Adopted Administrative Rules

JUSTIFICATION FOR ADMINISTRATIVE RULE ADOPTION
Speech-Language Pathologist and Audiologist
16 TAC Chapter 111, new rules Subchapter E, §111.41 and §111.42; Subchapter F, §111.51 and §111.52; Subchapter I, §111.81 and §111.82; Subchapter J, §111.91 and §111.92, and Subchapter V, §111.216; amendments Subchapter A, §111.2; Subchapter B, §111.10; Subchapter C, §§111.21, 111.22, and 111.23; Subchapter D, §§111.30, 111.35, and 111.37; Subchapter E, §§111.40, 111.45, and 111.47; Subchapter F, §§111.50, 111.55, and 111.57; Subchapter H, §§111.70, 111.75, and 111.77; Subchapter I, §§111.80, 111.85, and 111.87; Subchapter J, §§111.90, 111.95, and 111.97; Subchapter L, §111.115 and §111.117, Subchapter O, §111.140; Subchapter P, §111.151 and §111.154; Subchapter Q, §111.160; Subchapter R, §111.171; Subchapter S, §111.180, Subchapter U, §111.200; and Subchapter V, §111.213; and repeals Subchapter G, §§111.60, 111.65, and 111.66; and Subchapter K, §§111.100, 111.105, and 111.106

The Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.2; Subchapter B, §111.10; Subchapter C, §§111.21 - 111.23; Subchapter D, §111.37; Subchapter E, §111.47; Subchapter F, §111.55 and §111.57; Subchapter H, §§111.70, 111.75, and 111.77; Subchapter I, §§111.80, 111.85, and 111.87; Subchapter J, §§111.90, 111.95, and 111.97; Subchapter L, §111.115 and §111.117, Subchapter O, §111.140; Subchapter P, §111.151; Subchapter Q, §111.160; Subchapter R, §111.171; Subchapter S, §111.180, Subchapter U, §111.200; and Subchapter V, §111.213; adopts new rules at Subchapter E, §111.41 and §111.42; Subchapter F, §111.52; Subchapter I, §111.81 and §111.82; Subchapter J, §111.92, and Subchapter V, §111.216; and adopts the repeal of existing rules at Subchapter G, §§111.60, 111.65, and 111.66; and Subchapter K, §§111.100, 111.105, and 111.106, regarding the Speech-Language Pathologists and Audiologists program, without changes to the proposed text as published in the January 26, 2018, issue of the Texas Register (43 TexReg 400). The rules will not be republished.

The Commission also adopts amendments to existing rules at 16 TAC, Chapter 111, Subchapter D, §111.30 and §111.35; Subchapter E, §111.40 and §111.45; Subchapter F, §111.50; and Subchapter P, §111.154; and new rules at Subchapter F, §111.51; and Subchapter J, §111.91, regarding the Speech-Language Pathologists and Audiologists program, with changes to the proposed text as published in the January 26, 2018, issue of the Texas Register (43 TexReg 400). The rules will be republished.

JUSTIFICATION AND EXPLANATION OF THE RULES

The adopted rules are necessary to implement House Bill 4007 (H.B. 4007), 85th Legislature, Regular Session (2017); make licensing and other clean-up changes; and update the supervision provisions throughout the chapter. These three categories of rule changes have been combined into one adoption, since there is overlap in some of the affected rule sections and this combined adoption eliminates the need for separate, consecutive rulemakings.

H.B. 4007 Changes

The adopted rules implement H.B. 4007, 85th Legislature, Regular Session (2017).  H.B. 4007, in part, repealed the temporary certificate of registration in speech-language pathology and audiology, eliminated residency requirements for advisory board membership, and eliminated provisions regarding failing the written examination. It also repealed redundancies in regard to the licensing and regulation of the Speech-Language Pathologists and Audiologists program.

Licensing and Other Clean-up Changes

The adopted rules also make licensing and other clean-up changes identified by The Texas Department of Licensing and Regulation (Department) staff since the Speech-Language Pathologists and Audiologists program was transferred from the Department of State Health Services (DSHS) to the Department effective October 3, 2016, pursuant to S.B. 202, 84th Legislature, Regular Session (2015).  

Supervision Changes

In addition, the adopted rules implement changes developed by the Speech-Language Pathologists and Audiologists Advisory Board Standard of Care Workgroup and Department staff related to the supervision provisions throughout the chapter. The supervision changes include reorganizing existing rules and moving the internship, supervision, and practice and duties requirements into separate distinct rule sections. These changes will make it easier to find specific provisions, including supervision requirements.

The supervision rules, which are included in the combined rule adoption, were previously contained in a separate draft proposal that was the work product of the workgroup and Department staff. The separate supervision draft proposed rules were presented to and discussed by the Speech-Language Pathologists and Audiologists Advisory Board (Advisory Board) at its meeting on November 15, 2017. The advisory board members offered comments and suggested changes to several sections. The separate supervision draft proposed rules and the Advisory Board’s suggested changes were incorporated into the combined rule package.

SECTION-BY-SECTION SUMMARY

The adopted rules amend §111.2, Definitions. The adopted rules add new definitions for the following terms: Direct supervision related to Assistants (Speech-Language Pathology and Audiology); Direct supervision related to Interns (Speech-Language Pathology); In-person; Indirect supervision related to Assistants (Speech-Language Pathology and Audiology); Indirect supervision related to Interns (Speech-Language Pathology); Intern Plan and Agreement of Supervision Form (for Interns in Speech-Language Pathology and Audiology); and Supervisory Responsibility Statement (SRS) Form (for Assistants in Audiology or Speech-Language Pathology).  The adopted rules amend the following definitions: Assistant in audiology; Assistant in speech-language pathology; Intern in audiology; Intern in speech-language pathology; and Supervisor. The adopted rules repeal the following definition: Under the direction of. These changes are part of the supervision changes.

The adopted rules amend §111.10. Membership. The adopted rules removed former subsection (b)(1), which required an advisory board member to have been a resident of Texas for the two years preceding the date of appointment. This change is a result of H.B. 4007. 

The adopted rules amend §111.21, License Examination--Written Examination. The adopted rules repealed subsections (c) and (d), regarding reexamination. These subsections implemented Texas Occupations Code §401.307, which was repealed by H.B. 4007.

The adopted rules amend §111.22, Waiver of Written Examination Requirements. The adopted rules eliminated a sentence under subsection (a) that was unnecessary and that conflicted with §111.23 as amended. This change is part of the licensing and other clean-up change. 

The adopted rules amend §111.23, License Examination--Jurisprudence Examination. The adopted change aligns the rules with the former DSHS practice that continued with the transfer of the program to the Department effective October 3, 2016. The adopted rules require an applicant to show proof of successful completion of the jurisprudence examination at the time of application, unless applying for an upgrade. The new upgrade provisions are added to §111.35 and §111.75. The adopted rules change the timeline for completion of the jurisprudence examination from no more than 6 months to no more than 12 months prior to the date of licensure application.  These changes are part of the licensing and other clean-up changes. 

The adopted rules amend §111.30, Speech-Language Pathology License--Licensing Requirements. The adopted rules amend subsection (b) by eliminating outdated provisions and by adding and expanding an existing provision found under §111.35(d)(2) regarding applicants who have transcripts in a language other than English or earned degrees at a foreign university. The adopted rules update the terminology under subsection (d) by replacing references to “supervised professional experience” with “internship” for consistency in terminology across rule sections.  The adopted rules eliminate the 10-year requirement for exams under subsections (e) and (f). These changes are part of the licensing and other clean-up changes. 

The adopted rules amend §111.35, Speech-Language Pathology License--Application and Eligibility Requirements. The adopted rules amend subsection (b) by adding clarifying language regarding submitting transcripts and by relocating and expanding an existing provision found under subsection (d)(2) regarding applicants who have transcripts in a language other than English or earned degrees at a foreign university. The adopted rules also eliminate unnecessary provisions from subsection (b) by removing the submission of the Course Work and Clinical Experience Form and removing the submission of the supervisor’s diploma or transcript if the internship was completed out-of-state.  The adopted rules add clarifying language under subsection (c) regarding the submission of fingerprints. The adopted rules update and clarify the provisions under subsection (d) regarding the waiver of clinical experience and examination requirements. The adopted rules add a new subsection (e) regarding the upgrade from a Texas intern license to a full license, which aligns the rules with the former DSHS practice that continued with the transfer of the program to the Department effective October 3, 2016. These changes are part of the licensing and other clean-up changes. 

The adopted rules amend §111.37, Speech-Language Pathology License--License Terms; Renewals. The adopted rules remove former subsection (c)(2) and add subsection (d) to clarify that a licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.  This change is part of the licensing and other clean-up changes. 

The adopted rules amend §111.40, Intern in Speech-Language Pathology License--Licensing Requirements--Education and Clinical Work. The adopted rules amend subsection (b) by eliminating outdated provisions and by adding a provision regarding applicants who have transcripts in a language other than English or earned degrees at a foreign university. The adopted rules amend subsection (d) by providing examples of ways an applicant may show “proof of current knowledge” if the course work and clinical experience was earned more than 10 years before the date of application. The adopted rules update terminology under subsection (e). The adopted rules relocate the requirements regarding internships, supervision, and practice and duties found in §111.40 to new rule sections. The adopted rules repeal former subsections (g) through (q) and relocate most of those provisions to new §111.41 and §111.42.  The purpose is to make the rules more user-friendly by reorganizing the rules into smaller, more distinct rule sections. The changes to subsections (b), (d), and (e) are part of the licensing and other clean-up changes. The repeal and relocation of the provisions under former subsections (g) through (q) are part of the supervision changes.

The adopted rules add new §111.41, Intern in Speech-Language Pathology License--Internship and Supervision Requirements. The adopted rules relocate provisions found in former rules §111.40(g), (h), (i), (k), (l), and (q) to new §111.41. This new rule section sets out the internship and supervision requirements for interns in speech-language pathology. New §111.41(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words intern and supervisor. The provisions under new §111.41(d) and (g)(4) include licensing and other clean-up changes. The entire section includes supervision changes.

The adopted rules add new §111.42, Intern in Speech-Language Pathology License--Practice and Duties of Interns.  The adopted rules relocate provisions found in former rules §111.40(m), (n), (o), and (p) to new §111.42. This new rule section sets out the practice and duties requirements for interns in speech-language pathology. New §111.42(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words intern and supervisor. The provisions under new §111.42(e) include licensing and other clean-up changes. The entire section includes supervision changes. 

The adopted rules amend §111.45, Intern in Speech-Language Pathology License--Application and Eligibility Requirements. The adopted rules amend subsection (b) by clarifying the documents to be submitted if the degree has been conferred or has not been conferred; adding a provision regarding applicants who have transcripts in a language other than English or earned degrees at a foreign university; and making technical clean-up changes. The adopted rules also eliminate the requirement under subsection (b) that all applicants must submit the Clinical Work and Clinical Experience Form, and clarify that this form is only submitted if the degree has not been conferred yet. The adopted rules add clarifying language under subsection (c) regarding the submission of fingerprints. These changes are part of the licensing and other clean-up changes. 

The adopted rules amend §111.47, Intern in Speech-Language Pathology License--License Terms; Renewals. The adopted rules remove former subsection (c)(2) and add subsection (d) to clarify that a licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.  The adopted rules also remove former subsection (c)(5) that required a licensed intern in speech-language pathology to submit an evaluation of the intern’s progress or performance and any intern plans and supervisory evaluations to the Department as part of the license renewal process. These changes are part of the licensing and other clean-up changes. 

The adopted rules amend §111.50, Assistant in Speech-Language Pathology License--Licensing Requirements--Education and Clinical Observation and Experience. The adopted rules add clarifying language under subsection (a).  The adopted rules amend subsection (b) by providing examples of ways an applicant may show “proof of current knowledge” if the course work and clinical experience was earned more than 10 years before the date of application. The adopted rules add a proof of current knowledge requirement to subsection (c). The adopted rules amend subsection (e) by adding clarifying language that all hours worked by the licensed assistant must be completed under in-person, direct supervision of the licensed speech-language pathologist, and by eliminating the requirement that certain documents under subsection (e)(4) be submitted to the Department.

The adopted rules relocate the requirements regarding supervision and practice and duties found in §111.50 to new rule sections. The adopted rules repeal former subsections (f) through (n) and relocate most of those provisions to new §111.51 and new §111.52. The purpose is to make the rules more user-friendly by reorganizing the rules into smaller, more distinct rule sections. The changes to subsections (a), (b), (c), and (e) are part of the licensing and other clean-up changes. The repeal and relocation of the provisions under former subsections (f) through (n) are part of the supervision changes.

The adopted rules add new §111.51, Assistant in Speech-Language Pathology License--Supervision Requirements. The adopted rules relocate provisions found in former rules §111.50(f), (g), (h)(1)-(3), (j), (m), and (n) to new §111.51. This new rule section sets out the supervision requirements for assistants in speech-language pathology. New §111.51(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words assistant and supervisor. The adopted rules add new §111.51(e) regarding the supervisor only providing direct supervision at the worksite in which the assistant provides services to existing clients or while the assistant provides services to cases previously delegated to the assistant. The adopted rules update the requirements under §111.51(g) by restructuring the subsection, adding clarifying language, and addressing situations in which fewer than four weeks are worked in a calendar month. The entire section includes supervision changes.

The adopted rules add new §111.52, Assistant in Speech-Language Pathology License--Practice and Duties of Assistants. The adopted rules relocate provisions found in former rules §111.50(h)(4)-(5), (i), (k), and (l) to new §111.52. This new rule section sets out the practice and duties requirements for assistants in speech-language pathology. New §111.52(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words assistant and supervisor. The provisions under new §111.52 include licensing and other clean-up changes by changing references from “Individual Education Plan” to “Individual Education Program.” The entire section includes supervision changes. 

The adopted rules amend §111.55, Assistant in Speech-Language Pathology License--Application and Eligibility Requirements. The adopted rules eliminated language in subsection (b)(2) that is now part of the definition of Supervisory Responsibility Statement Form and the requirements under §111.51. The adopted rules clarify and correct the language under subsection (b)(3). These changes are part of the licensing and other clean-up changes.

The adopted rules amend §111.57, Assistant in Speech-Language Pathology License--License Terms; Renewals. The adopted rules remove former subsection (c)(2) and add subsection (d) to clarify that a licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints. The adopted rules also make clean-up changes to renumbered subsection (c)(4). These changes are part of the licensing and other clean-up changes.

The adopted rules repeal Subchapter G, Requirements for Temporary Certificate of Registration in Speech-Language Pathology. The adopted repeal is due to H.B. 4007, which repealed the temporary certificate of registration in speech-language pathology.

