SECOND REGULAR SESSION
93RD GENERAL ASSEMBLY
INTRODUCED BY REPRESENTATIVE SCHAAF.
Pre-filed December 1, 2005 and copies ordered printed.
STEPHEN S. DAVIS, Chief Clerk
AN ACT
To repeal sections 345.015 and 345.030, RSMo, and to enact in lieu thereof two new sections relating to audiologists.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Sections 345.015 and 345.030, RSMo, are repealed and two new sections enacted in lieu thereof, to be known as sections 345.015 and 345.030, to read as follows:
345.015. As used in sections 345.010 to 345.080, the following terms mean:
(1) "Audiologist", a person who is licensed as an audiologist pursuant to sections 345.010 to 345.080 to practice audiology;
(2) "Audiology aide", a person who is registered as an audiology aide by the board, who does not act independently but works under the direction and supervision of a licensed audiologist. Such person assists the audiologist with activities which require an understanding of audiology but do not require formal training in the relevant academics. To be eligible for registration by the board, each applicant shall submit a registration fee, be of good moral and ethical character; and:
(a) Be at least eighteen years of age;
(b) Furnish evidence of the person's educational qualifications which shall be at a minimum:
a. Certification of graduation from an accredited high school or its equivalent; and
b. On-the-job training;
(c) Be employed in a setting in which direct and indirect supervision are provided on a regular and systematic basis by a licensed audiologist.
However, the aide shall not administer or interpret hearing screening or diagnostic tests, fit or dispense hearing instruments, make ear impressions, make diagnostic statements, determine case selection, present written reports to anyone other than the supervisor without the signature of the supervisor, make referrals to other professionals or agencies, use a title other than speech-language pathology aide or clinical audiology aide, develop or modify treatment plans, discharge clients from treatment or terminate treatment, disclose clinical information, either orally or in writing, to anyone other than the supervising speech-language pathologist/audiologist, or perform any procedure for which he or she is not qualified, has not been adequately trained or both;
(3) "Board", the state board of registration for the healing arts;
(4) "Clinical fellowship", the supervised professional employment period following completion of the academic and practicum requirements of an accredited training program as defined in sections 345.010 to 345.080;
(5) "Commission", the advisory commission for speech-language pathologists and audiologists;
(6) "Hearing instrument" or "hearing aid", any wearable device or instrument designed for or offered for the purpose of aiding or compensating for impaired human hearing and any parts, attachments or accessories, including ear molds, but excluding batteries, cords, receivers and repairs;
(7) "Person", any individual, organization, or corporate body, except that only individuals may be licensed pursuant to sections 345.010 to 345.080;
(8) "Practice of audiology"
(a) The application of accepted audiologic principles, methods and procedures for the measurement, testing, interpretation, appraisal and prediction related to disorders of the auditory system, balance system or related structures and systems;
(b) Provides consultation, counseling to the patient, client, student, their family or interested parties;
(c) Provides academic, social and medical referrals when appropriate;
(d) Provides for establishing goals, implementing strategies, methods and techniques, for habilitation, rehabilitation or aural rehabilitation, related to disorders of the auditory system, balance system or related structures and systems;
(e) Provides for involvement in related research, teaching or public education;
(f) Provides for rendering of services or participates in the planning, directing or conducting of programs which are designed to modify audition, communicative, balance or cognitive disorder, which may involve speech and language or education issues;
(g) Provides and interprets behavioral and neurophysiologic measurements of auditory balance, cognitive processing and related functions, including intraoperative monitoring;
(h) Provides involvement in any tasks, procedures, acts or practices that are necessary for evaluation of audition, hearing, training in the use of amplification or assistive listening devices;
(i) Provides selection [and], assessment, fitting, programming, and dispensing of hearing instruments, in accordance with the provisions of section 346.020, RSMo, assistive listening devices, and other amplification systems;
(j) Provides for taking impressions of the ear, making custom ear molds, ear plugs, swim molds and industrial noise protectors;
(k) Provides assessment of external ear and cerumen management;
(l) Provides advising, fitting, mapping assessment of implantable devices such as cochlear or auditory brain stem devices;
(m) Provides information in noise control and hearing conservation including education, equipment selection, equipment calibration, site evaluation and employee evaluation;
(n) Provides performing basic speech-language screening test;
(o) Provides involvement in social aspects of communication, including challenging behavior and ineffective social skills, lack of communication opportunities;
(p) Provides support and training of family members and other communication partners for the individual with auditory balance, cognitive and communication disorders;
(q) Provides aural rehabilitation and related services to individuals with hearing loss and their families;
(r) Evaluates, collaborates and manages audition problems in the assessment of the central auditory processing disorders and providing intervention for individuals with central auditory processing disorders;
(s) Develops and manages academic and clinical problems in communication sciences and disorders;
(t) Conducts, disseminates and applies research in communication sciences and disorders;
(9) "Practice of speech-language pathology":
(a) Provides screening, identification, assessment, diagnosis, treatment, intervention, including but not limited to prevention, restoration, amelioration and compensation, and follow-up services for disorders of:
a. Speech: articulation, fluency, voice, including respiration, phonation and resonance;
b. Language, involving the parameters of phonology, morphology, syntax, semantics and pragmatic; and including disorders of receptive and expressive communication in oral, written, graphic and manual modalities;
c. Oral, pharyngeal, cervical esophageal and related functions, such as dysphagia, including disorders of swallowing and oral functions for feeding; orofacial myofunctional disorders;
