Fla. Admin. Code Ann. R. 64B20-4.003 - On-the-Job Training, Role and Observation of Speech-Language Pathology and Audiology Assistants
(1) A licensee who
employs a speech-language pathology assistant or an audiology assistant shall
provide such assistant with on-the-job training, and shall maintain
responsibility for all services performed or omitted by such assistant. The
licensee shall not permit the assistant to perform any service on a client
unless:
(a) The licensee provides the
assistant with on-the-job training for each service for which there is no
available documentation of a previously acquired competency; and,
(b) The assistant is clearly identified as an
assistant by means of a nametag or similar identification.
(2) At a minimum, on-the-job training shall
include step by step instruction and demonstration of each and every service
the assistant is to perform and continuous visual observation by the licensee
of the assistant's performance of such service until the licensee establishes
the assistant's competency. The licensee shall maintain a record of each
service indicating the activity, date, time, and location of the foregoing
demonstration and observations concerning competency. The record shall be
signed by both the licensee and the assistant and a copy thereof shall be
provided to the assistant and shall be maintained by the supervising licensee
for the duration of employment and shall be maintained by the assistant as long
as the assistant is certified by the Board. A new supervising licensee shall
obtain and maintain for the duration of employment, records demonstrating
competency for all services performed by the assistant. Upon request of the
Department or Board, the supervising licensee and the assistant shall produce
the documentation of competency records required herein.
(3) The speech-language pathology or
audiology licensee shall notify the Department within thirty (30) days of any
changes in the roster of assistants registered under his or her name by
submitting Form DH-MQA 1269 (4/24), entitled "Board of Speech-Language
Pathology and Audiology Assistant Activity and Supervisory Plan," hereby
adopted and incorporated by reference, and can be obtained from the following
website at
http://www.flrules.org/Gateway/reference.asp?No=Ref-16717,
or http://www.doh.state.fl.us/mqa/speech/index.html.
(4) Following the completion of on-the-job
training, the speech-language pathology assistant shall engage only in those
services that are planned, designed and supervised by the speech-language
pathology licensee. The scope of services which a speech-language pathology
assistant may provide includes:
(a) Record
case history information.
(b)
Screen speech, language or hearing by the use of procedures that are included
in published material containing directions for administration and
scoring.
(c) Implement, without
diagnostic interpretation, evaluative procedures that are:
1. Planned and designed by the licensee;
and,
2. Included in published
materials which have directions for administration and scoring.
(d) Implement treatment programs
that:
1. Are planned and designed by the
licensee to meet pre-established goals; and,
2. Contain pre-established criteria for
mastery.
(e) Record,
chart, graph or otherwise display data relative to client
performance.
(f) Perform clerical
functions necessary to maintain clinical records.
(g) Report changes in client performance to
the licensee having responsibility for that client.
(h) Prepare clinical materials.
(i) Test equipment to determine if the
equipment is performing according to published specifications.
(j) Participate with the licensee in research
projects, in-service training, public relations programs, or similar activities
as planned, designed and directed by the licensee.
(k) Serve as an interpreter (translator) for
the speech-language pathology licensee during clinical procedures.
(l) Assist in the evaluation or treatment of
difficult-to-test clients.
(5) The speech-language pathology licensee
shall not delegate to the speech-language pathology assistant any tasks which
call for a diagnostic interpretation or put the client at physical risk. The
following tasks shall not be delegated to a speech-language pathology
assistant:
(a) Conducting the initial
interview with the client.
(b)
Performing initial testing or evaluation.
(c) Determining or discussing specific
diagnoses with the client or making statements regarding prognosis or levels of
proficiency.
(d) Relating or
discussing with clients or consumers of services the reports from other
professionals or related services unless those findings have previously been
interpreted and reported by the supervising licensee.
(e) Providing any interpretation or
elaboration of information that is contained in reports written by the
licensee, although he or she may, upon assignment from the licensee, present
information regarding clients at staffings or conferences; however, the
assistant may discuss with the client or consumer specifically observed
behaviors that have occurred during a treatment when they are supported by
objective data.
(f) Performing any
procedure where there is a risk of physical injury as a result of the
procedure; specifically, the insertion of tracheoesophageal prostheses or
catheter into the esophageal puncture; endoscopy; administration of barium or
other substances for the assessment of swallowing; fitting or insertion of
tracheal valves or instrumentation for generation of voice; and initial
measurements and fitting of oral prostheses.
