Complaints and Enforcement

Speech Language Pathologists and Audiologists Penalties and Sanctions

Speech Language Pathologists and Audiologists (SLP)
Texas Occupations Code Chapter 401
16 Texas Administrative Code (TAC) Chapter 111

Class A Penalties

Penalty: $50 up to $500

Administrative Violations

Violation Description	Texas Statute
Failing to inform the Department of a change of name, highest academic degree granted, address, telephone number, or employment information within thirty days of any change, or failing to use the Department-approved form for such changes	16 TAC 111.150(a); 16 TAC 111.115(a)(10)
Failed to display license	16 TAC 111.151(b)

Violation Description

Texas Statute

Failing to inform the Department of a change of name, highest academic degree granted, address, telephone number, or employment information within thirty days of any change, or failing to use the Department-approved form for such changes

16 TAC 111.150(a);

16 TAC 111.115(a)(10)

Failed to display license

16 TAC 111.151(b)

Violations by Interns or Assistants

Violation Description	Texas Statute
Used “SLP-CFY” or “SLP-CF” as a sole indicator of credentials	16 TAC 111.40(p)
Used “SLP-A” or “STA” as a sole indicator for credentials	16 TAC 111.50(i)(18)

Violations Related to the Supervision of Speech-Language Pathology Interns

Violation Description	Texas Statute
Failed to obtain Department approval before implementing any changes to the terms of the internship	16 TAC 111.40(l)
Failed to submit a Report of Completed Internship within 30 days of the date supervision is completed or ended for any other reason	16 TAC 111.40(l)(2)
Failed to notify the Department that the location of the internship changed within 30 days of the date of the change	16 TAC 111.40(l)(3)

Violations Related to the Supervision of Audiology Interns

Violation Description	Texas Statute
Failed to obtain Department approval before implementing any changes to the terms of the internship	16 TAC 111.80(g)
Failed to submit a Report of Completed Internship within 30 days of the date supervision ended	16 TAC 111.80(g)(2)
Failed to notify the Department that the location of the internship changed within 30 days of the date of the change	16 TAC 111.80(g)(3)

Class B Penalties

Penalty: $300 to $3,000 and/or up to 1 year full suspension

Records and Billing Violations

Violation Description	Texas Statute
Failure to include the Department’s name, mailing address, and telephone number on the written contract or bill for service for fitting and dispensing hearing instruments, or office information brochure	Occupations Code 401.403(b)(4); 16 TAC 111.151(a)(2); 16 TAC 111.220(c)(8)
Failed to prominently display a sign containing Department information in the primary place of business	16 TAC 111.151(a)(1)
Failed to provide results of an evaluation within 60 days, when requested	16 TAC 111.155(a)(18)

Violation Description

Texas Statute

Failure to include the Department’s name, mailing address, and telephone number on the written contract or bill for service for fitting and dispensing hearing instruments, or office information brochure

Occupations Code 401.403(b)(4);

16 TAC 111.151(a)(2);

16 TAC 111.220(c)(8)

Failed to prominently display a sign containing Department information in the primary place of business

16 TAC 111.151(a)(1)

Failed to provide results of an evaluation within 60 days, when requested

16 TAC 111.155(a)(18)

Unlicensed Activity – Related to Speech-Language Pathologists

Violation Description	Texas Statute
Practiced as a speech-language pathologist with an expired license	Occupations Code 401.301; 16 TAC 111.37(g); 16 TAC 111.30(a)
Practiced as an intern in speech-language pathology with an expired license	Occupations Code 401.301; 16 TAC 111.47(g); 16 TAC 111.40(a)
Practiced as an assistant in speech-language pathology with an expired license	Occupations Code 401.301; 16 TAC 111.57(g); 16 TAC 111.50(a)
Practiced as a speech-language pathologist without a current temporary certificate of registration	16 TAC 111.60(a)

Unlicensed Activity – Related to Audiologists

Violation Description	Texas Statute
Practiced as an audiologist with an expired license	Occupations Code 401.301; 16 TAC 111.77(g); 16 TAC 111.70(a)
Practiced as an intern in audiology with an expired license	Occupations Code 401.301; 16 TAC 111.87(g); 16 TAC 111.80(a)
Practiced as an assistant in audiology with an expired license	Occupations Code 401.301; 16 TAC 111.97(g); 16 TAC 111.90(a)
Practiced as an audiologist without a current temporary certificate of registration	16 TAC 111.100(a)

