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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