(g) Devising or planning treatment based upon
assessment or diagnostic findings.
(h) Providing counseling to the client or to
his or her family.
(i) Making
referrals for additional services.
(j) Signing any document without the
co-signature of the licensee.
(k)
Using any title other than the Speech-Language Pathology Assistant.
(l) Determining patient or client dismissal
criteria have been met.
(6) Following the completion of on-the-job
training by the supervising audiology licensee, the audiology assistant may
engage only in those services that are planned, designed, and supervised by the
licensee.
(7) The audiology
licensee may permit the audiology assistant to perform the following services
under the direct supervision of the supervising licensee or when acting
pursuant to Board of Speech Language Pathology and Audiology approved protocols
as established in Rule 64B20-4.0046, F.A.C., in order for the licensee to be
available for consultation and direction:
(a)
Conduct basic hearing testing without diagnostic interpretation, including air
and bone conduction thresholds and speech audiometry.
(b) Conduct impedance audiometric
testing.
(c) Assist in the
evaluation of difficult-to-test patients.
(d) Record case history
information.
(e) Assist in
conducting real ear measurements.
(f) Assist in ABR, ENG, and otoacoustic
emissions testing.
(g) Report
changes in client performance to the audiology licensee having responsibility
for that client.
(h) Participate
with the audiology licensee in research projects, in-service training, in
public relations programs, or similar activities as planned, designed and
directed by the audiology licensee.
(i) Assistant in implementing a plan or
program for management and/or treatment developed by the supervising audiology
licensee.
(8) The
following activities of a certified audiology assistant are permitted under the
responsible supervision of the supervising audiologist without the requirement
of the physical presence of a supervising audiologist:
(a) Demonstrate assistive listening
devices.
(b) Test prescription
hearing aids to determine if they meet appropriate specification and/or
mechanical performance. A prescription hearing aid is defined in Rule
64B20-8.0011, F.A.C.
(c)
Demonstrate care and use of the prescription hearing aid controls, battery
insertion and insertion of the hearing aid or ear mold into the ear.
(d) Perform clerical functions necessary to
maintain clinical records.
(e)
Prepare clinical materials and where appropriate, in accordance with universal
precautions.
(f) Test equipment to
determine if the equipment is performing according to published
specifications.
(g) Screen hearing
using established criteria on a pass/fail basis, including but not limited to
newborn hearing screening.
(9) The audiology licensee shall not delegate
to the audiology assistant any tasks which call for a diagnostic interpretation
or put the client at physical risk. The following tasks shall not be delegated
to an audiology assistant:
(a) Providing
diagnostic services to children below the age of five years or to other clients
whose hearing impairment, medical condition, behavior or other disabling
condition would preclude the use of services from anyone other than the
licensed audiologist.
(b)
Performing any procedure where there is a risk of physical injury as a result
of the procedure; specifically, where injury to the physical structures of
hearing is likely to occur.
(c)
Developing a plan of care or treatment for auditory or vestibular
disorders.
(10) The
speech-language pathologist shall directly observe the speech-language
pathology assistant's service as follows:
(a)
During the first 12 months of continuous employment on at least one occasion,
and if treatment is provided, a minimum of one session every 30 days per client
or more frequently depending upon the individual client's needs.
(b) Following the first 12 months of
continuous employment on at least one occasion and, if treatment is provided, a
minimum of one session every 60 days or more frequently depending upon the
individual client's needs.
(11) A speech-language pathology assistant
who has greater than 12 months continuous employment at one site and changes
employment settings shall, for the first 30 calendar days of employment within
a new facility, be provided the same level of supervision/observation as
required for new assistants. After the initial 30 days, with licensee
certification of competency, then the assistant will be provided supervision as
required for the assistant who has greater than 12 months experience.
Notes
Rulemaking Authority 468.1125(3), 468.1135(4) FS. Law Implemented 468.1125(3), (4), 468.1215 FS.
New 3-14-91, Formerly 21LL-4.003, 61F14-4.003, Amended 9-8-94, 8-17-95, Formerly 59BB-4.003, Amended 2-2-04, 2-21-05, 9-9-13, 3-18-20, 3-15-21, 5-3-23.
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