Rhode Island 2025 Regular Session

Rhode Island Senate Bill S0471 Compare Versions

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99 S T A T E O F R H O D E I S L A N D
1010 IN GENERAL ASSEMBLY
1111 JANUARY SESSION, A.D. 2025
1212 ____________
1313
1414 A N A C T
1515 RELATING TO BUSINESSES AND PROFESSIONS -- PROFESSIONAL LICENSING AND
1616 REGULATION OF SPEECH-LANGUAGE PATHOLOGIS TS AND AUDIOLOGISTS
1717 Introduced By: Senators Gallo, Tikoian, Lawson, LaMountain, DiPalma, Gu, Sosnowski,
1818 and Burke
1919 Date Introduced: February 26, 2025
2020 Referred To: Senate Health & Human Services
2121
2222
2323 It is enacted by the General Assembly as follows:
2424 SECTION 1. Sections 5-48.2-6, 5-48.2-8, 5-48.2-9, 5-48.2-10 and 5-48.2-11 of the General 1
2525 Laws in Chapter 5-48.2 entitled "Professional Licensing and Regulation of Speech-Language 2
2626 Pathologists and Audiologists" are hereby amended to read as follows: 3
2727 5-48.2-6. Issuance and renewal of license and fee. 4
2828 (a) The department shall issue a license as an audiologist or speech-language pathologist, 5
2929 or renewal thereof, for a period of two (2) years. The license, unless sooner suspended or revoked, 6
3030 shall expire on the first day of July, two (2) years following its issuance, and may be renewed 7
3131 biennially (in even years); provided the applicant meets the requirements of this chapter and the 8
3232 statutory provisions of the act. The licensee must maintain their certificate of clinical competence 9
3333 in their practicing area (speech-language pathology or audiology) in order to renew their license. 10
3434 (b) A license may be renewed by submission of the renewal application and renewal fee as 11
3535 set forth in the fee structure for licensing, laboratory, and administrative services provided by the 12
3636 department of health in their regulations payable before July 1 of even years (biennially). 13
3737 (c) A provisional license may be renewed annually from the date of issue, if the 14
3838 postgraduate professional experience has exceeded one year, by submission of the renewal 15
3939 application and renewal fee as set forth in the fee structure for licensing, laboratory, and 16
4040 administrative services provided by the department of health. A provisional license shall not exceed 17
4141 thirty-six (36) months past the initiation of the professional experience and will expire ninety (90) 18
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4545 days after the end of the postgraduate professional experience. 1
4646 (d)(1) Any licensee who allows their license to lapse by failing to renew it on or before the 2
4747 thirtieth day of June of even years (biennially), may have the license renewed by submitting to the 3
4848 department an application and renewal fee plus an additional late fee as set forth in the fee structure 4
4949 for licensing, laboratory, and administrative services provided by the department of health. 5
5050 (2) Any person who allows their license to lapse longer than two (2) consecutive licensing 6
5151 periods may be reinstated by the department, upon the filing of: 7
5252 (i) A reinstatement application for licensure; 8
5353 (ii) Payment of the current licensure renewal fee plus an additional late fee as set forth in 9
5454 the fee structure for licensing, laboratory, and administrative services provided by the department 10
5555 of health; and 11
5656 (iii) Documentation of completion of continuing education units (CEUs) as required in this 12
5757 chapter taken during the previous two (2) years. 13
5858 (e) Inactive status. 14
5959 (1) An individual licensed as a speech-language pathologist and/or audiologist in Rhode 15
6060 Island, not in the active practice of speech-language pathology or audiology within Rhode Island 16
6161 during any year, may upon request to the department have their name transferred to an inactive 17
6262 status and shall not be required to register biennially or pay any fee as long as the individual remains 18
6363 inactive. 19
6464 (2) Inactive status may be maintained for no longer than two (2) consecutive licensing 20
6565 periods, after which period licensure will be terminated and a reinstatement application submitted 21
6666 to the department will be required to resume practice. 22
6767 (3) Any individual whose name has been transferred to an inactive status may be restored 23
6868 to active status within two (2) licensing periods to practice speech-language pathology or audiology 24
6969 without a penalty fee, upon the filing of: 25
7070 (i) An application for licensure renewal with a licensure renewal fee as set forth in the fee 26