d. Cognitive aspects of communication, including communication disability and other functional disabilities associated with cognitive impairment;
e. Social aspects of communication, including challenging behavior, ineffective social skills, lack of communication opportunities;
(b) Provides consultation and counseling and makes referrals when appropriate;
(c) Trains and supports family members and other communication partners of individuals with speech, voice, language, communication and swallowing disabilities;
(d) Develops and establishes effective augmentative and alternative communication techniques and strategies, including selecting, prescribing and dispensing of augmentative aids and devices; and the training of individuals, their families and other communication partners in their use;
(e) Selects, fits and establishes effective use of appropriate prosthetic/adaptive devices for speaking and swallowing, such as tracheoesophageal valves, electrolarynges, or speaking valves;
(f) Uses instrumental technology to diagnose and treat disorders of communication and swallowing, such as videofluoroscopy, nasendoscopy, ultrasonography and stroboscopy;
(g) Provides aural rehabilitative and related counseling services to individuals with hearing loss and to their families;
(h) Collaborates in the assessment of central auditory processing disorders in cases in which there is evidence of speech, language or other cognitive communication disorders; provides intervention for individuals with central auditory processing disorders;
(i) Conducts pure-tone air conduction hearing screening and screening tympanometry for the purpose of the initial identification or referral;
(j) Enhances speech and language proficiency and communication effectiveness, including but not limited to accent reduction, collaboration with teachers of English as a second language and improvement of voice, performance and singing;
(k) Trains and supervises support personnel;
(l) Develops and manages academic and clinical programs in communication sciences and disorders;
(m) Conducts, disseminates and applies research in communication sciences and disorders;
(n) Measures outcomes of treatment and conducts continuous evaluation of the effectiveness of practices and programs to improve and maintain quality of services;
(10) "Speech-language pathologist", a person who is licensed as a speech-language pathologist pursuant to sections 345.010 to 345.080; who engages in the practice of speech-language pathology as defined in sections 345.010 to 345.080;
(11) "Speech-language pathology aide", a person who is registered as a speech-language aide by the board, who does not act independently but works under the direction and supervision of a licensed speech-language pathologist. Such person assists the speech-language pathologist with activities which require an understanding of speech-language pathology but do not require formal training in the relevant academics. To be eligible for registration by the board, each applicant shall submit a registration fee, be of good moral and ethical character; and:
(a) Be at least eighteen years of age;
(b) Furnish evidence of the person's educational qualifications which shall be at a minimum:
a. Certification of graduation from an accredited high school or its equivalent; and
b. On-the-job training;
(c) Be employed in a setting in which direct and indirect supervision is provided on a regular and systematic basis by a licensed speech-language pathologist. However, the aide shall not administer or interpret hearing screening or diagnostic tests, fit or dispense hearing instruments, make ear impressions, make diagnostic statements, determine case selection, present written reports to anyone other than the supervisor without the signature of the supervisor, make referrals to other professionals or agencies, use a title other than speech-language pathology aide or clinical audiology aide, develop or modify treatment plans, discharge clients from treatment or terminate treatment, disclose clinical information, either orally or in writing, to anyone other than the supervising speech-language pathologist/audiologist, or perform any procedure for which he or she is not qualified, has not been adequately trained or both;
(12) "Speech-language pathology assistant", a person who is registered as a speech-language pathology assistant by the board, who does not act independently but works under the direction and supervision of a licensed speech-language pathologist and whose activities require both academic and practical training in the field of speech-language pathology although less training than those established by sections 345.010 to 345.080 as necessary for licensing as a speech-language pathologist. To be eligible for registration by the board, each applicant shall submit the registration fee, be of good moral character and furnish evidence of the person's educational qualifications which meet the following:
(a) Hold a bachelor's level degree in the field of speech-language pathology from an institution accredited or approved by a regional accrediting body recognized by the United States Department of Education or its equivalent; and
(b) Submit official transcripts from one or more accredited colleges or universities presenting evidence of the completion of bachelor's level course work and clinical practicum requirements equivalent to that required or approved by a regional accrediting body recognized by the United States Department of Education or its equivalent.
345.030. 1. The board shall administer, coordinate, and enforce the provisions of sections 345.010 to 345.080, evaluate the qualifications of applicants, supervise the examination of applicants, issue licenses, and shall investigate persons engaging in practices which appear to violate the provisions of sections 345.010 to 345.080.
2. The board shall conduct such hearings and keep such records and minutes as shall be necessary to an orderly dispatch of business.
3. The board shall adopt reasonable rules and regulations which establish ethical standards of practice, including standards related to hearing and dispensing that ensure consumer protection equal to that provided under sections 346.007 to 346.250, RSMo, and may amend or repeal the same.
4. Regular meetings of the commission shall be held at such times and places as it prescribes, and special meetings may be held upon the call of the chairperson or by request of at least two other members of the commission, but at least one regular meeting shall be held each year.
5. No rule or portion of a rule promulgated pursuant to the authority of sections 345.010 to 345.080 shall become effective unless it has been promulgated pursuant to the provisions of chapter 536, RSMo.
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