Speech-Language Pathologists and Audiologists


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News and Updates

FDA Rules for Over-the-Counter Category of Hearing Instruments Now in Effect

Hearing instruments or hearing aids are regulated at the federal level as medical devices by the U.S. Food and Drug Administration (FDA). Changes have been made at the federal level to create an over-the-counter category of hearing instruments (hearing aids), and the FDA rules implementing these changes are now in effect.

In August 2017, the U.S. Congress passed the FDA Reauthorization Act of 2017, which in part defined “over-the-counter hearing aid,” required the FDA to establish a category of over-the-counter (OTC) hearing aids, and specified certain requirements that must be included in the FDA regulations. On October 20, 2021, the FDA published proposed regulations for public comment. These proposed regulations established the OTC category and realigned other regulations for hearing aids.

The FDA published the final regulations in the Federal Register (87 FR 50698) on August 17, 2022, with an effective date of October 17, 2022.

The FDA also has issued a final guidance document to clarify the regulatory requirements for hearing aids and personal sound amplification products. Additional information may be found on the FDA’s website on hearing aids.

TDLR Health Monitor – October 2022 Edition

Articles in the October 2022 edition of The Health Monitor include updates on:

  • Raising Awareness in October For Audiology, Dyslexia and Massage Therapy
  • Proposed Rule Amendments For Orthotists and Prosthetists
  • Podiatry Applications Now Available Online
  • Test Proctors Needed For HFD Exams

TDLR Health Monitor – June 2022 Edition

Articles in the June 2022 edition of The Health Monitor includes updates on:

  • Recent Rule Amendments
  • Updated Massage Therapy Consultation Document
  • Speech-Language Pathology Clinical Deficiency Plan
  • Hear Her Texas

Over-the-Counter Category Coming for Hearing Instruments

Hearing instruments or hearing aids are regulated at the federal level as medical devices by the U.S. Food and Drug Administration (FDA). Changes are being made at the federal level regarding hearing instruments that will affect two of TDLR’s programs, the Hearing Instrument Fitters and Dispensers program and the Speech-Language Pathologists and Audiologists program. These two programs regulate the fitting and dispensing of hearing instruments by Texas licensees.

In August 2017, the U.S. Congress passed the FDA Reauthorization Act of 2017 (FDARA) | FDA, which in part defined “over-the-counter hearing aid,” required the FDA to establish a category of over-the-counter (OTC) hearing aids, and specified certain requirements that must be included in the FDA regulations. On October 20, 2021, the FDA published proposed regulations for public comment. These proposed regulations establish the OTC category and realign other regulations for hearing aids. The FDA will eventually publish final regulations, taking public comments into account.

You will find the proposed regulations published in the Federal Register, 86 FR 58150. Electronic or written comments on the proposed regulations must be submitted to the FDA by January 18, 2022. The Federal Register notice includes all the details about submitting public comments.

The FDA has issued a letter clarifying that the over-the-counter category of hearing aids does not exist until the effective date of published final regulations. Licensed Hearing Instrument Fitters and Dispensers and licensed Audiologists may wish to visit the FDA’s website on hearing aids for additional information. 

Continuing Education Requirements

HB 1560, the Sunset legislation for the Texas Department of Licensing and Regulation, repealed Occupations Code §401.355 from the Speech-Language Pathologists and Audiologists statute, and transferred authority regarding the continuing education requirements to TDLR’s enabling statute, Chapter 51 of the Texas Occupations Code.

Please note that no changes were made, and Speech-Language Pathologists and Audiologists program licensees are still required to obtain continuing education (CE) credits as specified in the program rules.

Call for Subject Matter Experts

TDLR is seeking subject matter experts (SMEs) to assist our Enforcement Division with complaint case reviews. SMEs review complaint cases, generally involving standard of care issues, during the investigation stage of the enforcement process.

We currently have a shortage of Behavior Analyst, Podiatrist, and Speech-Language Pathologist SMEs.

If you are interested in becoming a SME, please complete the Expert Witness Application. Once the application is submitted, you will receive a questionnaire to complete and return. Documents are screened and contracts are issued to approved SMEs.

All SMEs receive training on their role in reviewing complaint cases. Tasks may include the following:

  • Reviewing documents and statements collected by investigators.
  • Writing a report stating an opinion as to whether the respondent violated a rule or law in the provision of care to a client.
  • Answering specific questions from the prosecutor about the case.
  • Testifying as a witness for TDLR at hearings.

