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Virginia Regulatory Town Hall

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Action:
Promulgate Chapter 21 & repeal existing Chapter 20; reduction in ...
Stage: Proposed
 

CHAPTER 20
REGULATIONS GOVERNING THE PRACTICE OF AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY (REPEALED)

Part I
General Provisions

18VAC30-20-10. Definitions. (Repealed.)

A. The words and terms "audiologist," "board," "practice of audiology," "practice of speech-language pathology," "speech-language disorders," and "speech-language pathologist" when used in this chapter shall have the meanings ascribed to them in § 54.1-2600 of the Code of Virginia.

B. The following words when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:

"Contact hour" means 60 minutes of time spent in continuing learning activities.

"School speech-language pathologist" means a person licensed pursuant to § 54.1-2603 of the Code of Virginia to provide speech-language pathology services solely in public school divisions.

"Supervision" means that the audiologist or speech-language pathologist is responsible for the entire service being rendered or activity being performed, is available for consultation, and is providing regular monitoring and documentation of clinical activities and competencies of the person being supervised.

"Type 1" means continuing learning activities that must be offered by an accredited sponsor or organization as specified in 18VAC30-20-300.

"Type 2" means continuing learning activities that may or may not be approved by an accredited sponsor or organization but shall be activities considered by the learner to be beneficial to practice or to continuing learning. In Type 2 activities, licensees document their own participation on the Continued Competency Activity and Assessment Form and are considered self-learning activities.

18VAC30-20-45. Required licenses.

There shall be separate licenses for the practices of audiology and speech-language pathology. It is prohibited for any person to practice as an audiologist or a speech-language pathologist unless the person has been issued the appropriate license.

18VAC30-20-50. Posting of license.

A licensee shall post his license in a place conspicuous to the public in each facility in which the licensee is employed and holds himself out to practice.

18VAC30-20-70. Records; accuracy of information.

A. All changes of name, address of record or public address, if different from the address of record, shall be furnished to the board within 30 days after the change occurs.

B. All notices required by law and by this chapter to be mailed by the board to any registrant or licensee shall be validly given when mailed to the latest address of record on file with the board.

18VAC30-20-80. Fees.

A. The following fees shall be paid as applicable for licensure:

 

1. Application for audiology or speech-language pathology license

$135

 

2. Application for school speech-language pathology license

$70

 

3. Verification of licensure requests from other states

$20

 

4. Annual renewal of audiology or speech-language pathology license

$75

 

5. Late renewal of audiology or speech-language pathology license

$25

 

6. Annual renewal of school speech-language pathology license

$40

 

7. Late renewal of school speech-language pathology license

$15

 

8. Reinstatement of audiology or speech-language pathology license

$135

 

9. Reinstatement of school speech-language pathology license

$70

 

10. Duplicate wall certificates

$25

 

11. Duplicate license

$5

 

12. Returned check

$35

 

13. Inactive license renewal for audiology or speech-language pathology

$40

 

14. Inactive license renewal for school speech-language pathology

$20

 

15. Approval of a continuing education sponsor

$200

 

16. Application for provisional license in audiology

$50

 

17. Renewal of provisional license in audiology

$25

B. Fees shall be made payable to the Treasurer of Virginia and shall not be refunded once submitted.

C. For the renewal of licenses by December 31, 2009, the fees shall be as follows:

 

1. Annual renewal of audiology or speech-language pathology license

$40

 

2. Annual renewal of school speech-language pathology license

$20

 

3. Inactive license renewal for audiology or speech-language pathology

$20

 

4. Renewal of provisional license in audiology

$15

Part II
Renewal and Reinstatement

18VAC30-20-150. Renewal.

A. A person who desires to renew his license shall, not later than December 31 of each year, return the renewal notice and applicable renewal fee. A licensee who fails to renew his license by the expiration date shall have a lapsed license, and practice with a lapsed license may constitute grounds for disciplinary action by the board.

B. A person who fails to renew his license by the expiration date may renew at any time within one year of expiration by submission of a renewal application, the renewal fee and late fee, and statement of compliance with continuing education requirements.

18VAC30-20-160. Reinstatement of lapsed license.

A. When a license has not been renewed within one year of the expiration date, a person may apply to reinstate his license by submission of a reinstatement application, payment of the reinstatement fee, and submission of documentation of 15 continuing competency hours for each year the license has been lapsed, not to exceed 60 hours obtained during the time the license in Virginia was lapsed.

B. A licensee who does not reinstate within five years as prescribed by subsection A of this section shall either:

1. Reapply for licensure as prescribed by 18VAC30-20-170 and meet the qualifications for licensure in effect at the time of the new application; or

2. Meet the continuing competency requirements specified in subsection A of this section and provide documentation of a current license in another jurisdiction in the United States and evidence of active practice for at least three of the past five years.

C. An applicant for reinstatement in audiology who does not meet one of the requirements of subsection B of this section may qualify for reinstatement by practice under supervision with a provisional license for six months and a recommendation for reinstatement by his supervisor. The board may issue a provisional license to an applicant who can provide evidence of having met the applicable educational qualifications prescribed in 18VAC30-20-170 and passage of the qualifying examination at the time of initial licensure. Provisional licensure shall be practiced under the supervision of a licensed audiologist and in accordance with subsections D and E of 18VAC30-20-171.

