1. (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. (1) possess a baccalaureate degree with an emphasis in communicative sciences or disorders;

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

      1. (A) at least 18 of the 24 semester hours must be in speech-language pathology;
      2. (B) at least three of the 24 semester hours must be in language disorders;
      3. (C) at least three of the 24 semester hours must be in speech disorders; and
      4. (D) the 24 semester hours excludes clinical experience and course work such as special education, deaf education, or sign language; and
   3. (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 or under the direct supervision at their place of employment.

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

   1. (1) Original or certified copy of the transcripts showing the conferred degree shall be submitted and reviewed as follows:

      1. (A) only course work earned within the past ten (10) years with a grade of "C" or above is acceptable;
      2. (B) a quarter hour of academic credit shall be considered as two-thirds of a semester credit hour; and
      3. (C) academic courses, the titles of which are not self-explanatory, shall be substantiated through course descriptions in official school catalogs or bulletins or by other official means.
   2. (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.
3. (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, which may include some leveling hours.
4. (d) Degrees and/or course work received at foreign universities shall be acceptable only if such course work and clinical practicum hours may be verified as meeting the requirements of subsection (a). The applicant must bear all expenses incurred during the procedure. The department shall evaluate the documentation, which shall include an original transcript and an original report from a credential evaluation services agency acceptable to the department.

5. (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. 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. (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:

      1. (A) the Supervisory Responsibility Statement Form; and
      2. (B) the prescribed Clinical Deficiency Plan.
   2. (2) The department shall evaluate the documentation and fees submitted to determine if the assistant license shall be issued. Additional information or revisions may be required before approval is granted.
   3. (3) The Clinical Deficiency Plan shall be completed within sixty (60) days of the issue date of the assistant's license or the licensed assistant must submit a new plan.

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

      1. (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;
      2. (B) a rating scale of the licensed assistant's performance; and
      3. (C) a statement or information that the licensed assistant successfully completed the clinical observation and clinical assisting experience 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. (5) Department staff shall evaluate the documentation required in paragraph (4) and inform the licensed assistant and licensed speech-language pathologist who provided the training if acceptable.
   6. (6) A licensed assistant may continue to practice under 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).
   7. (7) In the event another licensed speech-language pathologist shall supervise the licensed assistant after completion of the Clinical Deficiency Plan, a Supervisory Responsibility Statement Form shall be submitted to the department seeking approval for the change in supervision. If the documentation required by paragraph (4), has not been received and approved by the department, approval for the change in supervision shall not be granted.

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

      1. (A) application for an assistant license;
      2. (B) license renewal when there is a change in supervisor;
      3. (C) other changes in supervision; and
      4. (D) the addition of other department-approved supervisors.
   2. (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. (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. (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. (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.

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

   1. (1) Initial contacts directly with the client shall be conducted by the licensed speech-language pathologist department-approved supervisor.
   2. (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. (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. (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.

      1. (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.
      2. (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.

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

      1. (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;
      2. (B) notify the client or client's legal guardian(s) that services will be provided by a licensed assistant;
      3. (C) develop the client's treatment program in all settings and review them with the licensed assistant who will provide the service; and
      4. (D) maintain responsibility for the services provided by the licensed assistant.
   4. (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. (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:

      1. (A) conduct or participate in speech, language, and/or hearing screening;
      2. (B) implement the treatment program or the individual education plan (IEP) designed by the licensed speech-language pathologist department-approved supervisor;
      3. (C) provide carry-over activities which are the therapeutically designed transfer of a newly acquired communication ability to other contexts and situations;
      4. (D) collect data;
      5. (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;
      6. (F) maintain clinical records;
      7. (G) prepare clinical materials;
      8. (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;
      9. (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
      10. (J) must only work with assigned cases of the licensed speech-language pathologist department-approved supervisor's caseload.

9. (i) The licensed assistant shall not:

   1. (1) conduct evaluations, even under supervision, since this is a diagnostic and decision making activity;
   2. (2) interpret results of routine tests;
   3. (3) interpret observations or data into diagnostic statements, clinical management strategies, or procedures;
   4. (4) represent speech-language pathology at staff meetings or at an admission, review and dismissal (ARD), except as specified in this section;
   5. (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. (6) design or alter a treatment program or individual education plan (IEP);
   7. (7) determine case selection;
   8. (8) present written or oral reports of client information, except as provided by this section;
   9. (9) refer a client to other professionals or other agencies;
   10. (10) use any title which connotes the competency of a licensed speech-language pathologist;
   11. (11) practice as an assistant in speech-language pathology without a valid supervisory responsibility statement on file in the department;
   12. (12) perform invasive procedures;
   13. (13) screen or diagnose clients for feeding and swallowing disorders;
   14. (14) use a checklist or tabulated results of feeding or swallowing evaluations;
   15. (15) demonstrate swallowing strategies or precautions to clients, family, or staff;
   16. (16) provide client or family counseling;
   17. (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. (18) use "SLP-A" or "STA" as indicators for their credentials. Licensees shall use "Assistant SLP" or "SLP Assistant" to shorten their professional title.

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

    1. (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. (2) develop the student's new IEP goals and objectives and review them with the licensed assistant; and
    3. (3) maintain undiminished responsibility for the services provided and the actions of the licensed assistant.

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

    1. (1) The licensed assistant shall have written documentation of approval from the licensed, speech-language pathologist department-approved supervisor.
    2. (2) The licensed assistant shall have three years experience as a licensed assistant in the school setting.
    3. (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. (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. (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.
12. (l) In any professional context the licensee must indicate the licensee status as a licensed speech-language pathology assistant.

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

    1. (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. (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. (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.
14. (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.

Source Note:The provisions of this §111.50 adopted to be effective October 1, 2016, 41 TexReg 4441.