| Chapter 331 |
| 2025 -- H 5557 SUBSTITUTE A Enacted 06/30/2025 |
| A N A C T |
| RELATING TO BUSINESSES AND PROFESSIONS -- PROFESSIONAL LICENSING AND REGULATION OF SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS |
Introduced By: Representatives Shallcross Smith, Ackerman, Fellela, Perez, Baginski, Casimiro, Alzate, and Fogarty |
| Date Introduced: February 26, 2025 |
| It is enacted by the General Assembly as follows: |
| SECTION 1. Sections 5-48.2-6, 5-48.2-8, 5-48.2-9, 5-48.2-10 and 5-48.2-11 of the General |
| Laws in Chapter 5-48.2 entitled "Professional Licensing and Regulation of Speech-Language |
| Pathologists and Audiologists" are hereby amended to read as follows: |
| 5-48.2-6. Issuance and renewal of license and fee. |
| (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 chapter and the |
| statutory provisions of the act. The licensee must maintain their certificate of clinical competence |
| in their practicing area (speech-language pathology or audiology) in order to renew their license. |
| (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 in their regulations payable before July 1 of even years (biennially). |
| (c) A provisional license may be renewed annually from the date of issue, if the |
| postgraduate professional experience has exceeded one 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)(1) Any licensee who allows their license to lapse by failing to renew it on or before the |
| thirtieth 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. |
| (2) Any person who allows their license to lapse longer than two (2) consecutive licensing |
| periods may be reinstated by the department, upon the filing of: |
| (i) A reinstatement application for licensure; |
| (ii) 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; and |
| (iii) Documentation of completion of continuing education units (CEUs) as required in this |
| chapter 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 their name transferred to an inactive |
| status and shall not be required to register biennially or pay any fee as long as the individual remains |
| inactive. |
| (2) 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. |
| (3) 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: |
| (i) 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; and |
| (ii) Such other information as may be requested by the board. |
| 5-48.2-8. Support personnel. |
| (a) A speech-language pathology assistant (SLPA) 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: |
| (i) Normal processes in speech, language, and hearing three (3) hours; |
| (ii) Disorders of speech, language, and hearing nine (9) hours; |
| (iii) Equipment, materials, procedures, and data collection used in assessment and/or |
| management of speech, language, and hearing disorders six (6) hours; and |
| (iv) Completion of twenty-five percent (25%) of those practicum hours required for |
| professional personnel by the American Speech-Language-Hearing Association. |
| Possess at minimum a: |
| (i) Two-(2)year (2) speech-language pathology assistant program degree from an |
| accredited institution; or |
| (ii) Bachelor's degree in communication sciences and disorders from an accredited |
| institution; or |
| (iii) Bachelor's degree and a certificate from a board approved speech-language pathology |
| assistant program; or |
| (iv) Associate’s, bachelor’s, or advanced degree from an accredited institution in a related |
| field to include, but not limited to, human development and family sciences, education, or |
| psychology and complete at least eighteen (18) credit hours in coursework in speech-language |
| pathology in the following areas: introductory or overview course in communication disorders, |
| phonetics, anatomy and physiology of speech and hearing mechanisms, language development, |
| speech and language disorders, and clinical methods in speech-language pathology. |
| (2) Complete: |
| (i) Twenty-five (25) hours of documented observation of a licensed speech-language |
| pathologist, which may be accomplished within an undergraduate program of study; and |
| (ii) One hundred (100) clinical hours under the supervisions of a licensed speech-language |
| pathologist. |
| (b) Scope of practice of speech-language pathology assistants. A licensed speech-language |
| pathology assistant shall only engage in those duties that adhere to the code of ethics of the board |
| and are planned, designed, and supervised by a licensed speech-language pathologist, including: |
| (1) Developing low-tech augmentative and alternative communication materials for |
| students, patients, and clients; |
| (2) Assisting with speech, language, and hearing screenings without clinical interpretation |
| of results; |
| (3) Administering and scoring screenings for clinical interpretation by the supervising |
| speech-language pathologist; |
| (4) Assisting with, but not administering or interpreting the results of, client assessments, |
| including setting up the testing environment, gathering and preparing materials, and taking notes; |
| (5) Administering and scoring assessments and progress monitoring tools without clinical |
| interpretation of results, if the licensed speech-language pathology assistant meets the examiner |
| requirements for such tools and the supervising speech-language pathologist has verified that such |
| examiner requirements have been met; |
| (6) Performing routine activities for therapy sessions in accordance with a plan developed |