D. If the licensee holds licensure in any other state or jurisdiction, he shall provide evidence that no disciplinary action has been taken or is pending. The board reserves the right to deny a request for reinstatement to any licensee who has been determined to have committed an act in violation of 18VAC30-20-280.

Part III
Requirements for Licensure

18VAC30-20-170. Requirements for licensure.

A. The board may grant a license to an applicant who:

1. Holds a current and unrestricted Certificate of Clinical Competence in the area in which he seeks licensure issued by the American Speech-Language-Hearing Association, certification issued by the American Board of Audiology or any other accrediting body recognized by the board. Verification of currency shall be in the form of a certified letter from a recognized accrediting body issued within six months prior to licensure; and

2. Has passed the qualifying examination from an accrediting body recognized by the board within three years preceding the date of applying for licensure, or has been actively engaged in the respective profession for which he seeks licensure for one of the past three consecutive years preceding the date of application; or

B. The board may grant a license to an applicant for licensure as a speech-language pathologist who:

1. Holds a master's degree or its equivalent as determined by the board or a doctoral degree from a college or university whose speech-language program is accredited by the Council on Academic Accreditation of the American Speech-Language-Hearing Association or an equivalent accrediting body; and

2. Has passed a qualifying examination from an accrediting body recognized by the board within three years preceding the date of applying for licensure in Virginia or has been actively engaged as a speech-language pathologist for one of the past three consecutive years preceding the date of application.

C. The board may grant a license to an applicant as a school speech-language pathologist who:

1. Holds a master's degree in speech-language-pathology; and

2. Holds an endorsement in speech-language pathology from the Virginia Department of Education.

18VAC30-20-171. Provisional licensure in audiology.

A. The board may grant a provisional license in audiology to an applicant who submits a completed application and fee with documentation that the applicant:

1. Is currently enrolled in a doctoral program in audiology at a college or university whose audiology program is accredited by the Council on Academic Accreditation of the American Speech-Language-Hearing Association or an equivalent accrediting body;

2. Has successfully completed all the didactic coursework required for the doctoral degree as documented by the audiology program; and

3. Has passed a qualifying examination from an accrediting body recognized by the board within three years preceding the date of applying for provisional licensure in Virginia.

B. A provisional license shall expire 18 months from the date of issuance and may be renewed for an additional six months by payment of a renewal fee. Renewal of a provisional license beyond 24 months shall be for good cause shown as determined by a committee of the board.

C. The holder of a provisional license in audiology shall only practice under the supervision of a licensed audiologist in order to obtain clinical experience as required for certification by the American Speech-Language-Hearing Association, the American Board of Audiology or any other accrediting body recognized by the board. The provisional licensee shall be responsible and accountable for the safe performance of those direct patient care tasks to which he has been assigned.

D. Licensed audiologists providing supervision shall:

1. Notify the board of the intent to provide supervision for a provisional licensee;

2. Document the frequency and nature of the supervision of provisional licensees;

3. Be responsible and accountable for the assignment of patients and tasks based on their assessment and evaluation of the provisional licensee's knowledge and skills; and

4. Monitor clinical performance and intervene if necessary for the safety and protection of the patients.

E. The identity of a provisional licensee shall be disclosed to the client prior to treatment and shall be made a part of the client's file.

18VAC30-20-180. Application process.

A. Prior to seeking licensure as an audiologist, a speech-language pathologist, or a school speech-language pathologist, an applicant shall submit:

1. A completed and signed application;

2. The applicable fee prescribed in 18VAC30-20-80; and

3. Additional documentation as may be required by the board to determine eligibility of the applicant.

B. An incomplete application package shall be retained by the board for a period of one year.

18VAC30-20-185. Licensure by endorsement.

A. An applicant who has been licensed in another jurisdiction in the United States may apply for licensure in Virginia by submission of a completed application, payment of the application fee, and submission of documentation of 15 continuing competency hours for each year in which he has been licensed in the other jurisdiction, not to exceed 60 hours.

B. An applicant shall either:

1. Meet the qualifications for licensure as prescribed by 18VAC30-20-170; or

2. Provide documentation of a current license in another jurisdiction in the United States and evidence of active practice for at least three of the past five years.

C. An applicant for licensure by endorsement in audiology who does not meet one of the requirements of subsection B of this section may qualify for endorsement by practice under supervision with a provisional license for six months and a recommendation for licensure by his supervisor. The board may issue a provisional license to an applicant who can provide evidence of having met the educational qualifications prescribed in 18VAC30-20-170 and passage of the qualifying examination at the time of initial licensure. Provisional licensure shall be practiced under the supervision of a licensed audiologist and in accordance with subsections D and E of 18VAC30-20-171.

D. An applicant shall provide evidence that no disciplinary action has been taken or is pending against his license in another jurisdiction. The board reserves the right to deny a request for licensure to any applicant who has been determined to have committed an act in violation of 18VAC30-20-280.

Part IV
Standards of Practice

18VAC30-20-230. Prohibited conduct.

A. No person unless otherwise licensed to do so, shall prepare, order, dispense, alter or repair hearing aids or parts of or attachments to hearing aids for consideration. However, audiologists licensed under this chapter may make earmold impressions and prepare and alter earmolds for clinical use and research.

B. No person licensed as a school speech-language pathologist shall conduct the practice of speech-language pathology outside the scope of the public school setting.

18VAC30-20-240. Supervisory responsibilities; supervision of unlicensed assistants.

