Speech Pathologists and Audiologists (216-RICR-40-05-33)

These regulations are promulgated pursuant to the authority conferred under R.I. Gen. Laws § 5-48-3(c), for the purpose of establishing prevailing standards and procedures for licensing speech pathologists and audiologists in Rhode Island.

These regulations hereby adopt and incorporate the American Speech-Language-Hearing Association’s “American Speech-Language-Hearing Association Code of Ethics” (2016) by reference, not including any further editions or amendments thereof and only to the extent that the provisions therein are not inconsistent with these regulations.

A.Wherever used in this Part, the following terms shall be construed as follows:

1.“Accredited/approved” means that an institution/program holds regional accreditation from one (1) of six (6) regional accrediting bodies: Middle States Association of Colleges and Schools, New England Association of Schools and Colleges, North Central Association of Colleges and Schools, Northwest Association of Schools and Colleges, Southern Association of Colleges and Schools, and Western Association of Schools and Colleges.

2."Act" means R.I. Gen. Laws Chapter 5-48 entitled, "Speech Pathology and Audiology."

3."Audiologist" means an individual who is licensed by the Board to practice audiology.

4."Audiology" means the application of principles, methods, and procedures related to hearing and the disorders of the hearing and balance systems, to related language and speech disorders, and to aberrant behavior related to hearing loss by an audiologist. A hearing disorder is defined as altered sensitivity, acuity, function, processing, and/or damage to the integrity of the physiological auditory/vestibular systems, in individuals or groups of individuals who have or are suspected of having such disorders.

5."Audiology support personnel" shall operate under the title “audiometric aide” and means an individual who meets minimum qualifications, established by the Board, which are less than those established by the Act as necessary for licensing as an audiologist; does not act independently; is limited to hearing screening with pass/fail criteria, and works under the direction and supervision of an audiologist licensed under the Act who has been actively working in the field for twenty-four (24) months after completion of the postgraduate professional experience and who accepts the responsibility for the acts and performances of the audiometric aide while working under the Act.

6."Board" means the "State Board of Examiners for Speech Pathology and Audiology."

7."Clinical fellowship or traineeship" means the direct clinical work, consultation or other duties relevant to clinical speech language pathology work with individuals presenting disorders in communication, for a cumulative or equivalent total of nine (9) months of full- time employment following completion of professional speech language pathology education under supervision pursuant to R.I. Gen. Laws § 5-48-7.

8."Clinical fellow" means the person who is practicing speech language pathology under the supervision of a licensed speech language pathologist while completing the postgraduate professional experience as required by the Act and who holds a current provisional license in accordance with the requirements described in this Part.

9.“Department” means the Rhode Island Department of Health.

10."Director" means the Director of the Rhode Island Department of Health.

11.“Graduate program” means a post-baccalaureate accredited program leading to a master’s or doctoral degree, including a professional doctoral degree, whether offered through an accredited graduate or professional school.

12.“Newborn Hearing Screener” means an audiometric aide working in a hospital-based newborn hearing screening program under the direction of the RI Department of Health Newborn Hearing Screening Program or its appointee.

13."Person” means an individual, partnership, organization or corporation, except that only individuals can be licensed under the Act.

14."The practice of audiology" means an audiologist rendering or offering to render any service in audiology as defined in R.I. Gen. Laws § 5-48-1(8)(i).

15."The practice of speech language pathology" means rendering or offering to render any service in speech language pathology as defined in R.I. Gen. Laws § 5-48-1(9)(i).

16."Regionally accredited" means the official guarantee that a college or university or other educational institution is in conformity with the standards of education prescribed by a regional accrediting commission recognized by the United States Secretary of Education.

17.“School Hearing Screener” means an audiometric aide working in a school-based hearing screening program under the direction of the RI Department of Education or its appointee.

18."Speech language pathologist” means an individual who is licensed by the Board to practice speech language pathology.

19."Speech language pathology" means the activities defined in R.I. Gen. Laws § 5-48-1(12).

20."Speech language support personnel" means an individual who meets minimum qualifications established by the Board, which are less than those established by the Act as necessary for licensing as a speech language pathologist; does not act independently; and works under the direction and supervision of a speech language pathologist licensed under the Act who has been actively working in the field for twenty-four (24) months after completion of the postgraduate professional experience and who accepts the responsibility for the acts and performances of the speech language pathology assistant while working under the Act..

A.No person shall practice as, advertise as, or use the title of speech pathologist or audiologist unless licensed in accordance with the provisions of the Act and this Part. The provisions of the Act and this Part shall not apply to individuals specifically exempt from the provisions thereof by R.I. Gen. Laws § 5-48-10.

B.A provisional license for the clinical fellow (defined in § 33.3(A)(8) of this Part) shall be required in speech language pathology for that period of postgraduate professional experience as required in R.I. Gen. Laws § 5-48-7 and § 33.5 of this Part. A provisional license shall authorize an individual to practice speech-language pathology solely in connection with the completion of the supervised postgraduate professional experience.