| and directed by the speech-language pathologist who retains the professional responsibility for such |
| client, including: |
| (i) Implementing documented care plans or protocols; |
| (ii) Providing direct therapy services to address treatment goals; |
| (iii) Adjusting and documenting the amount and type of support or scaffolding provided to |
| the client in treatment to facilitate progress; and |
| (iv) Developing and implementing activities and materials for teaching and practice of |
| skills to address the goals of the client; |
| (7) Providing treatment through a variety of service delivery models as directed by the |
| supervising speech-language pathologist; |
| (8) Utilizing telecommunications technology to provide services remotely to clients as |
| directed by the supervising speech-language pathologist; |
| (9) Documenting client performance and reporting such performance information to the |
| supervising speech-language pathologist; |
| (10) Providing caregiver coaching, including modeling and teaching communication |
| strategies and providing feedback regarding caregiver-client interactions for facilitation and |
| carryover of skills; |
| (11) Sharing objective information regarding client performance without interpretation or |
| recommendations as directed by the supervising speech-language pathologist; |
| (12) Assisting with programming augmentative and alternative communication devices |
| and assisting and training clients with using such devices; |
| (13) Demonstrating strategies and assisting clients with skills included in the feeding and |
| swallowing plan developed by the supervising speech-language pathologist; |
| (14) Signing or initialing informal treatment notes and, upon request, co-signing formal |
| documents with the supervising speech-language pathologist; |
| (15) Assisting with clerical duties and site operations, including preparing materials, |
| scheduling appointments and activities, preparing charts, records, or graphs, and performing checks |
| and maintenance of equipment; |
| (16) Assisting clients with transitioning to and from therapy sessions; and |
| (17) Performing duties not otherwise restricted to the practice of speech-language |
| pathology. |
| (c) A speech-language pathologist assistant shall not hold themself out to be, or use the |
| title speech-language pathology assistant unless licensed pursuant to this chapter and shall not |
| engage in the practice of speech-language pathology, including the following: |
| (1) Representing themselves as a speech-language pathologist; |
| (2) Performing diagnostic tests or evaluations; |
| (3) Performing procedures that require a professional level of clinical judgment and |
| technical skill; |
| (4) Interpreting results and observations of feeding and swallowing evaluations or |
| screenings performed by a speech-language pathologist; |
| (5) Participating in formal conferences or meetings without the presence of the supervising |
| speech-language pathologist; |
| (6) Providing interpretative information to a client, the family of a client, or any other |
| individual; |
| (7) Writing, developing, or modifying a client's treatment plan; |
| (8) Assisting in or providing services described in subsection (a) of this section unless |
| directed by the supervising speech-language pathologist; |
| (9) Signing any formal documents in place of the supervising speech-language pathologist; |
| (10) Selecting a client for service or discharging a client from service; |
| (11) Making a decision regarding the need for additional services or making a referral for |
| service; |
| (12) Disclosing clinical or confidential information either orally or in writing to anyone |
| other than the supervising speech-language pathologist, unless mandated by law or authorized by |
| the supervising speech-language pathologist; |
| (13) Developing or determining the swallowing or feeding strategies or precautions for a |
| client or providing feeding or swallowing treatment; |
| (14) Selecting augmentative and alternative communication systems or devices; or |
| (15) Treating medically fragile students, patients, and clients without one hundred percent |
| (100%) direct supervision by a licensed speech-language pathologist. |
| (2)(d) A speech-language pathology assistant (SLPA) shall be registered licensed at the |
| department and be required to re-register renew their license every two (2) years. |
| (b)(e) Support personnel for audiologists (audiometric aide) or audiology assistants must |
| meet the following requirements: |
| (1) Hold a high school diploma; |
| (2) Receive intensive on-the-job training in accordance with the 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 or |
| audiology assistant under the supervising licensed audiologist’s supervision. |
| (3) Audiometric aides or audiology assistants shall be registered at the department and be |
| required to re-register every two (2) years. |
| 5-48.2-9. Supervision and responsibility. |
| (a)(1) A supervising professional must be a speech-language pathologist or audiologist who |
| is licensed under the act and this chapter; has attained and maintained their certificate of clinical |
| competency and 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 |
| pathology assistant (SLPA)/audiometric aide or audiology assistant. |
| (2) A licensee who supervises support personnel must: |