A. A licensed audiologist and speech-language pathologist shall provide documented supervision to unlicensed assistants, shall be held fully responsible for their performance and activities, and shall ensure that they perform only those activities which do not constitute the practice of audiology or speech-language pathology and which are commensurate with their level of training.

B. The identity of the unlicensed assistant shall be disclosed to the client prior to treatment and shall be made a part of the client's file.

18VAC30-20-280. Unprofessional conduct.

The board may refuse to issue a license to any applicant, suspend a license for a stated period of time or indefinitely, reprimand a licensee or place his license on probation with such terms and conditions and for such time as it may designate, impose a monetary penalty, or revoke a license for any of the following causes:

1. Guarantee of the results of any speech, voice, language, or hearing consultative or therapeutic procedure;

2. Diagnosis or treatment of speech, voice, language, and hearing disorders solely by written correspondence, provided this shall not preclude:

a. Follow-up by written correspondence or electronic communication concerning individuals previously seen; or

b. Providing patients with general information of an educational nature;

3. Disclosure of confidential patient information to unauthorized persons without the permission of the patient unless otherwise authorized by law;

4. Exploitation of patients by accepting them for treatment when benefit cannot reasonably be expected to occur, or by continuing treatment unnecessarily;

5. Incompetence or negligence in the practice of the profession;

6. Failure to comply with applicable state and federal statutes or regulations specifying the consultations and examinations required prior to the fitting of a new or replacement prosthetic aid for any communicatively impaired person;

7. Failure to refer a client to an appropriate health care practitioner when there is evidence of an impairment for which assessment, evaluation, care or treatment might be necessary;

8. Failure to supervise persons who assist them in the practice of speech-language pathology and audiology as well as failure to disclose the use and identity of unlicensed assistants;

9. Conviction of a felony or a misdemeanor involving moral turpitude;

10. Failure to comply with federal, state, or local laws and regulations governing the practice of audiology and speech-language pathology;

11. Failure to comply with any regulations of the board;

12. Inability to practice with skill and safety;

13. Making material misrepresentation in the course of practice;

14. Misrepresentation of one's professional credentials;

15. Aiding and abetting unlicensed activity; or

16. Revocation, suspension, restriction or any other discipline of a license or certificate to practice or surrender of license or certificate while investigation or administrative proceedings are pending in another state, the District of Columbia, a United States possession or territory, or a foreign jurisdiction.

18VAC30-20-290. Criteria for delegation of informal fact-finding proceedings to an agency subordinate.

A. Decision to delegate. In accordance with § 54.1-2400 (10) of the Code of Virginia, the board may delegate an informal fact-finding proceeding to an agency subordinate upon determination that probable cause exists that a practitioner may be subject to a disciplinary action.

B. Criteria for delegation. Cases that may not be delegated to an agency subordinate include, but are not limited to, those that involve:

1. Intentional or negligent conduct that causes or is likely to cause injury to a patient;

2. Mandatory suspension resulting from action by another jurisdiction or a felony conviction;

3. Impairment with an inability to practice with skill and safety;

4. Sexual misconduct;

5. Unauthorized practice.

C. Criteria for an agency subordinate.

1. An agency subordinate authorized by the board to conduct an informal fact-finding proceeding may include board members and professional staff or other persons deemed knowledgeable by virtue of their training and experience in administrative proceedings involving the regulation and discipline of health professionals.

2. The executive director shall maintain a list of appropriately qualified persons to whom an informal fact-finding proceeding may be delegated.

3. The board may delegate to the executive director the selection of the agency subordinate who is deemed appropriately qualified to conduct a proceeding based on the qualifications of the subordinate and the type of case being heard.

Part V
Continuing Competency Requirements

18VAC30-20-300. Continued competency requirements for renewal of an active license.

A. In order to renew an active license biennially on or after December 31, 2002, a licensee shall complete the Continued Competency Activity and Assessment Form that is provided by the board and which shall indicate completion of at least 30 contact hours of continuing learning activities within the two years immediately preceding renewal as follows:

1. A minimum of 15 of the 30 contact hours shall be in Type 1 programs or courses related to speech-language pathology or audiology, depending on the license held, and offered by one of the following accredited sponsors or organizations sanctioned by the profession:

a. The Speech-Language Hearing Association of Virginia or similar state speech-language hearing association of another state;

b. The American Academy of Audiology;

c. The American Speech-Language Hearing Association;

d. The Accreditation Council on Continuing Medical Education of the American Medical Association offering Category I continuing medical education;.

e. Local, state or federal government agencies;

f. Colleges and universities;

g. International Association of Continuing Education and Training;

h. Health care organizations accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO);

i. A sponsor approved by the board provided the sponsor has submitted satisfactory documentation on forms provided by the board.

2. No more than 15 of the 30 contact hours may be Type 2 activities or courses, which may or may not be approved by an accredited sponsor or organization but which shall be chosen by the licensee related to the licensed profession. Type 2 activities may include but not be limited to self-study, consultation with colleagues, independent study, participation on inter-disciplinary teams, and research or writing on subjects related to practice.

B. If the licensee is dually licensed by this board as an audiologist and speech-language pathologist, no more than 45 continuing education hours are required for renewal. A minimum of 30 of the 45 contact hours shall be Type 1 activities or courses, with a minimum of 15 contact hours in each profession. The remaining hours of the 45 hours may or may not be Type 2 activities or courses and may be related to either profession.

C. A licensee shall be exempt from the continuing competency requirements for the first biennial renewal following the date of initial licensure in Virginia.

