1. (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).
2. (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.

3. (c) A supervisor must ensure all training hours completed by the assistant are supervised.

   1. (1) Approval from the department must be required prior to practice by the assistant and prior to any changes in supervision.

   2. (2) An assistant supervision plan must be submitted upon:

      1. (A) application for an assistant license; and
      2. (B) any addition, change, or removal of supervisors.
   3. (3) If more than one audiologist agrees to supervise the assistant, each supervisor must submit an assistant supervision plan, in a form and manner prescribed by the department. Each supervisor must add the assistant to their license.
   4. (4) The assistant may not practice without an approved supervisor. The supervisor must verify that the assistant appears under the supervisor's license before allowing the assistant to practice.
   5. (5) The assistant must only provide services for the clients of the assistant's current, approved supervisors.
   6. (6) If the supervisor ceases supervision of the assistant, the supervisor must notify the department, in a form and manner prescribed by the department, and must inform the assistant to stop practicing immediately. The supervisor is responsible for the practice of the assistant until the assistant is removed from the supervisor's license. The supervisor is responsible for verifying the removal.
   7. (7) If the assistant's supervisor ceases supervision, the assistant must stop practicing immediately. The assistant may not practice until the assistant has a new approved supervisor and has been added to a new supervisor's license.
4. (d) Assistant Supervision Plan. An assistant must practice under an assistant supervision plan. This plan must be submitted in a form and manner prescribed by the department.
5. (e) A supervisor must assign duties and provide appropriate supervision to the assistant.

6. (f) Client Contacts.

   1. (1) All diagnostic contacts must be conducted by the supervisor.
   2. (2) Following the initial diagnostic contact, the supervisor must 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).

7. (g) Amount and Type of Supervision. Each supervisor must provide a minimum of four hours per week, or sixteen hours per calendar month, of supervision to the assistant. This subsection applies whether the assistant is employed full-time or part-time.

   1. (1) At least one hour per week, or four hours per calendar month, must be direct supervision.
   2. (2) The remaining hours may be performed using indirect supervision.
   3. (3) If fewer than four weeks are worked in a calendar month, then the number of hours of supervision provided will be based on the number of weeks worked. Four hours of supervision must be provided for each week worked, including one hour of direct supervision.
   4. (4) Tele-supervision may be used for direct and indirect supervision.
   5. (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 paragraph may be exceeded as determined by the supervisor.

8. (h) Delegating Clinical Tasks.

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

   3. (3) The supervisor must:

      1. (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;
      2. (B) notify the client or client's legal guardian(s) that services will be provided by a licensed assistant; and
      3. (C) maintain responsibility for the services provided by the assistant.

9. (i) Records. The supervisor must maintain the following records.

   1. (1) Supervisory records must 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. (2) The supervisor must keep job descriptions and performance records. Records must be current and be made available upon request to the department.

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

    1. (1) The department must notify an assistant and the supervisor in a form and manner prescribed by the department that the assistant has been selected for an audit.
    2. (2) Upon receipt of an audit notification, the assistant and the supervisor, who agreed to accept responsibility for the services provided by the assistant, must provide the requested proof of compliance to the department in a form and manner prescribed by the department.
    3. (3) The assistant and the supervisor must comply with the department's request for documentation and information concerning compliance with the audit.
11. (k) 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 §111.91 adopted to be effective May 1, 2018, 43 TexReg 2544; amended to be effective December 30, 2021, 46 TexReg 9021; amended to be effective December 1, 2025, 50 TexReg 7552.