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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)


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)


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

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)