D. The licensee shall retain his records on the completed form with all supporting documentation for a period of four years following the renewal of an active license.

E. The licensees selected in a random audit conducted by the board shall provide the completed Continued Competency Activity and Assessment Form and all supporting documentation within 30 days of receiving notification of the audit.

F. Failure to comply with these requirements may subject the licensee to disciplinary action by the board.

G. The board may grant an extension of the deadline for continuing competency requirements, for up to one year, for good cause shown upon a written request from the licensee prior to the renewal date.

H. The board may grant an exemption for all or part of the requirements for circumstances beyond the control of the licensee, such as temporary disability, mandatory military service, or officially declared disasters.

18VAC30-20-310. Inactive license.

A speech-language pathologist or audiologist who holds a current, unrestricted license in Virginia may, upon a request on the renewal application and submission of the required fee, be issued an inactive license. The holder of an inactive license shall not be required to maintain continuing competency requirements and shall not be entitled to perform any act requiring a license to practice speech-language pathology or audiology in Virginia.

18VAC30-20-320. Reinstatement of an inactive license.

A. A licensee whose license has been inactive and who requests reinstatement of an active license shall file a reinstatement application, pay the difference between the inactive and active renewal fees for the current year, and provide documentation of having completed continued competency hours equal to the requirement for the number of years, not to exceed four years, in which the license has been inactive.

B. The board reserves the right to deny a request for reactivation to any licensee who has been determined to have committed an act in violation of 18VAC30-20-280.

FORMS (18VAC30-20)

Application for Audiology License by ASHA or ABA Certification (rev. 6/08).

Application Checklist for Audiology License by ASHA or ABA Certification (rev. 5/08).

Application for a License to Practice Audiology by Endorsement (eff. 5/09).

Application Checklist for Applicants by Endorsement - Audiology (eff. 5/09).

Application for Provisional Licensure to Practice Audiology (rev. 9/07).

Application Checklist for Applicants Requesting Provisional Licensure (rev. 9/07).

Application for Provisional Audiologist to Apply for Full Audiology License (rev. 7/08).

Application Checklist for Provisional Applicants Requesting Full Audiologist Licensure (eff. 8/08).

Application for a License to Practice Speech-Language Pathology by Education (rev. 9/07).

Application Checklist for Applicants by Education (rev. 9/07).

Application for a License to Practice Speech-Language Pathology by ASHA Certification (rev. 5/08).

Application Checklist for Applicants by ASHA Certification (rev. 5/08).

Application for a License to Practice Speech-Language Pathology by Endorsement (eff. 5/09).

Application Checklist for Applicants by Endorsement - Speech-Language Pathology (eff. 5/09).

Application for a License to Practice as a School Speech-Language Pathologist (rev. 7/07).

Application Checklist for Applicants for School Speech-Language Pathology License (rev. 8/07).

Application for Reinstatement of License to Practice (rev. 11/07).

Reinstatement Application Checklist for Audiology and Speech-Language Pathology (rev. 8/08).

Application for Reinstatement of School Speech Language Pathology License (rev. 11/07).

Reinstatement Application Checklist for School Speech-Language Pathologists Applicants (rev. 8/07).

Application for Reinstatement of Inactive License to Practice (rev. 11/07).

Continued Competency Activity and Assessment Form (rev. 7/07).

Application for Approval as a Continuing Competency Sponsor (rev. 7/07).

CHAPTER 21

REGULATIONS GOVERNING AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY

Part I.  General Provisions.

18VAC30-21-10. Definitions.

A. The words and terms "audiologist," "board," "practice of audiology," "practice of speech-language pathology," "speech-language disorders," and "speech-language pathologist" when used in this chapter shall have the meanings ascribed to them in § 54.1-2600 of the Code of Virginia.

B. The following words when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:

"Active practice" means a minimum of 160 hours of professional practice as an audiologist or speech-language pathologist for each 12-month period immediately preceding application for licensure. Active practice may include supervisory, administrative, educational, research or consultative activities or responsibilities for the delivery of such services.

"ASHA" means the American Speech-Language-Hearing Association.

"Client" means a patient or person receiving services in audiology or speech-language pathology.

"Contact hour" means 60 minutes of time spent in continuing learning activities.

"School speech-language pathologist" means a person licensed pursuant to § 54.1-2603 of the Code of Virginia to provide speech-language pathology services solely in public school divisions.

"Supervision" means that the audiologist or speech-language pathologist is responsible for the entire service being rendered or activity being performed, is available for consultation, and is providing regular monitoring and documentation of clinical activities and competencies of the person being supervised.

18VAC30-21-20. Required licenses; posting of licenses.

A. There shall be separate licenses for the practices of audiology and speech-language pathology. It is prohibited for any person to practice as an audiologist or a speech-language pathologist unless the person has been issued the appropriate license.

B. A licensee shall post his license in a place conspicuous to the public in each facility in which the licensee is employed and holds himself out to practice; or if not practical to post the license, the licensee shall provide a copy of his license upon request.

18VAC30-21-30. Records; accuracy of information.

A. All changes of name, address of record or public address, if different from the address of record, shall be furnished to the board within 30 days after the change occurs.

B. A licensee who has changed his name shall submit as legal proof to the board a copy of the marriage certificate or court order evidencing the change. A duplicate license shall be issued by the board upon receipt of such evidence and the required fee.

