TITLE 16. ECONOMIC REGULATION

PART 4. TEXAS DEPARTMENT OF LICENSING AND REGULATION

CHAPTER 75. AIR CONDITIONING AND REFRIGERATION

16 TAC §§75.10, 75.20 - 75.23, 75.28 - 75.30, 75.70, 75.71, 75.73, 75.80, 75.120 - 75.123

The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 75, §§75.10, 75.20 - 75.23, 75.28 - 75.30, 75.70, 75.71, 75.73, 75.80, and proposes new rules at 16 TAC, §§75.120 - 75.123, regarding the Air Conditioning and Refrigeration program.

JUSTIFICATION AND EXPLANATION OF THE RULES

The proposed rules implement changes from House Bill 3029, 85th Legislature, Regular Session (2017), which adds the definition of certification training program, certified technician, and distinguishes the certified legacy technician. The proposed rules include editorial corrections. The proposed rules are necessary to implement House Bill 3029.

SECTION-BY-SECTION SUMMARY

The proposed amendments to §75.10 add the definition "certification training program", "certification training program provider", "certified technician", and "certified technician (legacy)". The section is also renumbered accordingly.

The proposed amendments to §75.20 update the language for clarity.

The proposed amendments to §75.21 update the language for ease and understanding.

The proposed amendments to §75.22 updates the language for clarity.

The proposed amendments to §75.23 make editorial corrections.

The proposed amendments to §75.28 establish the certified technician designation.

The proposed amendments to §75.29 add air conditioning and refrigeration technician certification to the renewal requirements.

The proposed amendments to §75.30 exempt certain persons who are enrolled in the certification training program.

The proposed amendments to §75.70 add certified technicians to the section and makes editorial corrections.

The proposed amendments to §75.71 add certified technicians to the responsibilities of the contracting company and makes editorial corrections.

The proposed amendments to §75.73 add the responsibilities for certified technicians and makes editorial changes.

The proposed amendments to §75.80 create an application and renewal fee for a certified technician; approval of a certification training program fee; and the registered technician renewal fee.

The proposed new §75.120 creates application and eligibility requirements for the certified technician.

The proposed new §75.121 establishes examination requirements for certified technicians.

The proposed new §75.122 details certification training program requirements.

The proposed new §75.123 establishes certification training program provider responsibilities.

FISCAL IMPACT ON STATE AND LOCAL GOVERNMENT

Brian E. Francis, Executive Director, has determined that in the first five years the proposed rules are in effect, there will be estimated additional costs to the State as a result of enforcing or administering the proposed rules. The anticipated cost for the first fiscal year is zero; for the second fiscal year, $80,226; for the third, $112,210; and for the fourth and fifth fiscal years, $108.822. These estimates assume the Department will need to hire up to two FTEs in order administer the program and respond to customer service inquiries.

Mr. Francis has determined that in the first five years the proposed rules are in effect, there will be an estimated increase of revenue to the State as a result of enforcing or administering the proposed rules. The estimated additional revenue for the first fiscal year is zero; for the second fiscal year, $32,550; for the third, $52,425; for the fourth, $56,760; and for the fifth fiscal year, $61,575.

Mr. Francis has determined that for the first five-year period the proposed rules are in effect, there will be no fiscal implications for local governments as a result of enforcing or administering the proposed rules.

LOCAL EMPLOYMENT IMPACT STATEMENT

Mr. Francis has determined that the proposed rules will not affect the local economy, so the agency is not required to prepare a local employment impact statement, under Government Code §2001.022.

PUBLIC BENEFITS

Mr. Francis has also determined that for each year of the first five-year period the proposed rules are in effect, the public will benefit from a more skilled and qualified labor force in the air conditioning and refrigeration industry.

PROBABLE ECONOMIC COSTS TO PERSONS REQUIRED TO COMPLY WITH PROPOSAL

Mr. Francis has determined that for each year of the first five-year period the proposed rules are in effect, there will be economic costs to persons who desire to become certified technicians. An individual wishing to become a certified technician pursuant to the provisions of House Bill 3029 and these rules will be required to pay an application fee of $50 and an annual renewal fee of $35. Additionally, a provider of a certification training program will be required to pay an annual fee of $90 for review and approval of the program.

FISCAL IMPACT ON SMALL BUSINESSES, MICRO-BUSINESSES, AND RURAL COMMUNITIES

There will be no adverse effect on small businesses, micro-businesses, or rural communities as a result of the proposed rules.

Since the agency has determined that the proposed rule will have no adverse economic effect on small businesses, micro-businesses, or rural communities, preparation of an Economic Impact Statement and a Regulatory Flexibility Analysis, as detailed under Texas Government Code §2006.002, are not required.

ONE-FOR-ONE REQUIREMENT FOR RULES WITH A FISCAL IMPACT

Under Government Code §2001.0045, a state agency may not adopt a proposed rule if the fiscal note states that the rule imposes a cost on regulated persons, including another state agency, a special district, or a local government, unless the state agency: (a) repeals a rule that imposes a total cost on regulated persons that is equal to or greater than the total cost imposed on regulated persons by the proposed rule; or (b) amends a rule to decrease the total cost imposed on regulated persons by an amount that is equal to or greater than the cost imposed on the persons by the proposed rule. There are exceptions for certain types of rules under §2001.0045(c).

Because the proposed rules are necessary to implement legislation, namely House Bill 3029 (85th R.S. 2017), the agency is not required to take any further action under Government Code §2001.0045. See Government Code §2001.045(c)(9).

GOVERNMENT GROWTH IMPACT STATEMENT

Pursuant to Government Code §2001.0221, the agency provides the following Government Growth Impact Statement for the proposed rules. For each year of the first five years the rule will be in effect, the agency has determined the following:

(1) The proposed rules do not create a government program. These proposed rules implement House Bill 3029, which creates the certified technician certification within the Department's existing Air Conditioning and Refrigeration program.

(2) Implementation of the proposed rules will require the creation of an estimated two new employee positions.

(3) Implementation of the proposed rules will not require an increase in future legislative appropriations to the agency.

(4) The proposed rules require an increase in fees paid to the agency. House Bill 3029 requires applicants to prove experience and educational requirements, and to pass a Department-developed examination. Under the law prior to House Bill 3029, applicants were merely required to register with the Department and pass an examination recognized, but not developed, by the Department. These increased requirements necessitate an increased application fee for certified technicians. Additionally, because the Department must ensure the integrity of certification training programs offered to prospective certified technicians, a fee is needed to fund the agency's review and audits of these training programs.

(5) The proposed rules create new regulations §75.120 - §75.123. The Technician Certificate is a new license type as well as Training Program Providers. The Training Program Providers will have to apply for approval and renew annually.

(6) The proposed rules expand and limit existing regulations. The proposed rule limits the existing certified registered technician (legacy). No more initial registrations of this type will be issued and the current registrants may only renew their registration.

(7) The proposed rules increase the number of individuals subject to the rules' applicability. The proposed rules require providers of certification training programs to receive approval from the Department. Expanding the scope of the rules in this way is necessary to implement House Bill 3029 effectively.

(8) The proposed rules do not adversely affect this state's economy.

PUBLIC COMMENTS

Comments on the proposal may be submitted by mail to Ana Villarreal, Legal Assistant, Texas Department of Licensing Regulation, P.O. Box 12157, Austin, Texas 78711; or by facsimile to (512) 475-3032, or electronically to erule.comments@tdlr.texas.gov. The deadline for comments is 30 days after publication in the Texas Register.

STATUTORY AUTHORITY

The amendments and new rules are proposed under Texas Occupations Code, Chapter 51, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, and 1302. No other statutes, articles, or codes are affected by the proposal.

§75.10.Definitions.

The following words and terms have the following meanings as used in this chapter:

(1) - (9) (No change.)

(10) Certification training program--A program of education and training, further addressed in §75.283, consisting of a combination of classroom instruction and supervised practical experience.

(11) Certification training program provider--A person providing or offering to provide a certification training program.

(12) Certified technician--A person granted an air conditioning and refrigeration technician certification by the department pursuant to §75.281, and §1302.5036 and §1302.5055 of the Act.

(13) Certified technician (legacy)--A person granted a certified technician designation by the department pursuant to §75.28, and §1302.508 of the Act, as continued by House Bill 3029 §18, 85th Leg., R.S. (2017).

(14) [(10)] Cheating--Attempting to obtain, obtaining, providing, or using answers to examination questions by deceit, fraud, dishonesty, or deception.

(15) [(11)] Cryogenics--Refrigeration that deals with producing temperatures ranging from:

(A) - (D) (No change.)

(16) [(12)] Department--The Texas Department of Licensing and Regulation.

(17) [(13)] Design of a system--Making decisions on the necessary size of equipment, number of grilles, placement and size of supply and return air ducts, and any other requirements affecting the ability of the system to perform the function for which it was designed.

(18) [(14)] Direct supervision--Directing and verifying the design, installation, construction, maintenance, service, repair altercation, or modification of an environmental air conditioning, refrigeration, process cooling, or process hearing product or equipment to assure mechanical integrity. Verification may include, but is not limited to:

(A) - (C) (No change.)

(19) [(15)] Employee--An individual who performs tasks assigned by an employer, and who is subject to the employer's control in all aspects of job performance, except that a licensed air conditioning and refrigeration contactor remains responsible for all air conditioning work he or she performs. An employee's wages are subject to deduction of federal income taxes and social security payments. An employee may be full time, part time, or seasonal. Simultaneous employment with a temporary employment agency, a staff leasing agency, or other employer does not affect an employee's status for the purpose of this chapter.

(20) [(16)] Executive Director--The executive director of the department.

(21) [(17)] Full Time employee--An employee who is present on the job either 40 hours a week, or at least 80% of the time the company is offering air conditioning and refrigeration contracting services to the public, whichever is less.

(22) [(18)] Licensee--An individual holding a contractor's license of the class and endorsement appropriate to the work performed under the Act and this chapter.

(23) [(19)] Offering to perform--Making a written or oral proposal, contracting in writing or orally to perform air conditioning and refrigeration work, or advertising in any form through any medium that a person or business entity is an air conditioning and refrigeration contractor, or that implies in any way that a person or business entity is available to contract for or perform air conditioning and refrigeration work.

(24) [(20)] Permanent office--Any location, which must be identified by a street address, or other data identifying a rural location, from which a person or business entity conducts the business of an air conditioning and refrigeration contracting company. A location not open to the public, or not located within the state, may serve as a permanent office so long as the department and consumers have access to the licensee required by §1302.252 of the Act to be employed in each permanent office.

(25) [(21)] Portable--Able to be easily transported and readily used as an entire system, without need for dismantling or assembly in whole or in part, or addition of parts, components, or accessories.

(26) [(22)] Primary process medium--A refrigerant or other primary process fluid that is classified in the current ANSI/ASHRAE Standard 34 as Safety Group A1, A2, B1, or B2. Safety Groups A3 and B3 refrigerants are specifically excluded.

(27) [(23)] Proper installation and service--Installing, servicing, repairing, and maintaining air conditioning and refrigeration equipment in accordance with:

(A) - (D) (No change.)

(28) [(24)] Registrant--A person who is registered with the department as a technician under the Act and this chapter.

(29) [(25)] Repair work--Diagnosing and repairing problems with air conditioning, commercial refrigeration, or process cooling or heating equipment, and remedying or attempting to remedy the problem. Repair work does not mean simultaneous replacement of the condensing unit, furnace, and evaporator coil.

(30)[(26)] Self-contained--Constructed so that all required parts, components, and accessories of the air conditioning or heating system are included within the same enclosure.

(31) [(27)] System balancing--A process of adjusting, regulating or proportioning air distribution equipment or any activity beyond system testing.

(32) [(28)] System testing--Assessing or measuring the performance of the air distribution equipment or air conditioning and refrigeration duct system through equipment that can be attached externally to the system. Testing does not include opening, adjusting or balancing equipment or ducts or any activity beyond assessing the system through the use of external equipment. Testing does not include testing fire and smoke dampers,

(33) [(29)] Total replacement of a system--Simultaneous replacement of the condensing unit, the evaporator coil, the furnace, if applicable, and the air handling unit, or replacement of a package system.

§75.20.Contractor Licensing Requirements--Application and Experience Requirements.

(a) To obtain a contractor license, an applicant must:

(1) submit a completed application on a department-approved form;

(2) satisfy the requirements of [have the requisite amount of experience as prescribed under] Occupations Code §1302.255 based on the date the application is filed with the department;

(3) - (6) (No change.)

(b) (No change.)

§75.21.Contractor Licensing Requirements--Examinations.

(a) A person must satisfy the requirements of [obtain the requisite amount of experience as prescribed under] Texas Occupations Code §1302.255[,] based on the date the application is filed with the department, prior to taking an examination.

(b) - (d) (No change.)

§75.22.Contractor Licensing Requirements--General.

(a) - (e) (No change.)

(f) A contractor who holds two licenses may have only one endorsement per license [when he has two licenses]. Both licenses must have the same business affiliation and permanent and business addresses.

(g) The insurance requirement for separate licenses may [can] be met with a single policy with limits at least as high as those required for a Class A license. A waiver of insurance for one license automatically applies to both licenses.

(h) (No change.)

§75.23.Contractor Licensing Requirements--Temporary Licenses.

(a) A company owner or officer[,] whose only license holder is no longer available due to death or disability[,] may request a temporary license.

(b) - (e) (No change.)

§75.28.Registered Technician [Registration Requirements]--Certified Technician (Legacy) Designation.

(a) This section applies only to a person who submits an application for a certified technician designation on or before August 31, 2018.

[(a) A registered technician is not required to be certified by the department, and a registrant may perform the same tasks as those performed by a certified technician.]

(b) A registered technician may use the designation "certified technician" after obtaining a certified technician designation from the department [department certification].

(c) (No change.)

§75.29.Registered and Certified Technician [Registration] Requirements--Renewal.

To renew a technician registration or air conditioning and refrigeration technician certification[, with or without the certified technician designation], a person must:

(1) submit a completed renewal application on a department-approved form; and

(2) submit the required fees.

§75.30.Exemptions.

(a) The Act and this chapter do not apply to those persons exempt under Occupations Code, Chapter 1302, with the following clarifications:

(1) - (5) (No change.)

(6) a student enrolled in a certification training program who is either younger than 18 years of age or is enrolled at a secondary school.

(b) (No change.)

§75.70.Responsibilities of the Contractor/Licensee.

(a) The licensee must:

(1) if affiliated with an air conditioning and refrigeration contracting company, assign the [his] license to one company or one permanent office of the company that will use the license;

(2) (No change.)

(3) use the [his] license for one business affiliation and one permanent office at any one given time;

(4) furnish the department with the licensee's [his] permanent mailing address and the name, physical address, and telephone number of the air conditioning and refrigeration contracting company through which the licensee provides services;

(5) verify that all work for which the licensee [he] has supervisory responsibility is performed so that mechanical integrity of installed products, system or equipment is maintained, and that all maintenance, service, and repair work has been done properly;

(6) if affiliated with an air condition and refrigeration contracting company, furnish to municipalities a list of authorized agents that may pull permits under the license, and, if subcontracting jobs to other licensed air conditioning and refrigeration contracting companies, furnish a list of agents of these license companies that may pull permits under the [his] license;

(7) - (9) (No change.)

(10) not knowingly provide air conditioning and refrigeration work for or on behalf of an unlicensed air conditioning and refrigeration contracting company, or a contracting company that does not have an affiliation with a licensed individual who supervises all air conditioning and refrigeration work as provided by Occupations Code, Chapter 1302, and this chapter; [and]

(11) only use licensed contractors, [or] registered technicians, certified technicians, or students meeting the requirements of §75.30(a)(6) to perform maintenance work; and[.]

(12) (No change.)

(b) (No change.)

(c) The design of a system may not be subcontracted to an unlicensed person, firm or corporation.

(d) (No change.)

(e) The licensee is responsible for all work performed under the licensee's [his] supervision, regardless of whether the owners, officers, or managers of the air conditioning and refrigeration contracting company allow the licensee the authority to supervise, train, or otherwise control complain with the Act.

(f) A licensee may not allow another individual to use the licensee's [his] license for any purpose.

(g) A licensee may not allow any air conditioning and refrigeration contracting company with which the licensee [he] has no business affiliation to use the licensee's [his] license for any purpose, except as otherwise allowed by this chapter.

(h) - (j) (No change.)

§75.71.Responsibilities of the Contracting Company.

(a) An air conditioning and refrigeration contracting company [Air Conditioning and Refrigeration Contracting Company] must:

(1) - (6) (No change.)

(b) - (j) (No change.)

(k) An air conditioning and refrigeration contracting company may only use licensed contractors, [or] registered technicians, certified technicians, or students meeting the requirements of §75.30(a)(6) to perform maintenance work.

§75.73.Responsibilities of Registered and Certified Technicians [the Technician/Registrant].

(a) A registrant or certified technician must:

(1) provide proper installation and service, and assure the mechanical integrity of work and installations performed [by the registrant];

(2) - (4) (No change.)

(5) not use the designation "certified technician" designated as [he has been] certified by the department pursuant to §75.28 or granted an air conditioning and refrigeration technician certification by the department pursuant to§75.120. [, or has certified by examination given by a nationally recognized certification organization, and the individual lists the organization.]

(b) A registrant or certified technician may not allow another individual to use a [his] registration or certificate for any purpose.

(c) A registrant or certified technician may not allow any air conditioning and refrigeration contracting company or any air condition and refrigeration contractor with which he or she is not employed to use a [his] registration or certificate for any purpose, expect as otherwise allowed by this chapter.

(d) A registrant or certified technician must notify the department in writing, within thirty (30) calendar days of any change in permanent mailing address or[, and] telephone number.

(e) Altering a registration or certificate in any way is prohibited and is grounds for imposition of administrative penalties and/or sanctions.

(f) A registered technician is not required to be certified by the department, and a registrant may perform the same tasks as those performed by a certified technician.

§75.80.Fees.

(a) - (b) (No change.)

(c) Air Conditioning and Refrigeration Technicians.

(1) Registered technician [Technician registration] application fee is $20.

(2) Registered technician renewal application fee is $20.

(3) Certified technician application fee is $50.

(4) Certified technician renewal application fee is $35.

(5) Certified technician (legacy) designation application fee is $15.

[(2) Certified technician designation application fee is $15. This fee is in addition to the technician registration application fee.]

[(3) Technician registration renewal application fee (with or without the certified technician designation) is $20.]

(6) [(4)] Revised/Duplicate License/Certificate/Permit/Registration--$15.

(d) The application fee for approval or renewal of a certification training program is $90.

(e) [(d)] Late renewal fees for licenses and registrations issued under this chapter are provided under §60.83 of this title (relating to Late Renewal Fees).

§75.120.Certified Technician--Application and Eligibility Requirements.

(a) To obtain an air conditioning and refrigeration technician certification, an applicant must:

(1) be at least 18 years old at the time of application;

(2) submit a completed application on a department-approved form;

(3) at the time of application, have either:

(A) completed a department-accepted or approved certification training program within the previous 48 months; or

(B) performed 24 months of air conditioning and refrigeration-related work:

(i) under the supervision of a licensed air conditioning and refrigeration contractor; or

(ii) as part of the applicant's military occupational specialty within the armed forces of the United States;

(4) pass the examination;

(5) submit the required fees; and

(6) complete all requirements, including passing the exam, within one year of the date the application is filed.

(b) An applicant must submit the proper documentation as prescribed by the department to receive credit for the claimed amount and type of classroom instruction and practical experience.

(c) An applicant who receives a certification pursuant to this section may use the designation "certified technician."

(d) A certification issued under this section expires on the first anniversary of the date of issuance.

§75.121.Certified Technician--Examinations.

(a) A person must satisfy the requirements of Texas Occupations Code §1302.5036, based on the date the application is filed with the department, prior to taking an examination.

(b) A passing grade is 70%.

(c) A person taking an examination must comply with the department's examination requirements under, Chapter 60, Subchapter E of this title.

(d) Cheating on an examination is grounds for denial, suspension, or revocation of a license and/or an administrative penalty.

§75.122.Certification Training Program Requirements.

(a) A certification training program provider must receive approval from the department before offering or providing a certification training program.

(b) To obtain approval of a certification training program, an applicant shall:

(1) file a completed application on a department-approved form;

(2) pay all applicable fees;

(3) demonstrate that the program includes a total of at least 2,000 hours of a combination of:

(A) classroom instruction at a secondary school, institution of higher learning as defined by §61.003 of the Texas Education Code, or an apprenticeship program accepted by the department; and

(B) practical experience in air conditioning and refrigeration-related work under the supervision of a licensed air conditioning and refrigeration contractor;

(4) provide copies of course material such as textbooks, videos, tapes, handouts, study materials, and any additional documentation; and

(5) provide the names and license numbers of all air conditioning and refrigeration contractors supervising program participants.

(c) Department approval of certification training program is valid for one year, and may be renewed. To renew, a provider shall:

(1) file a completed renewal application on a department-approved form;

(2) pay all applicable fees;

(3) certify that the program continues to meet the requirements of this chapter; and

(4) provide the department with a summary of changes to the curriculum or program materials, and provide copies of course materials upon request from the department; and

(5) provide the names and license numbers of all air conditioning and refrigeration contractors supervising program participants.