The adopted rules repeal §111.60, Temporary Certificate of Registration in Speech-Language Pathology--Registration Requirements. The adopted repeal is due to H.B. 4007, which repealed the temporary certificate of registration in speech-language pathology.

The adopted rules repeal §111.65, Temporary Certificate of Registration in Speech-Language Pathology--Application and Eligibility Requirements. The adopted repeal is due to H.B. 4007, which repealed the temporary certificate of registration in speech-language pathology.

The adopted rules repeal §111.66, Temporary Certificate of Registration in Speech-Language Pathology--Issuing Registration. The adopted repeal is due to H.B. 4007, which repealed the temporary certificate of registration in speech-language pathology.

The adopted rules amend §111.70, Audiology License--License Requirements. The adopted rules add a new subsection (c) regarding applicants who have transcripts in a language other than English or earned degrees at a foreign university. The adopted rules also eliminated the 10-year requirement for exams under re-lettered subsection (e). The adopted rules make a technical clean-up change under re-lettered subsection (f). These changes are part of the licensing and other clean-up changes. 

The adopted rules amend §111.75, Audiology License--Application and Eligibility Requirements. The adopted rules amend subsection (b) by adding clarifying language regarding submitting transcripts; updating a reference to the ASHA Council for Clinical Certification; and relocating and expanding an existing provision under subsection (d)(2) regarding applicants who have transcripts in a language other than English or earned degrees at a foreign university. The adopted rules also eliminate unnecessary provisions from subsection (b) by removing the submission of the Course Work and Clinical Experience Form and removing the submission of the supervisor’s diploma or transcript if the internship was completed out-of-state. The adopted rules add clarifying language under subsection (c) regarding the submission of fingerprints. The adopted rules update and clarify the provisions under subsection (d) regarding the waiver of clinical experience and examination requirements. The adopted rules add a new subsection (e) regarding the upgrade from a Texas intern license to a full license, which aligns the rules with the former DSHS practice that continued with the transfer of the program to the Department effective October 3, 2016. These changes are part of the licensing and other clean-up changes. 

The adopted rules amend §111.77, Audiology License--License Terms; Renewals. The adopted rules remove former subsection (c)(2) and add subsection (d) to clarify that a licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.  This change is part of the licensing and other clean-up changes. 

The adopted rules amend §111.80, Intern in Audiology License--Licensing Requirements--Education.  The adopted rules make a technical clean-up change to subsection (b). The adopted rules relocate the requirements regarding internships, supervision, and practice and duties formerly found in §111.80 to new rule sections. The adopted rules repeal former subsections (e) through (i) and relocate most of those provisions to new §111.81 and new §111.82. The purpose is to make the rules more user-friendly by reorganizing the rules into smaller, more distinct rule sections. The change to subsection (b) is part of the licensing and other clean-up changes. The repeal and relocation of the provisions under former subsections (e) through (i) are part of the supervision changes.

The adopted rules add new §111.81, Intern in Audiology License--Internship and Supervision Requirements. The adopted rules relocate provisions found in former rules §111.80(e), (f), (g)(1)-(3), and (i) to new §111.81. This new rule section sets out the internship and supervision requirements for interns in audiology. New §111.81(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words intern and supervisor. The provisions under new §111.81(e) include licensing and other clean-up changes.  The entire section includes supervision changes.

The adopted rules add new §111.82, Intern in Audiology License--Practice and Duties of Interns.  The adopted rules relocate provisions found in former rules §111.80(g)(4) and (h) to new §111.82. This new rule section sets out the practice and duties requirements for interns in audiology. New §111.82(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words intern and supervisor. The entire section includes supervision changes.

The adopted rules amend §111.85, Intern in Audiology License--Application and Eligibility Requirements. The adopted rules amend subsection (b) by removing the requirement to submit transcripts and by making technical changes. The adopted rules add clarifying language under subsection (c) regarding the submission of fingerprints. These changes are part of the licensing and other clean-up changes. 

The adopted rules amend §111.87, Intern in Audiology License--License Terms; Renewals. The adopted rules remove former subsection (c)(2) and add subsection (d) to clarify that a licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.  The adopted rules also remove former subsection (c)(3) that requires a licensed intern in audiology to submit an evaluation of the intern’s progress or performance and any intern plans and supervisory evaluations to the Department as part of the license renewal process. These changes are part of the licensing and other clean-up changes. 

The adopted rules amend §111.90, Assistant in Audiology License--Licensing Requirements--Education and Training. The adopted rules amend subsection (b) by adding a new subsection (b)(3) to provide that if the applicant holds a bachelor’s degree or higher in communicative sciences or disorders, the applicant does not need to complete the Council of Accreditation of Occupational Hearing Conservation (CAOHC) certification course and examination. The adopted rules eliminate language in former subsection (b)(4)(A) that is now part of the definition of Supervisory Responsibility Statement Form and the requirements under §111.91. The adopted rules relocate the provisions from former subsection (b)(4)(B) to new subsection (b)(5) and add “in-person” direct supervision by the supervisor. The adopted rules amend subsection (c) by adding a cross-reference to the job-specific competency-based training under subsection (b)(5).

The adopted rules relocate the requirements regarding supervision and practice and duties formerly found in §111.90 to new rule sections. The adopted rules repeal former subsections (d) through (j) and relocate most of those provisions to new §111.91 and new §111.92. The purpose is to make the rules more user-friendly by reorganizing the rules into smaller, more distinct rule sections.  The changes to subsections (b) and (c) are part of the supervision changes and the licensing and other clean-up changes.  The repeal and relocation of the provisions under former subsections (d) through (j) are part of the supervision changes.

The adopted rules add new §111.91, Assistant in Audiology License--Supervision Requirements. The adopted rules relocate provisions found in former rules §111.90(d), (e), (f)(1)-(2), (i), and (j) to new §111.91. This new rule section sets out the supervision requirements for assistants in audiology.  New §111.91(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words assistant and supervisor. The adopted rules update the requirements under §111.91(f) by restructuring the subsection, adding clarifying language, and addressing situations in which fewer than four weeks are worked in a calendar month. The entire section includes supervision changes.

The adopted rules add new §111.92, Assistant in Audiology License--Practice and Duties of Assistants. The adopted rules relocate provisions found in former rules §111.90(f)(3)-(5), (g), and (h) to new §111.92.  This new rule section sets out the practice and duties requirements for assistants in audiology. New §111.92(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words assistant and supervisor. The entire section includes supervision changes. 

The adopted rules amend §111.95, Assistant in Audiology License--Application and Eligibility Requirements. The adopted rules eliminated language in subsection (b)(2) that is now part of the definition of Supervisory Responsibility Statement Form and the requirements under §111.91.  The adopted rules add a new subsection (b)(6) to provide that if the applicant holds a bachelor’s degree or higher in communicative sciences or disorders, the applicant shall submit proof of the degree instead of the Council of Accreditation of Occupational Hearing Conservation (CAOHC) certificate. These changes are part of the licensing and other clean-up changes. 

The adopted rules amend §111.97, Audiology Assistant License--License Terms; Renewals. The adopted rules remove former subsection (c)(2) and add subsection (d) to clarify that a licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints. The adopted rules also make clean-up changes to renumbered subsection (c)(4). These changes are part of the licensing and other clean-up changes.

The adopted rules repeal Subchapter K, Requirements for Audiology Temporary Certificate of Registration. The adopted repeal is due to H.B. 4007, which repealed the temporary certificate of registration in audiology.

The adopted rules repeal §111.100, Temporary Certificate of Registration in Audiology--Registration Requirements. The adopted repeal is due to H.B. 4007, which repealed the temporary certificate of registration in audiology.

The adopted rules repeal §111.105, Audiology Temporary Certificate of Registration--Application and Eligibility Requirements. The adopted repeal is due to H.B. 4007, which repealed the temporary certificate of registration in audiology.

The adopted rules repeal §111.106, Temporary Certificate of Registration in Audiology--Issuing Registration. The adopted repeal is due to H.B. 4007, which repealed the temporary certificate of registration in audiology.

The adopted rules amend §111.115, Dual License in Speech-Language Pathology and Audiology--Application and Eligibility Requirements. The adopted rules clarify that an applicant must submit fingerprints if not previously submitted when applying for a full license, assistant license, or intern license. This change is part of the licensing and other clean-up changes. 

The adopted rules amend §111.117, Dual License in Speech-Language Pathology and Audiology--License Terms; Renewals. The adopted rules remove former subsection (c)(2) and add subsection (d) to clarify that a licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.  This change is part of the licensing and other clean-up changes. 

The adopted rules amend §111.140, Rules.    The adopted rules remove placeholder language and insert a specific rule citation to 16 TAC Chapter 100, Health Related Program Administrative Rules. This change is part of the licensing and other clean-up changes.

The adopted rules amend §111.151, Consumer Information and Display of License. The adopted rules remove former subsection (c) regarding the display of a temporary certificate of registration. This change is due to H.B. 4007, which repealed the temporary certificate of registrations in speech-language pathology and audiology.

The adopted rules amend §111.154, Requirements, Duties, and Responsibilities of Supervisors and Persons Being Supervised. The adopted rules revise the supervision limits under re-lettered subsection (f)(4).  The adopted rules return the supervision limits to the former limits when the program was regulated by DSHS. The adopted rules would allow a supervisor to supervise no more than a total of four (4) audiology interns and/or assistants, regardless of the type of degree held by an assistant.  In addition, the proposed rules: (1) add clarifying language to subsections (b) and (c); (2) add a new subsection (d) regarding the supervision of speech-language pathology assistants; (3) add language regarding the supervision of audiology assistants, add clarifying language, and remove unnecessary language under re-lettered subsection (e); and (4) make technical changes in re-lettered subsections (f), (g), and (h). These changes are part of the supervision changes.

The adopted rules amend §111.160, Fees.  The adopted rules amend subsection (b) and re-lettered subsection (e) to include upgrades from an intern license to a full license. This change is part of the licensing and other clean-up changes. In addition, the adopted rules repeal former subsections (e) and (i), regarding fees for temporary certificates of registration. This change is due to H.B. 4007, which repealed temporary certificates of registration.

The adopted rules amend §111.171, Complaints Regarding Standard of Care.  The adopted rules removed placeholder language and insert a specific rule citation to 16 TAC Chapter 100, Health Related Program Administrative Rules. This change is part of the licensing and other clean-up changes. 

The adopted rules amend §111.180, Administrative Penalties and Sanctions. The adopted rules make technical changes that reflect changes made by H.B. 4007. The bill repealed the program-specific administrative penalties section in Occupations Code Chapter 401, since it was redundant with the administrative penalties section in Occupations Code Chapter 51, which applies to all the Department’s programs. In addition, the adopted rules make a technical clean-up change. This change is part of the licensing and other clean-up changes.

The adopted rules amend §111.200, Registration of Audiologists and Interns in Audiology to Fit and Dispense Hearing Instruments. The adopted rules removed the former reference to the temporary audiology certificate in subsection (b). This change is due to H.B. 4007, which repealed the temporary certificate of registrations in audiology.

The adopted rules amend §111.213, Limitations on the Use of Telecommunications Technology by Speech-Language Pathologists. The adopted rules add provisions regarding supervision of speech-language pathology assistants and interns through the use of telecommunications technology. The adopted rules removed the former provisions that prohibited the use of telecommunications for supervision purposes unless an exception was approved by the Department. These changes are part of the supervision changes.

The adopted rules add new §111.216, Limitations on the Use of Telecommunications Technology by Audiologists. The adopted new §111.216 regarding audiologists is similar to §111.213 regarding speech-language pathologists. The adopted rules add a provision regarding supervision of audiology assistants through the use of telecommunications technology and a prohibition that telehealth services may not be provided by correspondence only. These changes are part of the supervision changes. 

PUBLIC COMMENTS

The Department drafted and distributed the proposed rules to persons internal and external to the agency. The proposed rules were published in the January 26, 2018, issue of the Texas Register (43 TexReg 400). The deadline for public comments was February 26, 2018. During the 30-day public comment period the Department received comments from three interested parties, including two individuals and the Texas Speech-Language-Hearing Association. The two individuals commented on several sections of the proposed rules. The public comments received are summarized below.

Comment-The Department received a comment from an individual who stated that not all of the references to the “Council for Academic Accreditation” in the existing rules should have been changed to the “Council for Clinical Certification” in the proposed rules.

Department Response--The Department appreciates the comment and has made the appropriate corrections.  The reference to “Council for Clinical Certification” in proposed rule §111.75(b)(3) is correct.  The references to “Council for Clinical Certification” in proposed rules §§111.30(b)(6), 111.35(b)(3), 111.40(b)(6), 111.40(f), 111.45(b)(3), and 111.50(b) have been corrected and returned to “Council on Academic Accreditation” as currently referenced in the existing rules. 

Comment--The Department received a comment from an individual regarding rule §111.50(a)(3) and (e), regarding the assisting experience for the speech-language pathology assistant license.  The commenter wanted to know whether the 25 hours of clinical assisting experience must be earned while “enrolled” as a student, and whether universities could offer students a way to get those hours without being “enrolled” in clinic practicum.  The commenter noted that the rules do not specifically state that the hours be earned while the student is “enrolled.” The commenter explained that there is an increasing problem that undergraduates finish their degrees without the assisting hours and employers are reluctant to hire them.  The commenter asked whether universities could offer a “boot camp” type experience to provide those hours and do some training for the job of a speech-language pathology assistant.  Universities may offer the experience in different ways, but however the experience is offered, the universities would provide documentation of the required 25 hours. 

Department Response--The Department has reviewed the statute and the existing and proposed rules at 16 TAC §111.50(a) and (e), regarding the speech-language pathology assistant licensing requirements.  The statute and rules do not require that the clinical assisting experience hours be obtained while the student is “enrolled”.  Specifically, existing and proposed rules §111.50(a) and (e) provide that these hours must be obtained “within” an educational institution or in one of its cooperating programs or obtained “through” an accredited college or university.  The proposed rules under §111.50(a) removed the language that these hours also may be earned “under the direct supervision at their place of employment,” and replaced this language with the statement: “If these hours are not completed, the applicant must complete the Clinical Deficiency Plan under subsection (e).” 

In response to the public comment on §111.50(a) and (e), the Department provides this interpretation that the suggested “boot camp” type of experience as explained in the comment letter or other clinical assisting experiences that are obtained within or through an educational institution or in one of its cooperating programs would meet the current statute and rules and would be allowed.  The person seeking a speech-language pathology assistant license does not need to earn the clinical assisting experience hours while “enrolled” as a student.  The Department did not make any changes to the proposed rules in response to this public comment. 

Comment--The Department received a comment from an individual who wanted to change §111.151, Consumer Information and Display of License, regarding the requirement for a licensee to display the license certificate with a current license card in the primary location of practice.  The commenter stated this requirement is not realistic in today’s healthcare environment where treatment rooms are shared with multiple providers and other specialties and do not allow for personal information with the clinic rooms.  Additionally, within a clinic area there are multiple specialties sharing charting rooms with no place to display individual licenses.