7171 structure for licensing, laboratory, and administrative services provided by the department of 27
7272 health; and 28
7373 (ii) Such other information as may be requested by the board. 29
7474 5-48.2-8. Support personnel. 30
7575 (a) A speech-language pathology assistant (SLPA) for speech-language pathologists shall 31
7676 meet the following requirements: 32
7777 (1) Hold a bachelor’s degree from an accredited college or university and have successfully 33
7878 completed no less than eighteen (18) hours of graduate credit in the areas of speech-language 34
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8282 pathology to include the following: 1
8383 (i) Normal processes in speech, language, and hearing three (3) hours; 2
8484 (ii) Disorders of speech, language, and hearing nine (9) hours; 3
8585 (iii) Equipment, materials, procedures, and data collection used in assessment and/or 4
8686 management of speech, language, and hearing disorders six (6) hours; and 5
8787 (iv) Completion of twenty-five percent (25%) of those practicum hours required for 6
8888 professional personnel by the American Speech-Language-Hearing Association. 7
8989 Possess at minimum a: 8
9090 (i) Two (2) year speech-language pathology assistant program degree from an accredited 9
9191 institution; or 10
9292 (ii) Bachelor's degree in communication sciences and disorders from an accredited 11
9393 institution; or 12
9494 (iii) Bachelor's degree and a certificate from a board approved speech-language pathology 13
9595 assistant program; or 14
9696 (iv) Associate’s, bachelor’s, or advanced degree from an accredited institution in a related 15
9797 field to include, but not limited to, human development and family sciences, education, or 16
9898 psychology and complete at least eighteen (18) credit hours in coursework in speech-language 17
9999 pathology in the following areas: introductory or overview course in communication disorders, 18
100100 phonetics, anatomy and physiology of speech and hearing mechanisms, language development, 19
101101 speech and language disorders, and clinical methods in speech language pathology. 20
102102 (2) Complete twenty (20) hours of observation of clinical practice with a licensed speech 21
103103 language pathologist. 22
104104 (b) Scope of practice of speech-language pathology assistants. A licensed speech-language 23
105105 pathology assistant shall only engage in those duties that adhere to the code of ethics of the board 24
106106 and are planned, designed, and supervised by a licensed speech-language pathologist, including: 25
107107 (1) Assisting with speech, language, and hearing screenings without clinical interpretation 26
108108 of results; 27
109109 (2) Administering and scoring screenings for clinical interpretation by the supervising 28
110110 speech-language pathologist; 29
111111 (3) Assisting with, but not administering or interpreting the results of, client assessments, 30
112112 including setting up the testing environment, gathering and preparing materials, and taking notes; 31
113113 (4) Administering and scoring assessments and progress monitoring tools without clinical 32
114114 interpretation of results, if the licensed speech-language pathology assistant meets the examiner 33
115115 requirements for such tools and the supervising speech-language pathologist has verified that such 34
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119119 examiner requirements have been met; 1
120120 (5) Performing routine activities for therapy sessions in accordance with a plan developed 2
121121 and directed by the speech-language pathologist who retains the professional responsibility for such 3
122122 client, including: 4
123123 (i) Implementing documented care plans or protocols; 5
124124 (ii) Providing direct therapy services to address treatment goals; 6
125125 (iii) Adjusting and documenting the amount and type of support or scaffolding provided to 7
126126 the client in treatment to facilitate progress; and 8
127127 (iv) Developing and implementing activities and materials for teaching and practice of 9
128128 skills to address the goals of the client; 10
129129 (6) Providing treatment through a variety of service delivery models as directed by the 11
130130 supervising speech-language pathologist; 12
131131 (7) Utilizing telecommunications technology to provide services remotely to clients as 13
132132 directed by the supervising speech-language pathologist; 14
133133 (8) Documenting client performance and reporting such performance information to the 15
134134 supervising speech-language pathologist; 16