A.Audiologists

1.In addition to the requirements set forth in R.I. Gen. Laws § 5-48-7.2, persons seeking initial licensure as an audiologist shall meet the following requirements:

a.Submit an official transcript indicating possession of an earned doctorate degree in audiology from a regionally accredited educational institution or other national accrediting organization as may be approved by the Board;

b.Pass a national examination in audiology approved by the Board;

c.Present evidence of practicum experience that is equivalent to a minimum of twelve (12) months of full-time, supervised experience, that may be completed as part of the graduate degree, as delineated in this Part;

d.Applicants with a Master’s Degree holding licensure from another state must present verification of a Certificate of Clinical Competence from the American Speech Language Hearing Association (ASHA) or other national accrediting association as may be approved by the Board.

B.Qualifications for Audiologists Licensed in Alternate Jurisdictions

1.Persons licensed as an audiologist in alternate jurisdictions on or before January 1, 2008 shall meet the requirements of Rhode Island that were in effect at the time of initial licensure in the alternate jurisdiction.

C.Speech Language Pathologists

1.In addition to the requirements set forth in R.I. Gen. Laws § 5-48-7 an applicant seeking licensure to practice as a speech language pathologist in Rhode Island must:

a.Have attained a master's degree or a doctoral degree or equivalent in speech language pathology from an accredited educational institution accredited by the Council on Academic Accreditation (CAA) of the American Speech Language Hearing Association (ASHA) or other national accrediting association as may be approved by the Board. The degree shall consist of course work in accordance with the current minimum requirements for the certificate of clinical competence issued by the American Speech Language Hearing Association (ASHA) or other national accrediting association as may be approved by the Board.

D.Qualifications for a Provisional License for Speech Language Pathologists

1.To be eligible for provisional licensure by the Department, the speech language pathologist must submit an application with the required application fee and be in compliance with the requirements of this Part and § 5-48-7.1 of the Act.

A.The Department shall issue a license as an audiologist or speech language pathologist, or renewal thereof, for a period of two (2) years. The license, unless sooner suspended or revoked, shall expire on the first day of July, two (2) years following its issuance, and may be renewed biennially (in even years), provided the applicant meets the requirements of this Part and the statutory provisions of the Act.

B.A license may be renewed by submission of the renewal application and renewal fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title) payable before July 1 of even years (biennially).

C. A provisional license may be renewed annually from the date of issue, if the post- graduate professional experience has exceeded one (1) year, by submission of the renewal application and renewal fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health. A provisional license shall not exceed thirty-six (36) months past the initiation of the professional experience and will expire ninety (90) days after the end of the postgraduate professional experience.

D.Any licensee who allows his or her license to lapse by failing to renew it on or before the thirtieth (30th) day of June of even years (biennially), may have the license renewed by submitting to the Department an application and renewal fee plus an additional late fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title).

1.Any person who allows his or her license to lapse longer than two (2) consecutive licensing periods may be reinstated by the Department, upon the filing of:

a.A reinstatement application for licensure;

b.Payment of the current licensure renewal fee plus an additional late fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title); and

c.Documentation of completion of CEUs as required in § 33.9(A) of this Part taken during the previous two (2) years.

E.Inactive Status

1.An individual licensed as a speech language pathologist and/or audiologist in Rhode Island, not in the active practice of speech-language pathology or audiology within Rhode Island during any year, may upon request to the Department, have his or her name transferred to an inactive status and shall not be required to register biennially or pay any fee as long as he or she remains inactive.

a.Inactive status may be maintained for no longer than two (2) consecutive licensing periods, after which period licensure will be terminated and a reinstatement application submitted to the Department will be required to resume practice.

b.Any individual whose name has been transferred to an inactive status may be restored to active status within two (2) licensing periods to practice speech language pathology or audiology without a penalty fee, upon the filing of:

(1)An application for licensure renewal with a licensure renewal fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title); and

(2)Such other information as may be requested by the Board.

A.The Board is authorized to suspend or revoke any license to practice speech language pathology and/or audiology upon finding by the Board that the person is guilty of conduct as set forth in R.I. Gen. Laws § 5-48-11, and in addition:

1.Violating any provision of the Act, any lawful order given, or rule or regulation adopted by the Board or departure from or failure to conform to the current standards of acceptable prevailing practice and code of ethics of speech language pathology or audiology as adopted by the Board and as contained in “American Speech-Language-Hearing Association Code of Ethics” as incorporated above at § 33.2 of this Part. The Board need not establish actual injury to clients in order to adjudge a speech language pathologist or audiologist of the above named conduct.

2.The procedure for denial, revocation or suspension shall be as that set forth in R.I. Gen. Laws § 5-48-13.

A.Support personnel for speech language pathologists shall meet the following requirements:

1.Hold a bachelor's degree from an accredited college or university and have successfully completed no less than eighteen (18) hours of graduate credit in the areas of speech language pathology to include the following:

a.Normal processes in speech, language and hearing (3 hours);

b.Disorders of speech, language and hearing (9 hours);

c.Equipment, materials, procedures and data collection used in assessment and/or management of speech, language and hearing disorders (6 hours); and

d.Completion of twenty-five percent (25%) of those practicum hours required for professional personnel by the American Speech-Language Hearing Association (ASHA).