Department Response--The Department appreciates the comment, but as the individual noted in the comment letter, these specific provisions were not open for change in this rulemaking. The proposed rules did not make any changes to §111.151(a) and (b). The proposed rules removed subsection (c) regarding the temporary certificate of registration and re-lettered subsection (d) as (c). The Advisory Board recommended to send this issue to a workgroup for study.  The workgroup study may result in a possible rulemaking in the future. The Department did not make any changes to the proposed rules in response to this public comment.

Comment--The Department received a comment from an individual who pointed out that rule §111.154(f)(4) states that the supervisor shall comply with the following “supervision ratios” but that (f)(4)(A) and (f)(4)(B) provide for a finite number of assistants and/or interns that a supervisor may supervise. The commenter stated that the rule should allow for a true ratio between supervisors and assistants and/or interns. The commenter provided suggested language to amend (f)(4)(A) and (f)(4)(B) to address sole supervision and shared supervision and provided several scenarios to explain the suggested changes.

Department Response--The Department appreciates the comment and for the opportunity to clarify the provision. The Department agrees that the word “ratio” could be confusing in §111.154(f)(4) where it precedes the set number limits in (f)(4)(A) and (f)(4)(B). The current intent and practice of this rule has been a set number limit, not a ratio, regarding supervising assistants and interns.  In addition, the Department staff believe using a ratio system may be difficult to track and may cause confusion. One Advisory Board member responded that the commenter’s work situation may be unique and that assistants and interns may rotate through a series of supervisors over the course of their training. The same Advisory Board member discouraged making changes that would loosen the current requirements or that would create confusion or problems. Another Advisory Board member responded that having a set cap on the number of assistants and interns is important guidance that assists licensed speech-language pathologists to manage workloads, but also ensures that the licensed speech-language pathologists are also providing direct client services not just supervising. The Advisory Board did not recommend that the rule be changed to use ratios instead of the set number caps. The Department has removed the words “supervision ratios” in §111.154(f)(4) so that is does not cause confusion with the set number limits under (f)(4)(A) and (f)(4)(B). These limits apply whether there is a single supervisor or multiple supervisors. 

During the Advisory Board meeting, it was discussed that the proposed changes to the audiology supervision provisions under §111.154(f)(4)(B) and (C) will align the supervision caps for speech-language pathology and for audiology. This change will allow the audiologist supervisors to use the online supervision reporting system, which is currently used by speech-language pathologists and which allows supervisors to update the supervision records in real time. Use of this online reporting system may help address some of the commenter’s concerns in a work environment in which assistants and/or interns may change supervisors on a more frequent basis.   

Comment--The Department received a comment from an individual on §111.91(f) regarding the amount and type of supervision under the audiology assistant license. The commenter stated that the proposed total amount of weekly/monthly supervision is appropriate and should be the same regardless of individual or shared supervision. The commenter stated, whether individual or shared, there should be a record of a total of 10 hours per week (or 40 hours per month) of supervision. The commenter stated that hopefully that this is the intent of the rule, since the section no longer states that in the case of multiple supervisors that each person must provide the minimum amount of supervision. 

Department Response--The Department appreciates the comment and for the opportunity to clarify the provision. The wording and the intent of the provisions under §111.91(f) is that the supervisor must provide 10 hours per week, or 40 hours per month, of supervision, not that the assistant receives this amount of supervision per week/month.  Each supervisor, regardless of individual or multiple supervisors, must provide the required minimum amount of supervision.  In addition, each supervisor must submit a Supervisory Responsibility Statement Form as required under §111.91(c)(2). The commenter stated that this section no longer includes a provision about multiple supervisors; however, this is not a provision that the Department removed when relocating the supervision provisions from §111.90 to §111.91 under the proposed rules. 

The Advisory Board recommended that §111.91(f) be amended to change the word “The” to “Each” at the beginning of the sentence, so that the sentence reads: “Each supervisor must provide a minimum of ten (10) hours per week, or forty (40) hours per calendar month, of supervision to the assistant.” The same provision regarding the amount and type of supervision is located in §111.51(g) for the speech-language pathology assistant license, although the specific amount of supervision per week and per month is different.  The Advisory Board recommended that the same change be made to §111.51(g) to clarify that “each” supervisor must provide the minimum amount of supervision. The Department made the recommended changes to §111.91(f) and §111.51(g), as a result of this public comment. 

Comment--The Department received a comment from the Texas Speech-Language-Hearing Association (TSHA) that states that it supports the other edits and “clean-up” changes to the rules.  This comment was included at the end of the TSHA comment letter, which primarily addressed the proposed telehealth rule (separate rule proposal).

Department Response--The Department appreciates the comment in support of the changes.  The Department did not make any changes to the proposed rules in response to this public comment.

On April 4, 2018, the Department received a late public comment on the proposed rules.  The Commission previously met on March 27, 2018, and adopted the proposed rules with changes as recommended by the Advisory Board.  The Department will not address or respond to this late public comment as part of this rulemaking.

ADVISORY BOARD RECOMMENDATIONS AND COMMISSION ACTION

The Speech-Language Pathologists and Audiologists Advisory Board (Advisory Board) met on January 4, 2018, to discuss the proposed rules. The Advisory Board members offered some clean-up and technical changes on the proposed rules. The Advisory Board recommended publication of the proposed rules with the changes discussed in the Texas Register for public comment.

The Advisory Board met again on March 6, 2018, to review the public comments received on the proposed rule and to make a recommendation to the Commission regarding the proposed rule.  Based on the public comments received, the Advisory Board and the Department made changes to the proposed rules as published. The Advisory Board recommended to the Commission that the proposed rules be adopted with the changes discussed at the Advisory Board meeting to the following sections: §§111.30(b)(6), 111.35(b)(3), 111.40(b)(6), 111.40(f), 111.45(b)(3), 111.50(b), 111.51(g), 111.91(f), and 111.154(f)(4). 

At its meeting held on March 27, 2018, the Commission adopted the proposed rules with changes as recommended by the Advisory Board.

STATUTORY AUTHORITY

The amendments and new rules are adopted under Texas Occupations Code, Chapters 51 and 401, which authorizes the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the adoption are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the adoption.

SUBCHAPTER A. GENERAL PROVISIONS.

§111.2. Definitions.

Unless the context clearly indicates otherwise, the following words and terms shall have the following meanings.

(1) ABA--The American Board of Audiology.

(2) Act--Texas Occupations Code, Chapter 401, relating to Speech-Language Pathologists and Audiologists.

(3) Acts--Texas Occupations Code, Chapter 401, relating to Speech-Language Pathologists and Audiologists; and Texas Occupations Code, Chapter 402, relating to Hearing Instrument Fitters and Dispensers.

(4) Advisory board--The Speech-Language Pathologists and Audiologists Advisory Board.

(5) ASHA--The American Speech-Language-Hearing Association.

(6) Assistant in audiology--An individual licensed under Texas Occupations Code §401.312 and §111.90 of this chapter and who provides audiological support services to clinical programs under the supervision of an audiologist licensed under the Act.

(7) Assistant in speech-language pathology--An individual licensed under Texas Occupations Code §401.312 and §111.60 of this chapter and who provides speech-language pathology support services under the supervision of a speech-language pathologist licensed under the Act.

(8) Audiologist--An individual who holds a license under Texas Occupations Code §401.302 and §401.304 to practice audiology.

(9) Audiology--The application of nonmedical principles, methods, and procedures for measurement, testing, appraisal, prediction, consultation, counseling, habilitation, rehabilitation, or instruction related to disorders of the auditory or vestibular systems for the purpose of providing or offering to provide services modifying communication disorders involving speech, language, or auditory or vestibular function or other aberrant behavior relating to hearing loss.

(10) Caseload--The number of clients served by the licensed speech-language pathologist or licensed speech-language pathology intern.

(11) Client--A consumer or proposed consumer of audiology or speech-language pathology services.

(12) Commission--The Texas Commission of Licensing and Regulation.

(13) Department--The Texas Department of Licensing and Regulation

(14) Direct supervision related to Assistants (Speech-Language Pathology and Audiology)--Real-time observation and guidance by the supervisor while a client contact or clinical activity or service is performed by the assistant. Direct supervision shall be performed in person or via telepractice/telehealth as authorized and prescribed by this chapter.

(15) Direct supervision related to Interns (Speech-Language Pathology)--Real-time observation and guidance by the supervisor while a client contact or clinical activity or service is performed by the intern.  Telepractice/telehealth may not be used for direct supervision of Speech-Language Pathology Interns.

(16) Ear specialist--A licensed physician who specializes in diseases of the ear and is medically trained to identify the symptoms of deafness in the context of the total health of the client, and is qualified by special training to diagnose and treat hearing loss. Such physicians are also known as otolaryngologists, otologists, neurotologists, otorhinolaryngologists, and ear, nose, and throat specialists.

(17) Executive director--The executive director of the department.

(18) Extended absence--More than two consecutive working days for any single continuing education experience.

(19) Extended recheck--Starting at 40 dB and going down by 10 dB until no response is obtained or until 20 dB is reached and then up by 5 dB until a response is obtained. The frequencies to be evaluated are 1,000, 2,000, and 4,000 hertz (Hz).

(20) Fitting and dispensing hearing instruments--The measurement of human hearing by the use of an audiometer or other means to make selections, adaptations, or sales of hearing instruments. The term includes the making of impressions for earmolds to be used as a part of the hearing instruments and any necessary postfitting counseling for the purpose of fitting and dispensing hearing instruments.

(21) Hearing instrument--Any wearable instrument or device designed for, or represented as aiding, improving or correcting defective human hearing. This includes the instrument's parts and any attachment, including an earmold, or accessory to the instrument. The term does not include a battery or cord.

(22) Hearing screening--A test administered with pass/fail results for the purpose of rapidly identifying those persons with possible hearing impairment which has the potential of interfering with communication.

(23) In-person--The supervisor must be physically present, observing the assistant’s or the intern’s client contact or clinical activity or service.  Telepractice/telehealth is not considered in-person.

(24) Indirect supervision related to Assistants (Speech-Language Pathology and Audiology)--The supervisor performs monitoring activities or provides guidance to the assistant, either of which does not occur during actual client contact by the assistant or while the assistant is providing a clinical activity or service. Telepractice/telehealth may be used for indirect supervision as authorized and prescribed under this chapter.

(25) Indirect supervision related to Interns (Speech-Language Pathology)--The supervisor performs monitoring activities or provides guidance to the intern, either of which does not occur during actual client contact by the intern or while the intern is providing a clinical activity or service. Telepractice/telehealth may be used for indirect supervision as authorized and prescribed under this chapter.

(26) Intern in audiology--An individual licensed under Texas Occupations Code §401.311 and §111.80 of this chapter and who is supervised by an individual who holds an audiology license under Texas Occupations Code §401.302 and §401.304.

(27) Intern in speech-language pathology--An individual licensed under Texas Occupations Code §401.311 and §111.40 of this chapter and who is supervised by an individual who holds a speech-language pathology license under Texas Occupations Code §401.302 and §401.304.

(28) Intern Plan and Agreement of Supervision Form (for Interns in Speech-Language Pathology and Audiology)--An agreement between a supervisor and an intern in which the parties enter into a supervisory relationship and the supervisor agrees to assume responsibility for all services provided by the intern.

(29) Provisional Licensee--An individual granted a provisional license under Texas Occupations Code §401.308.

(30) Sale or purchase--Includes the sale, lease or rental of a hearing instrument or augmentative communication device to a member of the consuming public who is a user or prospective user of a hearing instrument or augmentative communication device.

(31) Speech-language pathologist--An individual who holds a license under Texas Occupations Code §401.302 and §401.304, to practice speech-language pathology.

(32) Speech-language pathology--The application of nonmedical principles, methods, and procedures for measurement, testing, evaluation, prediction, counseling, habilitation, rehabilitation, or instruction related to the development and disorders of communication, including speech, voice, language, oral pharyngeal function, or cognitive processes, for the purpose of evaluating, preventing, or modifying or offering to evaluate, prevent, or modify those disorders and conditions in an individual or a group.

(33) Supervisor--An individual who holds a license under Texas Occupations Code §401.302 and §401.304 and whom the department has approved to oversee the services provided by the assigned assistant and/or intern. The term “supervisor” and “department-approved supervisor” have the same meaning as used throughout this chapter.

(34) Supervisory Responsibility Statement (SRS) Form (for Assistants in Audiology or Speech-Language Pathology)--An agreement between a supervisor and an assistant in which the parties enter into a supervisory relationship, the supervisor agrees to assume responsibility for the assistant’s activities, and the assistant agrees to perform only those activities assigned by the supervisor that are not prohibited under this chapter.

(35) Telehealth--See definition(s) in Subchapter V, Telehealth.

SUBCHAPTER B. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS ADVISORY BOARD.

§111.10. Membership. 

(a) The advisory board consists of nine members appointed by the presiding officer of the commission with the approval of the commission as follows:

(1) three audiologist members;

(2) three speech-language pathologist members; and

(3) three members who represent the public.

(b) Advisory board members must:

(1) be from the various geographic regions of the state; and

(2) be from varying employment settings.

(c) The advisory board members appointed under subsections (a)(1) and (2) must:

(1) have been engaged in teaching, research, or providing services in speech-language pathology or audiology for at least five years; and

(2) be licensed under this chapter.

(d) One of the public advisory board members must be a physician licensed in this state and certified in otolaryngology or pediatrics.

SUBCHAPTER C. EXAMINATIONS.

§111.21 License Examination--Written Examination.  

(a) The written examination shall be the Speech-Language Pathology and Audiology Examination (Praxis exam), a national examination administered by the Educational Testing Service.

(b) An applicant shall have a passing score as determined by the Educational Testing Service on the written examination.  

§111.22 Waiver of Written Examination Requirement.

(a) This section is applicable to applicants applying for a speech-language pathology license under Subchapter D or an audiology license under Subchapter H. This waiver only applies to the written examination under §111.21.

(b) The department may waive the written examination requirement and issue a license to an applicant who holds the ASHA Certificate of Clinical Competence ASHA or the ABA Certification.

(c) An applicant for a license issued by the department who currently holds the ASHA Certificate of Clinical Competence, may submit official documentation from ASHA as evidence that the applicant meets the clinical experience and examination requirements as set out in the Act and this chapter for a speech-language pathology license.

(d) An applicant for a license issued by the department who currently holds either the ASHA Certificate of Clinical Competence or the ABA Certification, may submit official documentation from ASHA or ABA as evidence that the applicant meets the clinical experience and examination requirements as set out in the Act and this chapter for an audiology license.

