may be renewed 21
176176 biennially (in even years); provided the applicant meets the requirements of this chapter and the 22
177177 statutory provisions of the act. The licensee must maintain their certificate of clinical competence 23
178178 in their practicing area (speech-language pathology or audiology) in order to renew their license. 24
179179 (b) A license may be renewed by submission of the renewal application and renewal fee as 25
180180 set forth in the fee structure for licensing, laboratory and administrative services provided by the 26
181181 department of health in their regulations payable before July 1 of even years (biennially). 27
182182 (c) A provisional license may be renewed annually from the date of issue, if the post-28
183183 graduate professional experience has exceeded one year, by submission of the renewal application 29
184184 and renewal fee as set forth in the fee structure for licensing, laboratory and administrative services 30
185185 provided by the department of health. A provisional license shall not exceed thirty-six (36) months 31
186186 past the initiation of the professional experience and will expire ninety (90) days after the end of 32
187187 the postgraduate professional experience. 33
188188 (d) Any licensee who allows his or her license to lapse by failing to renew it on or before 34
189189
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192192 the thirtieth day of June of even years (biennially), may have the license renewed by submitting to 1
193193 the department an application and renewal fee plus an additional late fee as set forth in the fee 2
194194 structure for licensing, laboratory and administrative services provided by the department of health. 3
195195 (1) Any person who allows his or her license to lapse longer than two (2) consecutive 4
196196 licensing periods may be reinstated by the department, upon the filing of: 5
197197 (i) A reinstatement application for licensure; 6
198198 (ii) Payment of the current licensure renewal fee plus an additional late fee as set forth in 7
199199 the fee structure for licensing, laboratory and administrative services provided by the department 8
200200 of health; and 9
201201 (iii) Documentation of completion of CEUs as required in this chapter taken during the 10
202202 previous two (2) years. 11
203203 (e) Inactive status. 12
204204 (1) An individual licensed as a speech-language pathologist and/or audiologist in Rhode 13
205205 Island, not in the active practice of speech-language pathology or audiology within Rhode Island 14
206206 during any year, may upon request to the department, have his or her name transferred to an inactive 15
207207 status and shall not be required to register biennially or pay any fee as long as he or she remains 16
208208 inactive. 17
209209 (2) Inactive status may be maintained for no longer than two (2) consecutive licensing 18
210210 periods, after which period licensure will be terminated and a reinstatement application submitted 19
211211 to the department will be required to resume practice. 20
212212 (3) Any individual whose name has been transferred to an inactive status may be restored 21
213213 to active status within two (2) licensing periods to practice speech-language pathology or audiology 22
214214 without a penalty fee, upon the filing of: 23
215215 (i) An application for licensure renewal with a licensure renewal fee as set forth in the fee 24
216216 structure for licensing, laboratory and administrative services provided by the department of health; 25
217217 and 26
218218 (ii) Such other information as may be requested by the board. 27
219219 5-48.2-7. Denial, suspension and revocation of license. 28
220220 (a) The board is authorized to suspend or revoke any license to practice speech-language 29
221221 pathology and/or audiology upon finding by the board that the person is guilty of conduct as set 30
222222 forth in § 5-48-11, and in addition: 31
223223 (1) Violating any provision of the act, any lawful order given, or rule or regulation adopted 32
224224 by the board or departure from or failure to conform to the current standards of acceptable 33
225225 prevailing practice and code of ethics of speech-language pathology or audiology as adopted by the 34
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229229 board and as contained in the "American Speech-Language-Hearing Association Code of Ethics" 1
230230 as incorporated in this chapter. The board need not establish actual injury to clients in order to 2
231231 adjudge a speech-language pathologist or audiologist of the above named conduct. 3
232232 (2) The procedure for denial, revocation or suspension shall be as that set forth § 5-48-13. 4
233233 5-48.2-8. Support personnel. 5
234234 (a) A speech-language pathology assistant (SLPA) for speech-language pathologists shall 6
235235 meet the following requirements: 7
236236 (1) Hold a bachelor's degree from an accredited college or university and have successfully 8
