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 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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