135135 (9) Providing caregiver coaching, including modeling and teaching communication 17
136136 strategies and providing feedback regarding caregiver-client interactions for facilitation and 18
137137 carryover of skills; 19
138138 (10) Sharing objective information regarding client performance without interpretation or 20
139139 recommendations as directed by the supervising speech-language pathologist; 21
140140 (11) Assisting with programming augmentative and alternative communication devices 22
141141 and assisting and training clients with using such devices; 23
142142 (12) Demonstrating strategies and assisting clients with skills included in the feeding and 24
143143 swallowing plan developed by the supervising speech-language pathologist; 25
144144 (13) Signing or initialing informal treatment notes and, upon request, co-signing formal 26
145145 documents with the supervising speech-language pathologist; 27
146146 (14) Assisting with clerical duties and site operations, including preparing materials, 28
147147 scheduling appointments and activities, preparing charts, records, or graphs, and performing checks 29
148148 and maintenance of equipment; 30
149149 (15) Assisting clients with transitioning to and from therapy sessions; and 31
150150 (16) Performing duties not otherwise restricted to the practice of speech-language 32
151151 pathology. 33
152152 (c) A speech-language pathologist assistant shall not engage in the practice of speech-34
153153
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156156 language pathology, including the following: 1
157157 (1) Representing themselves as a speech-language pathologist; 2
158158 (2) Performing diagnostic tests or evaluations; 3
159159 (3) Performing procedures that require a professional level of clinical judgment and 4
160160 technical skill; 5
161161 (4) Interpreting results and observations of feeding and swallowing evaluations or 6
162162 screenings performed by a speech-language pathologist; 7
163163 (5) Participating in formal conferences or meetings without the presence of the supervising 8
164164 speech-language pathologist; 9
165165 (6) Providing interpretative information to a client, the family of a client, or any other 10
166166 individual; 11
167167 (7) Writing, developing, or modifying a client's treatment plan; 12
168168 (8) Assisting in or providing services described in subsection (a) of this section unless 13
169169 directed by the supervising speech-language pathologist; 14
170170 (9) Signing any formal documents in place of the supervising speech-language pathologist; 15
171171 (10) Selecting a client for service or discharging a client from service; 16
172172 (11) Making a decision regarding the need for additional services or making a referral for 17
173173 service; 18
174174 (12) Disclosing clinical or confidential information either orally or in writing to anyone 19
175175 other than the supervising speech-language pathologist, unless mandated by law or authorized by 20
176176 the supervising speech-language pathologist; or 21
177177 (13) Developing or determining the swallowing or feeding strategies or precautions for a 22
178178 client or providing feeding or swallowing treatment. 23
179179 (2)(d) A speech-language pathology assistant (SLPA) shall be registered at the department 24
180180 and be required to re-register every two (2) years. 25
181181 (b)(e) Support personnel for audiologists (audiometric aide) or audiology assistants must 26
182182 meet the following requirements: 27
183183 (1) Hold a high school diploma; 28
184184 (2) Receive intensive on-the-job training in accordance with the American Speech-29
185185 Language-Hearing Association (ASHA) or American Academy of Audiology (AAA) guidelines 30
186186 for support personnel by the supervising licensed audiologist prior to providing services. Any 31
187187 subsequent supervising licensed audiologist may require retraining of an audiometric aide or 32
188188 audiology assistant under the supervising licensed audiologist’s supervision. 33
189189 (3) Audiometric aides or audiology assistants shall be registered at the department and be 34
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193193 required to re-register every two (2) years. 1
194194 5-48.2-9. Supervision and responsibility. 2
195195 (a)(1) A supervising professional must be a speech-language pathologist or audiologist who 3
196196 is licensed under the act and this chapter; has attained and maintained their certificate of clinical 4
197197 competency and who has been actively working in the field for twenty-four (24) months after 5