237237 completed no less than eighteen (18) hours of graduate credit in the areas of speech-language 9
238238 pathology to include the following: 10
239239 (i) Normal processes in speech, language and hearing three (3) hours; 11
240240 (ii) Disorders of speech, language and hearing nine (9) hours; 12
241241 (iii) Equipment, materials, procedures and data collection used in assessment and/or 13
242242 management of speech, language and hearing disorders six (6) hours; and 14
243243 (iv) Completion of twenty-five percent (25%) of those practicum hours required for 15
244244 professional personnel by the American Speech-Language-Hearing Association. 16
245245 (2) A speech-language pathology assistant (SLPA) shall be registered at the department 17
246246 and be required to re-register every two (2) years. 18
247247 (b) Support personnel for audiologists (audiometric aide) or audiology assistants must meet 19
248248 the following requirements: 20
249249 (1) Hold a high school diploma; 21
250250 (2) Receive intensive on-the-job training in accordance with the American Speech-22
251251 Language-Hearing Association (ASHA) or American Academy of Audiology (AAA) guidelines 23
252252 for support personnel by the supervising licensed audiologist prior to providing services. Any 24
253253 subsequent supervising licensed audiologist may require retraining of an audiometric aide or 25
254254 audiology assistants under his/her supervision. 26
255255 (3) Audiometric aides or audiology assistants shall be registered at the department and be 27
256256 required to re-register every two (2) years. 28
257257 5-48.2-9. Supervision and responsibility. 29
258258 (a) A supervising professional must be a speech-language pathologist or audiologist who 30
259259 is licensed under the act and this chapter, has attained and maintained their certificate of clinical 31
260260 competency and who has been actively working in the field for twenty-four (24) months after 32
261261 completion of the postgraduate professional experience, and must be responsible for the acts and 33
262262 performances, patient screening, and specific tasks assigned by the licensee to the speech-language 34
263263
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266266 pathology assistant (SLPA)/audiometric aide or audiology assistant. 1
267267 (1) A licensee who supervises support personnel must: 2
268268 (i) Utilize the services of only those who meet the minimum requirements enumerated 3
269269 under this chapter; 4
270270 (ii) Ensure that the support personnel are assigned only those duties and responsibilities for 5
271271 which the person has been specifically trained and which the assistant is qualified to perform; 6
272272 (iii) Ensure that persons who will be receiving services from support personnel, or the 7
273273 person's legal representative, are informed that services are being rendered by support personnel; 8
274274 (iv) Provide supervision of the support personnel (other than newborn hearing screeners 9
275275 and school hearing screeners); and 10
276276 (v) Complete of a minimum of two (2) hours of professional development in clinical 11
277277 instruction/supervision. 12
278278 (b) A speech-language pathologist supervisor may only supervise one full-time equivalent 13
279279 speech-language pathology assistant (SLPA) support personnel and an audiologist supervisor may 14
280280 only supervise three (3) full-time equivalent audiometric aides or audiology assistants unless 15
281281 otherwise approved by the board. 16
282282 (c) Observations of support audiometric aides must be completed and documented as to 17
283283 date, amount of time, and accuracy and efficacy of service according to the following: Direct on-18
284284 site observations of the first ten (10) hours of direct client contact; and five percent (5%) of all 19
285285 clinical sessions after the first ten (10) hours for every forty (40) consecutive hours worked; and 20
286286 Indirect supervision (e.g. home, interactive television, audio/video review or patient record review) 21
287287 of five percent (5%) of each forty (40) consecutive hours worked. 22
288288 5-48.2-10. Supervision of the support personnel -- newborn hearing screeners and 23
289289 school hearing screeners. 24
290290 (a) Hospital-based newborn hearing screeners and school-based hearing screeners shall be 25
291291 trained by a licensed audiologist working in the newborn hearing or school screening program 26
292292 according to training guidelines established by the programs. 27
293293 (b) Supervision shall include a method of evaluation and documenting the competency of 28
294294 each screener upon completion of the initial training and at least annually thereafter by a licensed 29
295295 audiologist working in the newborn hearing or school screening program. 30
296296 (c) Observations of a speech-language pathology assistant (SLPA) pathology support 31
297297 personnel must be completed and documented as to date, amount of time, and accuracy and efficacy 32