C. All notices required by law and by this chapter to be mailed by the board to any registrant or licensee shall be validly given when mailed to the latest address of record on file with the board.

18VAC30-21-40. Fees required.

A. The following fees shall be paid as applicable for licensure:

 

1. Application for audiology or speech-language pathology license

$135

 

2. Application for school speech-language pathology license

$70

 

3. Verification of licensure requests from other states

$25

 

4. Annual renewal of audiology or speech-language pathology license

$75

 

5. Late renewal of audiology or speech-language pathology license

$25

 

6. Annual renewal of school speech-language pathology license

$40

 

7. Late renewal of school speech-language pathology license

$15

 

8. Reinstatement of audiology or speech-language pathology license

$160

 

9. Reinstatement of school speech-language pathology license

$85

 

10. Reinstatement after suspension or revocation

$500

 

11. Duplicate wall certificates

$25

 

12. Duplicate license

$15

 

13. Returned check

$35

 

14. Inactive license renewal for audiology or speech-language pathology

$40

 

15. Inactive license renewal for school speech-language pathology

$20

 

16. Application for provisional license in audiology

$50

 

17. Renewal of provisional license in audiology

$25

B. Fees shall be made payable to the Treasurer of Virginia and shall not be refunded once submitted.

Part II. Requirements for Licensure.

18VAC30-21-50. Application requirements.

A. A person seeking licensure as an audiologist, a speech-language pathologist, or a school speech-language pathologist shall submit:

1. A completed and signed application;

2. The applicable fee prescribed in 18VAC30-21-40;

3. Documentation as required by the board to determine if the applicant has met the qualifications for licensure specified in 18VAC30-21-60 for audiology or 18VAC30-21-80 for speech-language pathology; and

4. An attestation that the applicant has read, understands and will comply with the statutes and regulations governing the practice of audiology or speech-language pathology.

B. An incomplete application package shall be retained by the board for a period of one year from the date the application is received by the board.  If an application is not completed within the year, an applicant shall reapply and pay a new application fee.

18VAC30-21-60. Qualifications for initial licensure in audiology.

The board may grant a license to an applicant for licensure in audiology who:

1. Holds a current and unrestricted Certificate of Clinical Competence in audiology issued by the American Speech-Language-Hearing Association, certification issued by the American Board of Audiology or any other accrediting body recognized by the board. Verification of currency shall be in the form of a certified letter from a recognized accrediting body issued within six months prior to licensure; and

2. Has passed the qualifying examination from an accrediting body recognized by the board within the three years preceding application.  If the examination was not passed within three years preceding the date of applying for licensure, the applicant shall provide:

a. Evidence of active practice in audiology for one of the past three years immediately preceding application;

b. Practice for six months with a provisional license under supervision; or

c. Retake the licensure examination.

18VAC30-21-70. Provisional licensure in audiology.

A. Provisional license to qualify for initial licensure. An applicant may be issued a provisional license in order to obtain clinical experience required for certification by the American Speech-Language-Hearing Association, the American Board of Audiology or any other accrediting body recognized by the board.  To obtain a provisional license in order to qualify for initial licensure, the applicant shall submit a completed application and fee with documentation that he:

1. Has successfully completed all the didactic coursework required for the doctoral degree as documented by a college or university whose audiology program is accredited by the Council on Academic Accreditation of the American Speech-Language-Hearing Association or an equivalent accrediting body;

2. Has read, understands and will comply with the statutes and regulations governing the practice of audiology; and

3. Has passed a qualifying examination from an accrediting body recognized by the board.

B. Provisional license to qualify for endorsement or re-entry into practice. An applicant may be issued a provisional licensure in order to qualify for licensure by endorsement pursuant to subdivision 7 of 18VAC30-21-90, reactivation of an inactive license pursuant to subsection D of 18VAC30-21-120 or reinstatement of a lapsed license pursuant to subsection C of 18VAC30-21-130. To obtain a provisional license in order to qualify for licensure by endorsement or for re-entry to practice, he shall submit a completed application and fee with documentation that he:

1. Holds a master's degree or its equivalent as determined by the board or a doctoral degree from a college or university whose audiology program is accredited by the Council on Academic Accreditation of the American Speech-Language-Hearing Association or an equivalent accrediting body; and

2. Passed a qualifying examination from an accrediting body recognized by the board at the time of initial licensure.

C. All provisional licenses shall expire 18 months from the date of issuance and may be renewed for an additional six months by payment of a renewal fee. Renewal of a provisional license beyond 24 months shall be for good cause shown as determined by a committee of the board.

D. The holder of a provisional license in audiology shall only practice under the supervision of a licensed audiologist and shall be responsible and accountable for the safe performance of those direct client care tasks to which he has been assigned.

E. Licensed audiologists providing supervision shall:

1. Notify the board of the intent to provide supervision for a provisional licensee;

2. Have at least three years of active practice as an audiologist prior to acting as a supervisor;

3. Document the frequency and nature of the supervision of provisional licensees;

4. Be responsible and accountable for the assignment of clients and tasks based on their assessment and evaluation of the provisional licensee's knowledge and skills; and

5. Monitor clinical performance and intervene if necessary for the safety and protection of the clients.

F. The identity of a provisional licensee shall be disclosed to the client prior to treatment and shall be made a part of the client's file.

18VAC30-21-80. Qualifications for licensure in speech-language pathology.