(d) The department may deny approval or renewal of a certification training program if a provider is past due on the payment of any administrative penalties, or provides false information on an application.

(e) To determine whether a provider is complying with the requirements of this chapter, department employees and representatives may conduct audits of a provider an any certification training program offered by a provider.

(f) Upon a finding that the certification training program provider has not complied with the requirements of this chapter, or that a certification training program does not meet the requirements of this chapter, the department may rescind approval of a certification training program.

§75.123.Certification Training Program Provider Responsibilities.

(a) No later than ten (10) days after the completion date of the certification training program, a provider must issue to each participant who completed the program a certificate that includes the following information:

(1) name of the provider and number of the certification training program;

(2) program completion date;

(3) printed name and signature of a provider representative; and

(4) name of the participant.

(b) No later than ten (10) days after completion of the certification training program, a provider must submit an electronic record, in a manner and format prescribed by the department, containing the following information:

(1) name of the provider and number of the certification training program;

(2) program completion date; and

(3) the full name of each participant who completed the program.

(c) A certification training program provider must retain participant completion records for a period of two years after completion of a program.

(d) Upon request, a certification training program provider shall provide information, including copies of specified records, to the department within ten (10) days of the date of the request.

(e) A certification training program provider shall cooperate fully with the department in the investigation of a compliant or performance of an audit.

(f) A certification training program provider may not publish false or misleading advertisements.

(g) Certification training program providers are responsible for the administration of their programs, including the verification of participant attendance and performance. Providers shall ensure that their programs are administered in substantiality the same manner as represented in the application for approval.

(h) Certification training program providers must maintain current contact information on file with the department. This includes, at minimum, a mailing address, phone number, and license numbers of all supervising air conditioning and refrigeration contractors.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800095

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-3671


CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS

The Texas Department of Licensing and Regulation (Department) proposes changes to rules at 16 Texas Administrative Code (TAC) Chapter 111, by adding new rules under Subchapter E, §111.41 and §111.42; Subchapter F, §111.51 and §111.52; Subchapter I, §111.81 and §111.82; Subchapter J, §111.91 and §111.92, and Subchapter V, §111.216; by amending existing rules under Subchapter A, §111.2; Subchapter B, §111.10; Subchapter C, §§111.21, 111.22, and 111.23; Subchapter D, §§111.30, 111.35, and 111.37; Subchapter E, §§111.40, 111.45, and 111.47; Subchapter F, §§111.50, 111.55, and 111.57; Subchapter H, §§111.70, 111.75, and 111.77; Subchapter I, §§111.80, 111.85, and 111.87; Subchapter J, §§111.90, 111.95, and 111.97; Subchapter L, §111.115 and §111.117, Subchapter O, §111.140; Subchapter P, §111.151 and §111.154; Subchapter Q, §111.160; Subchapter R, §111.171; Subchapter S, §111.180, Subchapter U, §111.200; and Subchapter V, §111.213; and by repealing existing rules under Subchapter G, §§111.60, 111.65, and 111.66; and Subchapter K, §§111.100, 111.105, and 111.106, regarding the Speech-Language Pathologists and Audiologists Program.

JUSTIFICATION AND EXPLANATION OF THE RULES

The existing rules under 16 TAC Chapter 111 implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists. The statute and rules govern the licensing and regulation of speech-language pathologists and audiologists.

The proposed rules are necessary to implement House Bill 4007 (H.B. 4007), 85th Legislature, Regular Session (2017); make licensing and other clean-up changes; and update the supervision provisions throughout the chapter. These three categories of rule changes have been combined into one proposal, since there is overlap in some of the affected rule sections and this combined proposal eliminates the need for separate, consecutive rulemakings.

H.B. 4007 Changes

The proposed rules implement H.B. 4007, 85th Legislature, Regular Session (2017). H.B. 4007, in part, repealed the temporary certificate of registration in speech-language pathology and audiology, eliminated residency requirements for advisory board membership, and eliminated provisions regarding failing the written examination. It also repealed redundancies in regard to the licensing and regulation of the Speech-Language Pathologists and Audiologists program.

Licensing and Other Clean-up Changes

The proposed rules also make licensing and other clean-up changes identified by Department staff since the Speech-Language Pathologists and Audiologists program was transferred from the Department of State Health Services (DSHS) to TDLR effective October 3, 2016, pursuant to S.B. 202, 84th Legislature, Regular Session (2015).

Supervision Changes

In addition, the proposed rules implement changes developed by the Speech-Language Pathologists and Audiologists Advisory Board Standard of Care Workgroup and Department staff related to the supervision provisions throughout the chapter. The supervision changes include reorganizing existing rules and moving the internship, supervision, and practice and duties requirements into separate distinct rule sections. These changes will make it easier to find specific provisions, including supervision requirements.

The supervision proposed rules, which are included in the combined rule proposal, were previously contained in a separate draft proposal that was the work product of the workgroup and Department staff. The separate supervision draft proposed rules were presented to and discussed by the Speech-Language Pathologists and Audiologists Advisory Board (Advisory Board) at its meeting on November 15, 2017. The advisory board members offered comments and suggested changes to several sections. The separate supervision draft proposed rules and the Advisory Board’s suggested changes were incorporated into the combined rule proposal.

This combined rule proposal, which contains all three categories of changes, was presented to and discussed by the Advisory Board at its meeting on January 4, 2018. The Advisory Board recommended that the combined rule proposal be published in the Texas Register for public comment.

SECTION-BY-SECTION SUMMARY

The proposed rules amend §111.2, Definitions. The proposed rules add new definitions for the following terms: Direct supervision related to Assistants (Speech-Language Pathology and Audiology); Direct supervision related to Interns (Speech-Language Pathology); In-person; Indirect supervision related to Assistants (Speech-Language Pathology and Audiology); Indirect supervision related to Interns (Speech-Language Pathology); Intern Plan and Agreement of Supervision Form (for Interns in Speech-Language Pathology and Audiology); and Supervisory Responsibility Statement (SRS) Form (for Assistants in Audiology or Speech-Language Pathology). The proposed rules amend the following definitions: Assistant in audiology; Assistant in speech-language pathology; Intern in audiology; Intern in speech-language pathology; and Supervisor. The proposed rules repeal the following definition: Under the direction of. These changes are part of the supervision changes.

The proposed rules amend §111.10. Membership. The proposed rules remove subsection (b)(1), which requires an advisory board member to have been a resident of Texas for the two years preceding the date of appointment. This change is a result of H.B. 4007.

The proposed rules amend §111.21, License Examination--Written Examination. The proposed rules repeal subsections (c) and (d), regarding reexamination. These subsections implemented Texas Occupations Code §401.307, which was repealed by H.B. 4007.

The proposed rules amend §111.22, Waiver of Written Examination Requirements. The proposed rules eliminate a sentence under subsection (a) that is unnecessary and that conflicts with §111.23 as amended. This change is part of the licensing and other clean-up change.

The proposed rules amend §111.23, License Examination--Jurisprudence Examination. The proposed change aligns the rules with the former DSHS practice that continued with the transfer of the program to the Department effective October 3, 2016. The proposed rules require an applicant to show proof of successful completion of the jurisprudence examination at the time of application, unless applying for an upgrade. The new upgrade provisions are added to §111.35 and §111.75. The proposed rules change the timeline for completion of the jurisprudence examination from no more than 6 months to no more than 12 months prior to the date of licensure application. These changes are part of the licensing and other clean-up changes.

The proposed rules amend §111.30, Speech-Language Pathology License--Licensing Requirements. The proposed rules amend subsection (b) by eliminating outdated provisions; updating a reference to the American Speech-Language-Hearing Association (ASHA) Council for Clinical Certification; and adding and expanding an existing provision found under §111.35(d)(2) regarding applicants who have transcripts in a language other than English or earned degrees at a foreign university. The proposed rules update the terminology under subsection (d) by replacing references to "supervised professional experience" with "internship" for consistency in terminology across rule sections. The proposed rules eliminate the 10-year requirement for exams under subsections (e) and (f). These changes are part of the licensing and other clean-up changes.

The proposed rules amend §111.35, Speech-Language Pathology License--Application and Eligibility Requirements. The proposed rules amend subsection (b) by adding clarifying language regarding submitting transcripts; updating a reference to the ASHA Council for Clinical Certification; and relocating and expanding an existing provision found under subsection (d)(2) regarding applicants who have transcripts in a language other than English or earned degrees at a foreign university. The proposed rules eliminate unnecessary provisions from subsection (b) by removing the submission of the Course Work and Clinical Experience Form and removing the submission of the supervisor’s diploma or transcript if the internship was completed out-of-state. The proposed rules add clarifying language under subsection (c) regarding the submission of fingerprints. The proposed rules update and clarify the provisions under subsection (d) regarding the waiver of clinical experience and examination requirements. The proposed rules add a new subsection (e) regarding the upgrade from a Texas intern license to a full license, which aligns the rules with the former DSHS practice that continued with the transfer of the program to the Department effective October 3, 2016. These changes are part of the licensing and other clean-up changes.

The proposed rules amend §111.37, Speech-Language Pathology License--License Terms; Renewals. The proposed rules remove existing subsection (c)(2) and add subsection (d) to clarify that a licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints. This change is part of the licensing and other clean-up changes.

The proposed rules amend §111.40, Intern in Speech-Language Pathology License--Licensing Requirements--Education and Clinical Work. The proposed rules amend subsection (b) by eliminating outdated provisions; updating a reference to the ASHA Council for Clinical Certification; and adding a provision regarding applicants who have transcripts in a language other than English or earned degrees at a foreign university. The proposed rules amend subsection (d) by providing examples of ways an applicant may show "proof of current knowledge" if the course work and clinical experience was earned more than 10 years before the date of application. The proposed rules update terminology and references under subsections (e) and (f). The proposed rules relocate the requirements regarding internships, supervision, and practice and duties found in §111.40 to new rule sections. The proposed rules repeal subsections (g) through (q) and relocate most of those provisions to new §111.41 and §111.42. The purpose is to make the rules more user-friendly by reorganizing the rules into smaller, more distinct rule sections. The changes to subsections (b), (d), (e), and (f) are part of the licensing and other clean-up changes. The repeal and relocation of the provisions under subsections (g) through (q) are part of the supervision changes.

The proposed rules add new §111.41, Intern in Speech-Language Pathology License-Internship and Supervision Requirements. The proposed rules relocate provisions found in existing rules §111.40(g), (h), (i), (k), (l), and (q) to new §111.41. This new rule section sets out the internship and supervision requirements for interns in speech-language pathology. New §111.41(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words intern and supervisor. The provisions under new §111.41(d) and (g)(4) include licensing and other clean-up changes. The entire section includes supervision changes.

The proposed rules add new §111.42, Intern in Speech-Language Pathology License-Practice and Duties of Interns. The proposed rules relocate provisions found in existing rules §111.40(m), (n), (o), and (p) to new §111.42. This new rule section sets out the practice and duties requirements for interns in speech-language pathology. New §111.42(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words intern and supervisor. The provisions under new §111.42(e) include licensing and other clean-up changes. The entire section includes supervision changes.

The proposed rules amend §111.45, Intern in Speech-Language Pathology License-Application and Eligibility Requirements. The proposed rules amend subsection (b) by clarifying the documents to be submitted if the degree has been conferred or has not been conferred; updating a reference to ASHA Council for Clinical Certification; adding a provision regarding applicants who have transcripts in a language other than English or earned degrees at a foreign university; and making technical clean-up changes. The proposed rules eliminate the requirement under subsection (b) that all applicants must submit the Clinical Work and Clinical Experience Form, and clarify that this form is only submitted if the degree has not been conferred yet. The proposed rules add clarifying language under subsection (c) regarding the submission of fingerprints. These changes are part of the licensing and other clean-up changes.

The proposed rules amend §111.47, Intern in Speech-Language Pathology License-License Terms; Renewals. The proposed rules remove existing subsection (c)(2) and add subsection (d) to clarify that a licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints. The proposed rules also remove existing subsection (c)(5) that requires a licensed intern in speech-language pathology to submit an evaluation of the intern’s progress or performance and any intern plans and supervisory evaluations to the Department as part of the license renewal process. These changes are part of the licensing and other clean-up changes.

The proposed rules amend §111.50, Assistant in Speech-Language Pathology License-Licensing Requirements-Education and Clinical Observation and Experience. The proposed rules add clarifying language under subsection (a). The proposed rules amend subsection (b) by updating a reference to ASHA Council for Clinical Certification; and by providing examples of ways an applicant may show "proof of current knowledge" if the course work and clinical experience was earned more than 10 years before the date of application. The proposed rules add a proof of current knowledge requirement to subsection (c). The proposed rules amend subsection (e) by adding clarifying language that all hours worked by the licensed assistant must be completed under in-person, direct supervision of the licensed speech-language pathologist, and by eliminating the requirement that certain documents under subsection (e)(4) be submitted to the Department.

The proposed rules relocate the requirements regarding supervision and practice and duties found in §111.50 to new rule sections. The proposed rules repeal subsections (f) through (n) and relocate most of those provisions to new §111.51 and new §111.52. The purpose is to make the rules more user-friendly by reorganizing the rules into smaller, more distinct rule sections. The changes to subsections (a), (b), (c), and (e) are part of the licensing and other clean-up changes. The repeal and relocation of the provisions under subsections (f) through (n) are part of the supervision changes.

The proposed rules add new §111.51, Assistant in Speech-Language Pathology License--Supervision Requirements. The proposed rules relocate provisions found in existing rules §111.50(f), (g), (h)(1) - (3), (j), (m), and (n) to new §111.51. This new rule section sets out the supervision requirements for assistants in speech-language pathology. New §111.51(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words assistant and supervisor. The proposed rules add new §111.51(e) regarding the supervisor only providing direct supervision at the worksite in which the assistant provides services to existing clients or while the assistant provides services to cases previously delegated to the assistant. The proposed rules update the current requirements under new §111.51(g) by restructuring the subsection, adding clarifying language, and addressing situations in which fewer than four weeks are worked in a calendar month. The entire section includes supervision changes.

The proposed rules add new §111.52, Assistant in Speech-Language Pathology License--Practice and Duties of Assistants. The proposed rules relocate provisions found in existing rules §111.50(h)(4)-(5), (i), (k), and (l) to new §111.52. This new rule section sets out the practice and duties requirements for assistants in speech-language pathology. New §111.52(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words assistant and supervisor. The provisions under new §111.52 include licensing and other clean-up changes by changing references from "Individual Education Plan" to "Individual Education Program." The entire section includes supervision changes.

The proposed rules amend §111.55, Assistant in Speech-Language Pathology License--Application and Eligibility Requirements. The proposed rules eliminate language in subsection (b)(2) that is now part of the definition of Supervisory Responsibility Statement Form and the requirements under §111.51. The proposed rules clarify and correct the language under subsection (b)(3). These changes are part of the licensing and other clean-up changes.

The proposed rules amend §111.57, Assistant in Speech-Language Pathology License--License Terms; Renewals. The proposed rules remove existing subsection (c)(2) and add subsection (d) to clarify that a licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints. The proposed rules also make clean-up changes to renumbered subsection (c)(4). These changes are part of the licensing and other clean-up changes.

The proposed rules repeal Subchapter G, Requirements for Temporary Certificate of Registration in Speech-Language Pathology. The proposed repeal is due to H.B. 4007, which repealed the temporary certificate of registration in speech-language pathology.

The proposed rules repeal §111.60, Temporary Certificate of Registration in Speech-Language Pathology--Registration Requirements. The proposed repeal is due to H.B. 4007, which repealed the temporary certificate of registration in speech-language pathology.

The proposed rules repeal §111.65, Temporary Certificate of Registration in Speech-Language Pathology--Application and Eligibility Requirements. The proposed repeal is due to H.B. 4007, which repealed the temporary certificate of registration in speech-language pathology.

The proposed rules repeal §111.66, Temporary Certificate of Registration in Speech-Language Pathology--Issuing Registration. The proposed repeal is due to H.B. 4007, which repealed the temporary certificate of registration in speech-language pathology.

The proposed rules amend §111.70, Audiology License--License Requirements. The proposed rules add a new subsection (c) regarding applicants who have transcripts in a language other than English or earned degrees at a foreign university. The proposed rules also eliminate the 10-year requirement for exams under re-lettered subsection (e). The proposed rules make a technical clean-up change under re-lettered subsection (f). These changes are part of the licensing and other clean-up changes.

The proposed rules amend §111.75, Audiology License--Application and Eligibility Requirements. The proposed rules amend subsection (b) by adding clarifying language regarding submitting transcripts; updating a reference to the ASHA Council for Clinical Certification; and relocating and expanding an existing provision under subsection (d)(2) regarding applicants who have transcripts in a language other than English or earned degrees at a foreign university. The proposed rules eliminate unnecessary provisions from subsection (b) by removing the submission of the Course Work and Clinical Experience Form and removing the submission of the supervisor’s diploma or transcript if the internship was completed out-of-state. The proposed rules add clarifying language under subsection (c) regarding the submission of fingerprints. The proposed rules update and clarify the provisions under subsection (d) regarding the waiver of clinical experience and examination requirements. The proposed rules add a new subsection (e) regarding the upgrade from a Texas intern license to a full license, which aligns the rules with the former DSHS practice that continued with the transfer of the program to the Department effective October 3, 2016. These changes are part of the licensing and other clean-up changes.

The proposed rules amend §111.77, Audiology License--License Terms; Renewals. The proposed rules remove existing subsection (c)(2) and add subsection (d) to clarify that a licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints. This change is part of the licensing and other clean-up changes.

The proposed rules amend §111.80, Intern in Audiology License--Licensing Requirements--Education. The proposed rules make a technical clean-up change to subsection (b). The proposed rules relocate the requirements regarding internships, supervision, and practice and duties found in §111.80 to new rule sections. The proposed rules repeal subsections (e) through (i) and relocate most of those provisions to new §111.81 and new §111.82. The purpose is to make the rules more user-friendly by reorganizing the rules into smaller, more distinct rule sections. The change to subsection (b) is part of the licensing and other clean-up changes. The repeal and relocation of the provisions under subsections (e) through (i) are part of the supervision changes.

The proposed rules add new §111.81, Intern in Audiology License--Internship and Supervision Requirements. The proposed rules relocate provisions found in existing rules §111.80(e), (f), (g)(1)-(3), and (i) to new §111.81. This new rule section sets out the internship and supervision requirements for interns in audiology. New §111.81(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words intern and supervisor. The provisions under new §111.81(e) include licensing and other clean-up changes. The entire section includes supervision changes.

The proposed rules add new §111.82, Intern in Audiology License--Practice and Duties of Interns. The proposed rules relocate provisions found in existing rules §111.80(g)(4) and (h) to new §111.82. This new rule section sets out the practice and duties requirements for interns in audiology. New §111.82(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words intern and supervisor. The entire section includes supervision changes.

The proposed rules amend §111.85, Intern in Audiology License--Application and Eligibility Requirements. The proposed rules amend subsection (a) by removing the requirement to submit transcripts and making technical changes. The proposed rules add clarifying language under subsection (c) regarding the submission of fingerprints. These changes are part of the licensing and other clean-up changes.

The proposed rules amend §111.87, Intern in Audiology License--License Terms; Renewals. The proposed rules remove existing subsection (c)(2) and add subsection (d) to clarify that a licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints. The proposed rules also remove existing subsection (c)(3) that requires a licensed intern in audiology to submit an evaluation of the intern’s progress or performance and any intern plans and supervisory evaluations to the Department as part of the license renewal process. These changes are part of the licensing and other clean-up changes.

The proposed rules amend §111.90, Assistant in Audiology License--Licensing Requirements--Education and Training. The proposed rules amend subsection (b) by adding a new subsection (b)(3) to provide that if the applicant holds a bachelor’s degree or higher in communicative sciences or disorders, the applicant does not need to complete the Council of Accreditation of Occupational Hearing Conservation (CAOHC) certification course and examination. The proposed rules eliminate language in subsection (b)(4)(A) that is now part of the definition of Supervisory Responsibility Statement Form and the requirements under §111.91. The proposed rules relocate the provisions from subsection (b)(4)(B) to new subsection (b)(5) and add "in-person" direct supervision by the supervisor. The proposed rules amend subsection (c) by adding a cross-reference to the job-specific competency-based training under subsection (b)(5).

The proposed rules relocate the requirements regarding supervision and practice and duties found in §111.90 to new rule sections. The proposed rules repeal subsections (d) through (j) and relocate most of those provisions to new §111.91 and new §111.92. The purpose is to make the rules more user-friendly by reorganizing the rules into smaller, more distinct rule sections. The changes to subsections (b) and (c) are part of the supervision changes and the licensing and other clean-up changes. The repeal and relocation of the provisions under subsections (d) through (j) are part of the supervision changes.

The proposed rules add new §111.91, Assistant in Audiology License--Supervision Requirements. The proposed rules relocate provisions found in existing rules §111.90(d), (e), (f)(1)-(2), (i), and (j) to new §111.91. This new rule section sets out the supervision requirements for assistants in audiology. New §111.91(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words assistant and supervisor. The proposed rules update the current requirements under §111.91(f) by restructuring the subsection, adding clarifying language, and addressing situations in which fewer than four weeks are worked in a calendar month. The entire section includes supervision changes.