198198 completion of the postgraduate professional experience; and must be responsible for the acts and 6
199199 performances, patient screening, and specific tasks assigned by the licensee to the speech-language 7
200200 pathology assistant (SLPA)/audiometric aide or audiology assistant. 8
201201 (2) A licensee who supervises support personnel must: 9
202202 (i) Utilize the services of only those who meet the minimum requirements enumerated 10
203203 under this chapter; 11
204204 (ii) Ensure that the support personnel are assigned only those duties and responsibilities for 12
205205 which the person has been specifically trained and which the assistant is qualified to perform; 13
206206 (iii) Ensure that persons who will be receiving services from support personnel, or the 14
207207 person’s legal representative, are informed that services are being rendered by support personnel; 15
208208 (iv) Provide supervision of the support personnel (other than newborn hearing screeners 16
209209 and school hearing screeners); and 17
210210 (v) Complete a minimum of two (2) hours of professional development in clinical 18
211211 instruction/supervision. 19
212212 (b) A speech-language pathologist supervisor may only supervise one full-time equivalent 20
213213 speech-language pathology assistant (SLPA) support personnel and not more than two (2) SLPAs 21
214214 at any time and an audiologist supervisor may only supervise three (3) full-time equivalent 22
215215 audiometric aides or audiology assistants unless otherwise approved by the board. At no time 23
216216 should support personnel perform tasks when a supervising SLPA cannot be reached by personal 24
217217 contact, phone, pager, or other immediate means. When multiple supervisors are used, the 25
218218 supervisors are encouraged to coordinate and communicate with each other. 26
219219 (c) Observations of support audiometric aides must be completed and documented as to 27
220220 date, amount of time, and accuracy and efficacy of service according to the following: Direct on-28
221221 site observations of the first ten (10) hours of direct client contact; and five percent (5%) of all 29
222222 clinical sessions after the first ten (10) hours for every forty (40) consecutive hours worked; and 30
223223 indirect supervision (e.g., home, interactive television, audio/video review, or patient record 31
224224 review) of five percent (5%) of each forty (40) consecutive hours worked. 32
225225 (d) Observations of a speech-language pathology assistant (SLPA) pathology support 33
226226 personnel shall be completed and documented as to date, amount of time, and accuracy and efficacy 34
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230230 of service according to the following: 1
231231 (1) Direct supervision means in-view observation and guidance while the SLPA is 2
232232 performing a clinical activity. Direct supervision does not include reviewing an audio or video 3
233233 recorded session later. 4
234234 (2) A minimum of twenty percent (20%) direct supervision and ten percent (10%) indirect 5
235235 supervision is required of all the time that assistant is providing services during the first ninety (90) 6
236236 days of employment. After the first ninety (90) days, the supervising SLPA may adjust their amount 7
237237 of supervision if they determine that the SLPA meets appropriate competencies. A minimum of ten 8
238238 percent (10%) direct and ten percent (10%) indirect supervision is required every one hundred 9
239239 eighty (180) days regardless of employment status. 10
240240 (e) Supervisors shall maintain records which document the frequency and type of 11
241241 supervision of support personnel, such records to be available for audit upon request by the board. 12
242242 5-48.2-10. Supervision of support personnel — Newborn hearing screeners and school 13
243243 hearing screeners. 14
244244 (a) Hospital-based newborn hearing screeners and school-based hearing screeners shall be 15
245245 trained by a licensed audiologist working in the newborn hearing or school screening program 16
246246 according to training guidelines established by the programs. 17
247247 (b) Supervision shall include a method of evaluation and documenting the competency of 18
248248 each screener upon completion of the initial training and at least annually thereafter by a licensed 19
249249 audiologist working in the newborn hearing or school screening program. 20
250250 (c) Observations of a speech-language pathology assistant (SLPA) pathology support 21
251251 personnel must be completed and documented as to date, amount of time, and accuracy and efficacy 22
252252 of service according to the following: 23