A. The board may grant a license to an applicant for licensure as a speech-language pathologist who:

1. Holds a master's degree or its equivalent as determined by the board or a doctoral degree from a college or university whose speech-language program is accredited by the Council on Academic Accreditation of the American Speech-Language-Hearing Association or an equivalent accrediting body; or

2. Holds a current and unrestricted Certificate of Clinical Competence in speech-language pathology issued by the American Speech-Language-Hearing Association or any other accrediting body recognized by the board as verified by a certified letter from the recognized accrediting body issued within six months prior to licensure; and

3. Has passed a qualifying examination from an accrediting body recognized by the board within three years preceding the date of applying for licensure in Virginia. If the examination was not passed within three years preceding the date of applying for licensure, the applicant shall provide:

a. Evidence of active practice in speech-language pathology for one of the past three years immediately preceding application; or

b. Retake the licensure examination.

B. The board may grant a license to an applicant as a school speech-language pathologist who:

1. Holds a master's degree in speech-language-pathology; and

18VAC30-21-90. Qualifications for licensure by endorsement.

An applicant for licensure in audiology or speech-language pathology who has been licensed in another U. S. jurisdiction may apply for licensure in Virginia by submission of:

1. A completed application and payment of the application fee;

2. Documentation of a current, unrestricted license in another U. S. jurisdiction, or if lapsed, evidence of eligibility for reinstatement;

3. An attestation that the applicant has read, understands and will comply with the statutes and regulations governing the practice of audiology or speech-language pathology;

4. Submission of documentation of 10 continuing competency hours for each year in which he has been licensed in the other jurisdiction, not to exceed 30 hours;

5. Documentation that no disciplinary action is pending or unresolved against his license in another jurisdiction. The board reserves the right to deny a request for licensure to any applicant who has been determined to have committed an act in violation of 18VAC30-21-160.

6. Documentation of:

a. A current and unrestricted Certificate of Clinical Competence in the area in which he seeks licensure issued by the American Speech-Language-Hearing Association, certification issued by the American Board of Audiology or any other accrediting body recognized by the board. Verification of currency shall be in the form of a certified letter from a recognized accrediting body; or

b. A graduate degree from a college or university whose audiology or speech-language pathology program is accredited by the Council or Academic Accreditation of ASHA or an equivalent body and passage of a qualifying examination from an accrediting body recognized by the board; and

7. Evidence of active practice in another U. S. jurisdiction for at least three of the past five years.

a. An applicant for licensure in audiology who does not meet the requirement for active practice may qualify by practice for six months with a provisional license in accordance with 18VAC30-21-70 and by receiving a recommendation for licensure by his supervisor.

b. An applicant for licensure in speech-language pathology who does not meet the requirement for active practice shall meet the requirements of 18VAC30-21-80.

Part III.  Renewal and Continuing Competency.

18VAC30-21-100. Renewal requirements.

A. A person who desires to renew his license shall, not later than December 31 of each year, submit the renewal notice and applicable renewal fee. A licensee who fails to renew his license by the expiration date shall have a lapsed license, and practice with a lapsed license may constitute grounds for disciplinary action by the board.

B. A person who fails to renew his license by the expiration date may renew at any time within one year of expiration by submission of a renewal notice, the renewal fee and late fee, and statement of compliance with continuing education requirements.

18VAC30-21-110. Continuing competency requirements for renewal of an active license.

A. In order to renew an active license, a licensee shall complete at least 10 contact hours of continuing learning activities in the year immediately preceding renewal. Continuing learning hours in excess of the number required for renewal may be transferred or credited to the next renewal year for a total of not more than 10 hours.

B. Continuing learning activities shall be activities, programs or courses related to speech-language pathology or audiology, depending on the license held, and offered or approved  by one of the following accredited sponsors or organizations sanctioned by the profession:

1. The Speech-Language Hearing Association of Virginia or similar state speech-language hearing association of another state;

2. The American Academy of Audiology;

3. The American Speech-Language Hearing Association;

4. The Accreditation Council on Continuing Medical Education of the American Medical Association offering Category I continuing medical education;.

5. Local, state or federal government agencies;

6. Colleges and universities;

7. International Association of Continuing Education and Training; or

8. Health care organizations accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).

C. If the licensee is dually licensed by this board as an audiologist and speech-language pathologist, a total of no more than 15 continuing learning hours are required for renewal of both licenses with a minimum of 7.5 contact hours in each profession.

D. A licensee shall be exempt from the continuing competency requirements for the first renewal following the date of initial licensure by examination in Virginia.

E. The licensee shall retain his records on the completed form with all supporting documentation for a period of three years following the renewal of an active license. Supporting documentation shall include the title of the course, the name of the sponsoring organization, the date of the course and the number of hours credited.

F. The board shall periodically conduct an audit for compliance with continuing competency requirements.  Licensees selected for an audit conducted by the board shall complete the Continued Competency Activity and Assessment Form and provide all supporting documentation within 30 days of receiving notification of the audit.

G. The board may grant an extension of the deadline for continuing competency requirements, for up to one year, for good cause shown upon a written request from the licensee prior to the renewal date. The board may grant an exemption for all or part of the requirements for circumstances beyond the control of the licensee, such as temporary disability, mandatory military service, or officially declared disasters.

H. Failure to comply with these requirements may subject the licensee to disciplinary action by the board.

Part IV.  Reactivation and reinstatement.

18VAC30-21-120. Inactive licensure; reactivation.