The proposed rules add new §111.92, Assistant in Audiology License--Practice and Duties of Assistants. The proposed rules relocate provisions found in existing rules §111.90(f)(3) - (5), (g), and (h) to new §111.92. This new rule section sets out the practice and duties requirements for assistants in audiology. New §111.92(a) clearly restates the supervision requirement and helps streamline and improve the readability of the section by specifying the use of the words assistant and supervisor. The entire section includes supervision changes.

The proposed rules amend §111.95, Assistant in Audiology License--Application and Eligibility Requirements. The proposed rules eliminate language in subsection (b)(2) that is now part of the definition of Supervisory Responsibility Statement Form and the requirements under §111.91. The proposed rules add a new subsection (b)(6) to provide that if the applicant holds a bachelor’s degree or higher in communicative sciences or disorders, the applicant shall submit proof of the degree instead of the Council of Accreditation of Occupational Hearing Conservation (CAOHC) certificate. These changes are part of the licensing and other clean-up changes.

The proposed rules amend §111.97, Audiology Assistant License--License Terms; Renewals. The proposed rules remove existing subsection (c)(2) and add subsection (d) to clarify that a licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints. The proposed rules also make clean-up changes to renumbered subsection (c)(4). These changes are part of the licensing and other clean-up changes.

The proposed rules repeal Subchapter K, Requirements for Audiology Temporary Certificate of Registration. The proposed repeal is due to H.B. 4007, which repealed the temporary certificate of registration in audiology.

The proposed rules repeal §111.100, Temporary Certificate of Registration in Audiology--Registration Requirements. The proposed repeal is due to H.B. 4007, which repealed the temporary certificate of registration in audiology.

The proposed rules repeal §111.105, Audiology Temporary Certificate of Registration--Application and Eligibility Requirements. The proposed repeal is due to H.B. 4007, which repealed the temporary certificate of registration in audiology.

The proposed rules repeal §111.106, Temporary Certificate of Registration in Audiology--Issuing Registration. The proposed repeal is due to H.B. 4007, which repealed the temporary certificate of registration in audiology.

The proposed rules amend §111.115, Dual License in Speech-Language Pathology and Audiology--Application and Eligibility Requirements. The proposed rules clarify that an applicant must submit fingerprints if not previously submitted when applying for a full license, assistant license, or intern license. This change is part of the licensing and other clean-up changes.

The proposed rules amend §111.117, Dual License in Speech-Language Pathology and Audiology--License Terms; Renewals. The proposed rules remove existing subsection (c)(2) and add subsection (d) to clarify that a licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints. This change is part of the licensing and other clean-up changes.

The proposed rules amend §111.140, Rules. The proposed rules remove placeholder language and insert a specific rule citation to 16 TAC Chapter 100, Health Related Program Administrative Rules. This change is part of the licensing and other clean-up changes.

The proposed rules amend §111.151, Consumer Information and Display of License. The proposed rules remove existing subsection (c) regarding the display of a temporary certificate of registration. This change is due to H.B. 4007, which repealed the temporary certificate of registrations in speech-language pathology and audiology.

The proposed rules amend §111.154, Requirements, Duties, and Responsibilities of Supervisors and Persons Being Supervised. The proposed rules revise the supervision ratios under re-lettered subsection (f)(4). The proposed rules return the supervision ratios to the former ratios when the program was regulated by DSHS. The proposed rules would allow a supervisor to supervise no more than a total of four (4) audiology interns and/or assistants, regardless of the type of degree held by an assistant. In addition, the proposed rules: (1) add clarifying language to subsections (b) and (c); (2) add a new subsection (d) regarding the supervision of speech-language pathology assistants; (3) add language regarding the supervision of audiology assistants, add clarifying language, and remove unnecessary language under re-lettered subsection (e); and (4) make technical changes in re-lettered subsections (f), (g), and (h). These changes are part of the supervision changes.

The proposed rules amend §111.160, Fees. The proposed rules amend subsection (b) and re-lettered subsection (e) to include upgrades from an intern license to a full license. This change is part of the licensing and other clean-up changes. In addition, the proposed rules repeal existing subsections (e) and (i), regarding fees for temporary certificates of registration. This proposed repeal is due to H.B. 4007, which repealed temporary certificates of registration.

The proposed rules amend §111.171, Complaints Regarding Standard of Care. The proposed rules remove placeholder language and insert a specific rule citation to 16 TAC Chapter 100, Health Related Program Administrative Rules. This change is part of the licensing and other clean-up changes.

The proposed rules amend §111.180, Administrative Penalties and Sanctions. The proposed rules make technical changes that reflect changes made by H.B. 4007. The bill repealed the program-specific administrative penalties section in Occupations Code Chapter 401, since it was redundant with the administrative penalties section in Occupations Code Chapter 51, which applies to all the Department’s programs. In addition, the proposed rules make a technical clean-up change. This change is part of the licensing and other clean-up changes.

The proposed rules amend §111.200, Registration of Audiologists and Interns in Audiology to Fit and Dispense Hearing Instruments. The proposed rules remove the reference in subsection (b) to the temporary audiology certificate. This change is due to H.B. 4007, which repealed the temporary certificate of registrations in audiology.

The proposed rules amend §111.213, Limitations on the Use of Telecommunications Technology by Speech-Language Pathologists. The proposed rules add provisions regarding supervision of speech-language pathology assistants and interns through the use of telecommunications technology. The proposed rules remove the existing provisions that prohibited the use of telecommunications for supervision purposes unless an exception was approved by the Department. These changes are part of the supervision changes.

The proposed rules add new §111.216, Limitations on the Use of Telecommunications Technology by Audiologists. The proposed new §111.216 regarding audiologists is similar to §111.213 regarding speech-language pathologists. The proposed rules add a provision regarding supervision of audiology assistants through the use of telecommunications technology and a prohibition that telehealth services may not be provided by correspondence only. These changes are part of the supervision changes.

FISCAL IMPACT ON STATE AND LOCAL GOVERNMENT

Brian E. Francis, Executive Director, has determined that for each year of the first five years the new rules are in effect, there are no estimated additional costs or reductions in costs to the state or local government as a result of enforcing or administering the proposed amendment.

Mr. Francis has determined that for each year of the first five years the proposed rules are in effect, there will be a minor loss in revenue to the state government as a result of enforcing or administering the proposed amendment. An average of four temporary certificates of registration have been issued by the program each year for the last three fiscal years. The application fee for a temporary certificate of registration was $55, resulting in a loss of state revenue of an average of $220 for each year of the first five years the proposed rules are in effect. The temporary certificates of registration for speech-language pathology and audiology were eliminated by H.B. 4007.

Mr. Francis has determined that for each year of the first five years the new rules are in effect, there is no estimated increase or loss in revenue to local government as a result of enforcing or administering the proposed amendment.

Mr. Francis has determined that for each year of the first five years the proposed repeal of the rules is in effect, enforcing or administering the proposed repeal of the rules does not have foreseeable implications relating to costs or revenues of local governments.

LOCAL EMPLOYMENT IMPACT STATEMENT

Mr. Francis has determined that the proposed rules will not affect the local economy, so the agency is not required to prepare a local employment impact statement under Government Code §2001.022.

PUBLIC BENEFITS

Mr. Francis also has determined that for each year of the first five-year period the proposed rules are in effect, the public benefit will be implementation of changes due to H.B. 4007 and implementation of supervision, licensing, and other clean-up changes. Supervisors, assistants, and interns will benefit from the revised supervision rules, which add definitions, clarify and simplify requirements, and provide more flexibility in supervision through telepractice. The public, licensees, and the Department staff will benefit from the reorganization of the existing rules into smaller, more distinct rules, which will make the rules more user-friendly. The proposed rules also update the rules to reflect current agency practice, which also will benefit the public, licensees, and the Department staff.

PROBABLE ECONOMIC COSTS TO PERSONS REQUIRED TO COMPLY WITH PROPOSAL

Mr. Francis has determined that for each year of the first five-year period the proposed rules are in effect, there are no anticipated economic costs to persons who are required to comply with the proposed rules.

FISCAL IMPACT ON SMALL BUSINESSES, MICRO-BUSINESSES, AND RURAL COMMUNITIES

There will be no adverse effect on small businesses, micro-businesses, or rural communities as a result of the proposed rules.

Since the agency has determined that the proposed rule will have no adverse economic effect on small businesses, micro-businesses, or rural communities, preparation of an Economic Impact Statement and a Regulatory Flexibility Analysis, as detailed under Texas Government Code §2006.002, are not required.

ONE-FOR-ONE REQUIREMENT FOR RULES WITH A FISCAL IMPACT

Under Government Code §2001.0045, a state agency may not adopt a proposed rule if the fiscal note states that the rule imposes a cost on regulated persons, including another state agency, a special district, or a local government, unless the state agency: (a) repeals a rule that imposes a total cost on regulated persons that is equal to or greater than the total cost imposed on regulated persons by the proposed rule; or (b) amends a rule to decrease the total cost imposed on regulated persons by an amount that is equal to or greater than the cost imposed on the persons by the proposed rule. There are exceptions for certain types of rules under §2001.0045(c).

The proposed rules do not have a fiscal note that imposes a cost on regulated persons, including another state agency, a special district, or a local government. Therefore, the agency is not required to take any further action under Government Code §2001.0045.

GOVERNMENT GROWTH IMPACT STATEMENT

Pursuant to Government Code §2001.0221, the agency provides the following Government Growth Impact Statement for the proposed rules. For each year of the first five years the rule will be in effect, the agency has determined the following:

(1) The proposed rule does not create or eliminate a government program.

(2) Implementation of the proposed rule does not require the creation of new employee positions or the elimination of existing employee positions.

(3) Implementation of the proposed rule does not require an increase or decrease in future legislative appropriations to the agency.

(4) The proposed rule does require a decrease in fees paid to the agency. Pursuant to H.B. 4007, temporary certificated of registration were repealed from the statute. The repeal of the temporary certificate of registration fees from the proposed rules will result in less fees paid to the agency.

(5) The proposed rule does create a new regulation. The proposed rules implement changes due to H.B. 4007, licensing and other clean-up changes, and supervision changes. Some existing rule sections are being reorganized and separated into smaller, more distinct rule sections, which results in some new rule sections being created.

(6) The proposed rule does expand, limit, or repeal an existing regulation. The proposed rules implement changes due to H.B. 4007, licensing and other clean-up changes, and supervision changes. H.B. 4007 repealed temporary certificates of registration and a few other provisions, which results in some rule sections being repealed.

(7) The proposed rule does not increase or decrease the number of individuals subject to the rule's applicability.

(8) The proposed rule does not positively or adversely affect this state's economy.

PUBLIC COMMENTS

Comments on the proposal may be submitted to Pauline Easley, Legal Assistant, Texas Department of Licensing and Regulation, P.O. Box 12157, Austin, Texas 78711, or facsimile (512) 475-3032, or electronically: erule.comments@tdlr.texas.gov. The deadline for comments is 30 days after publication in the Texas Register.

SUBCHAPTER A. GENERAL PROVISIONS

16 TAC §111.2

STATUTORY AUTHORITY

The amendments are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51, 401, and 402. No other statutes, articles, or codes are affected by the proposal.

§111.2.Definitions.

Unless the context clearly indicates otherwise, the following words and terms shall have the following meanings.

(1) - (5) (No change.)

(6) Assistant in audiology--An individual licensed under Texas Occupations Code §401.312 and §111.90 of this chapter and who provides audiological support services to clinical programs under the supervision of an [a department-approved ] audiologist licensed under the Act.

(7) Assistant in speech-language pathology--An individual licensed under Texas Occupations Code §401.312 and §111.60 of this chapter and who provides speech-language pathology support services under the supervision of a speech-language pathologist licensed under the Act.

(8) - (13) (No change.)

(14) Direct supervision related to Assistants (Speech-Language Pathology and Audiology)--Real-time observation and guidance by the supervisor while a client contact or clinical activity or service is performed by the assistant. Direct supervision shall be performed in person or via telepractice/telehealth as authorized and prescribed by this chapter.

(15) Direct supervision related to Interns (Speech-Language Pathology)--Real-time observation and guidance by the supervisor while a client contact or clinical activity or service is performed by the intern. Telepractice/telehealth may not be used for direct supervision of Speech-Language Pathology Interns.

(16) [(14)] Ear specialist--A licensed physician who specializes in diseases of the ear and is medically trained to identify the symptoms of deafness in the context of the total health of the client, and is qualified by special training to diagnose and treat hearing loss. Such physicians are also known as otolaryngologists, otologists, neurotologists, otorhinolaryngologists, and ear, nose, and throat specialists.

(17) [(15)] Executive director--The executive director of the department.

(18) [(16)] Extended absence--More than two consecutive working days for any single continuing education experience.

(19) [(17)] Extended recheck--Starting at 40 dB and going down by 10 dB until no response is obtained or until 20 dB is reached and then up by 5 dB until a response is obtained. The frequencies to be evaluated are 1,000, 2,000, and 4,000 hertz (Hz).

(20) [(18)] Fitting and dispensing hearing instruments--The measurement of human hearing by the use of an audiometer or other means to make selections, adaptations, or sales of hearing instruments. The term includes the making of impressions for earmolds to be used as a part of the hearing instruments and any necessary postfitting counseling for the purpose of fitting and dispensing hearing instruments.

(21) [(19)] Hearing instrument--Any wearable instrument or device designed for, or represented as aiding, improving or correcting defective human hearing. This includes the instrument's parts and any attachment, including an earmold, or accessory to the instrument. The term does not include a battery or cord.

(22) [(20)] Hearing screening--A test administered with pass/fail results for the purpose of rapidly identifying those persons with possible hearing impairment which has the potential of interfering with communication.

(23) In-person--The supervisor must be physically present, observing the assistant’s or the intern’s client contact or clinical activity or service. Telepractice/telehealth is not considered in-person.

(24) Indirect supervision related to Assistants (Speech-Language Pathology and Audiology)--The supervisor performs monitoring activities or provides guidance to the assistant, either of which does not occur during actual client contact by the assistant or while the assistant is providing a clinical activity or service. Telepractice/telehealth may be used for indirect supervision as authorized and prescribed under this chapter.

(25) Indirect supervision related to Interns (Speech-Language Pathology)--The supervisor performs monitoring activities or provides guidance to the intern, either of which does not occur during actual client contact by the intern or while the intern is providing a clinical activity or service. Telepractice/telehealth may be used for indirect supervision as authorized and prescribed under this chapter.

(26) [(21)] Intern in audiology--An individual licensed under Texas Occupations Code §401.311 and §111.80 of this chapter and who is supervised by [works under the direction of] an individual who holds an audiology license under Texas Occupations Code §401.302 and §401.304.

(27) [(22)] Intern in speech-language pathology--An individual licensed under Texas Occupations Code §401.311 and §111.40 of this chapter and who is supervised by [works under the direction of] an individual who holds a speech-language pathology license under Texas Occupations Code §401.302 and §401.304.

(28) Intern Plan and Agreement of Supervision Form (for Interns in Speech-Language Pathology and Audiology)--An agreement between a supervisor and an intern in which the parties enter into a supervisory relationship and the supervisor agrees to assume responsibility for all services provided by the intern.

(29) [(23)] Provisional Licensee--An individual granted a provisional license under Texas Occupations Code §401.308.

(30) [(24)] Sale or purchase--Includes the sale, lease or rental of a hearing instrument or augmentative communication device to a member of the consuming public who is a user or prospective user of a hearing instrument or augmentative communication device.

(31) [(25)] Speech-language pathologist--An individual who holds a license under Texas Occupations Code §401.302 and §401.304, to practice speech-language pathology.

(32) [(26)] Speech-language pathology--The application of nonmedical principles, methods, and procedures for measurement, testing, evaluation, prediction, counseling, habilitation, rehabilitation, or instruction related to the development and disorders of communication, including speech, voice, language, oral pharyngeal function, or cognitive processes, for the purpose of evaluating, preventing, or modifying or offering to evaluate, prevent, or modify those disorders and conditions in an individual or a group.

(33) [(27)] Supervisor--An individual who holds a license under Texas Occupations Code §401.302 and §401.304 and whom the department has approved to [directly] oversee the services provided by the assigned [department-approved] assistant and/or intern. The term "supervisor" and "department-approved supervisor" have the same meaning as used throughout this chapter.

(34) Supervisory Responsibility Statement (SRS) Form (for Assistants in Audiology or Speech-Language Pathology)--An agreement between a supervisor and an assistant in which the parties enter into a supervisory relationship, the supervisor agrees to assume responsibility for the assistant’s activities, and the assistant agrees to perform only those activities assigned by the supervisor that are not prohibited under this chapter.

(35) [(28)] Telehealth--See definition(s) in Subchapter V, Telehealth.

[(29) Under the direction of--The speech-language pathologist or audiologist supervises and directly oversees the services provided and accepts professional responsibility for the actions of the personnel he or she agrees to direct.]

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800100

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER B. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS ADVISORY BOARD

16 TAC §111.10

The amendments are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.10.Membership.

(a) (No change.)

(b) Advisory board members must:

[(1) have been a resident of this state for the two years preceding the date of appointment;]

(1) [(2)] be from the various geographic regions of the state; and

(2) [(3)] be from varying employment settings.

(c) - (d) (No change.)

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800101

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER C. EXAMINATIONS

16 TAC §§111.21 - 111.23

The amendments are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.21.License Examination--Written Examination.

(a) - (b) (No change.)

[(c) A person who fails the examination may take a subsequent examination upon payment of a nonrefundable fee.]

[(d) Pursuant to Texas Occupations Code §401.307(b), an applicant who fails two examinations may not be reexamined until the person:]

[(1) submits a new application accompanied by a nonrefundable application fee; and]

[(2) presents evidence acceptable to the department of additional study in the area for which a license is sought.]

§111.22.Waiver of Written Examination Requirement.

(a) This section is applicable to applicants applying for a speech-language pathology license under Subchapter D or an audiology license under Subchapter H. This waiver only applies to the written examination under §111.21. [The applicant must still take the Jurisprudence Examination under §111.23.]

(b) - (d) (No change.)

§111.23.License Examination--Jurisprudence Examination.

(a) - (b) (No change.)

(c) All applicants for licensure shall submit proof of successful completion of the Jurisprudence Examination at the time of application, unless applying for an upgrade. The Jurisprudence Examination must be completed no more than 12 [six] months prior to the date of licensure application.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800102

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER D. REQUIREMENTS FOR SPEECH-LANGUAGE PATHOLOGY LICENSE

16 TAC §§111.30, 111.35, 111.37

The amendments are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.30.Speech-Language Pathology License--Licensing Requirements.

(a) (No change.)

(b) Education. The graduate degree shall be completed at a college or university which has a program accredited by a national accrediting organization that is approved by the department and recognized by the United States Secretary of Education under the Higher Education Act of 1965 (20 U.S.C. §1001, et seq.).

(1) Original or certified copies of the transcripts showing the conferred degree shall verify the applicant completed the following:

(A) at least thirty-six (36) semester credit hours shall be in professional course work acceptable toward a graduate degree; and

(B) at least twenty-four (24) semester credit hours acceptable toward a graduate degree shall be earned in the area of speech-language pathology, including normal development and use of speech, language, and hearing; prevention evaluation, habilitation, and rehabilitation of speech, language, and hearing disorders; and related fields that augment the work of clinical practitioners of speech-language pathology.[; and]

[(C) for applications filed before January 1, 2015, six semester credit hours shall be earned in the area of hearing disorders, hearing evaluation, and habilitative or rehabilitative procedures with individuals who have a hearing impairment.]

(2) A maximum of six (6) academic semester credit hours associated with clinical experience and a maximum of six (6) academic semester credit hours associated with a thesis or dissertation may be counted toward the thirty-six (36) hours but not in lieu of the requirements of paragraph [paragraphs ] (1)(B) [and (1)(C)].

(3) - (4) (No change.)

(5) An applicant whose transcript is in a language other than English or whose degree was earned at a foreign university shall submit an original evaluation form from an approved transcript evaluation service. The transcript evaluation service must determine that the applicant's degree is a master's degree or higher with a major in one of the areas of communicative sciences or disorders. The applicant shall bear all expenses incurred during the procedure.

(6) [(5)] An applicant who graduated from a college or university not accredited by the ASHA Council for Clinical Certification [Council on Academic Accreditation] shall submit an original signed letter from ASHA stating the Council for Clinical Certification accepted the course work and clinical experience. The applicant shall bear all expenses incurred during the procedure.

(c) (No change.)

(d) Internship [Supervised Professional Experience]. An applicant must have completed an internship [supervised professional experience] in which clinical work has been accomplished in speech-language pathology as set out in §111.41 [§111.40].

(1) An individual shall be licensed under §111.41 [§111.40], prior to the beginning of the internship [supervised professional experience].

(2) The supervisor of an individual who completed an internship in another state and met the requirements set out in §111.41 [§111.40] shall:

(A) be licensed in that other state; or

(B) hold the ASHA Certificate of Clinical Competence in speech-language pathology if the other state did not require licensing.

(e) Examination. An applicant shall pass the examination referenced under §111.21. [within:]

[(1) the past ten (10) years; and]

[(2) two years of the completion date of the internship referenced in subsection (d).]