§111.23 License Examination--Jurisprudence Examination.

(a) The department shall develop and administer a Jurisprudence Examination to determine an applicant's knowledge of the Act, this chapter, and any other applicable laws of this state affecting the practice of speech-language pathology or audiology.

(b) The department shall revise the Jurisprudence Examination as needed.

(c) All applicants for licensure shall submit proof of successful completion of the Jurisprudence Examination at the time of application, unless applying for an upgrade. The Jurisprudence Examination must be completed no more than 12 months prior to the date of licensure application.

SUBCHAPTER D. REQUIREMENTS FOR SPEECH-LANGUAGE PATHOLOGY LICENSE.

§111.30 Speech-Language Pathology License--Licensing Requirements.

(a) An individual shall not practice as a speech-language pathologist without a current license issued by the department. An applicant for a speech-language pathology license shall meet the requirements set out in the Act and this section.

(b) Education. The graduate degree shall be completed at a college or university which has a program accredited by a national accrediting organization that is approved by the department and recognized by the United States Secretary of Education under the Higher Education Act of 1965 (20 U.S.C. §1001, et seq.).

(1) Original or certified copies of the transcripts showing the conferred degree shall verify the applicant completed the following:

(A) at least thirty-six (36) semester credit hours shall be in professional course work acceptable toward a graduate degree; and

(B) at least twenty-four (24) semester credit hours acceptable toward a graduate degree shall be earned in the area of speech-language pathology, including normal development and use of speech, language, and hearing; prevention evaluation, habilitation, and rehabilitation of speech, language, and hearing disorders; and related fields that augment the work of clinical practitioners of speech-language pathology.  

(2) A maximum of six (6) academic semester credit hours associated with clinical experience and a maximum of six (6) academic semester credit hours associated with a thesis or dissertation may be counted toward the thirty-six (36) hours but not in lieu of the requirements of paragraph (1)(B).

(3) A quarter hour of academic credit shall be considered as two-thirds of a semester credit hour.

(4) An applicant who possesses a master's degree with a major in audiology and is pursuing a license in speech-language pathology may apply if, the department has an original transcript showing completion of a master's degree with a major in audiology on file and a letter from the program director or designee of the college or university stating that the individual completed enough hours to establish a graduate level major in speech-language pathology and would meet the academic and clinical experience requirements for a license as a speech-language pathologist.

(5) An applicant whose transcript is in a language other than English or whose degree was earned at a foreign university shall submit an original evaluation form from an approved transcript evaluation service. The transcript evaluation service must determine that the applicant’s degree is a master’s degree or higher with a major in one of the areas of communicative sciences or disorders. The applicant shall bear all expenses incurred during the procedure.

(6) An applicant who graduated from a college or university not accredited by the ASHA Council on Academic Accreditation shall submit an original signed letter from ASHA stating the Council for Clinical Certification accepted the course work and clinical experience. The applicant shall bear all expenses incurred during the procedure.

(c) Clinical Work. An applicant shall complete at least twenty-five (25) clock hours of supervised observation before completing the minimum of the following hours of supervised clinical direct client contact, which may be referred to as clinical practicum, with individuals who present a variety of communication disorders within an educational institution or in one of its cooperating programs:

(1) 275 clock hours if the master's degree was earned prior to November 10, 1993; or

(2) 350 clock hours if the master's degree was earned between November 10, 1993 and December 31, 2004; or

(3) 400 clock hours if the master's degree was earned on or after January 1, 2005.

(d) Internship. An applicant must have completed an internship in which clinical work has been accomplished in speech-language pathology as set out in §111.41.

(1) An individual shall be licensed under §111.41, prior to the beginning of the internship.

(2) The supervisor of an individual who completed an internship in another state and met the requirements set out in §111.41 shall:

(A) be licensed in that other state; or

(B) hold the ASHA Certificate of Clinical Competence in speech-language pathology if the other state did not require licensing.

(e) Examination. An applicant shall pass the examination referenced under §111.21.  

§111.35 Speech-Language Pathology License--Application and Eligibility Requirements.

(a) Unless otherwise indicated, an applicant must submit all required information and documentation of credentials on current department-approved forms.

(b) An applicant for a speech-language pathology license must submit the following required documentation:

(1) a completed application on a department-approved form;

(2) if not previously submitted when applying for an intern’s license, an original or certified copy of the transcript(s), which shows all relevant course work and which shows the applicant possesses a minimum of a master’s degree with a major in one of the areas of communicative sciences or disorders;

(3) if the applicant graduated from a college or university with a program not accredited by the ASHA Council on Academic Accreditation, an original signed letter from ASHA stating the Council for Clinical Certification accepted the course work and clinical experience;

(4) if the applicant’s transcript is in a language other than English or the degree was earned at a foreign university, an original evaluation form from an approved transcript evaluation service stating that the applicant’s degree is a master’s degree or higher with a major in one of the areas of communicative sciences or disorders;

(5) a Report of Completed Speech-Language Pathology Internship Form completed by the applicant’s department-approved supervisor and signed by both the applicant and the department-approved supervisor;

(6) if the internship was completed out-of-state, one of the following documents regarding the supervisor must be submitted:

(A) if that state requires licensure, a copy of the supervisor’s valid license to practice in that state; or

(B) if that state does not require licensure, an original letter from ASHA stating the supervisor held the Certificate of Clinical Competence when the applicant completed the internship;

(7) a Praxis Exam Score Report showing the applicant passed the examination described in §111.21;

(8) proof of successfully completing the Texas Jurisprudence Examination under §111.23; and

(9) the initial application fee required under §111.160.

(c) If not previously submitted when applying for an assistant or intern license, an applicant for a speech-language pathology license must submit a completed legible set of fingerprints, on a department-approved form, to the Department of Public Safety for the purpose of obtaining criminal history record information. An applicant must successfully pass a criminal history background check.

(d) Waiver of Clinical Experience and Examination Requirements.  An applicant who currently holds the ASHA Certificate of Clinical Competence may submit official documentation from ASHA of the Certificate of Clinical Competence as evidence that the applicant meets the clinical experience and examination requirements as set out in the Act and this subchapter for a speech-language pathology license. Such an applicant must submit:

(1) an original or certified copy of a signed letter from ASHA, which verifies the applicant currently holds the Certificate of Clinical Competence in the area of speech-language pathology;

(2) an original or certified copy of the transcript(s) showing the conferred degree of all relevant course work which also verifies that the applicant possesses a minimum of a master’s degree with a major in one of the areas of communicative sciences or disorders;

(3) the required documents under subsection (b)(1) and (8) and subsection (c); and

(4) the initial application fee required under §111.160.

(e) Upgrade from Intern License to Full License. An applicant, who holds a current Texas intern in speech-language pathology license, may upgrade to a speech-language pathology license by submitting:

(1) a completed upgrade application on a department-approved form;

(2) the required documents under subsection (b)(2), (5), and (7) and subsection (c); and

(3) the initial application fee required under §111.160.

(f) An applicant must complete all licensing requirements within one year from the date the application was submitted. After that year an applicant will be required to submit a new application and all required materials in addition to paying a new application fee.

§111.37 Speech-Language Pathology License--License Terms; Renewals.

(a) A speech-language pathology license is valid for two years from the date of issuance and may be renewed biennially.

(b) A licensee is responsible for submitting all required documentation and information and paying the renewal application fee prior to the expiration date of the license.

(c) To renew a speech-language pathology license, a licensee must:

(1) submit a completed renewal application on a department-approved form;

(2) complete 20 hours of continuing education as required under §111.130;

(3) comply with the continuing education audit process described under §111.132, if selected for an audit; and

(4) submit the license renewal fee required under §111.160.

(d) A licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.

(e) The department may deny the renewal of the license pursuant to Texas Occupations Code §401.451.

(f) If all conditions required for renewal are met prior to expiration, the department shall issue a renewed license.

(g) A person whose license has expired may late renew the license in accordance with the procedures set out under §60.31 and §60.83 of this title.

(h) A person whose license has expired may not practice or engage in speech-language pathology.

SUBCHAPTER E. REQUIREMENTS FOR INTERN IN SPEECH-LANGUAGE PATHOLOGY LICENSE.

§111.40.  Intern in Speech-Language Pathology License--Licensing Requirements--Education and Clinical Work.  

(a) An individual shall not practice as an intern in speech-language pathology without a current license issued by the department. An applicant for an intern in speech-language pathology license must meet the requirements under the Act and this section.

(b) Education. The graduate degree shall be completed at a college or university which has a program accredited by a national accrediting organization that is approved by the department and recognized by the United States Secretary of Education under the Higher Education Act of 1965 (20 U.S.C. §1001, et seq.).

(1) Original or certified copies of the transcripts showing the conferred degree shall verify the applicant completed the following:

(A) at least thirty-six (36) semester credit hours shall be in professional course work acceptable toward a graduate degree; and

(B) at least twenty-four (24) semester credit hours acceptable toward a graduate degree shall be earned in the area of speech-language pathology including normal development and use of speech, language, and hearing; prevention evaluation, habilitation, and rehabilitation of speech, language, and hearing disorders; and related fields that augment the work of clinical practitioners of speech-language pathology.

(2) A maximum of six academic semester credit hours associated with clinical experience and a maximum of six academic semester credit hours associated with a thesis or dissertation may be counted toward the thirty-six (36) hours but not in lieu of the requirements of paragraph (1)(B).

(3) A quarter hour of academic credit shall be considered as two-thirds of a semester credit hour.

(4) An applicant who possesses a master's degree with a major in audiology and is pursuing a license in speech-language pathology may apply if the department has an original transcript showing completion of a master's degree with a major in audiology on file and a letter from the program director or designee of the college or university stating that the individual completed enough hours to establish a graduate level major in speech-language pathology and would meet the academic and clinical experience requirements for a license as a speech-language pathologist.

(5) An applicant whose transcript is in a language other than English or whose degree was earned at a foreign university shall submit an original evaluation form from an approved transcript evaluation service.  The transcript evaluation service must determine that the applicant’s degree is a master’s degree or higher with a major in one of the areas of communicative sciences or disorders. The applicant shall bear all expenses incurred during the procedure.

(6) An applicant who graduated from a college or university not accredited by the ASHA Council on Academic Accreditation shall submit an original signed letter from ASHA stating the Council for Clinical Certification accepted the course work and clinical experience. The applicant shall bear all expenses incurred during the procedure.

(c) Clinical Work. An applicant shall complete at least twenty-five (25) clock hours of supervised observation before completing the minimum of the following hours of supervised clinical direct client contact, which may be referred to as clinical practicum, with individuals who present a variety of communication disorders within an educational institution or in one of its cooperating programs:

(1) 275 clock hours if the master's degree was earned prior to November 10, 1993; or

(2) 350 clock hours if the master's degree was earned between November 10, 1993 and December 31, 2004; or

(3) 400 clock hours if the master's degree was earned on or after January 1, 2005.

(d) In the event the course work and clinical experience set out in subsections (b) - (c), were earned more than ten (10) years before the date of application for the intern license, the applicant shall submit proof of current knowledge of the practice of speech-language pathology. Proof of current knowledge may include: recently completing continuing education or other courses; holding a current license in another state; holding a current ASHA certification; or retaking and passing the written examination.  

(e) An applicant who successfully completed all education and clinical requirements under this section, but who has not had the degree officially conferred may be licensed as an intern in order to begin the internship but shall submit verification from the program director or designee verifying the applicant has met all academic course work, clinical experience requirements, and completed a thesis or passed a comprehensive examination, if required, and is awaiting the date of next graduation for the degree to be conferred.

(f) An applicant whose master’s degree is received at a college or university accredited by the ASHA Council on Academic Accreditation will receive automatic approval of the course work and clinical experience if the program director or designee verifies that all requirements have been met and review of the transcript shows that the applicant has successfully completed at least twenty-four (24) semester credit hours acceptable toward a graduate degree in the area of speech-language pathology.

§111.41.  Intern in Speech-Language Pathology License--Internship and Supervision Requirements. 

(a) A licensed intern in speech-language pathology (intern) must be supervised by a licensed speech-language pathologist who has been approved by the department to serve as the intern’s supervisor (supervisor).

(b) A supervisor must agree to assume responsibility for all services provided by the intern. The supervisor must comply with the requirements set out in the Act and §111.154. 

(c) Intern Plan and Agreement of Supervision Form.  A Speech-Language Pathology Intern Plan and Agreement of Supervision Form shall be submitted in a manner prescribed by the department and completed by both the applicant and the proposed supervisor.  The proposed supervisor must meet the requirements set out in the Act and §111.154. 

(1) Approval from the department shall be required prior to practice by the intern. The Speech-Language Pathology Intern Plan and Agreement of Supervision Form shall be submitted upon:

(A) application for an intern license;

(B) any changes in supervision; and

(C) the addition of other supervisors.

(2) If more than one speech-language pathologist agrees to supervise the intern, each proposed supervisor must submit a Speech-Language Pathology Intern Plan and Agreement of Supervision Form.

(3) The intern may not practice without an approved Speech-Language Pathology Intern Plan and Agreement of Supervision Form.  The supervisor may not allow an intern to practice before a Speech-Language Pathology Intern Plan and Agreement of Supervision Form is approved.

(4) If the supervisor ceases supervision of the intern, the supervisor shall notify the department, in a manner prescribed by the department, and shall inform the intern to stop practicing immediately.  The supervisor is responsible for the practice of the intern until notification has been received by the department.

(5) If the intern’s supervisor ceases supervision, the intern shall stop practicing immediately.  The intern may not practice until a new Speech-Language Pathology Intern Plan and Agreement of Supervision Form has been submitted to and approved by the department.

(d) Internship Requirements. The internship shall:

(1) be completed within a maximum period of forty-eight (48) months once initiated;

(2) be successfully completed after no more than two attempts;

(3) consist of thirty-six (36) weeks of full-time supervised professional experience (thirty-five (35) hours per week) totaling a minimum of 1,260 hours, or its part-time equivalent, of supervised professional experience in which clinical work has been accomplished in speech-language pathology.  Professional experience of less than five hours per week cannot be used to meet the minimum 1,260 hours, but the professional experience still must be supervised by a licensed speech-language pathologist.

(4) involve primarily clinical activities such as assessment, diagnosis, evaluation, screening, treatment, report writing, family/client consultation, and/or counseling related to the management process of individuals who exhibit communication disabilities;

(5) be divided into three (3) segments with no fewer than thirty-six (36) clock hours of supervisory activities to include: 

(A) six (6) hours of in-person direct supervision per segment by the supervisor(s) of the intern's direct client contact at the worksite in which the intern provides screening, evaluation, assessment, habilitation, and rehabilitation; and

(B) 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, evaluations by professional colleagues; or

(C) an alternative plan as approved by the department.

