36-1940.04. Speech-language pathology assistants; licensure requirements; scope of practice; supervision

A. A person who wishes to be licensed as a speech-language pathology assistant shall:

1. Submit a nonrefundable application fee as prescribed by section 36-1908.

2. Submit written evidence satisfactory to the director that the applicant has completed:

(a) An approved training program for speech-language pathology assistants or the equivalent from a nationally or regionally accredited college or university that consisted of a minimum of sixty semester credit hours of coursework with the following curriculum content:

(i) Twenty to forty semester credit hours of general education or a bachelor's degree.

(ii) Twenty to forty semester credit hours of speech-language pathology technical coursework.

(b) A minimum of one hundred hours of clinical interaction that does not include observation, under the supervision of a licensed master's level speech-language pathologist.

3. Not have had a license revoked or suspended by a state within the preceding two years and not be presently ineligible for licensure in any state because of a prior revocation or suspension.

B. The director may waive the requirements of subsection A, paragraph 2 of this section if the applicant holds certification as a speech-language pathology assistant from a nationally recognized speech-language hearing association approved by the department in the field for which the applicant is applying for licensure.

C. A speech-language pathology assistant may do the following under the supervision of a licensed speech-language pathologist:

1. Conduct speech and language screenings without interpretation, using screening protocols specified by the supervising speech-language pathologist.

2. Provide direct treatment assistance, including feeding for nutritional purposes to patients, clients or students except for patients, clients or students with dysphagia, identified by the supervising speech-language pathologist by following written treatment plans, individualized education programs, individual support plans or protocols developed by the supervising speech-language pathologist.

3. Document patient, client or student progress toward meeting established objectives as stated in the treatment plan, individual support plan or individualized education program without interpreting the findings and report this information to the supervising speech-language pathologist.

4. Assist the speech-language pathologist in collecting and tallying data for assessment purposes, without interpreting the data.

5. Act as a second-language interpreter during assessments.

6. Assist with informal documentation during an intervention session by collecting and tallying data as directed by the speech-language pathologist, preparing materials and assisting with other clerical duties as specified by the supervising speech-language pathologist.

7. Schedule activities and prepare charts, records, graphs or other displays of data.

8. Perform checks and maintenance of equipment.

9. Participate with the speech-language pathologist in research projects, in-service training and public relations programs.

10. Sign and initial treatment notes for review and cosignature by the supervising speech-language pathologist.

D. A speech-language pathology assistant shall not:

1. Conduct swallowing screening, assessment and intervention protocols, including modified barium swallow studies.

2. Administer standardized or nonstandardized diagnostic tests or formal or informal evaluations or interpret test results.

3. Participate in parent conferences, case conferences or any interdisciplinary team meeting without the presence of the supervising speech-language pathologist, except for individualized education program or individual support plan meetings if the licensed speech-language pathologist has been excused by the individualized education program team or the individual support plan team.

4. Write, develop or modify a patient's, client's or student's treatment plan, individual support plan or individualized education program in any way.

5. Provide intervention for patients, clients or students without following the treatment plan, individual support plan or individualized education program prepared by the supervising speech-language pathologist.

6. Sign any formal documents, including treatment plans, individual support plans, individualized education programs, reimbursement forms or reports.

7. Select patients, clients or students for services.

8. Discharge patients, clients or students from services.

9. Unless required by law, disclose clinical or confidential information orally or in writing to anyone not designated by the speech-language pathologist.

10. Make a referral for any additional service.

11. Communicate with the patient, client or student or with family or others regarding any aspect of the patient, client or student status without the specific consent of the supervising speech-language pathologist.

12. Claim to be a speech-language pathologist.

13. Write a formal screening, diagnostic, progress or discharge note.

14. Perform any task without the express knowledge and approval of the supervising speech-language pathologist.

E. All services provided by a speech-language pathology assistant shall be performed under the direction and supervision of a speech-language pathologist who is licensed pursuant to this chapter.

F. A licensed speech-language pathologist who supervises or directs the services provided by a speech-language pathology assistant shall:

1. Have at least two years of full-time professional experience as a licensed speech-language pathologist.

2. Provide direction and supervision to not more than two full-time or three part-time speech-language pathology assistants at one time.

3. Ensure that the amount and type of supervision and direction provided to a speech-language pathology assistant is consistent with the individual's skills and experience, the needs of the patient, client or student served, the setting in which services are provided and the tasks assigned and provide:

(a) At least twenty percent direct supervision and ten percent indirect supervision of all the time that the speech-language pathology assistant is providing services during the individual's first ninety days of employment. After the first ninety days of the speech-language pathology assistant's employment, the supervising speech-language pathologist may adjust the amount of supervision if the supervising speech-language pathologist determines that the speech-language pathology assistant meets appropriate competencies and skill levels regarding various disorders of communication and related disorders.  Minimum ongoing supervision after the first ninety days shall include documentation of direct and indirect supervision provided by the supervising speech-language pathologist and shall include at least one hour of direct supervision weekly and as much indirect supervision as needed to maintain the delivery of quality services. Minimum ongoing supervision after the first ninety days shall include documentation by the supervising speech-language pathologist of the supervisor's direct contact with at least ten percent of the speech-language pathology assistant's patients, clients or students served each quarter. The supervising speech-language pathologist shall ensure that the ten percent direct client contact varies each quarter. The supervising speech-language pathologist shall require direct supervision of a speech-language pathology assistant when services are provided to a medically fragile individual.

(b) At least ten percent direct supervision and ten percent indirect supervision of all the time that the speech-language pathology assistant is providing services during the individual's first thirty days of employment if the speech-language pathology assistant completed supervision pursuant to subdivision (a) of this paragraph at a previous employer and provides documentation of that supervision to the supervising speech-language pathologist. After the first thirty days of the speech-language pathology assistant's employment, the supervising speech-language pathologist may adjust the amount of supervision if the supervising speech-language pathologist determines that the speech-language pathology assistant meets appropriate competencies and skill levels regarding various disorders of communication and related disorders.  Minimum ongoing supervision after the first thirty days of employment shall include documentation of direct and indirect supervision provided by the supervising speech-language pathologist and shall include at least one hour of direct supervision weekly and as much indirect supervision as needed to maintain the delivery of quality services.  Minimum ongoing supervision after the first ninety days shall include documentation by the supervising speech-language pathologist of the supervisor's direct contact with at least ten percent of the speech-language pathology assistant's patients, clients or students served each quarter. The supervising speech-language pathologist shall ensure that the ten percent direct client contact varies each quarter. The supervising speech-language pathologist shall require direct supervision of a speech-language pathology assistant when services are provided to a medically fragile individual.

4. Inform a patient, client or student when the services of a speech-language pathology assistant are being provided.

5. Document all periods of direct supervision and indirect supervision provided to a speech-language pathology assistant.

G. If more than one speech-language pathologist provides supervision to a speech-language pathology assistant, one of the speech-language pathologists shall be designated as the primary supervisor who is responsible for coordinating any supervision provided by other speech-language pathologists.