A. A. speech-language pathologist or audiologist who holds a current, unrestricted license in Virginia may, upon a request on the renewal application and submission of the required fee, be issued an inactive license. The holder of an inactive license shall not be required to maintain continuing competency requirements and shall not be entitled to perform any act requiring a license to practice speech-language pathology or audiology in Virginia.

B. A licensee whose license has been inactive and who requests reactivation of an active license shall file an application, pay the difference between the inactive and active renewal fees for the current year, and provide documentation of current ASHA certification or of having completed 10 continued competency hours equal to the requirement for the number of years in which the license has been inactive, not to exceed 40 contact hours.

C. A licensee who does not reactivate within five years shall meet the requirements of subsection B of this section and shall either:

1. Meet the requirements for initial licensure as prescribed by 18VAC30-21-60 for an audiologist or 18VAC30-21-80 for a speech-language pathologist; or

2. Provide documentation of a current license in another jurisdiction in the United States and evidence of active practice for at least three of the past five years.

D. An applicant for reactivation in audiology who does not meet one of the requirements of subsection C of this section may qualify for reactivation of licensure by practice under supervision with a provisional license for six months and a recommendation for reinstatement by his supervisor. The board may issue a provisional license to an applicant who can provide evidence of having met the applicable qualifications prescribed in subsection B of 18VAC30-21-70. Provisional licensure shall be practiced under the supervision of a licensed audiologist and in accordance with 18VAC30-21-70.

E. The board reserves the right to deny a request for reactivation to any licensee who has been determined to have committed an act in violation of 18VAC30-21-160.

18VAC30-21-130. Reinstatement of a lapsed license.

A. When a license has not been renewed within one year of the expiration date, a person may apply to reinstate his license by submission of a reinstatement application, payment of the reinstatement fee, and submission of documentation of current ASHA certification or at least 10 continuing competency hours for each year the license has been lapsed, not to exceed 40 hours, obtained during the time the license in Virginia was lapsed.

B. A licensee who does not reinstate within five years shall meet the requirements of subsection A of this section and shall either:

1. Reinstate by meeting the requirements for initial licensure as prescribed by 18VAC30-21-60 for an audiologist or 18VAC30-21-80 for a speech-language pathologist; or

2. Provide documentation of a current license in another U. S. jurisdiction and evidence of active practice for at least three of the past five years.

C. An applicant for reinstatement in audiology who does not meet one of the requirements of subsection B of this section may qualify for reinstatement by practice under supervision with a provisional license for six months and a recommendation for reinstatement by his supervisor. The board may issue a provisional license to an applicant who can provide evidence of having met the applicable qualifications prescribed in subsection B of 18VAC30-21-70. Provisional licensure shall be practiced under the supervision of a licensed audiologist and in accordance with 18VAC30-21-70.

D. If the licensee holds licensure in any other state or jurisdiction, he shall provide evidence that no disciplinary action is unresolved or is pending. The board reserves the right to deny a request for reinstatement to any licensee who has been determined to have committed an act in violation of 18VAC30-21-160.

Part V. Standards of practice.

18VAC30-21-140. Supervision of unlicensed assistants.

A. A licensed audiologist and speech-language pathologist shall provide documented supervision to unlicensed assistants, shall be held fully responsible for their performance and activities, and shall ensure that they perform only those activities which do not constitute the practice of audiology or speech-language pathology and which are commensurate with their level of training.

B. A licensee may delegate to an unlicensed assistant such activities or functions that are non-discretionary and do not require the exercise of professional judgment for their performance.

C. The identity of the unlicensed assistant shall be disclosed to the client prior to treatment and shall be made a part of the client's file.

18VAC30-21-141. Performance of flexible endoscopic evaluation of swallowing.

A. For the purposes of this section, an endoscopic procedure shall mean a flexible endoscopic evaluation of swallowing limited to the use of flexible endoscopes to observe, collect data, and measure the parameters of swallowing for the purposes of functional assessment and therapy planning. 

B. A speech-language pathologist who performs an endoscopic procedure shall meet the following qualifications:

1. Completion of a course or courses or an educational program offered by a provider approved in 18VAC30-20-300 that includes at least 12 hours on endoscopic procedures;

2. Successful performance of at least 25 flexible endoscopic procedures under the immediate and direct supervision of a board-certified otolaryngologist or another speech-language pathologist who has successfully performed at least 50 flexible endoscopic procedures beyond the 25 required for initial qualification and has been approved in writing by a board-certified otolaryngologist to provide that supervision; and

3. Current certification in Basic Life Support (BLS).

C. The speech-language pathologist who qualifies to perform an endoscopic procedure, pursuant to subsection B, shall maintain documentation of course completion and written verification from the supervising otolaryngologist or speech-language pathologist of successful completion of flexible endoscopic procedures. 

D. An endoscopic procedure shall only be performed by a speech-language pathologist on referral from an otolaryngologist or other qualified physician.

E. A speech-language pathologist shall only perform an endoscopic procedure in a facility that has protocols in place for emergency medical backup. A flexible endoscopic evaluation of swallowing shall only be performed by a speech-language pathologist in either:

1. A licensed hospital or nursing home under the general supervision of a physician who is readily available in the event of an emergency, including physical presence in the facility or available by telephone; or

2. A physician's office at which the physician is on premises and available to provide on-site supervision.

F. The speech-language pathologist shall promptly report any observed abnormality or adverse reaction to the referring physician and/or an appropriate medical specialist.  The speech-language pathologist shall provide a report of an endoscopic procedure to the referring physician in a timely manner and, if requested, shall ensure access to a visual recording for viewing. 