(e) Extension Request. An applicant who does not meet the time frames defined in subsection (d)(1), shall request an extension, in writing, explaining the reason for the request. The request must be signed by both the intern and the supervisor in a manner prescribed by the department. Evaluation of the intern's progress of performance from all supervisors must accompany the request. Intern plans and supervisory evaluations for any completed segments must be submitted in a manner prescribed by the department. The department shall determine if the internship:

(1) should be revised or extended; and

(2) whether additional course work, continuing professional education hours, or passing the examination referenced in §111.21 is required. 

(f) Evaluations. During each segment of the internship, each supervisor shall conduct a formal evaluation of the intern's progress in the development of professional skills. Documentation of this evaluation shall be maintained by both parties for three years or until the speech-language pathology license is granted. A copy of this documentation shall be submitted to the department upon request.

(g) Changes in Internship.  Prior to implementing changes in the internship, approval from the department is required. 

(1) If the intern changes his or her supervisor or adds additional supervisors, a current Speech-Language Pathology Intern Plan and Agreement of Supervision Form shall be submitted by the new proposed supervisor and approved by the department before the intern may resume practice as prescribed under subsection (c). 

(2) If the intern changes his or her supervisor, the Speech-Language Pathology Report of Completed Internship Form shall be completed by the former supervisor and the intern and submitted to the department upon completion of that portion of the internship.  It is the decision of the former supervisor to determine whether the internship is acceptable. The department shall review the form and inform the intern of the results.

(3) Each supervisor who ceases supervising an intern shall submit a Speech-Language Pathology Report of Completed Internship Form for the portion of the internship completed under the supervisor's supervision. This must be submitted within thirty (30) days of the date the supervision ended.

(4) If no hours were earned under an approved supervisor, the licensed intern or the approved supervisor must submit a signed, written statement that no hours were earned and provide the reason.  

(5) If the intern changes his or her employer but the supervisor and the number of hours employed per week remain the same, the supervisor shall notify the department in a manner prescribed by the department of the new location. This must be submitted within thirty (30) days of the date the change occurred. 

(h) Notwithstanding the supervision provisions in this section, the department may establish procedures, processes, and mechanisms for the monitoring and reporting of the supervision requirements. 

§111.42.  Intern in Speech-Language Pathology License--Practice and Duties of Interns. 

(a) A licensed intern in speech-language pathology (intern) must perform assigned duties under the supervision of a licensed speech-language pathologist who has been approved by the department to serve as the intern’s supervisor (supervisor).  

(b) In any professional context the intern must indicate the intern’s status as a licensed speech-language pathology intern. 

(c) An intern shall not use "SLP-CFY" or "SLP-CF" as indicators for their credentials. Licensees shall use "Intern SLP" or "SLP Intern" to shorten their professional title. 

(d) If the intern wishes to continue to practice after the completion of the internship specified in §111.41(d), the intern shall apply for a speech-language pathology license under Subchapter D, if the intern passed the examination referenced in §111.21.

(e) The intern may continue to practice while awaiting the processing of the speech-language pathology license if the intern meets the following conditions:

(1) holds a valid intern in speech-language pathology license;

(2) practices under the supervision of the current supervisor, who filed the Speech-Language Pathology Intern Plan and Agreement of Supervision Form and the Speech-Language Pathology Report of Completed Internship Form; and

(3) practices under the terms of the current Speech-Language Pathology Intern Plan and Agreement of Supervision Form. 

§111.45. Intern in Speech-Language Pathology License--Application and Eligibility Requirements.

(a) Unless otherwise indicated, an applicant must submit all required information and documentation of credentials on department-approved forms. 

(b) An applicant for an intern in speech-language pathology license must submit the following required documentation:

(1) a completed application on a department-approved form;

(2) if the graduate degree has been conferred, an original or certified copy of the transcript(s), which shows all relevant course work and which shows the applicant possesses a minimum of a master’s degree with a major in one of the areas of communicative sciences or disorders;

(3) if the applicant graduated from a college or university with a program not accredited by the ASHA Council on Academic Accreditation, an original signed letter from ASHA stating the Council for Clinical Certification accepted the course work and clinical experience;

(4) if the graduate degree has not been conferred, the Course Work and Clinical Experience Form completed by the university program director or designee of the college or university attended;

(5) if the applicant’s transcript is in a language other than English or the degree was earned at a foreign university, an original evaluation form from an approved transcript evaluation service stating that the applicant’s degree is a master’s degree or higher with a major in one of the areas of communicative sciences or disorders; 

(6) an Intern Plan and Agreement of Supervision Form completed by the proposed supervisor and signed by both the applicant and the proposed supervisor;

(7) proof of successfully completing the Texas Jurisprudence Examination under §111.23; and

(8) the initial application fee required under §111.160.

(c) If not previously submitted when applying for an assistant license, an applicant for an intern in speech-language pathology license must submit a completed legible set of fingerprints, on a form prescribed by the department, to the Department of Public Safety for the purpose of obtaining criminal history record information. An applicant must successfully pass a criminal history background check.

(d) An applicant must complete all licensing requirements within one year from the date the application was submitted. After that year an applicant will be required to submit a new application and all required materials in addition to paying a new application fee.

§111.47.  Intern in Speech-Language Pathology License--License Terms; Renewals.

(a) An intern in speech-language pathology license is valid for one year from the date of issuance and may be renewed annually.

(b) A licensee is responsible for submitting all required documentation and information and paying the renewal application fee prior to the expiration date of the license.

(c) To renew an intern in speech-language pathology license, a licensee must:

(1) submit a completed renewal application on a department-approved form;

(2) complete ten (10) hours of continuing education as required under §111.130;

(3) comply with the continuing education audit process described under §111.132, if selected for an audit;

(4) submit an Intern Plan and Agreement of Supervision Form for the intern's upcoming experience unless the intern is currently not practicing. In that event, the intern shall provide an explanation of the reason for not practicing; and

(5) submit the license renewal fee required under §111.160.

(d) A licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.

(e) The department may deny the renewal of the license pursuant to Texas Occupations Code §401.451.

(f) If all conditions required for renewal are met prior to expiration, the department shall issue a renewed license.

(g) A person whose license has expired may late renew the license in accordance with the procedures set out under §60.31 and §60.83 of this title.

(h) A person whose license has expired may not practice or engage in speech-language pathology.

SUBCHAPTER F. REQUIREMENTS FOR ASSISTANT IN SPEECH-LANGUAGE PATHOLOGY LICENSE.

§111.50.  Assistant in Speech-Language Pathology License—Licensing Requirements--Education and Clinical Observation and Experience.

(a) An individual shall not practice as an assistant in speech-language pathology without a current license issued by the department. An applicant for an assistant in speech-language pathology license must meet the requirement under the Act and this section. The applicant must meet the following requirements:

(1) possess a baccalaureate degree with an emphasis in communicative sciences or disorders;

(2) have acquired at least twenty-four (24) semester credit hours in speech-language pathology and/or audiology with a grade of "C" or above with the following conditions:

(A) at least 18 of the 24 semester credit hours must be in speech-language pathology;

(B) at least three (3) of the 24 semester credit hours must be in language disorders;

(C) at least three (3) of the 24 semester credit hours must be in speech disorders; 

(D) the 24 semester credit hours excludes course work such as special education, deaf education, or sign language; and

(E) the 24 semester credit hours must be academic course work and excludes any clinical experience; and

(3) have earned no fewer than twenty-five (25) hours of clinical observation in the area of speech-language pathology and twenty-five (25) hours of clinical assisting experience in the area of speech-language pathology obtained within an educational institution or in one of its cooperating programs. If these hours are not completed, the applicant must complete the Clinical Deficiency Plan under subsection (e).

(b) The baccalaureate degree shall be completed at a college or university which has a program accredited by the ASHA Council on Academic Accreditation or holds accreditation or candidacy status from a recognized regional accrediting agency.

(1) Original or certified copy of the transcripts showing the conferred degree shall be submitted and reviewed as follows:

(A) only course work earned within the past ten (10) years with a grade of "C" or above is acceptable;

(B) a quarter hour of academic credit shall be considered as two-thirds of a semester credit hour; and

(C) academic courses, the titles of which are not self-explanatory, shall be substantiated through course descriptions in official school catalogs or bulletins or by other official means.

(2) In the event the course work and clinical experience set out in subsection (a), were earned more than ten (10) years before the date of application for the assistant license, the applicant shall submit proof of current knowledge of the practice of speech-language pathology to be evaluated by the department.  Proof of current knowledge may include: recently completing continuing education or other courses; or holding a current license in another state.

(c) An applicant who possesses a baccalaureate degree with a major that is not in communicative sciences or disorders may qualify for the assistant license. The department shall evaluate transcripts on a case-by-case basis to ensure equivalent academic preparation, and shall determine if the applicant satisfactorily completed twenty-four (24) semester credit hours in communicative sciences or disorders and meets the requirements of 111.50(b)(2), which may include some leveling hours.

(d) Degrees and/or course work received at foreign universities shall be acceptable only if such course work and clinical practicum hours may be verified as meeting the requirements of subsection (a). The applicant must bear all expenses incurred during the procedure. The department shall evaluate the documentation, which shall include an original transcript and an original report from a credential evaluation services agency acceptable to the department.

(e) An applicant who has not acquired the twenty-five (25) hours of clinical observation and twenty-five (25) hours of clinical experience referenced in subsection (a)(3), shall not meet the minimum qualifications for the assistant license. These hours must be obtained through an accredited college or university, or through a Clinical Deficiency Plan. All hours must be completed under in-person, direct supervision.  In order to acquire these hours, the applicant shall first obtain the assistant license by submitting the forms, fees, and documentation referenced in §111.55 and include the prescribed Clinical Deficiency Plan to acquire the clinical observation and clinical assisting experience hours lacking.

(1) The licensed speech-language pathologist who will provide the applicant with the training to acquire these hours must meet the requirements set out in the Act and §111.154 and shall submit:

(A) the Supervisory Responsibility Statement Form prescribed under §111.51; and

(B) the prescribed Clinical Deficiency Plan.

(2) The department shall evaluate the documentation and fees submitted to determine if the assistant license shall be issued. Additional information or revisions may be required before approval is granted.

(3) The Clinical Deficiency Plan shall be completed within sixty (60) days of the issue date of the assistant's license or the licensed assistant must submit a new plan.

(4) Immediately upon completion of the Clinical Deficiency Plan, the licensed speech-language pathologist identified in the plan shall submit a statement or information that the licensed assistant successfully completed the clinical observation and clinical assisting experience and that all hours worked by the licensed assistant were under the in-person, direct supervision of the licensed speech-language pathologist. This statement shall specify the number of hours completed and verify completion of the training identified in the Clinical Deficiency Plan.

(5) Department staff shall evaluate the documentation required in paragraph (4) and inform the licensed assistant and licensed speech-language pathologist who provided the training if acceptable.

(6) A licensed assistant may continue to practice under the in-person, direct supervision of the licensed speech-language pathologist who provided the licensed assistant with the training while the department evaluates the documentation identified in paragraph (4). All hours worked by the licensed assistant must be under the in-person, direct supervision of the licensed speech-language pathologist.

(7) In the event another licensed speech-language pathologist shall supervise the licensed assistant after completion of the Clinical Deficiency Plan, a Supervisory Responsibility Statement Form shall be submitted to the department seeking approval for the change in supervision. If the documentation required by paragraph (4), has not been received and approved by the department, approval for the change in supervision shall not be granted.

§111.51.  Assistant in Speech-Language Pathology License--Supervision Requirements.

(a) A licensed assistant in speech-language pathology (assistant) must be supervised by a licensed speech-language pathologist who has been approved by the department to serve as the assistant’s supervisor (supervisor). 

(b) A supervisor must agree to assume responsibility for all services provided by the assistant.  The supervisor must comply with the requirements set out in the Act and §111.154. 

(c) Supervisory Responsibility Statement Form.  A Supervisory Responsibility Statement Form shall be submitted in a manner prescribed by the department by both the applicant and the proposed supervisor.  The proposed supervisor must meet with the requirements set out in the Act and §111.154. 

(1) Approval from the department shall be required prior to practice by the assistant. The Supervisor Responsibility Statement Form shall be submitted upon:

(A) application for an assistant license;

(B) any changes in supervision; and

(C) the addition of other supervisors.

(2) If more than one speech-language pathologist agrees to supervise the assistant, each proposed supervisor must submit a separate Supervisor Responsibility Statement Form in manner prescribed by the department. 

(3) The assistant may not practice without an approved Supervisor Responsibility Statement Form. The supervisor may not allow an assistant to practice before a Supervisor Responsibility Statement Form is approved.

(4) The assistant shall only provide services for the caseload of the assistant’s supervisors who have current Supervisor Responsibility Statement Forms on file with the department.

(5) If the supervisor ceases supervision of the assistant, the supervisor shall notify the department, in a manner prescribed by the department, and shall inform the assistant to stop practicing immediately.  The supervisor is responsible for the practice of the assistant until notification has been received by the department.

(6) If the assistant’s supervisor ceases supervision, the assistant shall stop practicing immediately. The assistant may not practice until a new Supervisor Responsibility Statement Form has been submitted to and approved by the department.

(d) The supervisor shall assign duties and provide appropriate supervision to the assistant.

(e) Direct supervision of the assistant may only occur at the worksite in which the assistant provides services to existing clients or while the assistant provides services to cases previously delegated to the assistant. The supervisor may not make temporary, short-term assignments from the supervisor’s caseload to the assistant in order to fulfill direct supervision requirements.

(f) Client Contacts. 

(1) Initial contacts directly with the client shall be conducted by the supervisor.

(2) Following the initial contact, the supervisor shall determine whether the assistant has the competence to perform specific duties before delegating tasks.

(g) Amount and Type of Supervision. Each supervisor shall provide a minimum of eight (8) hours per calendar month of supervision to the assistant. This subsection applies whether the assistant is employed full-time or part-time.

(1) At least four (4) hours must be direct supervision. At least two (2) of the direct supervision hours must be in-person. The other two (2) hours may be in-person or by telehealth/telepractice. 

(2) The remaining hours may be performed using indirect supervision.

(3) If fewer than four (4) weeks are worked in a calendar month, then the number of hours of supervision provided will be based on the number of weeks worked.  Two (2) hours of supervision must be provided for each week worked, including one (1) hour of direct supervision and one (1) hour of indirect supervision.

(4) For the purposes of this subsection the telehealth/telepractice provisions allowed by Subchapter V may be used for up to six (6) hours of supervision (two (2) hours of direct supervision and four (4) hours of indirect supervision).

(5) When determining the amount and type of supervision, the supervisor must consider the skill and experience of the assistant as well as the services to be provided.  The supervision hours established in this subsection may be exceeded as determined by the supervisor.

(h) Delegating Clinical Tasks. 