| (i) Utilize the services of only those who meet the minimum requirements enumerated |
| under this chapter; |
| (ii) 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; |
| (iii) 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; |
| (iv) Provide supervision of the support personnel (other than newborn hearing screeners |
| and school hearing screeners); and |
| (v) Complete a minimum of two (2) hours of professional development in clinical |
| instruction/supervision. |
| (b) A speech-language pathologist supervisor may only supervise one full-time equivalent |
| speech-language pathology assistant (SLPA) support personnel and not more than two (2) SLPAs |
| at any time and an audiologist supervisor may only supervise three (3) full-time equivalent |
| audiometric aides or audiology assistants unless otherwise approved by the board. At no time |
| should support personnel perform tasks when a supervising SLPA cannot be reached by personal |
| contact, phone, pager, or other immediate means. When multiple supervisors are used, the |
| supervisors are encouraged to coordinate and communicate with each other. |
| (c) 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: 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 (10) hours for every forty (40) consecutive hours worked; and |
| indirect supervision (e.g., home, interactive television, audio/video review, or patient record |
| review) of five percent (5%) of each forty (40) consecutive hours worked. |
| (d) Observations of a speech-language pathology assistant (SLPA) pathology support |
| personnel shall be completed and documented as to date, amount of time, and accuracy and efficacy |
| of service according to the following: |
| (1) Direct supervision means in-view observation and guidance while the SLPA is |
| performing a clinical activity. Direct supervision does not include reviewing an audio or video |
| recorded session later. |
| (2) A minimum of twenty percent (20%) direct supervision and ten percent (10%) indirect |
| supervision is required of all the time that assistant is providing services during the first ninety (90) |
| days of employment. After the first ninety (90) days, the supervising SLPA may adjust their amount |
| of supervision if they determine that the SLPA meets appropriate competencies. A minimum of ten |
| percent (10%) direct and ten percent (10%) indirect supervision is required every one hundred |
| eighty (180) days regardless of employment status. |
| (e) Before any SLPA begins to provide support independently, the supervising SLP must |
| have first contact with all individuals on the caseload. For purposes of this section, first contact |
| includes establishing rapport, gathering baseline data, and securing other necessary documentation |
| to begin (or continue) the plan of care for the student, patient, or client. |
| (f) Supervisors shall 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. |
| 5-48.2-10. Supervision of support personnel — Newborn hearing screeners and school |
| hearing screeners. |
| (a) 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. |
| (b) Supervision shall 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. |
| (c) Observations of a speech-language pathology assistant (SLPA) pathology support |
| personnel must be completed and documented as to date, amount of time, and accuracy and efficacy |
| of service according to the following: |
| (1) 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 |
| (2) Indirect supervision (e.g., phone, interactive television, audio/video review) of ten |
| percent (10%) of each forty (40) consecutive hours worked. |
| (d) Supervisors shall must observe all provisions of the ASHA policy regarding support |
| personnel unless a specific policy is addressed in this chapter, including, but not limited to, that the |
| licensee must maintain records that document the frequency and type of supervision of support |
| personnel, such records to be available for audit upon request by the board. |
| 5-48.2-11. Continuing education requirements. |
| (a) On or before the thirtieth 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 renewal period to the |
| next. |
| (d)(1) Continuing education hours must be in accordance with the American Speech- |
| Language-Hearing Association’s requirements including at least two (2) hours in cultural |
| competency, cultural humility, culturally responsive practice or diversity, equity, and inclusion |
| (DEI) and at least one hour in the area of ethics. |
| (2) If the licensee is acting as a clinical supervisor, a minimum of two (2) hours of |
| professional development in clinical instruction/supervision is required. |
| (e) Speech-language pathologists or audiologists initially licensed by examination after the |
| July 1 renewal date shall be exempt from the continuing education requirements stated in this |
| section until the date of the next renewal cycle (i.e., June 30 of the second year following its |
| issuance). |
| (f) 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. |
| (g) The board shall promulgate regulations requiring continuing education for any speech- |
| language pathology assistant license renewal or reinstatement. The board may grant exceptions or |
| exemptions from these continuing education requirements. |
| SECTION 2. This act shall take effect upon passage. |
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| LC001844/SUB A |
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