G. A speech-language pathologist is not authorized to possess or administer prescription drugs except as provided in § 54.1-3408 B of the Code of Virginia.

H. A speech-language pathologist who has been performing flexible endoscopic evaluations of swallowing prior to (insert effective date of regulation) may continue to perform such evaluations provided he has written verification from a board-certified otolaryngologist that he has the appropriate training, knowledge and skills to safely perform such evaluations.

18VAC30-21-150. Prohibited conduct.

A. No person unless otherwise licensed to do so, shall prepare, order, dispense, alter or repair hearing aids or parts of or attachments to hearing aids for consideration. However, audiologists licensed under this chapter may make earmold impressions and prepare and alter earmolds for clinical use and research.

B. No person licensed as a school speech-language pathologist shall conduct the practice of speech-language pathology outside the scope of the public school setting.

18VAC30-21-160. Unprofessional conduct.

The board may refuse to issue a license to any applicant, suspend a license for a stated period of time or indefinitely, reprimand a licensee or place his license on probation with such terms and conditions and for such time as it may designate, impose a monetary penalty, or revoke a license for any of the following causes:

1. Guarantee of the results of any speech, voice, language, or hearing consultative or therapeutic procedure or exploitation of clients by accepting them for treatment when benefit cannot reasonably be expected to occur, or by continuing treatment unnecessarily;

2. Diagnosis or treatment of speech, voice, language, and hearing disorders solely by written correspondence, provided this shall not preclude:

a. Follow-up by written correspondence or electronic communication concerning individuals previously seen; or

b. Providing clients with general information of an educational nature;

3. Failure to comply with provisions of § 32.1-127.1:03 of the Code of Virginia related to the confidentiality and disclosure of client records or related to provision of client records to another practitioner or to the client or his personal representative;

4. Failure to properly manage and keep timely, accurate, legible and complete client records to include the following:

 a. For licensees who are employed by a health care institution, school system or other entity, in which the individual practitioner does not own or maintain his own records, failure to maintain client records in accordance with the policies and procedures of the employing entity; or

b. For licensees who are self-employed or employed by an entity in which the individual practitioner does own and is responsible for client records, failure to maintain a client record for:

(1) A minimum of six years following the last client encounter with the following exceptions; or

(2) For records of a minor child, until the child reaches the age of 18 or becomes emancipated, with a minimum time for record retention of six years from the last client encounter regardless of the age of the child; or

c. Records that have previously been transferred to another practitioner or health care provider or provided to the client or his personal representative are not required to be maintained for such periods;

5. Engaging or attempting to engage in a relationship with a client that constitutes a professional boundary violation in which the practitioner uses his professional position to take advantage of the vulnerability of a client or his family, including but not limited to sexual misconduct with a client or a member of his family or other conduct that results or could result in personal gain at the expense of the client;

6. Incompetence or negligence in the practice of the profession;

7. Failure to comply with applicable state and federal statutes or regulations specifying the consultations and examinations required prior to the fitting of a new or replacement prosthetic aid for any communicatively impaired person;

8. Failure to refer a client to an appropriate health care practitioner when there is evidence of an impairment for which assessment, evaluation, care or treatment might be necessary;

9. Failure to supervise persons who assist them in the practice of speech-language pathology and audiology as well as failure to disclose the use and identity of unlicensed assistants;

10. Conviction of a felony or a misdemeanor involving moral turpitude;

11. Failure to comply with federal, state, or local laws and regulations governing the practice of audiology or speech-language pathology;

12. Publishing or causing to be published in any manner an advertisement relating to his professional practice which is false, deceptive or misleading;

13. Inability to practice with skill and safety;

14. Fraud, deceit or misrepresentation in submission of an application for licensure or renewal of licensure, in the submission of supervisory forms, or in the practice of audiology or speech-language pathology;

15. Aiding and abetting unlicensed activity; or

16. Revocation, suspension, restriction or any other discipline of a license or certificate to practice or surrender of license or certificate while investigation or administrative proceedings are pending in another regulatory agency in Virginia, another U. S. jurisdiction or a foreign jurisdiction.

18VAC30-21-170. Criteria for delegation to an agency subordinate.

A. Decision to delegate. In accordance with § 54.1-2400 (10) of the Code of Virginia, the board may delegate an informal fact-finding proceeding to an agency subordinate upon determination that probable cause exists that a practitioner may be subject to a disciplinary action.

B. Criteria for delegation. Cases that may not be delegated to an agency subordinate include, but are not limited to, those that involve:

1. Intentional or negligent conduct that causes or is likely to cause injury to a patient;

2. Mandatory suspension resulting from action by another jurisdiction or a felony conviction;

3. Impairment with an inability to practice with skill and safety;

4. Sexual misconduct;

5. Unauthorized practice.

C. Criteria for an agency subordinate.

1. An agency subordinate authorized by the board to conduct an informal fact-finding proceeding may include board members and professional staff or other persons deemed knowledgeable by virtue of their training and experience in administrative proceedings involving the regulation and discipline of health professionals.

2. The executive director shall maintain a list of appropriately qualified persons to whom an informal fact-finding proceeding may be delegated.

3. The board may delegate to the executive director the selection of the agency subordinate who is deemed appropriately qualified to conduct a proceeding based on the qualifications of the subordinate and the type of case being heard.