(1) The supervisor may delegate specific clinical tasks to an assistant; however, the responsibility to the client for all services provided cannot be delegated.

(2) The supervisor shall ensure that all services are documented and provided in compliance with the Act and this chapter.

(3) The supervisor shall: 

(A) in writing, determine the skills and assigned tasks the assistant is able to carry out under §111.52. This document must be agreed upon by the assistant and the supervisor; 

(B) notify the client or client’s legal guardian(s) that services will be provided by a licensed assistant;

(C) develop the client’s treatment program in all settings and review it with the assistant who will provide the service; and

(D) maintain responsibility for the services provided by the assistant.

(i) Admission, Review, and Dismissal Meetings. The supervisor, prior to an Admission, Review and Dismissal (ARD) meeting, shall:

(1) notify the parents of students with speech impairments that services will be provided by the assistant and that the assistant will represent Speech Pathology at the ARD;

(2) develop the student’s new Individual Education Program (IEP) goals and objectives and review them with the assistant; and

(3) maintain undiminished responsibility for the services provided and the actions of the assistant. 

(j) Records. The supervisor shall maintain the following records.

(1) The supervisor shall maintain for a period of three years supervisory records that verify regularly scheduled monitoring, assessment, and evaluation of the assistant’s and client’s performance.  Such documentation may be requested by the department. 

(2) The supervisor shall keep job descriptions and performance records of the assistant. Records shall be current and made available upon request to the department.

(k) Supervision Audits. The department may audit a random sampling of assistants for compliance with this section and §111.154. 

(1) The department shall notify the assistant and the supervisor in a manner prescribed by the department that the assistant has been selected for an audit.

(2) Upon receipt of an audit notification, the assistant and the supervisor shall provide in a manner prescribed by the department the requested proof of compliance to the department.

(3) The assistant and the supervisor shall comply with the department’s request for documentation and information concerning compliance with the audit.

(l) Notwithstanding the supervision provisions in this section, the department may establish procedures, processes, and mechanisms for the monitoring and reporting of the supervision requirements. 

§111.52.  Assistant in Speech-Language Pathology License--Practice and Duties of Assistants.

(a) A licensed assistant in speech-language pathology (assistant) must perform assigned duties under the supervision of a licensed speech-language pathologist who has been approved by the department to serve as the assistant’s supervisor (supervisor). 

(b) The assistant may execute specific components of the clinical speech, language, and/or hearing program if the supervisor:

(1) determines that the assistant has received the training and has the skill to accomplish that task; and

(2) provides sufficient supervision to ensure appropriate completion of the task assigned to the assistant.

(c) Duties that a supervisor may assign to an assistant, who has received appropriate training, include the following: 

(1) conduct or participate in speech, language, and/or hearing screening;

(2) implement the treatment program or the Individual Education Program (IEP) designed by the supervisor;

(3) provide carry-over activities which are the therapeutically designed transfer of a newly acquired communication ability to other contexts and situations;

(4) collect data;

(5) administer routine tests if the test developer does not specify a graduate degreed examiner and the supervisor has determined the assistant is competent to perform the test;

(6) maintain clinical records;

(7) prepare clinical materials;

(8) participate with the supervisors’ research projects, staff development, public relations programs, or similar activities as designated and supervised by the supervisor; and

(9) write lesson plans based on the therapy program developed by the supervisor. The lesson plans shall be reviewed and approved by the supervisor.

(d) The assistant shall not:

(1) work with any cases that are not assigned to the supervisor’s caseload;

(2) conduct evaluations;

(3) interpret results of routine tests;

(4) interpret observations or data into diagnostic statements, clinical management strategies, or procedures;

(5) represent speech-language pathology at staffing meetings or at an Admission, Review and Dismissal (ARD) meeting, except as specified in this section;

(6) attend staffing meeting or ARD without the supervisor being present except as specified in this section;

(7) design or alter a treatment program or Individual Education Program (IEP);

(8) determine case selection;

(9) present written or oral reports of client information, except as provided by this section;

(10) refer a client to other professionals or other agencies;

(11) use any title which connotes the competency of a licensed speech-language pathologist;

(12) practice as an assistant without a current Supervisory Responsibility Statement on file with the department;

(13) perform invasive procedures;

(14) screen or diagnose clients for feeding and swallowing disorders;

(15) use a checklist or tabulated results of feeding or swallowing evaluations;

(16) demonstrate swallowing strategies or precautions to clients, family, or staff;

(17) provide client or family counseling;

(18) sign any formal document relating to the reimbursement for or the provision of speech-language pathology services without the supervisor's signature; or

(19) use "SLP-A" or "STA" as indicators for their credentials. Licensees shall use "Assistant SLP" or "SLP Assistant" to shorten their professional title.

(e) An assistant may represent special education and speech pathology at the Admission, Review, and Dismissal (ARD) meetings with the following stipulations.

(1) The assistant shall have written documentation of approval from the supervisor.

(2) The assistant shall have three years of experience as an assistant in the school setting.

(3) The assistant may attend, with written approval of the supervisor, a student's annual review ARD meeting if the meeting involves a student for whom the assistant provides services. If an assistant attends a meeting as provided by this rule, the supervisor is not required to attend the meeting. A supervisor must attend an ARD meeting if the purpose of the meeting is to develop a student’s initial Individual Education Program (IEP) or if the meeting is to consider the student's dismissal, unless the supervisor has submitted his or her recommendation in writing on or before the date of the meeting.

(4) The assistant shall present IEP goals and objectives that have been developed by the supervisor and reviewed with the parent by the supervisor.

(5) The assistant shall discontinue participation in the ARD meeting and shall contact the supervisor when questions or changes arise regarding the IEP document.

(f) In any professional context the assistant must indicate the assistant’s status as a speech-language pathology assistant. 

§111.55. Assistant in Speech-Language Pathology License--Application and Eligibility Requirements.

(a) Unless otherwise indicated, an applicant must submit all required information and documentation of credentials on department-approved forms.

(b) An applicant for an assistant in speech-language pathology license must submit the following required documentation:

(1) a completed application on a department-approved form;

(2) a completed Supervisory Responsibility Statement Form as prescribed under §111.51;

(3) an original or certified copy of the transcript(s), which shows the 24 semester credit hours of required course work and which shows the applicant possesses a baccalaureate degree with an emphasis in communicative sciences or disorders or a baccalaureate degree that qualifies under §111.50(c); 

(4) if not previously submitted, a Clinical Observation and Clinical Experience Form completed by the university program director or designee of the college or university training program verifying the applicant completed the requirements set out in §111.50(a)(3);

(5) for an applicant who did not obtain the hours referenced in paragraph (4), a Clinical Deficiency Plan Form to obtain the hours lacking;

(6) proof of successfully completing the Texas Jurisprudence Examination under §111.23; and

(7) the initial application fee required under §111.160.

(c) An applicant for an assistant in speech-language pathology license must submit a completed legible set of fingerprints, on a form prescribed by the department, to the Department of Public Safety for the purpose of obtaining criminal history record information. An applicant must successfully pass a criminal history background check.

(d) An applicant must complete all licensing requirements within one year from the date the application was submitted. After that year an applicant will be required to submit a new application and all required materials in addition to paying a new application fee.

§111.57.  Assistant in Speech-Language Pathology License--License Terms; Renewals.

(a) An assistant in speech-language pathology license is valid for two years from the date of issuance and may be renewed biennially.

(b) A licensee is responsible for submitting all required documentation and information and paying the renewal application fee prior to the expiration date of the license.

(c) To renew an assistant in speech-language pathology license, a licensee must:

(1) submit a completed renewal application on a department-approved form;

(2) complete twenty (20) hours of continuing education as required under §111.30; 

(3) comply with the continuing education audit process described under §111.32, if selected for an audit;

(4) submit, in a manner prescribed by the department, a Supervisory Responsibility Statement Form or information from each supervisor unless the assistant is currently not practicing or the supervisor(s) has not changed; and

(5) submit the license renewal fee required under §111.160.

(d) A licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.

(e) The department may deny the renewal of the license pursuant to Texas Occupations Code §401.451.

(f) If all conditions required for renewal are met prior to expiration, the department shall issue a renewed license.

(g) A person whose license has expired may late renew the license in accordance with the procedures set out under §60.31 and §60.83 of this title.

(h) A person whose license has expired may not practice or engage in speech-language pathology.

SUBCHAPTER H. REQUIREMENTS FOR AUDIOLOGY LICENSE.

§111.70.  Audiology License--Licensing Requirements.

(a) An individual shall not practice as an audiologist without a current license issued by the department. An applicant for the audiology license shall meet the requirements set out in the Act and this section.

(b) Education. The doctoral degree in audiology or a related hearing science shall be completed at a college or university that has a program accredited by a national accrediting organization that is approved by the department and recognized by the United States Secretary of Education under the Higher Education Act of 1965 (20 U.S.C. §1001 et seq.).

(c) An applicant whose transcript is in a language other than English or whose degree was earned at a foreign university shall submit an original evaluation form from an approved transcript evaluation service.  The transcript evaluation service must determine that the applicant’s degree is a doctoral degree in audiology or a related hearing science. The applicant shall bear all expenses incurred during the procedure.

(d) An applicant who graduated from a college or university program not accredited by a national accrediting organization that is approved by the department and recognized by the United States Secretary of Education under the Higher Education Act of 1965 (20 U.S.C. §1001 et seq.) shall have the ASHA Council for Clinical Certification evaluate the course work to determine whether the applicant qualified for the Certificate of Clinical Competence. The applicant shall bear all expenses incurred during the procedure.

(e) Examination. An applicant shall pass the examination referenced under §111.21.

(f) An applicant who previously held the ASHA Certificate of Clinical Competence or the ABA Certification may have the certificate reinstated and apply for licensure under §111.75(d).

§111.75.  Audiology License--Application and Eligibility Requirements.

(a) Unless otherwise indicated, an applicant must submit all required information and documentation of credentials on department-approved forms.  

(b) An applicant for an audiology license must submit the following required documentation:

(1) a completed application on a department-approved form;

(2) if not previously submitted when applying for an intern’s license, an original or certified copy of the transcript(s), which shows the conferred doctoral degree in audiology or a related hearing science;

(3) if the degree was not earned at an institution as described in §111.70(b), official documentation from the ASHA Council for Clinical Certification that the conferred doctoral degree is adequate for ASHA Certification or from the ABA that the conferred doctoral degree is adequate for ABA Certification;

(4) if the applicant’s transcript is in a language other than English or the degree was earned at a foreign university, an original evaluation form from an approved transcript evaluation service stating that the applicant’s degree is a master’s degree or higher with a major in one of the areas of communicative sciences or disorders;

(5) if the applicant currently holds a Texas intern in audiology license, a Report of Completed Audiology Internship Form completed by the applicant’s supervisor and signed by both the applicant and the supervisor; 

(6) if the internship was completed out-of-state, one of the following documents regarding the supervisor must be submitted:

(A) if that state requires licensure, a copy of the supervisor’s valid license to practice in that state; or

(B) if that state does not require licensure, an original letter from ASHA stating the supervisor held the Certificate of Clinical Competence or ABA Certification when the applicant completed the internship;

(7) a Praxis Exam Score Report showing the applicant passed the examination described in §111.21;

(8) proof of successfully completing the Texas Jurisprudence Examination under §111.23; and

(9) the initial application fee required under §111.160.

(c) If not previously submitted when applying for an assistant or intern license, an applicant for an audiology license must submit a completed legible set of fingerprints, on a form prescribed by the department, to the Department of Public Safety for the purpose of obtaining criminal history record information. An applicant must successfully pass a criminal history background check. 

(d) Waiver of Clinical Experience and Examination Requirements. An applicant who currently holds either the ASHA Certificate of Clinical Competence or the ABA Certification may submit official documentation from ASHA or ABA as evidence that the applicant meets the clinical experience and examination requirements as set out in the Act and this subchapter for an audiology license. Such an applicant must submit:

(1) an original or certified copy of a signed letter from ASHA or ABA which verifies the applicant currently holds the ASHA Certificate of Clinical Competence or ABA Certification in the area of audiology;

(2) an original or certified copy of the transcript(s) showing the conferred degree of all relevant course work which also verifies that the applicant possesses a minimum of a doctoral degree in audiology or a related hearing science;

(3) the required documents under subsection (b)(1) and (8) and subsection (c); and

(4) the initial application fee required under §111.160.

(e) Upgrade from Intern License to Full License. An applicant, who holds a current Texas intern in audiology license, may upgrade to an audiology license by submitting:

(1) a completed upgrade application on a department-approved form;

(2) the required documents under subsection (b)(2), (5), and (7) and subsection (c); and

(3) the initial application fee required under §111.160.

(f) An applicant must complete all licensing requirements within one year from the date the application was submitted. After that year an applicant will be required to submit a new application and all required materials in addition to paying a new application fee.

§111.77.  Audiology License--License Terms; Renewals.

(a) An audiology license is valid for two years from the date of issuance and may be renewed biennially.

(b) A licensee is responsible for submitting all required documentation and information and paying the renewal application fee prior to the expiration date of the license.

(c) To renew an audiology license, a licensee must:

(1) submit a completed renewal application on a department-approved form;

(2) complete 20 hours of continuing education as required under §111.130; 

(3) comply with the continuing education audit process described under §111.132, if selected for an audit; and

(4) submit the license renewal fee required under §111.160.

(d) A licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.

(e) The department may deny the renewal of the license pursuant to Texas Occupations Code §401.451.

(f)  If all conditions required for renewal are met prior to expiration, the department shall issue a renewed license.

(g) A person whose license has expired may late renew the license in accordance with the procedures set out under §60.31 and §60.83 of this title.

(h) A person whose license has expired may not practice or engage in audiology.

SUBCHAPTER I. REQUIREMENTS FOR INTERN IN AUDIOLOGY LICENSE.

§111.80.  Intern in Audiology License--Licensing Requirements--Education.

(a) An individual shall not practice as an intern in audiology without a current license issued by the department. An applicant for the intern in audiology license shall meet the requirements set out in the Act and this section.    

(b) Education. The doctoral degree in audiology or a related hearing science shall be obtained at a college or university that has a program accredited by a national accrediting organization that is approved by the department and recognized by the United States Secretary of Education under the Higher Education Act of 1965 (20 U.S.C. §1001 et seq.).

(c) An applicant who graduated from a college or university program not accredited by a national accrediting organization that is approved by the department and recognized by the United States Secretary of Education under the Higher Education Act of 1965 (20 U.S.C. §1001 et seq.) shall have the ASHA Council for Clinical Certification evaluate the course work to determine whether the applicant qualified for the Certificate of Clinical Competence.  The applicant shall bear all expenses incurred during the procedure.

(d) The applicant shall submit the department prescribed form signed by the university program director or designee verifying the applicant is enrolled in a professionally recognized accredited doctoral program as approved by the department.

