PURPOSE: This rule details the supervision requirements for speech-language pathology assistants.

1. (1) All applications for registration to practice as a speech-language pathology assistant must include a statement from a speech-language pathologist holding current, unrestricted licensure to practice in the state of Missouri pursuant to section 345.015(10), RSMo, acknowledging acceptance of the legal and ethical responsibilities for supervising the assistant. A speech-language pathologist practicing with a provisional license pursuant to section 345.022, RSMo shall not be the supervisor for a speech-language pathology assistant.
2. (2) The supervising speech-language pathologist is responsible for the clinical activities of the assistant.
3. (3) The supervising speech-language pathologist has the responsibility of ensuring and protecting the interests of all patients and/or clients at all times during which the assistant is practicing and/or interacting with patients and/or clients; this responsibility includes the supervisor’s and the assistant’s compliance with the ethical standards of practice as specified in rule 4 CSR 150-4.080.
4. (4) The supervising speech-language pathologist shall ensure that the scope and intensity of the assistant’s training encompasses all of the activities assigned to the assistant.
5. (5) The supervising speech-language pathologist shall provide the assistant with information specifying the assistant’s role and function as well as specifying the role and function of the supervising speech-language pathologist.
6. (6) The supervising speech-language pathologist shall provide continuing opportunities to ensure that the speech-language pathology assistant’s practices are current and skills are maintained.
7. (7) The supervising speech-language pathologist shall directly supervise the assistant’s initial client contact. Thereafter, one out of every three sessions for each client shall be directly supervised. Direct supervision is defined as on-site, in view of the assistant and patient/client. If an alternative arrangement is necessary the supervising speech-language pathologist must submit a proposed plan of supervision for the review of the advisory commission and board to determine if the supervision plan is acceptable. All other client contacts shall be indirectly supervised. Indirect methods of supervision such as audio or video tape recording, telephone communication, numerical data, or other means of reporting may be utilized.
8. (8) The supervising speech-language pathologist must be available for the purpose of providing guidance and support to the assistant at all times, via telephone contact, facsimile, etc.
9. (9) The supervising speech-language pathologist shall review and sign all patient/client documented progress notes written by the speech-language pathology assistant.
10. (10) The supervising speech-language pathologist shall assign and the assistant shall accept only those duties and responsibilities for which the assistant has been specifically trained and is qualified to perform, pursuant to the judgement of the supervising speechlanguage pathologist, and in compliance with the provisions of Chapter 345, RSMo.
11. (11) The speech-language pathology assistant shall maintain supervisory logs and the speech-language pathologist shall sign verifying the hours of supervision per month, such logs shall be made available to the board within thirty (30) days upon receipt of a request for such logs from the board.
12. (12) The maximum number of speech-language pathology assistants supervised by one licensee shall not exceed one (1).

AUTHORITY: sections 345.015, 345.022 and 345.030, RSMo Supp. 1999.* This rule originally filed as 4 CSR 150-4.201. Original rule filed July 31, 2000, effective Feb. 28, 2001. Moved to 20 CSR 2150-4.201, effective Aug. 28, 2006. *Original authority: 345.015, RSMo 1973, amended 1986, 1995, 1998; 345.022, RSMo 1995, amended 1998; and 345.030, RSMo 1973, amended 1981, 1995, 1998.