B.Support personnel for audiologists (audiometric aide) must meet the following requirements:

1.Hold a high school diploma;

2.Receive intensive on-the-job training in accordance with American Speech-Language Hearing Association (ASHA) or American Academy of Audiology (AAA) guidelines for support personnel by the supervising licensed audiologist prior to providing services. (Any subsequent supervising licensed audiologist may require retraining of an audiometric aide under his/her supervision).

C.Supervision and Responsibility: A supervising professional must be licensed under the Act who has been actively working in the field for twenty-four (24) months after completion of the postgraduate professional experience, and must be responsible for the acts and performances, patient screening, and specific tasks assigned by the licensee to the speech language pathologist/audiometric aide.

1.A licensee who supervises support personnel must:

a.Utilize the services of only those who meet the minimum requirements enumerated under § 33.8 of this Part;

b.Ensure that the support personnel are assigned only those duties and responsibilities for which the person has been specifically trained and which the assistant is qualified to perform;

c.Ensure that persons who will be receiving services from support personnel, or the person's legal representative, are informed that services are being rendered by support personnel;

d.Provide supervision of the support personnel (other than newborn hearing screeners and school hearing screeners):

(1)A speech/language pathologist supervisor may only supervise one (1) full- time equivalent speech language support personnel and an audiologist supervisor may only supervise three (3) full-time equivalent audiometric aides, unless otherwise approved by the Board;

(2)Observations of support audiometric aides must be completed and documented as to date, amount of time, and accuracy and efficacy of service according to the following:

(AA)Direct on-site observations of the first ten (10) hours of direct client contact; and five percent (5%) of all clinical sessions after the first ten hours for every forty (40) consecutive hours worked; and

(BB)Indirect supervision (e.g. Phone, interactive television, audio/video review or patient record review) of five percent (5%) of each forty (40) consecutive hours worked.

(3)Observations of speech language pathology support personnel must be completed and documented as to date, amount of time, and accuracy and efficacy of service according to the following:

(AA)Direct on-site observations of the first ten (10) hours of direct client contact; and ten percent (10%) of clinical sessions after the first ten (10) hours of each forty (40) consecutive hours worked; and

(BB)(Indirect supervision (e.g. phone, interactive television, audio/video review) of ten percent (10%) of each forty (40) consecutive hours worked.

e.Provide supervision of the support personnel (newborn hearing screeners and school hearing screeners):

(1)Hospital-based newborn hearing screeners and school-based hearing screeners shall be trained by a licensed audiologist working in the newborn hearing or school screening program according to training guidelines established by the programs.

(2)Supervision will include a method of evaluation and documenting the competency of each screener upon completion of the initial training and at least annually thereafter by a licensed audiologist working in the newborn hearing or school screening program.

f.Observe all provisions of the ASHA policy regarding support personnel unless a specific policy is addressed in this Part, including but not limited to, that the licensee must maintain records which document the frequency and type of supervision of support personnel, such records to be available for audit upon request by the Board.

A.On or before the thirtieth (30th) day of June of even years, every person licensed to practice speech language pathology and/or audiology within Rhode Island shall complete not less than twenty (20) clock hours of continuing education within the preceding two (2) years and be able to present satisfactory evidence of completion to the Department.

1.Course descriptions, proof of attendance, or other documentation of completion shall be retained by the licensee for a minimum of four (4) years and is subject to random audit by the Department.

2.Activities approved by the Board for continuing education credit are those sponsored by the American Speech-Language Hearing Association (ASHA), the American Academy of Audiology (AAA), a state department of education, other International Association for Continuing Education and Training (IACET)-authorized providers, and/or continuing medical education units (CMEs) from the Accreditation Council for Continuing Medical Education (ACCME). Approved activities may include conferences, seminars, self- study programs, courses, or workshops sponsored by the organizations noted above, or course work from an accredited institution.

B.Those persons holding licensure in both speech language pathology and audiology must have completed and have evidence of completion of not less than thirty (30) clock hours of continuing education within the preceding two (2) years.

C.Continuing education hours may not be carried over from one (1) renewal period to the next.

D.Speech language pathologist or audiologists initially licensed by examination after the July 1st renewal date shall be exempt from the continuing education requirements stated in this Part until the date of the next renewal cycle (i.e., June 30th of the second year following its issuance).

E.The Board, at its discretion, may extend, reduce, or waive for a person the requirement for continuing education for hardship or other extenuating circumstances as the Board deems appropriate.

An audiologist who engages in the dispensing and/or selling of hearing aids shall comply with any and all federal and state laws and regulations governing the sale of hearing aids.

All hearings and reviews required under the provisions of the Act shall be held in accordance with the provisions of the rules and regulations regarding Practices and Procedures Before the Department of Health (Part 10-05-4 of this Title) and Access to Public Records (Part 10-05-1 of this Title).