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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2025

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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

     Referred To: House Corporations

     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

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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;

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     (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

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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.

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     (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

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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

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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

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(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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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- PROFESSIONAL LICENSING AND

REGULATION OF SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS

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     This act would establish prevailing standards and procedures for licensing speech-language

pathologists and audiologists in Rhode Island.

     This act would take effect upon passage.

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