§111.81.  Intern in Audiology License--Internship and Supervision Requirements.

(a) A licensed intern in audiology (intern) must be supervised by a licensed audiologist who has been approved by the department to serve as the intern’s supervisor (supervisor). 

(b) A supervisor must agree to assume responsibility for all services provided by the intern. The supervisor must comply with the requirements set out in the Act and §111.154.

(c) Intern Plan and Agreement of Supervision Form. An Audiology Intern Plan and Agreement of Supervision Form shall be submitted in a manner prescribed by the department and completed by both the applicant and the proposed supervisor. The proposed supervisor must meet the requirements set out in the Act and §111.154.

(1) Written approval from the department shall be required prior to practice by the intern in audiology. The Audiology Intern Plan and Agreement of Supervision Form shall be submitted upon: 

(A) application for an intern license;

(B) any changes in supervision; and

(C) the addition of other supervisors.

(2) If more than one audiologist agrees to supervise the intern, each proposed supervisor must submit an Audiology Intern Plan and Agreement of Supervision Form. 

(3) The intern may not practice without an approved Audiology Intern Plan and Agreement of Supervision Form.  The supervisor may not allow an intern to practice before an Audiology Intern Plan and Agreement of Supervision Form is approved.

(4) If the supervisor ceases supervision of the intern, the supervisor shall notify the department, in a manner prescribed by the department, and shall inform the intern to stop practicing immediately. The supervisor is responsible for the practice of the intern until notification has been received by the department.

(5) If the intern’s supervisor ceases supervision, the intern shall stop practicing immediately.  The intern may not practice until a new Audiology Intern Plan and Agreement of Supervision Form has been submitted to and approved by the department.

(d) Internship Requirements. The internship shall:

(1) begin after completion of all academic course work under §111.80;

(2) consist of 1,600 hours of supervised clinical work as defined in paragraph (3); and

(3) involve primarily clinical activities such as assessment, diagnosis, evaluation, screening, treatment, report writing, family/client consultation, and/or counseling related to the management process of individuals.

(e) Changes in Internship.  Prior to implementing changes in the internship, written approval from the department is required.

(1) If the intern changes his or her supervisor or adds additional supervisors, a current Audiology Intern Plan and Agreement of Supervision Form shall be submitted by the new proposed supervisor and approved by the department before the intern may resume practice as prescribed under subsection (c).

(2) If the intern changes his or her supervisor, the Audiology Report of Completed Internship Form shall be completed by the former supervisor and the intern and submitted to the department upon completion of that portion of the internship.  It is the decision of the former supervisor to determine whether the internship meets the department’s requirements. The department shall review the form and inform the intern of the results. 

(3) A supervisor who ceases supervising an intern shall submit an Audiology Report of Completed Internship Form for the portion of the internship completed under his or her supervision. This must be submitted within 30 days of the date the supervision ended. 

(4) If no hours were earned under an approved supervisor, the licensed intern or the approved supervisor must submit a signed, written statement that no hours were earned and provide the reason. 

(5) If the intern changes his or her employer but the supervisor and the number of hours employed per week remain the same, the supervisor shall submit a signed statement or submit in a manner prescribed by the department giving the name, address and phone number of the new location. This must be submitted within thirty (30) days of the date the change occurred. 

(f) Notwithstanding the supervision provisions in this section, the department may establish procedures, processes, and mechanisms for the monitoring and reporting of the supervision requirements. 

§111.82.  Intern in Audiology License--Practice and Duties of Interns.

(a) A licensed intern in audiology (intern) must perform assigned duties under the supervision of a licensed audiologist who has been approved by the department to serve as the intern’s supervisor (supervisor). 

(b) In any professional context the intern must indicate the intern’s status as a licensed intern in audiology. 

(c) The intern may continue to practice while awaiting the processing of the audiology license if the intern meets the following conditions:

(1) holds a valid intern in audiology license;

(2) practices under the supervision of the current supervisor, who filed the Audiology Intern Plan and Agreement of Supervision Form and the Report of Completed Internship in Audiology; and

(3) practices under the terms of the current Audiology Intern Plan and Agreement of Supervision Form. 

§111.85. Intern in Audiology License--Application and Eligibility Requirements.

(a) Unless otherwise indicated, an applicant must submit all required information and documentation of credentials on department-approved forms.

(b) An applicant for an intern in audiology license must submit the following required documentation:

(1) a completed application on a department-approved form;

(2) a Course Work and Clinical Experience Form for Audiology Intern completed by the university program director or designee of the college or university attended which verifies the applicant is enrolled in a professionally recognized accredited doctoral program as approved by the department, and has completed all required academic and clinical course work; 

(3) an Intern Plan and Agreement of Supervision Form completed by the proposed supervisor and signed by both the applicant and the proposed supervisor; 

(4) proof of successfully completing the Texas Jurisprudence Examination under §111.23; and

(5) the initial application fee required under §111.160.

(c) If not previously submitted when applying for an assistant license, an applicant for an intern in audiology license must submit a completed legible set of fingerprints, on a form prescribed by the department, to the Department of Public Safety for the purpose of obtaining criminal history record information.  An applicant must successfully pass a criminal history background check.

(d) An applicant must complete all licensing requirements within one year from the date the application was submitted. After that year an applicant will be required to submit a new application and all required materials in addition to paying a new application fee.

§111.87.  Intern in Audiology License--License Terms; Renewals.

(a) An intern in audiology license is valid for one year from the date of issuance and may be renewed annually.

(b) A licensee is responsible for submitting all required documentation and information and paying the renewal application fee prior to the expiration date of the license.

(c) To renew an intern in audiology license, a licensee must:

(1) submit a completed renewal application on a department-approved form;

(2) submit an Intern Plan and Agreement of Supervision Form for the intern's upcoming experience unless the intern is currently not practicing. In that event, the intern shall provide an explanation of the reason for not practicing; and

(3) submit the license renewal fee required under §111.160.

(d) A licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.

(e) The department may deny the renewal of the license pursuant to Texas Occupations Code §401.451.

(f) If all conditions required for renewal are met prior to expiration, the department shall issue a renewed license.

(g) A person whose license has expired may late renew the license in accordance with the procedures set out under §60.31 and §60.83 of this title.

(h) A person whose license has expired may not practice or engage in audiology.

SUBCHAPTER J. REQUIREMENTS FOR ASSISTANT IN AUDIOLOGY LICENSE.

§111.90.  Assistant in Audiology License--Licensing Requirements--Education and Training.

(a) An individual shall not practice as an assistant in audiology without a current license issued by the department. An applicant for an assistant in audiology license shall meet the requirements set out in the Act and this section.

(b) An assistant in audiology shall meet the following requirements: 

(1) reach the minimum age of 18 years old and possess a high school diploma or equivalent;

(2) complete the approved 20-hour certification course from the Council for Accreditation of Occupational Hearing Conservation (CAOHC) and earn a passing score on the examination;

(3) if the applicant holds a bachelor’s degree or higher in communicative sciences or disorders, the applicant does not need to complete the certification course and examination under subsection (b)(2);

(4) submit the Supervisory Responsibility Statement for an Assistant in Audiology Form prescribed under §111.91; and

(5) submit a plan to complete a minimum of twenty-five (25) hours of job-specific competency-based training to be carried out by the supervisor.  Until this training is complete, the licensed assistant in audiology may practice only under in-person, direct supervision by the supervisor.

(c) Upon satisfactory completion of the job-specific competency-based training under subsection (b)(5), the supervisor shall submit the Report of Completed Training for an Assistant in Audiology Form on behalf of the licensed assistant in audiology. After the department approves the report, the licensed assistant may practice only in compliance with the supervision requirements under §111.91 and §111.92.    

§111.91. Assistant in Audiology License--Supervision Requirements.

(a) A licensed assistant in audiology (assistant) must be supervised by a licensed audiologist who has been approved by the department to serve as the assistant’s supervisor (supervisor). 

(b) A supervisor must agree to assume responsibility for all services provided by the assistant.  The supervisor must comply with the requirements set out in the Act and §111.154. 

(c) Supervisory Responsibility Statement Form. A Supervisory Responsibility Statement Form shall be submitted in a manner prescribed by the department by both the applicant and the proposed supervisor. The proposed supervisor must meet the requirements set out in the Act and §111.154.

(1) Approval from the department shall be required prior to practice by the licensed assistant in audiology. The Supervisory Responsibility Statement for an Assistant in Audiology Form shall be submitted upon: 

(A) application for a license;

(B) any changes in supervision; and

(C) addition of other supervisors.

(2) If more than one audiologist agrees to supervise the assistant, each proposed supervisor must submit a separate Supervisory Responsibility Statement Form in a manner prescribed by the department. 

(3) The assistant may not practice without an approved Supervisor Responsibility Statement Form. The supervisor may not allow an assistant to practice before a Supervisor Responsibility Statement Form is approved.

(4) The assistant shall only provide services for the caseload of the assistant’s supervisors who have current Supervisor Responsibility Statement Forms on file with the department.

(5) If the supervisor ceases supervision of the assistant, the supervisor shall notify the department, in a manner prescribed by the department, and shall inform the assistant to stop practicing immediately.  The supervisor is responsible for the practice of the assistant until notification has been received by the department.

(6) If the assistant’s supervisor ceases supervision, the assistant shall stop practicing immediately.  The assistant may not practice until a new Supervisor Responsibility Statement Form has been submitted to and approved by the department.

(d) A supervisor shall assign duties and provide appropriate supervision to the assistant. 

(e) Client Contacts.

(1) All diagnostic contacts shall be conducted by the supervisor.

(2) Following the initial diagnostic contact, the supervisor shall determine whether the assistant has the competence to perform specific non-diagnostic and non-prohibited duties before delegating tasks as referenced in §111.92(c).

(f) Amount and Type of Supervision.  Each supervisor must provide a minimum of ten (10) hours per week, or forty (40) hours per calendar month, of supervision to the assistant. This subsection applies whether the assistant is employed full-time or part-time. 

(1) At least one (1) hour per week, or four (4) hours per calendar month, must be direct supervision. 

(2)  The remaining hours may be performed using indirect supervision.

(3) If fewer than four (4) weeks are worked in a calendar month, then the number of hours of supervision provided will be based on the number of weeks worked.  Ten (10) hours of supervision must be provided for each week worked, including one (1) hour of direct supervision.

(4) The supervisor shall provide in-person, direct supervision for the duties described under §§111.92(c)(1) - (4). 

(5) For the purposes of this subsection, the telehealth and telepractice provisions described under §111.215 may be used except for duties described under §§111.92(c)(1) - (4) where the supervisor must provide in-person, direct supervision.

(6) When determining the amount and type of supervision, the supervisor must consider the skill and experience of the assistant as well as the services to be provided.  The supervision hours established in this paragraph may be exceeded as determined by the supervisor.

(g) Delegating Clinical Tasks. 

(1) Although the supervisor may delegate specific clinical tasks to an assistant, the responsibility to the client for all services provided cannot be delegated.

(2) The supervisor shall ensure that all services are documented and provided in compliance with the Act and this chapter. 

(3) The supervisor shall:

(A) in writing, determine the skills and assigned tasks the assistant is able to carry out under §111.92. This document must be agreed upon by the assistant and the supervisor; 

(B) notify the client or client’s legal guardian(s) that services will be provided by a licensed assistant; and

(C) maintain responsibility for the services provided by the assistant.

(h) Records. The supervisor shall maintain the following records.

(1) Supervisory records shall be maintained by the supervisor for a period of three years which verify regularly scheduled monitoring, assessment, and evaluation of the assistant’s and client’s performance. Such documentation may be requested by the department. 

(2) The supervisor shall keep job descriptions and performance records. Records shall be current and be made available upon request to the department. 

(i) Supervision Audits. The department may audit a random sampling of assistants for compliance with this section and §111.154. 

(1) The department shall notify an assistant and the supervisor in a manner prescribed by the department that the assistant has been selected for an audit.

(2) Upon receipt of an audit notification, the assistant and the supervisor, who agreed to accept responsibility for the services provided by the assistant, shall provide the requested proof of compliance to the department in a manner prescribed by the department.

(3) The assistant and the supervisor shall comply with the department’s request for documentation and information concerning compliance with the audit.

(j) Notwithstanding the supervision provisions in this section, the department may establish procedures, processes, and mechanisms for the monitoring and reporting of the supervision requirements.

§111.92.  Assistant in Audiology License--Practice and Duties of Assistants.

(a) A licensed assistant in audiology (assistant) must perform assigned duties under the supervision of a licensed audiologist who has been approved by the department to serve as the assistant’s supervisor (supervisor).  

(b) The assistant may execute specific components of the clinical hearing program if the supervisor:

(1) determines that the assistant has received the training and has the skill to accomplish that task; and

(2) provides sufficient supervision to ensure appropriate completion of the task assigned to the assistant. 

(c) Duties that a supervisor may assign to an assistant, who has received appropriate training, include the following: 

(1) under in-person, direct supervision, conduct or participate in, hearing screening including screening otoscopy, tympanometry, otoacoustic emissions procedures and pure tone air conduction procedures, but may not diagnose hearing loss or disorders of the auditory system, or make statements of severity or implication;

(2) under in-person, direct supervision, assist the audiologist with play audiometry, visual reinforcement audiometry, and tasks such as picture-pointing speech audiometry;

(3) under in-person, direct supervision, assist the audiologist in the evaluation of difficult-to-test patients;

(4) under in-person, direct supervision, assist the audiologist with technical tasks for diagnostic evaluation such as preparing test rooms, attaching electrodes, and preparing patients prior to procedures;

(5) maintain clinical records;

(6) prepare clinical materials;

(7) participate with the supervisor in research projects, staff development, public relations programs, or similar activities as designated and supervised by the supervisor;

(8) maintain equipment by conducting biologic and electroacoustic calibration of audiometric equipment, perform preventative maintenance checks and safety checks of equipment;

(9) explain the proper care of hearing instruments and assistive listening devices to patients;

(10) maintain hearing instruments including cleaning, replacing ear mold tubing, minor hearing instrument repairs, determining need for repair, and performing biologic and electroacoustic checks of hearing instruments;

(11) provide case history and/or self-assessment forms and clarify questions on the forms to patients as needed;

(12) conduct basic record keeping and prepare paperwork for signature by the audiologist;

(13) coordinate ear mold and hearing instrument records or repairs and other orders;

(14) attach hearing aids to computers and use software to verify internal electroacoustic settings; and

(15) perform other non-diagnostic duties not prohibited in subsection (d), for which the assistant has been trained and demonstrates appropriate skills, as assigned by the supervisor.

