(Editor's Note: Due to editing errors in the proposed rulemaking notice, incorrect language appeared in 16 TAC §§111.131, 111.182, 111.213, and 111.220 as published in the January 8, 2016, issue of the Texas Register (41 TexReg 362). For the purpose of clarity, those sections are being republished in this issue as originally submitted by the Texas Department of Licensing and Regulation.)

The Texas Commission of Licensing and Regulation (Commission) adopts new rules at 16 Texas Administrative Code (TAC) Chapter 111, Subchapter A, §111.1 and §111.2; Subchapter B, §§111.10 - 111.14; Subchapter C, §§111.20 - 111.23; Subchapter D, §§111.30, 111.35 - 111.37; Subchapter E, §§111.40, 111.45 - 111.47; Subchapter F, §§111.55 - 111.57; Subchapter G, §§111.60, 111.65 and 111.66; Subchapter H, §§111.70, 111.75 - 111.77; Subchapter I, §§111.80, 111.85 - 111.87; Subchapter J, §§111.95 - 111.97; Subchapter K, §§111.100, 111.105 and 111.106; Subchapter L, §§111.110, 111.115 - 111.117; Subchapter N, §111.130 and §111.132; Subchapter O, §111.140; Subchapter P, §§111.150 - 111.155; Subchapter Q, §111.160; Subchapter R, §111.170 and §111.171; Subchapter S, §§111.180, 111.181, and 111.183; Subchapter T, §§111.190 - 111.192; Subchapter U, §§111.200 - 111.202; Subchapter V, §§111.210 - 111.212, 111.214, and 111.215; and Subchapter X, §§111.230 - 111.232, regarding the Speech Language Pathologists and Audiologists program, without changes to the proposed text as published in the January 8, 2016, issue of the Texas Register (41 TexReg 362). These rules will not be republished.

The Commission also adopts new rules at 16 TAC Chapter 111, Subchapter F, §111.50 and Subchapter J, §111.90 with changes to the proposed text as published in the January 8, 2016, issue of the Texas Register (41 TexReg 362). These rules will be republished. As previously noted, §§111.131, 111.182, 111.213, and 111.220 will be republished for the purposes of clarification.

The Texas Legislature enacted Senate Bill 202 (S.B. 202), 84th Legislature, Regular Session (2015), which, in part, transferred 13 occupational licensing programs in two phases from the Department of State Health Services (DSHS) to the Commission and the Texas Department of Licensing and Regulation (Department). The Speech Language Pathologists and Audiologists program is part of the phase 1 transfer.

The adopted new rules under 16 TAC Chapter 111 are necessary to implement S.B. 202 and to regulate the Speech Language Pathologists and Audiologists program under the authority of the Commission and the Department. The rules provide for the Department to perform the various functions, including licensing, compliance, and enforcement, necessary to regulate the program. These adopted new rules are separate from and are not to be confused with the DSHS rules located at 22 TAC Chapter 741, regarding Speech-Language Pathologists and Audiologists.

The rule sections are adopted with an effective date of October 1, 2016. The Department will officially commence all regulatory functions for the Speech Language Pathologists and Audiologists program on October 3, 2016.

Adopted new Subchapter A provides the General Provisions for the proposed new rules.

Adopted new §111.1 provides the statutory authority for the Commission and Department to regulate speech-language pathologists and audiologists.

Adopted new §111.2 creates the definitions to be used in the speech-language pathologists and audiologists program.

Adopted new Subchapter B creates the Speech-Language Pathologists and Audiologists Advisory Board.

Adopted new §111.10 provides the composition and membership requirements of the advisory board.

Adopted new §111.11 details the duties of the advisory board.

Adopted new §111.12 sets the terms and vacancies process for advisory board members.

Adopted new §111.13 provides for a presiding officer of the advisory board.

Adopted new §111.14 provides details regarding advisory board meetings.

Adopted new Subchapter C establishes the examination requirements for the program.

Adopted new §111.20 provides general examination requirements.

Adopted new §111.21 explains the written examination requirement.

Adopted new §111.22 explains the waiver of the written examination requirement.

Adopted new §111.23 details the requirements for the Jurisprudence Examination.

Adopted new Subchapter D establishes the requirements to obtain a speech-language pathology license.

Adopted new §111.30 explains the licensing requirements for those seeking a speech-language pathology license.

Adopted new §111.35 details the application and eligibility requirements for the speech-language pathology license.

Adopted new §111.36 explains the process for issuing a speech-language pathology license.

Adopted new §111.37 details the license terms and renewal requirements for the speech-language pathology license.

Adopted new Subchapter E establishes the requirements to obtain an intern in speech-language pathology license.

Adopted new §111.40 explains the licensing and internship requirements for the intern in speech-language pathology license.

Adopted new §111.45 details the application and eligibility requirements for an intern in speech-language pathology license.

Adopted new §111.46 explains the process for issuing an intern in speech-language pathology license.