Violations by Interns

Violation Description	Texas Statute
Failed to indicate status as a speech-language pathology intern in any professional context	16 TAC 111.40(m)
Failed to indicate status as an intern in audiology in any professional context	16 TAC 111.80(g)(4)

Violations by Assistants

Violation Description	Texas Statute
Failed to indicate status as a licensed speech-language pathology assistant in any professional context	16 TAC 111.50(l)
Failed to indicate status as a licensed audiology assistant in any professional context	16 TAC 111.90(g)

Violations Related to Supervision of Interns or Assistants

Violation Description	Texas Statute
Supervised an intern or an assistant when the supervisor had less than two years of professional experience providing direct clinical services in the area of licensure	16 TAC 111.154(a)
Supervised an intern or assistant who is within the first degree of consanguinity to the licensee	16 TAC 111.154(b)
Failed to verify that the intern had a current license	16 TAC 111.154(e)(1)(A)

Violations Related to Supervision of Speech-Language Pathology Interns or Assistants

Violation Description	Texas Statute
Failed to maintain documentation of an intern’s formal evaluations for a period of three years or until the intern obtained a speech-language pathology license	16 TAC 111.40(k)
Failed to submit an Intern Plan and Agreement of Supervision form before beginning to supervise an intern	16 TAC 111.40(g)(1)
Failed to provide the minimum number of hours of supervision for a speech-language pathology assistant	16 TAC 111.50(g)(3)
Failed to maintain supervisory records for a speech-language pathology assistant for a period of three years	16 TAC 111.50(g)(4)
Failed to maintain job descriptions and performance records of a licensed speech-language pathology assistant	16 TAC 111.50(h)(2)
Failed to notify the parents of students that services will be provided by a licensed assistant	16 TAC 111.50(j)(1)
Supervised an intern in speech-language pathology when the supervisor had less than a master’s degree in one of the areas of communicative sciences or disorders	16 TAC 111.154(c)

Violations Relating to Supervision of Audiology Interns or Assistants

Violation Description	Texas Statute
Failed to submit an Intern Plan and Agreement of Supervision form before beginning to supervise an intern	16 TAC 111.80(e)(1)
Failed to maintain job descriptions and performance records of a licensed assistant in audiology	16 TAC 111.90(f)(2)
Supervised an intern in audiology when the supervisor had less than the required level of education	16 TAC 111.154(d)

Violations Related to Continuing Education

Violation Description	Texas Statute
Failed to complete required continuing education	16 TAC 111.130; 16 TAC 111.131
Failed to maintain record of continuing education for at least three years	16 TAC 111.132

Violation Description

Texas Statute

Failed to complete required continuing education

16 TAC 111.130;

16 TAC 111.131

Failed to maintain record of continuing education for at least three years

16 TAC 111.132

Class C Penalties

Penalty: $1,000 to $5,000 and/or up to revocation

Records and Billing Violations

Violation Description	Texas Statute
Failed to maintain accurate records of professional services rendered	16 TAC 111.153(a)
Failed to maintain records for five years or longer as warranted	16 TAC 111.153(b); 16 TAC 111.220(d)
Billed for services not rendered	16 TAC 111.153(e)
Falsified records	16 TAC 111.155(b)(13)
Failed to comply with all laws, rules, and regulations governing the maintenance of client records related to the provision of telehealth services	16 TAC 111.212(n)

Unlicensed Activity – Related to Speech-Language Pathologists

Violation Description	Texas Statute
Practice as a speech and language pathologist or represent oneself as a speech-language pathologist without a license	Occupations Code 401.301; 16 TAC 111.30(a)
Practice as a speech-language pathology intern without an intern’s license	16 TAC 111.40(a)
Practice as an assistant in speech-language pathology without a license	16 TAC 111.50(a)
Practiced as an assistant without a valid supervisory responsibility statement on file in the Department	16 TAC 111.50(i)(11)
Aided or abetted the practice of an unlicensed person when that person is required to have a license	16 TAC 111.155(b)(14)

Unlicensed Activity – Related to Audiologists

Violation Description	Texas Statute
Practice as an audiologist or represent oneself as an audiologist without a license	Occupations Code 401.301; 16 TAC 111.70(a)
Practice as an audiologist intern without an intern’s license	16 TAC 111.80(a)
Practice as an assistant in audiology without a license	16 TAC 111.90(a)
Practiced as an assistant without a valid supervisory responsibility statement on file in the Department	16 TAC 111.90(f)(5)(R)
Aided or abetted the practice of an unlicensed person when that person is required to have a license	16 TAC 111.155(b)(14)