Our mission is to protect the citizens of Texas and the hard-working members of your profession. We cannot do that without your specialized knowledge of the complexities of your profession. Please consider becoming a SME today.

Notice to prospective licensees, current licensees renewing their licenses, and stakeholders

Applicants can apply for new licenses and renew licenses online. TDLR strongly encourages you to take advantage of the opportunity to apply or renew online. The process is secure and easy to use – and faster than submitting paper-based applications and supporting documents, especially as TDLR deals with significant staffing issues related to COVID-19.

  • Applications submitted online can take 30 days to process once TDLR receives all required documents.
  • Applications submitted by mail may face significant delays, which may take up to 90 days once TDLR receives all required documents.

Access the online licensing system here. If you need to submit a document outside of the online application, please scan the document and send it to TDLR using our online customer service form.

If you need to submit a transcript, please ask your university to send electronic transcripts to TDLR at cs.transcript@tdlr.texas.gov instead of mailing in an original or certified copy of an original transcript. If your need to submit other documents, such as receipt of fingerprint submission, please scan the document and send it electronically to TDLR using our Customer Service form.

Thank you for helping us process your application or renewal more quickly.

86th Legislative Session Update

Notice to Health Care Practitioners of New Training Requirement

House Bill 2059 requires certain health care practitioners to complete a Health and Human Services Commission (HHSC) approved human trafficking prevention training course to renew their license. The bill also requires HHSC to post a list of approved courses on their website. Licensees are required to comply with the training requirements beginning September 1, 2020. For more information, visit our Human Trafficking Prevention Training for Health Care Practitioners webpage.

Clarification on Continuation of Telehealth Services for the Speech-Language Pathologists and Audiologists Program

TDLR’s statute and rule suspensions, which allow speech-language pathology (SLP) interns and SLP assistants to provide services and receive supervision through telehealth, were approved pursuant to Governor Abbott’s Disaster Declaration, which was issued on March 13, 2020. (See TDLR announcement on April 9, 2020, regarding the granted suspensions). These suspensions continue in effect until terminated by the Office of the Governor.

The suspension of the TDLR rules to allow SLP interns and SLP assistants to provide telehealth services is separate from the HHSC/Medicaid requirements regarding reimbursement for telehealth services. Please continue to confirm reimbursement policies with the billing entities you are working with. Eligibility for reimbursement does not affect a licensee’s ability to provide services through telehealth.

If you have not already done so, please sign up for email notices from TDLR regarding the Speech-Language Pathologists and Audiologists program and any COVID-19 updates. TDLR will notify its email subscribers when any granted suspensions will be coming to an end, and will post a notice to the TDLR COVID-19 webpage.

COVID-19 Update: Required Grades for a Speech-Language Pathology Assistant License

The COVID-19 pandemic caused universities to close their campuses and switch to online classes and led many universities to adopt a pass/fail grading policy for the 2020 spring semester.

Current Speech-Language Pathologists and Audiologists program rules, 16 TAC §111.50(a)(2) and §111.50(b)(1)(A), require applicants for a speech-language pathology assistant license to have earned at least 24 semester hours in speech-language pathology and/or audiology with a grade of “C” or better.

For the spring 2020 semester only, TDLR will accept a "passing" grade as meeting the requirement of a grade of "C" or better for undergraduate students applying for a speech-language pathology assistant license.

The number and type of required semester credit hours will remain the same: 18 of the 24 semester credit hours must be in speech-language pathology, with at least three (3) credit hours in language disorders and at least three (3) credit hours in speech disorders. The 24 semester credit hours exclude course work such as special education, deaf education, or sign language. The 24 semester credit hours must be academic course work and excludes any clinical experience.

Governor Approves Regulatory Suspensions to Facilitate Services to Speech-Language Pathologist and Audiologist Clients During the COVID-19 Pandemic

To help combat the spread of Coronavirus, TDLR requested and received authority from Governor Greg Abbott to suspend certain regulatory requirements, to the extent necessary, to allow licensees of the Speech-Language Pathologist and Audiologist program to provide more services to clients through telehealth and to ease other licensing restrictions.