298298 of service according to the following: 33
299299 (1) Direct on-site observations of the first ten (10) hours of direct client contact; and ten 34
300300
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303303 percent (10%) of clinical sessions after the first ten (10) hours of each forty (40) consecutive hours 1
304304 worked; and 2
305305 (2) Indirect supervision (e.g. phone, interactive television, audio/video review) of ten 3
306306 percent (10%) of each forty (40) consecutive hours worked. 4
307307 (d) Supervisors must observe all provisions of the ASHA policy regarding support 5
308308 personnel unless a specific policy is addressed in this chapter, including, but not limited to, that the 6
309309 licensee must maintain records which document the frequency and type of supervision of support 7
310310 personnel, such records to be available for audit upon request by the board. 8
311311 5-48.2-11. Continuing education requirements. 9
312312 (a) On or before the thirtieth day of June of even years, every person licensed to practice 10
313313 speech-language pathology and/or audiology within Rhode Island shall complete not less than 11
314314 twenty (20) clock hours of continuing education within the preceding two (2) years and be able to 12
315315 present satisfactory evidence of completion to the department. 13
316316 (1) Course descriptions, proof of attendance, or other documentation of completion shall 14
317317 be retained by the licensee for a minimum of four (4) years and is subject to random audit by the 15
318318 department. 16
319319 (2) Activities approved by the board for continuing education credit are those sponsored 17
320320 by the American Speech-Language Hearing Association (ASHA), the American Academy of 18
321321 Audiology (AAA), a state department of education, other International Association for Continuing 19
322322 Education and Training (IACET)-authorized providers, and/or continuing medical education units 20
323323 (CMEs) from the Accreditation Council for Continuing Medical Education (ACCME). Approved 21
324324 activities may include conferences, seminars, self-study programs, courses, or workshops 22
325325 sponsored by the organizations noted above, or course work from an accredited institution. 23
326326 (b) Those persons holding licensure in both speech-language pathology and audiology must 24
327327 have completed and have evidence of completion of not less than thirty (30) clock hours of 25
328328 continuing education within the preceding two (2) years. 26
329329 (c) Continuing education hours may not be carried over from one renewal period to the 27
330330 next. 28
331331 (d) Continuing education hours must be in accordance with the American-Speech-29
332332 Language-Hearing Association's requirements including at least two (2) hours in cultural 30
333333 competency, cultural humility, culturally responsive practice or diversity, equity, and inclusion 31
334334 (DEI) and at least one hour in the area of ethics. 32
335335 (1) If the licensee is acting as a clinical supervisor a minimum of two (2) hours of 33
336336 professional development in clinical instruction/supervision is required. 34
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340340 (e) Speech-language pathologists or audiologists initially licensed by examination after the 1
341341 July 1 renewal date shall be exempt from the continuing education requirements stated in this 2
342342 section until the date of the next renewal cycle (i.e., June 30 of the second year following its 3
343343 issuance). 4
344344 (f) The board, at its discretion, may extend, reduce, or waive for a person the requirement 5
345345 for continuing education for hardship or other extenuating circumstances as the board deems 6
346346 appropriate. 7
347347 5-48.2-12. Rules governing the dispensing and/or selling of hearing aids. 8
348348 An audiologist who engages in the dispensing and/or selling of hearing aids shall comply 9
349349 with any and all federal and state laws and regulations governing the sale of hearing aids. 10
350350 5-48.2-13. Rules governing practices and procedures. 11
351351 All hearings and reviews required under the provisions of the act shall be held in 12
352352 accordance with the provisions of the rules and regulations regarding practices and procedures 13
353353 before the department of health. 14
354354 SECTION 2. This act shall take effect upon passage. 15
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361361 EXPLANATION
362362 BY THE LEGISLATIVE COUNCIL
363363 OF
364364 A N A C T
365365 RELATING TO BUSINESSES AND PROFESSIONS -- PROFESSIONAL LICENSING AND
366366 REGULATION OF SPEECH-LANGUAGE PATHOLOGIST S AND AUDIOLOGISTS
367367 ***
368368 This act would establish prevailing standards and procedures for licensing speech-language 1
369369 pathologists and audiologists in Rhode Island. 2
370370 This act would take effect upon passage. 3
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