Violations by Speech-Language Pathology Assistants

Violation Description	Texas Statute
Conducted evaluations	16 TAC 111.50(i)(1)
Interpreted results of routine tests	16 TAC 111.50(i)(2)
Interpreted observations or data into diagnostic statements, clinical management strategies, or procedures	16 TAC 111.50(i)(3)
Represented speech-language pathology at staff meetings, or at an admission, review and dismissal (ARD), except as specified	16 TAC 111.50(i)(4)
Attended staffing meeting or ARD without the licensed assistant’s supervising speech-language pathologist department-approved supervisor being present, except as specified	16 TAC 111.50(i)(5)
Designed or altered a treatment program or IEP	16 TAC 111.50(i)(6)
Determined case selection	16 TAC 111.50(i)(7)
Presented written or oral reports of client information, except as specified	16 TAC 111.50(i)(8)
Referred a client to other professionals or agencies	16 TAC 111.50(i)(9)
Used any title which connotes the competency of a licensed speech-language pathologist	16 TAC 111.50(i)(10)
Performed invasive procedures	16 TAC 111.50(i)(12)
Screened or diagnosed clients for feeding and swallowing disorders	16 TAC 111.50(i)(13)
Used a checklist or tabulated results of feeding or swallowing evaluations	16 TAC 111.50(i)(14)
Demonstrated swallowing strategies or precautions to clients, family or staff	16 TAC 111.50(i)(15)
Provided client or family counseling	16 TAC 111.50(i)(16)
Signed any formal document relating to the reimbursement for or the provision of speech-language pathology services without the licensed assistant’s supervisor’s signature	16 TAC 111.50(i)(17)

Violations by Audiology Assistants

Violation Description	Texas Statute
Conducted aural habilitation or rehabilitation activities or therapy	16 TAC 111.90(f)(5)(A)
Provided carry-over activities for patients in aural rehabilitation therapy	16 TAC 111.90(f)(5)(B)
Collected data during aural rehabilitation therapy documenting progress and results of therapy	16 TAC 111.90(f)(5)(C)
Administered assessments during aural rehabilitation therapy to assess therapeutic progress	16 TAC 111.90(f)(5)(D)
Conducted audiological procedure that requires decision-making or leads to a diagnosis	16 TAC 111.90(f)(5)(E)
Interpreted results of procedures and evaluations, except screening tests	16 TAC 111.90(f)(5)(F)
Made diagnostic statements, or proposed or developed clinical management strategies	16 TAC 111.90(f)(5)(G)
Made ear impressions	16 TAC 111.90(f)(5)(H)
Caused a substance to enter the ear canal or placed an instrument or object in an ear canal for the purpose of removing cerumen or debris	16 TAC 111.90(f)(5)(I)
Made changes to the internal settings of a hearing instrument manually or using computer software	16 TAC 111.90(f)(5)(J)
Represented audiology at staff meetings or an admission, review, and dismissal (ARD) committee	16 TAC 111.90(f)(5)(K)
Attended staffing meetings or ARD committee meetings without the department-approved supervisor being present	16 TAC 111.90(f)(5)(L)
Designed a treatment program	16 TAC 111.90(f)(5)(M)
Determined a case selection	16 TAC 111.90(f)(5)(N)
Presented written or oral reports of client information, except to his or her department-approved supervisor	16 TAC 111.90(f)(5)(O)
Referred a client to other professionals or agencies	16 TAC 111.90(f)(5)(P)
Used any title which connotes the competency of a licensed audiologist	16 TAC 111.90(f)(5)(Q)