[(f) In the event the applicant passed the examination referenced in subsection (e) more than two years after the completion date of the internship, the applicant shall repeat the thirty-six (36) weeks supervised internship before applying for the speech-language pathology license. The applicant shall obtain the intern license as required by §111.40, prior to repeating the internship. The applicant may appeal to the executive director for waiver of the requirement to repeat the internship.]

§111.35.Speech-Language Pathology License--Application and Eligibility Requirements.

(a) (No change.)

(b) An applicant for a speech-language pathology license must submit the following required documentation:

(1) a completed application on a department-approved form;

(2) if not previously submitted when applying for an intern's license, an original or certified copy of the transcript(s), which shows [showing the conferred degree of] all relevant course work and which shows [also verifies that] the applicant possesses a minimum of a master's degree with a major in one of the areas of communicative sciences or disorders;

(3) if the applicant graduated from a college or university with a program not accredited by the ASHA Council for Clinical Certification [Council on Academic Accreditation], an original signed letter from ASHA stating the Council for Clinical Certification accepted the course work and clinical experience;

(4) if the applicant's transcript is in a language other than English or the degree was earned at a foreign university, an original evaluation form from an approved transcript evaluation service stating that the applicant's degree is a master's degree or higher with a major in one of the areas of communicative sciences or disorders [not previously submitted when applying for an intern's license, a Course Work and Clinical Experience Form completed by the program director or designee of the college or university attended which verifies the applicant has met the requirements established in §111.30(b) - (c)];

(5) a Report of Completed Speech-Language Pathology Internship Form completed by the applicant's department-approved supervisor and signed by both the applicant and the department-approved supervisor;

(6) if the internship was completed out-of-state, one of the following documents regarding the supervisor must be submitted:

[(A) a copy of the supervisor's diploma or transcript showing a master's degree in one of the areas of communicative sciences or disorders; and]

[(B) one of the following:]

(A) [(i)] if that state requires licensure, a copy of the supervisor's valid license to practice in that state; or

(B) [(ii)] if that state does not require licensure, an original letter from ASHA stating the supervisor held the Certificate of Clinical Competence when the applicant completed the internship;

(7) - (9) (No change.)

(c) If not previously submitted when applying for an assistant or intern license, an [An] applicant for a speech-language pathology license must submit a completed legible set of fingerprints, on a department-approved form, to the Department of Public Safety for the purpose of obtaining criminal history record information. An applicant must successfully pass a criminal history background check.

(d) Waiver of Clinical Experience and Examination Requirements. An applicant who currently holds the ASHA Certificate of Clinical Competence may submit official documentation from ASHA of the Certificate of Clinical Competence as evidence that the applicant meets the clinical experience and examination requirements as set out in the Act and this subchapter for a speech-language pathology license. Such an applicant must submit:

(1) (No change.)

(2) an original or certified copy of the transcript(s) showing the conferred degree of all relevant course work which also verifies that the applicant possesses a minimum of a master's degree with a major in one of the areas of communicative sciences or disorders; [however, an applicant whose transcript is in a language other than English shall submit an original evaluation form from an approved credentialing agency; and]

(3) the required documents [and fees] under subsection (b)(1) and[,] (8) [and (9)] and subsection (c); and

(4) the initial application fee required under §111.160.

(e) Upgrade from Intern License to Full License. An applicant, who holds a current Texas intern in speech-language pathology license, may upgrade to a speech-language pathology license by submitting:

(1) a completed upgrade application on a department-approved form;

(2) the required documents under subsection (b)(2), (5), and (7) and subsection (c); and

(3) the initial application fee required under §111.160.

(f) [(e)] An applicant must complete all licensing requirements within one year from the date the application was submitted. After that year an applicant will be required to submit a new application and all required materials in addition to paying a new application fee.

§111.37.Speech-Language Pathology License--License Terms; Renewals.

(a) - (b) (No change.)

(c) To renew a speech-language pathology license, a licensee must:

(1) submit a completed renewal application on a department-approved form;

[(2) successfully pass a criminal history background check;]

(2) [(3)] complete 20 hours of continuing education as required under §111.130;

(3) [(4)] comply with the continuing education audit process described under §111.132, if selected for an audit; and

(4) [(5)] submit the license renewal fee required under §111.160.

(d) A licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.

(e) [(d)] The department may deny the renewal of the license pursuant to Texas Occupations Code §401.451.

(f) [(e)] If all conditions required for renewal are met prior to expiration, the department shall issue a renewed license.

(g) [(f)] A person whose license has expired may late renew the license in accordance with the procedures set out under §60.31 and §60.83 of this title.

(h) [(g)] A person whose license has expired may not practice or engage in speech-language pathology.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800103

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER E. REQUIREMENTS FOR INTERN IN SPEECH-LANGUAGE PATHOLOGY LICENSE

16 TAC §§111.40 - 111.42, 111.45, 111.47

The amendments and new rules are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.40.Intern in Speech-Language Pathology License--Licensing [and Internship] Requirements--Education and Clinical Work.

(a) (No change.)

(b) Education. The graduate degree shall be completed at a college or university which has a program accredited by a national accrediting organization that is approved by the department and recognized by the United States Secretary of Education under the Higher Education Act of 1965 (20 U.S.C. §1001, et seq.).

(1) Original or certified copies of the transcripts showing the conferred degree shall verify the applicant completed the following:

(A) at least thirty-six (36) semester credit hours shall be in professional course work acceptable toward a graduate degree; and

(B) at least twenty-four (24) semester credit hours acceptable toward a graduate degree shall be earned in the area of speech-language pathology including normal development and use of speech, language, and hearing; prevention evaluation, habilitation, and rehabilitation of speech, language, and hearing disorders; and related fields that augment the work of clinical practitioners of speech-language pathology.[; and]

[(C) for applications filed before January 1, 2015, six semester credit hours shall be earned in the area of hearing disorders, hearing evaluation, and habilitative or rehabilitative procedures with individuals who have a hearing impairment].

(2) A maximum of six academic semester credit hours associated with clinical experience and a maximum of six academic semester credit hours associated with a thesis or dissertation may be counted toward the thirty-six (36) hours but not in lieu of the requirements of paragraph [paragraphs] (1)(B) [and (1)(C)].

(3) - (4) (No change.)

(5) An applicant whose transcript is in a language other than English or whose degree was earned at a foreign university shall submit an original evaluation form from an approved transcript evaluation service. The transcript evaluation service must determine that the applicant's degree is a master's degree or higher with a major in one of the areas of communicative sciences or disorders. The applicant shall bear all expenses incurred during the procedure.

(6) [(5)] An applicant who graduated from a college or university not accredited by the ASHA Council for Clinical Certification [Council on Academic Accreditation] shall submit an original signed letter from ASHA stating the Council for Clinical Certification accepted the course work and clinical experience. The applicant shall bear all expenses incurred during the procedure.

(c) (No change.)

(d) In the event the course work and clinical experience set out in subsections (b) - (c), were earned more than ten (10) years before the date of application for the intern license, the applicant shall submit proof of current knowledge of the practice of speech-language pathology. Proof of current knowledge may include: recently completing continuing education or other courses; holding a current license in another state; holding a current ASHA certification; or retaking and passing the written examination.

(e) An applicant who successfully completed all education and clinical requirements under this section, but who has not had the degree officially conferred may be licensed as an intern in order to begin the internship [supervised professional experience ] but shall submit verification from the program director or designee verifying the applicant has met all academic course work, clinical experience requirements, and completed a thesis or passed a comprehensive examination, if required, and is awaiting the date of next graduation for the degree to be conferred.

(f) An applicant whose master's degree is received at a college or university accredited by the ASHA Council for Clinical Certification [Council on Academic Accreditation] will receive automatic approval of the course work and clinical experience if the program director or designee verifies that all requirements have been met and review of the transcript shows that the applicant has successfully completed at least twenty-four (24) semester credit hours acceptable toward a graduate degree in the area of speech-language pathology.

[(g) Intern Plan and Agreement of Supervision. A Speech-Language Pathology Intern Plan and Agreement of Supervision Form shall be submitted in a manner prescribed by the department and completed by both the applicant and the licensed speech-language pathologist who agrees to assume responsibility for all services provided by the intern in speech-language pathology. The proposed department-approved supervisor must meet the requirements set out in the Act and §111.154.]

[(1) Approval from the department shall be required prior to practice by the intern in speech-language pathology. The Speech-Language Pathology Intern Plan and Agreement of Supervision Form shall be submitted upon:]

[(A) application for a license;]

[(B) license renewal;]

[(C) changes in supervision; and]

[(D) the addition of other proposed department-approved supervisors.]

[(2) In the event more than one licensed speech-language pathologist agrees to supervise the intern in speech-language pathology, each proposed department-approved supervisor must submit a signed Speech-Language Pathology Intern Plan and Agreement of Supervision Form which shall also identify all proposed department-approved supervisors.]

[(3) In the event the department-approved supervisor ceases supervision of the intern in speech-language pathology, the intern shall stop practicing immediately. The department shall hold the department-approved supervisor responsible for the practice of the intern in speech-language pathology until the department-approved supervisor notifies the department, in writing, of the change in supervision.]

[(4) Should the intern in speech-language pathology practice without approval from the department, disciplinary action may be initiated against the intern in speech-language pathology. If the department-approved supervisor had knowledge of this violation, disciplinary action against the department-approved supervisor may also be initiated.]

[(h) Internship Requirements. The internship shall:]

[(1) begin within four years after the academic and clinical experience requirements as required by subsections (b) and (c) have been met;]

[(2) be completed within a maximum period of forty-right (48) months once initiated;]

[(3) be successfully completed after no more than two attempts;]

[(4) consist of thirty-six (36) weeks of full-time supervised professional experience (thirty-five (35) hours per week) totaling a minimum of 1,260 hours, or its part-time equivalent, of supervised professional experience in which clinical work has been accomplished in speech-language pathology. Professional experience of less than five hours per week cannot be used to meet the supervised professional experience.]

[(5) involve primarily clinical activities such as assessment, diagnosis, evaluation, screening, treatment, report writing, family/client consultation, and/or counseling related to the management process of individuals who exhibit communication disabilities;]

[(6) be divided into three segments with no fewer than thirty-six (36) clock hours of supervisory activities to include:]

[(A) six hours of in person observations per segment by the department-approved supervisor(s) of the intern's direct client contact at the worksite in which the intern provides screening, evaluation, assessment, habilitation, and rehabilitation; and]

[(B) six hours of other monitoring activities per segment with the department-approved supervisor(s) which may include correspondence, review of videotapes, evaluation of written reports, phone conferences with the intern, evaluations by professional colleagues; or]

[(C) an alternative plan as approved by the department.]

[(i) Extension Request. An applicant who does not meet the time frames defined in subsection (h)(1) and (2), shall request an extension, in writing, explaining the reason for the request. The request must be signed by both the intern and the department-approved supervisor in a manner prescribed by the department. Evaluation of the intern's progress of performance from all department-approved supervisors must accompany the request. Intern plans and supervisory evaluations for any completed segments must be submitted in a manner prescribed by the department. The department shall determine if the internship:]

[(1) should be revised or extended; and]

[(2) whether additional course work, continuing professional education hours, or passing the examination referenced in §111.21 is required.]

[(j) An intern, who is employed full-time as defined by subsection (h)(4), and wishes to practice at an additional site, shall notify the department in a manner prescribed by the department.]

[(k) Evaluations. During each segment of the internship, each department-approved supervisor shall conduct a formal evaluation of the intern's progress in the development of professional skills. Documentation of this evaluation shall be maintained by both parties for three years or until the speech-language pathology license is granted. A copy of this documentation shall be submitted to the department upon request.]

[(l) Changes. Prior to implementing changes in the internship, approval from the department is required.]

[(1) If the intern changes his or her department-approved supervisor or adds additional department-approved supervisors, a current Intern Plan and Agreement of Supervision Form shall be submitted by the new proposed department-approved supervisor and approved by the department before the intern may resume practice. The Report of Completed Internship Form or information shall be completed by the past department-approved supervisor and intern and submitted to the department upon completion of that portion of the internship. It is the decision of the department-approved supervisor to determine whether the internship is acceptable. The department shall review the form and inform the intern of the results.]

[(2) Each department-approved supervisor who ceases supervising an intern shall submit a Report of Completed Internship Form for the portion of the internship completed under the department-approved supervisor's supervision. This must be submitted within thirty (30) days of the date the supervision ended.]

[(3) If the intern changes his or her employer but the department-approved supervisor and the number of hours employed per week remain the same, the department-approved supervisor shall notify the department in a manner prescribed by the department of the new location. This must be submitted within thirty (30) days of the date the change occurred.]

[(m) In any professional context the licensee must indicate the licensee's status as a speech-language pathology intern.]

[(n) If the intern wishes to continue to practice after the completion of the supervised professional experience as defined in subsection (h), the intern shall apply for either:]

[(1) a speech-language pathology license under Subchapter D, if the intern passed the examination referenced in §111.21; or]

[(2) a temporary certificate of registration under Subchapter G if the intern has not passed the examination referenced in §111.21.]

[(o) If the intern holds a valid license, the intern may continue to practice under supervision for up to thirty (30) days after the department receives the Report of Completed Internship Form.]

[(p) A licensed intern shall not use "SLP-CFY" or "SLP-CF" as indicators for their credentials. Licensees shall use "Intern SLP" or "SLP Intern" to shorten their professional title.]

[(q) Notwithstanding the supervision provisions in this section, the department may establish procedures, processes, and mechanisms for the monitoring and reporting of the supervision requirements.]

§111.41.Intern in Speech-Language Pathology License--Internship and Supervision Requirements.

(a) A licensed intern in speech-language pathology (intern) must be supervised by a licensed speech-language pathologist who has been approved by the department to serve as the intern's supervisor (supervisor).

(b) A supervisor must agree to assume responsibility for all services provided by the intern. The supervisor must comply with the requirements set out in the Act and §111.154.

(c) Intern Plan and Agreement of Supervision Form. A Speech-Language Pathology Intern Plan and Agreement of Supervision Form shall be submitted in a manner prescribed by the department and completed by both the applicant and the proposed supervisor. The proposed supervisor must meet the requirements set out in the Act and §111.154.

(1) Approval from the department shall be required prior to practice by the intern. The Speech-Language Pathology Intern Plan and Agreement of Supervision Form shall be submitted upon:

(A) application for an intern license;

(B) any changes in supervision; and

(C) the addition of other supervisors.

(2) If more than one speech-language pathologist agrees to supervise the intern, each proposed supervisor must submit a Speech-Language Pathology Intern Plan and Agreement of Supervision Form.

(3) The intern may not practice without an approved Speech-Language Pathology Intern Plan and Agreement of Supervision Form. The supervisor may not allow an intern to practice before a Speech-Language Pathology Intern Plan and Agreement of Supervision Form is approved.

(4) If the supervisor ceases supervision of the intern, the supervisor shall notify the department, in a manner prescribed by the department, and shall inform the intern to stop practicing immediately. The supervisor is responsible for the practice of the intern until notification has been received by the department.

(5) If the intern's supervisor ceases supervision, the intern shall stop practicing immediately. The intern may not practice until a new Speech-Language Pathology Intern Plan and Agreement of Supervision Form has been submitted to and approved by the department.

(d) Internship Requirements. The internship shall:

(1) be completed within a maximum period of forty-eight (48) months once initiated;

(2) be successfully completed after no more than two attempts;

(3) consist of thirty-six (36) weeks of full-time supervised professional experience (thirty-five (35) hours per week) totaling a minimum of 1,260 hours, or its part-time equivalent, of supervised professional experience in which clinical work has been accomplished in speech-language pathology. Professional experience of less than five hours per week cannot be used to meet the minimum 1,260 hours, but the professional experience still must be supervised by a licensed speech-language pathologist.

(4) involve primarily clinical activities such as assessment, diagnosis, evaluation, screening, treatment, report writing, family/client consultation, and/or counseling related to the management process of individuals who exhibit communication disabilities;

(5) be divided into three (3) segments with no fewer than thirty-six (36) clock hours of supervisory activities to include:

(A) six (6) hours of in-person direct supervision per segment by the supervisor(s) of the intern's direct client contact at the worksite in which the intern provides screening, evaluation, assessment, habilitation, and rehabilitation; and

(B) six (6) hours of indirect supervision per segment with the supervisor(s) which may include correspondence, review of videos, evaluation of written reports, phone conferences with the intern, evaluations by professional colleagues; or

(C) an alternative plan as approved by the department.

(e) Extension Request. An applicant who does not meet the time frames defined in subsection (d)(1), shall request an extension, in writing, explaining the reason for the request. The request must be signed by both the intern and the supervisor in a manner prescribed by the department. Evaluation of the intern's progress of performance from all supervisors must accompany the request. Intern plans and supervisory evaluations for any completed segments must be submitted in a manner prescribed by the department. The department shall determine if the internship:

(1) should be revised or extended; and

(2) whether additional course work, continuing professional education hours, or passing the examination referenced in §111.21 is required.

(f) Evaluations. During each segment of the internship, each supervisor shall conduct a formal evaluation of the intern's progress in the development of professional skills. Documentation of this evaluation shall be maintained by both parties for three years or until the speech-language pathology license is granted. A copy of this documentation shall be submitted to the department upon request.

(g) Changes in Internship. Prior to implementing changes in the internship, approval from the department is required.

(1) If the intern changes his or her supervisor or adds additional supervisors, a current Speech-Language Pathology Intern Plan and Agreement of Supervision Form shall be submitted by the new proposed supervisor and approved by the department before the intern may resume practice as prescribed under subsection (c).

(2) If the intern changes his or her supervisor, the Speech-Language Pathology Report of Completed Internship Form shall be completed by the former supervisor and the intern and submitted to the department upon completion of that portion of the internship. It is the decision of the former supervisor to determine whether the internship is acceptable. The department shall review the form and inform the intern of the results.

(3) Each supervisor who ceases supervising an intern shall submit a Speech-Language Pathology Report of Completed Internship Form for the portion of the internship completed under the supervisor's supervision. This must be submitted within thirty (30) days of the date the supervision ended.

(4) If no hours were earned under an approved supervisor, the licensed intern or the approved supervisor must submit a signed, written statement that no hours were earned and provide the reason.

(5) If the intern changes his or her employer but the supervisor and the number of hours employed per week remain the same, the supervisor shall notify the department in a manner prescribed by the department of the new location. This must be submitted within thirty (30) days of the date the change occurred.

(h) Notwithstanding the supervision provisions in this section, the department may establish procedures, processes, and mechanisms for the monitoring and reporting of the supervision requirements.

§111.42.Intern in Speech-Language Pathology License--Practice and Duties of Interns.

(a) A licensed intern in speech-language pathology (intern) must perform assigned duties under the supervision of a licensed speech-language pathologist who has been approved by the department to serve as the intern's supervisor (supervisor).

(b) In any professional context the intern must indicate the intern's status as a licensed speech-language pathology intern.

(c) An intern shall not use "SLP-CFY" or "SLP-CF" as indicators for their credentials. Licensees shall use "Intern SLP" or "SLP Intern" to shorten their professional title.

(d) If the intern wishes to continue to practice after the completion of the internship specified in §111.41(d), the intern shall apply for a speech-language pathology license under Subchapter D, if the intern passed the examination referenced in §111.21.

(e) The intern may continue to practice while awaiting the processing of the speech-language pathology license if the intern meets the following conditions:

(1) holds a valid intern in speech-language pathology license;

(2) practices under the supervision of the current supervisor, who filed the Speech-Language Pathology Intern Plan and Agreement of Supervision Form and the Speech-Language Pathology Report of Completed Internship Form; and

(3) practices under the terms of the current Speech-Language Pathology Intern Plan and Agreement of Supervision Form.

§111.45.Intern in Speech-Language Pathology License--Application and Eligibility Requirements.

(a) (No change.)

(b) An applicant for an intern in speech-language pathology license must submit the following required documentation:

(1) (No change.)

(2) if the graduate degree has been conferred, an original or certified copy of the transcript(s), which shows [showing the conferred degree of] all relevant course work and which shows [also verifies that] the applicant possesses a minimum of a master's degree with a major in one of the areas of communicative sciences or disorders;

(3) if the applicant graduated from a college or university with a program not accredited by the ASHA Council for Clinical Certification [Council on Academic Accreditation], an original signed letter from ASHA stating the Council for Clinical Certification accepted the course work and clinical experience;

(4) if the graduate degree has not been [officially] conferred, the Course Work and Clinical Experience Form completed by the university program director or designee of the college or university attended [an original or certified copy of transcript(s) and verification from the university attended verifying the applicant successfully completed all requirements for the graduate degree, and is only awaiting the date of next graduation for the degree to be conferred];

(5) if the applicant's transcript is in a language other than English or the degree was earned at a foreign university, an original evaluation form from an approved transcript evaluation service stating that the applicant's degree is a master's degree or higher with a major in one of the areas of communicative sciences or disorders [a Course Work and Clinical Experience Form completed by the university program director or designee of the college or university attended which verifies the applicant has met the requirements established in §111.40(b) - (c)];

(6) an Intern Plan and Agreement of Supervision Form completed by the proposed [department-approved] supervisor and signed by both the applicant and the proposed [department-approved ] supervisor;

(7) - (8) (No change.)