Adopted new §111.47 details the license terms and renewal requirements for the intern in speech-language pathology license.

Adopted new Subchapter F establishes the requirements to obtain an assistant in speech-language pathology license.

Adopted new §111.50 explains the licensing requirements for the assistant in speech-language pathology license.

Adopted new §111.55 details the application and eligibility requirements for an assistant in speech-language pathology license.

Adopted new §111.56 explains the process for issuing an assistant in speech-language pathology license.

Adopted new §111.57 details the license terms and renewal requirements for the assistant in speech-language pathology license.

Adopted new Subchapter G establishes the requirements to obtain a temporary certificate of registration in speech-language pathology.

Adopted new §111.60 explains the registration requirements for the temporary certificate of registration in speech-language pathology.

Adopted new §111.65 details the application and eligibility requirements for the temporary certificate of registration in speech-language pathology.

Adopted new §111.66 explains the process for issuing a temporary certificate of registration in speech-language pathology.

Adopted new Subchapter H establishes the requirements to obtain an audiology license.

Adopted new §111.70 explains the licensing requirements for the audiology license.

Adopted new §111.75 details the application and eligibility requirements for an audiology license.

Adopted new §111.76 explains the process for issuing an audiology license.

Adopted new §111.77 details the license terms and renewal requirements for the audiology license.

Adopted new Subchapter I establishes the requirements to obtain an intern in audiology license.

Adopted new §111.80 explains the licensing and internship requirements for the intern in audiology license.

Adopted new §111.85 details the application and eligibility requirements for an intern in audiology license.

Adopted new §111.86 explains the process for issuing an intern in audiology license.

Adopted new §111.87 details the license terms and renewal requirements for the intern in audiology license.

Adopted new Subchapter J establishes the requirements to obtain an assistant in audiology license.

Adopted new §111.90 explains the licensing requirements for the assistant in audiology license.

Adopted new §111.95 details the application and eligibility requirements for an assistant in audiology license.

Adopted new §111.96 explains the process for issuing an assistant in audiology license.

Adopted new §111.97 details the license terms and renewal requirements for the assistant in audiology license.

Adopted new Subchapter K establishes the requirements to obtain a temporary certificate of registration in audiology.

Adopted new §111.100 explains the registration requirements for the temporary certificate of registration in audiology.

Adopted new §111.105 details the application and eligibility requirements for the temporary certificate of registration in audiology.

Adopted new §111.106 explains the process for issuing a temporary certificate of registration in audiology.

Adopted new Subchapter L establishes the requirements to obtain a dual license in speech-language pathology and audiology.

Adopted new §111.110 explains the licensing requirements for those seeking a dual license in speech-language pathology and audiology.

Adopted new §111.115 details the application and eligibility requirements for the dual speech-language pathology and audiology license.

Adopted new §111.116 explains the process for issuing a dual speech-language pathology and audiology license.

Adopted new §111.117 details the license terms and renewal requirements for the dual speech-language pathology and audiology license.

Adopted new Subchapter N establishes the continuing professional education requirements for this program.

Adopted new §111.130 provides the continuing professional education requirements and hours for this program.

Adopted new §111.131 details continuing professional education courses and credits.

Adopted new §111.132 explains the continuing professional education audit process and the records that must be kept.

Adopted new Subchapter O establishes the responsibilities of the Commission and the Department.

Adopted new §111.140 requires the Commission to adopt rules necessary to implement the Speech-Language Pathology and Audiology program, including rules governing changes to the standards of practice rules.

Adopted new Subchapter P establishes the responsibilities of the licensee and creates the code of ethics for this program.

Adopted new §111.150 requires a licensee to notify the Department of a change of name, address, or other pertinent information.

Adopted new §111.151 provides requirements for displaying a license and notifying consumers.

Adopted new §111.152 prohibits false, misleading or deceptive advertising.

Adopted new §111.153 establishes record keeping and billing requirements.

Adopted new §111.154 explains the requirements, duties and responsibilities of supervisors.

Adopted new §111.155 creates the standards of ethical practice (code of ethics) for all licensees in this program.

Adopted new Subchapter O establishes fees for the Speech-Language Pathologists and Audiologists program.

Adopted new §111.160 details all fees associated with the Speech-Language Pathologists and Audiologists program as regulated by the Commission and the Department.

Adopted new Subchapter R establishes a subchapter to address complaints.

Adopted new §111.170 requires the Department to provide a toll free number for complaints to be filed.

Adopted new §111.171 provides that the Commission will adopt rules regarding complaints involving standard of care.

Adopted new Subchapter S establishes enforcement provisions.

Adopted new §111.180 allows for administrative penalties and sanctions.

Adopted new §111.181 provides the authority to enforce Texas Occupations Code, Chapter 401 and this chapter.

Adopted new §111.182 provides the authority to order refunds for a hearing instrument.

Adopted new §111.183 requires a license holder or registration holder to surrender the license or registration to the Department on demand.

Adopted new Subchapter T establishes screening procedures.