Standard of Care Violations

Violation Description	Texas Statute
Failed to conduct sound-level measurements at the time of testing or failed to ensure that ambient noise levels met the permissible testing threshold	Occupations Code 401.401(a)
Practiced out of the scope of license	16 TAC 111.155(a)(1)
Failed to ensure a safe therapy environment	16 TAC 111.155(a)(2)
Failed to provide services as specified in the treatment plan, Individual Education Plan (IEP), or Individualized Family Service Plans (IFSP)	16 TAC 111.155(a)(3)
Failed to seek appropriate medical consultation when indicated	16 TAC 111.155(a)(4)
Failed to identify competent, dependable referral for clients	16 TAC 111.155(a)(5)
Failed to maintain objectivity in all matters concerning the welfare of the client	16 TAC 111.155(a)(6)
Failed to ensure that all equipment used in providing services was in proper working order and properly calibrated; including equipment used in providing telehealth services	16 TAC 111.155(a)(7); 16 TAC 111.201(2); 16 TAC 111.212(g)
Failed to terminate a professional relationship when it is reasonably clear that the client is not benefiting from the services being provided	16 TAC 111.155(a)(8)
Failed to provide accurate information to clients and the public about the nature and of communication disorders and about the profession and the services rendered	16 TAC 111.155(a)(9)
Failed to comply with the Health and Safety Code, Chapter 85, Subchapter I, concerning the prevention of the transmission of HIV or Hepatitis B virus by infected health care workers	16 TAC 111.155(a)(17)
Failed to fully inform clients of the nature and possible effects of the services rendered; and nature, possible effects, and consequences of activities if the client is participating in research or teaching activities	16 TAC 111.155(a)(18)
Engaged in the medical treatment of speech-language and hearing disorders	16 TAC 111.155(b)(1)
Jeopardized a client's safety by any inattentive behavior;	16 TAC 111.155(b)(2)
Guaranteed, directly or by implication, the results of any therapeutic procedures or misled clients to expect results that could not be predicted from reliable evidence	16 TAC 111.155(b)(3)
Delegated any service requiring professional competence of a licensee or registrant to anyone not licensed or registered for the performance of that service	16 TAC 111.155(b)(4)
Provided services if the services cannot be provided with reasonable skill or safety to the client	16 TAC 111.155(b)(5)
Provide any services which create an unreasonable risk that the client may be mentally or physically harmed	16 TAC 111.155(b)(6)
Revealed, without authorization, any professional or personal information about the person served professionally, unless required by law to do so, or unless doing so is necessary to protect the welfare of the person or of the community	16 TAC 111.155(b)(9)
Participate in activities that constitute a conflict of professional interest	16 TAC 111.155(b)(10)
Used his or her professional relationship with a client, intern, assistant, or student to promote for personal gain or profit any item, procedure, or service unless the licensee or registrant has disclosed to the client, intern, assistant, or student the nature of the licensee's or registrant's personal gain or profit	16 TAC 111.155(b)(11)
Misrepresented his or her training or competence	16 TAC 111.155(b)(12)
Endangered the health, welfare, or safety of the public	16 TAC 111.155(b)(17)
Failed to conduct a communication screening in the client’s dominate language and primary mode of communication	16 TAC 111.190(c)
Failed to perform or interpret a hearing screening in the required manner	16 TAC 111.191(b)
Failed to comply with 25 TAC Chapter 37 regarding reporting hearing screening or audiologic outcomes to the Department of State Health Services in the required manner regarding referral of children under the age of three to ECI within two days of identification	16 TAC 111.192(b)

Violations Related to Telehealth by Speech-Language Pathologists

Violation Description	Texas Statute
Failed to ensure that the quality of electronic transmissions used in telehealth services was the same as if those services were provided in person	16 TAC 111.212(d)
Utilized technology which the licensee was not competent to use as part of telehealth services	16 TAC 111.212(e)
Failed to maintain equipment used for telehealth services at the clinician site in appropriate operational status to provide the appropriate quality of services	16 TAC 111.212(f)
Provided telehealth services to a client without first having an initial contact at the same physical location to assess the client’s candidacy for telehealth	16 TAC 111.212(h)
Failed to adjust the practice to maximize the client or consultant’s level of comfort with technology used in providing telehealth services	16 TAC 111.212(i)
Failed to be sensitive to cultural and linguistic variables that affect the identification, assessment, treatment, and management of clients	16 TAC 111.212(l)
Failed to notify the client, guardian, caregiver, and the multidisciplinary team, if appropriate of the client’s rights related to the provision of telehealth services	16 TAC 111.212(o)