(c) If not previously submitted when applying for an assistant license, an [An] applicant for an intern in speech-language pathology license must submit a completed legible set of fingerprints, on a form prescribed by the department, to the Department of Public Safety for the purpose of obtaining criminal history record information. An applicant must successfully pass a criminal history background check.

(d) (No change.)

§111.47.Intern in Speech-Language Pathology License--License Terms; Renewals.

(a) - (b) (No change.)

(c) To renew an intern in speech-language pathology license, a licensee must:

(1) submit a completed renewal application on a department-approved form;

[(2) successfully pass a criminal history background check;]

(2) [(3)] complete ten (10) hours of continuing education as required under §111.130;

(3) [(4)] comply with the continuing education audit process described under §111.132, if selected for an audit;

[(5) submit an evaluation of the intern's progress or performance from all department-approved supervisors and any intern plans and supervisory evaluations for completed segments;]

(4) [(6)] submit an Intern Plan and Agreement of Supervision Form for the intern's upcoming experience unless the intern is currently not practicing. In that event, the intern shall provide an explanation of the reason for not practicing; and

(5) [(7)] submit the license renewal fee required under §111.160.

(d) A licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.

(e) [(d)] The department may deny the renewal of the license pursuant to Texas Occupations Code §401.451.

(f) [(e)] If all conditions required for renewal are met prior to expiration, the department shall issue a renewed license.

(g) [(f)] A person whose license has expired may late renew the license in accordance with the procedures set out under §60.31 and §60.83 of this title.

(h) [(g)] A person whose license has expired may not practice or engage in speech-language pathology.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800104

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER F. REQUIREMENTS FOR ASSISTANT IN SPEECH-LANGUAGE PATHOLOGY LICENSE

16 TAC §§111.50 - 111.52, 111.55, 111.57

The amendments and new rules are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.50.Assistant in Speech-Language Pathology License--Licensing Requirements--Education and Clinical Observation and Experience.

(a) An individual shall not practice as an assistant in speech-language pathology without a current license issued by the department. An applicant for an assistant in speech-language pathology license must meet the requirement under the Act and this section. The applicant must meet the following requirements:

(1) (No change.)

(2) have acquired at least twenty-four (24) semester credit hours in speech-language pathology and/or audiology with a grade of "C" or above with the following conditions:

(A) at least 18 of the 24 semester credit hours must be in speech-language pathology;

(B) at least three (3) of the 24 semester credit hours must be in language disorders;

(C) at least three (3) of the 24 semester credit hours must be in speech disorders; [and]

(D) the 24 semester credit hours excludes [clinical experience and] course work such as special education, deaf education, or sign language; and

(E) the 24 semester credit hours must be academic course work and excludes any clinical experience; and

(3) have earned no fewer than twenty-five (25) hours of clinical observation in the area of speech-language pathology and twenty-five (25) hours of clinical assisting experience in the area of speech-language pathology obtained within an educational institution or in one of its cooperating programs. If these hours are not completed, the applicant must complete the Clinical Deficiency Plan under subsection (e). [or under the direct supervision at their place of employment.]

(b) The baccalaureate degree shall be completed at a college or university which has a program accredited by the ASHA Council for Clinical Certification [Council on Academic Accreditation] or holds accreditation or candidacy status from a recognized regional accrediting agency.

(1) (No change.)

(2) In the event the course work and clinical experience set out in subsection (a), were earned more than ten (10) years before the date of application for the assistant license, the applicant shall submit proof of current knowledge of the practice of speech-language pathology to be evaluated by the department. Proof of current knowledge may include: recently completing continuing education or other courses; or holding a current license in another state.

(c) An applicant who possesses a baccalaureate degree with a major that is not in communicative sciences or disorders may qualify for the assistant license. The department shall evaluate transcripts on a case-by-case basis to ensure equivalent academic preparation, and shall determine if the applicant satisfactorily completed twenty-four (24) semester credit hours in communicative sciences or disorders and meets the requirements of §111.50(b)(2), which may include some leveling hours.

(d) (No change.)

(e) An applicant who has not acquired the twenty-five (25) hours of clinical observation and twenty-five (25) hours of clinical experience referenced in subsection (a)(3), shall not meet the minimum qualifications for the assistant license. These hours must be obtained through an accredited college or university, or through a Clinical Deficiency Plan. All hours must be completed under in-person, direct supervision. In order to acquire these hours, the applicant shall first obtain the assistant license by submitting the forms, fees, and documentation referenced in §111.55 and include the prescribed Clinical Deficiency Plan to acquire the clinical observation and clinical assisting experience hours lacking.

(1) The licensed speech-language pathologist who will provide the applicant with the training to acquire these hours must meet the requirements set out in the Act and §111.154 and shall submit:

(A) the Supervisory Responsibility Statement Form prescribed under §111.51; and

(B) the prescribed Clinical Deficiency Plan.

(2) - (3) (No change.)

(4) Immediately upon completion of the Clinical Deficiency Plan, the licensed speech-language pathologist identified in the plan shall submit[:]

[(A) a supervision log that verifies the specific times and dates in which the hours were acquired with a brief description of the training conducted during each session;]

[(B) a rating scale of the licensed assistant's performance; and]

[(C)] a statement or information that the licensed assistant successfully completed the clinical observation and clinical assisting experience and that all hours worked by the licensed assistant were under the in-person, direct supervision of the licensed speech-language pathologist [under his or her 100% direct, in person supervision]. This statement shall specify the number of hours completed and verify completion of the training identified in the Clinical Deficiency Plan.

(5) (No change.)

(6) A licensed assistant may continue to practice under the in-person, direct supervision [100% direct, in person supervision] of the licensed speech-language pathologist who provided the licensed assistant with the training while the department evaluates the documentation identified in paragraph (4). All hours worked by the licensed assistant must be under the in-person, direct supervision of the licensed speech-language pathologist.

(7) (No change.)

[(f) A Supervisory Responsibility Statement Form shall be completed and signed by both the applicant and the proposed department-approved supervisor who agrees to assume responsibility for all services provided by the licensed assistant or submitted in a manner prescribed by the department. The proposed department-approved supervisor must meet the requirements set out in the Act and §111.154.]

[(1) Approval from the department shall be required prior to practice by the licensed assistant. The Supervisor Responsibility Statement Form shall be submitted upon:]

[(A) application for an assistant license;]

[(B) license renewal when there is a change in supervisor;]

[(C) other changes in supervision; and]

[(D) the addition of other department-approved supervisors.]

[(2) In the event more than one licensed speech-language pathologist agrees to supervise the licensed assistant, each licensed speech-language pathologist department-approved supervisor shall be identified on the Supervisor Responsibility Statement Form, and meet the minimum requirement of supervision as referenced in subsection (g)(4). The licensed assistant shall only provide services for the caseload of the licensed speech-language pathologist department-approved supervisors.]

[(3) A licensed assistant may renew the license if there is a change in supervision, but may not practice until a new Supervisory Responsibility Statement Form is approved.]

[(4) In the event the licensed speech-language pathologist department-approved supervisor ceases supervision of the licensed assistant, the licensed speech-language pathologist department-approved supervisor shall notify the department, in writing, and shall inform the licensed assistant to stop practicing immediately. The department shall hold the licensed department-approved supervisor responsible for the practice of the licensed assistant until written notification has been received by the department.]

[(5) Should the licensed assistant practice without approval from the department, disciplinary action may be initiated against the licensed assistant. If the licensed speech-language pathologist department-approved supervisor had knowledge of this violation, disciplinary action against the licensed speech-language pathologist department-approved supervisor may also be initiated.]

[(g) A licensed speech-language pathologist department-approved supervisor shall assign duties and provide appropriate supervision to the licensed assistant.]

[(1) Initial contacts directly with the client shall be conducted by the licensed speech-language pathologist department-approved supervisor.]

[(2) Following the initial contact, the licensed speech-language pathologist department-approved supervisor shall determine whether the licensed assistant has the competence to perform specific duties before delegating tasks.]

[(3) The licensed speech-language pathologist department-approved supervisor shall provide a minimum of eight (8) hours per month of supervision, at least four (4) hours of which are direct, and at least two (2) hours of which is in person and onsite supervision where the licensed assistant is providing the therapy. This paragraph applies whether the licensed assistant's practice is employed full- or part-time. For the purposes of this paragraph the telehealth and telepractice provisions allowed by Subchapter V may be used for up to six (6) hours of supervision without applying for the exception referenced under §111.213. When determining the amount and type of supervision, the department-approved supervisor must consider the skill and experience of the licensed assistant as well as the services to be provided. The supervision hours established in this paragraph may be exceeded as determined by the department-approved supervisor.]

[(4) Supervisory records shall be maintained for a period of three years by the licensed speech-language pathologist that verify regularly scheduled monitoring, assessment, and evaluation of the licensed assistant's and client's performance. Such documentation may be requested by the department.]

[(A) A licensed assistant may not conduct an evaluation which includes diagnostic testing and observation, test interpretation, diagnosis, decision making, statement of severity or implication, case selection or case load decisions.]

[(B) A licensed assistant may conduct assessments which includes data collection, clinical observation and routine test administration if the licensed assistant has been appropriately trained and the assessments are conducted under the direction of the licensed speech-language pathologist department-approved supervisor. A licensed assistant may not conduct a test if the test developer has specified that a graduate degreed examiner should conduct the test.]

[(h) Although the licensed speech-language pathologist department-approved supervisor may delegate specific clinical tasks to a licensed assistant, the responsibility to the client for all services provided cannot be delegated. The licensed speech-language pathologist department-approved supervisor shall ensure that all services provided are in compliance with this chapter.]

[(1) The licensed speech-language pathologist department-approved supervisor need not be present when the licensed assistant is completing the assigned tasks; however, the licensed speech-language pathologist department-approved supervisor shall document all services provided and the supervision of the licensed assistant.]

[(2) The licensed speech-language pathologist department-approved supervisor shall keep job descriptions and performance records of the licensed assistant. Records shall be current and made available upon request to the department.]

[(3) The licensed speech-language pathologist department-approved supervisor of the licensed assistant shall:]

[(A) in writing, determine the skills and assigned tasks the licensed assistant is able to carry out within the licensed assistant's scope of practice. This document must be agreed upon by the licensed assistant and the licensed speech-language pathologist department-approved supervisor;]

[(B) notify the client or client's legal guardian(s) that services will be provided by a licensed assistant;]

[(C) develop the client's treatment program in all settings and review them with the licensed assistant who will provide the service; and]

[(D) maintain responsibility for the services provided by the licensed assistant.]

[(4) The licensed assistant may execute specific components of the clinical speech, language, and/or hearing program if the licensed speech-language pathologist department-approved supervisor determines that the licensed assistant has received the training and has the skill to accomplish that task, and the licensed speech-language pathologist department-approved supervisor provides sufficient supervision to ensure appropriate completion of the task assigned to the licensed assistant.]

[(5) Examples of duties that a licensed speech-language pathologist department-approved supervisor may assign to a licensed assistant who has received appropriate training include the following:]

[(A) conduct or participate in speech, language, and/or hearing screening;]

[(B) implement the treatment program or the individual education plan (IEP) designed by the licensed speech-language pathologist department-approved supervisor;]

[(C) provide carry-over activities which are the therapeutically designed transfer of a newly acquired communication ability to other contexts and situations;]

[(D) collect data;]

[(E) administer routine tests if the test developer does not specify a graduate degreed examiner and the department-approved supervisor has determined the licensed assistant is competent to perform the test;]

[(F) maintain clinical records;]

[(G) prepare clinical materials;]

[(H) participate with the licensed speech-language pathologist department-approved supervisors' research projects, staff development, public relations programs, or similar activities as designated and supervised by the licensed speech-language pathologist department-approved supervisor;]

[(I) may write lesson plans based on the therapy program developed by the licensed speech-language pathologist department-approved supervisor. The lesson plans shall be reviewed and approved by the licensed speech-language pathologist department-approved supervisor; and]

[(J) must only work with assigned cases of the licensed speech-language pathologist department-approved supervisor's caseload.]

[(i) The licensed assistant shall not:]

[(1) conduct evaluations, even under supervision, since this is a diagnostic and decision making activity;]

[(2) interpret results of routine tests;]

[(3) interpret observations or data into diagnostic statements, clinical management strategies, or procedures;]

[(4) represent speech-language pathology at staff meetings or at an admission, review and dismissal (ARD), except as specified in this section;]

[(5) attend staffing meeting or ARD without the licensed assistant's supervising speech-language pathologist department-approved supervisor being present except as specified in this section;]

[(6) design or alter a treatment program or individual education plan (IEP);]

[(7) determine case selection;]

[(8) present written or oral reports of client information, except as provided by this section;]

[(9) refer a client to other professionals or other agencies;]

[(10) use any title which connotes the competency of a licensed speech-language pathologist;]

[(11) practice as an assistant in speech-language pathology without a valid supervisory responsibility statement on file in the department;]

[(12) perform invasive procedures;]

[(13) screen or diagnose clients for feeding and swallowing disorders;]

[(14) use a checklist or tabulated results of feeding or swallowing evaluations;]

[(15) demonstrate swallowing strategies or precautions to clients, family, or staff;]

[(16) provide client or family counseling;]

[(17) sign any formal document relating to the reimbursement for or the provision of speech-language pathology services without the licensed assistant's licensed speech-language pathologist department-approved supervisor's signature; or]

[(18) use "SLP-A" or "STA" as indicators for their credentials. Licensees shall use "Assistant SLP" or "SLP Assistant" to shorten their professional title.]

[(j) The licensed speech-language pathologist department-approved supervisor of the licensed assistant, prior to the ARD, shall:]

[(1) notify the parents of students with speech impairments that services will be provided by a licensed assistant and that the licensed assistant will represent Speech Pathology at the ARD;]

[(2) develop the student's new IEP goals and objectives and review them with the licensed assistant; and]

[(3) maintain undiminished responsibility for the services provided and the actions of the licensed assistant.]

[(k) A licensed assistant may represent special education and speech pathology at the ARD meetings with the following stipulations.]

[(1) The licensed assistant shall have written documentation of approval from the licensed, speech-language pathologist department-approved supervisor.]

[(2) The licensed assistant shall have three years experience as a licensed assistant in the school setting.]

[(3) The licensed assistant may attend, with written approval of the speech-language pathologist department-approved supervisor, a student's annual review ARD meeting if the meeting involves a student for whom the licensed assistant provides services. If a licensed assistant attends a meeting as provided by this rule, the licensed speech-language pathologist department-approved supervisor is not required to attend the meeting. A licensed speech-language pathologist department-approved supervisor must attend an ARD meeting if the purpose of the meeting is to develop a student's initial IEP or if the meeting is to consider the student's dismissal, unless the licensed speech-language pathologist department-approved supervisor has submitted his or her recommendation in writing on or before the date of the meeting.]

[(4) The licensed assistant shall present IEP goals and objectives that have been developed by the licensed speech-language pathologist department-approved supervisor and reviewed with the parent by the licensed speech-language pathologist department-approved supervisor.]

[(5) The licensed assistant shall discontinue participation in the ARD meeting, and contact the department-approved supervising speech-language pathologist, when questions or changes arise regarding the IEP document.]

[(l) In any professional context the licensee must indicate the licensee status as a licensed speech-language pathology assistant.]

[(m) The department may audit a random sampling of licensed assistants for compliance with this section and §111.154.]

[(1) The department shall notify a licensed assistant and licensed speech-language pathologist department-approved supervisor in a manner prescribed by the department that the licensee has been selected for an audit.]

[(2) Upon receipt of an audit notification, the licensed assistant and the licensed speech-language pathologist department-approved supervisor, who agreed to accept responsibility for the services provided by the licensed assistant, shall provide in a manner prescribed by the department the requested proof of compliance to the department.]

[(3) The licensed assistant and the licensed speech-language pathologist department-approved supervisor shall comply with the department's request for documentation and information concerning compliance with the audit.]

[(n) Notwithstanding the supervision provisions in this section, the department may establish procedures, processes, and mechanisms for the monitoring and reporting of the supervision requirements.]

§111.51.Assistant in Speech-Language Pathology License--Supervision Requirements.

(a) A licensed assistant in speech-language pathology (assistant) must be supervised by a licensed speech-language pathologist who has been approved by the department to serve as the assistant's supervisor (supervisor).

(b) A supervisor must agree to assume responsibility for all services provided by the assistant. The supervisor must comply with the requirements set out in the Act and §111.154.

(c) Supervisory Responsibility Statement Form. A Supervisory Responsibility Statement Form shall be submitted in a manner prescribed by the department by both the applicant and the proposed supervisor. The proposed supervisor must meet with the requirements set out in the Act and §111.154.

(1) Approval from the department shall be required prior to practice by the assistant. The Supervisor Responsibility Statement Form shall be submitted upon:

(A) application for an assistant license;

(B) any changes in supervision; and

(C) the addition of other supervisors.

(2) If more than one speech-language pathologist agrees to supervise the assistant, each proposed supervisor must submit a separate Supervisor Responsibility Statement Form in manner prescribed by the department.

(3) The assistant may not practice without an approved Supervisor Responsibility Statement Form. The supervisor may not allow an assistant to practice before a Supervisor Responsibility Statement Form is approved.

(4) The assistant shall only provide services for the caseload of the assistant's supervisors who have current Supervisor Responsibility Statement Forms on file with the department.

(5) If the supervisor ceases supervision of the assistant, the supervisor shall notify the department, in a manner prescribed by the department, and shall inform the assistant to stop practicing immediately. The supervisor is responsible for the practice of the assistant until notification has been received by the department.

(6) If the assistant's supervisor ceases supervision, the assistant shall stop practicing immediately. The assistant may not practice until a new Supervisor Responsibility Statement Form has been submitted to and approved by the department.

(d) The supervisor shall assign duties and provide appropriate supervision to the assistant.

(e) Direct supervision of the assistant may only occur at the worksite in which the assistant provides services to existing clients or while the assistant provides services to cases previously delegated to the assistant. The supervisor may not make temporary, short-term assignments from the supervisor's caseload to the assistant in order to fulfill direct supervision requirements.

(f) Client Contacts.

(1) Initial contacts directly with the client shall be conducted by the supervisor.

(2) Following the initial contact, the supervisor shall determine whether the assistant has the competence to perform specific duties before delegating tasks.

(g) Amount and Type of Supervision. The supervisor shall provide a minimum of eight (8) hours per calendar month of supervision to the assistant. This subsection applies whether the assistant is employed full-time or part-time.

(1) At least four (4) hours must be direct supervision. At least two (2) of the direct supervision hours must be in-person. The other two (2) hours may be in-person or by telehealth/telepractice.

(2) The remaining hours may be performed using indirect supervision.

(3) If fewer than four (4) weeks are worked in a calendar month, then the number of hours of supervision provided will be based on the number of weeks worked. Two (2) hours of supervision must be provided for each week worked, including one (1) hour of direct supervision and one (1) hour of indirect supervision.

(4) For the purposes of this subsection the telehealth/telepractice provisions allowed by Subchapter V may be used for up to six (6) hours of supervision (two (2) hours of direct supervision and four (4) hours of indirect supervision).

(5) When determining the amount and type of supervision, the supervisor must consider the skill and experience of the assistant as well as the services to be provided. The supervision hours established in this subsection may be exceeded as determined by the supervisor.

(h) Delegating Clinical Tasks.

(1) The supervisor may delegate specific clinical tasks to an assistant; however, the responsibility to the client for all services provided cannot be delegated.

(2) The supervisor shall ensure that all services are documented and provided in compliance with the Act and this chapter.

(3) The supervisor shall:

(A) in writing, determine the skills and assigned tasks the assistant is able to carry out under §111.52. This document must be agreed upon by the assistant and the supervisor;

(B) notify the client or client's legal guardian(s) that services will be provided by a licensed assistant;

(C) develop the client's treatment program in all settings and review it with the assistant who will provide the service; and

(D) maintain responsibility for the services provided by the assistant.

(i) Admission, Review, and Dismissal Meetings. The supervisor, prior to an Admission, Review and Dismissal (ARD) meeting, shall:

(1) notify the parents of students with speech impairments that services will be provided by the assistant and that the assistant will represent Speech Pathology at the ARD;

(2) develop the student's new Individual Education Program (IEP) goals and objectives and review them with the assistant; and

(3) maintain undiminished responsibility for the services provided and the actions of the assistant.

(j) Records. The supervisor shall maintain the following records.

(1) The supervisor shall maintain for a period of three years supervisory records that verify regularly scheduled monitoring, assessment, and evaluation of the assistant's and client's performance. Such documentation may be requested by the department.

(2) The supervisor shall keep job descriptions and performance records of the assistant. Records shall be current and made available upon request to the department.

(k) Supervision Audits. The department may audit a random sampling of assistants for compliance with this section and §111.154.

(1) The department shall notify the assistant and the supervisor in a manner prescribed by the department that the assistant has been selected for an audit.

(2) Upon receipt of an audit notification, the assistant and the supervisor shall provide in a manner prescribed by the department the requested proof of compliance to the department.

(3) The assistant and the supervisor shall comply with the department's request for documentation and information concerning compliance with the audit.

(l) Notwithstanding the supervision provisions in this section, the department may establish procedures, processes, and mechanisms for the monitoring and reporting of the supervision requirements.

§111.52.Assistant in Speech-Language Pathology License--Practice and Duties of Assistants.