(d) The assistant shall not:

(1) conduct aural habilitation or rehabilitation activities or therapy;

(2) provide carry-over activities (therapeutically designed transfer of a newly acquired communication ability to other contexts and situations) for patients in aural rehabilitation therapy;

(3) collect data during aural rehabilitation therapy documenting progress and results of therapy;

(4) administer assessments during aural rehabilitation therapy to assess therapeutic progress;

(5) conduct any audiological procedure that requires decision-making or leads to a diagnosis;

(6) interpret results of procedures and evaluations, except for screening tests;

(7) make diagnostic statements, or propose or develop clinical management strategies;

(8) make ear impressions;

(9) cause any substance to enter the ear canal or place any instrument or object in the ear canal for the purpose of removing cerumen or debris;

(10) make any changes to the internal settings of a hearing instrument manually or using computer software;

(11) represent audiology at staffing meetings or on an admission, review and dismissal (ARD) committee;

(12) attend staffing meetings or ARD committee meetings without the supervisor being present;

(13) design a treatment program;

(14) determine case selection;

(15) present written or oral reports of client information, except to his or her supervisor;

(16) refer a client to other professionals or other agencies;

(17) use any title which connotes the competency of a licensed audiologist; or

(18) practice as an assistant without a valid Supervisory Responsibility Statement for an Audiology Assistant Form on file with the department.

(e) In any professional context the assistant must indicate the assistant’s status as a licensed audiology assistant. 

(f) A licensed assistant in audiology may not engage in the fitting, dispensing or sale of a hearing instrument under this chapter; however, a licensed assistant in audiology who is licensed under the Texas Occupations Code, Chapter 402 may engage in activities as allowed by that law and is not considered to be functioning under his or her assistant in audiology license when performing those activities.

§111.95.  Assistant in Audiology License--Application and Eligibility Requirements.

(a) Unless otherwise indicated, an applicant must submit all required information and documentation of credentials on department-approved forms.

(b) An applicant for an assistant in audiology license must submit the following required documentation:

(1) a completed application on a department-approved form;

(2) a completed Supervisory Responsibility Statement Form as prescribed under §111.91;

(3) certification on the application that the applicant is at least 18 years old;

(4) high school diploma or equivalent;

(5) an original or certified copy of the Council for Accreditation of Occupational Hearing Conservation (CAOHC) certificate indicating that the applicant has completed the required CAOHC training and passed the required examination;

(6) if the applicant holds a bachelor’s degree or higher in communicative sciences or disorders, submit proof of degree instead of the certificate under subsection (b)(5);

(7) proof of successfully completing the Texas Jurisprudence Examination under §111.23; and

(8) the initial application fee required under §111.160.

(c) An applicant for an assistant in audiology license must submit a completed legible set of fingerprints, on a form prescribed by the department, to the Department of Public Safety for the purpose of obtaining criminal history record information. An applicant must successfully pass a criminal history background check.

(d) An applicant must complete all licensing requirements within one year from the date the application was submitted. After that year an applicant will be required to submit a new application and all required materials in addition to paying a new application fee.

§111.97. Audiology Assistant License--License Terms; Renewals.

(a) An assistant in audiology license is valid for two years from the date of issuance and may be renewed biennially.

(b) A licensee is responsible for submitting all required documentation and information and paying the renewal application fee prior to the expiration date of the license.

(c) To renew an assistant in audiology license, a licensee must:

(1) submit a completed renewal application on a department-approved form;

(2) complete 20 hours of continuing education as required under §111.130;

(3) comply with the continuing education audit process described under §111.132, if selected for an audit;

(4) submit, in a manner prescribed by the department, a Supervisory Responsibility Statement Form or information from each supervisor unless the assistant is currently not practicing or the supervisor(s) has not changed; and

(5) submit the license renewal fee required under §111.160.

(d) A licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.

(e) The department may deny the renewal of the license pursuant to Texas Occupations Code §401.451.

(f) If all conditions required for renewal are met prior to expiration, the department shall issue a renewed license.

(g) A person whose license has expired may late renew the license in accordance with the procedures set out under §60.31 and §60.83 of this title.

(h) A person whose license has expired may not practice or engage in audiology.

SUBCHAPTER L. REQUIREMENTS FOR DUAL LICENSE IN SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY.

§111.115.  Dual License in Speech-Language Pathology and Audiology--Application and Eligibility Requirements. 

(a) Unless otherwise indicated, an applicant must submit all required information and documentation of credentials on department-approved forms.

(b) An applicant for a dual license in speech-language pathology and audiology must submit the following required documentation:

(1) all of the documentation required under §111.35 for a Speech-Language Pathology License;

(2) all of the documentation required under §111.75 for an Audiology License;

(3) proof of successfully completing the Texas Jurisprudence Examination under §111.23; and

(4) two separate initial application fees required under §111.160, or if the applicant already holds one of the licenses, the initial application fee required under §111.160 for the other license.

(c) If not previously submitted when applying for a full license, assistant license, or intern license, an applicant for a dual license must submit a completed legible set of fingerprints, on a form prescribed by the department, to the Department of Public Safety for the purpose of obtaining criminal history record information, unless the applicant has already submitted fingerprints as part of a single license. An applicant must successfully pass a criminal history background check. 

(d) An applicant that qualifies for a waiver under §111.35 or §111.75 must submit the waiver documentation required under those two sections.

§111.117.  Dual License in Speech-Language Pathology and Audiology--License Terms; Renewals.

(a) A dual license in speech-language pathology and audiology is valid for two years from the date of issuance and may be renewed biennially.

(b) A licensee is responsible for submitting all required documentation and information and paying the renewal application fee prior to the expiration date of the license.

(c) To renew a dual license in speech-language pathology and audiology, a licensee must:

(1) submit a separate renewal application form and other documents required under §111.37 and §111.77;           

(2) complete 30 hours of continuing education as required under §111.130; 

(3) comply with the continuing education audit process described under §111.132, if selected for an audit; and

(4) pay two separate license renewal fees required under §111.160.

(d) A licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.

(e) The department may deny the renewal of the license pursuant to Texas Occupations Code §401.451.

(f) If all conditions required for renewal are met prior to expiration, the department shall issue a renewed license.

(g) A person whose license has expired may late renew the license in accordance with the procedures set out under §60.31 and §60.83 of this title.

(h) A person whose license has expired may not practice or engage in speech-language pathology or audiology.

SUBCHAPTER O. RESPONSIBILITIES OF THE COMMISSION AND THE DEPARTMENT.

§111.140.  Rules.

(a) Pursuant to the authority under Texas Occupations Code §51.203, the commission shall adopt rules necessary to implement the Speech-Language Pathologists and Audiologists program. Pursuant to 16 TAC §60.22, the department is authorized to propose rules.

(b) The commission has adopted rules governing changes to the standards of practice rules pursuant to §51.2031. These rules are located at 16 TAC Chapter 100.

SUBCHAPTER P. RESPONSIBILITIES OF THE LICENSEE AND CODE OF ETHICS.

§111.151. Consumer Information and Display of License.

(a) A licensee shall notify each client of the name, mailing address, telephone number and website of the department for the purpose of directing complaints to the department. A licensee shall display this notification:

(1) on a sign prominently displayed in the primary place of business of each licensee; and

(2) on a written document such as a written contract, a bill for service, or office information brochure provided by the licensee to a client or third party.

(b) A licensee shall display the license certificate with a current license card as issued by the department in the primary location of practice.

(c) A licensee shall not make any alteration on official documents issued by the department.

§111.154.  Requirements, Duties, and Responsibilities of Supervisors and Persons Being Supervised

(a) A licensee must have two years of professional experience in providing direct client services in the area of licensure in order to supervise an intern or assistant. The licensee's internship year shall be counted toward the two years of experience.

(b) A licensee may not supervise an individual that is related to the licensee within the first degree of consanguinity, as determined under Government Code, Chapter 573, Subchapter B.  

(c) A supervisor of an intern in speech-language pathology must be a licensed speech-language pathologist who is approved by the department and who possesses at least a master’s degree with a major in one of the areas of communicative sciences or disorders.

(d) A supervisor of an assistant in speech-language pathology must be a licensed speech-language pathologist who is approved by the department.

(e) A supervisor of an intern in audiology or an assistant in audiology must be a licensed audiologist who is approved by the department.

(f) A supervisor of an intern or assistant shall:

(1) ensure that all services provided are in compliance with this chapter and the Act, such as verifying:

(A) the intern or assistant holds a current license;

(B) the supervisor has been approved by the department;

(C) the practice and duties of the intern or assistant are appropriate; and

(D) the intern or assistant is qualified to perform the procedure;

(2) be responsible for all client services performed by the intern or assistant;

(3) provide appropriate supervision after the department approves the supervisory agreement; and

(4) comply with the following:

(A) supervise no more than a total of four (4) speech-language pathology interns and/or assistants; or

(B) supervise no more than a total of four (4) audiology interns and/or assistants.

(g) In addition to the provisions listed in subsection (f), a supervisor of an assistant shall:

(1) be responsible for evaluations, interpretation, and case management; and

(2) not designate anyone other than a licensed speech-language pathologist or intern in speech-language pathology to represent speech-language pathology to an Admission, Review, and Dismissal (ARD) meetings, except as provided by §111.51 and §111.52. 

(h) A licensed intern or assistant shall abide by the decisions made by his or her supervisor relating to the intern’s or assistant’s practice and duties.  If the supervisor requests that the intern or assistant violate this chapter, the Act, or any other law, the intern or assistant shall refuse to do so and immediately notify the department and any other appropriate authority. 

SUBCHAPTER Q. FEES.

§111.160.  Fees.

(a) All fees paid to the department are nonrefundable.

(b) Speech Language Pathology License (including upgrade from intern license):

(1) Initial application fee (includes two-year initial license)--$150.

(2) Renewal application fee (for two-year license)--$100.

(c) Intern in Speech Language Pathology License:

(1) Initial application fee (includes one-year initial license)--$75.

(2) Renewal application fee (for one year license)--$75;

(d) Assistant in Speech Language Pathology License:

(1) Initial application fee (includes two-year initial license)--$150.

(2) Renewal application fee (for two-year license)--$100.

(e) Audiology License (including upgrade from intern license):

(1) Initial application fee (includes two-year initial license)--$150.

(2) Renewal application fee (for two-year license)--$100.

(f) Intern in Audiology License:

(1) Initial application fee (includes one-year initial license)--$75.

(2) Renewal application fee (for one-year license)--$75.

(g) Assistant in Audiology License:

(1) Initial application fee (includes two-year initial license)--$150.

(2) Renewal application fee (for two-year license)--$100.

(h) Dual License in Speech Language Pathology and Audiology:

(1) Initial application fee (includes two-year initial license):

(A) An applicant for a dual license in speech-language pathology and audiology shall submit two separate initial application fees for speech-language pathology and audiology.

(B) An applicant who currently holds one license and wishes to obtain a dual license shall submit the initial application fee for the other license.

(2) Renewal application fee (for two-year license): Each license must be renewed separately and fees will be determined separately.

(i) A duplicate/replacement fee for a license or certificate issued under this chapter is $25.

(j) Late renewal fees for licenses issued under this chapter are provided under §60.83 of this title (relating to Late Renewal Fees).

(k) A dishonored/returned check or payment fee is the fee prescribed under §60.82 of this title (relating to Dishonored Payment Device).

(l) The fee for a criminal history evaluation letter is the fee prescribed under §60.42 of this title (relating to Criminal History Evaluation Letters).

SUBCHAPTER R. COMPLAINTS.

§111.171.  Complaints Regarding Standard of Care.

The commission has adopted rules related to handling complaints regarding standard of care pursuant to Texas Occupations Code §51.2031. These rules are located at 16 Texas Administrative Code Chapter 100.

SUBCHAPTER S. ENFORCEMENT PROVISIONS.

§111.180.  Administrative Penalties and Sanctions.

If a person or entity violates any provision of Texas Occupations Code, Chapters 51 or 401, this chapter, or any rule or order of the executive director or commission, proceedings may be instituted to impose administrative penalties, administrative sanctions, or both in accordance with the provisions of Texas Occupations Code, Chapters 51 and 401, as applicable, and any associated rules.

SUBCHAPTER U.  FITTING AND DISPENSING OF HEARING INSTRUMENTS.

§111.200.  Registration of Audiologists and Interns in Audiology to Fit and Dispense Hearing Instruments.

(a) The audiology license constitutes registration to fit and dispense hearing instruments. 

(b) The audiology intern license constitutes registration to fit and dispense hearing instruments under the supervision of a licensed audiologist approved by the department to supervise the internship.

SUBCHAPTER V. TELEHEALTH.

§111.213.  Limitations on the Use of Telecommunications Technology by Speech-Language Pathologists.  

(a) The limitations of this section apply to the use of telecommunications technology by speech-language pathologists.

(b) Supervision of a licensed assistant in speech-language pathology may be undertaken through the use of telecommunications technology as described under §111.51 and as follows:

(1) no more than two (2) hours of direct supervision per month shall be undertaken through the use of telecommunications technology; and

(2) no more than six (6) total hours of supervision per month shall be undertaken through the use of telecommunications technology.

(c) Direct supervision of a licensed intern in speech-language pathology shall not be undertaken through the use of telecommunications technology. 

(d) Telehealth services may not be provided by correspondence only, e.g., mail, email, faxes, although they may be adjuncts to telepractice.

§111.216. Limitations on the Use of Telecommunications Technology by Audiologists.

(a) The limitations of this section apply to the use of telecommunications technology by audiologists.

(b) Supervision of a licensed assistant in audiology may be undertaken through the use of telecommunications technology as described under §111.91, except for duties described under §§111.92(c)(1) - (4) where the supervisor must provide in-person, direct supervision.

(c) Telehealth services may not be provided by correspondence only, e.g., mail, email, faxes, although they may be adjuncts to telepractice.

[SUBCHAPTER G. REQUIREMENTS FOR TEMPORARY CERTIFICATE OF REGISTRATION IN SPEECH-LANGUAGE PATHOLOGY.]
[§111.60 Temporary Certificate of Registration in Speech-Language Pathology--Registration Requirements.]
[§111.65 Temporary Certificate of Registration in Speech-Language Pathology--Application and Eligibility Requirements.]
[§111.66 Temporary Certificate of Registration in Speech-Language Pathology--Issuing Registration.]   

[SUBCHAPTER K. REQUIREMENTS FOR AUDIOLOGY TEMPORARY CERTIFICATE OF REGISTRATION.]
[§111.100 Temporary Certificate of Registration in Audiology--Registration Requirements.]
[§111.105 Audiology Temporary Certificate of Registration--Application and Eligibility Requirements.]
[§111.106 Temporary Certificate of Registration in Audiology--Issuing Registration.]

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency’s legal authority.

Filed with the Office of the Secretary of State, on April 10, 2018.

Brian E. Francis
Executive Director
Texas Department of Licensing and Regulation