Adopted new §111.190 provides communication screening requirements.

Adopted new §111.191 details the hearing screening process.

Adopted new §111.192 explains the authority for newborn hearing screening.

Adopted new Subchapter U establishes provisions for fitting and dispensing of hearing instruments.

Adopted new §111.200 explains registration of audiologists and interns in audiology to fit and dispense hearing instruments.

Adopted new §111.201 provides general practice requirements of audiologists and interns in audiology who fit and dispense hearing instruments.

Adopted new §111.202 creates requirements for audiologists and interns in audiology conducting audiometric testing for the purpose of fitting and dispensing hearing instruments.

Adopted new Subchapter V establishes provisions for telehealth.

Adopted new §111.210 establishes definitions relating to telehealth.

Adopted new §111.211 explains the service delivery models for speech-language pathologists.

Adopted new §111.212 creates requirements for the use of telehealth by speech-language pathologists.

Adopted new §111.213 details limitations on the use of telecommunications technology by speech-language pathologists.

Adopted new §111.214 establishes requirements for providing telehealth services in speech-language pathology.

Adopted new §111.215 establishes requirements for providing telepractice services in audiology.

Adopted new Subchapter W establishes joint rules regarding the sale of hearing instruments. Texas Occupations Code Chapters 401 and 402 require the Commission, with the assistance of the Speech-Language Pathologists and Audiologist Advisory Board and the Hearing Instrument Fitters and Dispensers Advisory Board, to adopt rules to establish requirements regarding the sale of hearing instruments.

Adopted new §111.220 details the requirements regarding the sale of hearing instruments.

Adopted new Subchapter X establishes joint rules for fitting and dispensing of hearing instruments by telepractice. Texas Occupations Code Chapters 401 and 402 require the Commission, with the assistance of the Speech-Language Pathologists and Audiologist Advisory Board and the Hearing Instrument Fitters and Dispensers Advisory Board, to adopt rules to establish requirements regarding the fitting and dispensing of hearing instruments by telepractice.

Adopted new §111.230 explains the purpose of the subchapter.

Adopted new §111.231 creates definitions to be used in this subchapter.

Adopted new §111.232 establishes requirements for providing telehealth services for the fitting and dispensing of hearing instruments.

The Department drafted and distributed the proposed rules to persons internal and external to the agency. The proposed rules were published in the January 8, 2016, issue of the Texas Register (41 TexReg 362). The deadline for public comments was February 8, 2016. The Department received comments from ten interested parties, consisting of eight individuals, the Texas Speech-Language Hearing Association (TSHA), and the Texas Academy of Audiology on the proposed rules during the 30-day public comment period.

Comment--The Department received comments from the TSHA and from an individual regarding the number of direct and indirect supervision hours under §111.50(g)(3), Assistant in Speech-Language Pathology License--License Requirements. The commenters appreciated the flexibility given in supervising the licensed assistants while maintaining a minimum of eight hours per month of supervision, at least four hours of which are direct supervision. The commenters had some concern with the telehealth and telepractice provisions that may be used for up to seven hours of supervision. The commenters stated that due to the complexity and variety of the communication disorders serviced by speech language pathologists, not all patients/clients/students would be appropriate candidates for treatment via telepractice, which is also a concern regarding the supervision of a licensed assistant. The commenters stated that they would support the use of telepractice for up to four hours of indirect supervision and up to one hour of direct supervision, for a total of up to five hours of supervision by telepractice.

Department Response-- Based on the public comments and the Advisory Board discussion and recommendation, the Department has made changes to §111.50(g)(3). The number of in person and onsite supervision hours was increased from one hour to two hours, and the total number of hours that may be supervised using telepractice was decreased from seven hours to six hours. The Advisory Board did not think it would be more burdensome to the supervisor to increase the in person and onsite hours of supervision from one hour to two hours per month, since this type of supervision could occur in one supervision trip or session and that the two hours did not need to be conducted during separate trips or sessions during the month. The Department made other changes to §111.50(g)(3) based on a separate comment discussed below.

Comment--The Department received another comment from an individual regarding §111.50(g)(3), Assistant in Speech-Language Pathology License--License Requirements, and §111.213, Limitations on the Use of Telecommunications Technology by Speech-Language Pathologists. The commenter had questions regarding the interaction between these two sections of the proposed rules. The commenter asked whether telepractice can be used for seven hours of supervision a month at the supervisor's discretion, or only if an exception to the supervisor plan is approved. The commenter stated that it is unclear in reading the proposed rules.

Department Response-- In response to this public comment and the Advisory Board discussion and recommendations, the Department has amended §111.50(g)(3) by add clarifying language that the telehealth and telepractice provisions allowed by Subchapter V may be used for up to six hours of supervision without applying for the exception referenced under §111.213. The Department made changes in the number and type of supervision hours based on a separate comment on §111.50(g)(3) as discussed above. The Department did not make any changes to §111.213 in response to this comment.