(a) A licensed assistant in speech-language pathology (assistant) must perform assigned duties under the supervision of a licensed speech-language pathologist who has been approved by the department to serve as the assistant's supervisor (supervisor).

(b) The assistant may execute specific components of the clinical speech, language, and/or hearing program if the supervisor:

(1) determines that the assistant has received the training and has the skill to accomplish that task; and

(2) provides sufficient supervision to ensure appropriate completion of the task assigned to the assistant.

(c) Duties that a supervisor may assign to an assistant, who has received appropriate training, include the following:

(1) conduct or participate in speech, language, and/or hearing screening;

(2) implement the treatment program or the Individual Education Program (IEP) designed by the supervisor;

(3) provide carry-over activities which are the therapeutically designed transfer of a newly acquired communication ability to other contexts and situations;

(4) collect data;

(5) administer routine tests if the test developer does not specify a graduate degreed examiner and the supervisor has determined the assistant is competent to perform the test;

(6) maintain clinical records;

(7) prepare clinical materials;

(8) participate with the supervisors' research projects, staff development, public relations programs, or similar activities as designated and supervised by the supervisor; and

(9) write lesson plans based on the therapy program developed by the supervisor. The lesson plans shall be reviewed and approved by the supervisor.

(d) The assistant shall not:

(1) work with any cases that are not assigned to the supervisor's caseload;

(2) conduct evaluations;

(3) interpret results of routine tests;

(4) interpret observations or data into diagnostic statements, clinical management strategies, or procedures;

(5) represent speech-language pathology at staffing meetings or at an Admission, Review and Dismissal (ARD) meeting, except as specified in this section;

(6) attend staffing meeting or ARD without the supervisor being present except as specified in this section;

(7) design or alter a treatment program or Individual Education Program (IEP);

(8) determine case selection;

(9) present written or oral reports of client information, except as provided by this section;

(10) refer a client to other professionals or other agencies;

(11) use any title which connotes the competency of a licensed speech-language pathologist;

(12) practice as an assistant without a current Supervisory Responsibility Statement on file with the department;

(13) perform invasive procedures;

(14) screen or diagnose clients for feeding and swallowing disorders;

(15) use a checklist or tabulated results of feeding or swallowing evaluations;

(16) demonstrate swallowing strategies or precautions to clients, family, or staff;

(17) provide client or family counseling;

(18) sign any formal document relating to the reimbursement for or the provision of speech-language pathology services without the supervisor's signature; or

(19) use "SLP-A" or "STA" as indicators for their credentials. Licensees shall use "Assistant SLP" or "SLP Assistant" to shorten their professional title.

(e) An assistant may represent special education and speech pathology at the Admission, Review, and Dismissal (ARD) meetings with the following stipulations.

(1) The assistant shall have written documentation of approval from the supervisor.

(2) The assistant shall have three years of experience as an assistant in the school setting.

(3) The assistant may attend, with written approval of the supervisor, a student's annual review ARD meeting if the meeting involves a student for whom the assistant provides services. If an assistant attends a meeting as provided by this rule, the supervisor is not required to attend the meeting. A supervisor must attend an ARD meeting if the purpose of the meeting is to develop a student's initial Individual Education Program (IEP) or if the meeting is to consider the student's dismissal, unless the supervisor has submitted his or her recommendation in writing on or before the date of the meeting.

(4) The assistant shall present IEP goals and objectives that have been developed by the supervisor and reviewed with the parent by the supervisor.

(5) The assistant shall discontinue participation in the ARD meeting and shall contact the supervisor when questions or changes arise regarding the IEP document.

(f) In any professional context the assistant must indicate the assistant's status as a speech-language pathology assistant.

§111.55.Assistant in Speech-Language Pathology License--Application and Eligibility Requirements.

(a) (No change.)

(b) An applicant for an assistant in speech-language pathology license must submit the following required documentation:

(1) (No change.)

(2) a completed Supervisory Responsibility Statement Form as prescribed under §111.51 [completed by the licensed supervisor who agrees to accept responsibility for the services provided by the assistant and signed by both the applicant and the proposed department-approved supervisor or submitted in a manner prescribed by the department];

(3) an original or certified copy of the transcript(s), which shows the 24 semester credit hours of required [showing the conferred degree of relevant] course work and which shows [also verifies that] the applicant possesses a baccalaureate degree with an emphasis in communicative sciences or disorders or a baccalaureate degree that qualifies under §111.50(c) [speech-language pathology and/or audiology];

(4) - (7) (No change.)

(c) - (d) (No change.)

§111.57.Assistant in Speech-Language Pathology License--License Terms; Renewals.

(a) - (b) (No change.)

(c) To renew an assistant in speech-language pathology license, a licensee must:

(1) submit a completed renewal application on a department-approved form;

[(2) successfully pass a criminal history background check;]

(2) [(3)] complete twenty (20) hours of continuing education as required under §111.30;

(3) [(4)] comply with the continuing education audit process described under §111.32, if selected for an audit;

(4) [(5)] submit, in a manner prescribed by the department, a Supervisory Responsibility Statement Form or information from each [department-approved] supervisor [providing the supervision] unless the assistant is currently not practicing or the [department-approved] supervisor(s) has not changed; and

(5) [(6)] submit the license renewal fee required under §111.160.

(d) A licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.

(e) [(d)] The department may deny the renewal of the license pursuant to Texas Occupations Code §401.451.

(f) [(e)] If all conditions required for renewal are met prior to expiration, the department shall issue a renewed license.

(g) [(f)] A person whose license has expired may late renew the license in accordance with the procedures set out under §60.31 and §60.83 of this title.

(h) [(g)] A person whose license has expired may not practice or engage in speech-language pathology.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800105

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER G. REQUIREMENTS FOR TEMPORARY CERTIFICATE OF REGISTRATION IN SPEECH-LANGUAGE PATHOLOGY

16 TAC §§111.60, 111.65, 111.66

The repeals are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.60.Temporary Certificate of Registration in Speech-Language Pathology--Registration Requirements.

§111.65.Temporary Certificate of Registration in Speech-Language Pathology--Application and Eligibility Requirements.

§111.66.Temporary Certificate of Registration in Speech-Language Pathology--Issuing Registration.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800098

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER H. REQUIREMENTS FOR AUDIOLOGY LICENSE

16 TAC §§111.70, 111.75, 111.77

The amendments are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.70.Audiology License--Licensing Requirements.

(a) - (b) (No change.)

(c) An applicant whose transcript is in a language other than English or whose degree was earned at a foreign university shall submit an original evaluation form from an approved transcript evaluation service. The transcript evaluation service must determine that the applicant’s degree is a doctoral degree in audiology or a related hearing science. The applicant shall bear all expenses incurred during the procedure.

(d) [(c)] An applicant who graduated from a college or university program not accredited by a national accrediting organization that is approved by the department and recognized by the United States Secretary of Education under the Higher Education Act of 1965 (20 U.S.C. §1001 et seq.) shall have the ASHA Council for Clinical Certification evaluate the course work to determine whether the applicant qualified for the Certificate of Clinical Competence. The applicant shall bear all expenses incurred during the procedure.

(e) [(d)] Examination. An applicant shall pass the examination referenced under §111.21[, within the past 10 years from the date of the application].

(f) [(e)] An applicant who previously held the ASHA Certificate of Clinical Competence or the ABA Certification [certification] may have the certificate reinstated and apply for licensure under §111.75(d).

§111.75.Audiology License--Application and Eligibility Requirements.

(a) (No change.)

(b) An applicant for an audiology license must submit the following required documentation:

(1) a completed application on a department-approved form;

(2) if not previously submitted when applying for an intern’s license, an original or certified copy of the transcript(s), which shows [showing] the conferred doctoral degree in audiology or a related hearing science;

(3) if the degree was not earned at an institution as described in §111.70(b), official documentation from the ASHA Council for Clinical Certification [Council on Academic Accreditation] that the conferred doctoral degree is adequate for ASHA Certification or from the ABA that the conferred doctoral degree is adequate for ABA Certification;

(4) if the applicant’s transcript is in a language other than English or the degree was earned at a foreign university, an original evaluation form from an approved transcript evaluation service stating that the applicant’s degree is a master’s degree or higher with a major in one of the areas of communicative sciences or disorders [not previously submitted when applying for an intern’s license, a Course Work and Clinical Experience Form completed by the program director or designee of the college or university attended which verifies the applicant has met the requirements under §111.70(b) - (c)];

(5) if the applicant currently holds a Texas [an] intern in audiology license, a Report of Completed Audiology Internship Form completed by the applicant’s [department-approved ] supervisor and signed by both the applicant and the [department-approved] supervisor;

(6) if the internship was completed out-of-state, one of the following documents regarding the supervisor must be submitted:

[(A) a copy of the supervisor’s diploma or transcript showing a master's or doctoral degree in communicative sciences or disorders; and]

[(B) one of the following:]

(A) [(i)] if that state requires licensure, a copy of the supervisor’s valid license to practice in that state; or

(B) [(ii)] if that state does not require licensure, an original letter from ASHA stating the supervisor held the Certificate of Clinical Competence or ABA Certification when the applicant completed the internship;

(7) - (9) (No change.)

(c) If not previously submitted when applying for an assistant or intern license, an [An] applicant for an audiology license must submit a completed legible set of fingerprints, on a form prescribed by the department, to the Department of Public Safety for the purpose of obtaining criminal history record information. An applicant must successfully pass a criminal history background check.

(d) Waiver of Clinical Experience and Examination Requirements. An applicant who currently holds either the ASHA Certificate of Clinical Competence or the ABA Certification may submit official documentation from ASHA or ABA as evidence that the applicant meets the clinical experience and examination requirements as set out in the Act and this subchapter for an audiology license. Such an applicant must submit:

(1) an original or certified copy of a signed letter from ASHA or ABA which verifies the applicant currently holds the ASHA Certificate of Clinical Competence or ABA Certification in the area of audiology;

(2) an original or certified copy of the transcript(s) showing the conferred degree of all relevant course work which also verifies that the applicant possesses a minimum of a doctoral degree in audiology or a related hearing science; [however, an applicant whose transcript is in a language other than English shall submit an original evaluation form from an approved credentialing agency; and]

(3) the required documents [and fees] under subsection [subsections] (b)(1) and[,] (8) [and (9)] and subsection (c); and[.]

(4) the initial application fee required under §111.160.

(e) Upgrade from Intern License to Full License. An applicant, who holds a current Texas intern in audiology license, may upgrade to an audiology license by submitting:

(1) a completed upgrade application on a department-approved form;

(2) the required documents under subsection (b)(2), (5), and (7) and subsection (c); and

(3) the initial application fee required under §111.160.

(f) [(e)] An applicant must complete all licensing requirements within one year from the date the application was submitted. After that year an applicant will be required to submit a new application and all required materials in addition to paying a new application fee.

§111.77.Audiology License--License Terms; Renewals.

(a) - (b) (No change.)

(c) To renew an audiology license, a licensee must:

(1) (No change.)

[(2) successfully pass a criminal history background check;]

(2) [(3)] complete 20 hours of continuing education as required under §111.130;

(3) [(4)] comply with the continuing education audit process described under §111.132, if selected for an audit; and

(4) [(5)] submit the license renewal fee required under §111.160.

(d) A licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.

(e) [(d)] The department may deny the renewal of the license pursuant to Texas Occupations Code §401.451.

(f) [(e)] If all conditions required for renewal are met prior to expiration, the department shall issue a renewed license.

(g) [(f)] A person whose license has expired may late renew the license in accordance with the procedures set out under §60.31 and §60.83 of this title.

(h) [(g)] A person whose license has expired may not practice or engage in audiology.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800106

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER I. REQUIREMENTS FOR INTERN IN AUDIOLOGY LICENSE

16 TAC §§111.80 - 111.82, 111.85, 111.87

The amendments and new rules are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.80.Intern in Audiology License--Licensing [and Internship] Requirements--Education.

(a) (No change.)

(b) Education. The doctoral degree in audiology or a related hearing science shall be obtained [completed] at a college or university that has a program accredited by a national accrediting organization that is approved by the department and recognized by the United States Secretary of Education under the Higher Education Act of 1965 (20 U.S.C. §1001 et seq.).

(c) An applicant who graduated from a college or university program not accredited by a national accrediting organization that is approved by the department and recognized by the United States Secretary of Education under the Higher Education Act of 1965 (20 U.S.C. §1001 et seq.) shall have the ASHA Council for Clinical Certification evaluate the course work to determine whether the applicant qualified for the Certificate of Clinical Competence. The applicant shall bear all expenses incurred during the procedure.

(d) The applicant shall submit the department prescribed form signed by the university program director or designee verifying the applicant is enrolled in a professionally recognized accredited doctoral program as approved by the department.

[(e) Intern Plan and Agreement of Supervision. The department prescribed Intern Plan and Agreement of Supervision for an Intern in Audiology Form shall be completed and signed in a manner prescribed by the department by both the applicant and the licensed audiologist who agrees to assume responsibility for all services provided by the intern in audiology. The proposed department-approved supervisor shall: hold a valid Texas license in audiology; possess a master’s degree or higher with a major in one of the areas of communicative sciences or disorders, if the supervisor applied for the audiology license before September 1, 2011, or possess a doctoral degree or higher in audiology or a related hearing science, if the supervisor applied for the audiology license on or after September 1, 2011; and meet the requirements set out in the Act and §111.154.]

[(1) Written approval from the department shall be required prior to practice by the intern in audiology. The Intern Plan and Agreement of Supervision of An Intern in Audiology Form shall be submitted upon:]

[(A) application for a license;]

[(B) license renewal;]

[(C) changes in supervision; and/or]

[(D) addition of other proposed department-approved supervisors.]

[(2) In the event more than one licensed audiologist agrees to supervise the intern in audiology, the department-approved supervisor shall be identified and separate forms shall be submitted by each department-approved supervisor.]

[(3) In the event the department-approved supervisor ceases supervision of the intern, the intern in audiology shall stop practicing immediately until a new supervisor is approved by the department.]

[(4) Should the intern in audiology practice without approval from the department, disciplinary action shall be initiated against the intern. If the department-approved supervisor had knowledge of this violation, disciplinary action against the department-approved supervisor shall also be initiated.]

[(f) Internship Requirements. The internship shall:]

[(1) consist of 1,600 hours of supervised clinical work as defined in paragraph (2). The internship shall begin after completion of all academic course work; and]

[(2) involve primarily clinical activities such as assessment, diagnosis, evaluation, screening, treatment, report writing, family/client consultation, and/or counseling related to the management process of individuals.]

[(g) Changes. Prior to implementing changes in the internship, written approval from the department is required.]

[(1) If the intern in audiology changes his or her department-approved supervisor or adds additional department-approved supervisors, a current Intern Plan and Agreement of Supervision of An Intern in Audiology Form shall be submitted by the new proposed supervisor and approved by the department before the intern in audiology may resume practice. A Report of Completed Internship of An Intern in Audiology Form shall be completed by the previous department-approved supervisor and the intern in audiology and submitted to the department upon completion of that portion of the internship. It is the decision of the department-approved supervisor to determine whether the internship meets the department’s requirements. The department shall review the form and inform the intern in audiology of the results.]

[(2) A department-approved supervisor who ceases supervising an intern in audiology shall submit a Report of Completed Internship of An Intern in Audiology Form or information for the portion of the internship completed under his or her supervision. This must be submitted within 30 days of the date the supervision ended.]

[(3) If the intern in audiology changes his or her employer but the department-approved supervisor and the number of hours employed per week remain the same, the department-approved supervisor shall submit a signed statement or submit in a manner prescribed by the department giving the name, address and phone number of the new location. This must be submitted within thirty (30) days of the date the change occurred.]

[(4) In any professional context the licensee must indicate the licensee's status as an intern in audiology.]

[(h) The intern in audiology may continue to practice under supervision if he or she holds a valid intern in audiology license while awaiting the processing of the audiology license. If the intern in audiology changes department-approved supervisors, the new department-approved supervisor shall first submit the Intern Plan and Agreement of Supervision of An Intern in Audiology Form or information and receive department approval before the intern in audiology may resume practice.]

[(i) Notwithstanding the supervision provisions in this section, the department may establish procedures, processes, and mechanisms for the monitoring and reporting of the supervision requirements.]

§111.81.Intern in Audiology License--Internship and Supervision Requirements.

(a) A licensed intern in audiology (intern) must be supervised by a licensed audiologist who has been approved by the department to serve as the intern’s supervisor (supervisor).

(b) A supervisor must agree to assume responsibility for all services provided by the intern. The supervisor must comply with the requirements set out in the Act and §111.154.

(c) Intern Plan and Agreement of Supervision Form. An Audiology Intern Plan and Agreement of Supervision Form shall be submitted in a manner prescribed by the department and completed by both the applicant and the proposed supervisor. The proposed supervisor must meet the requirements set out in the Act and §111.154.

(1) Written approval from the department shall be required prior to practice by the intern in audiology. The Audiology Intern Plan and Agreement of Supervision Form shall be submitted upon:

(A) application for an intern license;

(B) any changes in supervision; and

(C) the addition of other supervisors.

(2) If more than one audiologist agrees to supervise the intern, each proposed supervisor must submit an Audiology Intern Plan and Agreement of Supervision Form.

(3) The intern may not practice without an approved Audiology Intern Plan and Agreement of Supervision Form. The supervisor may not allow an intern to practice before an Audiology Intern Plan and Agreement of Supervision Form is approved.

(4) If the supervisor ceases supervision of the intern, the supervisor shall notify the department, in a manner prescribed by the department, and shall inform the intern to stop practicing immediately. The supervisor is responsible for the practice of the intern until notification has been received by the department.

(5) If the intern’s supervisor ceases supervision, the intern shall stop practicing immediately. The intern may not practice until a new Audiology Intern Plan and Agreement of Supervision Form has been submitted to and approved by the department.

(d) Internship Requirements. The internship shall:

(1) begin after completion of all academic course work under §111.80;

(2) consist of 1,600 hours of supervised clinical work as defined in paragraph (3); and

(3) involve primarily clinical activities such as assessment, diagnosis, evaluation, screening, treatment, report writing, family/client consultation, and/or counseling related to the management process of individuals.

(e) Changes in Internship. Prior to implementing changes in the internship, written approval from the department is required.

(1) If the intern changes his or her supervisor or adds additional supervisors, a current Audiology Intern Plan and Agreement of Supervision Form shall be submitted by the new proposed supervisor and approved by the department before the intern may resume practice as prescribed under subsection (c).

(2) If the intern changes his or her supervisor, the Audiology Report of Completed Internship Form shall be completed by the former supervisor and the intern and submitted to the department upon completion of that portion of the internship. It is the decision of the former supervisor to determine whether the internship meets the department’s requirements. The department shall review the form and inform the intern of the results.

(3) A supervisor who ceases supervising an intern shall submit an Audiology Report of Completed Internship Form for the portion of the internship completed under his or her supervision. This must be submitted within 30 days of the date the supervision ended.

(4) If no hours were earned under an approved supervisor, the licensed intern or the approved supervisor must submit a signed, written statement that no hours were earned and provide the reason.

(5) If the intern changes his or her employer but the supervisor and the number of hours employed per week remain the same, the supervisor shall submit a signed statement or submit in a manner prescribed by the department giving the name, address and phone number of the new location. This must be submitted within thirty (30) days of the date the change occurred.

(f) Notwithstanding the supervision provisions in this section, the department may establish procedures, processes, and mechanisms for the monitoring and reporting of the supervision requirements.

§111.82.Intern in Audiology License--Practice and Duties of Interns.

(a) A licensed intern in audiology (intern) must perform assigned duties under the supervision of a licensed audiologist who has been approved by the department to serve as the intern’s supervisor (supervisor).

(b) In any professional context the intern must indicate the intern’s status as a licensed intern in audiology.

(c) The intern may continue to practice while awaiting the processing of the audiology license if the intern meets the following conditions:

(1) holds a valid intern in audiology license;

(2) practices under the supervision of the current supervisor, who filed the Audiology Intern Plan and Agreement of Supervision Form and the Report of Completed Internship in Audiology; and

(3) practices under the terms of the current Audiology Intern Plan and Agreement of Supervision Form.

§111.85.Intern in Audiology License--Application and Eligibility Requirements.

(a) (No change.)

(b) An applicant for an intern in audiology license must submit the following required documentation:

(1) (No change.)

[(2) an original or certified copy of the most current transcript(s);]

(2) [(3)] a Course Work and Clinical Experience Form for Audiology Intern completed by the university program director or designee of the college or university attended which verifies the applicant is enrolled in a professionally recognized accredited doctoral program as approved by the department, and has completed all required academic and clinical course work;

(3) [(4)] an Intern Plan and Agreement of Supervision Form completed by the proposed [department-approved ] supervisor and signed by both the applicant and the proposed [department-approved] supervisor;

(4) [(5)] proof of successfully completing the Texas Jurisprudence Examination under §111.23; and

(5) [(6)] the initial application fee required under §111.160.

(c) If not previously submitted when applying for an assistant license, an [An] applicant for an intern in audiology license must submit a completed legible set of fingerprints, on a form prescribed by the department, to the Department of Public Safety for the purpose of obtaining criminal history record information. An applicant must successfully pass a criminal history background check.

(d) (No change.)

§111.87.Intern in Audiology License--License Terms; Renewals.

(a) - (b) (No change.)