These suspensions are in effect until terminated by the Office of the Governor or until the March 13, 2020 disaster declaration is lifted or expires. In accordance with Section 418.016 of the Texas Government Code, the Office of the Governor has granted TDLR’s request to suspend the following provisions:

Supervision:

Speech-Language Pathology (SLP) interns may now receive direct supervision through telehealth. The SLP internship is at least 36 weeks and 1,260 hours, divided into three (3) segments with no fewer than thirty-six (36) clock hours of supervisory activities to include:

  • six (6) hours of direct supervision per segment by the supervisor(s) of the intern's client contact in which the intern provides screening, evaluation, assessment, habilitation, and rehabilitation; and
  • six (6) hours of indirect supervision per segment with the supervisor(s) which may include correspondence, review of videos, evaluation of written reports, phone conferences with the intern, and evaluations by professional colleagues.

As a result of the suspension, all supervision hours—both direct and indirect—may be conducted through telehealth (suspension of 16 TAC §111.2(15), (23), and (25) and §111.213(c)).

Under a previous suspension granted by the Governor, SLP assistants may receive 100 percent of their monthly supervision through telehealth. Supervisors must provide a minimum of four hours of direct supervision each month and four hours of indirect supervision each month. Supervisors may use telehealth for both direct and indirect supervision (suspension of 16 TAC §111.51(g)(1) and (4); §111.2(14), (23), and (24); and §111.213(b)(1) and (2)).

Audiology assistants may now be supervised for all assigned tasks through telehealth (suspension of 16 TAC §111.2(14), (23), and (24); §111.91(f) and §111.216(b)).

Audiology interns are allowed to be supervised for all assigned tasks through telehealth (no suspension of the rules was required).

Practice:

For all licensees approved to provide telehealth services:

  • A smart phone, or any audio-visual, real-time, or two-way interactive communication system, qualifies as telecommunications technology and may now be used to provide telehealth services, as well as telehealth services related to fitting and dispensing hearing instruments (suspension of 16 TAC §§111.210(7)-(12), §111.213(d), §111.216(c), §§111.231(9)-(12) and §§111.232(b), (d) and (i)).
  • The same code of ethics and professional standards apply whether a client is seen via telehealth or an in-person visit as required under 16 TAC §111.212 and §111.215.

SLP interns:

  • SLP interns may now provide services to clients remotely using telehealth (suspension of 16 TAC §111.210(5)).

SLP Assistants:

  • SLP assistants may now provide services through telehealth, as directed by their supervisor, according to the SLP assistant practice and duties under 16 TAC §111.52 (suspension of §111.210(5)).

Audiologists and Audiology Interns:

  • Audiologists and audiology interns who fit and dispense hearing instruments through telehealth are no longer required to conduct an initial professional contact in person at the same physical location (suspension of 16 TAC §111.232(j)).

Services provided through telehealth must be performed with the same standard of care as in-person health care and within the licensee’s scope of practice and competence. The equipment used must be appropriate for the situation and properly working as required under 16 TAC §111.232(h) and (i).

Facilitators:

If a facilitator assists with the provision of telehealth services, no prior training is necessary if the provider determines that the facilitator has the competence needed to assist with the services given (suspension of 16 TAC §111.232(e) and (f)(1)).

Licensees who need additional information on billing policies relating to the provision of telehealth services during the COVID-19 pandemic should contact Texas Health and Human Services Medicaid or managed care organizations (MCOs), as policies are changing rapidly. It is critical to check with your payor before initiating a new type of service or service delivery model, such as telehealth.

Before providing telehealth services, licensees should verify the applicability of other requirements and obligations, such as HIPAA and other medical and personal privacy requirements.

COVID-19: TDLR Waives Continuing Education, Other Requirements

To help combat the spread of the COVID-19 virus, TDLR requested authority from Governor Greg Abbott to suspend certain regulatory requirements statewide, including the following:

  • Speech-Language Pathology assistants may receive 100 percent of their monthly supervision through telehealth. Supervisors must provide a minimum of four hours of direct supervision each month and four hours of indirect supervision each month.  Supervisors may use telehealth for all supervision of SLP assistants (16 TAC §111.51(g)(1) and (4) and §111.213(b)(1) and (2)).
  • Continuing education requirements are waived for all licenses expiring in March, April, and May 2020. Licensees will still submit their renewal applications, pay the required fees, and have their criminal histories checked but they will not need to complete any required continuing education requirements this licensing cycle. (51.405, Occupations Code)

Please check the TDLR COVID-19 webpage for the most up-to-date information.


Advisory Board Meetings

November 2, 2021

The Speech-Language Pathologists and Audiologists Advisory Board met November 2, 2021 via videoconference. The agenda and staff reports are available online. The meeting was archived and is available on TDLR's YouTube channel.