253253 (1) Direct on-site observations of the first ten (10) hours of direct client contact; and ten 24
254254 percent (10%) of clinical sessions after the first ten (10) hours of each forty (40) consecutive hours 25
255255 worked; and 26
256256 (2) Indirect supervision (e.g., phone, interactive television, audio/video review) of ten 27
257257 percent (10%) of each forty (40) consecutive hours worked. 28
258258 (d) Supervisors shall must observe all provisions of the ASHA policy regarding support 29
259259 personnel unless a specific policy is addressed in this chapter, including, but not limited to, that the 30
260260 licensee must maintain records that document the frequency and type of supervision of support 31
261261 personnel, such records to be available for audit upon request by the board. 32
262262 5-48.2-11. Continuing education requirements. 33
263263 (a) On or before the thirtieth day of June of even years, every person licensed to practice 34
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267267 speech-language pathology and/or audiology within Rhode Island shall complete not less than 1
268268 twenty (20) clock hours of continuing education within the preceding two (2) years and be able to 2
269269 present satisfactory evidence of completion to the department. 3
270270 (1) Course descriptions, proof of attendance, or other documentation of completion shall 4
271271 be retained by the licensee for a minimum of four (4) years and is subject to random audit by the 5
272272 department. 6
273273 (2) Activities approved by the board for continuing education credit are those sponsored 7
274274 by the American Speech-Language-Hearing Association (ASHA), the American Academy of 8
275275 Audiology (AAA), a state department of education, other International Association for Continuing 9
276276 Education and Training (IACET)-authorized providers, and/or continuing medical education units 10
277277 (CMEs) from the Accreditation Council for Continuing Medical Education (ACCME). Approved 11
278278 activities may include conferences, seminars, self-study programs, courses, or workshops 12
279279 sponsored by the organizations noted above, or course work from an accredited institution. 13
280280 (b) Those persons holding licensure in both speech-language pathology and audiology must 14
281281 have completed and have evidence of completion of not less than thirty (30) clock hours of 15
282282 continuing education within the preceding two (2) years. 16
283283 (c) Continuing education hours may not be carried over from one renewal period to the 17
284284 next. 18
285285 (d)(1) Continuing education hours must be in accordance with the American Speech-19
286286 Language-Hearing Association’s requirements including at least two (2) hours in cultural 20
287287 competency, cultural humility, culturally responsive practice or diversity, equity, and inclusion 21
288288 (DEI) and at least one hour in the area of ethics. 22
289289 (2) If the licensee is acting as a clinical supervisor, a minimum of two (2) hours of 23
290290 professional development in clinical instruction/supervision is required. 24
291291 (e) Speech-language pathologists or audiologists initially licensed by examination after the 25
292292 July 1 renewal date shall be exempt from the continuing education requirements stated in this 26
293293 section until the date of the next renewal cycle (i.e., June 30 of the second year following its 27
294294 issuance). 28
295295 (f) The board, at its discretion, may extend, reduce, or waive for a person the requirement 29
296296 for continuing education for hardship or other extenuating circumstances as the board deems 30
297297 appropriate. 31
298298 (g) The board shall promulgate regulations requiring continuing education for any speech-32
299299 language pathology assistant license renewal or reinstatement. The board may grant exceptions or 33
300300 exemptions from these continuing education requirements. 34
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304304 SECTION 2. This act shall take effect upon passage. 1
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311311 EXPLANATION
312312 BY THE LEGISLATIVE COUNCIL
313313 OF
314314 A N A C T
315315 RELATING TO BUSINESSES AND PROFESSIONS -- PROFESSIONAL LICENSING AND
316316 REGULATION OF SPEECH-LANGUAGE PATHOLOGIS TS AND AUDIOLOGISTS
317317 ***
318318 This act would establish prevailing standards and procedures for licensing speech-language 1
319319 pathologists and audiologists in Rhode Island. 2
320320 This act would take effect upon passage. 3
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