(c) To renew an intern in audiology license, a licensee must:

(1) (No change.)

[(2) successfully pass a criminal history background check;]

[(3) submit an evaluation of the intern's progress or performance from all department-approved supervisors and any intern plans and supervisory evaluations for completed segments;]

(2) [(4)] submit an Intern Plan and Agreement of Supervision Form for the intern's upcoming experience unless the intern is currently not practicing. In that event, the intern shall provide an explanation of the reason for not practicing; and

(3) [(5)] submit the license renewal fee required under §111.160.

(d) A licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.

(e) [(d)] The department may deny the renewal of the license pursuant to Texas Occupations Code §401.451.

(f) [(e)] If all conditions required for renewal are met prior to expiration, the department shall issue a renewed license.

(g) [(f)] A person whose license has expired may late renew the license in accordance with the procedures set out under §60.31 and §60.83 of this title.

(h) [(g)] A person whose license has expired may not practice or engage in audiology.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800107

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER J. REQUIREMENTS FOR ASSISTANT IN AUDIOLOGY LICENSE

16 TAC §§111.90 - 111.92, 111.95, 111.97

The amendments and new rules are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.90.Assistant in Audiology License--Licensing Requirements--Education and Training.

(a) (No change.)

(b) An assistant in audiology shall meet the following requirements:

(1) (No change.)

(2) complete the approved 20-hour certification course from the Council for Accreditation of Occupational Hearing Conservation (CAOHC) and earn a passing score on the examination; [and]

(3) if the applicant holds a bachelor’s degree or higher in communicative sciences or disorders, the applicant does not need to complete the certification course and examination under subsection (b)(2);

(4) [(3)] submit the [department-prescribed ] Supervisory Responsibility Statement for an Assistant in Audiology Form prescribed under §111.91; and[, that shall include:]

[(A) an agreement signed by both the licensed proposed department-approved supervisor (who must meet the requirements set out in the Act and §111.154) and the applicant, to enter into a supervisory relationship, in which the proposed department-approved supervisor agrees to assume responsibility for the applicant's activities, and the applicant agrees to perform only those activities assigned by the department-approved supervisor that are not prohibited under this section; and]

[(B) a plan for a minimum of twenty-five (25) hours of job-specific competency-based training to be carried out by the department-approved supervisor. Until this training is complete, the licensed assistant in audiology may practice only under direct supervision by the department-approved supervisor.]

(5) submit a plan to complete a minimum of twenty-five (25) hours of job-specific competency-based training to be carried out by the supervisor. Until this training is complete, the licensed assistant in audiology may practice only under in-person, direct supervision by the supervisor.

(c) Upon satisfactory completion of the job-specific competency-based training under subsection (b)(5), the [department-approved] supervisor shall submit the Report of Completed Training for an Assistant in Audiology Form on behalf of the licensed assistant in audiology. After the department approves the report, the licensed assistant may practice only in compliance with the supervision requirements under §111.91 and §111.92 [subsection (e)(3)].

[(d) The Supervisory Responsibility Statement for an Assistant in Audiology Form must be completed and signed by both the applicant and the licensed audiologist who agrees to assume responsibility for all services provided by the licensed assistant in audiology. The department-approved supervisor must meet the requirements set out in the Act and §111.154.]

[(1) Approval from the department shall be required prior to practice by the licensed assistant in audiology. The Supervisory Responsibility Statement for an Assistant in Audiology Form shall be submitted upon:]

[(A) application for a license;]

[(B) license renewal;]

[(C) changes in supervision; and]

[(D) addition of other department-approved supervisors.]

[(2) In the event more than one licensed audiologist agrees to supervise the licensed assistant in audiology, each licensed audiologist shall be identified and a separate Supervisory Responsibility Statement for an Assistant in Audiology Form be submitted by each department-approved supervisor in a manner prescribed by the department.]

[(3) A licensed assistant in audiology may renew the license but may not practice until a new Supervisory Responsibility Statement for an Assistant in Audiology Form is approved.]

[(4) In the event the department-approved supervisor ceases supervision of the licensed assistant in audiology, the licensed assistant in audiology shall stop practicing immediately.]

[(5) Should the licensed assistant in audiology practice without approval from the department, disciplinary action shall be initiated against the licensed assistant in audiology. If the department-approved supervisor had knowledge of this violation, disciplinary action against the department-approved supervisor shall also be initiated.]

[(e) A licensed audiologist department-approved supervisor shall assign duties and provide appropriate supervision to the licensed assistant in audiology.]

[(1) All diagnostic contacts shall be conducted by the licensed audiologist department-approved supervisor.]

[(2) Following the initial diagnostic contact, the licensed audiologist department-approved supervisor shall determine whether the licensed assistant in audiology has the competence to perform specific non-diagnostic and non-prohibited duties before delegating tasks (as referenced in subsection (f)(4)).]

[(3) The licensed audiologist department-approved supervisor shall be on-site at the licensed assistant in audiology's employment location for at least ten (10) hours per week, or forty (40) hours per month, and provide at least one (1) hour per week or four (4) hours per month of direct supervision, at the location where the assistant is employed. However, the licensed audiologist department-approved supervisor shall be on-site and provide direct supervision for the duties described under subsections (f)(4)(A) - (D). This paragraph applies whether the licensed assistant in audiology is employed full- or part-time. For the purposes of this paragraph, the telehealth and telepractice provisions described under §111.215 may be used except for duties described under subsections (f)(4)(A) - (D) where the department-approved supervisor must be on-site and provide direct supervision. When determining the amount and type of supervision, the department-approved supervisor must consider the skill and experience of the licensed assistant as well as the services to be provided. The supervision hours established in this paragraph may be exceeded as determined by the department-approved supervisor.]

[(4) Supervisory records shall be maintained by the licensed audiologist department-approved supervisor for a period of three years which verify regularly scheduled monitoring, assessment, and evaluation of the licensed assistant in audiology's and client's performance. Such documentation may be requested by the department.]

[(f) Although the licensed audiologist department-approved supervisor may delegate specific clinical tasks to a licensed assistant, the responsibility to the client for all services provided cannot be delegated. The licensed audiologist department-approved supervisor shall ensure that all services provided are in compliance with this chapter.]

[(1) The licensed audiologist department-approved supervisor need not be in direct supervision when the licensed assistant is completing the assigned tasks; however, the licensed audiologist department-approved supervisor shall document all services provided and the supervision of the licensed assistant.]

[(2) The licensed audiologist department-approved supervisor shall keep job descriptions and performance records. Records shall be current and be made available upon request to the department.]

[(3) The licensed assistant may execute specific components of the clinical hearing program if the licensed audiologist department-approved supervisor determines that the licensed assistant has received the training and has the skill to accomplish that task, and the licensed audiologist department-approved supervisor provides sufficient supervision to ensure appropriate completion of the task assigned to the licensed assistant.]

[(4) Examples of duties that a licensed audiologist department-approved supervisor may assign to a licensed assistant who has received appropriate training include the following:]

[(A) conduct or participate in, with the department-approved supervisor on-site, hearing screening including screening otoscopy, tympanometry, otoacoustic emissions procedures and pure tone air conduction procedures, but may not diagnose hearing loss or disorders of the auditory system, or make statements of severity or implication;]

[(B) assist the audiologist, who must be on-site, with play audiometry, visual reinforcement audiometry, and tasks such as picture-pointing speech audiometry;]

[(C) assist the audiologist, who must be on-site, in the evaluation of difficult-to-test patients;]

[(D) assist the audiologist, who must be on-site, with technical tasks for diagnostic evaluation such as preparing test rooms, attaching electrodes, and preparing patients prior to procedures;]

[(E) maintain clinical records;]

[(F) prepare clinical materials;]

[(G) participate with the department-approved supervisor in research projects, staff development, public relations programs, or similar activities as designated and supervised by the department approved supervisor;]

[(H) maintain equipment by conducting biologic and electroacoustic calibration of audiometric equipment, perform preventative maintenance checks and safety checks of equipment;]

[(I) explain the proper care of hearing instruments and assistive listening devices to patients;]

[(J) maintain hearing instruments including cleaning, replacing ear mold tubing, minor hearing instrument repairs, determining need for repair, and performing biologic and electroacoustic checks of hearing instruments;]

[(K) provide case history and/or self-assessment forms and clarify questions on the forms to patients as needed;]

[(L) conduct basic record keeping and prepare paperwork for signature by the audiologist;]

[(M) coordinate ear mold and hearing instrument records or repairs and other orders;]

[(N) attach hearing aids to computers and use software to verify internal electroacoustic settings; and]

[(O) perform other non-diagnostic duties not prohibited in paragraph (5), for which the assistant has been trained and demonstrates appropriate skills, as assigned by the licensed audiologist department-approved supervisor.]

[(5) The licensed assistant shall not:]

[(A) conduct aural habilitation or rehabilitation activities or therapy;]

[(B) provide carry-over activities (therapeutically designed transfer of a newly acquired communication ability to other contexts and situations) for patients in aural rehabilitation therapy;]

[(C) collect data during aural rehabilitation therapy documenting progress and results of therapy;]

[(D) administer assessments during aural rehabilitation therapy to assess therapeutic progress;]

[(E) conduct any audiological procedure that requires decision-making or leads to a diagnosis, even under direct supervision;]

[(F) interpret results of procedures and evaluations, except for screening tests;]

[(G) make diagnostic statements, or propose or develop clinical management strategies;]

[(H) make ear impressions;]

[(I) cause any substance to enter the ear canal or place any instrument or object in the ear canal for the purpose of removing cerumen or debris;]

[(J) make any changes to the internal settings of a hearing instrument manually or using computer software;]

[(K) represent audiology at staff meetings or on an admission, review and dismissal (ARD) committee;]

[(L) attend staffing meetings or ARD committee meetings without the department-approved supervisor being present;]

[(M) design a treatment program;]

[(N) determine case selection;]

[(O) present written or oral reports of client information, except to his or her department-approved supervisor;]

[(P) refer a client to other professionals or other agencies;]

[(Q) use any title which connotes the competency of a licensed audiologist; or]

[(R) practice as a licensed assistant in audiology without a valid Supervisory Responsibility Statement for an Audiology Assistant Form or information on file with the department.]

[(g) In any professional context the licensee must indicate the licensee's status as a licensed audiology assistant.]

[(h) A licensed assistant in audiology may not engage in the fitting, dispensing or sale of a hearing instrument; however, a licensed assistant in audiology who is licensed under the Texas Occupations Code, Chapter 402 may engage in activities as allowed by that law and is not considered to be functioning under his or her assistant in audiology license when performing those activities.]

[(i) The department may audit a random sampling of licensed assistants in audiology for compliance with this section and §111.154.]

[(1) The department shall notify a licensed assistant in audiology and the licensed audiologist department-approved supervisor in a manner prescribed by the department that the licensee has been selected for an audit.]

[(2) Upon receipt of an audit notification, the licensed assistant in audiology and the licensed audiologist department-approved supervisor, who agreed to accept responsibility for the services provided by the licensed assistant in audiology, shall provide the requested proof of compliance to the department in a manner prescribed by the department.]

[(3) The licensed assistant in audiology and the licensed audiologist department-approved supervisor shall comply with the department’s request for documentation and information concerning compliance with the audit.]

[(j) Notwithstanding the supervision provisions in this section, the department may establish procedures, processes, and mechanisms for the monitoring and reporting of the supervision requirements.]

§111.91.Assistant in Audiology License--Supervision Requirements.

(a) A licensed assistant in audiology (assistant) must be supervised by a licensed audiologist who has been approved by the department to serve as the assistant’s supervisor (supervisor).

(b) A supervisor must agree to assume responsibility for all services provided by the assistant. The supervisor must comply with the requirements set out in the Act and §111.154.

(c) Supervisory Responsibility Statement Form. A Supervisory Responsibility Statement Form shall be submitted in a manner prescribed by the department by both the applicant and the proposed supervisor. The proposed supervisor must meet the requirements set out in the Act and §111.154.

(1) Approval from the department shall be required prior to practice by the licensed assistant in audiology. The Supervisory Responsibility Statement for an Assistant in Audiology Form shall be submitted upon:

(A) application for a license;

(B) any changes in supervision; and

(C) addition of other supervisors.

(2) If more than one audiologist agrees to supervise the assistant, each proposed supervisor must submit a separate Supervisory Responsibility Statement Form in a manner prescribed by the department.

(3) The assistant may not practice without an approved Supervisor Responsibility Statement Form. The supervisor may not allow an assistant to practice before a Supervisor Responsibility Statement Form is approved.

(4) The assistant shall only provide services for the caseload of the assistant’s supervisors who have current Supervisor Responsibility Statement Forms on file with the department.

(5) If the supervisor ceases supervision of the assistant, the supervisor shall notify the department, in a manner prescribed by the department, and shall inform the assistant to stop practicing immediately. The supervisor is responsible for the practice of the assistant until notification has been received by the department.

(6) If the assistant’s supervisor ceases supervision, the assistant shall stop practicing immediately. The assistant may not practice until a new Supervisor Responsibility Statement Form has been submitted to and approved by the department.

(d) A supervisor shall assign duties and provide appropriate supervision to the assistant.

(e) Client Contacts.

(1) All diagnostic contacts shall be conducted by the supervisor.

(2) Following the initial diagnostic contact, the supervisor shall determine whether the assistant has the competence to perform specific non-diagnostic and non-prohibited duties before delegating tasks as referenced in §111.92(c).

(f) Amount and Type of Supervision. The supervisor must provide a minimum of ten (10) hours per week, or forty (40) hours per calendar month, of supervision to the assistant. This subsection applies whether the assistant is employed full-time or part-time.

(1) At least one (1) hour per week, or four (4) hours per calendar month, must be direct supervision.

(2) The remaining hours may be performed using indirect supervision.

(3) If fewer than four (4) weeks are worked in a calendar month, then the number of hours of supervision provided will be based on the number of weeks worked. Ten (10) hours of supervision must be provided for each week worked, including one (1) hour of direct supervision.

(4) The supervisor shall provide in-person, direct supervision for the duties described under §111.92(c)(1) - (4).

(5) For the purposes of this subsection, the telehealth and telepractice provisions described under §111.215 may be used except for duties described under §111.92(c)(1) - (4) where the supervisor must provide in-person, direct supervision.

(6) When determining the amount and type of supervision, the supervisor must consider the skill and experience of the assistant as well as the services to be provided. The supervision hours established in this paragraph may be exceeded as determined by the supervisor.

(g) Delegating Clinical Tasks.

(1) Although the supervisor may delegate specific clinical tasks to an assistant, the responsibility to the client for all services provided cannot be delegated.

(2) The supervisor shall ensure that all services are documented and provided in compliance with the Act and this chapter.

(3) The supervisor shall:

(A) in writing, determine the skills and assigned tasks the assistant is able to carry out under §111.92. This document must be agreed upon by the assistant and the supervisor;

(B) notify the client or client’s legal guardian(s) that services will be provided by a licensed assistant; and

(C) maintain responsibility for the services provided by the assistant.

(h) Records. The supervisor shall maintain the following records.

(1) Supervisory records shall be maintained by the supervisor for a period of three years which verify regularly scheduled monitoring, assessment, and evaluation of the assistant’s and client’s performance. Such documentation may be requested by the department.

(2) The supervisor shall keep job descriptions and performance records. Records shall be current and be made available upon request to the department.

(i) Supervision Audits. The department may audit a random sampling of assistants for compliance with this section and §111.154.

(1) The department shall notify an assistant and the supervisor in a manner prescribed by the department that the assistant has been selected for an audit.

(2) Upon receipt of an audit notification, the assistant and the supervisor, who agreed to accept responsibility for the services provided by the assistant, shall provide the requested proof of compliance to the department in a manner prescribed by the department.

(3) The assistant and the supervisor shall comply with the department’s request for documentation and information concerning compliance with the audit.

(j) Notwithstanding the supervision provisions in this section, the department may establish procedures, processes, and mechanisms for the monitoring and reporting of the supervision requirements.

§111.92.Assistant in Audiology License--Practice and Duties of Assistants.

(a) A licensed assistant in audiology (assistant) must perform assigned duties under the supervision of a licensed audiologist who has been approved by the department to serve as the assistant’s supervisor (supervisor).

(b) The assistant may execute specific components of the clinical hearing program if the supervisor:

(1) determines that the assistant has received the training and has the skill to accomplish that task; and

(2) provides sufficient supervision to ensure appropriate completion of the task assigned to the assistant.

(c) Duties that a supervisor may assign to an assistant, who has received appropriate training, include the following:

(1) under in-person, direct supervision, conduct or participate in, hearing screening including screening otoscopy, tympanometry, otoacoustic emissions procedures and pure tone air conduction procedures, but may not diagnose hearing loss or disorders of the auditory system, or make statements of severity or implication;

(2) under in-person, direct supervision, assist the audiologist with play audiometry, visual reinforcement audiometry, and tasks such as picture-pointing speech audiometry;

(3) under in-person, direct supervision, assist the audiologist in the evaluation of difficult-to-test patients;

(4) under in-person, direct supervision, assist the audiologist with technical tasks for diagnostic evaluation such as preparing test rooms, attaching electrodes, and preparing patients prior to procedures;

(5) maintain clinical records;

(6) prepare clinical materials;

(7) participate with the supervisor in research projects, staff development, public relations programs, or similar activities as designated and supervised by the supervisor;

(8) maintain equipment by conducting biologic and electroacoustic calibration of audiometric equipment, perform preventative maintenance checks and safety checks of equipment;

(9) explain the proper care of hearing instruments and assistive listening devices to patients;

(10) maintain hearing instruments including cleaning, replacing ear mold tubing, minor hearing instrument repairs, determining need for repair, and performing biologic and electroacoustic checks of hearing instruments;

(11) provide case history and/or self-assessment forms and clarify questions on the forms to patients as needed;

(12) conduct basic record keeping and prepare paperwork for signature by the audiologist;

(13) coordinate ear mold and hearing instrument records or repairs and other orders;

(14) attach hearing aids to computers and use software to verify internal electroacoustic settings; and

(15) perform other non-diagnostic duties not prohibited in subsection (d), for which the assistant has been trained and demonstrates appropriate skills, as assigned by the supervisor.

(d) The assistant shall not:

(1) conduct aural habilitation or rehabilitation activities or therapy;

(2) provide carry-over activities (therapeutically designed transfer of a newly acquired communication ability to other contexts and situations) for patients in aural rehabilitation therapy;

(3) collect data during aural rehabilitation therapy documenting progress and results of therapy;

(4) administer assessments during aural rehabilitation therapy to assess therapeutic progress;

(5) conduct any audiological procedure that requires decision-making or leads to a diagnosis;

(6) interpret results of procedures and evaluations, except for screening tests;

(7) make diagnostic statements, or propose or develop clinical management strategies;

(8) make ear impressions;

(9) cause any substance to enter the ear canal or place any instrument or object in the ear canal for the purpose of removing cerumen or debris;

(10) make any changes to the internal settings of a hearing instrument manually or using computer software;

(11) represent audiology at staffing meetings or on an admission, review and dismissal (ARD) committee;

(12) attend staffing meetings or ARD committee meetings without the supervisor being present;

(13) design a treatment program;

(14) determine case selection;

(15) present written or oral reports of client information, except to his or her supervisor;

(16) refer a client to other professionals or other agencies;

(17) use any title which connotes the competency of a licensed audiologist; or

(18) practice as an assistant without a valid Supervisory Responsibility Statement for an Audiology Assistant Form on file with the department.

(e) In any professional context the assistant must indicate the assistant’s status as a licensed audiology assistant.

(f) A licensed assistant in audiology may not engage in the fitting, dispensing or sale of a hearing instrument under this chapter; however, a licensed assistant in audiology who is licensed under the Texas Occupations Code, Chapter 402 may engage in activities as allowed by that law and is not considered to be functioning under his or her assistant in audiology license when performing those activities.

§111.95.Assistant in Audiology License--Application and Eligibility Requirements.

(a) (No change.)

(b) An applicant for an assistant in audiology license must submit the following required documentation:

(1) (No change.)

(2) a completed Supervisory Responsibility Statement Form as prescribed under §111.91 [or information completed by the proposed department-approved supervisor who agrees to accept responsibility for the services provided by the assistant and signed by both the applicant and the proposed department-approved supervisor or submitted in a manner prescribed by the department];

(3) - (5) (No change.)

(6) if the applicant holds a bachelor’s degree or higher in communicative sciences or disorders, submit proof of degree instead of the certificate under subsection (b)(5);

(7) [(6)] proof of successfully completing the Texas Jurisprudence Examination under §111.23; and

(8) [(7)] the initial application fee required under §111.160.

(c) - (d) (No change.)

§111.97.Audiology Assistant License--License Terms; Renewals.

(a) - (b) (No change.)

(c) To renew an assistant in audiology license, a licensee must:

(1) (No change.)

[(2) successfully pass a criminal history background check;]

(2) [(3)] complete 20 hours of continuing education as required under §111.130;

(3) [(4)] comply with the continuing education audit process described under §111.132, if selected for an audit;

(4) [(5)] submit, in a manner prescribed by the department, a Supervisory Responsibility Statement Form or information from each [department-approved] supervisor [providing the supervision] unless the assistant is currently not practicing or the [department-approved] supervisor(s) has not changed; and

(5) [(6)] submit the license renewal fee required under §111.160.