Violations Related to Telehealth for Fitting and Dispensing Hearing Instruments

Violation Description	Texas Statute
Failed to be visible and audible in real-time when carrying out a telehealth service	16 TAC 111.232(d)
Failed to document the facilitator’s qualifications, training, and competence in each task and in the methodology and equipment prior to allowing a facilitator to assist in rendering a telehealth service	16 TAC 111.232(e)
Allowed a facilitator at a client site to perform tasks for which they are not qualified	16 TAC 111.232(f)
Rendered a telehealth session to a client when the situation required the presence of a facilitator to ensure a safe and effective service	16 TAC 111.232(g)
Rendered a telehealth session without ensuring the telecommunications technology and equipment located at the client site and provider site are properly calibrated, in good working order, and sufficient quality	16 TAC 111.232(i)
Failed to perform initial professional contact in person at the same physical location	16 TAC 111.232(j)
Failed to comply with all laws, rules, and regulations governing the maintenance of records	16 TAC 111.232(k)

Violations Related to Fitting and Dispensing of Hearing Instruments

Violation Description	Texas Statute
Failed to adhere to federal Food and Drug Administration regulations in accordance with 21 Code of Federal Regulations §§ 801.420 and 801.421	16 TAC 111.201(1)
Failed, before selling a hearing instrument, to receive a written statement signed by a physician stating that a client’s hearing has been medically evaluated during the previous six months and that the client is a candidate for a hearing instrument	16 TAC 111.201(3)
Failed to verify appropriate fit of the hearing instrument	16 TAC 111.201(4)
Failed to adhere to the most current American National Standards Institute octave band criteria for permissible ambient noise levels during audiometric testing	16 TAC 111.202(1)
Failed to follow guidelines for the 30-day trial period	16 TAC 111.220(b)
Failed to provide a written contract to each client upon sale or change of model or serial number of a hearing instrument that contains the required information	16 TAC 111.220(c)

Code of Ethics Violations

Violation Description	Texas Statute
Sold a hearing instrument to a minor without obtaining a written statement from a licensed physician specializing in diseases of the ear	Occupations Code 401.404
Failed to inform the department of violations of the Act, this code of ethics, or of any other provision of this chapter	16 TAC 111.155(a)(12)
Failed to report in accordance with the Family Code §261.101(b), if there is cause to believe that a child's physical or mental health or welfare has been or may be adversely affected by abuse or neglect by any person	16 TAC 111.155(a)(14)
Failed to cooperate with the department by promptly furnishing required documents and by promptly responding to a request for information from, or a subpoena issued by, the department or the department's designee	16 TAC 111.155(a)(15); 16 TAC 111.212(m)
Used alcohol or drugs when the use adversely affects or could adversely affect the licensee's provision of professional services	16 TAC 111.155(b)(8)
Interfered with a department investigation or disciplinary proceeding by willful misrepresentation or omission of facts to the department or the department's designee or by the use of threats or harassment against any person	16 TAC 111.155(b)(15)
Intentionally or knowingly offered to pay or agreed to accept any remuneration for securing or soliciting clients or patronage for or from any health care professional	16 TAC 111.155(b)(16)
Used threats, threatening behavior, or acts of violence towards clients, employees, or employers	16 TAC 111.155(b)(18)

Violations Related to the Supervision of Interns and Assistants

Violation Description	Texas Statute
Failed to obtain Department approval as a supervisor for interns or assistants	16 TAC 111.154(e)(1)(B)
Delegated tasks to an assistant that assistants are prohibited from performing	16 TAC 111.50(g)(4)(A); 16 TAC 111.50(i); 16 TAC 111.90(f)(5);
Failed to be responsible for all client services provided by the intern or assistant	16 TAC 111.50(j)(3); 16 TAC 111.154(e)(2)
Failed to provide appropriate supervision	16 TAC 111.154(e)(3)
Supervised more than the permitted number of interns or assistants	16 TAC 111.154(e)(4)

Class D Penalties

Penalty: $5,000 and/or revocation

Violation Description	Texas Statute
Failed to comply with a previous order of the Commission or Executive Director	Occupations Code 51.353(a); Occupations Code 401.451(a)(1); 16 TAC 111.155(a)(13)
Obtained, or attempted to obtain, a license by fraud, misrepresentation, or concealment of a material fact	Occupations Code 401.451(a)(2); Occupations Code 60.23(a)(1)
Sold, bartered, or offered to sell or barter a license or certificate of registration	Occupations Code 401.451(a)(3)
Engaged in unprofessional conduct that endangered the health, welfare, or safety of the public	Occupations Code 401.451(a)(4)(A)
Failed to pay the Department for a dishonored payment or processing fee	Occupations Code 60.82
Engaged in sexual contact, including intercourse, kissing, or fondling, with a client or an assistant, intern, or student supervised by the licensee	16 TAC 111.155(b)(7)