(d) A licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.

(e) [(d)] The department may deny the renewal of the license pursuant to Texas Occupations Code §401.451.

(f) [(e)] If all conditions required for renewal are met prior to expiration, the department shall issue a renewed license.

(g) [(f)] A person whose license has expired may late renew the license in accordance with the procedures set out under §60.31 and §60.83 of this title.

(h) [(g)] A person whose license has expired may not practice or engage in audiology.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800108

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER K. REQUIREMENTS FOR AUDIOLOGY TEMPORARY CERTIFICATE OF REGISTRATION

16 TAC §§111.100, 111.105, 111.106

The repeals are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.100.Temporary Certificate of Registration in Audiology--Registration Requirements.

§111.105.Audiology Temporary Certificate of Registration--Application and Eligibility Requirements.

§111.106.Temporary Certificate of Registration in Audiology--Issuing Registration.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800099

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER L. REQUIREMENTS FOR DUAL LICENSE IN SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY

16 TAC §111.115, §111.117

The amendments are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.115.Dual License in Speech-Language Pathology and Audiology--Application and Eligibility Requirements.

(a) - (b) (No change.)

(c) If not previously submitted when applying for a full license, assistant license, or intern license, an [An] applicant for a dual license must submit a completed legible set of fingerprints, on a form prescribed by the department, to the Department of Public Safety for the purpose of obtaining criminal history record information, unless the applicant has already submitted fingerprints as part of a single license. An applicant must successfully pass a criminal history background check.

(d) (No change.)

§111.117.Dual License in Speech-Language Pathology and Audiology--License Terms; Renewals.

(a) - (b) (No change.)

(c) To renew a dual license in speech-language pathology and audiology, a licensee must:

(1) (No change.)

[(2) successfully pass a criminal history background check;]

(2) [(3)] complete 30 hours of continuing education as required under §111.130;

(3) [(4)] comply with the continuing education audit process described under §111.132, if selected for an audit; and

(4) [(5)] pay two separate license renewal fees required under §111.160.

(d) A licensee must successfully pass a criminal history background check in order to renew the license; however, the licensee does not need to submit new fingerprints.

(e) [(d)] The department may deny the renewal of the license pursuant to Texas Occupations Code §401.451.

(f) [(e)] If all conditions required for renewal are met prior to expiration, the department shall issue a renewed license.

(g) [(f)] A person whose license has expired may late renew the license in accordance with the procedures set out under §60.31 and §60.83 of this title.

(h) [(g)] A person whose license has expired may not practice or engage in speech-language pathology or audiology.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800109

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER O. RESPONSIBILITIES OF THE COMMISSION AND THE DEPARTMENT

16 TAC §111.140

The amendments are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.140.Rules.

(a) (No change.)

[(b) Pursuant to §51.2031, the department will not propose changes to standards of practice rules without being proposed by the advisory board.]

(b) [(c)] The commission has adopted [will adopt] rules governing changes to the standards of practice rules pursuant to §51.2031. These rules are located at 16 TAC Chapter 100.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800110

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER P. RESPONSIBILITIES OF THE LICENSEE AND CODE OF ETHICS

16 TAC §111.151, §111.154

The amendments are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.151.Consumer Information and Display of License.

(a) - (b) (No change.)

[(c) A holder of a temporary certificate of registration shall display the certificate as issued by the department in the primary location of practice.]

(c) [(d)] A licensee shall not make any alteration on official documents issued by the department.

§111.154.Requirements, Duties, and Responsibilities of Supervisors and Persons Being Supervised.

(a) (No change.)

(b) A licensee may not supervise an individual that is related to the licensee within the first degree of consanguinity, as determined under Government Code, Chapter 573, Subchapter B.

(c) A [department-approved] supervisor of an intern in speech-language pathology must be a licensed speech-language pathologist who is approved by the department and who possesses [possess] at least a master's degree with a major in one of the areas of communicative sciences or disorders.

(d) A supervisor of an assistant in speech-language pathology must be a licensed speech-language pathologist who is approved by the department.

(e) [(d)] A [department-approved ] supervisor of an intern in audiology or an assistant in audiology must be a licensed audiologist who is approved by the department. [possess either:]

[(1) at least a master's degree with a major in one of the areas of communicative sciences or disorders, if the department-approved supervisor applied for the audiology license before September 1, 2011; or]

[(2) at least a doctoral degree in audiology or a related hearing science, if the department-approved supervisor applied for the audiology license on or after September 1, 2011.]

(f) [(e)] A [department-approved ] supervisor of an intern or assistant shall:

(1) ensure that all services provided are in compliance with this chapter and the Act, such as verifying:

(A) - (B) (No change.)

(C) the practice and duties of the intern or assistant are [scope of practice is] appropriate; and

(D) (No change.)

(2) - (3) (No change.)

(4) comply with the following supervision ratios:

(A) supervise no more than a total of four (4) speech-language pathology interns and/or assistants; or

(B) supervise no more than a total of four (4) audiology interns and/or assistants.[, if an assistant holds a baccalaureate degree; or]

[(C) supervise no more than a total of two (2) audiology interns and/or assistants, if an assistant holds a high school diploma or equivalent.]

(g) [(f)] In addition to the provisions listed in subsection (f) [(e)], a [department-approved] supervisor of an assistant shall:

(1) be responsible for evaluations, interpretation, and case management; and

(2) not designate anyone other than a licensed speech-language pathologist or intern in speech-language pathology to represent speech-language pathology to an Admission, Review, and Dismissal (ARD) meetings, except as provided by §111.51 and §111.52 [§111.50].

(h) [(g)] A licensed intern or assistant shall abide by the decisions made by his or her [department-approved ] supervisor relating to the intern's or assistant's practice and duties. If [scope of practice. In the event] the [department-approved] supervisor requests that the intern or assistant violate this chapter, the Act, or any other law, the intern or assistant shall refuse to do so and immediately notify the department and any other appropriate authority.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800111

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER Q. FEES

16 TAC §111.160

The amendments are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.160.Fees.

(a) (No change.)

(b) Speech Language Pathology License (including upgrade from intern license):

(1) Initial application fee (includes two-year initial license)--$150.

(2) Renewal application fee (for two-year license)--$100.

(c) - (d) (No change.)

[(e) Temporary Certificate of Registration in Speech Language Pathology: Initial application fee (includes certificate of registration)--$55.]

(e) [(f)] Audiology License (including upgrade from intern license):

(1) Initial application fee (includes two-year initial license)--$150.

(2) Renewal application fee (for two-year license)--$100.

(f) [(g)] Intern in Audiology License:

(1) Initial application fee (includes one-year initial license)--$75.

(2) Renewal application fee (for one-year license)--$75.

(g) [(h)] Assistant in Audiology License:

(1) Initial application fee (includes two-year initial license)--$150.

(2) Renewal application fee (for two-year license)--$100.

[(i) Temporary Certificate of Registration in Audiology: Initial application fee (includes certificate of registration)--$55.]

(h) [(j)] Dual License in Speech Language Pathology and Audiology:

(1) Initial application fee (includes two-year initial license):

(A) An applicant for a dual license in speech-language pathology and audiology shall submit two separate initial application fees for speech-language pathology and audiology.

(B) An applicant who currently holds one license and wishes to obtain a dual license shall submit the initial application fee for the other license.

(2) Renewal application fee (for two-year license): Each license must be renewed separately and fees will be determined separately.

(i) [(k)] A duplicate/replacement fee for a license or certificate issued under this chapter is $25.

(j) [(l)] Late renewal fees for licenses issued under this chapter are provided under §60.83 of this title (relating to Late Renewal Fees).

(k) [(m)] A dishonored/returned check or payment fee is the fee prescribed under §60.82 of this title (relating to Dishonored Payment Device).

(l) [(n)] The fee for a criminal history evaluation letter is the fee prescribed under §60.42 of this title (relating to Criminal History Evaluation Letters).

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800112

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER R. COMPLAINTS

16 TAC §111.171

The amendments are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.171.Complaints Regarding Standard of Care.

The commission has adopted rules [will adopt rule] related to handling complaints regarding standard of care pursuant to Texas Occupations Code §51.2031. These rules are located at 16 Texas Administrative Code Chapter 100.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800113

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER S. ENFORCEMENT PROVISIONS

16 TAC §111.180

The amendments are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.180.Administrative Penalties and Sanctions.

If a person or entity violates any provision of Texas Occupations Code, Chapters 51 or 401, this chapter, or any rule or order of the executive director or commission, proceedings may be instituted to impose administrative penalties, administrative sanctions, or both in accordance with the provisions of Texas Occupations Code, Chapters [Chapter] 51 and 401, as applicable, and any associated rules.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800114

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER U. FITTING AND DISPENSING OF HEARING INSTRUMENTS

16 TAC §111.200

The amendments are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.200.Registration of Audiologists and Interns in Audiology to Fit and Dispense Hearing Instruments.

(a) (No change.)

(b) The audiology intern license constitutes [and the temporary audiology certificate constitute] registration to fit and dispense hearing instruments under the supervision of a licensed audiologist approved by the department to supervise the internship.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800115

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER V. TELEHEALTH

16 TAC §111.213, §111.216

The amendments and new rules are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.213.Limitations on the Use of Telecommunications Technology by Speech-Language Pathologists.

(a) (No change.)

(b) Supervision of a licensed assistant in speech-language pathology may be undertaken through the use of telecommunications technology as described under §111.51 and as follows:

(1) no more than two (2) hours of direct supervision per month shall be undertaken through the use of telecommunications technology; and

(2) no more than six (6) total hours of supervision per month shall be undertaken through the use of telecommunications technology.

(c) [(b)] Direct supervision [Supervision] of a licensed [assistant and/or] intern in speech-language pathology shall not be undertaken through the use of telecommunications technology [unless an exception to this prohibition is secured pursuant to the terms of this section].

[(c) An exception to subsection (b) shall be requested by the speech-language pathologist submitting the prescribed alternate supervision request form for review by the department. The department shall approve or not approve the plan. The plan shall be for not more than one year's duration.]

[(d) If the exception referenced in subsection (c) is approved and the reason continues to exist, the licensed supervising speech-language pathologist shall annually resubmit a request to be evaluated by the department. The department shall approve or not approve the plan.]

(d) [(e)] Telehealth services may not be provided by correspondence only, e.g., mail, email, faxes, although they may be adjuncts to telepractice.

§111.216.Limitations on the Use of Telecommunications Technology by Audiologists.

(a) The limitations of this section apply to the use of telecommunications technology by audiologists.

(b) Supervision of a licensed assistant in audiology may be undertaken through the use of telecommunications technology as described under §111.91, except for duties described under §111.92(c)(1) - (4) where the supervisor must provide in-person, direct supervision.

(c) Telehealth services may not be provided by correspondence only, e.g., mail, email, faxes, although they may be adjuncts to telepractice.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800116

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179


SUBCHAPTER V. TELEHEALTH

16 TAC §111.212

The Texas Department of Licensing and Regulation (Department) proposes amendments to an existing rule at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter V, §111.212, regarding the Speech-Language Pathologists and Audiologists Program.

JUSTIFICATION AND EXPLANATION OF THE RULES

The existing rules under 16 TAC Chapter 111 implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists. The statute and rules govern the licensing and regulation of speech-language pathologists and audiologists. Existing rule 16 TAC §111.212 establishes the requirements for the use of telehealth by speech-language pathologists. The proposed rule amends §111.212(h), which requires in-person initial contact with clients.

The proposed rule is a result of changes in regulation involving telepractice and telehealth, specifically related to in-person initial contact. According to the U.S. Federal Trade Commission staff, of the 19 states and the District of Columbia that have telepractice laws, rules, or policies for speech-language pathology or audiology, Texas is one of only three states that has an in-person initial contact or evaluation requirement. (Source: Letter dated November 29, 2016, from the U.S. Federal Trade Commission (FTC) staff to the Delaware Board of Speech/Language Pathologists, Audiologists, and Hearing Aid Dispensers (DE Board) regarding the DE Board's proposed telepractice rules.)

In the FTC letter, the FTC staff discussed various regulations and developments in the use of telepractice to deliver speech-language pathology and audiology services, and the potential increase in competition and access to services through telepractice. The FTC staff encouraged the DE Board to reconsider its proposed telepractice rules by allowing licensees to determine whether telepractice is appropriate for an initial evaluation and by eliminating the requirement that all initial evaluations must be in-person.

In addition, the Texas Legislature enacted S.B. 1107, 85th Legislature, Regular Session (2017). This bill, in part, addressed provisions in the Texas Medical Board's statute and rules regarding telemedicine and face-to-face contact with patients. The bill also included provisions regarding telehealth, including provisions that the standard of care for services provided by telehealth is the same as the standard of care for services provided in-person, and that a regulatory agency cannot adopt rules that would impose a higher standard of care for telehealth services than for services provided in-person.

The Department viewed these changes and others as guidance in reviewing its existing telehealth/telepractice rules. The Department is amending §111.212 due to changes in regulation regarding telehealth/telepractice related to in-person initial contact.

The proposed rule is necessary to eliminate a restriction on the use of telehealth by speech-language pathologists. Specifically, the proposed rule eliminates the requirement that the initial contact with a client must be in-person at the same physical location to determine the client's candidacy for telehealth before any services can be provided by telehealth. The proposed rule eliminates an unnecessary restriction that may be viewed as anti-competitive or as an obstacle to obtaining or providing speech-language pathology services.

The Department staff made a presentation at the Speech-Language Pathologists and Audiologists Advisory Board (Advisory Board) meeting on June 30, 2017, regarding the trends in regulation involving telehealth/telepractice and in-person initial contact with clients. Draft options for the proposed rules were presented to and discussed by the Advisory Board at its meetings on November 15, 2017, and January 4, 2018. The proposed rule reflects those discussions with Advisory Board members and Department staff and reflects the option selected by the Advisory Board. At its meeting on January 4, 2018, the Advisory Board voted and recommended that the proposed rule be published in the Texas Register for public comment.

SECTION-BY-SECTION SUMMARY

The proposed rule amends §111.212, Requirements for the Use of Telehealth by Speech-Language Pathologists. The proposed rule amends subsection (h) by eliminating the requirement that a speech-language pathologist's initial contact with a client must be at the same physical location to determine the client's candidacy for telehealth before any services can be provided by telehealth. The proposed rule allows a speech-language pathologist's initial contact with a client to be either at the same physical location or through telehealth/telepractice, as determined appropriate by the licensed speech-language pathologist.

The language in existing subsection (h) related to determining the client's candidacy for telehealth has been modified and relocated to new subsection (i). New subsection (i) provides that the speech-language pathologist shall consider relevant factors including the client's behavioral, physical, and cognitive abilities in determining the appropriateness of providing services via telehealth/telepractice. This determination is not tied to the initial contact with the client.

FISCAL IMPACT ON STATE AND LOCAL GOVERNMENT

Brian E. Francis, Executive Director, has determined that for each year of the first five years the proposed rule is in effect, there are no estimated additional costs or reductions in costs to state or local government as a result of enforcing or administering the proposed amendments.

Mr. Francis has determined that for each year of the first five years the proposed rule is in effect, there is no estimated increase or loss in revenue to the state or local government as a result of enforcing or administering the proposed amendments.

Mr. Francis has determined that for each year of the first five years the proposed rule is in effect, the proposed rule does not have foreseeable implications relating to costs or revenues of state or local governments as a result of enforcing or administering the proposed amendment.

LOCAL EMPLOYMENT IMPACT STATEMENT

Mr. Francis has determined that the proposed rule will not affect the local economy, so the agency is not required to prepare a local employment impact statement under Government Code §2001.022.

PUBLIC BENEFITS

Mr. Francis also has determined that for each year of the first five-year period the proposed rule is in effect, the public benefit will be the elimination of a restriction on the use of telehealth, which may make it easier for qualified, licensed individuals to provide speech-language pathology services remotely. It could also benefit clients, especially those who do not live close to licensed speech-language pathologists, saving the clients time and travel costs associated with attending an initial visit at the same physical location as the licensed speech-language pathologist.

PROBABLE ECONOMIC COSTS TO PERSONS REQUIRED TO COMPLY WITH PROPOSAL

Mr. Francis has determined that for each year of the first five-year period the proposed rule is in effect, there are no anticipated economic costs to persons licensed as speech-language pathologists in Texas. Whether the initial visit is performed at the same physical location or performed through telehealth/telepractice, there is no appreciable economic cost to licensed individuals to comply with the proposed rules.

FISCAL IMPACT ON SMALL BUSINESSES, MICRO-BUSINESSES, AND RURAL COMMUNITIES

There will be no adverse effect on small businesses, micro-businesses, or rural communities as a result of the proposed rule.

Since the agency has determined that the proposed rule will have no adverse economic effect on small businesses, micro-businesses, or rural communities, preparation of an Economic Impact Statement and a Regulatory Flexibility Analysis, as detailed under Texas Government Code §2006.002, are not required.

ONE-FOR-ONE REQUIREMENT FOR RULES WITH A FISCAL IMPACT

Under Government Code §2001.0045, a state agency may not adopt a proposed rule if the fiscal note states that the rule imposes a cost on regulated persons, including another state agency, a special district, or a local government, unless the state agency: (a) repeals a rule that imposes a total cost on regulated persons that is equal to or greater than the total cost imposed on regulated persons by the proposed rule; or (b) amends a rule to decrease the total cost imposed on regulated persons by an amount that is equal to or greater than the cost imposed on the persons by the proposed rule. There are exceptions for certain types of rules under §2001.0045(c).

The proposed rule does not have a fiscal note that imposes a cost on regulated persons, including another state agency, a special district, or a local government. Therefore, the agency is not required to take any further action under Government Code §2001.0045.

GOVERNMENT GROWTH IMPACT STATEMENT

Pursuant to Government Code §2001.0221, the agency provides the following Government Growth Impact Statement for the proposed rule. For each year of the first five years the rule will be in effect, the agency has determined the following:

(1) The proposed rule does not create or eliminate a government program.

(2) Implementation of the proposed rule does not require the creation of new employee positions or the elimination of existing employee positions.

(3) Implementation of the proposed rule does not require an increase or decrease in future legislative appropriations to the agency.

(4) The proposed rule does not require an increase or decrease in fees paid to the agency.

(5) The proposed rule does not create a new regulation. One rule subsection has been amended and separated into two rule subsections.

(6) The proposed rule does expand, limit, or repeal an existing regulation. The proposed rule eliminates a restriction on the use of telehealth and allows for the use of telehealth/telepractice by speech-language pathologists for initial contacts with clients.

(7) The proposed rule does not increase or decrease the number of individuals subject to the rule's applicability.

(8) The proposed rule does not positively or adversely affect this state's economy.

PUBLIC COMMENTS

Comments on the proposal may be submitted to Pauline Easley, Legal Assistant, Texas Department of Licensing and Regulation, P.O. Box 12157, Austin, Texas 78711, or facsimile (512) 475-3032, or electronically: erule.comments@tdlr.texas.gov. The deadline for comments is 30 days after publication in the Texas Register.

STATUTORY AUTHORITY

The amendments to an existing rule are proposed under Texas Occupations Code, Chapters 51 and 401, which authorize the Commission, the Department's governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the proposal are those set forth in Texas Occupations Code, Chapters 51 and 401. No other statutes, articles, or codes are affected by the proposal.

§111.212.Requirements for the Use of Telehealth by Speech-Language Pathologists.

(a) - (g) (No change.)

(h) The initial contact between a licensed speech-language pathologist and client may [shall] be at the same physical location or through telehealth/telepractice, as determined appropriate by the licensed speech-language pathologist [to assess the client's candidacy for telehealth, including behavioral, physical, and cognitive abilities to participate in services provided via telecommunications prior to the client receiving telehealth services].

(i) A provider shall consider relevant factors including the client's behavioral, physical, and cognitive abilities in determining the appropriateness of providing services via telehealth/telepractice.

(j) [(i)] A provider shall be aware of the client or consultant level of comfort with the technology being used as part of the telehealth services and adjust their practice to maximize the client or consultant level of comfort.

(k) [(j)] When a provider collaborates with a consultant from another state in which the telepractice services are delivered, the consultant in the state in which the client receives services shall be the primary care provider for the client.

(l) [(k)] As pertaining to liability and malpractice issues, a provider shall be held to the same standards of practice as if the telehealth services were provided in person.

(m) [(l)] A provider shall be sensitive to cultural and linguistic variables that affect the identification, assessment, treatment, and management of the clients.

(n) [(m)] Upon request, a provider shall submit to the department data which evaluates effectiveness of services provided via telehealth including, but not limited to, outcome measures.

(o) [(n)] Telehealth providers shall comply with all laws, rules, and regulations governing the maintenance of client records, including client confidentiality requirements, regardless of the state where the records of any client within this state are maintained.

(p) [(o)] Notification of telehealth services shall be provided to the client, the guardian, the caregiver, and the multi-disciplinary team, if appropriate. The notification shall include, but not be limited to: the right to refuse telehealth services, options for service delivery, and instructions on filing and resolving complaints.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 12, 2018.

TRD-201800097

Brian E. Francis

Executive Director

Texas Department of Licensing and Regulation

Earliest possible date of adoption: February 25, 2018

For further information, please call: (512) 463-8179